JP5032622B2 - カテーテル法のアクセスのための方法及び装置 - Google Patents
カテーテル法のアクセスのための方法及び装置 Download PDFInfo
- Publication number
- JP5032622B2 JP5032622B2 JP2010067514A JP2010067514A JP5032622B2 JP 5032622 B2 JP5032622 B2 JP 5032622B2 JP 2010067514 A JP2010067514 A JP 2010067514A JP 2010067514 A JP2010067514 A JP 2010067514A JP 5032622 B2 JP5032622 B2 JP 5032622B2
- Authority
- JP
- Japan
- Prior art keywords
- access tube
- distal end
- stylet
- tube assembly
- access
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0102—Insertion or introduction using an inner stiffening member, e.g. stylet or push-rod
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/02—Holding devices, e.g. on the body
- A61M25/04—Holding devices, e.g. on the body in the body, e.g. expansible
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/06—Body-piercing guide needles or the like
- A61M25/0662—Guide tubes
- A61M25/0668—Guide tubes splittable, tear apart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3474—Insufflating needles, e.g. Veress needles
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Biophysics (AREA)
- Pulmonology (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Endoscopes (AREA)
Description
背景技術の説明
新鮮な又は樹立した腎フィステル成形管を介する導入のための Foleyカテーテルの伸長及び剛化のための内部棒の利用がCope (1981) Urology 27 : 606に記載されている。Copeら、 Atlas of Interventional Radiology, Lippencott, 1990, p11.5-11.6も参照のこと。内部スタイレットにより軸張力を適用することによって小径形態に保たれた自己膨張式遠位端を有するさやを用いる経皮塞栓切除術がVorwerekら(1992) Radiology 187 : 415-418 ; Weigeleら (1992) Radiology (1992) 185 : 604-606;及びヨーロッパ特許出願第 385,920号に記載されている。鋭利な内部スタイレットを用いて挿入された鼓膜のためのドレインが米国特許第 3,948,271号に記載されている。米国特許第 5,102,401号はウェットな環境にさらされたときに膨張する親水性材料より成るカテーテルを述べている。放射状膨張式ダイレーターが米国特許第 5,183,464号に記載されている。放射状膨張式気管支チューブが米国特許第 4,141,364号に記載されている。その他の経皮導入式チューブ及びさやは米国特許第 5,183,471; 5,176,649; 5,074,867; 4,871,358; 4,589,868; 4,112,932;及び 4,077,412号に記載されている。
特定の態様の説明
本発明の装置及び方法は、標的箇所、一般には空洞身体器官又は腔もしくはその他の処置すべき領域、例えば嚢胞に対するアクセスを担うために、患者に弾性アクセスチューブを経皮的に設置するのに利用されうる。このアクセスチューブは一般に標的箇所、例えば膀胱、腎臓、胸部、肺、胆嚢、腹膜、小腸、嚢胞等の排液のために利用されるであろう。このアクセスチューブは胃に至る挿入により患者に栄養供給するためにも有用であろう。「経皮」とは、アクセスチューブを患者の外皮を通じて、そして任意的にそのすぐ隣りの組織及び器官構造を通じて所望の体腔又はその他位置に至るまで設置せしめることを意味するであろう。アクセスチューブを経皮導入するための特定の装置及び方法を以降により詳しく説明する。あるケースにおいて、このアクセスチューブは脈管系に対する周囲がシールされたアクセスを供するためにも利用されうる。
Claims (15)
- アクセスチューブ集成体であって:
近位端、遠位端及びこの近位端から遠位端に及ぶ中央ルーメンを有する弾性アクセスチューブ、ここでこのチューブは軸張力又は放射状圧縮に委ねられていないときは固有の長さ及び固有の外径を有している;
前記中央ルーメン内に受容可能であり、且つ前記弾性アクセスチューブの遠位端に対して結合可能であるスタイレット;並びに
近位端、遠位端、軸状ルーメン及びこの遠位端にある貫入部材を有する放射状に膨張する管状本体を含む長い拡張部材;
含んで成り、ここでこの弾性アクセスチューブの遠位端はこのスタイレット由来の張力下に委ねられているときに第一の非テーパー状形態から第二のテーパー状形態へと変形し、これによりこのテーパー状の遠位端は前記長い拡張部材の軸状ルーメンを介する前記アクセスチューブ及びスタイレットの導入を促すことを特徴とする;
アクセスチューブ集成体。 - 前記弾性アクセスチューブがその遠位端付近に膨張式アンカーを有する、請求項1記載のアクセスチューブ集成体。
- 前記膨張式アンカーがマレコット構造をとっており、ここでこの構造は前記スタイレットが前記弾性アクセスチューブの遠位端と結合して縦方向に伸長したときに伸長、そして崩壊できるものである、請求項2記載のアクセスチューブ集成体。
- 前記膨張式アンカーが膨張式バルーンである、請求項2記載のアクセスチューブ集成体。
- 前記アクセスチューブの近位端を着脱式に固定するための前記スタイレット上のラッチ機構を更に含んで成り、ここでこのラッチ機構は前記スタイレットの遠位端から前記弾性アクセスチューブの固有の長さよりも20%以上長い距離離れて位置している、請求項1記載のアクセスチューブ集成体。
