MEDICAL DEVICE
20170224463 · 2017-08-10
Assignee
Inventors
- Junichi KOBAYASHI (Cupertino, CA, US)
- Tomonori HATTA (Cupertino, CA, US)
- Taiga NAKANO (Sunnyvale, CA, US)
Cpc classification
A61B17/221
HUMAN NECESSITIES
A61B17/320758
HUMAN NECESSITIES
A61F2/013
HUMAN NECESSITIES
International classification
Abstract
A medical device is disclosed for collecting substances inside a body lumen. The medical device includes an elongated shaft portion; a filter portion that has multiple gaps, that is formed in a net shape, that is deformable to be in an expanded state where the filter portion has a basket shape so as to form a concave portion, and that is deformable from the expanded state to be in a contracted state where an opening end portion of the concave portion is contracted; and a support portion that is formed to include a gap larger than gaps of the filter portion and that includes an interlock portion interlocked with the opening end portion of the filter portion and a support side connection portion connected to the shaft portion.
Claims
1. A medical device for collecting substances inside a body lumen, the medical device comprising: an elongated shaft portion; a filter portion that has multiple gaps, that is formed in a net shape, that is deformable to be in an expanded state where the filter portion has a basket shape so as to form a concave portion, and that is deformable from the expanded state to be in a contracted state where an opening end portion of the concave portion is contracted; and a support portion that is formed to include a gap larger than gaps of the filter portion and that includes an interlock portion interlocked with the opening end portion of the filter portion and a support side connection portion connected to the shaft portion, wherein in the expanded state, the support side connection portion can be located in the concave portion, and in the contracted state, the interlock portion contracts with the opening end portion, and the support side connection portion is located away from the filter portion so as to protrude outwardly from the concave portion.
2. The medical device according to claim 1, wherein in a state where an external force is not applied, the filter portion and the support portion are shaped to be in the expanded state.
3. The medical device according to claim 1, wherein a through-hole is formed in the support side connection portion, and the shaft portion is connected to the support side connection portion by slidably penetrating the through-hole.
4. The medical device according to claim 3, wherein a through-hole is formed at an opposite side to the interlock portion of the filter portion in the contracted state, and a filter side connection portion is provided in the through-hole so that the shaft portion is connected to the filter side connection portion by slidably penetrating through the through-hole, and the shaft portion has a stopper part that is located between the support side connection portion and the filter side connection portion and has a size that cannot pass through the support side connection portion and the filter side connection portion.
5. The medical device according to claim 2, wherein a through-hole is formed in the support side connection portion, and the shaft portion is connected to the support side connection portion by slidably penetrating the through-hole.
6. The medical device according to claim 5, wherein a through-hole is formed at an opposite side to the interlock portion of the filter portion in the contracted state, and a filter side connection portion is provided in the through-hole so that the shaft portion is connected to the filter side connection portion by slidably penetrating through the through-hole, and the shaft portion has a stopper part that is located between the support side connection portion and the filter side connection portion and has a size that cannot pass through the support side connection portion and the filter side connection portion.
7. The medical device according to claim 1, further comprising: a tubular sheath that accommodates the filter portion and the support portion in the contracted state and that prevents the filter portion and the support portion from being deformed to the expanded state.
8. The medical device according to claim 1, wherein at least a portion of the filter portion, the support portion, and the shaft portion has an X-ray contrast property.
9. A medical device for collecting substances inside a body lumen, the medical device comprising: an elongated shaft portion; a filter portion that has multiple gaps, that is formed in a net shape, that is deformable to be in an expanded state where the filter portion has a basket shape so as to form a concave portion, and that is deformable from the expanded state to be in a contracted state where an opening end portion of the concave portion is contracted; a support portion that is formed to include a gap larger than the gaps of the filter portion and that includes an interlock portion interlocked with the opening end portion of the filter portion and a support side connection portion connected to the shaft portion, wherein in the expanded state, the support side connection portion can be located in the concave portion, and in the contracted state, the interlock portion contracts with the opening end portion, and the support side connection portion is located away from the filter portion so as to protrude outwardly from the concave portion; and a tubular sheath that accommodates the filter portion and the support portion in the contracted state and that prevents the filter portion and the support portion from being deformed to the expanded state, and wherein at least a portion of the filter portion, the support portion, and the shaft portion has an X-ray contrast property.
