JP3532730B2 - 二股ステントとその作製方法 - Google Patents
二股ステントとその作製方法Info
- Publication number
- JP3532730B2 JP3532730B2 JP11582297A JP11582297A JP3532730B2 JP 3532730 B2 JP3532730 B2 JP 3532730B2 JP 11582297 A JP11582297 A JP 11582297A JP 11582297 A JP11582297 A JP 11582297A JP 3532730 B2 JP3532730 B2 JP 3532730B2
- Authority
- JP
- Japan
- Prior art keywords
- edge
- sheet
- stem
- bifurcated stent
- leg
- 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
Links
Classifications
-
- 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
- A61F2/856—Single tubular stent with a side portal passage
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
-
- 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
- A61F2/852—Two or more distinct overlapping stents
-
- 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
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- 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
- A61F2/91—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 made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
-
- 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
- A61F2/91—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 made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—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 made from perforated sheets or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
-
- 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
- A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
-
- 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
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
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-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/065—Y-shaped blood vessels
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-
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- 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
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- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0058—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements soldered or brazed or welded
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- A—HUMAN NECESSITIES
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- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
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- A61F2240/00—Manufacturing or designing of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2240/001—Designing or manufacturing processes
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
- Y10S623/901—Method of manufacturing prosthetic device
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T29/00—Metal working
- Y10T29/49—Method of mechanical manufacture
- Y10T29/494—Fluidic or fluid actuated device making
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)
- Gastroenterology & Hepatology (AREA)
- Pulmonology (AREA)
- Physics & Mathematics (AREA)
- Optics & Photonics (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
Description
関し、特に、分岐管内に挿入される二股ステント(bifur
cated stent)の作製方法に関する。
トは当該技術分野で良く知られている。一般にステント
は、内圧が加わったときに膨張可能な円筒形の金網から
形成される。或いは、ワイヤを円筒形に巻いたりシート
材を円筒形に形成したりすることによっても、ステント
を形成できる。
一般に植え込まれて、血管の崩壊、部分的閉塞、弱化又
は異常拡張した部分を補強する装置である。またステン
トは、例えば尿路や胆管等の他の領域に植え込まれてそ
のような身体導管を補強するためにも、首尾よく使用さ
れている。米国特許第4,994,071号(マクレガ
ー)は、連結形成された可撓性の主円筒格子を備えた膨
張可能な二股ステントを開示する。主格子よりも小径の
2個の補助円筒格子が同様に形成される。主格子は、主
格子を一方の補助格子に連結する可撓性ワイヤを備え
る。第2の可撓性ワイヤが、主格子を他方の補助格子に
連結する。これら可撓性ワイヤは、主格子及び各補助格
子に沿って軸方向へ延びる背骨部分を構成する。この二
股ステントの1つの課題は、背骨部分を構成する可撓性
ワイヤをループ状構造の各格子に連結する作業が複雑さ
を伴うことにある。
課題を解決すべく、茎部と2個の脚部とを備えた二股ス
テントを作製しかつ配備する方法を提供することにあ
る。
に、請求項1に記載の発明は、二股ステントの作製方法
であって、a)基端及び末端を備えた第1シートを用意
し、b)第1シートの末端を変形して第1脚部を形成す
るとともに、第1シートの基端を変形して茎部第1半体
を形成し、c)基端及び末端を備えた第2シートを用意
し、d)第2シートの末端を変形して第2脚部を形成す
るとともに、第2シートの基端を変形して茎部第2半体
を形成し、e)茎部第1半体を茎部第2半体に連結して
茎部を形成する、各ステップを有した方法を提供する。
及び末端を備え、末端の変形により第1脚部を形成する
とともに基端の変形により茎部第1半体を形成する第1
シートと、b)基端及び末端を備え、末端の変形により
第2脚部を形成するとともに基端の変形により茎部第2
半体を形成する第2シートと、c)茎部第1半体を茎部
第2半体に連結して茎部を形成する連結手段と、を具備
することを特徴とする二股ステントを提供する。
ントの作製方法であって、a)基端及び末端を備えると
ともに、第1縁、第2縁、第3縁、第4縁、第5縁、第
6縁、第7縁及び第8縁を備えた第1シートを用意し、
b)第1シートの末端を変形しかつ第4縁を第6縁に連
結して第1脚部を形成するとともに、第1シートの基端
を変形して茎部第1半体を形成し、c)基端及び末端を
備えるとともに、第1縁、第2縁、第3縁、第4縁、第
5縁、第6縁、第7縁及び第8縁を備えた第2シートを
用意し、d)第2シートの末端を変形しかつ第4縁を第
6縁に連結して第2脚部を形成するとともに、第2シー
トの基端を変形して茎部第2半体を形成し、e)茎部第
1半体の第8縁を茎部第2半体の第2縁に連結するとと
もに、茎部第1半体の第2縁を茎部第2半体の第8縁に
連結して茎部を形成する、各ステップを有した方法を提
供する。
及び末端を備えるとともに第1縁、第2縁、第3縁、第
4縁、第5縁、第6縁、第7縁及び第8縁を備え、第4
