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WO2025074196A1 - Dispositifs et procédés pour procédures de dérivation portosystémique intrahépatique transjugulaire - Google Patents

Dispositifs et procédés pour procédures de dérivation portosystémique intrahépatique transjugulaire Download PDF

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Publication number
WO2025074196A1
WO2025074196A1 PCT/IB2024/059286 IB2024059286W WO2025074196A1 WO 2025074196 A1 WO2025074196 A1 WO 2025074196A1 IB 2024059286 W IB2024059286 W IB 2024059286W WO 2025074196 A1 WO2025074196 A1 WO 2025074196A1
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WO
WIPO (PCT)
Prior art keywords
devices
catheter
portal vein
wire
tract
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.)
Pending
Application number
PCT/IB2024/059286
Other languages
English (en)
Inventor
Amanda CENTAZZO-COLELLA
Patrick Ryan
Michael DALLIMORE
Amanda Hartley
Luke KEAVENEY
Pat MCHUGH
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.)
Baylis Medical Technologies Inc
Baylis Medical Technologies Usa Inc
Original Assignee
Baylis Medical Technologies Inc
Baylis Medical Technologies Usa Inc
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 Baylis Medical Technologies Inc, Baylis Medical Technologies Usa Inc filed Critical Baylis Medical Technologies Inc
Publication of WO2025074196A1 publication Critical patent/WO2025074196A1/fr
Pending legal-status Critical Current
Anticipated expiration legal-status Critical

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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
    • A61F2/02—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
    • A61F2/064—Blood vessels with special features to facilitate anastomotic coupling
    • 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
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3478—Endoscopic needles, e.g. for infusion

