JPH0447575B2 - - Google Patents

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Publication number
JPH0447575B2
JPH0447575B2 JP58501556A JP50155683A JPH0447575B2 JP H0447575 B2 JPH0447575 B2 JP H0447575B2 JP 58501556 A JP58501556 A JP 58501556A JP 50155683 A JP50155683 A JP 50155683A JP H0447575 B2 JPH0447575 B2 JP H0447575B2
Authority
JP
Japan
Prior art keywords
tubular body
diameter
linear elements
state
linear
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
Application number
JP58501556A
Other languages
English (en)
Other versions
JPS59500652A (ja
Inventor
Hansu Iuaaru Uarusuten
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
MEDANUAN SA
Original Assignee
MEDANUAN SA
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Family has litigation
First worldwide family litigation filed litigation Critical https://patents.darts-ip.com/?family=20346693&utm_source=google_patent&utm_medium=platform_link&utm_campaign=public_patent_search&patent=JPH0447575(B2) "Global patent litigation dataset” by Darts-ip is licensed under a Creative Commons Attribution 4.0 International License.
Application filed by MEDANUAN SA filed Critical MEDANUAN SA
Publication of JPS59500652A publication Critical patent/JPS59500652A/ja
Publication of JPH0447575B2 publication Critical patent/JPH0447575B2/ja
Granted legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/01Filters implantable into blood vessels
    • A61F2/0105Open ended, i.e. legs gathered only at one side
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2/07Stent-grafts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/95Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/958Inflatable balloons for placing stents or stent-grafts
    • DTEXTILES; PAPER
    • D04BRAIDING; LACE-MAKING; KNITTING; TRIMMINGS; NON-WOVEN FABRICS
    • D04CBRAIDING OR MANUFACTURE OF LACE, INCLUDING BOBBIN-NET OR CARBONISED LACE; BRAIDING MACHINES; BRAID; LACE
    • D04C1/00Braid or lace, e.g. pillow-lace; Processes for the manufacture thereof
    • D04C1/06Braid or lace serving particular purposes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/01Filters implantable into blood vessels
    • A61F2/011Instruments for their placement or removal
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/01Filters implantable into blood vessels
    • A61F2002/016Filters implantable into blood vessels made from wire-like elements
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/01Filters implantable into blood vessels
    • A61F2002/018Filters implantable into blood vessels made from tubes or sheets of material, e.g. by etching or laser-cutting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008Fixation appliances for connecting prostheses to the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0028Shapes in the form of latin or greek characters
    • A61F2230/005Rosette-shaped, e.g. star-shaped
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0069Three-dimensional shapes cylindrical

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Manufacturing & Machinery (AREA)
  • Textile Engineering (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Pulmonology (AREA)
  • Prostheses (AREA)

