JP2007510458A - 中隔貫通穿刺装置 - Google Patents
中隔貫通穿刺装置 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3468—Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
- A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/06066—Needles, e.g. needle tip configurations
- A61B2017/06095—Needles, e.g. needle tip configurations pliable
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
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- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
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Abstract
Description
本出願は、米国仮特許出願第60/517,983号(2003年11月6日出願)への優先権およびその出願の利益を主張する。米国仮特許出願第60/517,983号の内容は、本明細書中に参考として援用される。
本発明は、一般に、心臓内中隔貫通穿刺手順を行なうためのデバイスに関する。より具体的には、このデバイスは、卵円孔開存(PFO)のような心臓内欠陥の処置、および心臓に関連する疾患についての他の治療用途のための、心房中隔の中隔貫通穿刺に関する。
中隔の穿刺は、心臓の2つの心房の間に連通が存在する患者、例えば、卵円孔開存(PFO)を有する患者において、利用される。PFOは、重なっているが未癒合の組織の2つの層(一次中隔および二次中隔)からなり、その患者を塞栓性発作の高い危険に置き得るトンネル様の「穴」をこの2つの組織の間に形成する。多くのPFOのトンネル様の性質に起因して、このPFOを修復するために使用される閉塞デバイスは、それが移植されたとき、多くの場合、中隔壁上に平坦に静止せず、その結果、閉塞具の一部分が、PFOトンネルに配置される。この理由のために、中隔穿刺によりPFOの近くの心房中隔の一次中隔部分に第2の穴が導入され、次いで(PFOトンネルを通してではなく)この第2の穴を通して閉塞デバイスが配置される。
本発明は、一般に、現在行われている中隔貫通穿刺手順の安全な代替法である中隔貫通穿刺手順を行なうためのデバイスおよび方法に関する。
本明細書中に記載される発明は、例えば、卵円孔開存のような心臓内欠陥、塞栓性発作を引き起こし得る心臓内塞栓源、および心臓疾患に関する欠陥の処置のために、経皮経路を経由して心房中隔を穿刺するためのデバイスおよび方法に関する。
図14Bの端面図により図示されるように、中央セクション540が、概して、可撓性部材142’’’により規定される平面の中心に位置するような形態である。この形態において、可撓性部材142’’’の中央セクション540は、は、可撓性部材142’’’を堅くすることを補助し、このことは、例えば、可撓性部材142’’’が、操作者により組織(例えば、心房中隔)に力を付与するために使用される場合、曲がりを最小にする。この形態において、可撓性部材142は、例えば、組織の第1の側面および第2の側面と接触するようなサイズおよび形状である閉じたループを形成する。
本発明は、本発明の趣旨または本質的な特徴から逸脱することなく他の特定の形態で具現化され得る。それゆえに、上記の実施形態は、あらゆる点で、本明細書中に記載された発明を限定するものではなく、例示するものとみなされるべきである。従って、本発明の範囲は、上述の記載によるのではなく、添付の特許請求の範囲により示され、そして特許請求の範囲の等価物の趣旨および範囲内に入るすべての変更は、本発明の中に包含されることが意図される。
本出願で引用されたすべての刊行物および特許文献は、すべての目的のために、あたかも各々の個々の刊行物または特許文献の内容が本明細書中に援用された場合と同じ程度に、それらの全体が参考として本明細書中に援用される。
Claims (21)
- 患者の心房中隔を穿刺するためのデバイスであって、
第1の外側針であって、鈍い遠位端および該外側針を通して長軸方向に配置される内腔を備える、第1の外側針;
該外側針の内腔中に軸方向に配置される第2の内側針であって、近位部分、中間部分、および遠位部分を備え、該中間部分が、該内側針の該近位部分または該遠位部分に比較して可撓性である、第2の内側針、
を備える、デバイス。 - 前記中間部分が、ポリマーを含む、請求項1に記載のデバイス。
- 前記中間部分が、くびれ部分を備える、請求項1に記載のデバイス。
- 前記遠位部分が、ベンドを備える、請求項1に記載のデバイス。
- 前記遠位部分が、テーパー、らせん、曲線、コークスクリューおよびフックからなる群より選択される形状を備える、請求項1に記載のデバイス。
- 前記中間部分が、前記内側針の前記遠位端から約5mm〜約30mmのセグメントを備える、請求項1に記載のデバイス。
- 前記中間部分が、前記内側針の前記遠位端から約20mmのセグメントを備える、請求項1に記載のデバイス。
- 前記中間部分が、約0.5mm〜約30mmの長さである、請求項1に記載のデバイス。
- 前記中間部分が、約2mmの長さである、請求項1に記載のデバイス。
- 前記中間部分が、テーパー状である、請求項1に記載のデバイス。