Definitions

  • a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure may be performed.
  • TIPS Transjugular Intrahepatic Portosystemic Shunt
  • a shunt is created from the hepatic to the portal vein, which allows flow to bypass the liver and alleviates the portal pressure. Creation of the shunt is done percutaneously and uses dedicated TIPS kits, catheters, and wires.
  • FIG. 3 C is an illustration of a catheter comprising radiopaque marker bands in accordance with an embodiment of the present invention.
  • FIG. 3D is an illustration of catheter and needle hubs in accordance with an embodiment of the present invention.
  • FIG. 4 is a flow diagram showing a method of performing a TIPS procedure using a telescoping assembly in accordance with an embodiment of the present invention
  • FIGS. 5 A to 5F disclose a method of facilitating a TIPS procedure in accordance with an embodiment of the present invention
  • FIG. 6 is a flow diagram showing a method of performing a TIPS procedure using a telescoping assembly in accordance with an alternative embodiment of the present invention
  • embodiments of the present invention comprise a method of performing a trans-jugular intrahepatic portosystemic shunt (TIPS) procedure using a medical device assembly including a plurality of devices positioned within a patient’s body comprising at least one puncture device and one or more elongate members, the method comprising the steps of: puncturing through a liver to create a tract between a hepatic vein and a portal vein; dilating the tract; and measuring at least one pressure in at least one of the hepatic vein and the portal vein; where at least one of the plurality of devices is used to perform at least two of the steps of puncturing, dilating, and measuring.
  • TIPS trans-jugular intrahepatic portosystemic shunt
  • the at least one of the plurality of devices is a catheter, and the catheter is used for the steps of measuring at least one pressure and confirming portal vein access.
  • the method of claim 1 further comprises a step of injecting fluid to visualize at least one of: a portion of the hepatic vein, a portion of the portal vein, and a portion of the tract, and the at least one of the plurality of devices is used to perform at least two of the steps of puncturing, dilating, measuring, and injecting.
  • the at least one of the plurality of devices is a steerable sheath, and the steerable sheath is used for the steps of measuring at least one pressure and injecting fluid.
  • the at least one of the plurality of devices is a dilator, and the dilator is used for the steps of dilating the tract and injecting fluid.
  • the at least one of the plurality of devices is the puncture device, and the puncture devices comprises a radio frequency (RF) wire, and the RF wire is used for the steps of puncturing through the liver and tracking into the portal vein.
  • the RF wire comprises a flexible distal end.
  • the method of claim 1 further comprising a step of aiming the medical device assembly from a first blood vessel to a second blood vessel, and the at least one of the plurality of devices is used to perform at least two of the steps of puncturing, dilating, measuring, and aiming.
  • the first blood vessel is an inferior vena cava and the second blood vessel is the hepatic vein.
  • the first blood vessel is the hepatic vein
  • the second blood vessel is the portal vein
  • the puncture device is a needle, and the needle is configured to create the tract and confirm portal vein access.
  • the at least one of the plurality of devices is a catheter, and the catheter is configured to measure the length of the tract and manipulate fluid.
  • the RF wire comprises a flexible distal end.
  • the number of devices positioned within the patient’s body remains constant while the at least one of the plurality of devices is used to perform the at least two steps.
  • the present inventors have conceived of novel and inventive devices, assemblies, and methods for reducing the number of exchanges by performing multiple steps in the procedure using fewer devices, thereby speeding up procedure time. In other words, modifying a single device to perform two (or more) steps that are usually performed using two devices. In some embodiments, individual devices have modifications to enable to them perform multiple functions during TIPS procedure.
  • catheter 300 comprises a visual indicator that is visible under one or more imaging modalities, for example fluoroscopy.
  • the visual indicator comprises a plurality of markers located on the outer surface or embedded within the inner and outer walls of the catheter. Markers may be radiopaque maker bands, radiopaque ink, or any other known marking that may show up under one more imaging modalities.
  • catheter 300 comprises a plurality of radiopaque marker bands 302. Radiopaque marker bands 302 may be used to measure the tract length between the hepatic vein 12 and portal vein 14, to select an appropriately sized stent for the TIPS procedure.
  • any one of the sheath 100, dilator 200, or puncture device 400 may comprise a visual indicator to measure the tract length.
  • catheter 300 comprises a catheter hub 304 at the proximal end which may be connected a fluid manipulation device, such that contrast can be injected, or a pressure measurement could be taken at the catheter distal end.
  • the catheter is configured such that the fluid manipulation device can inject contrast fluid or measure a pressure while the puncture device 400 or wire guide 500 is within the catheter lumen.
  • the inner device does not need to be removed from the catheter in order to inject contrast or measure a pressure using the catheter.
  • dilator 200 is configured to manipulate fluids while a smaller device, for example catheter 300, is within the dilator 200 primary lumen.
  • catheter 300 comprises a spacer 308 located on the proximal end, proximal to catheter hub 304.
  • Spacer 308 is configured to prevent the needle 400 from advancing past a certain distance while the spacer 308 is in place.
  • spacer 308 may prevent the distal end of needle 400 from advancing out of the catheter 300 distal end, to prevent the needle from damaging tissue.
  • the spacer may be in place for the steps prior to the puncture step.
  • the spacer 308 is removed and the needle 400 is advanced such that the needle distal tip 402 protrudes out of the catheter 300 distal end.