- 前記弾性アクセスチューブが2cm〜20cmの範囲の固有の長さ及び2mm〜8mmの範囲の固有の外径を有する、請求項5記載のアクセスチューブ集成体。
- 前記弾性アクセスチューブの近位端上に固定具を更に含んで成り、ここでこの固定具は前記ラッチ機構によって固定されており、そしてこのラッチ機構は前記スタイレットの遠位端から3cm〜40cmの範囲の距離離れて位置している、請求項6記載のアクセスチューブ集成体。
- 前記貫入部材が鋭利な遠位端と密閉具とを含んで成り、この密閉具は前記貫入部材が組織に貫通している間は引っ込んでおり、そして遠位方向にはね戻る、請求項1記載のアクセスチューブ集成体。
- 前記スタイレットがその遠位端にテーパー状のシリンダーを含み、このテーパー状のシリンダーは前記アクセスチューブの遠位端を受容するための冠状のくぼみを規定している、請求項8記載のアクセスチューブ集成体。
- 前記放射状に膨張式管状本体が弾性チューブである、請求項1記載のアクセスチューブ集成体。
- 前記スタイレットの遠位端が前記アクセスチューブの遠位端に着脱式に固定可能である、請求項1記載のアクセスチューブ集成体。
- 前記弾性アクセスチューブの遠位部を少なくとも覆い、かつ当該弾性アクセスチューブの固有の外径よりも小さい内径を有する取外式さやをさらに含んでなる、請求項11記載のアクセスチューブ集成体。
- 前記取外式さやが2mm〜8mmの範囲の内径を有するポリマーチューブである、請求項12記載のアクセスチューブ集成体。
- 前記ポリマーチューブが、前記さやの分割及び除去を促すために少なくとも片側上に軸状に筋が付けられているか又は分割されているものである、請求項13記載のアクセスチューブ集成体。
- 前記第二のテーパー状形態が概して円錐形状である、請求項13記載のアクセスチューブ集成体。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/240,059 US5454790A (en) | 1994-05-09 | 1994-05-09 | Method and apparatus for catheterization access |
US08/240,059 | 1994-05-09 |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2004363342A Division JP2005161065A (ja) | 1994-05-09 | 2004-12-15 | カテーテル法のアクセスのための方法及び装置 |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2011050730A JP2011050730A (ja) | 2011-03-17 |
JP5032622B2 true JP5032622B2 (ja) | 2012-09-26 |
Family
ID=22904943
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP52916595A Expired - Fee Related JP3660358B2 (ja) | 1994-05-09 | 1995-05-08 | カテーテル法のアクセスのための装置 |
JP2004363342A Withdrawn JP2005161065A (ja) | 1994-05-09 | 2004-12-15 | カテーテル法のアクセスのための方法及び装置 |
JP2010067514A Expired - Lifetime JP5032622B2 (ja) | 1994-05-09 | 2010-03-24 | カテーテル法のアクセスのための方法及び装置 |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP52916595A Expired - Fee Related JP3660358B2 (ja) | 1994-05-09 | 1995-05-08 | カテーテル法のアクセスのための装置 |
JP2004363342A Withdrawn JP2005161065A (ja) | 1994-05-09 | 2004-12-15 | カテーテル法のアクセスのための方法及び装置 |
Country Status (6)
Country | Link |
---|---|
US (1) | US5454790A (ja) |
EP (2) | EP0843569B1 (ja) |
JP (3) | JP3660358B2 (ja) |
AU (1) | AU2476495A (ja) |
DE (2) | DE69529578T2 (ja) |
WO (1) | WO1995030449A1 (ja) |
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- 1995-05-08 DE DE69529578T patent/DE69529578T2/de not_active Expired - Lifetime
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- 1995-05-08 JP JP52916595A patent/JP3660358B2/ja not_active Expired - Fee Related
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AU2476495A (en) | 1995-11-29 |
DE69529578D1 (de) | 2003-03-13 |
EP0843569A4 (en) | 1998-12-09 |
EP1334744A3 (en) | 2003-08-27 |
WO1995030449A1 (en) | 1995-11-16 |
JP2011050730A (ja) | 2011-03-17 |
EP0843569B1 (en) | 2003-02-05 |
US5454790A (en) | 1995-10-03 |
JP3660358B2 (ja) | 2005-06-15 |
EP0843569A1 (en) | 1998-05-27 |
DE69529578T2 (de) | 2003-12-11 |
JPH09512732A (ja) | 1997-12-22 |
EP1334744B1 (en) | 2005-09-21 |
DE69534481D1 (de) | 2006-02-02 |
DE69534481T2 (de) | 2006-06-14 |
JP2005161065A (ja) | 2005-06-23 |
EP1334744A2 (en) | 2003-08-13 |
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