JP5602129B2 - ステントグラフト及び装置並びに取り付け方法 - Google Patents
ステントグラフト及び装置並びに取り付け方法 Download PDFInfo
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- JP5602129B2 JP5602129B2 JP2011503974A JP2011503974A JP5602129B2 JP 5602129 B2 JP5602129 B2 JP 5602129B2 JP 2011503974 A JP2011503974 A JP 2011503974A JP 2011503974 A JP2011503974 A JP 2011503974A JP 5602129 B2 JP5602129 B2 JP 5602129B2
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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
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
-
- 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
-
- 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
- A61F2/9517—Instruments specially adapted for placement or removal of stents or stent-grafts handle assemblies therefor
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/89—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
-
- 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
- A61F2/07—Stent-grafts
- A61F2002/075—Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching
-
- 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
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Cardiology (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Pulmonology (AREA)
- Gastroenterology & Hepatology (AREA)
- Prostheses (AREA)
Description
ピンバイス54のバイスの係合部材(図示せず)は、該ピンバイスがねじられたとき、ガイドワイヤーカテーテル24に当接して押し付ける、すなわち、該カテーテルと係合する。バイスの係合部材が係合するとき、ガイドワイヤーカテーテル24は本体48と共に動くことだけができ、従って、それは押出部材30と共に動くことだけができる。ねじ蓋56が締め付けられた状態で、アセンブリ全体を1つの構成要素として一体で動かすことができる。
2 大動脈
3 大動脈弓
4 近位端
6 遠位端
7 端部、内側
8 動脈瘤
9 ネック部
10 導入器
12 外部操作部分
14 遠位取付領域
16 拡張器先端
18 移植片
20 拡張器先端
22 穴
24 ガイドワイヤーカテーテル
25 ガイドワイヤ
26 連結器具
28 穴
30 押出部材
32 シース
34 止血剤シーリングユニット
36 側管
38 ルアーロック
40 遠位取付部分
42 遠位トリガーワイヤ
44 環状空間
46 遠位ワイヤ解放機構
48 本体
50 近位ワイヤ解放機構
52 ねじ
54 ピンバイス
56 ねじ蓋
74 近位端
76 大動脈弓
78 左鎖骨下動脈
84 上行大動脈
100 ステントグラフト
102 近位端
104 糸
106 ステントリング
108 ループ
110 自由端
112 結び目
114 糸のループ
116 頂点
118 谷部
120 カニューレ
121 カニューレ、ルーメン
122 遠位端
126 結ばれたループ
128 棒、制御棒
130 ループ状端部
140 引張り紐
142 ループ状端部
150 糸
152 糸
154 翼
Claims (16)
- グラフト材で相互に連結した複数のステントを有するステントグラフトであり、糸の締め付け可能ループ(108)を含み、前記締め付け可能ループ(108)は、結び目(112)で閉じられた第1端部と、結び目(112)を通り且つ少なくとも締め付け可能ループ(108)の締め付け方向に摺動することができる第2端部(110)とを含み、前記締め付け可能ループ(108)は、該締め付け可能ループ(108)の締め付けが当該ステントグラフト(100)を湾曲させるように該ステントグラフトに取り付けられており、且つ、該締め付け可能ループ(108)は、前記ステントグラフトの一部分に前記結び目(112)を連結する結び要素(114)を備えているステントグラフト。
- 前記締め付け可能ループ(108)は、前記各ステント(106)に隣接する複数の位置で前記ステントグラフトの表面に保持されるように取り付けられ、それにより、前記締め付け可能ループ(108)が、隣接したステント(106)間のグラフト材を折り曲げるように締め付けられるとき、少なくとも前記ステント(106)の幾つかがお互いに重なるように前記ステントを引っ張る、請求項1に記載のステントグラフト。
- 前記締め付け可能ループ(108)は、それが締め付けられるときに、該締め付け可能ループ(108)に保持された隣接した各ステント(106)の重なりを生じさせるようにされている、請求項2に記載のステントグラフト。
- 前記締め付け可能ループ(108)は、それが締め付けられて当該ステントグラフトが湾曲させられるときに、当該湾曲させられる内側部分において、当該ステントグラフトの近位端から遠位端へ向かう方向における各ステント(106)の後端(118)が隣接するステントの前端の上方又は下方に摺動するように取付けられる、請求項3に記載のステントグラフト。
- 前記締め付け可能ループ(108)は、それが締め付けられて当該ステントグラフトが湾曲させられたときに、当該湾曲させられた内側部分において、前記ステント(106)の少なくとも1つがその両側に配置されたステントに対して、当該ステントグラフトの内側位置、又は外側位置となるように動かすように取り付けられる、請求項2から4の何れかに記載のステントグラフト。
