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WO2011110356A1 - Dispositif médical pour extraire des concrétions présentes dans des organes corporels creux et procédé pour produire un tel dispositif - Google Patents

Dispositif médical pour extraire des concrétions présentes dans des organes corporels creux et procédé pour produire un tel dispositif Download PDF

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Publication number
WO2011110356A1
WO2011110356A1 PCT/EP2011/001195 EP2011001195W WO2011110356A1 WO 2011110356 A1 WO2011110356 A1 WO 2011110356A1 EP 2011001195 W EP2011001195 W EP 2011001195W WO 2011110356 A1 WO2011110356 A1 WO 2011110356A1
Authority
WO
WIPO (PCT)
Prior art keywords
receiving element
wall
longitudinal edges
receiving
medical device
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/EP2011/001195
Other languages
German (de)
English (en)
Inventor
Giorgio Cattaneo
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.)
Acandis GmbH and Co KG
Original Assignee
Acandis GmbH and Co KG
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 Acandis GmbH and Co KG filed Critical Acandis GmbH and Co KG
Publication of WO2011110356A1 publication Critical patent/WO2011110356A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22031—Gripping instruments, e.g. forceps, for removing or smashing calculi
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00287—Bags for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop

Definitions

  • Medical device for removing concretions from hollow organs of the body and method for producing such a device
  • the invention relates to a medical device for removing concretions from hollow organs of the body and to methods for producing such a device.
  • the thrombus can be gripped by the catcher element or connected to the catcher element.
  • a proximal movement of the guide wire the thrombus can be gripped by the catcher element or connected to the catcher element.
  • thrombi are often present in vessel bends or in the region of a branching of the vessel, ie a bifurcation, there is a risk that the tip of the catheter or the guide wire will injure distal, in particular curved, vascular sections when advancing the catheter or the guide wire.
  • the widening of the catcher element distal to the thrombus can also lead to injuries to the vessel walls.
  • thrombus can indeed be pulled to remove by the catcher element in the proximal direction.
  • the thrombus is guided into vessels which have a larger cross-sectional diameter, whereby a blood flow is made possible laterally around the thrombus, a detachment of Thrombus particles can cause.
  • the thrombus particles may cause a re-occlusion downstream.
  • proximal thrombus attack there is generally the disadvantage that the thrombus is not firmly connected to the capture element during the removal. By friction between the thrombus and the vessel wall, there is a risk that the thrombus or at least parts of the thrombus' detach and thus cause further vascular occlusions in downstream areas.
  • the known devices for proximal Thrombusangriff may have a suction device, the continuous one
  • Negative pressure generated in the area of the thrombus to remove detached particles from the blood vessel is unreachable due to the generated negative pressure, so that there detachable particles can move freely in downstream vessels.
  • the object of the invention is to provide a medical device for removing concretions from hollow organs of the body, which enables a safe and efficient removal of concrements, wherein the risk of particle detachment is reduced. Furthermore, the object of the invention is to provide a method for producing such a device.
  • the invention is based on the idea of a medical device for removing concretions from hollow organs of the body with a catheter, one in the catheter
  • the receiving element is convertible from a compressed state to an expanded state. In the expanded state, the receiving element takes at least partially a rotationally symmetric shape.
  • the receiving element has a flexible wall with at least two free longitudinal edges, which in the transition of the receiving element from the compressed state in the
  • the receiving opening can be converted into an open position to a laterally arranged next to the receiving element calculus by the
  • the receiving element can then be converted into a closed position in order to retain the concretion in the receiving element.
  • the receiving element In the open position, the receiving element is adapted to receive a concretion in a receiving space formed within the receiving element.
  • the longitudinal edges In the open position, the longitudinal edges thus at a distance from each other or form a
  • the receiving element may form in the open position at least partially a c-shaped cross-sectional profile.
  • the receiving opening is formed at least temporarily.
  • the discharge of the receiving element from the catheter may have several temporal phases, wherein in at least one phase of the discharge, the receiving opening is formed. This means that the open position of the receiving opening is present in at least one expansion phase of the receiving element.
  • the receiving opening takes the
  • the transition between the open position and the closed position of the receiving opening can be carried out fluently in the temporal sequence of the expansion of the receiving element.
  • the expansion of the receiving element may comprise an opening phase of the receiving opening and a closing phase of the receiving opening.
  • Opening phase and the closing phase of the receiving opening may be fluid.
  • Opening phase widens the receiving opening to enclose a concretion or encapsulate or to include the calculus in the receiving element.
  • Closing phase closes the receiving opening, wherein the longitudinal edges in
  • the distance between the free longitudinal edges to each other, ie the width of the receiving opening is preferably greater in the closed position than in the open position or in a
  • the receiving opening may have a width which is greater than the width of the
  • the device according to the invention has the flexible receiving element which can be positioned and expanded, in particular laterally of the concretion, in order to accommodate the
  • the receiving element envelops the
  • the receiving opening which is formed by the two free longitudinal edges of the wall, allow access to the Freraüm within the receiving element.
  • the lateral receiving opening allows a particularly gentle removal of the
  • Another advantage of the invention is that the positioning of catheters on the side of a concretion forms a routine medical procedure.
  • Catheter positioned for distal angiography as part of routine intervention on the side of a thrombus.
  • the executive physician is therefore familiar with the handling, so that the device can be used quickly, safely and efficiently.
  • the flexible wall is folded or rolled in the compressed state of the receiving element about at least one longitudinal axis of the receiving element.
  • the flexible wall is folded or rolled in the compressed state of the receiving element about at least one longitudinal axis of the receiving element.
  • Receiving element in the expanded state in particular in the expanded state within a hollow body organ, a receiving space for receiving the concretion is formed.
  • the receiving element in the compressed state, may be folded, rolled, stretched or the like compressed such that essentially no receiving space is recognizable. In this way, it is ensured that the receiving element in the compressed state a has relatively small footprint.
  • the receiving element in the compressed state preferably has a relatively small cross-sectional diameter. The field of use of the device is broadened as the device is thus suitable for removing concretions from small body cavities, for example cerebral blood vessels.