縁と第6縁との変形及び連結により第1脚部を形成する
とともに基端の変形により茎部第1半体を形成する第1
シートと、b)基端及び末端を備えるとともに第1縁、
第2縁、第3縁、第4縁、第5縁、第6縁、第7縁及び
第8縁を備え、第4縁と第6縁との変形及び連結により
第2脚部を形成するとともに基端の変形により茎部第2
半体を形成する第2シートと、c)茎部第1半体の第8
縁を茎部第2半体の第2縁に連結するとともに、茎部第
1半体の第2縁を茎部第2半体の第8縁に連結して茎部
を形成する連結手段と、を具備することを特徴とする二
股ステントを提供する。
シートを用意することにより作製される。各シートに対
し、シートの一部分の長手方向両縁を巻上げて互いに固
定することにより、二股ステントの2つの脚部の一方が
形成される。2枚のシートの各々の残りの自由縁を連結
することにより、ステントの茎部が形成される。
て作製された二股ステント5を示す。二股ステント5
は、第1脚部10、第2脚部15及び茎部20を備え
る。図2は、第1脚部10を形成するために使用される
第1シート25と、第2脚部15を形成するために使用
される第2シート30と、茎部20を形成するために使
用される第3シート35とを示す。第1シート25及び
第2シート30は、実質的に平坦で所定の長さ及び幅を
有する。多くの適用に対し、第1シート25及び第2シ
ート30は実質的同一寸法を有して、実質的同一寸法の
両脚部10、15を形成する。しかし両脚部10、1
5、及びそれらの形成に使用される両シート25、30
は、特定の適用に応じて異なる寸法を有することができ
る。このステントは、組立てたときにその最終寸法を呈
するように寸法設定できるが、好適な形態では、ステン
トは膨張可能であって、膨張時にその最終寸法を呈する
ように寸法設定される。ステント用の両シート25、3
0は、特定の適用に応じて様々なパターンを形成する孔
群をそれらに模様付け又は食刻することにより、前述し
た所要の膨張可能性の特徴を得ることができる。第3シ
ート35は、それを巻いて管を形成したときに、その内
側断面形状が第1脚部10及び第2脚部15の断面外径
部分を収容できるように寸法設定される。第1シート2
5は、第1縁26、第2縁27、第3縁28及び第4縁
29を備える。第2シート30は、第1縁31、第2縁
32、第3縁33及び第4縁34を備える。第3シート
35は、第1縁36、第2縁37、第3縁38及び第4
縁39を備える。板金を切断して各シート25、30、
35を形成した後、各シートを変形して巻き、対向2縁
を合わせて円筒を形成する。図2及び図3の形態では、
第2縁27と第4縁29とが溶接部14を介して接合さ
れて、第1脚部10が形成される。また、第2縁32と
第4縁34とが溶接部19を介して接合されて、第2脚
部15が形成される。さらに、第2縁37と第4縁39
とが溶接部24を介して接合されて、茎部20が形成さ
れる。これら縁は、例えばねじ留め、ひだ付け、はんだ
付け等の、この目的に適した当業者に周知の様々な方法
で接合できるが、好適な形態では溶接が採用される。特
に好適な形態では、スポット溶接が採用される。図3に
示すように、第1脚部10は基端11及び末端12を備
え、長手方向ボア13を画成する。第2脚部15は基端
16及び末端17を備え、長手方向ボア18を画成す
る。茎部20は基端21及び末端22を備え、長手方向
ボア23を画成する。図4は、組立直前の第1脚部1
0、第2脚部15及び茎部20を示す。二股ステント5
を形成するために、第1脚部10の基端11と第2脚部
15の基端16とが茎部20の末端22に接合され、各
長手方向ボア13、18、23が互いに連通される。図
5は組立てられたステントの端面図であり、図6は同側
面図である。
って作製された二股ステント50を示す。二股ステント
50は、茎部65に付設される第1脚部55及び第2脚
部60を備える。二股ステント50は、図7(a)に示
す第1シート70と第2シート75とから形成される。
ステント用の両シート70、75は、特定の適用に応じ
て様々なパターンを形成する孔群をそれらに模様付け又
は食刻することにより、前述した所要の膨張可能性の特
徴を得ることができる。両シート70、75は実質的に
平坦で所定の長さ及び幅を有する。第1シート70は、
第1縁71、第2縁72、第3縁73及び第4縁74を
備える。第2シート75は、第1縁76、第2縁77、
第3縁78及び第4縁79を備える。ステントの両脚部
を形成するために、第2縁72の一部が第4縁74の一
部に向けて巻かれ、第2縁77の一部が第4縁79の一
部に向けて巻かれる。図8に示すように、両シート7
0、75には境界画定点80、81、82、83が選定
される。これら境界画定点80、81、82、83は、
特定の適用の要求に適合すべく選定されるものであり、
両脚部55、60に要求される長さ及び茎部65に要求
される長さに応じて調整できる。第1縁71及び第3縁
73から等距離に境界画定点80、81を選定し、かつ