- 前記くびれ部分が、直径約0.1mm〜約0.5mmである、請求項3に記載のデバイス。
- 前記くびれ部分が、直径約0.1mm〜約1mmである、請求項3に記載のデバイス。
- 患者の心臓の心房中隔を穿刺するための方法であって、
血管を通して右心房にアクセスする工程;
該右心房に、中隔貫通穿刺デバイスを導入する工程であって、該デバイスは、
第1の外側針であって、鈍い遠位端および該外側針を通して長軸方向に配置される内腔を備える、第1の外側針;
該外側針の内腔中に軸方向に配置される第2の内側針であって、近位部分、中間部分、および遠位部分を備え、該中間部分が、該内側針の該近位部分または該遠位部分に対して可撓性である、第2の内側針、
を備える、工程;
該外側針と心房中隔とを接触させる工程;
該内側針を、該外側針より先に押して該中隔に通す工程;ならびに
該中隔貫通穿刺デバイスを取り除く工程、
を包含する、方法。 - 前記中隔貫通穿刺デバイスが、さらにシースを備え、該シースを通して前記外側針が軸方向に配置され、そして前記方法が、
前記中隔を通して該シースを前進させる工程、
をさらに包含する、請求項13に記載の方法。 - 前記中隔貫通穿刺デバイスが、さらにシースを備え、該シースを通して前記外側針が軸方向に配置され、そして前記方法が、
前記中隔を通して該シースを前進させる工程、および
該外側針を取り除く工程、
をさらに包含する、請求項13に記載の方法。 - 配置器デバイスを使用して、穿刺の前に前記心房中隔をつなぎ止める工程をさらに包含する、請求項13に記載の方法。
- 患者の心房中隔を穿刺するためのデバイスであって、
第1の外側針であって、鈍い遠位端および該外側針を通して長軸方向に配置される内腔を備える、第1の外側針;ならびに
該外側針の内腔中に軸方向に配置される第2の内側針であって、該針の直線的通路から逸れる遠位部分を備える、第2の内側針、
を備える、デバイス。 - 前記遠位部分が、ベンドを備える、請求項17に記載のデバイス。
- 前記遠位部分が、テーパー、らせん、曲線、コークスクリューまたはフック形状を備える、請求項17に記載のデバイス。
- 患者の心房中隔を穿刺するためのデバイスであって、
第1の外側針であって、鈍い遠位端および該外側針を通して長軸方向に配置される内腔を備える、第1の外側針;ならびに
該外側針の内腔中に軸方向に配置される第2の内側針であって、近位部分および遠位部分を備え、該遠位部分の直径が、該近位部分の直径よりも小さい、第2の内側針、
を備える、デバイス。 - 前記遠位部分と前記近位部分との間に中間部分をさらに備え、該中間部分がテーパー状である、請求項20に記載のデバイス。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US51798303P | 2003-11-06 | 2003-11-06 | |
PCT/US2004/014296 WO2005046487A1 (en) | 2003-11-06 | 2004-05-07 | Transseptal puncture apparatus |
Publications (2)
Publication Number | Publication Date |
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JP2007510458A true JP2007510458A (ja) | 2007-04-26 |
JP4496223B2 JP4496223B2 (ja) | 2010-07-07 |
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Application Number | Title | Priority Date | Filing Date |
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JP2006537957A Expired - Lifetime JP4496223B2 (ja) | 2003-11-06 | 2004-05-07 | 中隔貫通穿刺装置 |
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Country | Link |
---|---|
US (3) | US7666203B2 (ja) |
EP (1) | EP1694214A1 (ja) |
JP (1) | JP4496223B2 (ja) |
CA (1) | CA2542280A1 (ja) |
WO (1) | WO2005046487A1 (ja) |
Cited By (6)
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JP2013503693A (ja) * | 2009-09-02 | 2013-02-04 | サーキュライト・インコーポレーテッド | 同軸経中隔ガイドワイヤおよび針アセンブリ |
JP2016530928A (ja) * | 2013-08-07 | 2016-10-06 | ベイリス メディカル カンパニー インコーポレイテッドBaylis Medical Company Inc. | 組織を穿刺する方法およびデバイス |
WO2017094708A1 (ja) * | 2015-11-30 | 2017-06-08 | マニー株式会社 | 刺通針付きカニューレ |
JP2018089431A (ja) * | 2012-08-09 | 2018-06-14 | ユニバーシティ オブ アイオワ リサーチ ファウンデーション | カテーテル、カテーテルシステム、及び組織構造を刺通する方法 |