  • the guide element can be connected to a proximal end of the receiving element, in particular directly connected.
  • the receiving element may form a distal end of the guide element.
  • the guide member extends through the catheter beyond the proximal end of the catheter such that a proximal end of the guide member is graspable and operable by a user.
  • the proximal actuation may be directly on the distal end of the guide element, in particular the
  • distal refers to further away from the user arranged components or
  • Sections of an element designates closer to the user arranged components or sections of components.
  • the receiving element in the expanded state has a funnel-shaped portion.
  • the funnel-shaped portion is advantageously achieved that the concretion is secured in the longitudinal direction of the receiving element substantially positive fit.
  • the funnel-shaped section prevents concretion particles extending from a longitudinal end, in particular the proximal or distal end, of the
  • the funnel-shaped portion may be disposed at a distal end of the receiving member.
  • the medical device is preferably guided in the direction of flow to the treatment site.
  • particles of concretion entrained by the blood flow may be present be stopped or captured. Closure of distal or downstream body organs or vessels is effectively avoided.
  • the funnel-shaped portion can also be arranged at a proximal end of the receiving element. In this way, the funnel-shaped portion allows a simple retraction of the receiving element into the catheter. In particular, it is through the funnel-shaped portion or by the rising from the proximal to distal
  • Receiving element ensures that the receiving element automatically compresses when retracted into the catheter. A repositioning of the receiving element is thus facilitated. Furthermore, the funnel-shaped portion arranged at the proximal end of the receiving element reduces the risk of injury to hollow organs of the body when the
  • Receiving element for example, for removing a concretion of the
  • Hollow body organ is pulled in the proximal direction through the hollow body organ.
  • the receiving element has both a proximally arranged, and a distally arranged funnel-shaped portion.
  • the funnel-shaped sections can be directly connected to each other. It is also possible that between the funnel-shaped portion further, differently shaped portions of the receiving element are formed, for example, may be arranged between the proximal and the distal end funnel-shaped portion, a cylindrical portion.
  • the funnel-shaped portion may have a tip connected to a distal end of the guide member.
  • the tip may be in the expansion of the
  • Form receiving element In particular, the free longitudinal edges of the flexible wall can be shaped or formed such that at the transition of
  • Receiving element from the compressed state in the expanded state forms the top.
  • the tip or generally the funnel-shaped portion may be formed at the proximal and / or distal end of the receiving element.
  • the connection of the guide element with the receiving element is particularly advantageous in the region of the tip. In particular, when the tip is arranged at the proximal end of the receiving element, is achieved by the connection of the guide element with the tip, that the receiving element can be easily withdrawn into the catheter. Upon retraction, the interaction of the catheter with the tip of the funnel-shaped portion, the compression of the
  • Receiving element can be achieved.
  • the connection with the guide element can stabilize the distal end of the guide member and / or the receiving element can be effected.
  • the guide element as a support element or stiffening element for the flexible receiving element, in particular the flexible wall, act.
  • the tip of the funnel-shaped portion at least partially expanded
  • Hollow organ or a vessel wall can be avoided by the distal end of the guide wire.
  • the tip is substantially rounded or atraumatic.
  • the receiving element in the expanded state has a cylindrical
  • the cylindrical portion allows on the one hand a uniform support of the receiving element on a wall of the hollow body organ or a vessel wall.
  • a receiving space for the concretion is provided with the cylindrical portion, wherein the flexible wall of the receiving element in the cylindrical portion can create particularly close to the wall of the hollow body vessel. The efficiency in removing the calculus is thus increased.
  • the cylindrical portion may form an inclined end edge at an axial end of the receiving element.
  • the oblique end edge can be connected to the guide element.
  • the sloping end edge is in an area with the
  • Coupled guide element which forms an axial end point of the receiving element.
  • the oblique end edge can also merge in one piece into the guide element.
  • the guide element can be integrally connected or formed with the receiving element.
  • the tip of the funnel-shaped portion of the receiving element may be aligned substantially in alignment with the common longitudinal axis of the receiving element.
  • the tip can also be arranged outside the longitudinal axis of the receiving element.
  • the tip with the peripheral plane of the receiving element in particular with the peripheral plane of the cylindrical portion, are aligned.
  • the funnel-shaped portion may in this case be tapered in extension of the peripheral wall of the cylindrical portion.
  • the free longitudinal edges can be arranged parallel to each other at least in sections in the expanded state in the longitudinal direction of the receiving element. In this way it is achieved that the free longitudinal edges in the expansion of the receiving element in a hollow body member substantially uniformly over the inner circumference of
  • Body hollow organ move.
  • the direction of movement of the longitudinal edges is in
  • Circumferential circumferential direction and solve from the vessel wall or wall of the body hollow organ.
  • the free longitudinal edges are formed spirally.
  • the free longitudinal edges extend spirally along the receiving element.
  • the free longitudinal edges can spiral around the longitudinal axis of the receiving element.
  • at least one free longitudinal edge may be zigzag-shaped.
  • the prongs formed by the zigzag shape allow for improved fixation of the concretion, especially when the receiving opening is not completely closed during expansion, in particular in the fully expanded state.
  • the receiving opening may be open in the expanded state.
  • the prongs of the two longitudinal edges can be aligned in such a way that the prongs interlock at least partially when closing the receiving opening.
  • the receiving opening preferably forms a forceps-like or claw-like mouth. It is also possible that the prongs are at least partially directed radially inward. The teeth can thus intervene in the calculus.
  • the longitudinal edges are aligned at least in sections radially inward. This allows a simple and gentle compression of the receiving element, in particular when the receiving element is retracted into the catheter.
  • the receiving element can be easily and gently repositioned in this way.
  • the free longitudinal edges are arranged in the expanded state of the receiving element, in particular in the closed position of the receiving opening, at least in the region of the cylindrical portion in abutment.