Description

【発明の詳細な説明】 〔技術分野〕 本発明は、例えば生きている動物または生きて
いる人間の血管または他の接近しにくい部位に用
いられる人工器官または交換器官に関するもので
ある。この人工器官は、可撓性の管状本体を備え
ており、その管状本体の径が伸縮できる構成とな
つている。さらに、本発明は、血管、気管または
それらに類似する部位のための拡張自動固定人工
器官による機械的な経体内管路的移植に特に有用
である。本発明の装置によつて、損傷した血管ま
たはその他の器官の内壁を人工組織によつて内張
りすることも可能である。
外科手術及びその他の医療技術においては、所
定の部位に残される管または器官の系統を所定部
位に支持するために、例えば血管、尿路または他
の接近しにくい部位に装置を挿入し、拡張するこ
とが時々必要となる。
本発明による装置は、また多くの医療に使用す
ることができ、そしてその例として、ある種の管
の拡張によつて顕在化される種々の動脈瘤、また
はこれとは逆に血管の収縮を伴う狭窄症への使用
を挙げることができる。従つて、本発明は、さら
に特定的には静脈組織の管を支持し、且つ拡開状
態に保持し、病理学的な管の破壊部分を閉塞し、
内部の管壁の病理学的な肥大症及び破壊部分を橋
絡し、または気管支を安定させるために使用する
ことができる。本発明による装置は、また例えば
肺塞栓症を防止するために下大静脈に用いて血栓
症のフイルタとして機能させるように設計するこ
とも可能である。本発明は、体内の血管またはそ
の他の管状組織中で使用するための例えば植接用
片のような人工器官として特に好適に使用され
る。しかしながら、本発明は、上述した用途に限
定されるものではなく、前述した用途は単に適用
例として考えるべきものである。
〔背景技術〕
米国特許第3868956号明細書には、例えば血管
中への挿入後に拡張可能な装置が記載されてい
る。この装置の作用部分は、所謂「形状記憶機
能」を有する金属合金であつて、加熱によつて初
期の形状に復帰する材料を使用することに基づい
ている。この先行技術おいては、この材料の加熱
は電気加熱により行われ、装置は関連する部位に
挿入される。しかしながら、この既知の技術は電
気抵抗による加熱を、加熱中に損傷を受ける可能
性のある周囲の感受性の高い組織に関連して行わ
なければならないという基本的な問題を有してい
る。この米国特許明細書(第3欄第42〜48行参
照)には、血管中に装置を挿入する時に患者の血
液が冷却媒体として機能することが示されてい
る。しかしながら、血液もまた、加熱された時に
望ましくない凝固を生ずる感熱性物質である。
〔発明の説明〕
本発明の目的は、既知の技術の欠点を解消する
半径方向に伸縮可能な人工器官を提供することに
ある。
本発明は、可撓性の管状本体を備え、該管状本
体の直径をその管状本体の両端部を軸線方向に相
対的に変位させることにより伸縮変化させること
ができる人工器官を使用することに基づくもので
ある。好適な一実施態様においては、管状本体
は、それ自体が放射方向に拡張した状態となる。
管状本体が無負荷状態に保たれている時、放射方
向への外力は全く作用しない。この管状本体は、
複数のそれぞれに剛性を有するとともに可撓性を
持つた線状要素で構成され、各線状要素は、共通
軸線としての管状本体の中心軸線の回りに螺旋状
に巻回されている。複数の線状要素は、同一の方
向で、軸線方向に相対的に変囲して巻回されてい
る。また、これらの同一方向に巻回された複数の
線状要素は、同様に軸線方向に相対的に変位して
反対方向に巻回された複数の線状要素と交差す
る。
所望の機能を発揮するために、交差する線状要
素の交差角は、管状本体に外部からの負荷が与え
られていない状態で、約60゜よりも大きい角度が
適当であり、約90゜を越える鈍角とすることが好
ましい。
交差する線状要素は、一種の編組形状に形成す
ることが好ましく、この編組形状は、例えば平織
りの技法を利用する等既知の編組技法によつて、
必要に応じて形状を変更できるように構成する。
こうした構成の目的は、管状本体に所要の安定性
を付与するためである。可撓性の管状本体に使用
する線状要素の数をnとした場合、このnは約10
から約50までの範囲とすることが好ましい。管状
本体の線状要素は、それぞれ半分の数の線状要素
を巻回方向を逆にして対称に配置することが望ま
しい。これに関して、以下の説明において管状本
体の複数の線状要素とは、常に管状本体の支持機
能を保持するために必要な数の線状要素を指すも
のである。線状要素の数nは、管状本体の直径、
線状要素の直径、線状要素の材質、及び他の因子
によつて決定される。非常に一般的には、所定の
材料で形成された線状要素の数は、管状本体の径
が増加するに従つて、この管状本体に安定性を付
与するために必要な数が増加するものである。
2個またはそれ以上の管状体が互いの頂部に同
心的に配列されて本体に改善された安定性を与え
る。これは小直径の線状要素を使用する場合そし
て/または要素の数が小さい場合に特に有用であ
る。
本発明による可撓性の管状本体は、生体の血管
またはこれに類する器官の経体内管路的な移植の
ための人工器官として使用するのに非常に適して
いることが判明した。この管状本体は、組織中の
所定の位置に収縮された状態、即ち径が小さな状
態で挿入される。本発明による管状本体は、所定
の位置に挿入された後に拡開され、負荷を与えら
れていない状態における管状本体の径が、周囲の
器官の内壁の径よりも若干大きく選択されていれ
ば、自動固定により所定の位置に拡開状態で保持
することが可能となる。この結果、器官の内壁部
に対して常に係合圧力が作用するものとなり、良
好な安定した固定状態が確実に得られるものとな
る。
この移植方法は、非拡張性の人工器官を使用す
る周知の移植技術に比較して極めて簡単であり、
しかも危険の少ないものとなる。例えば、移植部
位から所定の距離離間した血管の壁部を通して挿
入された、放射方向に収縮された状態の人工器官
を、従来行われていたような置き換えられる器官
の部分を切除することなしに固定することが可能
となる。従つて、血液の流れを全く停止させるこ
となく移植を行うことができるものとなる。さら
に、この人工器官は、血管に縫合することを必要
とせず、挿入後数日を経過すれば、この人工器官
は天然組織の成長によつて完全に体に固定され、
数カ月後には、天然組織の成長が完了して、人工
器官の内壁は新しい天然組織で蔽われることとな
る。
この可撓性の管状本体は、幾つかの方法で放射
方向に拡開することが可能である。多くの理由か
ら、管状本体は、自動的に拡開して無負荷状態と
なる特性を有していることが好ましいことが判明
した。管状本体の拡張または拡開状態は、線状要
素の固有の剛性に左右されるが、生体の外套膜に
接合して設けられ、軸線方向に伸縮可能な弾性
糸、弾性バンド、または弾性膜によつて制御する
ことも可能である。これらの糸、バンドまたは膜
の弾性によつて、管状本体を軸線方向に牽引する
ことによつて、管状本体を拡開状態に保持するこ
とも可能である。
管状本体に、拡開方向の性状を与える他の方法
は、線状要素を交差位置において、溶接、にかわ
接着等の適宜な方法によつて結合させることであ
る。
可撓性の管状本体を形成する線状要素は、薬学
的に認容し得る物質でなければならず、プラスチ
ツクまたは金属によつて形成することができる。
これらの線状要素は、好ましくは弾性とともに所
定の弾力または剛性を持つものである。これらの
線状要素は、例えばポリプロピレン、ダクロンの
ような単繊維(モノフイラメント)または他の好
適なプラスチツクで形成するか、または複合材料
で形成される。また、この線状要素を、スチール
等の薬学的に認容可能な金属材料によつて形成す
ることもできる。
管状本体の線状要素の自由端部は、幾つかの方
