JP4628101B2 - 分岐グラフト装置とその方法 - Google Patents
分岐グラフト装置とその方法 Download PDFInfo
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- JP4628101B2 JP4628101B2 JP2004533026A JP2004533026A JP4628101B2 JP 4628101 B2 JP4628101 B2 JP 4628101B2 JP 2004533026 A JP2004533026 A JP 2004533026A JP 2004533026 A JP2004533026 A JP 2004533026A JP 4628101 B2 JP4628101 B2 JP 4628101B2
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- 238000000034 method Methods 0.000 title description 10
- 230000000717 retained effect Effects 0.000 claims abstract description 5
- 230000008602 contraction Effects 0.000 claims description 18
- 210000004204 blood vessel Anatomy 0.000 claims description 14
- 239000011324 bead Substances 0.000 abstract description 4
- 238000004873 anchoring Methods 0.000 abstract description 3
- 230000014759 maintenance of location Effects 0.000 abstract 2
- 210000003090 iliac artery Anatomy 0.000 description 21
- 206010002329 Aneurysm Diseases 0.000 description 5
- 241001465754 Metazoa Species 0.000 description 2
- 230000006835 compression Effects 0.000 description 2
- 238000007906 compression Methods 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 230000005855 radiation Effects 0.000 description 2
- 230000002792 vascular Effects 0.000 description 2
- 102000008186 Collagen Human genes 0.000 description 1
- 108010035532 Collagen Proteins 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 210000000038 chest Anatomy 0.000 description 1
- 229920001436 collagen Polymers 0.000 description 1
- 239000000470 constituent Substances 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 239000000835 fiber Substances 0.000 description 1
- 239000012530 fluid Substances 0.000 description 1
- 239000011159 matrix material Substances 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- HLXZNVUGXRDIFK-UHFFFAOYSA-N nickel titanium Chemical compound [Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ti].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni].[Ni] HLXZNVUGXRDIFK-UHFFFAOYSA-N 0.000 description 1
- 229910001000 nickel titanium Inorganic materials 0.000 description 1
- 230000001737 promoting effect Effects 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 230000001225 therapeutic effect Effects 0.000 description 1
- 210000000115 thoracic cavity Anatomy 0.000 description 1
- 210000005166 vasculature Anatomy 0.000 description 1
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Classifications
-
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
-
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
-
- 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
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/065—Y-shaped blood vessels
-
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
- A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Life Sciences & Earth Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Cardiology (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Control Of Driving Devices And Active Controlling Of Vehicle (AREA)
- Treatment Of Water By Ion Exchange (AREA)
Description
前記アンカーワイヤ・解放ワイヤは、留置装置の遠位端でアンカーワイヤ解放機構まで伸びて、留置中は患者の体外に配置される。
(A) 留置装置をブラインド血管が伸びる血管内に留置するステップと、
(B) リムが横方向かつ先端方向に伸びるように、分岐ステントグラフトの本体のリムを留置装置から解放するステップと、
(C) ガイドワイヤをリムからブラインド血管内に伸ばすステップと
(D) 留置装置を引くことによりリムがガイドワイヤに関連するブラインド血管内に入るよう留置装置を操作するステップと
(E) 分岐ステントグラフトを留置装置から解放するステップと
を有する。
留置状態の直径にステントグラフト本体を拡張するよう、「ひも」を解放するトリガワイヤ機構とを有する。
前記アンカー解放ワイヤは、留置装置の遠位端でアンカーワイヤ解放機構まで伸びて、留置中は患者の体外に配置される。
ことを特徴とする請求項30記載の脈管内ステントグラフト留置システム。
3 外部シース
4 内部シース
6 外部シース・マニュピュレータ
7 内部シース・マニュピュレータ
8 ノーズコーン
9 ガイドワイヤカテーテル
10 ピンバイス
11 領域
12 ガイドワイヤ装置
13 ガイドワイヤカテーテル
14 ガイドワイヤ
15 分岐部