  • the dimensions of the receiving element, in particular the flexible wall be adapted so that the free longitudinal edges are arranged in the expanded state in shock. That has the advantage, that the receiving element forms a circumferentially completely closed wall in the implanted state, so that the concretion safely within the
  • Receiving element in particular in a formed by the receiving element
  • the expanded state can relate both to the resting state, ie the state unaffected by external forces, of the receiving element, and to the implanted state which the receiving element occupies within a body hollow organ.
  • the receiving element or the receiving opening forms the closed position. This applies to all embodiments mentioned in the application.
  • the free longitudinal edges can in the expanded state of the receiving element
  • the funnel-shaped section can thus act as a catching device or filter device for self-detaching concretion particles.
  • the free longitudinal edges can in the expanded state of the receiving element
  • the receiving element in kraftunbelasteten state ie at rest or fully expanded state, form a gap-like receiving opening, which is bounded by two spaced-apart, free longitudinal edges.
  • Longitudinal edges can form a pincer-like gripping element in this configuration.
  • the longitudinal edges can grip the calculus like a pincers.
  • the longitudinal edges In the expanded state there is no overlap of the longitudinal edges, but by the
  • the wall is at least partially formed like a film.
  • the wall may have a film produced by thin-film technology.
  • the foil-like design of the wall a reliable and safe encapsulation of the concretion is achieved.
  • the film-like design is accompanied by high flexibility of the wall.
  • the wall may be simply folded or rolled to make the compressed state.
  • the foil-like Wall a substantially uniform and smooth surface, so that the wall during the transition from the compressed state in the expanded state can easily slide between a vessel wall and the calculus.
  • the wall may have a grid structure, in particular a
  • the grid structure allows a simple and compact compression of the wall or generally of the receiving element.
  • the lattice structure has a high flexibility in the axial direction, in particular in the expanded state.
  • the grid structure can therefore be used in regions of a hollow body organ, for example a blood vessel, which have a curvature. Due to the increased axial flexibility in the expanded state is the
  • the lattice structure can easily follow curvatures of the body hollow organ.
  • the wall can comprise a structuring, in particular a perforation, preferably a pore pattern, so that the receiving element can be stretched longitudinally axially in the compressed state.
  • a structuring in particular a perforation, preferably a pore pattern
  • it may be provided to structure the surface of the wall in order to allow increased flexibility of the compression or improved crimpability. This is particularly advantageous by a
  • the pore structure of the wall may be formed by a lattice structure.
  • a flexibility in the circumferential direction of the receiving element is provided so that the circumferential width of the receiving element, so the distance between the longitudinal edges along the wall in the circumferential direction of the receiving element is variable.
  • the lattice or pore structure of the wall which may be formed generally stent-like, that the circumferential width of the wall increases in the expansion of the receiving element.
  • the circumferential width of the wall is referred to in the context of this application, the distance of the two free longitudinal edges in the circumferential direction along the wall.
  • the circumferential width corresponds to the width of the wall in a flat-spreading state.
  • the distance between the longitudinal edges over the receiving opening, ie the width of the receiving opening, is referred to in the context of the application, however, as the circumferential distance of the longitudinal edges.
  • the Sum of circumferential width of the wall and circumferential distance of the longitudinal edges gives the total circumference of the receiving element.
  • the circumferential distance of the longitudinal edges may increase in a first expansion phase to form the receiving opening (open position or opening phase). As the expansion progresses, the circumferential distance of the longitudinal edges may decrease. The free longitudinal edges approach each other, whereby the receiving opening is reduced
  • the Device has the receiving element in the compressed state two longitudinal axes which extend in the longitudinal direction of the receiving element.
  • the flexible wall preferably forms two windings, which are space-saving rolled around one of the longitudinal axes.
  • the free longitudinal edges can slide along the circumference of the concretion. The expansion is thus facilitated.
  • the longitudinal edges can be rolled up in the compressed state in such a way that the longitudinal edges are uncovered late during the rolling out or expansion of the wall. This reduces the risk of the longitudinal edges separating particles as they slide along the concretion.
  • a repositioning of the receiving element facilitates. Specifically, in this way, the receiving element can be easily and gently withdrawn into the catheter.
  • the receiving element expands both by rolling out or unfolding of the wall, as well as by changing the circumferential width of the wall.
  • the receiving element may comprise a grid structure, which is at least partially wound or rolled in the compressed state about one or two longitudinal axes.
  • a rolling out or unfolding of the lattice structure or, in general, of the wall of the receiving element and, on the other hand, a widening of the wall or of the lattice structure in the circumferential direction can take place.
  • the circumferential width of the wall increases.
  • the wall or the lattice structure shortens in the longitudinal direction.
  • This effect of changing the circumferential width of a lattice structure is known per se, for example, from the expansion behavior of stents comprising a lattice structure.
  • the invention is based on the idea of a
  • a thin-film process in particular a deposition process, preferably a sputtering process and / or an etching process
  • a further, subsidiary aspect of the invention provides a method for producing the above-described medical device, comprising the following steps:
  • Another alternative method of manufacturing the medical device described above forms a further, ancillary aspect of the invention.
  • the method comprises the following steps:
  • Embodiment a development of a grid structure for a receiving element of the device according to the invention according to a preferred
  • Embodiment a development of a receiving element of the device according to the invention according to a preferred embodiment; a development of a grid mesh for a wall of a
  • Receiving element of the device according to the invention according to a preferred embodiment; a development of a grid mesh for a wall of a
  • Receiving element of the device according to the invention according to a further preferred embodiment; a front view of the device according to the invention according to a preferred embodiment when transferring the compressed state in the expanded state in a hollow body member with a concretion; a front view of the device according to the invention according to a preferred embodiment in the expanded state in a hollow body member with a concretion; a front view and a corresponding side view of the medical device according to the invention according to a preferred embodiment when positioning the side of a concretion in a hollow body organ; and 11 is a front view and a corresponding side view of
  • a receiving element 10 of the medical device is shown in the expanded state.
  • the receiving element 10 has a flexible wall 11 which bulges about a common longitudinal axis of the receiving element 10.
  • the receiving element 10 is formed substantially rotationally symmetrical.
  • the receiving element 10 forms a lumen.
