WO2005084742A1 - カフ部材 - Google Patents
カフ部材 Download PDFInfo
- Publication number
- WO2005084742A1 WO2005084742A1 PCT/JP2005/003775 JP2005003775W WO2005084742A1 WO 2005084742 A1 WO2005084742 A1 WO 2005084742A1 JP 2005003775 W JP2005003775 W JP 2005003775W WO 2005084742 A1 WO2005084742 A1 WO 2005084742A1
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- WO
- WIPO (PCT)
- Prior art keywords
- cuff member
- resin
- porous
- dimensional network
- flange portion
- Prior art date
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Classifications
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L31/00—Materials for other surgical articles, e.g. stents, stent-grafts, shunts, surgical drapes, guide wires, materials for adhesion prevention, occluding devices, surgical gloves, tissue fixation devices
- A61L31/14—Materials characterised by their function or physical properties, e.g. injectable or lubricating compositions, shape-memory materials, surface modified materials
- A61L31/146—Porous materials, e.g. foams or sponges
-
- 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
- A61M2025/0266—Holding devices, e.g. on the body using pads, patches, tapes or the like
-
- 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
- A61M2025/0293—Catheter, guide wire or the like with means for holding, centering, anchoring or frictionally engaging the device within an artificial lumen, e.g. tube
Definitions
- the present invention relates to a cuff member capable of invading cells from a living tissue and obtaining a strong adhesion with the living tissue, and more particularly, to an auxiliary treatment which is a subcutaneous insertion of a force-Eureta catheter.
- the present invention relates to cuff members useful for living skin insertion such as blood circulation with artificial heart, peritoneal dialysis therapy, central parenteral nutrition, transgastric fistula nutrition, power-Yure DDS and transcatheter DDS.
- the force-eurecate catheter used in therapies such as ventricular assist devices and peritoneal dialysis that have been developed in recent years is inserted into open vessels to the outside world. Unlike airway surgery, it is necessary to make an incision in the subcutaneous tissue, make a puncture, and place it in the living body. If the indwelling in the living body is for a long period of time, use a cuff member (also called skin force) to separate the inside of the living body from the outside world and prevent bacteria from entering the living body and volatilization of body fluid moisture. It is practiced to seal the insertion portion in a pseudo manner.
- a cuff member also called skin force
- a fabric bellow mainly made of polyester fiber is wrapped around the puncture input-yure, and the fabric velor and the subcutaneous tissue are fixed to the puncture portion by suturing, and the force is applied.
- -Yure is in custody.
- the catheter is indwelled by fixing a fiber bolster, such as polyester fiber cap, as a cuff member to the skin insertion position of the catheter, and suturing the subcutaneous tissue so as to press the cuff member. are doing.
- a fiber bolster such as polyester fiber cap
- Some of these fabric velours are impregnated with collagen or the like to achieve more robust adhesion.
- a cuff member made of a member having excellent biocompatibility is fixed to the subcutaneous tissue at the insertion part.
- the blood circulation method using an assisted artificial heart is a therapy that assists blood circulation by a pulsation pump installed outside the patient, the vibration of the pulsation pump equivalent to about 1.5 Hz -I tell Yure. That is, the force-Yure piercing portion is always subjected to a mechanical load due to vibration. Furthermore, when the patient changes his or her body position, No matter how the force-Yure moves, a stress is generated at the adhesive interface between the subcutaneous tissue and the cuff member in an attempt to remove it.
- a typical example of a problem that is considered to be due to a decrease in the adhesion between the cuff member and the subcutaneous tissue due to these stress loads is an infection problem such as a tunnel infection. The number of experiences of infection troubles is very large. Considering the complications of bacterial infection and its effects on heart failure, it is urgent to develop a cuff member that can prevent infection in this therapy.
- a cuff member or the like mainly composed of collagen has been developed.
- the volume is increased by absorbing a liquid such as physiological saline, alcohol, isodine, blood, and body fluid. Therefore, it is difficult to grow subcutaneous tissue at the catheter insertion site, and as a result, the effect of suppressing downgrowth has not been obtained.
- a cuff material using a sponge-like material capable of growing subcutaneous tissue a material in which a biocompatible resin-made porous body is placed in an insertion tube such as a catheter is disclosed in Japanese Patent Application Laid-Open No. Hei 4-502722. No. 5,009,045.
- a cuff material even if the subcutaneous tissue infiltrates the porous part and is organized, the epidermis sneaks into the subcutaneous tissue along the puncture tube without adhering to the porous body. Downgrowth is not suppressed.
- a cuff material in which a subcutaneous tissue infiltrates the disc surface by combining a substantially disc-like porous body and a cylindrical porous body has been considered. Good infiltration Although it is effective in suppressing downgrowth, the adhesion of the epidermis is not achieved, and a gap is created between the epidermis and the discoid porous body as the epidermis crawls on the extracorporeal exposed part of the catheter, Here, there was a problem that pocket infection was caused by factors such as accumulation of pus and disinfectant debris.
- the present invention has been achieved in view of the problems of the prior art, and an object of the present invention is to provide a cuff member unit in which exposure due to a downgrowth action is suppressed and a cuff member therefor.
- the subcutaneous tissue forces can easily penetrate and engraft the cells in the living body, and adhere to the subcutaneous tissue by the formation of capillaries, thereby suppressing the progress of downgrowth.
- it is a cuff material that reduces the risk of various infections, including tunnel infections, and improves the isolation between the subcutaneous tissue and the outside world, and enables patients to take a shower even in assisted heart therapy. It is an object of the present invention to provide a cuff member.
- the cuff member of the first aspect is a cuff member having a flange portion that overlaps the outer surface of a living body and a cylindrical portion that is provided with one surface force of the flange portion, and is made of thermoplastic resin or formed at the substrate ⁇ consisting thermally hardening property ⁇ , an average pore diameter of 50- 1000 m, an apparent density of 0.5 01-0. of 5GZcm 3, a porous three-dimensional network structure portion with a communicability It is characterized by having.
- the cuff member of the second aspect is a cuff member of a living body insertion tube, and includes a first flange portion overlapping the living body, and a cylindrical portion provided with one surface force of the first flange portion.
- a second flange portion having one surface overlapping the other surface of the first flange portion; and a polymer material pad overlapping the other surface of the second flange portion.
- Part and cylindrical part are formed of a base resin made of thermoplastic resin or thermosetting resin, average pore size 100-1000 m In apparent density 0.5 01-0.
