JPH07241343A - 動脈瘤の治療用の大動脈腔内人工器官の移植のためのバルーン装置 - Google Patents

動脈瘤の治療用の大動脈腔内人工器官の移植のためのバルーン装置

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JPH07241343A
JPH07241343A JP28039091A JP28039091A JPH07241343A JP H07241343 A JPH07241343 A JP H07241343A JP 28039091 A JP28039091 A JP 28039091A JP 28039091 A JP28039091 A JP 28039091A JP H07241343 A JPH07241343 A JP H07241343A
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balloon
catheter
aneurysm
implantation
treatment
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JP3195390B2 (ja
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Hector D Barone
ヘクター・デイ・バロン
Juan C Parodi
ジユアン・シー・パロデイ
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/958—Inflatable balloons for placing stents or stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/89—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • A61F2002/075—Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2002/826—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents more than one stent being applied sequentially
    • 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
    • A61M25/10—Balloon catheters
    • A61M25/1011—Multiple balloon catheters

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (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)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Pulmonology (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Child & Adolescent Psychology (AREA)
  • Biophysics (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Prostheses (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Surgical Instruments (AREA)

Abstract

(57)【要約】 【構成】 動脈瘤の治療用の大動脈、又は大動脈二腸骨
腔内人工器官の移植のためのバルーン装置は人工器官に
伴う２個のステントを拡大するための膨張できるバルー
ンを２個持つカテーテルを使用する。 【効果】 これまで冗長で時間がかかった処置を簡潔に
することができ、動脈瘤が腸骨動脈の分枝点に非常に近
接した腹部大動脈にある場合の人工器官の移植から生ず
る問題も解決することができた。