  • a lumen is understood to mean an elongated hollow body whose outer surface is at least partially adaptable to the vessel wall.
  • the lumen generally forms one
  • tubular hollow body in particular an at least partially
  • tubular hollow body The tubular hollow body is expandable in the radial direction. This means that the diameter of the tubular hollow body increases during the expansion or during the transfer from the compressed to the expanded state.
  • the receiving element 10 and thus the lumen is expandable. This is concrete
  • the receiving element 10 has a cylindrical portion 12 which forms a substantially rotationally symmetrical shape.
  • the cylindrical section 12 may have an at least partially oval shape or generally flattened areas. In general, that forms
  • Receiving element 10 and the wall 11 of the receiving element 10 in use the shape of the inner circumference of a body hollow organ to be treated, for example, a blood vessel from.
  • the wall can therefore in the expanded state or in use
  • the receiving element 10 may form, for example, a double cone-like shape. In particular, the receiving element 10 two
  • funnel-shaped portions 13 which are directly connected to each other.
  • the base surfaces of the funnel-shaped portions 13 are connected to each other, so that the receiving element 10 has a tip 15 both at a distal end and at a proximal end.
  • Receiving element 10 may generally comprise a rectilinear rotational axis.
  • the axis of rotation which is based on the rotationally symmetrical shape of the receiving element 10, also non-rectilinear, in particular curved, preferably spirally formed.
  • the receiving element 10 may be spirally wound overall.
  • the spiral shape of the receiving element 10 may be embodied, for example, in the manner described in the German patent application no. 10 2009 052 002, which is based on the Applicant.
  • the receiving element 10 according to FIG. 1 furthermore has a funnel-shaped section 13.
  • the funnel-shaped portion 13 is directly connected to the cylindrical portion 12.
  • the funnel-shaped portion 13 is integrally formed with the cylindrical portion 12.
  • the funnel-shaped portion 13 forms a tip 15, which is the
  • Receiving element 10 is limited in the axial direction.
  • the tip 15 is disposed at a distal end of the receiving element 10.
  • the tip 15 may also form a proximal end of the receiving element 10.
  • the tip 15 is aligned with the peripheral plane of the cylindrical portion 12. In other words, the wall 11 of the cylindrical portion 12 in the circumferential plane is partially extended to the top 15.
  • the wall 11 or generally the receiving element 10 also has two free longitudinal edges 14a, 14b.
  • the longitudinal edges 14a, 14b extend over the entire length of the
  • the longitudinal edges 14a, 14b are free and can move freely in the circumferential direction during expansion and compression.
  • the longitudinal edges 14a, 14b define a wall portion of the receiving element 10 and are - apart from this wall portion - connected to any other component of the receiving element 10.
  • the longitudinal edges 14a, 14b are not interconnected or not connected to each other. This does not exclude that the longitudinal edges 14a, 14c At least partially overlap, since the mobility of the longitudinal edges 14a, 14b in the circumferential direction is not or at least not significantly affected.
  • the longitudinal edges 14a, 14b at least at the distal end of the outer member 10 are free, that is not connected to each other.
  • the distal end of the outer member 10 is slotted. in the
  • the longitudinal edges 14a, 14b may overlap, be arranged in abutment or form a gap.
  • the free longitudinal edges 14a, 14b extend in the proximal direction.
  • the longitudinal edges 14a, 14b are exposed at the proximal end of the receiving element 10, i. not connected.
  • the receiving element 10 is thus slotted along its entire length, wherein the slot extends up to and including the distal end and up to and including the proximal end.
  • the longitudinal edges 14a, 14b form the slot.
  • the longitudinal edges 14a, 14b extend over the cylindrical portion 12, wherein the longitudinal edges 14a, 14b are arranged spaced apart in the expanded state.
  • the longitudinal edges 14a, 14b define a receiving opening 16, which is open in the expanded state shown in FIG. 1 over the entire length of the receiving element 10.
  • the receiving opening 16 forms an access to a receiving space 18, which is bounded by the wall 11 in the circumferential direction.
  • a receiving space 18 is formed, which is provided for receiving a concretion.
  • longitudinal edges 14a, 14b may extend over a part, in particular a section, of the receiving element 10.
  • the longitudinal edges 14a, 14b may extend at least over a part, in particular at least along a portion of the
  • the longitudinal edges 14a, 14b are free at least at the distal end of the receiving element 10, that is to say at the end of the receiving element which is more remote from the user.
  • the longitudinal edges 14a, 14b are therefore not connected to one another at least at the distal end, but can move freely relative to one another.
  • Receiving member 10 which includes the free longitudinal edges 14a, 14b, extending from the distal end of the receiving member 10 in the proximal direction, i. in the direction of the user.
  • the length of this section is such that the wall of the
  • Expand receiving element 10 in the region of this section along the vessel wall can, in particular unfold or roll out.
  • expanding, in particular the unfolding or rolling out of the wall 11 it is achieved that the wall 11 or, more specifically, the longitudinal edges 14a, 14b between the concretion to be removed and the
  • the longitudinal edges 14a, 14b are free along the entire length of the receiving element 10. This is not mandatory. It is also possible for the longitudinal edges 14a, 14b to extend freely over only one part, in particular a section of the receiving element 10, so that they can be moved relative to one another in this area.
  • the length of the free longitudinal edges 14a, 14b depends on the function of the receiving element to release a concretion of a vessel wall. The length of the section required for this purpose is determined by the person skilled in the art as required, depending on the vessel diameter and the length of the concretion.
  • the longitudinal edges 14a, 14b can converge towards one another or converge towards one another.
  • the longitudinal edges 14a, 14b may touch each other or form an intersection or a junction. For example, the
  • the funnel-shaped section 13 may have a completely closed wall 11.
  • the longitudinal edges 14a, 14b may merge into an end edge 17 at an axial end of the receiving element 10.
  • the end edge 17 may, for example, the
  • the junction or the transition between the longitudinal edges 14a, 14b and the end edge 17 may be rounded.