- the second flange portion is made of a thermoplastic ⁇ or thermosetting ⁇ It is characterized by having a porous three-dimensional network structure having an average pore diameter of 1 to 100 m and an apparent density of 0.05 to lgZcm 3 , which is formed of a resin base material, and which has communicability. is there.
- the cuff member of the first and second aspects has a communicating porous three-dimensional network structure portion made of a thermoplastic resin or a thermosetting resin having the specific average pore diameter and apparent density described above. Therefore, cells easily invade into the pores of the porous three-dimensional network structure and survive, and a strong adhesion with living tissue is obtained.
- the subcutaneous tissue force of the living body easily penetrates and survives, and the capillary is constructed, whereby the adhesion with the subcutaneous tissue is robustly obtained.
- the adhesion with the subcutaneous tissue is robustly obtained.
- it isolates the wound from the outside world, protects against aggravating factors such as bacterial infection during the healing process, suppresses the progress of downgrowth, reduces tunnel infections and other various infection troubles, and provides cuff members. .
- the cuff members of the first and second aspects are a blood circulation method using an assisted artificial heart, which is a treatment for subcutaneously inserting a force-Eureta catheter, a peritoneal dialysis treatment, a central parenteral nutrition, a transgastric fistula nutrition. It can be suitably used for a living skin puncture site such as a power-Yure DDS and a transcatheter DDS.
- the flange portion is covered by the pad, and the pad extends outside the flange portion. Therefore, it takes much time for the downgrowth effect of the skin to reach the tubular portion, and it is possible to prevent water from penetrating into the subcutaneous tissue along the force-Yure.
- the first flange portion covered by the polymer resin pad since the first flange portion covered by the polymer resin pad is present, it takes a long time for the downgrowth action to reach the cylindrical portion, and the liquid is removed. Infiltration into the subcutaneous tissue along the force-ure is also prevented.
- the first flange is implanted subcutaneously and is organized by infiltration of the subcutaneous tissue.
- the end of the epidermis existing on the first flange is adhered to the edge of the second flange, so that it can be crawled on the polymer resin pad and can be mounted without going up. The phenomenon that the skin sneaks under the polymer resin pad is prevented for a long time.
- the cuff member unit can be attached to the living body without being affected by downgrowth for a long period of time, and the patient can be showered in the assisted artificial heart therapy without piercing and wetting the Yure. It is also possible to take a bath.
- the pad overlaps the outer surface of the living body, vibration such as pulsation of the tube is transmitted to the living body even through the pad, and the stress applied to the living body is dispersed in a wide range.
- the epidermis is fixed to the second flange by bonding it to the second flange, so it is possible to mount the epidermis without lifting the epidermis above the pad, and to prevent the epidermis from trying to dive under the pad. By stopping, the infection pocket can be prevented from being formed.
- FIG. 1 is a configuration diagram of a cuff member according to an embodiment.
- FIG. 2 is a sectional view showing an example of use of the cuff member of FIG. 1.
- FIG. 3 is an explanatory diagram of a comparative example.
- FIG. 4 is a configuration diagram of a cuff member according to another embodiment.
- FIG. 5A and FIG. 5B are configuration diagrams of a cuff member according to still another embodiment.
- FIG. 6 is a typical SEM photograph of a cut surface of a porous structure.
- FIG. 7 is a view showing a pore size distribution of a porous structure.
- FIG. 8 is a photograph showing a situation in which a skin of a goat and a pad are well bonded on an organized flange portion using a cuff member of a first aspect.
- FIG. 9 is a photograph showing a state where infection and a downgrowth phenomenon were observed along tube 6 in a comparative example.
- FIG. 10a and FIG. 10b are configuration diagrams of a cuff member unit according to an embodiment of the second aspect.
- FIG. 11 is a sectional view showing an example of use of the cuff member unit of FIG.
- FIG. 12 is a configuration diagram of a cuff member unit according to another embodiment.
- FIG. 13a and FIG. 13b are configuration diagrams of a cuff member unit according to still another embodiment.
- FIG. 14 is a view showing a pore size distribution of a porous structure of a second flange portion.
- FIG. 15 is a photograph showing how a cuff member is embedded in a goat.
- FIG. 16 is a photograph showing a situation in which a skin and a pad portion of an adult goat are well bonded on an organized flange portion using a cuff member unit of a second aspect.
- FIG. 17 is a photograph showing a tissue infiltrated into a porous structure layer.
- FIG. 18 is a photograph of the cuff member of the second aspect three months after the operation.
- FIG. 19 is a photograph of the cuff member of the second aspect 12 months after the operation.
- FIG. 20 is a photograph showing a tissue specimen near the boundary between the second flange of the cuff member of the second aspect and the epidermis 12 months after the operation.
- FIG. La is an exploded perspective view of the cuff member according to the embodiment of the first aspect
- Fig. Lb is a longitudinal cross-sectional view of this cuff member
- Fig. 2 is a cross-sectional view showing an example of use of this cuff member.
- FIG. 3 is a sectional view showing a comparative example
- FIGS. 4 and 5 are longitudinal sectional views of a cuff member according to another embodiment of the first aspect.
- the cuff member 2 has a flange portion 3 and a cylindrical portion 3b erected from one surface of the flange portion 3.
- a circular opening 3a having a diameter of about 5 to 100 mm is provided coaxially with the cylindrical portion 3b.
- a plurality of tubes 6 can be passed through the cuff member.
- the force to pierce the patient with two tubes 6 force-Yure
- two openings 5a are provided in the pad 5 and the flange 3 is provided in the flange 3.
- two tubes can be inserted into one cuff member, and there is a possibility that invasion to the patient can be reduced. It is better to insert two blood cuffs or cuff members independently of the blood supply vessel and the blood removal vessel, or it is better to insert the blood supply blood vessel and the blood removal vessel at the same time with one cuff member or cuff member unit. Alternatively, the person skilled in the art can appropriately use them in consideration of clinical significance, patient condition, degree of invasion, or insert a blood vessel and a blood vessel into one thicker tube. It is also possible to insert the single tube into a living body via a cuff member or a cuff member unit, and to insert the tube in a so-called double lumen type. Of course, besides Assist Artificial Heart Therapy Multiple linear structures such as power cords, control cords, measurement cords, and thin tubes for DDS can be combined into a single tube and inserted through a cuff member or cuff member unit. .
- the diameter of the opening 3a is the same as the inner diameter (diameter) of the cylindrical portion 3b.
- the cuff member 2 is made of a porous resin material having excellent adhesion to a living tissue, which will be described later, and is provided with the cylindrical portion 3b and the flange portion 2 integrally.
