JP5588978B2 - 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
-
- 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
- A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
-
- 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
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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
- A61B2017/22097—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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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Cardiology (AREA)
- Veterinary Medicine (AREA)
- Vascular Medicine (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Mechanical Engineering (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
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 (13)
- 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破砕カテーテル(10)と、
前記カテーテル(10)の遠位部分に配置され、前記カテーテル(10)のハウジング(12,22)から出た時に、振動し機械的な衝撃を発生し、前記心臓弁の小葉における石灰化部と接触する衝撃発生要素(14,24)と、
前記衝撃発生要素(14,24)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、前記衝撃発生要素(14,24)が前記石灰化部を破砕するように駆動するエネルギー源(34)と、
アンビル(30)とを備え、
前記衝撃発生要素(14,24)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(26)を備え、
前記石灰化部が、前記衝撃発生要素(14,24)によって前記アンビル(30)に対して衝撃を加えることで破砕されるように構成され、
前記アンビルが小葉の内側に入り込む部分を含み、当該部分に対して前記衝撃発生弓状アーム(26)から衝撃を加えることによって、その間に挟まれた前記石灰化部を破砕するように構成したことを特徴とするデバイス。 - 前記アンビルがバルーン(30)を備えることを特徴とする請求項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1つ以上の衝撃発生弓状アームは、小葉基部の全体を同時にカバーするワイヤーループ(26)であることを特徴とする請求項1に記載のデバイス。
- 前記衝撃発生弓状アームは、前記カテーテルの前記ハウジング内に引き込み可能に構成されている、請求項5に記載のデバイス。
- 前記バルーンの膨張と収縮によって、前記衝撃発生要素と前記石灰化部との間の押付け力が変化するように構成した、請求項2に記載のデバイス。
- 前記破砕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。
- 前記衝撃発生要素は、回転要素(68)と当該回転要素を回転駆動するモータに対して、軸をずらして連結された重り(66)を備えている、請求項1に記載のデバイス。
- 前記衝撃発生弓状アーム(82)は、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5に記載のデバイス。
- 前記衝撃発生弓状アーム(82)は、調節可能な角度位置を有する、請求項5に記載のデバイス。
- 自然弁を回収する経皮回収デバイス(120)をさらに備え、
前記経皮回収デバイスは、中心管孔(122)を有するメッシュであって、前記中心管孔(122)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(122)内に新しい弁を移植可能にするよう適合されている、そのようなメッシュと;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(124)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(124)は、前記自然弁の小葉を切断または鋸引きする、鋭い縁部(126)を有する、請求項12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 |
---|---|
JP2011528963A JP2011528963A (ja) | 2011-12-01 |
JP5588978B2 true 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 |
---|---|
US (1) | US9717513B2 (ja) |
EP (1) | EP2326264B1 (ja) |
JP (1) | JP5588978B2 (ja) |
ES (1) | ES2659322T3 (ja) |
WO (1) | WO2010014515A2 (ja) |
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