  • the end edge 17 may be arranged in a vertical plane to the longitudinal axis of the receiving element 10. It is possible that the
  • End edge 17 extends in a plane which is arranged obliquely to the longitudinal axis of the receiving element 17.
  • the plane of the end edge 17 may also have a curvature. In other words, the end edge 17 obliquely relative to the longitudinal axis of
  • Receiving element 10 may be arranged.
  • the angle of inclination is arbitrarily adjustable, for example via a variation of the braiding angle of the wall 11 forming
  • the end edge 17 defines a planar opening of the axial end of the receiving element 10. It is also possible that the end edge 17 has a curved contour, in particular a concave or convex curved contour. This applies to all embodiments described in the application.
  • the longitudinal edges 14a, 14b in the expanded state are arranged substantially parallel to one another and delimit over the entire length
  • the longitudinal edges 14a, 14b or the receiving opening 16, in particular the gap 19 can also spiral around the longitudinal axis of the receiving element 10.
  • the receiving opening 16, in particular the gap 19, form different longitudinal contours.
  • the receiving opening 16 extend transversely to the longitudinal axis of the receiving element 10 and / or have a zigzag-shaped or wavy longitudinal contour.
  • Receiving opening 16 or the gap 19 may have a different course, that is not rectilinear and aligned parallel to the longitudinal axis of the receiving element 10.
  • the distance of the longitudinal edges 14a, 14b along the receiving element 10 in the expanded state vary.
  • Receiving opening 16 may extend over a part or a portion of the receiving element 10.
  • the receiving opening 16 may be arranged parallel to the longitudinal axis of the receiving element 10 or spirally around the longitudinal axis of the receiving element 10.
  • the receiving opening 16 is preferably arranged in the cylindrical portion 12 of the receiving element 10.
  • the longitudinal edges 14a, 14b can be aligned or arranged such that the wall 11 overlaps at least in sections along the receiving element 10 in the expanded state. Such a configuration is shown in FIG.
  • the receiving element 10 according to FIG. 2 is essentially constructed analogously to the receiving element 10 according to FIG. 1, with the difference that the wall 11 overlaps in the region of the funnel-shaped section 13 in the expanded state.
  • the wall 11 has, in the region of the funnel-shaped section 13, an overlapping section 18 which, in the expanded state, engages over one of the two longitudinal edges 14a, 14b.
  • the receiving element 10 or the wall 11 comprises a first longitudinal edge 14a and a second longitudinal edge 14b, wherein the second longitudinal edge 14b in the region of the funnel-shaped portion 13, the first longitudinal edge 14a overlaps.
  • the longitudinal edges 14a, 14b intersect.
  • the second longitudinal edge 14b extends above the first longitudinal edge 14a.
  • the second longitudinal edge 14b is thus in the expanded state on the wall 11. In this way, a closed funnel-shaped portion 13 is formed.
  • Receiving element 10 closed.
  • the receiving space 18 is axially bounded by the funnel-shaped portion 13, in particular closed.
  • the longitudinal edges 14a, 14b spaced from each other and form the open receiving opening 16.
  • the receiving opening 16 is formed as a gap 19 in the circumferential direction of the receiving element 10 by the longitudinal edges 14a, 14b and in the axial direction through the Intersection of the longitudinal edges 14a, 14b is limited. Towards the end edge 17, the gap 19 is opened.
  • the receiving opening 16 may also be completely closed in the expanded state.
  • the receiving opening 16 may be closed in the expanded state over the entire length of the receiving element 10, as shown in Fig. 3.
  • the longitudinal edges 14a, 14b are in this case preferably arranged on impact or touch each other.
  • the receiving space 18 formed by the expanded wall 11 is completely closed in the circumferential direction. In the axial direction of the receiving space 18 is limited by the closed funnel-shaped portion 13.
  • the receiving element 10 according to FIG. 1 to 3 in the expanded state has a quiver-like shape.
  • the receiving element 10 is connected to a guide element 20 or connectable.
  • the guide element 20 may be welded or glued to the receiving element 10.
  • the guide element 20 may be formed as a guide wire.
  • the guide member 20 is longitudinally displaceable in a catheter 30 is arranged.
  • the guide member 20 may be connected to an axial end of the receiving element 10.
  • the guide element 20 is connected to a proximal end of the receiving element 10.
  • the guide element 20 can be connected to the funnel-shaped section 13, in particular the tip 15, and / or the cylindrical section 12 of the receiving element 10.
  • Receiving member 10 may have an orientation in which the funnel-shaped portion 13, the distal end and the cylindrical portion 12, the proximal end of the
  • Receiving element 10 forms, wherein the guide member 20 is connected to the proximal end. It is preferred if the guide element 20 through the
  • Receiving element 10 extends and with the distal end, in particular the tip 15, is connected.
  • the guide element 20 may form part of the wall 11 at least along the receiving element 10. This applies to all described in the application
  • the medical device in particular the receiving element 10 can be produced by a thin-film technique.
  • the receiving element comprises FIG. 10 shows a film or sheet-like structure made by a thin-film technique, for example, a sputtering method and / or an etching method.
  • a thin film can be produced in a planar shape and then heat-treated on a cylindrical, funnel-shaped or generally round shaped body.
  • the film can be made directly in a cylindrical shape.
  • the film can, for example, directly on the
  • the receiving element 10 can be made of a tube, in particular a sputtered tube.
  • the film or the wall 11 formed by the film may be closed or have openings, for example pores, meshes or cells 41.
  • the structuring, in particular the production of the openings, can be carried out by laser cutting or by etching.
  • the film has a layer thickness which is at most 30 ⁇ m, in particular at most 25 ⁇ m, in particular at most 20 ⁇ m, in particular at most 15 ⁇ m, in particular at most 10 ⁇ m,
  • the receiving element 10 may comprise a stent-like lattice structure 40.
  • the grid structure 40 may comprise meshes or cells 41.
  • the mesh or cells 51 may be diamond-shaped.
  • a suitable grid structure 40 is shown by way of example in FIG. 4.
  • Fig. 4 shows a grid structure for a receiving element 10 in an unfolded state. This means that the wall 11 of the receiving element 10 is shown expanded in a plane.