法で変形または保護することができる。また、自
由端部を持たない他の変形例としては、管状本体
全体を単一の凝集性要素によつて形成するもので
ある。これと最も密接に関連する変形例は、長い
線材を切断して生じる自由端部を、熱溶接、にか
わ接着等の適宜の方法によつてU字状部材の両側
脚部に連結するものである。この要領により、同
一巻回方向または逆の巻回方向の線状要素を二つ
ずつ結合することができる。
これらの実施態様に換わる実施態様は、線材の
切断以前の材料のリングとの交点を電気抵抗溶接
または溶着等によつて接合して、その後に接合部
に隣接した外側部分で切断することである。この
場合、接合部より外側に延長された端部部分は、
例えば制御しながら加熱することによつてプラス
チツクを軽度に変形させて管状本体の内側に向か
つて折り込むことができる。さらに、他の方法に
よれば、線状要素の自由端をループ状に折り曲げ
るように構成することも可能である。
前述したように、本発明による管状本体は、所
謂植接用片として使用するのに好適である。この
場合、管状本体は、植接用片としての機能を発揮
することができる。即ち、管状本体がそれ自体に
より所望の密度及び多孔性を与えるような線状要
素で構成され、従つて、少なくとも複数の線状要
素が重合繊維(ポリフイラメント)によつて形成
されている場合には、管状本体が植接用片として
の機能を発揮する。所望の密度を管状本体に付与
することのできる線状要素の他の態様は、管状本
体に例えばプラスチツクまたはその他の適宜の材
料によつてある種の表面層を形成するものであ
る。こうした表面層を設けることにより、線状要
素の各交点が同時に接合固定されるので、管状本
体の放射方向に拡開する性状を与えることができ
る。
管状本体の外側または内側若しくは管状本体と
一体に、別のスリーブまたは膜を設けることがで
きる。これは、管状本体とともに移植可能な、管
状本体に被着されるストツキング状の多孔性ウエ
ブで構成することができる。この場合、ストツキ
ング状のウエブは、その伸縮性によつてまたは重
ね合わせて折り畳むことによつて、さらには例え
ば線状要素によつて管状本体を形成したのと同じ
要領で形成することによつて、管状本体の伸縮に
ならつて伸縮する。また、トリコツトタイプの織
物または巻縮繊維織物等も使用が可能なものと考
えられる。こうした別製の部材を使用する場合に
は、大きな管等に取り付ける時に終端位置が正確
となるように管状本体に対して軸線方向に固定す
ることが好ましい。
管状本体の放射方向の伸縮は、管状本体を軸線
方向に伸張、収縮させる手段を備えた装置によつ
て行うことができる。こうした手段は、種々の方
法で設計することができる。例えば、環状本体の
両端部を互いに軸線方向に移動させて、その径を
伸縮させるように構成することが可能である。こ
の装置には、管状本体の両端部を把持し、かつ、
両端部を互いに軸線方向に移動させる把持部材を
設ける必要がある。この把持部材は、管状本体を
所望の部位に配置した後に、管状本体の端部を解
放することが出来るように構成して、管状本体を
除く装置が管状本体の配設位置から除去できるよ
うに構成させる。さらに、この装置は、別の態様
においては、管状本体を収縮状態で内挿した可撓
性チユーブと、所望の配設部位において管状本体
を拡張させながら可撓性チユーブより押し出すこ
とが可能な作動部材とによつて構成することがで
きる。
その他の特徴は、特許請求の範囲の記載から明
かである。
〔実施例〕
以下に、本発明を添付図面に関連して実施態様
により説明する。なお、本発明はこれらの実施態
様に限定されるものではない。これらの実施態様
は添付図面に示されている。
第1A図及び第1B図には、全体を符号1で示
した円筒形の管状本体の形態の人工器官の一例が
示されている。第1A図より明らかなように、管
状本体1の外周壁は、複数の線状要素2,3及び
2a,3aで形成されている。これらの線状要素
のうち、線状要素2,3は、管状本体1の中心軸
線7を共通の軸線として、軸線方向に相互に変位
して、即ち所定位相分移相して、螺旋状に巻回さ
れている。また、他方の線状要素2a,3aも同
様に、管状本体1の中心軸線7を共通の軸線とし
て、軸線方向に相互に変位して螺旋状に巻回され
ているが、その巻回方向は線状要素2,3とは逆
向きとなつている。従つて、第1A図に示すよう
に、二組の線状要素2,3及び2a,3aは相互
に交差して巻回されている。
このように構成された管状本体の直径は、管状
本体の両端部を中心軸線7の方向に互いに変位さ
せることにより、伸縮変化させることができる第
2A図には、第1A図による管状本体1の直径
が、その両端部8,9を矢印方向に互いに離間す
るように移動させることによつて減少させる態様
を例示し、一方、第2B図は、管状本体1の両端
部8,9を互いに離れる方向に移動させて収縮状
態となつた、管状本体1の直径が示されている。
第3図及び第4図は、第1図及び第2図に示し
た部材の詳細を示しており、これに関してさらに
詳述する。第3図及び第4図は、管状本体1の各
個の線状要素を示しており、この線状要素の螺旋
形状は、管状本体1の伸縮に伴つて変化する。
第3図には、第2A図において概括的に参照符
号10で示す線状要素に相当する単体の線状要素
が示されている。この第3図の状態において、螺
旋状の巻回径はd1であり、このときの線状要素1
0の長さはl1である。第4図には、第1A図の管
状本体の状態に対応した拡張状態となつた場合の
線状要素10の形状を示している。この時の螺旋
状の巻回径は第3図のd1からd2に増加するが一
方、長さはl1からl2に減少している。
管状本体は、幾つかの方法で拡張させることが
できる。前述したように、管状本体は、例えば第
1A図の拡張状態を初期状態として、第2A図に
示す収縮状態において初期状態、即ち拡張状態に
復元する復元力を持つていることが好ましい。な
お、本明細書において、「拡張」なる用語は、常
に放射方向への拡張、即ち巻回径の増大を意味す
るものとして使用される。自己拡張性は、管状本
体1の外周壁表面に対して平行に、かつ軸線方向
に延長された糸状部材またはバンド部材11を配
設することによつて付与することができる。この
形式の実施例が第7図に示されている。糸状部材
またはバンド部材11は、好ましくは弾性材料で
形成され、管状本体1を拡張状態とした状態で、
管状本体に弾性負荷のない状態で取付けられる。
管状本体1の両端部が相互に離間する方向に変位
され、管状本体が軸線方向に伸張されて、その径
を縮小されると、弾性をもつ糸状部材またはバン
ド部材11には張力が負荷され、拡張方向の復元
力が蓄積される。この状態で管状本体1に対する
伸張方向の作用力を解除すると、糸状部材または
バンド部材11に蓄積された張力によつて、管状
本体は軸線方向の長さが短縮されて、この結果管
状本体の径が拡張されることとなる。
管状本体1には、前述したように、線状要素
2,3及び線状要素2a,3aの交差点5,6
(第1図)において、相互に固定結合することに
よつても、管状本体1に対して軸線方向の引つ張
り負荷を作用させた収縮状態から、初期の拡張状
態への復元力を付与することが可能である。ま
た、同様の復元力は、弾性材料で形成された薄い
管状部材を管状本体の外周面または内周面に少な
くとも管状本体の両端に固定した状態で被覆する
ことによつても得ることができる。
第5図には、例えば血管の所望の部位に、上記
において説明した自己拡張性を有する管状本体2
0を収縮状態及び拡張状態で挿入するための装置
18が示されている。管状本体20は、装置18
の前部に設ける管状部19を包囲するとともに、
両端部が把持装置21,22に取り付けられてい
る。装置18の前側部に設ける管状部19は、可
撓性のチユーブ部材23を介して作動部材24に