Description

【発明の詳細な説明】
【０００１】
【発明の背景】
１．発明の分野 本発明は動脈瘤の治療用の大動脈、又は大動脈二腸骨腔
内人工器官の移植のためのバルーン装置、より正確には
大動脈の壁に管状人工器官を取り付けるための道具を適
合させるためにカテーテル上におかれた膨張させられる
バルーンの装置に関する。
【０００２】２．先行技術の説明 バルーンカテーテル上の導入部分を用いて組織内に配置
される、“ステント”と呼ばれる血管内装置が周知であ
る。
【０００３】血管内人工器官を取り付けるための手段と
して用いられるこれらのステントは、バルーンの膨張に
より中側から拡大するとその直径が増加して変形し、動
脈の壁の内側に閉じ込められる。
【０００４】Ｊｕｌｉｏ Ｃ．Ｐａｌｍａｚ、及び本発
明者等による１９９０年６月１１日のＵ．Ｓ．特許出願
番号５３５，７４５は、動脈瘤の影響下にある血管領域
に沿って移植された柔軟性の同軸管により連結した２個
の結合手段、又はステントを含む人工器官に関する。
【０００５】現在のバルーン装置を用いると、人工器官
の末端へのステントの取り付けは冗長で時間を浪費する
処置である。
【０００６】カテーテルを用いて導入することはでき
ず、必要な領域にさらに切開を必要とする、ステントの
取り付けのために設計された装置もあり、１９７２年４
月２５日に受理されたＲｏｂｅｒｔ ＥｒｓｅｋのＵ．
Ｓ．特許３，６５７，７４４に記載されている。
【０００７】弁形成、及び血管形成術における膨張でき
るバルーンを持つカテーテルの導入法が知られており、
その場合内腔のための１個又はそれ以上の拡張カテーテ
ルを使用する。
【０００８】現在の拡張カテーテルを用いて、２個の取
り付け手段又はステントを持ち柔軟性管により同軸につ
なげた上記の人工器官を移植することが必要な場合、中
心のステント及び末端のステントを連続的に拡張するた
めに同時に２本のカテーテルを使用することが必要であ
る。
【０００９】この処置は困難であり、時間がかかり、推
薦できない。
【００１０】
【発明の要約】本発明の装置は、動脈瘤の治療用の上記
人工器官を移植するための３個の内腔を持つ同一のカテ
ーテル上の２個のバルーンを用いることにより処置を単
純化する。
【００１１】本発明の装置は動脈瘤が腸骨動脈の分枝点
に非常に近接した腹部大動脈にある場合の人工器官の移
植から生ずる問題も解決する。
【００１２】本発明の主な目的は動脈瘤の治療用の大動
脈、又は大動脈二腸骨腔内人工器官の移植のためのバル
ーン装置であり、あらかじめ決められた距離で隔たった
２個の膨張できるバルーンがその内部に少なくとも３個
の通路を持つカテーテル上に位置し、各バルーンが該内
部通路のひとつと連結している点が新しい。
【００１３】該バルーンを用いた本発明の好ましい実行
法において、末端バルーンは該カテーテルの導入末端に
近接しており、中心部バルーンは移植する人工器官の長
さに比例する距離だけ他方から離れて位置する。
【００１４】この好ましい実行法において、中心部バル
ーンは（末端バルーンの反対側に）バルーンの対称軸か
ら該対称軸に関して約３０度の角度で置き換えられたカ
テーテルの入り口を持つ。
【００１５】本発明の装置の主な目的、及び利点の両方
を、図を参照しながら以下に説明する本発明の好ましい
実行法により評価することができる。
【００１６】本発明を好ましい具体化に関連して記載す
るが、本発明をその具体化に制限するつもりではないと
ことを理解して欲しい。逆に付随特許請求の範囲に定義
する本発明の精神、及び範囲に含まれるすべての変更、
修正、及び同等例を網羅するものである。 〔発明の詳細な説明〕
【００１７】図１は治療するべき腹部大動脈の部分の設
計を示す図であり、その上部が胸部大動脈１と連結さ
れ、そこから腎動脈２が分枝している。
【００１８】腹分大動脈は動脈瘤５を呈しており、それ
はほとんど胸部大動脈１から腸骨動脈１１の分枝点１０
まで達している。
【００１９】治療は動脈瘤５中に人工器官を移植して行
い、人工器官は一端が柔軟性ライナー７に縫合された末
端ステント４を含み、ライナー７はダクロンなどの不活
性材料で作られ、他端が他方の中心部ステント８に縫合
されている。
【００２０】上記の通り、ステント４、及び８は非常に
薄い壁の管でその内部から圧力がかかると拡張し、最初
の管より大きい直径の壁を持つ管となる。
【００２１】ステント４、及び８の直径の増加はバルー
ン３及び９を用いて行われ、バルーンはカテーテル６を
用いて動脈内に導入され、カテーテルはバルーン３及び
９に吹き込まれる流体が通過する線、又は“内腔”をそ
の内部に持つ。
【００２２】金属線から成り、大腿動脈の切開部を通過
し、放射測定によりその位置を観察するために作られた
導入部分、及びガイド線を使用してユニットを配置す
る。
【００２３】導入部分を治療するべき動脈瘤５の領域に
配置した後、導入部分により線の１本を通し、ステント
４、及び８をバルーン３、９上にあらかじめ埋め込み、
その直径を最小にするために圧縮したカテーテル６を導
入する。
【００２４】不活性材料でできた管、又はライナー７は
バルーン３、９上の２本のステント４、８の間にある。
【００２５】その内部に対応するバルーン３を持つ末端
ステント４が動脈瘤５の上の健康な壁に達したら、導入
部分を引き、バルーン３をその最大直径まで膨張させ、
その結果ステント４が図１に示す形態となり動脈の壁に
移植される。
【００２６】ステント８と中心部バルーン９の場合も方
法は同様である。
【００２７】バルーン６及び９の膨張は同時にも、ある
いは交替にも行うことができる。
【００２８】ステント４、８を適所に置いた後、バルー
ン３、９を収縮させ、カテーテルを同時に引く。
【００２９】図１に示すように動脈瘤５が腸骨動脈１１
の分枝点１０に近接している場合、ここではカテーテル
６が腹部大動脈と同軸でなく、バルーン９によりステン
ト８の内壁に向かって吹き込まれる圧力が等しくないの
で、中心部ステント８の正確な取り付けは困難になる。
【００３０】この場合、中心部バルーン９は図２に示す
特別な形態を取らねばならない。
【００３１】中心部バルーン９は、バルーン９の縦軸か
らその半径の半分の距離“ｄ”の位置にカテーテル６の
入り口１３を持ち、カテーテル６はバルーン９からその
縦軸に関して約３０度の角アルファで出る。腸骨動脈の
分枝点１０に鞍型があるので、バルーン９の内部はほぼ
鞍型をとる。
【００３２】動脈瘤５が腸骨動脈１１を含む場合、分枝
管型のライナー７を使用し、その場合中心部バルーン９
は腸骨動脈１１の直径に対応する直径を持つべきであ
り、末端バルーン３と同様にカテーテル６と同軸でなけ
ればならない。
【００３３】装置の好ましい実行法において、カテーテ
ル６の長さは５０−７５ｃｍであり、厚さはフレンチス
ケールの５−１０であり、ポリビニルクロリド製であ
り、例えばその末端は先の丸い円錐台の形をしている。
【００３４】カテーテル６の中心通路、又は中心内腔は
ガイドコードの導入、及び又造影剤の注入に使用する。
他の二通路、又は内腔は各バルーン３、９の膨張及び収
縮に使用する。
【００３５】カテーテル６は１５ｃｍ毎に表面に印があ
り、各バルーン３、９の最初、及び最後に放射線を通さ
ない印がある。
【００３６】好ましい実行法において、バルーン３、９
はポリビニルクロリド、又はポリエチレンで作られてお
り、先の丸い円筒状であり、長さがカテーテル６に沿っ
て３−５ｃｍであり、直径が１６−３０ｍｍである。
【００３７】本発明は上記の構造の正確な詳細、操作、
正確な材料、又は具体化に制限されるものではなく、明
らかな修正、及び同等物は同業者に明白となるであろ
う。従って本発明は付随特許請求の範囲にのみ制限され
るものである。
【００３８】本発明の主たる特徴及び態様は以下の通り
である。
【００３９】１．動脈瘤の治療用の大動脈、又は腔内大
動脈二腸骨人工器官の移植のためのバルーン装置におい
て：少なくとも三本の内部通路を持つカテーテル；及び
カテーテルの上に配置され、あらかじめ決められた距離
で隔てられ、それぞれ少なくとも１本の内部通路に連結
した第１、及び第２の膨張可能なバルーンを含むことを
特徴とする装置。
【００４０】２．第１項に記載のバルーン装置におい
て、カテーテルが導入末端を持ち、第１のバルーンがカ
テーテルの導入末端に近接して位置し、第２のバルーン
が移植するべき人工器官の長さに対応する距離で第１の
バルーンと隔てられた位置にあることを特徴とする装
置。
【００４１】３．第２項に記載のバルーン装置におい
て、カテーテルが第２バルーンを通過し、第２バルーン
は第１、及び第２端、ならびに縦軸を有し、第２バルー
ンの第１端が第２バルーンの第２端より第１バルーンに
近く位置し；カテーテルは第２バルーンの第２端にその
縦軸に関して約３０度の角度で入ることを特徴とする装
置。
【００４２】４．第３項に記載のバルーン装置におい
て、第２バルーンが半径がＲの実質的に管状の断面の構
造を持ち；カテーテルが第２バルーンの縦軸から約１／
２Ｒの距離で第２バルーンの第２端に入ることを特徴と
する装置。
【００４３】５．第２項に記載のバルーン装置におい
て、第１、及び第２バルーンがそれぞれ実質的に管状の
断面の構造を持ち、その縦軸の回りの半径はＲであり；
第１バルーンの半径Ｒが第２バルーンの半径Ｒより大で
あり、カテーテルが第１及び第２バルーンの縦軸と同軸
で第１及び第２バルーンを通過することを特徴とする装
置。
【図面の簡単な説明】
【図１】図１は移植した時の人工器官を示す図である。
【図２】図２は本発明の装置の中心部バルーンの形態の
図である。
───────────────────────────────────────────────────── フロントページの続き (72)発明者 ジユアン・シー・パロデイ アルゼンチン・ブエノスアイレス1419メル セデス4255