  • the grid structure 40 has webs 42 which bound the cells 41 of the grid structure 40.
  • the lattice structure 40 or the wall 11 formed by the lattice structure 40 has a first longitudinal edge 14a and a second longitudinal edge 14b.
  • the longitudinal edges 14a, 14b each include a first edge portion 14c and a second edge portion 14d.
  • the two first edge regions 14c of the two longitudinal edges 14a, 14b form a V-shaped boundary for the funnel-shaped section 13 of the receiving element 10.
  • the first edge regions 14c are formed by webs 42 having the same orientation direction, so that the first edge regions 14c as a whole have a smooth Forming edge.
  • the two second edge regions 14d define the cylindrical portion 12 of the
  • the second edge regions 14d are formed by webs 42 of the lattice structure 40, which have a different orientation direction alternately or alternately.
  • the second edge regions 14d thus form a serrated, in particular zigzag, shaped edge.
  • the width or circumferential extent of the wall 11 is variable and can therefore be converted in the change in state of the receiving element 10 of a substantially cylindrical or other form in a funnel shape. This can be achieved, for example, by a suitable, sectionally different choice of the angle between the webs 42.
  • Receiving element 10 can be manufactured in a flat shape and then compressed without the wall 10 rolling or curling.
  • the grid structure 40 may also be rolled, wound or folded in the compressed state, so that in the
  • the receiving element 10 or the wall 11 may be wound in the form of a
  • Single wire 51 be prepared, as shown in Fig. 5.
  • the individual wire 51 is meandering wound in a plane.
  • the sweeping or loops 52 of the meandering turns are arranged in the longitudinal direction of the receiving element 10 in alignment with one another and form the longitudinal edges 14a, 14b.
  • the wall 11 can also be produced by laser cutting or etching from a foil or a tube.
  • the wall 11 may comprise a mesh 50.
  • the grid can be braided on a shaped body, in particular a braiding mandrel, wherein the
  • the braiding mandrel has deflecting pins which are arranged in two rows along the longitudinal axis of the braiding mandrel.
  • the individual wires 51 are deflected at the deflecting pins, so that loops 52 and sweeping form. In this way, a cylindrical,
  • funnel-shaped or generally rotationally symmetrical braid formed in Circumferential direction is open or has two free longitudinal edges 14a, 14b, as shown for example in Fig. 6.
  • the braiding mandrel can also have one or more funnel-shaped regions, so that the funnel-shaped section 13 can be formed by a grid mesh 50.
  • the grid mesh 50 shown in FIG. 6 is further provided to merge the wire ends of the individual wires 51 at the axial ends and with a
  • the grid mesh 50 may be formed such that the receiving element 10 has a substantially planar shape in the compressed state. This means that the longitudinal edges 14a, 14b can be arranged substantially in a plane in the compressed state, wherein the wall 11 is flat or stretched. Through the grid mesh 50, the wall 11 can stretch during compression, so extend in the longitudinal direction. In the stretched or compressed state, the wall 11 can essentially form a flat band comprising the mesh 50. With the expansion this shortens
  • the grid mesh 50 can roll or wrap around the longitudinal axis of the receiving element 10 at the same time.
  • the mesh 50 in the catheter 30 is both wound and stretched.
  • the grid mesh 50 can thus be rolled up in the compressed state, wherein the grid mesh 50 and the receiving element 10 in comparison to
  • Receiving element 10 and the grid 50 it comes to shortening (Foreshortening). Incidentally, this also applies to lattice structures 40, which are produced by laser cutting or other manufacturing methods from a tubular raw material.
  • the behavior in the expansion of the mesh 50 is mainly determined by the loops 52 forming the longitudinal edges 14a, 14b.
  • the loop angle or radius of curvature of the loops 52 increases.
  • the loop angle or the radius of curvature of the loops 52 reduces.
  • the restoring force of the loops 52 is effective, so that the expansion in the
  • FIG. 7 A particularly suitable variant of a receiving element 10 with a mesh 50 is shown in Fig. 7.
  • the mesh 50 forms the wall 11 of the receiving element 10 with two free longitudinal edges 14a, 14b.
  • the free longitudinal edges 14a, 14b may be in the expanded state touching, overlapping or spaced from each other, as explained in connection with FIGS. 1 to 3.
  • the mesh 50 has a plurality of individual wires 51 which define meshes or cells 41.
  • the grid mesh 50 forms in each case an end mesh 55.
  • One of the end meshes 55 preferably the one at the proximal end of the receiving element 10
  • Guide element 20 may also be formed, at least partially, by twisted individual wires 51 of the lattice braid 50.
  • the individual wires are partially twisted into strands 54 which extend through the mesh 50.
  • the strands 54 are singulated and the individual wires 51 are transferred into a smooth end edge 17 or first edge regions 14c of the longitudinal edges 14a, 14b.
  • the strands 54 have an increased height compared to the individual strands 51
  • Patent Application No. 10 2009 056 450 which is assigned to the Applicant.
  • the content of patent application no. 10 2009 056 450 is incorporated by reference in its entirety into the present application.
  • the weave configuration disclosed therein is characterized in that, when expanding the grid structure, not only an increase in the circumferential width of the wall is achieved, but at the same time a rotation of the grid structure 40 or the wall 11 about a common longitudinal axis is achieved. This rotation can be advantageously used in the present medical device for peeling off a concretion from the vessel wall of a hollow body organ.
  • Figs. 8a to 8e the operation of the medical device is shown.
  • Embodiment a wall 11, which in the compressed state by two
  • the wall 11 comprises two longitudinal edges 14 a, 14 b, which are each arranged in the interior of a roll or winding formed by the wall 11. In other words, the wall 11 is wound helically, starting from a longitudinal edge 14a, 14b.
  • the compressed receiving element 10 is arranged longitudinally displaceably in the catheter 30.
  • the catheter 30 is guided or positioned laterally next to a concretion 61. In particular, the catheter 30 is positioned with the receiving element 10 between the vessel wall 62 of the blood vessel 60 and the concretion 61.