取り付けられている。把持装置21及び22は、
作動部材24の操作部材25,26及び27によ
り所望の状態に制御することができる。
第5図には、管状本体20が、収縮状態にある
装置18を、例えば仮想線28で示した血管中に
挿入する状態を示している。操作部材26を仮想
線29で示した位置まで前進させると、把持装置
22がこれに従つて対応した仮想線30で示す位
置まで前進するように、作動部材24が把持部材
22に連結されている。この結果、この把持部材
22は仮想線30で示す前進位置まで移動する。
この時、他方の把持部材21は固定位置とされて
いる。このため、管状本体20の直径が拡張さ
れ、その端部が仮想線30に到達した時点で、仮
想線31で示したように拡張状態となり、管状部
材が血管の内壁に接触する。このとき管状本体2
0の両端部は依然として把持部材21,22に保
持されているので、図示のように管状本体は両端
部が収縮された風船状の形状となる。
操作部材27も、例えば管状部材23に挿通さ
れたワイヤ等によつて把持部材22に連結されて
いる。操作部材27は、軸線方向に連結されて、
仮想線30の位置に移動された把持部材22を操
作して管状本体20を釈放する。同様に、操作部
材25は把持部材21に連結されており、この操
作部材25を軸線方向に操作することにより管状
本体20の前端部を釈放することができるように
構成されている。両端が釈放されると、管状本体
20は、軸線方向の長さを短縮しながら拡張して
円筒形状に復帰する。
第6図には、装置18の前側部に設ける管状部
19の構成が拡大して詳細に示されている。管状
本体20の前後端部32及び33は、外側可撓性
チユーブ35の内側に同軸に配設された薄い壁部
を有する内側可撓性チユーブ34を包囲して取り
付けられる。これらの可撓性チユーブ34,35
は、第5図の可撓性チユーブ部材23を形成して
いる。内側チユーブ34の前側には、管状部材3
6が配置されている。管状部材36中には、管状
本体20の前端部32が嵌合される。管状本体2
0の後端部33は、同様に環状部材37に嵌合さ
れる。環状部材37の後部には内側チユーブ34
に摺動可能に支持されており、内側チユーブ34
に沿つて軸線方向に移動可能となつている。内側
チユーブ34の前端部には、内側把持部材を形成
する前側ラツチ38が設けられている。この前側
ラツチ38はバネ鋼で形成することが好ましく、
ほぼ直角に折曲されるとともに、尖つた前端部3
9を有している。この前端部39は、内側チユー
ブ34の周壁に形成した孔に挿通して放射方向外
向きに突出する。前端部39は、リング40によ
り放射方向に変位操作可能となつている。リング
40は内側チユーブ34の内側に配設され、軸線
方向に移動可能となつている。リング40はワイ
ヤ41に連結されている。ワイヤ41は、内側チ
ユーブ34に挿通され、軸線方向に進退してリン
グを移動させ、前側ラツチ38を放射方向に変位
させることができるように構成されている。第6
図に示す状態において、前側ラツチ38の前端部
39は環状本体20の前端部32を貫通した状態
で示されている。
後側ラツチ42には、前側ラツチ38と同様に
尖つた前端部43が設けられており、環状本体2
0の後端部33に係合する。この後側ラツチ42
は、外側チユーブ35の外周に設けられており、
外側から環状本体20の後端部33に係合する。
この後側ラツチ42を放射方向に操作するため
に、リング44が設けられている。このリング4
4も、外側チユーブ35の外周に設けられてお
り、内側及び外側チユーブ34,35間の間〓に
挿通されたケーブル45に連結されている。ワイ
ヤ41及びケーブル45は、それぞれ第5図の操
作部材25,27に連結されている。
前後端部32,33をそれぞれ環状部材36,
37によつて規制された状態で、外側チユーブ3
5に連結された操作部材26を操作することによ
り中央部を風船状に拡張された管状本体20か
ら、装置の他の部分を解放するために、操作部材
25,27を操作することによつて、ワイヤ41
及びケーブル45を介してリング40,44が軸
線方向に移動され、前側ラツチ38を放射方向内
向きに変位させ、後側ラツチ42を放射方向外向
きに変位させて、それぞれの前端部39,45を
管状本体20の前後端部32,33から離脱させ
る。これにより環状部材36,37が、それぞれ
に嵌合する管状本体20の前後端部32,33に
対して変位可能となり、管状部19の軸線方向の
移動により管状本体の前後端部から離脱して、管
状本体を釈放する。第6図から明らかなように、
装置の前端部は、環状部材36に取り付けられた
ボスまたはケーシング46によつて保護される。
前述のように、この拡張可能な管状本体は、外
科手術において、幾つかの用途で使用される。例
えば、第1図に示した実施例においては、管状本
体は、血管等の壁部を支持するために利用され
る。第8図には、可撓性の管状本体の変形例が示
されている。この実施例において、管状本体は、
円筒形部53で構成されている。この円筒形部5
3は、その一端部に、同様の線状要素によつて構
成された先細端部43を有している。この装置
は、血栓症を防止するためのフイルタとしての使
用に適している。第8図に示した装置は、肺の細
胞層の陥入を防止する目的で、例えば下大静脈の
内部の所定の位置に配置して使用することができ
る。血栓症を捕捉するために血管の内部に使用さ
れる従来技術におけるフイルタ装置は、尖つた端
部またはラツチ等により、血管内に恒久的に取り
付けられ、フイルタの位置の修正またはフイルタ
の除去が不可能であるという欠点を有している。
こうした装置の一例は、米国特許第3540413号明
細書に記載されている。本発明による装置は、非
常に高い精度で大静脈中に挿入することができ、
今日同じ目的のために外科手術に使用されている
既知の装置の場合のような、周囲の血管に損傷を
与える危険性の全くないものである。
第9図には、植接用片として使用される本発明
明による管状本体の例を示している。この場合に
は、管状本体55は、第1図及び第2図に示した
実施例よりも緻密な外周壁をもつて構成される、
この緻密な外周壁は、第1図の支持用線状要素
2,3及び2a,3aの間に弾性糸を織り込むこ
とによつて得られる。これにより多孔性が制御さ
れた外周壁が形成される。こうして形成された、
多孔性を制御された多孔質の外周壁を有する管状
本体は、一種の拡張性植接用片として各種の用途
に使用される。
第9図に示した用途においては、管状本体55
が血管の周壁が拡張した状態の動脈瘤のある大動
脈56に移植される。拡張可能な植接用片として
の管状本体55を、大動脈の疾患部から所定の距
離の位置に挿入され、次いで動脈瘤の中央部に配
置されることによつて、動脈瘤が橋絡され、従つ
て動脈瘤を手術により切除する必要が解消する。
第9図においては、大動脈が円錐形の血管である
ことを示している。このため、管状本体55を移
植するための手順は、植接用片として機能する人
工器官としての管状本体を、例えば第5図に示し
た装置により大動脈の所定の位置に配置する。大
動脈が、円錐形であるため、外科手術の技術は次
の通りとなる。
第5図の装置を利用して、植接用片として機能
する管状本体55の前端部が大動脈中に最終配設
位置よりも若干深く挿入される。前端部の挿入位
置は、第9図において仮想線59で示されてい
る。第5図の装置における管状本体55の後端部
は、釈放前の状態で、実線60で示す最終配設位
置に配置される。図示の例において、大動脈の管
状本体55の後端部配設位置は、動脈の上流側で
あり、前端部の配設位置の周壁の径に較べて幾分
径が小さくなつている。このため、管状本体55
の後端部の直径は、実線60で示す位置における
大動脈の周壁の径を越えて拡張することはできな