10. The medical device according to claim 9, wherein in a state where an external force is not applied, the filter portion and the support portion are shaped to be in the expanded state.
11. The medical device according to claim 9, wherein a through-hole is formed in the support side connection portion, and the shaft portion is connected to the support side connection portion by slidably penetrating the through-hole.
12. The medical device according to claim 11, wherein a through-hole is formed at an opposite side to the interlock portion of the filter portion in the contracted state, and a filter side connection portion is provided in the through-hole so that the shaft portion is connected to the filter side connection portion by slidably penetrating through the through-hole, and the shaft portion has a stopper part that is located between the support side connection portion and the filter side connection portion and has a size that cannot pass through the support side connection portion and the filter side connection portion.
13. The medical device according to claim 10, wherein a through-hole is formed in the support side connection portion, and the shaft portion is connected to the support side connection portion by slidably penetrating the through-hole.
14. The medical device according to claim 13, wherein a through-hole is formed at an opposite side to the interlock portion of the filter portion in the contracted state, and a filter side connection portion is provided in the through-hole so that the shaft portion is connected to the filter side connection portion by slidably penetrating through the through-hole, and the shaft portion has a stopper part that is located between the support side connection portion and the filter side connection portion and has a size that cannot pass through the support side connection portion and the filter side connection portion.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION
[0042] Hereinafter, an embodiment according to the present disclosure will be described with reference to the drawings. In some cases, a dimension ratio in the drawings may be exaggerated and different from a ratio used in practice in order to facilitate the description.
[0043] A medical device 10 according to the embodiment of the present disclosure can be used in treating (taking measures for) a stenosed site or an occluded site caused by plaque, a thrombus, or the like inside a blood vessel. In accordance with an exemplary embodiment, the medical device can be used in order to collect debris (substances) which are dropping down from the stenosed site or the occluded site and flowing inside the blood vessel. In the description, a side of the device which is inserted into the blood vessel is referred to as a “distal side”, and an operating hand side is referred to as a “proximal side”. In addition, the debris is not necessarily limited to the substances dropping down from the stenosed site or the occluded site, and all substances which can be present inside a living body lumen can be referred to as the debris.
[0044] As illustrated in
[0045] The filter device 20 can include a deformation portion 22 which is deformable and can include multiple interwoven wires 21, and an elongated shaft portion 40 which can penetrate the deformation portion 22.
[0046] As illustrated in
[0047] As illustrated in
[0048] As illustrated in
[0049] The number of wires 21 is not particularly limited, and can be 72, for example. A condition for interweaving the wires 21 is not particularly limited, and the wires 21 are interwoven by using, for example, a two-under and two-over pattern.
[0050] The outer diameter of the wires 21 can be appropriately selected depending on a material of the wires 21 or use of the deformation portion 22, and can be, for example, 20 μm to 100 μm. As an example, the outer diameter can be set to 40 μm.
[0051] As a configuration material of the wires 21, a flexible material is preferably used. For example, a shape memory alloy can be used for which a shape memory effect and superelasticity can be provided by heat treatment, stainless steel, Ta, Ti, Pt, Au, W, polyolefin such as polyethylene, or polypropylene, polyester such as polyamide, or polyethylene terephthalate, fluorinated polymer such as ETFE, polyether ether ketone (PEEK), or polyimide. As the shape memory alloy, a Ni—Ti based alloy, a Cu—Al—Ni based alloy, a Cu—Zn—Al based alloy, a combination thereof, or the like can be preferably used. For example, a structure having multiple materials combined therein can include a structure in which a core wire made of Pt is coated with the Ni—Ti alloy in order to provide contrast performance, or a structure in which a core wire made of the Ni—Ti alloy is subjected to gold plating.