- 前記締め付け可能ループ(108)が、当該ステントグラフト(100)の内部空間とその外側の間で複数回通過し、それにより、当該ステントグラフトの前記内部空間から前記外側までの前記締め付け可能ループ(108)の移行箇所の間の各位置において当該ステントグラフト(100)が圧縮されまたは折り曲げられるように、前記医療装置に取付けられる、請求項1乃至5の何れかに記載のステントグラフト。
- 当該ステントグラフトの近位端をその湾曲の間束縛する収縮装置(150、152)を含む、請求項1乃至6の何れかに記載のステントグラフト。
- 前記収縮装置は、当該ステントグラフトの前記近位端の周りに巻き付けられた少なくとも1つの糸(150、152)を含み、前記少なくとも1つの糸が当該ステントグラフト(100)の完全な配置を可能にするために束縛する構成から解放可能である、請求項7に記載のステントグラフト。
- 患者の管腔に、請求項1乃至8の何れかに記載のステントグラフトを配備するのに適している導入器アセンブリであって、
遠位端に開口部(124)を有するカニューレ(120)と、
前記開口部を当該カニューレの内側から外側に通され、且つ前記カニューレの外側にある前記ステントグラフトの一部分に連結される結びループ(126)と、
前記カニューレ(120)の内側を前記結びループ(126)内を通って該カニューレの長さ方向に延びて、前記結びループ(126)を前記カニューレ(120)に保持する制御要素(128)と、
を有し、
該制御要素(128)は前記カニューレ(120)から前記結びループ(126)を開放するために引き込み可能である、導入器アセンブリ。 - 前記制御要素が制御棒又はワイヤ(128)である、請求項9に記載の導入器アセンブリ。
- 前記カニューレ(120)が前記ステントグラフト(100)の前記締め付け可能ループ(108)の第2端部(110)を収容するルーメン(121)を有する、請求項9又は10に記載の導入器アセンブリ。
- 前記締め付け可能ループ(108)の第2端部(110)に取り付けられる引張り紐又はワイヤ(140)を更に含む、請求項9から11の何れかに記載の導入器アセンブリ。
- 前記制御要素(128)が前記締め付け可能ループ(108)の第2端部(110)を引張り紐(140)から解放することができる、請求項12に記載の導入器アセンブリ。
- 前記引張り紐(140)が、前記締め付け可能ループ(108)の前記第2端部のループ状端部(130)と係合可能なループ状端部(142)を有しており、前記引張り紐(140)の前記ループ状端部(142)は、前記制御要素(128)によって保持することができ、前記制御要素(128)の引き抜きによって解放可能であることにより、前記導入器アセンブリから前記締め付け可能ループ(108)を取り外す、請求項13に記載の導入器アセンブリ。
- 前記ステントグラフト(100)の近位端部を配備中に収縮した形状に保持するための収縮装置(150、152)を解放する手段を含む、請求項9から14の何れかに記載の導入器アセンブリ。
- 前記収縮装置を解放する手段が制御要素(128)を含む、請求項15に記載の導入器アセンブリ。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US12353108P | 2008-04-09 | 2008-04-09 | |
US61/123,531 | 2008-04-09 | ||
PCT/US2009/002098 WO2009126227A2 (en) | 2008-04-09 | 2009-04-03 | Stent-graft and apparatus and fitting method |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2011516202A JP2011516202A (ja) | 2011-05-26 |
JP5602129B2 true JP5602129B2 (ja) | 2014-10-08 |
Family
ID=40765548
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2011503974A Active JP5602129B2 (ja) | 2008-04-09 | 2009-04-03 | ステントグラフト及び装置並びに取り付け方法 |
Country Status (4)
Country | Link |
---|---|
US (1) | US8043356B2 (ja) |
EP (1) | EP2262444B1 (ja) |
JP (1) | JP5602129B2 (ja) |
WO (1) | WO2009126227A2 (ja) |
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JP2000167063A (ja) * | 1998-12-04 | 2000-06-20 | Yuichi Mori | ステントおよびステントグラフト |
AUPR847301A0 (en) * | 2001-10-26 | 2001-11-15 | Cook Incorporated | Endoluminal prostheses for curved lumens |
CA2619585C (en) * | 2005-08-18 | 2014-04-29 | William A. Cook Australia Pty. Ltd. | Design and assembly of fenestrated stent grafts |
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2009
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- 2009-04-03 US US12/384,362 patent/US8043356B2/en active Active
- 2009-04-03 EP EP09729743.6A patent/EP2262444B1/en active Active
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EP2262444A2 (en) | 2010-12-22 |
WO2009126227A2 (en) | 2009-10-15 |
JP2011516202A (ja) | 2011-05-26 |
EP2262444B1 (en) | 2018-02-28 |
AU2009234483A1 (en) | 2009-10-15 |
WO2009126227A3 (en) | 2009-12-10 |
US8043356B2 (en) | 2011-10-25 |
US20090259291A1 (en) | 2009-10-15 |
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