い。しかしながらこれは、装置の前端部により管
状本体55の前端部の位置を仮想線59で示す位
置から実線58で示す最終配設位置まで後退させ
て管状本体55を十分に拡張することにより解決
することができる。
第11図には、管状本体を拡張するために使用
される装置の他の実施例が示されている。
この装置は、収縮状態の管状本体を例えば血管
中に挿入し、次いで管状本体を血管中に配置する
ときに拡張させるように構成されている。この装
置の構成は、外側可撓性チユーブ61と、この外
側可撓性チユーブ61と同軸に配置された内側チ
ユーブ62とから構成されている。外側チユーブ
61の一方の端部には、作動部材63が配置され
ている。内側チユーブ62の自由端部には、他の
作動部材64が取又り付けられている。この構成
により、内側チユーブ62は、外側チユーブ61
に対して軸線方向に変位可能となる。内側チユー
ブ62の他方の端部には、ピストン65が取り付
けられている。ピストン65は、移動時に外側チ
ユーブ61の内周面にそつて摺動する。
この装置を使用するときは、収縮状態とされた
拡張可能な管状本体69は、まず外側チユーブ6
1内に収容される。次いで、内側チユーブ62が
ピストン65と共に外側チユーブ61の後側位置
66内に配置される。ピストン65の初期位置
は、第11図において破線で示されている。この
ピストン65の初期位置において、管状本体69
は、外側チユーブ61内に収縮状態で保持され
る。
移植中において、上記のように構成した装置の
内側及び外側チユーブ61,62が血管の管状本
体配設位置に挿入される。次いで、作動部材64
が矢印68の方向に押圧され、収縮状態の管状本
体69が外側チユーブ61より押し出される。外
側チユーブ61の前端部70を脱出した管状本体
の部分71は、放射方向の規制力が解除されてい
るので拡張して血管の内周壁72に当接、係合す
る。第11図においては、管状本体69及び管状
本体の拡張した部分71は、図示を明瞭にするた
め二本の線状要素として示されている。作動部材
63は、この状態から矢印73で示す方向に、拡
張した管状本体の部分71が血管の内周壁72に
当接するまで移動される。これによつて、外側チ
ユーブ61の前端部70が後退する。収縮した管
状本体69は、管状本体の後端をピストン65に
よつて押圧されて移動される。即ち、管状本体の
移植は、作動部材64,63を同時に反対方向に
移動させることによつて行われる。この場合、作
動部材64の変位は、部材63の変位より大きく
する。収縮した管状本体63が、外側チユーブ6
1より完全に押し出されたときに拡張が終了し、
装置は移植位置から除去される。
第11図による実施例の構造の細部は極めて簡
単であり、且つ高い信頼性をもつて操作すること
ができる大きな利点を有している。図示の器具
は、また非常に小さな直径を有する管状本体を移
植する場合に好適である。一例として、交差する
線状要素で形成された拡張可能な管状本体を用い
て実験を行つたところ、管状本体の収縮時の直径
がわずか2mmであり、拡張時の直径が6mmのもの
の移植が可能であつた。また、これよりも小さい
直径の管状本体の移植も当然可能であると考えら
れる。第11図による装置はまた、非常に大きな
直径を有する植接用片として用いられる管状本体
の移植にも当然使用することが可能である。
管状本体の長さが長い場合には、外側チユーブ
61内における管状本体の摺動抵抗が過大となる
ことが予測される。この場合には、内側チユーブ
62の前端部に設けるピストン65を可動カギ状
部材またはラツチに置き換えることが適当と考え
られる。この場合、可動カギ状部材またはラツチ
は、内側チユーブ62が矢印68の方向に前進移
動されると、管状本体の内周面に係合してこれを
前進させ、内側チユーブ62が矢印73の方向に
後退したときに管状本体から離脱する構成とな
る。従つて、第11図の装置は、ポンプと同様の
動作により、管状本体を血管内に配置する。
勿論、第11図に示した装置は、形成材料、形
状等を種々に変更することが可能である。従つ
て、例えば外科医にとつては、作動部材63及び
64の間の相対運動を機械的に制御することによ
り、移植作業を容易にすることが可能である。
移植において、成功を収めることができるよう
にするために、拡張し得る管状本体がある弾性を
有していることは必須である。例えば、管状本体
は血管の開いた状態に保つために挿入されるか、
または血管の人工器官として移植されるときに、
管状本体は生体の血管の弾性に可能な限り類似し
た弾性を有すべきである。管状本体は、器官が応
力及び歪を受けている間、包囲する器官、例えば
血管に対して固定された状態に保たれなければな
らない。管状本体はまた同時に例えば血管の脈動
または手足の曲げに追随するために十分な適応性
を有するように放射方向及び軸線方向に弾性を有
していなければならない。管状本体は、例えば外
圧を受けている時にその形状を維持するように十
分な固有の剛性を有しており、かつ内圧に耐える
ために十分な強度を有していなければならない。
これらの性質を得るために、実際の適用領域に
対する管状本体の線状要素の材料及び寸法を注意
して選択し、且つ適応させることが好ましい。線
状要素の材料が組織と適合し、即ちとりわけ拒絶
反応を最小とし、無毒性であり且つ細胞の成長を
可能にする明白な必要条件に加えて、材料が剛性
且つ弾性を有し、しかも任意の有意な範囲まで可
塑変形しないことが一般的に必要である。この材
料は、例えば、ポリエステル、ポリウレタン、ポ
リカーボネート、ポリスルフイド、ポリプロピレ
ン、ポリエチレン、ポリスルホネート、ステンレ
ス鋼、銀の単繊維(モノフイラメント)とするこ
とができる。単繊維の直径は、好ましくは0.01〜
0.5mmの範囲である。
ある場合には、管状本体が拡張されるかまたは
無負荷状態にあるか、または無負荷状態に近い状
態にある時に管状本体の線状要素2,2aの間の
角度がとりわけ上記の必要条件を満足する為に十
分大きな角度となつていることが重要である。角
度αが大きいほど、外圧を受けている時の管状本
体の安定度が高いことが判明した。この観点か
ら、理想的な角度は、180゜であるが、この角度は
実際には得られない。第1A図に示した角度は約
160゜であり、これは通常の上限に近い角度であ
る。
管状本体の直径を変えるためには、前述したよ
うに、管状本体の両端部を互いに相対して軸線方
向に変位させることが必要である。第10図に
は、この移動の間の一般的な関係が示されてい
る。管状本体の両端部を互いに離れるように移動
させる時の割合(%)で示した管状本体の直径の
変化をY軸にプロツトし、そして伸びとして表さ
れる対応した長さの変化率(%)をX軸にプロツ
トしてある。また、X軸線に沿つた管状本体の直
径の関数としての角度αをプロツトした。
第10図から理解されるように、相対的な直径
の減少は伸びのプロセスの開始時には小さく、そ
して伸びの初期位置を示す100%である時に90%
程度まで減少する。この初期位置では、角度は可
及的に180゜に近い角度とされる。200%の伸びに
おいて、直径の減少は75%であり、そのときに対
応する角度αは100゜である。直径の減少は伸びの
増加につれて加速する。従つて、伸びが250%か
ら300%に増加すると、直径の減少は60%から30
%に減少する。即ち、伸びが比較的小さいとき
に、比較的大きな直径の変化が起こる。この範囲
内では、角度は約70゜から40゜まで減少する。前述
したように、ある場合には、拡張した本体が第1
0図の曲線において出来る限り左方の位置となる
ことが望ましい。即ち、角度αは出来る限り大き
くすべきである。移植された管状本体は所定の圧
力で血管壁に係合して固定された状態に保たれな
ければならないので、移植部材の直径は自由に拡