16 ステントグラフト
17 近位体部分
18 遠位体部分
19 リム
20 外径収縮ひも
21 外径収縮ひも
25 アンカーワイヤカテーテル
26 アンカーワイヤ
27 アンカーワイヤ解放ワイヤ
28 ノット(結び目)
29 ビーズ
30 縫合糸
31 キャップ
32 キャップ
35 トリガワイヤ機構
36 トリガワイヤ解放機構
38 トリガワイヤ
39 トリガワイヤ
40 Y字型ピース
50 総腸骨動脈
51 内腸骨動脈
52 外腸骨動脈
55 繊維組織
56 レグ
57 ガイドワイヤ
Claims (13)
- 本体と前記本体から伸びるリム(19)とから構成される分岐ステントグラフト(16)のリム(19)を、ブラインド血管(51)内に留置するのに適した脈管内ステントグラフト留置システムにおいて
(A)遠位端と近位端とを有し、前記近位端に離脱可能に保持された前記分岐ステントグラフト(16)を搭載した留置カテーテル(1)と、
(B)前記留置カテーテル(1)にスライド可能に且つ同軸上に取り付けられた内部シース(4)と、
(C)前記留置カテーテル(1)の遠位端を通り、前記分岐ステントグラフト(16)の本体内にその遠位端から入り、更にリム(19)内に伸び、該リムの遠位端から伸びる変形可能なガイドワイヤ(14)と、
を有し、
前記リム(19)は、前記分岐ステントグラフト(16)の本体の分岐部分(15)から前記留置カテーテル(1)の遠位端方向に伸び、
前記分岐ステントグラフト(16)は、
留置カテーテル(1)が前記分岐ステントグラフト(16)の本体内を貫通して伸びた状態で、前記留置カテーテルに搭載され、
前記内部シース(4)は、前記分岐ステントグラフト(16)の本体を分岐部分(15)から該本体の遠位端側の部分を包囲している
ことを特徴とする脈管内ステントグラフト留置システム。 - (D)前記内部シース(4)上にスライド可能且つ同軸上に搭載され前記分岐ステントグラフト(16)の全体を包囲する外部シース(3)を更に有することを特徴とする請求項1記載の脈管内ステントグラフト留置システム。
- (E)前記内部シース(4)と前記外部シース(3)との間に伸び、前記分岐部(15)に隣接する前記分岐ステントグラフト(16)の本体まで伸び、前記分岐部(15)に隣接する前記分岐ステントグラフト(16)の本体に固定される解放可能なアンカーワイヤ装置を更に有することを特徴とする請求項2記載の脈管内ステントグラフト留置システム。
- 前記ガイドワイヤ(14)は、前記リム(19)を貫通して、前記リム(19)から遠位端方向に伸び、前記リム(19)がブラインド血管(51)内に入るのを補助するガイドワイヤ装置(12)を有することを特徴とする請求項1記載の脈管内ステントグラフト留置システム。
- 前記留置カテーテル(1)内に同軸状かつ移動可能に搭載されたガイドワイヤカテーテル(9)を有し、
前記ガイドワイヤカテーテル(9)は、ノーズコーン(8)まで伸び、
前記分岐ステントグラフト(16)は、前記ノーズコーン(8)の遠位端側に解放可能に保持される
ことを特徴とする請求項1記載の脈管内ステントグラフト留置システム。 - (F)前記分岐ステントグラフト(16)の本体の少なくとも一部の上に搭載された外径収縮装置を更に有することを特徴とする請求項1記載の脈管内ステントグラフト留置システム。
- (G)前記分岐ステントグラフト(16)の前記リム(19)上に搭載された外径収縮装置
を更に有することを特徴とする請求項1記載の脈管内ステントグラフト留置システム。 - 前記外径収縮装置は、
前記分岐ステントグラフト(16)の本体又は前記リム(19)の直径を、留置状態の直径から圧縮状態の直径まで小さくする、前記分岐ステントグラフト(16)の本体又は前記リム(19)の周囲に配置されたひも(20,21)と
留置状態の直径まで前記分岐ステントグラフト(16)又は前記リム(19)が拡張するよう、前記ひも(20,21)を解放するトリガーワイヤ機構(35)と
を有する
ことを特徴とする請求項6または7記載の脈管内ステントグラフト留置システム。 - 前記トリガワイヤ機構(35)は、前記留置カテーテルの遠位端に、留置中は患者の体外に配置されるトリガワイヤ解放機構(36)を有することを特徴とする請求項8記載の脈管内ステントグラフト留置システム。
- 前記分岐ステントグラフト(16)は、前記分岐ステントグラフト(16)の本体の近位端と遠位端の少なくとも一方及び前記リム(19)の遠位端に自己拡張型ステントを有することを特徴とする請求項1記載の脈管内ステントグラフト留置システム。
- 前記リム(19)に伸びる変形可能なガイドワイヤカテーテル(13)は、前記ガイドワイヤ(14)とガイドワイヤシースとを有し
前記ガイドワイヤ(14)は、留置中は患者の体外から前記ガイドワイヤシース内で移動可能である
ことを特徴とする請求項1記載の脈管内ステントグラフト留置システム。 - 前記リム(19)は、外側表面に血管への接着性を改良する繊維組織を有する
ことを特徴とする請求項1記載の脈管内ステントグラフト留置システム。 - 前記アンカーワイヤ装置は、アンカーワイヤ(26)とアンカー解放ワイヤ(27)とを有し
前記アンカー解放ワイヤ(27)は、前記留置カテーテルの遠位端で留置中は患者の体外に配置されるアンカーワイヤ解放機構まで伸びている
ことを特徴とする請求項3記載の脈管内ステントグラフト留置システム。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2002951147A AU2002951147A0 (en) | 2002-09-02 | 2002-09-02 | Branch grafting device and method |
PCT/US2003/027687 WO2004019823A1 (en) | 2002-09-02 | 2003-09-02 | Branch grafting device and method |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2005537099A JP2005537099A (ja) | 2005-12-08 |
JP4628101B2 true JP4628101B2 (ja) | 2011-02-09 |
Family
ID=27671473
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2004533026A Expired - Lifetime JP4628101B2 (ja) | 2002-09-02 | 2003-09-02 | 分岐グラフト装置とその方法 |
Country Status (8)
Country | Link |
---|---|
US (2) | US20040098084A1 (ja) |
EP (1) | EP1539040B1 (ja) |
JP (1) | JP4628101B2 (ja) |
AT (1) | ATE369097T1 (ja) |
AU (1) | AU2002951147A0 (ja) |
CA (1) | CA2495912C (ja) |
DE (1) | DE60315475T2 (ja) |
WO (1) | WO2004019823A1 (ja) |
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DE60315475T2 (de) | 2008-04-24 |
AU2002951147A0 (en) | 2002-09-19 |
CA2495912A1 (en) | 2004-03-11 |
US20040098084A1 (en) | 2004-05-20 |
ATE369097T1 (de) | 2007-08-15 |
JP2005537099A (ja) | 2005-12-08 |
EP1539040A1 (en) | 2005-06-15 |
DE60315475D1 (de) | 2007-09-20 |
WO2004019823A1 (en) | 2004-03-11 |
US20080114438A1 (en) | 2008-05-15 |
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