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WO2006105856A1 - Systeme catheter destine a prevenir une embolie lors d'une angioplastie - Google Patents

Systeme catheter destine a prevenir une embolie lors d'une angioplastie Download PDF

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Publication number
WO2006105856A1
WO2006105856A1 PCT/EP2006/002442 EP2006002442W WO2006105856A1 WO 2006105856 A1 WO2006105856 A1 WO 2006105856A1 EP 2006002442 W EP2006002442 W EP 2006002442W WO 2006105856 A1 WO2006105856 A1 WO 2006105856A1
Authority
WO
WIPO (PCT)
Prior art keywords
filter insert
catheter
filter
arrangement according
active position
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.)
Ceased
Application number
PCT/EP2006/002442
Other languages
German (de)
English (en)
Inventor
André Burch
Stéphane Delaloye
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.)
Biotronik VI Patent AG
Original Assignee
Biotronik VI Patent AG
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
Application filed by Biotronik VI Patent AG filed Critical Biotronik VI Patent AG
Publication of WO2006105856A1 publication Critical patent/WO2006105856A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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
    • A61F2/01—Filters implantable into blood vessels
    • A61F2/013—Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting
    • 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
    • A61F2/01—Filters implantable into blood vessels
    • A61F2002/018—Filters implantable into blood vessels made from tubes or sheets of material, e.g. by etching or laser-cutting
    • 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
    • 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
    • A61F2230/0004—Rounded shapes, e.g. with rounded corners
    • A61F2230/0006—Rounded shapes, e.g. with rounded corners circular
    • 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
    • A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063—Three-dimensional shapes
    • A61F2230/0073—Quadric-shaped
    • A61F2230/0076—Quadric-shaped ellipsoidal or ovoid