第1縁76及び第3縁78から等距離に境界画定点8
2、83を選定することにより、両脚部55、60が茎
部65に実質的に等しい長さを有するステントが形成さ
れる。これら境界画定点を第1縁71、76よりも第3
縁73、78に近い位置に選定した場合は、茎部の長さ
が各脚部の長さよりも長くなる。また、これら境界画定
点を第3縁73、78よりも第1縁71、76に近い位
置に選定した場合は、各脚部55、60の長さが茎部6
5の長さよりも長くなる。しかし好適な実施形態では、
各境界画定点80、81、82、83は、第2縁72、
77及び第4縁74、79の長さの約1/3がそれぞれ
基端縁72″、77″、74″及び79″を形成する位
置に選定される。図8に示すように、境界画定点80は
第2縁72をそのほぼ中間で末端縁72′と基端縁7
2″とに分割する。また境界画定点81は、第4縁74
をそのほぼ中間で末端縁74′と基端縁74″とに分割
する。また境界画定点82は、第2縁77をそのほぼ中
間で末端縁77′と基端縁77″とに分割する。また境
界画定点83は、第4縁79をそのほぼ中間で末端縁7
9′と基端縁79″とに分割する。
が溶接部90を介して末端縁74′に接続され、図9
(a)に示すように第1脚部55と茎部第1半体65′
とを備えた第1部材95が形成される。また、末端縁7
7′が溶接部91を介して末端縁79′に接続され、第
2脚部60と茎部第2半体65″とを備えた第2部材1
00が形成される。前述したように、これら縁は当業者
に周知の様々な方法で接続できる。図10(a)は、図
9(a)に示す第1部材95及び第2部材100を、組
立直前の相対位置合せ状態で示す。図11(a)及び図
12(a)に示す二股ステント50を作製するために、
基端縁72″が溶接部92を介して基端縁79″に接続
され、かつ基端縁74″が溶接部93を介して基端縁7
7″に接続されて、茎部第1半体65′と茎部第2半体
65″とにより茎部65を形成する。図12(a)は図
11(a)に示すステント50の横断面状の端面図であ
る。
70、75は正方形又は長方形のものである。しかし各
シート70、75はこのような形状に限定されるもので
なく、例えば図7(b)に示すような形状を採用でき
る。図11(b)は、図7(b)に示す第1シート27
0及び第2シート280を用いて作製された本発明の他
の実施形態による二股ステント250を示す。二股ステ
ント250は、茎部265に付設される第1脚部255
及び第2脚部260を備える。二股ステント250は、
図7(b)に示す第1シート270と第2シート280
とから形成される。ステント用の両シート270、28
0は、前述したようにして寸法設定及び食刻を行うこと
ができる。図7(b)に示すように、第1シート270
は、第1縁271、第2縁272、第3縁273、第4
縁274、第5縁275、第6縁276、第7縁146
及び第8縁147を備える。第2シート280は、第1
縁281、第2縁282、第3縁283、第4縁28
4、第5縁285、第6縁286、第7縁148及び第
8縁149を備える。図9(b)に示すように、第4縁
274が溶接部290を介して第6縁276に接続さ
れ、第1脚部255と茎部第1半体265′とを備えた
第1部材295が形成される。また、第4縁284が溶
接部291を介して第6縁286に接続され、第2脚部
260と茎部第2半体265″とを備えた第2部材30
0が形成される。前述したように、これら縁は当業者に
周知の様々な方法で接続できる。図10(b)は、図9
(b)に示す第1部材295及び第2部材300を、組
立直前の相対位置合せ状態で示す。図11(b)及び図
12(b)に示す二股ステント250を作製するため
に、第2縁272が溶接部292を介して第8縁149
に接続され、かつ第2縁282が溶接部293を介して
第8縁147に接続されて、茎部第1半体265′と茎
部第2半体265″とにより茎部265を形成する。図
12(b)は図11(b)に示すステント250の横断
面状の端面図である。図12(c)は図7(a)及び
(b)に示す形状の代わりに使用できる代替形状を示
す。
患部内に2ステップで順次に配置されて患部内で組立て
られることにより、二股ステントが作製される。図13
は、長手方向ボア131と、茎部125を構成する基端
115と、第1脚部130を構成する末端120とを備
えた茎及び第1脚部110を示す。第2脚部140は、
長手方向ボア132と基端145と末端150とを備え
る。茎及び第1脚部110と第2脚部140とは、前述
したように寸法設定でき、また模様付け又は刻設でき
る。茎及び第1脚部110の基端115と末端120と
の間に、枝穴135が配置される。枝穴135は、第2
脚部140を受容する寸法を有し、第2脚部140が枝
穴135内で膨張したときに第2脚部140を係合固定
するようになっている。第2脚部140は、膨張時に枝
穴135に係合して固定されるように寸法設定される。
図14〜図21は、二股ステントを分岐管腔内で組立て
る手順を示す。図14〜図21に示すように、処置すべ