張したときの直径よりも小さくなければならな
い。
本発明による拡張可能な管状本体を血管または
その他の管状本体の中に移植するために使用する
場合に必要となる拡張力は、例えば螺旋形の交差
した線状要素に固定された長手方向に延びる弾性
糸のような弾性手段等によつて付与することがで
きる。弾性手段が、線状要素に固定される時に大
きな角度αを選択することにより、前述した要求
条件を簡単に満足することができる。
角度αの値を大きくすることがしばしば望まし
い理由は、人工器官の弾性が角度の減少により損
なわれるからである。例えば、半径方向に外圧を
受けている時には、変形に対する抵抗が小さく、
そして人工器官と血管壁との間の局部的な軸線方
向の変位が起こり、その結果、変位部位における
細胞の成長を阻害するおそれがある。角度αを大
きな値に選択するもう一つの理由は、高い拡張
比、即ち拡張した時の管状本体の直径と収縮状態
での管状本体の直径との比が高いことが必要とさ
れるからである。例えば、2から約3の比を得る
為には、角度αは約120゜を越えるべきである。角
度αの選択はまた人工器官の線状要素の材料によ
つて左右される。プラスチツク材料が選択された
場合、角度αが小さすぎると、半径方向の弾性が
過大となる。しかしながら、ある他の場合、例え
ば、かなり大きな半径方向の屈曲が必要な場合に
は、小さな角度αを選択することが望ましいこと
もある。
第10図より、大きな角度αを使用する時に管
状本体を大きく拡張させなければならないことは
明らかである。小さな直径の通路を通して経体内
管路的移植を可能とするために、大きな角度αか
ら出発する伸びはかなり大きく、300%またはそ
れ以上になる可能性がある。
例えば、血管を開いた状態に保持するために、
例えば管道人工器官または同様な装置を移植する
ときに、一般的には、包囲する血管壁に作用する
圧力が少なくとも約100mmHgに達することが望ま
しい。また、超過してはならない最高圧力があ
る。この最高圧力は、場合により変化するが、血
管の人工器官として使用される時には約500〜
1000mmHgを越えてはならない。所要の圧力が長
手方向に延びる弾性部材または弾性スリーブまた
は膜によつて与えられるとすれば、固定のために
必要な圧力は有利な大きい角度αを選択した時に
合理的な力によつて得られる。従つて、計算は血
管人工器官と包囲する血管壁との間の円滑な円周
方向の係合において、角度αが150゜〜170゜である
とすれば、固定を行うために数ニユートン(〜
0.1−0.2kp)の総合的な力が必要であることを示
している。この事実は、また外圧を受けている移
植された人工器官の変位のリスクを減少させるこ
とに寄与する。その理由は、発生する摩擦力がこ
のような変位を阻止するために十分であるからで
ある。しかしながら、角度αが例えば45゜である
とすれば、約10〜20ニユートン(1〜2kp)の力
が必要となり、これは非常に不利である。
本発明の人工器官が使用されたときに、十分に
満足のゆく状態で、所要の固定を行う為には、所
要の拡張力を活性する弾性材料が、こうした条件
を満足していなければならない。この材料は、ま
た本体の線状要素への容認し得る接着を生じ、そ
して勿論移植のために生化学的に容認可能でなけ
ればならない。従つて、この材料は低い弾性係数
を有し、そして少なくとも250〜600%までの伸び
において力と伸びとの間に直線的な関係を示すべ
きであり、また有意なヒステリシスを保有してい
てはならない。
本発明による拡張可能な管状本体を製造するた
めに使用するのに好適であると判明した上記の必
要条件を満足する一群の弾性体がある。このよう
な弾性体はセグメントポリウレタン(PUR)と
呼ばれる物質の群中に包含されている。セグメン
トポリウレタンの幾つかは、ペレタン(アツプジ
ヨーン)、ビオマー(エチコン)、エスタングツド
リツチのような商品名で市販されている。これら
の物質は、好適な溶剤中で溶解して溶液を形成す
ることができる。これらの溶液から、管状本体の
骨組みを形成する螺旋状の支持用線状要素を取り
付けるための薄い弾性バンドまたは薄肉チユーブ
を調製することができる。
本発明による人工器官を所謂植接用片または血
管用人工器官として使用する場合に、人工器官の
壁部は前述したように多孔性であり、且つ薄く、
そして組織に適合すべきであり、かつ自然の組
織、とりわけ新脈管内膜(neointima)の成長を
可能ならしめるように構成されるべきである。セ
グメントポリウレタン(PUR)もまたこうした
壁部を形成するために好適に使用される。その理
由は、前記の性質を非常に高い弾性を有する壁部
の必要条件と組み合わせることができるからであ
る。このような壁部はPURの溶液から押し出し
により形成されたセグメントPURの繊維からな
る薄いチユーブの形態に調製することができる。
繊維は、交差した点において相互に付着され、壁
部は例えば繊維の厚さ及び密度を好適に調節する
ことにより所望の多孔性を有するように構成する
ことができる。得られたチユーブは、管状本体を
包囲するかまたは管状本体内部に取り付けること
ができる。また、別の態様として、チユーブを調
製するときに、管状本体の線状要素をチユーブ材
料と好適に結合させることができる。
血管用人工器官に所望の拡張力を与えるため
に、PURのバンドは、好適な多孔性の壁材料と
組み合わせることができる。この多孔性壁材料
は、管状本体の線状要素の間に織り込まれた単繊
維(モノフイラメント)または多繊維(マルチフ
イラメント)で構成するかまたは前述したように
調製された多孔性の弾性壁部で構成することがで
きる。
ある場合には、管状本体またはそのバンド、ス
リーブまたは膜をポリラクチド及び/またはポリ
ウレタンのような生化学的に崩壊可能な物質から
製造することも可能である。
本発明の原理を使用した実施態様の例(ただし
これらの例に限定されるものではない)を以下に
記載する。
例 1 血管用植接用片 拡張時の直径 20mm 角度α 160゜ 長 さ 100mm 直径15mm〜18mmの範囲内で大動脈の中に移植す
る為に好適である。
移植前の最小直径 8mm 合計の伸び 約300% 固定するための計算された軸方向の力0.0kpが
0.15mmの厚さ、気孔サイズ15〜50μmを有す
る微孔性の弾性PUR壁によつて与えられた。
線状要素の材料:0.15mmの直径を有するポリエ
ステル単繊維 線状要素の数n=72(2×36) 例 2 狭窄症に対する血管用人工器官 拡張時の直径 6mm 角度α 100゜ 長 さ 200mm 4〜5mmの直径範囲内で静脈中に移植。
合計の伸び 250% 拡張のための軸方向の力0.08kpが各々1.5mm幅
及び0.3mmの厚さを有する4個のセグメント
ポリウレタンの弾性バンドにより与えられ
た。
線状要素材料:0.09mmの直径を有しかつ線状要
素の数n=36(2×18)である
ポリプロピレン単繊維
【図面の簡単な説明】
第1A図及び第1B図は、本発明による可撓性
管状本体の側面図及び端面図である。第2A図及
び第2B図は、第1図に示した管状本体を収縮状
態で示す図である。第3図及び第4図は、管状本
体を構成する線状要素を示し、それぞれ管状本体
の収縮状態及び拡張状態に対応した形状を示す図
である。第5図は、本発明による管状本体を組み
込んだ装置の全体図である。第6図は、第5図の
装置の要部を一部断面にして示す拡大図である。
第7図は、管状本体の他の実施例を示す図であ
る。第8図は、植接用片及びフイルタとして構成
された管状本体を示す図である。第9図は、動脈
瘤部分に植接用片として管状本体を配設した状態
を示す図である。第10図は、管状本体の直径D
を角度α及び人工器官の伸張率%の関係として示
す図である。第11図は、本発明の人工器官を操
作するための装置の他の実施例を示す図である。

