JP2011528963A - 心臓弁における石灰化部の破砕 - Google Patents
心臓弁における石灰化部の破砕 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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
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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
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320725—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with radially expandable cutting or abrading elements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2427—Devices for manipulating or deploying heart valves during implantation
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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
- A61B17/00234—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
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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
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
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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
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00778—Operations on blood vessels
- A61B2017/00783—Valvuloplasty
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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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22061—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation for spreading elements apart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22065—Functions of balloons
- A61B2017/22069—Immobilising; Stabilising
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22097—Valve removal in veins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22098—Decalcification of valves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B2017/320716—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions comprising means for preventing embolism by dislodged material
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2412—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
- A61F2/2418—Scaffolds therefor, e.g. support stents
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- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
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- Orthopedic Medicine & Surgery (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Abstract
Description
12 外部ハウジング
14 衝撃発生要素
22 外部ハウジング
24 衝撃発生要素
26 衝撃発生ワイヤループ
28 案内ワイヤ
30 弁形成術バルーン
32 弁形成術バルーンシャフト
33 近位部分
34 衝撃源
35 遠位部分
36 ポンプ
40 経皮デバイス
42 外部シャフト
43 近位部分
44 衝撃送達シャフト
45 遠位部分
46 ワイヤアーチ
47 衝撃源
48 内部シャフト
49 拡張機構
50 永久磁石
52 電気コイル
54 電流源
56 塞栓保護ネット
60 経皮デバイス
62 バルーン
63 流体
64 遠位先端部
66 重り
68 回転要素
70 外部シャフト
72 重り
74 円筒形磁石
76 コイル
78 コイルリード線
79 AC電圧/電流発生器
80 経皮デバイス
82 アーム
84 内部要素
86 外部シース
88 バルーン
90 破砕カテーテル
92 アーム
94 鋸歯
96 電気コイル
97 電磁石
98 外部AC発電機
99 重り
100 バルーン
102 膨張チューブ
104 膨張ポンプ
106 膨張孔
108 重り
110 保護スリーブ
112 流れ開口
114 鋸歯開口
116 新しい弁
120 経皮回収デバイス
121 回収カテーテル
122 中心管孔
123 回収シース
124 延長部分
125 回収フック
126 鋸歯
130 保護スリーブ
132 アンカーアーム
133 近位開口部
134 半冠状ネット
135 回収ワイヤ
136 遠位ワイヤ
137 遠位リング
138 格納式シース
140 バルーンカテーテル
142 バルーン
144 新しい弁
146 弁送達システム
150 衝撃波脱石灰カテーテル
152 衝撃波源
154 支持構造体
156 支持構造体
158 想像上の楕円
Claims (22)
- 心臓弁内の石灰化部を破砕するデバイスにおいて、
心臓弁に経皮的に送達するように構成されたカテーテルと、
前記カテーテルの遠位部分に配置され、前記心臓弁の小葉における石灰化部と接触すると、石灰化部をさせて機械的に破砕するよう作動する破砕発生要素と、
前記破砕発生要素を振動させ、前記石灰化部を前記小葉から必ずしも取り除くことなく、前記破砕発生要素が前記石灰化を破砕するようにする、エネルギー源とを備えるデバイス。 - 前記破砕発生要素は、高速の衝撃発生要素を備える、請求項1に記載のデバイス。
- 前記エネルギー源は、前記カテーテルの近位部分に位置している、請求項1に記載のデバイス。
- 前記エネルギー源は、前記カテーテルの遠位部分に位置している、請求項1に記載のデバイス。
- 前記破砕発生要素は、前記心臓弁の2つ以上の領域で同時に石灰化部を機械的に破砕する、請求項1に記載のデバイス。
- 前記破砕発生要素は、その遠位端部から延びる1つ以上の衝撃発生弓状アームを備える、請求項1に記載のデバイス。
- 前記衝撃発生アームは、前記カテーテルの前記外部ハウジング内に引き込まれている、請求項6に記載のデバイス。
- バルーンの膨張と収縮によって、前記破砕発生要素と硬質組織との間の押付け力が変化するように、前記破砕発生要素に対して配置されたバルーンシャフトに取り付けられた弁形成術バルーンをさらに備える、請求項1に記載のデバイス。
- 前記衝撃発生アームは、前記衝撃発生アームを交互に収縮および拡張するよう、近位方向および遠位方向に移動可能な内部シャフトに接続されている、請求項6に記載のデバイス。
- 前記エネルギー源は、電磁式衝撃源を備え、摺動磁石が衝撃的衝突を発生させる、請求項1に記載のデバイス。
- 前記衝撃カテーテル上に配置された塞栓保護手段をさらに備える、請求項1に記載のデバイス。
- 前記破砕発生要素は、回転要素に対して軸をずらせて結合された重りと、前記回転要素を回転させるよう作動するモータとを備える、請求項1に記載のデバイス。
- 前記破砕発生要素は、前記カテーテル内に配置されたコイル内で前後に移動するよう配置された円筒形磁石に取り付けられた重りと、前記コイルに電力を供給して、選択された振幅および周波数で、前記重りを前後に振動させるよう作動する電圧/電流発生器とを備える、請求項1に記載のデバイス。