Definitions

  • the invention relates to a catheter assembly for Embolieschutz in angioplasty procedures, especially in arteries with the features specified in the preamble of claim 1.
  • catheter assembly is intended to mean any type of tubular or wire-like medical equipment that can be introduced over long distances into body vessels, such as, for example, so-called guide wires or thin catheters.
  • catheter arrangements are known by public prior uses. They have an elongate catheter body, such as a common guide wire, in common, which is insertable with its distal end into the vessel to be treated. In the region of the distal end of the catheter body, a filter insert is arranged, which is expandable between a contracted passive position during insertion and a lumen of an angioplasty vessel to be treated substantially filling active position.
  • a filter insert is arranged, which is expandable between a contracted passive position during insertion and a lumen of an angioplasty vessel to be treated substantially filling active position.
  • the filter insert is placed distally with respect to a stenosis into the affected vessel and in its active position it captures the deposition particles which may be discharged during the stenosis treatment, for example by setting a stent. Namely, such particles cause a considerable risk of embolism.
  • the filter pores introduced therein have a diameter of about 100 ⁇ m.
  • filter inserts which are purely made of a fine metal wire mesh are known, which are fastened like a rake to a wire loop defining the filter opening.
  • these additional supporting structures have a space requirement, which runs counter to the requirement for the smallest possible cross section of the arrangement in the contracted passive position of the filter insert.
  • these wire structures stiffen the catheter assembly.
  • the known filter cartridges are in need of improvement in terms of the lowest possible cross-sections necessary for a secure setting in the vessel and the highest possible flexibility.
  • Another problem of the known constructions is that, in particular in vessel curves, there is no form-fitting adaptation of the filter insert to the vessel lumen. In that regard, particles between the filter cartridge and the vessel wall can depart in the distal direction with the blood flow, which increases the risk of embolization mentioned above.
  • the invention is therefore an object of the invention to improve a catheter assembly for Embolieschutz so that compactness, flexibility and Embolieschutz be increased.
  • This object is achieved by the features specified in the characterizing part of claim 1, according to which the filter insert is formed from a hose-like, for the active position in a spherical shape expandable metal foil hollow body, which is provided in its wall with Filteröff- openings.
  • a metal foil as a filter medium can be completely dispensed with supporting structures, such as wire struts or loops.
  • supporting structures such as wire struts or loops.
  • such metal foils have the advantage of greater flexural strengths and intrinsic stiffnesses, so that the filter medium as such can be produced from a single piece or material in a thinner-walled manner, but in a self-supporting manner.
  • the cross section of the filter insert in the passive position can be kept extremely small, so that narrow stenoses in a vessel are easier passable.
  • the metal foils are still sufficiently flexible, so that even highly tortuous vascular systems can be easily passed by the catheter assembly according to the invention.
  • the convex shape in the expanded active position ensures optimal adaptation to the vessel wall, in particular also in regions of curvature.
  • Under “crowned” are basic shapes, such as balloon-like, an olive-shaped, conical-cylindrical-conical or mushroom-like to understand.
  • the wall of the filter cartridge can be provided with longitudinal folding grooves for the contraction and expansion of the filter cartridge.
  • catheter arrangement relate to the fixing and mounting of the filter cartridge on the catheter body.
  • it may be provided to interrupt the catheter body in the region of the filter insert, the latter bridging the resulting gap. Since no further structures can be accommodated within the filter insert, the cross section of the catheter arrangement in the region of the filter insert can be further reduced.
  • FIG. 1 is a schematic side view of the distal end of a guide wire with filter cartridge
  • FIG. 3 shows a cross section along the section line III-III of Fig. 1, 4 shows a schematic longitudinal section through the catheter arrangement according to FIG. 1 in its folded passive position in a folding sleeve with additional guide catheter, FIG.
  • FIG. 5 shows a schematic longitudinal section of the catheter arrangement according to FIG. 1 in an alternative application with aspiration catheter and guide catheter, FIG.
  • Fig. 6 is a longitudinal section of a guide wire with filter insert in a second embodiment, as well
  • FIG. 7 and 8 are schematic side views of filter cartridges in a third and fourth embodiment.
  • Fig. 1 and 2 shows a catheter assembly as a guide wire 1, which is controllable at its distal end by a predetermined bend 2 by curved vessel profiles and branches.
  • the diameter D of the guide wire is 0.010 "to 0.035", which corresponds to approximately 0.25 mm to 0.90 mm.
  • a filter insert 3 is mounted on the guide wire 1, which is shown in Fig. 1 and 2 in its expanded active position.
  • the filter insert 3 is formed in one piece from a hose-like metal-foil hollow body made of a nickel-titanium alloy, which is available on the market under the designation "Nitinol.”
  • the metal foil has a thickness of approximately 1-50
  • the convex shape of the filter element 3 is recognizable as an olive-like or balloon-like design.
  • the filter medium used in Fig. 1 and 2 in the left of the equatorial plane E lying distal region of the wall 5 attached filter openings 6, which have a width of about 60 - 120 microns.
  • sector-shaped passage openings 7 are mounted, which can stand between them thin straps 8 in the wall 5 of the filter element 3.
  • the blood flow through the passage openings 7 in the filter cartridge 3 can enter freely and the blood on the filter openings 6 of any residues from a stenosis freed further flow in the vessel.
  • the latter is indicated by dashed lines in Fig. 1 and provided with the reference numeral 10.
  • the proximal end 11 of the filter cartridge 3 is permanently secured by an annular fixation 12 in the form of a soldering or gluing on the guide wire 1.
  • the distal end 13 is gathered around the guide wire 1 so that expansion is not possible there.
  • the distal end 13 is axially displaceably mounted on the guide wire 1, which is significantly reduced there in diameter d relative to the main diameter D. The thus reduced rigidity is compensated by the filter element 3, so that overall a uniform over the length bending behavior of the catheter assembly is achieved.
  • FIG. 4 shows the guide wire 1 with filter insert 3 in its folded, contracted passive position in a folding sleeve 14.
  • This is axially displaceably guided on the guide wire 1 with a proximal guide shaft 15.
  • This is followed by the actual folded envelope 16 with a slightly larger diameter.
  • This is provided at its distal end with an ejection opening 17, from which the guide wire 1 runs out and which can pass through the folded filter cartridge 3.
  • the folding sleeve 14 is displaced in the proximal direction relative to the guide wire 1.
  • the filter cartridge 3 is released through the discharge opening 17 and can expand into the expanded active position shown in FIGS. 1 and 2 into the lumen of the vessel 10.
  • the expansion movement is supported on the one hand by the shape memory of the metal foil forming the filter element 3 into which the expanded form of the filter insert 3 is embossed, and on the other hand by the blood flow 9 flowing through the passage opening 7.
  • the guide wire 1 with filter insert 3 is shown in a so-called “monorail arrangement", in which the aspiration catheter 20 is pushed over the guide wire 1 at the distal end with the aid of an inlet 21.
  • the entire arrangement Guidewire 1 and aspiration catheter 20 are again housed in a guide catheter 18.
  • the guide wire with filter element 3 can be introduced in the usual way using the folding sleeve 14 and then the aspiration catheter 20 are moved over the guide wire 1 into the suction position shown in Fig. 5. In that regard, particles that have accumulated in the filter cartridge 3, are sucked through the aspiration catheter 20.
  • the catheter arrangements shown in FIGS. 4 and 5 have a hydrophilic coating 23 indicated by the dot-dash line in the area of the folded sheath 16 or at the distal end of the aspiration catheter 20.
  • the folding sleeve 14 at the proximal end and the aspiration catheter 20 at the distal end each have a metal ring 24 as an X-ray mark.
  • the filter insert 3 is fastened with its proximal end 11 and distal end 13 to the associated ends 27, 28 of the guide wire 1, respectively, and the latter is interrupted within the filter insert 3. Because the filter element 3 is thus empty in the interior, it can be more folded together for its passive position and thus has a relation to the embodiment of FIG. 1 even smaller cross-section.
  • FIG. 8 shows an embodiment of the filter cartridge 3 "in which the spherical shape is not balloon-shaped but limited to a mushroom-like configuration, meaning that only the proximal end 11 of the filter cartridge 3" is permanently fixed to the guide wire 1, the distal end 13, however, a blood flow 9 facing away from, large end opening 26 forms.