- the flange 3 may have a plan view shape such as a circular shape, an elliptical shape, a lens shape, and a teardrop shape. However, in general, when the skin is cut straight with a scalpel, the shape shown in FIG. Since the living tissue is exposed in an elliptical shape as exemplified, it is preferably an elliptical shape capable of efficiently covering the exposed site.
- the thickness of the flange portion 3 is related to complex factors such as the average pore diameter of the cuff member 2 and its inclination (these affect the depth of tissue infiltration and the degree of differentiation) described later. However, usually about 0.05 to 20 mm is preferable.
- the flange 3 When the flange 3 is circular, its diameter is preferably about 10 to 200 mm. When the flange 3 is elliptical, lens-shaped, teardrop-shaped, or the like, the major axis is preferably 10 to 200 mm, and the minor axis is preferably about 5 to 80% of the major axis.
- the length of the cylindrical portion 3b is preferably about 10 to 500 mm, and the thickness of the cylindrical portion 3b is not only the physical strength of the cylindrical portion 3b, but also the average hole diameter of the cuff member 2 described later and the thickness thereof. Although complicated factors such as the gradient (these affect the tissue infiltration depth and the degree of diversion) are related, usually 0.05 to 20 mm is preferable.
- the cylindrical portion 3b is not limited to a linear shape, and the insertion site force can be freely bent and used along the tube.
- a pad 5 is superimposed on the other surface of the flange portion 3 of the cuff member 2, and is integrated by bonding or the like.
- the pad 5 has a similar shape to the flange 3, but is preferably smaller than the flange 3.
- the pad 5 is provided with an opening 5a coaxial with the opening 3a of the flange portion 3 and the same size as the opening 3a.
- the node 5 is made of polychlorinated vinyl resin, polyurethane resin, polyamide resin, polylactic acid resin, polyolefin resin, polyester resin, fluorine resin, urea resin, phenol resin, and epoxy resin. Fat, polyimide resin, silicone resin, acrylic resin, metharyl resin, chitin, chitosan, keratin, hyaluronic acid, fiber mouth, and derivatives thereof It is made of one or more selected polymer materials.
- the thickness of the pad 5 is preferably about 0.1 to 100 mm, which is a force related to the flexibility of the polymer material. What is necessary is just to select suitably by those skilled in the art according to the site
- the cuff member 2 is suitably used for inserting the external force tube 6 into a living body.
- the tube 6 is inserted through the openings 5a and 3a and the cylindrical portion 3b, and is bonded to the pad portion 5 in a water-tight manner by high-frequency fusion, heat fusion, laser fusion, ultrasonic fusion, an adhesive, or the like.
- high-frequency fusion heat fusion
- laser fusion laser fusion
- ultrasonic fusion an adhesive
- the nod 5 and the tube 6 are fixed with an adhesive 7.
- the skin is incised to expose the tissue as shown in Fig. 2, and the subcutaneous tissue at the outer edge of the exposed tissue is slightly removed. Peel off to create a pocket.
- the living tissue is incised, the tube 6 is inserted into the living tissue, and the flange portion 3 is overlapped on the outer surface of the living tissue.
- the tubular portion 3b is embedded together with the tube 6 into the living tissue.
- the living tissue incision around the tube 6 is sutured as needed.
- the first flange portion 3 covers the exposed surface of the living tissue and is implanted in a pocket formed by exfoliating the subcutaneous tissue, that is, under the epidermis.
- the second flange portion 4 is superimposed on the edge of the skin around the exposed surface of the living tissue.
- the second flange portion 4 may be sutured to the epidermis. Since the second flange portion is made of a material having a flexible three-dimensional network structure, the sewing can be easily performed with a normal suturing needle.
- the adhesive tape (not shown) having air permeability and water shielding is attached to the outer edge of the second flange portion 4 and the skin around the outer edge of the second flange portion 4, water or the like can be obtained. It is also possible to prevent infiltration.
- the tube 6 When the tube 6 is inserted into the living tissue using the cuff member 2 as described above, the down growth of the skin will initially progress toward the boundary surface between the second flange portion 4 and the first flange portion. However, since there is no physical space where the epidermis can penetrate here, the epidermis is directed toward the outer edge of the first flange, and finally toward the lower side of the first flange, that is, the suture is stitched. Partial force Try to progress to regress.
- the tissue infiltrating the first flange portion penetrates through the flange and reaches the back of the epidermis, retraction of the epidermis that has been able to communicate with the living tissue is significantly suppressed on the first flange.
- the skin end is kept in close contact with the second flange.
- the stress that is pumped from the tube 6 to the living body due to the pulsation of the tube 6 is transmitted to the living body even through the nod 5, and the stress is dispersed over a wide range.
- the stimulus applied to the living tissue around the tube 6 is reduced.
- FIG. 3 shows a cylindrical cuff member 8 made of the same material as that of the cuff member 2, as disclosed in Japanese Patent Publication No. 4 502722, attached to the outer surface of the tube 6, and inserted into a living tissue.
- the following shows a comparative example.
- the tube 6 is a force extending perpendicular to the external surface of the living body.
- the tube 6 in Fig. 5a, 5b may be extended obliquely like the tube 6A in Fig. 4. It may extend along the pad 5 like 6B. This may be appropriately selected by those skilled in the art in consideration of the relationship between the patient's body position and the medical device to which the insertion tube is connected, the weight of the tubes 6, 6A, and 6B, the movable width, and the like.
- FIG. 10a is an exploded perspective view of a cuff member 2 'according to an embodiment of the second aspect
- Fig. 10b is a longitudinal sectional view of the cuff member
- Fig. 11 is a cross section showing an example of use of the cuff member.
- FIGS. 12 and 13 are longitudinal sectional views of a cuff member according to another embodiment of the second aspect.
- the cuff member 2 includes a first flange portion 3, a cylindrical portion 3b in which one surface force of the first flange portion 3 is also provided, and a second flange portion. 4 and a pad 5.
- a circular opening 3a having a diameter of about 5 to 100 mm is provided coaxially with the cylindrical portion 3b.
- the second flange portion 4 and the pad 5 are also provided with openings 4a and 5a having the same diameter as the opening 3a. Therefore, the diameter of the openings 3a, 4a, 5a is the same as the inner diameter (diameter) of the cylindrical portion 3b.
- the tube 6 is inserted through these openings 3a-5a and the cylindrical portion 3b.
- the cuff shown Although one tube 6 is inserted into the member, a plurality of tubes 6 can be passed by providing a plurality of sets of openings and cylindrical portions.
- a plurality of tubes 6 can be passed by providing a plurality of sets of openings and cylindrical portions.