- 前記衝撃発生アームは、前記硬質組織に対して切断力を加える、鋭い外部縁部を備える、請求項6に記載のデバイス。
- 前記衝撃発生アームは、調節可能な角度位置を有する、請求項6に記載のデバイス。
- 自然弁を回収する経皮回収デバイスをさらに備え、
前記経皮回収デバイスは、
中心管孔を有するメッシュであって、前記中心管孔は、自然弁の中心を通り、そして拡張することによって、前記中心管孔内に新しい弁を移植可能にするよう適合されている、メッシュと、
前記メッシュから外側に折り畳まれ、前記自然弁の空洞部に嵌まり込むよう適合された半月状の延長部分とを備える、請求項1に記載のデバイス。 - 前記半月状の延長部分は、前記自然弁の小葉を切断または鋸引きする、鋭い縁部を有する、請求項16に記載のデバイス。
- 前記保護手段は、スリーブ状の形状であり、前記スリーブから拡張可能な可撓性のアンカーアームを備える、請求項11に記載のデバイス。
- 前記スリーブの遠位部分から延びる半冠状ネットをさらに備える、請求項18に記載のデバイス。
- 前記保護スリーブが引き込まれる格納式シースをさらに備える、請求項18に記載のデバイス。
- 前記半冠状ネットは、閉位置において、直径が自然弁の直径と一致する遠位リングを有する、請求項19に記載のデバイス。
- バルーンの膨張と収縮によって、前記破砕発生要素と硬質組織との間の押付け力が変化するように、前記破砕発生要素に対して配置されたバルーンシャフトに取り付けられた弁形成術バルーンをさらに備える、請求項18に記載のデバイス。
Applications Claiming Priority (7)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US8393408P | 2008-07-27 | 2008-07-27 | |
US61/083,934 | 2008-07-27 | ||
US9606108P | 2008-09-11 | 2008-09-11 | |
US61/096,061 | 2008-09-11 | ||
US16234309P | 2009-03-23 | 2009-03-23 | |
US61/162,343 | 2009-03-23 | ||
PCT/US2009/051784 WO2010014515A2 (en) | 2008-07-27 | 2009-07-27 | Fracturing calcifications in heart valves |
Publications (2)
Publication Number | Publication Date |
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JP2011528963A true JP2011528963A (ja) | 2011-12-01 |
JP5588978B2 JP5588978B2 (ja) | 2014-09-10 |
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Application Number | Title | Priority Date | Filing Date |
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JP2011520248A Active JP5588978B2 (ja) | 2008-07-27 | 2009-07-27 | 心臓弁における石灰化部の破砕 |
Country Status (5)
Country | Link |
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US (1) | US9717513B2 (ja) |
EP (1) | EP2326264B1 (ja) |
JP (1) | JP5588978B2 (ja) |
ES (1) | ES2659322T3 (ja) |
WO (1) | WO2010014515A2 (ja) |
Cited By (32)
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JPH1049450A (ja) * | 1996-07-31 | 1998-02-20 | Kyocera Corp | 遠隔監視システムの異常時の復旧方式 |
JP2012508042A (ja) * | 2008-11-05 | 2012-04-05 | ダニエル ホーキンス、 | 衝撃波弁形成用カテーテルシステム |
JP2013540492A (ja) * | 2010-09-21 | 2013-11-07 | アンジオスコア, インコーポレイテッド | 弁狭窄症を処置するための方法およびシステム |
US8709075B2 (en) | 2011-11-08 | 2014-04-29 | Shockwave Medical, Inc. | Shock wave valvuloplasty device with moveable shock wave generator |
JP2015502809A (ja) * | 2011-12-05 | 2015-01-29 | ピーアイ‐アール‐スクエアード リミティッド | 心臓弁における石灰化部位の破砕 |
JP2015524709A (ja) * | 2012-08-08 | 2015-08-27 | ショックウェーブ メディカル, インコーポレイテッド | 複数のバルーンを伴う衝撃波弁形成 |
JP2015525657A (ja) * | 2012-08-17 | 2015-09-07 | ショックウェーブ メディカル, インコーポレイテッド | アーク事前調整を伴う衝撃波カテーテルシステム |
JP2015528329A (ja) * | 2012-08-06 | 2015-09-28 | ショックウェーブ メディカル, インコーポレイテッド | 衝撃波カテーテル |
JP2016501703A (ja) * | 2013-01-07 | 2016-01-21 | ピ−カーディア・リミテッド | 心臓弁における石灰沈着を破砕するためのスタビライザ組立体 |
US9375328B2 (en) | 2001-11-09 | 2016-06-28 | Angioscore, Inc. | Balloon catheter with non-deployable stent |
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JP2017516636A (ja) * | 2014-06-05 | 2017-06-22 | セントレ・ホスピタリエ・ユニヴェルシテール・デ・サン−エティエンヌ | 大動脈弁尖から石灰化した組織をアブレーションするための経カテーテルデバイス |
US9962529B2 (en) | 2003-01-21 | 2018-05-08 | Angioscore, Inc. | Apparatus and methods for treating hardened vascular lesions |
US10039561B2 (en) | 2008-06-13 | 2018-08-07 | Shockwave Medical, Inc. | Shockwave balloon catheter system |
US10086178B2 (en) | 2001-11-09 | 2018-10-02 | Angioscore, Inc. | Balloon catheter with non-deployable stent |
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JP2019512346A (ja) * | 2016-03-31 | 2019-05-16 | ピ−カーディア・リミテッド | 石灰化大動脈弁尖のリモデリング |
US10357264B2 (en) | 2016-12-06 | 2019-07-23 | Shockwave Medical, Inc. | Shock wave balloon catheter with insertable electrodes |
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US20110118634A1 (en) | 2011-05-19 |
JP5588978B2 (ja) | 2014-09-10 |
EP2326264B1 (en) | 2017-11-15 |
ES2659322T3 (es) | 2018-03-14 |
EP2326264A2 (en) | 2011-06-01 |
WO2010014515A3 (en) | 2010-08-12 |
WO2010014515A2 (en) | 2010-02-04 |
US9717513B2 (en) | 2017-08-01 |
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