  • the catheter 30 is pulled in the proximal direction, wherein the receiving element 10, preferably held by appropriate actuation of the guide member 20, is held stationary.
  • the catheter 30 can be held stationary and the receiving element 10 can be pushed in the distal direction.
  • the worm-like rollers or windings of the wall 11 unfold during expansion. The expansion preferably takes place automatically.
  • the wall 11 slides between the vessel wall 62 and the
  • the wall 11 rolls out along the vessel wall 62. In this case, the wall 11 forms the receiving space 18.
  • the receiving space 18 is formed during the expansion of the receiving element 10.
  • the longitudinal edges 14a, 14b form the
  • Receiving opening 16 which receives the thrombus 61 mouth-like in the receiving space 18.
  • the wall folded or rolled in the compressed state unfolds or unrolls during the expansion.
  • the wall expands.
  • the total diameter or the lumen of the receiving element changes.
  • the diameter or lumen increases during expansion.
  • the free longitudinal edges 14a, 14b have the function to peel off the concretion of the vessel wall.
  • the free longitudinal edges 14a, 14b are adapted to the
  • a first unfolding phase the regions of the wall 11 which are wound around a longitudinal axis in each case roll out, the wall 11 sliding on one another. This means that touch in the first deployment phase, the two spiral windings or worm-like rollers.
  • the worm-like rollers rotate in opposite directions in the unfolding phase, with the contacting wall sections of the worm-like rollers rolling on one another or sliding on one another.
  • the unfolding phase is shown substantially in Fig. 8b, wherein for reasons of clarity between the two helical rollers, a distance is shown. In practice, the distance between the helical rollers, which may also be part of the receiving opening 16, arises in a later phase of the expansion of the
  • the wall 11 slides along the thrombus 61.
  • the wall 11 or the helical rollers slides into a region between the thrombus 61 and the vessel wall 62. In this way, a bed or a support for the concretion is formed 61, as shown in Fig. 8c.
  • the sliding phase can on the one hand by self-expanding properties of the wall 11 and generally des
  • Receiving element 10 causes his.
  • the concretion or the thrombus 61 can cause the widening of the wall 11 or support the sliding phase.
  • the sliding phase preferably continues until the longitudinal edges 14a, 14b protrude from the inside of the helical rollers, as shown in Fig. 8d.
  • Fig. 8d shows the transition state between the sliding phase and a third opening phase of the expansion of the receiving element 10. In the opening phase forms the
  • Receiving opening 16 which is formed essentially by the longitudinal edges 14a, 14b.
  • the receiving element 10 forms in the opening phase or in the open position in Essentially a c-shaped cross-sectional contour.
  • a receiving space 18 is formed in the opening phase from the bed originally formed in the sliding phase for the concrement or thrombus 61.
  • the expansion of the receiving element 10 enters a fourth closing phase.
  • the longitudinal edges 14a, 14b approach each other to encapsulate or envelop the concretion or the thrombus 61.
  • the receiving opening 16 is reduced.
  • the receiving opening 16 assumes the closed position, as shown in Fig. 8e.
  • the longitudinal edges 14a, 14b are arranged in the closed position, ie after complete expansion, in the circumferential plane of the wall 11.
  • the receiving element 10 in the expanded state so an open receiving opening 16 and a gap 19 on.
  • the receiving element 10 surrounds the concrement or thrombus 61.
  • the receiving opening 16 go along. This means that the longitudinal edges 14a, 14b can progressively separate from one another or approach each other. The widening of the receiving opening 16 in the opening phase or the closure of the receiving opening 16 in the closing phase can thus take place in the longitudinal direction of the receiving element 10 offset in time. The receiving opening 16 can also take place in sections in the longitudinal direction of the receiving element 10 with different degrees of opening or closing.
  • the receiving element 10 has a wall 11 which is collapsible in the catheter 30 in the compressed state.
  • the wall 11 may be folded accordion-like or star-shaped in the compressed state. During expansion, the wall 11 unfolds and envelops the thrombus 61.
  • the folded or undulating structure of the wall 11 may, for example, by a
  • Heat treatment can be produced, wherein the wall 11 is applied to a shaped body with appropriate structuring and then subjected to the heat treatment.
  • the wall 11 may also have a corrugated shape in the fully unwound or expanded state.
  • the receiving element 10 can anchor in this way particularly well on the thrombus 61 or generally on a calculus.
  • the on The wall 11 embossed structuring may also include a spiral shape, depressions, dents or the like unevenness.
  • FIGS. 10 and 11 show a front view of the receiving element 10 in the catheter 30, wherein the wall 11 of the receiving element 10, in contrast to the embodiment of FIG. 8a is rolled around a single longitudinal axis.
  • the wall 11 does not overlap in the compressed state.
  • the wall 11 is formed by a mesh 50 or a grid structure 40.
  • the receiving element 10 extends in the compressed state, as shown in the side view of FIG. 10.
  • the wall 11 slides along the vessel wall 62, wherein the width of the wall 11 and the receiving element 10 increases.
  • the receiving element 10 is shortened.
  • the wall 11 may generally comprise a plastic, in particular polyurethane,
  • the structured wall 11 preferably the grid structure 40 or the grid 50, may comprise a plastic cover.
  • the cover may completely or at least partially cover the pores, cells or meshes of the wall 11.
  • Receiving element 10 have marker elements.
  • the marker elements can be any marker elements.
  • the marker elements can be any marker elements.
  • the marker element are arranged at least at the axial ends of the receiving element 10.
  • the marker elements facilitate the positioning of the receiving element 10 laterally of a concretion.
  • the cross-sectional diameter of the receiving element 10 may correspond to the diameter of the body cavity or blood vessel 60 to be treated in the resting state, that is to say in the fully expanded, force-unloaded state. It is also possible that that
  • Receiving member 10 has a smaller cross-sectional diameter than the body cavity to be treated, to exert a higher pressure on the calculus.
  • the cross-sectional diameter of the receiving element 10 may be larger than the
  • the receiving opening 16 may be closed at rest.