- two tubes 6 force-Yure
- two openings 5a are provided in the pad 5 and the flanges 3 and 4 are provided.
- two tubes can be inserted with one cuff member or cuff member unit, thereby invading the patient. May be reduced.
- the first flange portion 3, the cylindrical portion 3b, and the second flange portion 4 are made of a porous resin material excellent in adhesion to a living tissue described later.
- This porous resin has a three-dimensional network porous structure.
- the cylindrical portion 3b and the first flange portion 3 are provided integrally.
- the first flange portion 3 may have a plan view shape such as a circular shape, an elliptical shape, a lens shape, or a teardrop shape. Since the living tissue is exposed in an elliptical shape as exemplified in (1), it is preferable that the exposed portion is an elliptical shape that can efficiently cover the exposed portion.
- the thickness of the first flange portion 3 is not only the physical strength of the first flange portion 3 but also the average pore diameter of the first flange portion 3 described later and the inclination thereof (these affect the tissue infiltration depth and the degree of dilation). ), But a factor of 0.2 to 50 mm, especially 0.2 to 10 mm, especially about 17 mm is suitable.
- the diameter is preferably about 10 to 200 mm.
- the major axis is preferably 10 to 200 mm, and the minor axis is preferably about 5 to 80% of the major axis.
- the length of the cylindrical portion 3b is preferably about 10 to 500 mm.
- the wall thickness of the cylindrical portion 3b is complicated, such as the average pore diameter of the first flange portion 3 described later and the inclination thereof (these affect the tissue infiltration depth and the degree of differentiation). Although various factors are related, usually 0.05 to 20 mm is preferable.
- the cylindrical portion 3b is not limited to a linear shape, and can be used by freely bending along the tube from the insertion site.
- the second flange portion 4 is slightly smaller in size than the first flange portion 3, and the outer edge of the first flange portion 3 is preferably 10 to 20 mm larger than the outer edge of the second flange portion 4, and particularly preferably about 10 to 20 mm. It will overhang by about 15mm.
- the second flange portion 4 is provided with a concave portion 4b, and the pad 5 is fitted and arranged in the concave portion 4b.
- the width of the second flange 4 extending from the outer edge of the pad 5 is preferably about 0.1 to 30 mm.
- the width of the second flange portion 4 extending from the outer edge of the pad 5 may vary in the thickness direction of the second flange portion 4, for example, 3 mm or less on the upper surface of the pad, and the first flange portion It may be lmm-30mm on the bottom surface in contact with 3.
- the material and thickness of the pad 5 are the same as in the case of the first aspect.
- the flange portions 3, 4 and the pad 5 are overlapped and integrated by, for example, bonding with an adhesive.
- the tube 6 is passed through the openings 5a, 4a, 3a and the tubular portion 3b, and is watertightly sealed to the pad portion 5 by high-frequency welding, heat welding, laser welding, ultrasonic welding, an adhesive, or the like.
- the pad 5 and a part or all of the tube 6 can be integrally molded by using injection molding. In this embodiment, the nod 5 and the tube 6 are fixed by the adhesive 7
- the skin is incised to expose the living tissue as shown in Fig. 11, and the subcutaneous tissue at the outer edge of the exposed tissue is slightly removed. Peel off to create a pocket.
- the living tissue is incised, the tube 6 is inserted into the living tissue, and the cylindrical portion 3b is embedded in the living tissue together with the tube 6.
- the biological tissue incision around the tube 6 is sutured as needed.
- the first flange portion 3 covers the exposed surface of the living tissue and is embedded in a pocket created by peeling the subcutaneous tissue, that is, under the epidermis.
- the second flange portion 4 is overlaid on the edge of the skin around the exposed surface of the living tissue.
- the second flange portion 4 may be sutured to the epidermis. Since the second flange portion also has the material strength of a flexible three-dimensional network structure, it can be easily sewn with a normal suturing needle. Further, an air-permeable and water-blocking adhesive tape (not shown) is attached so as to straddle the outer edge of the second flange portion 4 and the skin around the outer edge to prevent water or the like from entering. Kai.
- the tube 6 When the tube 6 is inserted into the living tissue using the cuff member 2 'in this manner, the downgrowth of the skin initially proceeds toward the boundary surface between the second flange portion 4 and the first flange portion. However, there is no physical space where the epidermis can penetrate. In the direction of the outer edge of the joint portion, finally, it is aimed at the lower side of the first flange portion, that is, the epidermis tries to proceed so as to retreat at the suture site.
- the tissue infiltrated into the first flange portion of the living tissue penetrates through the flange and reaches the back of the epidermis, so that the epidermis that can communicate with the living tissue
- the retraction on the first flange is remarkably suppressed, and the end of the epidermis is maintained in close contact with the second flange.
- the tube 6 is a force extending perpendicular to the outer surface of the living body.
- the tube 6 in Figs. 13a and 13b may be extended obliquely like the tube 6A in Fig. 12. It may extend along the pad 5 like 6B. This may be appropriately selected by those skilled in the art in consideration of the relationship between the body position of the patient and the medical device to which the insertion tube is connected, the weight of the tubes 6, 6A, 6B, the movable width, and the like.
- a tube guide tube 5g is provided integrally with the nod 5.
- a large-diameter hole that largely deviates from the average pore diameter may exist on the contact surface side with the living tissue. Pore of about 500-2000 m is preferred as such a hole. Being near the surface layer on the body tissue side makes it easy to uniformly impregnate the extracellular matrix such as collagen to the deep part, and also has an advantageous effect such as invasion of cells from the tissue and construction of capillaries. .
- a large-diameter pore is not introduced into the concept of calculating the average pore diameter of the porous three-dimensional network structure in the present invention.
- the average pore diameter of the porous three-dimensional network structure of the first flange portion 3 and the tubular portion 3a is 50- 100 0 / zm particularly 100- 1000 m, an apparent density is 0. 01-0. 5gZcm 3
- the preferred average moss diameter is 150-600 m, more preferably 200-500 m. If the apparent density is within the range of 0.01 to 0.5 gZcm 3 , the cell engraftability is good, excellent physical strength is maintained, and cells are invaded and engrafted, and
- the force to obtain an elastic property close to that of the subcutaneous tissue is preferably 0.03-0.3 gZcm 3 , more preferably 0.05-0.2 g / cm 3 .
- the pore size distribution is desirably high at 150 to 400 m, which is an important pore size for cell invasion.
- the contribution ratio of the pores is 10% or more, preferably 20% or more, more preferably 30% or more, still more preferably 40% or more, and particularly preferably 50% or more, the cells can easily invade. This is preferable because the adhered cells easily adhere and grow.