JP6928399B1 (ja) * | 2020-06-22 | 2021-09-01 | ネットビジネスコンサルティング株式会社 | 閉塞デバイス及び閉塞デバイスの製造方法 |
US11986209B2 (en) | 2020-02-25 | 2024-05-21 | Boston Scientific Medical Device Limited | Methods and devices for creation of communication between aorta and left atrium |
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US7338514B2 (en) | 2001-06-01 | 2008-03-04 | St. Jude Medical, Cardiology Division, Inc. | Closure devices, related delivery methods and tools, and related methods of use |
US7976564B2 (en) | 2002-05-06 | 2011-07-12 | St. Jude Medical, Cardiology Division, Inc. | PFO closure devices and related methods of use |
US8192425B2 (en) | 2006-09-29 | 2012-06-05 | Baylis Medical Company Inc. | Radiofrequency perforation apparatus |
US10820925B2 (en) * | 2003-01-21 | 2020-11-03 | Baylis Medical Company Inc. | Transseptal needle |
US7293562B2 (en) | 2003-03-27 | 2007-11-13 | Cierra, Inc. | Energy based devices and methods for treatment of anatomic tissue defects |
US7186251B2 (en) | 2003-03-27 | 2007-03-06 | Cierra, Inc. | Energy based devices and methods for treatment of patent foramen ovale |
US7972330B2 (en) | 2003-03-27 | 2011-07-05 | Terumo Kabushiki Kaisha | Methods and apparatus for closing a layered tissue defect |
US6939348B2 (en) | 2003-03-27 | 2005-09-06 | Cierra, Inc. | Energy based devices and methods for treatment of patent foramen ovale |
US8021362B2 (en) | 2003-03-27 | 2011-09-20 | Terumo Kabushiki Kaisha | Methods and apparatus for closing a layered tissue defect |
EP1605848B1 (en) | 2003-03-27 | 2020-03-04 | Terumo Kabushiki Kaisha | Apparatus for treatment of patent foramen ovale |
US20040267306A1 (en) | 2003-04-11 | 2004-12-30 | Velocimed, L.L.C. | Closure devices, related delivery methods, and related methods of use |
US8372112B2 (en) | 2003-04-11 | 2013-02-12 | St. Jude Medical, Cardiology Division, Inc. | Closure devices, related delivery methods, and related methods of use |
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Also Published As
Publication number | Publication date |
---|---|
WO2005046487A9 (en) | 2005-08-11 |
US20120179188A1 (en) | 2012-07-12 |
WO2005046487A1 (en) | 2005-05-26 |
US20100106177A1 (en) | 2010-04-29 |
JP4496223B2 (ja) | 2010-07-07 |
US8157829B2 (en) | 2012-04-17 |
US20050101984A1 (en) | 2005-05-12 |
CA2542280A1 (en) | 2005-05-26 |
US8992556B2 (en) | 2015-03-31 |
EP1694214A1 (en) | 2006-08-30 |
US7666203B2 (en) | 2010-02-23 |
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