  • the longitudinal edges 14a, 14b may be arranged in the state of rest at impact or overlapping or spaced from one another.
  • the overlapping arrangement at rest has the advantage that in use the concrement is completely enveloped.
  • the spaced arrangement of the longitudinal edges 14a, 14b in the resting state results in a smaller width of the developed wall 11, so that the receiving element 10 can be inserted into a comparatively small catheter 30.
  • the receiving opening 16 or the gap 19 may be at least in the closed position
  • a width which is at most 50%, in particular at most 40%, in particular at most 30%, in particular at most 20%, in particular at most 15%, in particular at most 10%, in particular at most 5%, of the scope of
  • the width of the receiving opening 16 refers to the distance between the free longitudinal edges 14a, 14b to each other and is referred to as the circumferential distance of the free longitudinal edges 14a, 14b.
  • Circumferential direction of the receiving element 10 thus corresponds to the circumferential distance of the free longitudinal edges 14a, 14b.
  • Peripheral width of the wall 11 denotes.
  • the circumferential width of the wall 11 corresponds to the distance of the longitudinal edges 14a, 14b, when the wall 11 is arranged in a flat surface.
  • the circumferential spacing of the longitudinal edges 14a, 14b relative to one another ie the width of the receiving opening 16 or the gap 19 in the closed position, at least in sections at least 5%, in particular at least 10%, in particular at least 15%,
  • the free longitudinal edges 14a, 14b do not overlap in the closed position. This is particularly advantageous when using the device in small hollow organs of the body, for example cerebral blood vessels. Rather, the free longitudinal edges 14a, 14b in the closed position at a safe distance from each other.
  • the receiving element 10 forms with the free longitudinal edges 14a, 14b an open structure.
  • the receiving element 10 comprises a mesh 50, is in the
  • Expansion causes not only a torsion of the individual wires 51, but also a deformation of the loops 52 or sweeping, whereby an increased restoring force of the mesh 50 is achieved.
  • the receiving element 10 comprises marker elements, which allow in particular the recognizability of the receiving element 10 under X-ray control.
  • Marker elements therefore preferably have a radiopaque material.
  • Marker elements can advantageously be positioned in the region or on the longitudinal edges 14a, 14b of the wall 11. It is also possible to arrange the marker elements in the region of the wall 11 which, in the expanded state of the receiving element 10, is arranged opposite the longitudinal edges 14a, 14b. Several marker elements can be provided, which are distributed over the circumference of the receiving element 10. In particular, marker elements can be arranged in the region of the longitudinal edges 14a, 14b and in an opposite wall region of the wall 11.
  • Marker elements can be both the position, and the expansion process of the
  • Receiving element 10 can be controlled easily and safely.
  • the receiving element 10 has in the force-free state, ie when the receiving element 10 is disposed neither in the catheter nor in the vessel, a planar structure.
  • the wall 11 is straight, i. not curved.
  • the receiving element 10 is extensively unrolled.
  • the receiving element 10 is released from the supply system, in particular in the catheter line, into the open, ie not in a vessel, the receiving element 10 unrolls to a planar or planar structure.
  • An example of such a planar structure is shown in FIG.
  • the receiving element 10 can be rolled up about a longitudinal axis. Additionally or alternatively, the compression of the receiving element 10 can take place in that the receiving element 10 is stretched in the longitudinal direction. Then, a curvature of the receiving element 10 may be sufficient without the receiving element 10 is rolled up to compress the receiving element 10 so that it is in the
  • Supply system in particular fits into the catheter line.
  • An example of this is shown in FIG.
  • Receiving element 10 parallel to the longitudinal axis of the receiving element 10.
  • the longitudinal axis is at least in the expanded state substantially straight.
  • the wall 11 is straight in the axial direction and curved in the circumferential direction. This applies to the entire length of the Receiving element 10, in particular for the axial ends, in particular the distal end.
  • the receiving element 10 forms a part-cylindrical wall 11, in particular a slotted teilzylindhari wall 11.
  • Receiving opening 16 opposite bottom of the receiving element 10 is curved in the longitudinal axial direction straight and in the circumferential direction. This applies to the entire length of the receiving element 10, in particular for the axial ends, in particular the distal end.
  • a terminal edge 17 is formed, which extends in the circumferential direction of the receiving element 10.
  • the closing edge 17 defines an opening which is open in the axial direction of the receiving element 10.

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  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
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  • Orthopedic Medicine & Surgery (AREA)
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Abstract

L'invention concerne un dispositif médical pour extraire des concrétions présentes dans des organes corporels creux, comprenant un cathéter (30), un élément de guidage (20) disposé dans le cathéter (30) de manière à pouvoir se déplacer longitudinalement, et un élément de réception (10) flexible relié à l'élément de guidage (20), qui peut passer d'un état comprimé à un état dilaté, et qui adopte, à l'état dilaté, au moins par endroits, une forme à symétrie de rotation, l'élément de réception (10) comportant une paroi souple (11) présentant au moins deux arêtes longitudinales libres (14a, 14b) qui forment, au moins par endroits, une ouverture de réception (16) latérale dans le sens longitudinal de l'élément de réception (10) lorsque ce dernier passe de l'état comprimé à l'état dilaté. L'ouverture de réception (16) peut adopter une position ouverte pour introduire, dans l'élément de réception (10), par cette ouverture de réception (16), une concrétion située latéralement à côté de l'élément de réception (10) et peut adopter une position fermée pour retenir la concrétion dans l'élément de réception (10). L'invention concerne également un procédé pour produire un tel dispositif.
PCT/EP2011/001195 2010-03-10 2011-03-10 Dispositif médical pour extraire des concrétions présentes dans des organes corporels creux et procédé pour produire un tel dispositif Ceased WO2011110356A1 (fr)

Applications Claiming Priority (2)

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DE102010010849.9A DE102010010849B4 (de) 2010-03-10 2010-03-10 Medizinische Vorrichtung zum Entfernen von Konkrementen aus Körperhohlorganen und Verfahren zum Herstellen einer derartigen Vorrichtung
DE102010010849.9 2010-03-10

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