- the contribution rate of pores having a pore diameter of 150 to 400 ⁇ m in the average pore diameter of the porous three-dimensional network structure is based on the total number of pores in the method of measuring the average pore diameter in Example 1 described later.
- porous three-dimensional network structure having an average pore size, apparent density, and pore size distribution, cells easily penetrate into pores, and cells adhere to and grow in the porous three-dimensional network structure.
- Capillaries can be easily constructed, and a good cuff member can be obtained in which the adhesion between the subcutaneous tissue and the catheter or force-eure at the puncture site is strong and strong.
- the second flange portion 4 has an average pore diameter of the porous three-dimensional network structure of 5 to 80 ⁇ m and an apparent density of 0.1 to 0.7 gZcm 3 , particularly the porous three-dimensional network structure. It is preferable that the apparent density is 0.1-0.5 gZcm 3 with the average pore diameter of the part being 10 ⁇ 10.
- the thickness of the second flange portion 4 is preferably 0.1 to 10 mm, particularly preferably 0.5 to 5 mm.
- the thermoplastic resin or thermosetting resin constituting such a porous three-dimensional network structure portion includes polyurethane resin, polyamide resin, polylactic acid resin, polyolefin resin, polyester resin, One or more of fluorine resin, urea resin, phenol resin, epoxy resin, polyimide resin, acrylic resin and methacrylic resin and derivatives thereof can be exemplified, but polyurethane resin is preferred. Among them, a segmented polyurethane resin is preferable.
- the segmented polyurethane resin is synthesized by a three-component force of a polyol, a diisocyanate and a chain extender, and has an elastomer characteristic due to a block polymer structure having a so-called hard segment portion and a soft segment portion in a molecule.
- the elastic properties obtained when using such a segmented polyurethane resin show that the subcutaneous tissue can be used when the patient, catheter or force-eure moves, or when the skin around the puncture site is powered during disinfection. The effect of attenuating the stress generated at the interface between the cuff member and the cuff member can be expected.
- a layer having the specific porous three-dimensional network structure may be used as a first layer, and a second layer having a different structure may be further laminated on the first layer. It is possible.
- a fiber aggregate or a flexible film, or a porous three-dimensional network structure layer having an average pore diameter different from the porous three-dimensional network structure of the first layer ⁇ an apparent density can be used. Noh.
- the non-woven fabric or woven fabric preferably has a porosity in the range of 100 to 5000 cc Zcm 2 Zmin in terms of flexibility, suture strength with subcutaneous tissue, and the like.
- the porosity is a value measured according to JIS L 1004, and may be referred to as air permeability or air permeability.
- the fiber aggregate includes a polyurethane resin, a polyamide resin, a polylactic acid resin, a polyolefin resin, a polyester resin, a fluorine resin, an acrylic resin, a methacrylic resin, and a derivative thereof. It may be made of one or more selected synthetic resins, and may be a natural resin such as one or more selected from fibrous mouth, chitin, chitosan, cellulose and derivatives thereof. It is also possible to use fiber-based materials is there. Synthetic fibers and fibers derived from natural products may be used in combination.
- Examples of the flexible film include thermoplastic resin films, specifically, polyurethane resin, polyamide resin, polylactic acid resin, polyolefin resin, polyester resin, fluorine resin, and urea resin. Phenolic resin, epoxy resin, polyimide resin, acrylic resin and methacrylic resin, and a group consisting of one or more selected from the group consisting of these derivatives. It is a film of one or more selected from the group consisting of fluorinated resin, polyurethane resin, acrylic resin, butyl chloride, fluorinated resin and silicone resin.
- the thickness of the flexible film is preferably from 0.1 to 500 ⁇ m, particularly from 0.1 to 100 ⁇ m, especially from 0.1 to 50 ⁇ , and most preferably from 0.1-.
- the flexible film not only a solid film but also a porous film or a foam can be used.
- a cuff member having a large bacterial barrier property and effective for infection control can be obtained.
- the porous three-dimensional network When the second layer is a porous three-dimensional network having an average pore diameter / apparent density different from the porous three-dimensional network of the first layer, the porous three-dimensional network has an average pore diameter of Diameter. 1 Apparent density at 200 m. 01—1. OgZcm 3 , thickness. . A porous three-dimensional mesh structure of about 2 to 20 mm can be used.
- the second layer is formed of a fiber aggregate, a flexible film, and a porous three-dimensional network structure of the first layer.
- a method of bonding using an adhesive in particular, sandwiching a hot-melt nonwoven fabric between the first and second layers
- a hot-melt nonwoven fabric for example, a polyamide-type thermo-adhesive sheet such as PA1001 manufactured by Nitto Bo Co., Ltd. can be used.
- the polymer dope can be continuously laminated and formed by laminating and molding a fiber aggregate or a flexible film.
- the second layer may be a fiber aggregate, a flexible film, a porous three-dimensional network structure layer.
- a three-layer structure in which the porous three-dimensional network structure layer of the first layer is laminated via the second layer may be used.
- the porous three-dimensional network structure portions of the cuff members of the first and second aspects include collagen type I, collagen type II, collagen type III, collagen type IV, athero-type collagen, fibronectin, gelatin, Hyaluronic acid, heparin, keratanic acid, chondroitin, chondroitin sulfate, chondroitin sulfate B, elastin, heparan sulfate, laminin, thrombospondin, vitronectin, osteonetatin, entactin, hydroxyethylinomethacrylate and dimethylaminoethyl methacrylate Group consisting of polymer, copolymer of hydroxyethyl methacrylate and methacrylic acid, alginic acid, polyacrylamide, polydimethylacrylamide, and polyvinylpyrrolidone.
- embryonic stem cells which may be differentiated
- vascular endothelial growth factor angiopoi
- the cuff member of the first and second aspects can provide fine pores also in the skeleton itself made of thermoplastic resin or thermosetting resin that constructs the porous three-dimensional network structure layer. is there.
- Such micropores make the skeletal surface not a smooth surface but a complex uneven surface, and it is also effective for holding collagen and cell growth factors, etc., and as a result, it is possible to improve cell engraftment It is.
- the micropores in this case are not introduced into the concept of calculating the average pore diameter of the porous three-dimensional network structure layer in the present invention.
- the method for producing a cuff member of the present invention is as follows. The method is not limited.