Landscapes

  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (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)
  • Media Introduction/Drainage Providing Device (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un système cathéter destiné à prévenir une embolie lors d'une angioplastie. Ce système présente un corps cathéter (1) allongé et un élément filtrant (3) placé dans la zone de l'extrémité distale. Cet élément filtrant est expansible entre une position passive contractée et une position active remplissant sensiblement le lumen du vaisseau (10). L'élément filtrant (3) est constitué d'un corps creux métal-film de type tuyau flexible et expansible dans une forme bombée pour la position active. La paroi (5) de ce corps creux présente des orifices filtrants (6).
PCT/EP2006/002442 2005-04-02 2006-03-17 Systeme catheter destine a prevenir une embolie lors d'une angioplastie Ceased WO2006105856A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102005015173A DE102005015173A1 (de) 2005-04-02 2005-04-02 Katheteranordnung zum Embolieschutz bei der Angioplastie
DE102005015173.6 2005-04-02

Publications (1)

Publication Number Publication Date
WO2006105856A1 true WO2006105856A1 (fr) 2006-10-12

Family

ID=36469233

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2006/002442 Ceased WO2006105856A1 (fr) 2005-04-02 2006-03-17 Systeme catheter destine a prevenir une embolie lors d'une angioplastie

Country Status (2)

Country Link
DE (1) DE102005015173A1 (fr)
WO (1) WO2006105856A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009123715A1 (fr) * 2008-04-03 2009-10-08 Med Institute, Inc. Dispositifs auto-nettoyants, systèmes et procédés d'utilisation