[0052] As illustrated in
[0053] As illustrated in
[0054] The outer diameter of the outer tubes 55 and 65 is not particularly limited. However, for example, the outer diameter may be 0.3 mm to 1.5 mm. As an example, 0.65 mm to 0.70 mm can be employed. The inner diameter of the inner tubes 54 and 64 is not particularly limited. However, for example, the inner diameter may be 0.1 mm to 1.0 mm. As an example, 0.25 mm to 0.30 mm can be employed.
[0055] A configuration material of the inner tubes 54 and 55 and the outer tubes 55 and 65 is not particularly limited. However, for example, stainless steel, a shape memory alloy, or the like can be preferably used.
[0056] As illustrated in
[0057] This deformation portion 22 can be formed by deforming the wire 21 so as to be in an expanded state and performing shape memory processing thereon after the wire 21 made of a shape memory alloy is interwoven in a tubular shape. As an example of a method for performing the shape memory processing, the interwoven wires 21 can be first fixed to the support side connection portion 61 and the filter side connection portion 51, and a mold 70 (refer to
[0058] As illustrated in
[0059] A configuration material of the shaft portion 40 is not particularly limited. However, for example, stainless steel, a shape memory alloy, or the like can be used.
[0060] As illustrated in
[0061] A configuration material of the tubular body 31 is not particularly limited. However, for example, polyolefin such as polyethylene, polypropylene, ethylene-propylene copolymer, or ethylene-vinyl acetate copolymer, polyvinyl chloride, polystyrene, polyamide, polyimide, or a combination thereof can be used. The tubular body 31 may be configured to include multiple materials, or may be configured so that a reinforcing member such as a wire or the like may be embedded therein.
[0062] Next, a method of using the medical device 10 according to the present embodiment will be described by using an example where the medical device 10 is applied to atherectomy.
[0063] First, an introducer sheath (not illustrated) is percutaneously inserted into the blood vessel on an upstream side (proximal side) from a stenosed site S in the blood vessel, and a guidewire 80 is inserted into the blood vessel via the introducer sheath. Then, the guidewire 80 is pushed forward so as to reach the proximal side of the stenosed site S, as illustrated in
[0064] Next, the proximal end portion of the guidewire 80 located extracorporeally is inserted into a catheter opening 96 on the distal side of a support catheter 95, and the support catheter 95 is pushed forward to reach the proximal side of the stenosed site S. Thereafter, as illustrated in
[0065] Next, as illustrated in
[0066] Then, the sheath 30 is moved relatively to the proximal side from the filter device 20, and the deformation portion 22 is caused to protrude to the distal side from the tubular body 31. In this manner, as illustrated in
[0067] Then, as illustrated in
[0068] When the atherectomy device 100 is inserted into the blood vessel, the proximal end portion of the shaft portion 40 is inserted into the distal opening 104 so as to reach the inside of the blood vessel via the guiding catheter 90. Then, the rotary member 101 is arranged on the proximal side of the stenosed site S. If the rotary member 101 is rotatably driven and pushed forward to the distal side by the drive shaft 102, as illustrated in
[0069] Then, the proximal end portion of the shaft portion 40 is inserted into the tubular body opening 36 of the sheath 30 (aspiration catheter). As illustrated in
[0070] Then, if the shaft portion 40 is moved relatively to the proximal side from the sheath 30, as illustrated in
[0071] Thereafter, the filter device 20 is removed together with the sheath 30, and the guiding catheter 90 and the introducer sheath are removed. In this manner, the manipulation skill is completed.