- thermoplastic polyurethane resin In order to produce a porous three-dimensional network structure made of a thermoplastic polyurethane resin, first, a polyurethane resin, a water-soluble polymer compound described later as a pore-forming agent, and a good solvent for the polyurethane resin are used. To produce a polymer dope. Specifically, after mixing the polyurethane resin with an organic solvent to form a uniform solution, a water-soluble high molecular compound is mixed and dispersed in the solution. Examples of the organic solvent include N, N-dimethylformamide, N-methyl-2-pyrrolidinone, tetrahydrofuran and the like. If the thermoplastic polyurethane resin can be dissolved, this is not a limitation. Also, reduce or use the organic solvent. Instead, the polyurethane resin can be melted by the action of heat, and a pore-forming agent can be mixed therewith.
- water-soluble polymer compound as the pore-forming agent examples include polyethylene glycol, polypropylene glycol, polyvinyl alcohol, polyvinyl pyrrolidone, alginic acid, carboxymethinoresenorelose, hydroxypropinoresenorelose, methinoresenorelose, Forces such as ethynolessinose are not limited as long as they are uniformly dispersed with thermoplastic resin to form a polymer dope.
- lipophilic conjugates such as phthalic acid esters and noraffin, which are water-soluble polymer compounds, and inorganic salts such as lithium chloride and calcium carbonate. is there.
- a crystal nucleating agent for a polymer to promote the formation of secondary particles during coagulation, that is, the formation of a skeleton of a porous body.
- the polymer dope produced from a thermoplastic polyurethane resin, an organic solvent, a water-soluble polymer compound, or the like is then immersed in a coagulation bath containing a poor solvent of the thermoplastic polyurethane resin, and the organic solvent is added to the coagulation bath. And the water-soluble polymer compound is extracted and removed. By removing part or all of the organic solvent and the water-soluble polymer compound in this manner, a porous three-dimensional network structure material made of a polyurethane resin can be obtained.
- the poor solvent used here include water, lower alcohols, and ketones having a low carbon number.
- the coagulated polyurethane resin is finally washed with water, etc., and the remaining organic solvent pore forming agent Should be removed.
- Example 1 a cuff member having the shape shown in FIG. Lb according to the first aspect was prepared, and a goat transplantation experiment was performed. Animal experiments were conducted appropriately in consideration of ethics in accordance with international standards.
- Thermoplastic polyurethane resin (Milactran E980PNAT, manufactured by Nippon Milactran Co., Ltd.) was added to N-methyl-2-pyrrolidinone (Kanto Iridaku Co., Ltd., peptide synthesis reagent, NMP) using a dissolver (about 2, OOOrpm) at room temperature. Dissolved below to give a 12.5% solution (weight Z weight). Approximately 1. Okg of this NMP solution was weighed out with a planetary mixer (manufactured by Inoue Seisakusho Co., Ltd., 2. OL preparation, PLM type 2), and weighed in.
- Methyl cellulose equivalent to half the weight of polyurethane resin manufactured by Kanto Chemical Co., (50 cp grade) and stirred at 60 ° C. for 120 minutes.
- the solidified polyurethane resin was taken out of the frame made of fluororesin and washed in purified water of Japanese Pharmacopoeia for 72 hours to extract and remove methylcellulose, methanol and remaining NMP. This is dried under reduced pressure (20 mmHg) at room temperature for 24 hours, A porous three-dimensional network material made of plastic polyurethane resin was obtained.
- the average pore diameter and the apparent density were measured by the following methods.
- the cutting of the sample was performed at room temperature using a double blade force razor (manufactured by Feather, high stainless steel).
- the plane (cut surface) of the sample cut with a double-edged razor was scanned with an electron microscope (Topcon, SM200
- a typical example is shown in Fig. 6, and individual holes on the same plane are image-processed as a figure surrounded by the skeletal force of a three-dimensional network structure.
- the image was captured using a LUZEX AP, and the LEN50 from Sony Corporation was used as the CCD camera.) And the area of each figure was measured. This was defined as the true circle area, and the diameter of the corresponding circle was determined as the hole diameter.
- the pore size distribution was measured for all the measured pores, and is shown in FIG.
- the contribution rate of the pore diameter of 150 to 400 m was measured.
- the average pore diameter of the porous structure was 286.1 m, and the contribution rate of the pore diameter of 150 to 400 m was 87.6%. Was measured.
- the porous structure is cut into a rectangular parallelepiped of about 10 mm X 10 mm X 3 mm with a double-edged razor, and the volume is calculated from the dimensions obtained by measuring with a projector (Nikon, V-12), and the weight is divided by the volume.
- the apparent power was 0.118 ⁇ 0.006 g / cm 3 .
- thermoplastic polyurethane resin was molded into a cylindrical porous three-dimensional net-like structural material (inner diameter: 7.7 mm, outer diameter: 13.5 mm, length: 50 mm) by the same method as described above (see FIG. 1). Shape 3b).
- thermoplastic polyurethane resin is molded into a mirror-finished sheet with a thickness of 2.Omm using a standard heat press machine, and punched into the shape of pad 5 (100 mm long and 50 mm short) with a Thomson punching blade.
- Tetrahydrofuran (Kanto Iridaku, reagent, special grade) was applied to the surface of this node, The flanges made of the three-dimensional network material were overlapped and pressed together with a load of 1. OkgZcm 2 to open openings 5a and 3a at the center.
- Tube 6 (inside diameter 5. Omm, outside diameter 7.7 mm) is passed through this opening and fixed. Then, the cuff member of the first aspect was manufactured by mounting and fixing the tubular portion 3b so as to surround the tube 6.
- Two adult goats (both female, 54 kg and 53 kg in weight) were used as test samples, and the abdominal epidermis from the shaved left chest was used as the test site.
- the specimens were immediately intubated in the trachea in the left lateral position using conventional techniques, and maintained under general anesthesia with isoflurane.
- the epidermis around the thorax and abdomen was disinfected with isodine, the epidermis was incised by about 100 mm, and the cuff member of the present invention sterilized with ethylene oxide gas was embedded therein.
- the cuff member 2 protruded from the pad 5 over the entire circumference with a width of about 10 mm, and the outer peripheral portion of the cuff member 2 was embedded under the epidermis.
- the cuff member was fixed by suturing the subcutaneous tissue so that the outer peripheral portion of the nod 5 was aligned with the distal end portion of the incised epidermis.
- test site was disinfected twice a day with acidic water. Samples were supplied with water freely, and an appropriate amount (about lkg) of Hay Cube was fed as feed 5 times a day. One and two months after the operation, the previously implanted test piece and surrounding tissues were excised under general anesthesia.
- test piece and the surrounding tissue adhered densely, and peeling from each other was difficult. In addition, no signs of infection, inflammation, etc. were found in the surrounding area.