Claims (1)

  1. 【特許請求の範囲】 1 両端部を相互に相対して軸線方向に移動させ
    ることにより変更し得る直径を有し、且つ複数の
    各個が剛性でありしかも可撓性を有する線状要素
    から構成された可撓性の管状本体を有し、前記可
    撓性の線状要素の各々が共通軸線としての前記管
    状本体の中心軸線に対して螺旋状に巻回され、前
    記複数の線状要素は、第一の巻回方向に巻回され
    るとともに相互に相対的に軸線方向に変位された
    複数の第一の線状要素と、前記第一の巻回方向と
    逆の第二の巻回方向に巻回されるとともに相互に
    相対的に軸線方向に変位された複数の第二の線状
    要素とで構成され、各第一の線状要素は各第二の
    線状要素に交差して巻回されており、前記管状本
    体は、無負荷状態の第一の直径を有する第一の状
    態と、外部負荷を与えることにより両端を相対的
    に移動させ、前記第一の直径と異なる第二の直径
    を有する第二の状態とに状態を変化可能であり、
    前記第二の状態において前記第一の状態への復帰
    力を蓄積し、前記外部負荷の解除に応じて前記第
    一の状態に自動復帰するようにしたことを特徴と
    する経体内管路的移植のための人工器官。 2 前記第一の線状要素と前記第二の線状要素の
    交差角度が約60゜よりも大きく、好ましくは鈍角
    である特許請求の範囲第1項に記載の人工器官。 3 前記第一の線状要素と前記第二の線状要素
    は、前記管状本体に安定性を付与するために編組
    状に配列されている特許請求の範囲第1項または
    第2項に記載の人工器官。 4 前記管状本体を構成する前記線状要素の数が
    nであり、該nが少なくとも約10である特許請求
    の範囲第1項乃至第3項のいずれかに記載の人工
    器官。 5 前記第一の線状要素の数と前記第二の線状要
    素の数がそれぞれn/2である特許請求の範囲第4
    項に記載の人工器官。 6 前記第一の線状要素と前記第二の線状要素の
    交差位置において、前記第一の状態における交差
    状態で結合して、前記第二の状態における復帰力
    を発生するようにした特許請求の範囲第1項乃至
    第5項のいずれかに記載の人工器官。 7 前記管状本体がその少なくとも一方の端部に
    おいて直径を縮小するように構成されてフイルタ
    として機能する請求項第1項乃至第6項のいずれ
    かに記載した人工器官。 8 前記管状本体が好ましくはセグメントポリウ
    レタンからなる多孔性材料で形成される特許請求
    の範囲第7項に記載した人工器官。 9 血管用植接用片として使用する特許請求の範
    囲第1項乃至第8項のいずれかに記載した人工器
    官。 10 両端部を相互に相対して軸線方向に移動さ
    せることにより変更し得る直径を有し、且つ複数
    の各個が剛性でありしかも可撓性を有する線状要
    素から構成された可撓性の管状本体を有し、前記
    可撓性の線状要素の各々が共通軸線としての前記
    管状本体の中心軸線に対して螺旋状に巻回され、
    前記複数の線状要素は、第一の巻回方向に巻回さ
    れるとともに相互に相対的に軸線方向に変位され
    た複数の第一の線状要素と、前記第一の巻回方向
    と逆の第二の巻回方向に巻回されるとともに相互
    に相対的に軸線方向に変位された複数の第二の線
    状要素とで構成され、各第一の線状要素は各第二
    の線状要素に交差して巻回されており、前記管状
    本体が、該管状本体と同一空間に広がるバンドま
    たは弾性を有し、且つ好ましくは多孔性の膜等の
    弾性部材により前記管状本体の前記の第二の状態
    において軸線方向の弾性復帰力を前記管状本体に
    作用させるようにしたことを特徴とする経体内管
    路的移植のための人工器官。 11 血管用植接用片として使用する特許請求の
    範囲第10項に記載した人工器官。 12 両端部を相互に相対して軸線方向に移動さ
    せることにより変更し得る直径を有し、且つ複数
    の各個が剛性でありしかも可撓性を有する線状要
    素から構成された可撓性の管状本体を有し、前記
    可撓性の線状要素の各々が共通軸線としての前記
    管状本体の中心軸線に対して螺旋状に巻回され、
    前記複数の線状要素は、第一の巻回方向に巻回さ
    れるとともに相互に相対的に軸線方向に変位され
    た複数の第一の線状要素と、前記第一の巻回方向
    と逆の第二の巻回方向に巻回されるとともに相互
    に相対的に軸線方向に変位された複数の第二の線
    状要素とで構成され、各第一の線状要素は各第二
    の線状要素に交差して巻回されており、前記管状
    本体は、無負荷状態の第一の直径を有する第一の
    状態と、外部負荷を与えることにより両端を相対
    的に移動させ、前記第一の直径と異なる第二の直
    径を有する第二の状態とに状態を変化可能であ
    り、前記第二の状態において前記第一の状態への
    復帰力を蓄積し、前記外部負荷の解除に応じて前
    記第一の状態に自動復帰するように構成するとと
    もに、前記管状本体の長さの主な部分に沿つて管
    状本体と同一空間に広がる多孔性材料の膜を設け
    たことを特徴とする経体内管路的移植のための人
    工器官。 13 前記管状本体がその少なくとも一方の端部
    において直径を縮小するように構成されてフイル
    タとして機能する請求項第12項に記載した人工
    器官。 14 前記管状部材または膜が好ましくはセグメ
    ントポリウレタンからなる多孔性材料で形成され
    る特許請求の範囲第12項に記載した人工器官。 15 血管用植接用片として使用する特許請求の
    範囲第12項または第14項に記載した人工器
    官。
JP58501556A 1982-04-30 1983-04-11 伸縮可能な管状本体を備えた人工器官 Granted JPS59500652A (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SE8202739A SE445884B (sv) 1982-04-30 1982-04-30 Anordning for implantation av en rorformig protes
SE82027392FI 1982-04-30