[0072] As described above, the medical device 10 according to the embodiment has the elongated shaft portion 40, the filter portion 50 which is formed in a net shape including the multiple gaps 52, and which is deformable between the expanded state in a basket shape so as to form the concave portion 53 and the contracted state in which the opening end portion 53A of the concave portion 53 is contracted from the expanded state, and the support portion 60 which is formed to include the gap 62 larger than the gap 52 of the filter portion 50, and which can include the interlock portion 63 interlocked with the opening end portion 53A of the filter portion 50 and the support side connection portion 61 connected to the shaft portion 40. In the expanded state, the support side connection portion 61 can be located inside the concave portion 53 of the filter portion 50. In the contracted state, the interlock portion 63 contracts with the opening end portion 53A, and the support side connection portion 61 is located by being separated from the filter portion 50 so as to protrude outward from the concave portion 53. Therefore, the medical device 10 can effectively aspirate the debris D collected inside the concave portion 53 in such a way that the filter portion 50 which is delivered into the living body lumen in the contracted state is expanded and installed inside the living body lumen, the filter portion 50 is caused to function as the filter, and the aspiration catheter is caused to reach the inside of the concave portion 53 by using the shaft portion 40 reaching the inside of the concave portion 53 as the guide. Furthermore, when the filter portion 50 collecting the debris D is brought into the contracted state, since the gap 62 of the support portion 60 is larger than the gap 52 of the filter portion 50, the debris D passes through the gap 62 of the support portion 60, and is held inside the filter portion 50. Accordingly, the debris D can be prevented from dropping down from the filter portion 50. Therefore, restenosis can be prevented from occurring in a peripheral portion.
[0073] In addition, the filter portion 50 and the support portion 60 are shaped so as to be in an expanded state, in a natural state where an external force is not applied. The filter portion 50 and the support portion 60 can be brought into the expanded state by only releasing restriction in the shape after being delivered into the living body lumen in a contracted state, thereby improving operability.
[0074] In addition, the support side connection portion 61 is connected to the shaft portion 40 in such a way that the through-hole 67 is formed therein, and the shaft portion 40 penetrates the through-hole 67 so as to be slidable. Therefore, without moving the filter portion 50 installed inside the living body lumen, it is possible to operate only the shaft portion 40.
[0075] In addition, the through-hole 57 is formed on the side opposite to the interlock portion 63 of the filter portion 50 in the contacted state, and the filter side connection portion 51 connected to the shaft portion 40 by the shaft portion 40 penetrating the through-hole 57 so as to be slidable is disposed therein. The shaft portion 40 is located between the support side connection portion 61 and the filter side connection portion 51, and has the stopper portion 41 having a size which cannot pass through the support side connection portion 61 and the filter side connection portion 51. Therefore, the shaft portion 40 can be moved independently from the filter portion 50 within a predetermined range. Without moving the filter portion 50, it is possible to operate only the shaft portion 40. Furthermore, the shaft portion 40 is moved, and the stopper portion 41 is brought into contact with the support side connection portion 61 or the filter side connection portion 51. In this manner, the deformation or the movement of the filter portion 50 can be operated via the shaft portion 40.
[0076] In addition, the medical device 10 has the tubular sheath 30 which accommodates the filter portion 50 and the support portion 60 in the contracted state, and which can help prevent the filter portion 50 and the support portion 60 from being deformed to be in the expanded state. Accordingly, the filter portion 50 and the support portion 60 which are in the contracted state can be delivered to a desired position by being accommodated inside the sheath 30. Therefore, the filter portion 50 and the support portion 60 can be installed into the living body lumen after the filter portion 50 and the support portion 60 are brought into the expanded state by being released from the sheath 30.
[0077] In addition, the present disclosure provides a method of collecting debris (substances) inside the living body lumen. The method is performed by using a medical device including an elongated shaft portion, a filter portion that has multiple gaps, that is formed in a net shape, and that is deformable to be in an expanded state where the filter portion has a basket shape so as to form a concave portion and is deformable from the expanded state to be in a contracted state where an opening end portion of the concave portion is contracted, and a support portion that is formed to include a gap larger than the gaps of the filter portion, and can include an interlock portion interlocked with the opening end portion of the filter portion and a support side connection portion connected to the shaft portion, in which in the expanded state, the support side connection portion can be located inside the concave portion of the filter portion, and in the contracted state, the interlock portion contracts with the opening end portion and the support side connection portion is located away from the filter portion so as to protrude outward from the concave portion. Then, the method can include (i) a step of inserting the filter portion in the contracted state into the living body lumen, (ii) a step of installing the filter portion in the living body lumen by bringing the filter portion into the expanded state, (iii) a step of collecting the substances inside the living body lumen by using the filter portion, (iv) a step of inserting an aspiration catheter which can apply aspiration force to a distal opening via a lumen formed inside the aspiration catheter, into the living body lumen along the shaft portion, and fitting the distal opening into the concave portion of the filter portion, (v) a step of aspirating the substances collected inside the concave portion by using the aspiration catheter, (vi) a step of bringing the filter portion into the contracted state, and (vii) a step of removing the filter portion from the inside of the living body lumen. According to the method, the aspiration catheter can be caused to reach the inside of the concave portion by the shaft reaching the inside of the concave portion of the filter portion serving as a guide. Therefore, substances (debris) collected in the concave portion can be effectively aspirated and removed from the filter portion.