- FIG. 8 is a photograph of a cross-sectional loupe observing the boundary line where the nod 5 and the skin of the goat have contacted each other with a line on the embedded flange portion 3.
- the edge of the pad 5 and the epidermis do not touch each other, and there is only a forceful gap, and they are adhered and stable, and as shown in FIG. 2, the flange portion 3 of the cuff member adheres to the subcutaneous tissue. It can be seen that the downgrowth phenomenon, which even reaches the contact area between the epidermis and the tube 6 and the subcutaneous tissue, is completely suppressed.
- the cuff member of the first aspect is organically infiltrated by the infiltration of living cells into the flange portion 3 and the cylindrical portion 4, isolates the wound portion from the outside world, and causes bacterial sensation during healing. It was suggested to protect against exacerbation factors such as staining.
- the pad 5 and the flange 3 were removed from the cuff member unit of the first aspect, and a cuff member was manufactured by simply attaching the tubular portion 4 to the tube 6 (inner diameter 2. Omm, outer diameter 3. Omm).
- This cuff member was implanted into a goat in the same manner as in Example 1 so that the upper end of the cylindrical portion 4 was exposed about 2 mm from the epidermis.
- the test piece and surrounding tissues were excised in the same manner as in Example 1. In the deep part of the subcutaneous tissue, the test piece and the surrounding tissue adhered densely, and it was difficult to peel off each other. However, it hardly adhered to the portion near the epidermis, and it was easily peeled off. Fig.
- FIG. 9 is a loupe photograph of a cross section of the test piece and surrounding tissue.In the area near the epidermis, infection, inflammation, etc. were found around the epidermis. It was found that a down-growth phenomenon occurred along with the test piece, and there was consistency between the test piece and the tissue. It was necessary to clean the sebum etc. accumulated in the puncture site twice a day for the disinfection treatment. If this treatment was not carefully performed, infection was immediately caused. Also, the cuff member was easily pulled out by pulling it by hand.
- a polymer dope was obtained in exactly the same manner as in Example 1.
- the polyurethane resin whose fluorinated resin frame strength was also solidified was taken out, and washed in water made by Japanese Pharmacopoeia for 72 hours to extract and remove methylcellulose, methanol and residual NMP. This was dried under reduced pressure (20 mmHg) at room temperature for 24 hours to obtain a porous three-dimensional network material made of thermoplastic polyurethane resin.
- Example 1 The average pore diameter and apparent density of the obtained porous three-dimensional network structure material were measured by the same methods as in Example 1. The results were the same as those of Example 1.
- the second process was performed in the same manner as the molding of the porous body of the first flange.
- the porous structure of the flange portion was molded, and the average pore size and the apparent density were measured in the same manner as the porous structure of the first flange portion.
- the average pore size was 41.
- the pore size distribution is as shown in Fig. 14.
- the contribution ratio of the pores with a force pore size of 30 m to 60 m was 79.0%.
- the visual density was 0.228 ⁇ 0.011 g / cm 3 .
- Milactran E980PNAT was molded into a mirror-finished solid sheet with a thickness of 2 mm by a standard method, and punched out into a true ellipse with a long diameter of 40 mm and a short diameter of 30 mm using a Thomson blade to produce a high molecular weight resin pad 5. .
- the porous structure of the second flange portion having a thickness of 4 mm was punched into a true ellipse having a major axis of 50 mm and a minor axis of 40 mm using a Thomson blade, and the surface was flattened to a 3 mm-thick uniform porous sheet.
- a true elliptical groove with a major axis of 40 mm and a minor axis of 30 mm was carved to a depth of 2 mm in the center, and was cut into the second flange 4. Machining was performed using NC drawing machines (Roland, PNC-3200) based on CAD drawings.
- the porous structure of the first flange portion 3 was punched into a true ellipse having a major axis of 70mm and a minor axis of 60mm, and then the polymer resin pad of the second flange portion 4 was bonded.
- the other side was coated with tetrahydrofuran, superimposed on the first flange portion, and pressed with a load of 1.0 kgZcm 2 . Openings 5a, 4a and 3a were opened in the center.
- the tube 6 (inside diameter 5. Omm, outside diameter 7.7 mm) was fixed through this opening.
- the outer peripheral portion of the first flange portion 3 that protrudes is embedded under the epidermis), and the outer peripheral portion of the second flange portion 4 is aligned with the incised distal end portion of the epidermis to remove the subcutaneous tissue. It was sutured and secured (Figure 15). For one week after the operation, the suture site was disinfected twice a day with acidic water. Samples were provided with free water, and a suitable amount (about lkg) of Hay Cube was fed five times a day as feed. One week after the operation, the patient progressed smoothly without any disinfection treatment, no antibiotics, and no signs of infection.
- Fig. 16 is a photograph of the contact portion between the second flange and the skin of the goat.
- the edge portion of the second flange portion 4 and the skin are stably adhered to each other with only a slight gap, and the first flange portion 3 adheres to the subcutaneous thread and the fabric.
- the downgrowth phenomenon which even reaches the contact site of the epidermis to the tube 6 and the subcutaneous tissue, is completely suppressed.
- the porous three-dimensional network structure layer constituting the first flange portion 3 and the cylindrical portion 3b of the cuff member unit of the present invention has fibroblasts, macrophages, and Granulation tissue mainly composed of extracellular matrix such as collagen fibers was infiltrated, and many angiogenesis was confirmed (Fig. 17). At 1, 3, and 6 months post-mortem examination, it was observed that these infiltrated tissues formed over time into mature connective tissues.
- FIG. 20 The left side of FIG. 20 is an actual photograph of a cross-sectional specimen of a cuff member sample removed 12 months after the operation, and the right side of FIG. 20 is a photograph of a tissue specimen in the same field of view.
- the tissue that has penetrated the first flange reaches the second flange, and is in contact with the epidermis on the first flange to adhere.
- the epidermis is adhered and adhered almost completely to the second flange part ⁇ , and no infectious layer was found at the boundary.
- the cuff member unit of the second aspect is insulated by the infiltration of living cells into the first flange portion 3 and the cylindrical portion 3b, and the second flange portion adheres to the epidermis.
- the wound was isolated from the outside world and protected against exacerbation factors such as bacterial infection in the healing mechanism.