Publications (2)

Publication Number Publication Date
JPS59500652A JPS59500652A (ja) 1984-04-19
JPH0447575B2 true JPH0447575B2 (ja) 1992-08-04

Family

ID=20346693

Family Applications (1)

Application Number Title Priority Date Filing Date
JP58501556A Granted JPS59500652A (ja) 1982-04-30 1983-04-11 伸縮可能な管状本体を備えた人工器官

Country Status (14)

Country Link
US (2) US4655771B1 (ja)
JP (1) JPS59500652A (ja)
AU (1) AU1518683A (ja)
BE (1) BE896616A (ja)
CA (1) CA1239755A (ja)
CH (1) CH662051A5 (ja)
DE (1) DE3342798T1 (ja)
DK (1) DK159368B3 (ja)
FR (1) FR2525896B1 (ja)
GB (1) GB2135585B (ja)
IT (1) IT1169405B (ja)
NL (1) NL192600C (ja)
SE (1) SE445884B (ja)
WO (1) WO1983003752A1 (ja)

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CA1239755A (en) 1988-08-02
IT8320864A1 (it) 1984-10-29
GB2135585B (en) 1986-03-05
JPS59500652A (ja) 1984-04-19
WO1983003752A1 (en) 1983-11-10
SE445884B (sv) 1986-07-28
DK605483D0 (da) 1983-12-29
US4655771A (en) 1987-04-07
DE3342798C2 (ja) 1992-10-08
NL192600B (nl) 1997-07-01
US4954126A (en) 1990-09-04
NL192600C (nl) 1997-11-04
SE8202739L (sv) 1983-10-31
US4954126B1 (en) 1996-05-28
US4655771B1 (en) 1996-09-10
DE3342798T1 (de) 1985-01-10
AU1518683A (en) 1983-11-21
DK605483A (da) 1983-12-29
GB8411519D0 (en) 1984-06-13
DK159368C (da) 1991-04-22
DK159368B3 (da) 2002-02-04
NL8320142A (nl) 1984-08-01
FR2525896B1 (fr) 1990-11-30
GB2135585A (en) 1984-09-05
DK159368B (da) 1990-10-08
FR2525896A1 (fr) 1983-11-04
IT8320864A0 (it) 1983-04-29
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IT1169405B (it) 1987-05-27
CH662051A5 (de) 1987-09-15

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