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20020173819A1 (en) * 2001-05-21 2002-11-21 Bacchus Vascular, Inc. Apparatus and methods for capturing particulate material within blood vessels
US6562058B2 (en) * 2001-03-02 2003-05-13 Jacques Seguin Intravascular filter system
WO2003084437A2 (fr) * 2002-04-01 2003-10-16 Gore Enterprise Holdings, Inc. Dispositifs endoluminaux, filtres emboliques et leurs procedes de fabrication et d'utilisation
US20040158275A1 (en) * 2003-02-11 2004-08-12 Scimed Life Systems, Inc. Filter membrane manufacturing method
WO2006034074A1 (fr) * 2004-09-17 2006-03-30 Nitinol Development Corporation Dispositif de protection embolique a couche mince a memoire de forme

Family Cites Families (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3945385A (en) * 1974-10-25 1976-03-23 Physicians' Medical Patent Development Corporation Suction catheter
DE19622184A1 (de) * 1996-06-03 1997-12-04 Joern Martens Tragbares Gerät zur Langzeit-Perfusion von menschlichen und tierischen Geweben, als Herz-Lungen-Nieren-Leber-Maschine, für die umfassende, funktionell stützende Behandlung und besonders auch für die lebenserhaltende Notfall-Perfusion, zur Notfall-Versorgung von Patienten
US5807330A (en) * 1996-12-16 1998-09-15 University Of Southern California Angioplasty catheter
DE19961757A1 (de) * 1998-12-21 2000-08-24 Cardiothoracic Sys Inc Endovaskuläre Vorrichtung zum Aufrechterhalten der inneren Geometrie von Blutgefässen
US6375670B1 (en) * 1999-10-07 2002-04-23 Prodesco, Inc. Intraluminal filter
US6171328B1 (en) * 1999-11-09 2001-01-09 Embol-X, Inc. Intravascular catheter filter with interlocking petal design and methods of use
FR2808991A1 (fr) * 2000-05-18 2001-11-23 Perret Emile Lamy Sonde extensible interne a usage chirurgical pour la dilatation, le curetage et la protection de conduits physiologiques
US6997938B2 (en) * 2002-02-12 2006-02-14 Scimed Life Systems, Inc. Embolic protection device
DE10261575A1 (de) * 2002-12-23 2004-07-08 Nova Lung Gmbh Vorrichtung zur Kanülierung eines Blut führenden Gefäßes und deren Verwendung zur Kanülierung von Blut führenden Gefäßen
US8337519B2 (en) * 2003-07-10 2012-12-25 Boston Scientific Scimed, Inc. Embolic protection filtering device

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6562058B2 (en) * 2001-03-02 2003-05-13 Jacques Seguin Intravascular filter system
US20020173819A1 (en) * 2001-05-21 2002-11-21 Bacchus Vascular, Inc. Apparatus and methods for capturing particulate material within blood vessels
WO2003084437A2 (fr) * 2002-04-01 2003-10-16 Gore Enterprise Holdings, Inc. Dispositifs endoluminaux, filtres emboliques et leurs procedes de fabrication et d'utilisation
US20040158275A1 (en) * 2003-02-11 2004-08-12 Scimed Life Systems, Inc. Filter membrane manufacturing method
WO2006034074A1 (fr) * 2004-09-17 2006-03-30 Nitinol Development Corporation Dispositif de protection embolique a couche mince a memoire de forme

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009123715A1 (fr) * 2008-04-03 2009-10-08 Med Institute, Inc. Dispositifs auto-nettoyants, systèmes et procédés d'utilisation
JP2011517592A (ja) * 2008-04-03 2011-06-16 メッド・インスティテュート・インコーポレイテッド 自浄式装置、システムおよびその使用方法
US9044305B2 (en) 2008-04-03 2015-06-02 Cook Medical Technologies Llc Self cleaning devices, systems and methods of use

Also Published As

Publication number Publication date
DE102005015173A1 (de) 2006-10-05

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