き領域は第1すなわち本管腔190と第2すなわち枝管
腔195とを備えた分岐管腔である。図14に示すよう
に、第1ガイドワイヤ155が本管腔190内に導入さ
れ、第2ガイドワイヤ156が枝管腔195内に導入さ
れる。図15に示すように、バルーン式膨張可能な茎及
び第1脚部110は、バルーン175を長手方向ボア1
31内に配置するようにして、第1バルーンカテーテル
170の先端に配置される。次に第2バルーンカテーテ
ル171が、茎及び第1脚部110の長手方向ボア13
1内に導入され、バルーン176が枝穴135内に配置
されるように前進させられる。第1カテーテル170は
第1ガイドワイヤ155に装着され、第2カテーテル1
71は第2ガイドワイヤ156に装着される。図16に
示すように、非膨張状態の茎及び第1脚部110が処置
領域に案内され、それにより第1脚部130が本管腔1
90内に配置されるとともに、枝穴135が枝管腔19
5に連通させられる。第2ガイドワイヤ156は、枝穴
135を枝管腔195に向けるように作用する。従来一
般的なカテーテル及びバルーンの寸法は規定しないし、
当業者に周知の詳細事項は明瞭化のために省略する。バ
ルーン175の膨張により茎及び第1脚部110が膨張
し、図17に示すように茎及び第1脚部110が所望位
置に固定される。茎及び第1脚部110の外壁は膨張後
に本管腔190の内壁に接触するが、図では明瞭化のた
めに隙間を故意に残して示す。第1カテーテル170の
バルーン175は膨張状態に保持され、次に第2カテー
テル171のバルーン176が膨張して図18に示すよ
うに枝穴135を拡張させる。枝穴135が拡張するに
従い、枝穴135を画成するステントの一部分が外側に
押されて枝固定リップ180を形成する。
カテーテル171を引抜く一方で、第2ガイドワイヤ1
56を枝管腔195内の適所に残す。次に、バルーン1
76を長手方向ボア132内に配置するようにして第2
脚部140を第2カテーテル171に取付け、次いで第
2カテーテル171を第2ガイドワイヤ156に取付け
る。そして図19に示すように、第2脚部140を、茎
及び第1脚部110の長手方向ボア131内に案内しつ
つ導入し、かつ枝穴135を通して前進させ、それによ
り第2脚部140の末端150を枝管腔195内に突出
させるとともに、基端145を長手方向ボア131に連
通させる。そこで第2カテーテル171のバルーン17
6を不完全に膨張させ、次いで第1カテーテル170の
バルーン175を、バルーン176内の圧力と実質的同
一の圧力まで不完全に膨張させる。その後、両バルーン
175、176を実質的同一圧力まで同時に膨張させ
る。図20に示すように、第2カテーテル171のバル
ーン176の膨張により第2脚部140が膨張し、第2
脚部の外壁が枝穴135の周辺領域に係合して固定され
る。第1カテーテル170のバルーン175の膨張は、
バルーン176の膨張時に茎及び第1脚部110を折曲
させないように作用する。膨張後に、第2脚部140の
外壁は枝管腔195の内壁に接触するが、図では明瞭化
のために隙間を故意に残して示す。両バルーン175、
176を抜気し、両ガイドワイヤ155、156を引抜
く一方で、組立てられた二股ステント160を図21に
示すように適所に残す。
ントを示す斜視図である。
用される各シートを示す平面図である。
図である。
る。
テントの端面図である。
二股ステントに使用される各シートを示す平面図、及び
(b)本発明の他の実施形態に従って作製される二股ス
テントに使用される各シートを示す平面図、である。
平面図である。
す斜視図、及び(b)図7(b)の各シートを管状に巻
いた状態で示す斜視図、である。
示す斜視図、及び(b)図9(b)の各管を組立直前の
状態で示す斜視図、である。
組立後の状態で示す側面図、並びに(b)図9(b)及
び図10(b)の各管を組立後の状態で示す側面図、で
ある。
の端面図、(b)図11(b)に示す組立後のステント
の端面図、並びに(c)図7(a)及び(b)に示す各
シート形状の代わりに使用できるシート形状を示す平面
図、である。
股ステントに使用される茎及び第1脚部と第2脚部とを
示す斜視図である。
両ガイドワイヤを示す図である。
第1脚部と、両ガイドワイヤとを、処置対象の管腔内に
挿入される前段階で示す図である。
分岐部分に送給した後でかつ膨張前の状態で示す図であ
る。
図である。
示す図である。
る。
二股ステントを示す図である。
Claims (36)
- 【請求項1】 二股ステントの作製方法であって、 a)基端及び末端を備えた第1シートを用意し、 b)前記第1シートの前記末端を変形して第1脚部を形
成するとともに、該第1シートの前記基端を変形して茎
部第1半体を形成し、 c)基端及び末端を備えた第2シートを用意し、 d)前記第2シートの前記末端を変形して第2脚部を形
成するとともに、該第2シートの前記基端を変形して茎
部第2半体を形成し、 e)前記茎部第1半体を前記茎部第2半体に連結して茎