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Anesthesiology (AREA)
- Dispersion Chemistry (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Pulmonology (AREA)
- Biophysics (AREA)
- Chemical & Material Sciences (AREA)
- Hematology (AREA)
- Surgery (AREA)
- Vascular Medicine (AREA)
- Epidemiology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- External Artificial Organs (AREA)
- Materials For Medical Uses (AREA)
Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP05720047A EP1731191A4 (en) | 2004-03-08 | 2005-03-04 | BRASSARD MEMBER |
JP2006510746A JP4779968B2 (ja) | 2004-03-08 | 2005-03-04 | カフ部材 |
US11/506,815 US20070198053A1 (en) | 2004-03-08 | 2006-08-21 | Cuff member |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2004-064563 | 2004-03-08 | ||
JP2004064563 | 2004-03-08 | ||
JP2004064562 | 2004-03-08 | ||
JP2004-064562 | 2004-03-08 |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US11/506,815 Continuation US20070198053A1 (en) | 2004-03-08 | 2006-08-21 | Cuff member |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2005084742A1 true WO2005084742A1 (ja) | 2005-09-15 |
Family
ID=34921722
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP2005/003775 WO2005084742A1 (ja) | 2004-03-08 | 2005-03-04 | カフ部材 |
Country Status (4)
Country | Link |
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US (1) | US20070198053A1 (ja) |
EP (1) | EP1731191A4 (ja) |
JP (1) | JP4779968B2 (ja) |
WO (1) | WO2005084742A1 (ja) |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2008279138A (ja) * | 2007-05-11 | 2008-11-20 | Hi-Lex Corporation | 皮膚ボタン |
JP2008279188A (ja) * | 2007-05-14 | 2008-11-20 | National Cardiovascular Center | カニューレ |
JP2009028150A (ja) * | 2007-07-25 | 2009-02-12 | National Cardiovascular Center | カフ部材及びカフ部材ユニット |
JP2012105721A (ja) * | 2010-11-15 | 2012-06-07 | National Cerebral & Cardiovascular Center | カフ部材及びその製造方法 |
CN106456940A (zh) * | 2014-03-17 | 2017-02-22 | 皮皮创新有限责任公司 | 用于维护和保护被置于患者身体区域的导管的套件 |
CN108938028A (zh) * | 2018-07-30 | 2018-12-07 | 孙治华 | 吸引器头套筒以及其在荷包缝合过程中的应用方法 |
Families Citing this family (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2007098116A (ja) * | 2005-09-09 | 2007-04-19 | National Cardiovascular Center | カフ部材及びカフ部材ユニット |
US8715336B2 (en) * | 2007-04-19 | 2014-05-06 | Medtronic Vascular, Inc. | Methods and apparatus for treatment of aneurysms adjacent to branch arteries |
US20140031753A1 (en) * | 2012-07-25 | 2014-01-30 | Neil T. Winthrop | Thoracostomy devices and methods of use |
US20180214619A1 (en) * | 2017-01-30 | 2018-08-02 | Scivad LCC | Flexible Protection Device For Circulatory Support Device And Related Systems And Methods |
FR3077207A1 (fr) * | 2018-01-29 | 2019-08-02 | Franck Zinzindohoue-Marsaudon | Catheter muni d’un manchon en composite carbone-carbone |
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JP2001129076A (ja) * | 1999-11-01 | 2001-05-15 | Terumo Corp | 腹腔内留置カテーテル用カフ部材 |
WO2003082366A1 (fr) * | 2002-03-28 | 2003-10-09 | Japan As Represented By President Of National Cardiovascular Center | Materiau support d'ingenierie tissulaire, vaisseau artificiel, element de manchette et revetement destine a des implants |
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US4897081A (en) * | 1984-05-25 | 1990-01-30 | Thermedics Inc. | Percutaneous access device |
JPH0342936Y2 (ja) * | 1986-06-18 | 1991-09-09 | ||
US4886502A (en) * | 1986-12-09 | 1989-12-12 | Thermedics, Inc. | Peritoneal access catheter |
CA2033336A1 (en) * | 1989-06-02 | 1990-12-03 | Michael D. Hallett | Porous percutaneous access device |
US5554106A (en) * | 1994-10-13 | 1996-09-10 | Quinton Instrument Company | Hydrocolloid exit site dressing |
US6103255A (en) * | 1999-04-16 | 2000-08-15 | Rutgers, The State University | Porous polymer scaffolds for tissue engineering |
US6544206B1 (en) * | 1999-10-14 | 2003-04-08 | Robert H. Johnston, Jr. | Dialysis access system and method |
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2005
- 2005-03-04 WO PCT/JP2005/003775 patent/WO2005084742A1/ja active Application Filing
- 2005-03-04 JP JP2006510746A patent/JP4779968B2/ja active Active
- 2005-03-04 EP EP05720047A patent/EP1731191A4/en not_active Withdrawn
-
2006
- 2006-08-21 US US11/506,815 patent/US20070198053A1/en not_active Abandoned
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
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JPH04502722A (ja) * | 1989-06-02 | 1992-05-21 | バクスター、インターナショナル、インコーポレイテッド | 多孔質経皮アクセス器具 |
JP2001129076A (ja) * | 1999-11-01 | 2001-05-15 | Terumo Corp | 腹腔内留置カテーテル用カフ部材 |
WO2003082366A1 (fr) * | 2002-03-28 | 2003-10-09 | Japan As Represented By President Of National Cardiovascular Center | Materiau support d'ingenierie tissulaire, vaisseau artificiel, element de manchette et revetement destine a des implants |
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Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2008279138A (ja) * | 2007-05-11 | 2008-11-20 | Hi-Lex Corporation | 皮膚ボタン |
JP2008279188A (ja) * | 2007-05-14 | 2008-11-20 | National Cardiovascular Center | カニューレ |
JP2009028150A (ja) * | 2007-07-25 | 2009-02-12 | National Cardiovascular Center | カフ部材及びカフ部材ユニット |
JP2012105721A (ja) * | 2010-11-15 | 2012-06-07 | National Cerebral & Cardiovascular Center | カフ部材及びその製造方法 |
CN106456940A (zh) * | 2014-03-17 | 2017-02-22 | 皮皮创新有限责任公司 | 用于维护和保护被置于患者身体区域的导管的套件 |
CN108938028A (zh) * | 2018-07-30 | 2018-12-07 | 孙治华 | 吸引器头套筒以及其在荷包缝合过程中的应用方法 |
Also Published As
Publication number | Publication date |
---|---|
US20070198053A1 (en) | 2007-08-23 |
EP1731191A4 (en) | 2010-01-27 |
JPWO2005084742A1 (ja) | 2007-11-29 |
JP4779968B2 (ja) | 2011-09-28 |
EP1731191A1 (en) | 2006-12-13 |
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