[0078] In addition, the above-described method may further include a step of scraping off stenosis substances or occluding substances formed inside the living body lumen on an upstream side (proximal side) of the filter portion, after the step of installing the filter portion in the living body lumen, and before the step of collecting the substances inside the living body lumen by using the filter portion. In this manner, the debris generated by the stenosis substances or the occluding substances being scraped off is filtered and collected by the filter portion. Accordingly, the debris can be effectively aspirated and removed from the filter portion by using the aspiration catheter.
[0079] In addition, according to the above-described method, in the step of bringing the filter portion into the contracted state, the filter portion may be brought into the contracted state by accommodating the filter portion inside the aspiration catheter. In this manner, the filter portion can be brought into the contracted state by using the aspiration catheter, thereby improving workability. In addition, the filter portion can be accommodated inside the aspiration catheter by applying aspiration force. In this manner, the filter portion can be contracted while the debris inside the filter portion is prevented from dropping down therefrom.
[0080] The present invention is not limited to the above-described embodiment, and can be modified in various ways within the technical idea of the present invention by those skilled in the art. For example, in the present embodiment, in the filter portion 50, the proximal side in an expanded state is concave to become the concave portion 53. However, depending on use, the distal side may be the concave portion.
[0081] In addition, the living body lumen into which the medical device 10 is inserted is not limited to the blood vessel. For example, the living body lumen may be vascular, ureteral, biliary, a fallopian tube, a hepatic duct, or the like. In addition, the medical device can be applied to another purpose in addition to the manipulation skill using the atherectomy device.
[0082] In addition, as in a modification example illustrated in
[0083] In addition, as in another modification example illustrated in
[0084] In addition, according to the above-described embodiment, in a natural state where external force is not applied, the filter portion 50 and the support portion 60 are brought into an expanded state. However, without being limited thereto, the filter portion 50 and the support portion 60 may be brought into a contracted state in a natural state. In this case, the external force is applied so as to deform the filter portion and the support portion, thereby bringing the filter portion and the support portion into the expanded state. For example, as in still another modification example illustrated in
[0085] In addition, as illustrated in
[0086] In addition, at least a portion of the filter portion 50 including the filter side connection portion 51 and the wires 21, the support portion 60 including the support side connection portion 61 and the wires 21, and the shaft portion 40 including the stopper portion 41 may be formed so that a configuration material of the filter portion 50, the support portion 60, and the shaft portion can contain a material having X-ray contrast performance. For example, a portion of the multiple wires 21 may be formed so that the configuration material contains the material having X-ray contrast performance. In this manner, a position can be accurately recognized by using X-ray contrast. Accordingly, required manipulation skill becomes easier. For example, as the material having X-ray contrast performance, it can be preferable to use gold, platinum, a platinum-iridium alloy, silver, stainless steel, molybdenum, tungsten, tantalum, palladium, or an alloy thereof.
[0087] The detailed description above describes a collection method. The invention is not limited, however, to the precise embodiments and variations described. Various changes, modifications and equivalents can effected by one skilled in the art without departing from the spirit and scope of the invention as defined in the accompanying claims. It is expressly intended that all such changes, modifications and equivalents which fall within the scope of the claims are embraced by the claims.