部を形成する、 各ステップを有した方法。 - 【請求項2】 前記第2シートに膨張可能なパターンを
付与するステップをさらに有する請求項1に記載の方
法。 - 【請求項3】 前記第1シートと前記第2シートとが実
質的同一の寸法を有する請求項1に記載の方法。 - 【請求項4】 前記第1シートと前記第2シートとが異
なる寸法を有する請求項1に記載の方法。 - 【請求項5】 前記連結ステップがねじ留めを利用して
行われる請求項1に記載の方法。 - 【請求項6】 前記連結ステップがひだ付けを利用して
行われる請求項1に記載の方法。 - 【請求項7】 前記連結ステップがはんだ付けを利用し
て行われる請求項1に記載の方法。 - 【請求項8】 前記連結ステップが溶接を利用して行わ
れる請求項1に記載の方法。 - 【請求項9】 前記溶接ステップがスポット溶接を利用
して行われる請求項8に記載の方法。 - 【請求項10】 a)基端及び末端を備え、該末端の変
形により第1脚部を形成するとともに該基端の変形によ
り茎部第1半体を形成する第1シートと、 b)基端及び末端を備え、該末端の変形により第2脚部
を形成するとともに該基端の変形により茎部第2半体を
形成する第2シートと、 c)前記茎部第1半体を前記茎部第2半体に連結して茎
部を形成する連結手段と、 を具備すること を特徴とする二股ステント。 - 【請求項11】 前記第1シートと前記第2シートとが
実質的同一の寸法を有する請求項10に記載の二股ステ
ント。 - 【請求項12】 前記第1シートと前記第2シートとが
異なる寸法を有する請求項10に記載の二股ステント。 - 【請求項13】 前記連結手段がねじである請求項10
に記載の二股ステント。 - 【請求項14】 前記連結手段がひだである請求項10
に記載の二股ステント。 - 【請求項15】 前記連結手段がはんだである請求項1
0に記載の二股ステント。 - 【請求項16】 前記連結手段が溶接である請求項10
に記載の二股ステント。 - 【請求項17】 前記溶接がスポット溶接である請求項
16に記載の二股ステント。 - 【請求項18】 前記第1及び第2シートに膨張可能な
パターンが食刻されてなる請求項10に記載の二股ステ
ント。 - 【請求項19】 二股ステントの作製方法であって、 a)基端及び末端を備えるとともに、第1縁、第2縁、
第3縁、第4縁、第5縁、第6縁、第7縁及び第8縁を
備えた第1シートを用意し、 b)前記第1シートの前記末端を変形しかつ前記第4縁
を前記第6縁に連結して第1脚部を形成するとともに、
該第1シートの前記基端を変形して茎部第1半体を形成
し、 c)基端及び末端を備えるとともに、第1縁、第2縁、
第3縁、第4縁、第5縁、第6縁、第7縁及び第8縁を
備えた第2シートを用意し、 d)前記第2シートの前記末端を変形しかつ前記第4縁
を前記第6縁に連結して第2脚部を形成するとともに、
該第2シートの前記基端を変形して茎部第2半体を形成
し、 e)前記茎部第1半体の前記第8縁を前記茎部第2半体
の前記第2縁に連結するとともに、前記茎部第1半体の
前記第2縁を前記茎部第2半体の前記第8縁に連結して
茎部を形成する、 各ステップを有した方法。 - 【請求項20】 前記第1シートと前記第2シートとが
実質的同一の寸法を有する請求項19に記載の方法。 - 【請求項21】 前記第1シートと前記第2シートとが
異なる寸法を有する請求項19に記載の方法。 - 【請求項22】 前記連結ステップがねじ留めを利用し
て行われる請求項19に記載の方法。 - 【請求項23】 前記連結ステップがひだ付けを利用し
て行われる請求項19に記載の方法。 - 【請求項24】 前記連結ステップがはんだ付けを利用
して行われる請求項19に記載の方法。 - 【請求項25】 前記連結ステップが溶接を利用して行
われる請求項19に記載の方法。 - 【請求項26】 前記溶接ステップがスポット溶接を利
用して行われる請求項25に記載の方法。 - 【請求項27】 前記第1及び第2シートに食刻パター
ンを付与するステップをさらに有する請求項19に記載
の方法。 - 【請求項28】 a)基端及び末端を備えるとともに第
1縁、第2縁、第3縁、第4縁、第5縁、第6縁、第7
縁及び第8縁を備え、該第4縁と該第6縁との変形及び
連結により第1脚部を形成するとともに該基端の変形に
より茎部第1半体を形成する第1シートと、 b)基端及び末端を備えるとともに第1縁、第2縁、第
3縁、第4縁、第5縁、第6縁、第7縁及び第8縁を備
え、該第4縁と該第6縁との変形及び連結により第2脚
部を形成するとともに該基端の変形により茎部第2半体
を形成する第2シートと、 c)前記茎部第1半体の前記第8縁を前記茎部第2半体
の前記第2縁に連結するとともに、該茎部第1半体の前
記第2縁を該茎部第2半体の前記第8縁に連結して茎部
を形成する連結手段と、 を具備することを特徴とする二股ステント。 - 【請求項29】 前記第1シートと前記第2シートとが
実質的同一の寸法を有する請求項28に記載の二股ステ
ント。 - 【請求項30】 前記第1シートと前記第2シートとが