Claims (1)

    【特許請求の範囲】
  1. 【請求項１】 動脈瘤の治療用の腔内大動脈、又は大動
    脈二腸骨人工器官の移植のためのバルーン装置におい
    て：少なくとも三本の内部通路を持つカテーテル；及び
    カテーテルの上に配置され、あらかじめ決められた距離
    で隔てられ、それぞれ少なくとも１本の内部通路に連結
    した第１、及び第２のバルーンを含むことを特徴とする
    装置。
JP28039091A 1990-10-03 1991-10-02 動脈瘤の治療用の大動脈腔内人工器官の移植のためのバルーン装置 Expired - Lifetime JP3195390B2 (ja)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AR317999 1990-10-03
AR90317999A AR246020A1 (es) 1990-10-03 1990-10-03 Un dispositivo de balon para implantar una protesis intraluminal aortica para reparar aneurismas.

Publications (2)

Publication Number Publication Date
JPH07241343A true JPH07241343A (ja) 1995-09-19
JP3195390B2 JP3195390B2 (ja) 2001-08-06

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Country Status (11)

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US (1) US5219355A (ja)
EP (1) EP0479557B1 (ja)
JP (1) JP3195390B2 (ja)
KR (1) KR0172124B1 (ja)
AR (1) AR246020A1 (ja)
AT (1) ATE168549T1 (ja)
AU (1) AU646890B2 (ja)
BR (1) BR9104356A (ja)
CA (1) CA2052354C (ja)
DE (1) DE69129830T2 (ja)
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DE69129830T2 (de) 1999-01-28
US5219355A (en) 1993-06-15
CA2052354C (en) 1999-08-17
ATE168549T1 (de) 1998-08-15
EP0479557A1 (en) 1992-04-08
JP3195390B2 (ja) 2001-08-06
AU8488291A (en) 1992-04-09
KR0172124B1 (ko) 1999-02-01
CA2052354A1 (en) 1992-04-04
AR246020A1 (es) 1994-03-30
KR920007647A (ko) 1992-05-27
EP0479557B1 (en) 1998-07-22
DE69129830D1 (de) 1998-08-27
BR9104356A (pt) 1992-06-09
AU646890B2 (en) 1994-03-10
ZA917820B (en) 1992-08-26

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