異なる寸法を有する請求項28に記載の二股ステント。 - 【請求項31】 前記連結手段がねじである請求項28
に記載の二股ステント。 - 【請求項32】 前記連結手段がひだである請求項28
に記載の二股ステント。 - 【請求項33】 前記連結手段がはんだである請求項2
8に記載の二股ステント。 - 【請求項34】 前記連結手段が溶接である請求項28
に記載の二股ステント。 - 【請求項35】 前記溶接がスポット溶接である請求項
34に記載の二股ステント。 - 【請求項36】 前記第1及び第2シートが膨張可能な
パターンを備えてなる請求項28に記載の二股ステン
ト。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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US64229796A | 1996-05-03 | 1996-05-03 | |
US08/642297 | 1996-05-03 |
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JP2003333592A Division JP2004041766A (ja) | 1996-05-03 | 2003-09-25 | 二股ステントとその作製方法 |
JP2003333781A Division JP4456842B2 (ja) | 1996-05-03 | 2003-09-25 | 二股ステント |
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JPH1043313A JPH1043313A (ja) | 1998-02-17 |
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ID=24576029
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JP11582297A Expired - Lifetime JP3532730B2 (ja) | 1996-05-03 | 1997-05-06 | 二股ステントとその作製方法 |
JP2003333592A Pending JP2004041766A (ja) | 1996-05-03 | 2003-09-25 | 二股ステントとその作製方法 |
JP2003333781A Expired - Lifetime JP4456842B2 (ja) | 1996-05-03 | 2003-09-25 | 二股ステント |
JP2007130921A Expired - Lifetime JP4567707B2 (ja) | 1996-05-03 | 2007-05-16 | 二股ステントの作製方法 |
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Application Number | Title | Priority Date | Filing Date |
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JP2003333592A Pending JP2004041766A (ja) | 1996-05-03 | 2003-09-25 | 二股ステントとその作製方法 |
JP2003333781A Expired - Lifetime JP4456842B2 (ja) | 1996-05-03 | 2003-09-25 | 二股ステント |
JP2007130921A Expired - Lifetime JP4567707B2 (ja) | 1996-05-03 | 2007-05-16 | 二股ステントの作製方法 |
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US (7) | US5755734A (ja) |
EP (2) | EP1040795B1 (ja) |
JP (4) | JP3532730B2 (ja) |
KR (1) | KR970073534A (ja) |
CN (1) | CN1154449C (ja) |
AR (3) | AR007008A1 (ja) |
AT (2) | ATE299359T1 (ja) |
AU (1) | AU729227B2 (ja) |
BR (1) | BR9703057A (ja) |
CA (2) | CA2204338C (ja) |
CZ (1) | CZ130097A3 (ja) |
DE (3) | DE69734691T2 (ja) |
EE (1) | EE03739B1 (ja) |
HK (1) | HK1032899A1 (ja) |
IL (6) | IL192178A (ja) |
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