  • steerable sheath 100 and steerable catheter 301 may be used together during a TIPS procedure.
  • steerable sheath 100 may be used to aim the assembly in the hepatic vein 12 for the puncture
  • the steerable catheter 301 may be used to aim the assembly to track into the portal vein 14 after the puncture.
  • the devices are configured to perform various functions while telescoped inside each other.
  • one or more of the functions listed herein can be performed using an outer device without having to first remove an inner device.
  • catheter 300 may be used to manipulate fluids through its primary lumen without having the remove puncture device 400 or wire guide 500.
  • dilator 200 may be used to manipulate fluids without having to remove catheter 300.
  • sheath 100 may be used to manipulate fluids without having to remove catheter.
  • the devices are introduced at the start of the procedure.
  • the devices are introduced into the various blood vessels, pressures measurements are taken, the puncture is made through the liver creating the tract, pressures are measured again, contrast is injected before and/or after the puncture. All of these steps can be performed at least once while the same four devices remain in the patient’s body, i.e., a device does not need to be removed. In other words, the configuration of the assembly is maintained during various steps.
  • the number of devices within the patient’s body does not change. In other words, the number of devices remains constant.
  • the steps of aiming, measuring pressure, puncturing, dilating the tract (initially), and confirming portal vein access are all performed with the same four-device assembly configuration. This will be described further in the method steps below.
  • FIG. 4 discloses a method of performing a TIPS procedure using a telescoping assembly 1000 in accordance with one embodiment of the present invention. The method may be better understood by referring to FIGS. 5 A to 5F, which illustrate the devices in use during the procedure.
  • the telescoping assembly including the sheath, dilator, catheter, and needle are introduced over the wire guide and positioned near the hepatic vein.
  • the assembly is aimed towards the hepatic vein, so that the wire guide can be advanced into the hepatic vein. Once the wire guide has advanced, the assembly can also be advanced into the hepatic vein, as shown in FIG. 5A. Once the assembly is in the hepatic vein, the 0.035” wire guide is removed.
  • the needle In order to perform the puncture, the needle is advanced so that the distal end of the needle extends, or protrudes, distally out of the assembly.
  • the needle is also secured to the catheter at the proximal end, creating a needle-catheter assembly, such that the needle and catheter can be advanced as a single device. In other words, the needle and catheter are advanced or retracted simultaneously.
  • the puncture is then performed with the needle-catheter assembly.
  • the needle-catheter assembly is mechanically forced/pushed through the hepatic vein wall, through the liver, into the portal vein, and possibly past the portal vein, as shown in FIG.5B. If the needle has gone through the portal vein, the distal end of the needle and/or catheter must be retracted back into the portal vein to continue with the procedure. Confirming that the distal end of the needle in the portal vein may be referred to as “confirming access” to the portal vein or “confirming portal vein access”.
  • Portal vein access may be confirmed with any elongate device that comprises a hollow lumen with aspiration capabilities, for example the catheter 300.
  • other methods of confirming access include: 1) viewing the device tip on ultrasound (IVUS/ICE) with an echogenic tip, 2) injecting contrast, 3) advance a wire down the needle lumen to see if it tracks into the portal vein.
  • the physician aspirates through the needle while also retracting the needle proximally.
  • a syringe with contrast agent may be attached to the proximal end of the needle, and the needle is retracted proximally while the syringe is also pulled back, creating suction. The needle is retracted until blood is observed in the syringe, which confirms the distal end of the needle is in the portal vein.
  • a flexible wire guide is then inserted through the needle and advanced further into the portal vein, also referred to as “tracking” into the portal vein.
  • Tracking into the portal vein means that the wire guide is advanced far enough such that the wire guide will not leave the portal vein as other steps of the procedure are performed, for example as other devices are removed and inserted over the wire guide.
  • the wire guide may be advanced approximately 5 centimeters into the portal vein.
  • the needle is uncoupled from the catheter and is removed from the assembly.
  • FIG. 5C shows the assembly with the wire guide in the portal vein. The distal end of the catheter remains in the portal vein.
  • a splenogram and/or venogram may be made to visualize one or more blood vessels around the liver and/or the tract.
  • Contrast fluid may be injected through the dilator to visualize the confluence of the IVC and HV.
  • Contrast fluid may also be injected through the catheter to visualize the portal vein and gastrointestinal varices using the splenogram/venogram. Once contrast fluid is injected, the tract length is measured by observing and counting a series of radiopaque marker bands located on the catheter. Contrast fluid is represented by the arrows in FIG. 5E.
  • the physician Before moving to the next step, using the long catheter described herein, the physician has the option of cannulating the splenic vein or other deeper veins in the portal system, to visualize or treating varices.
  • the needle is configured to perform the puncture through the liver to create the tract from the hepatic vein to the portal vein, and the needle is configured to aspirate and/or inject fluids in order to confirm portal vein access.
  • the catheter is configured to measure the pressure in the portal vein, to inject contrast fluid into the portal vein, and to determine the tract length using a visual indicator.
  • the dilator is configured to dilate the tract, to measure the pressure in the hepatic vein, and to inject contrast fluid in the hepatic vein.
  • the sheath is configured to aim the assembly, to measure the pressure in the hepatic vein, and to inject contrast fluid into the hepatic vein.
  • Steps 4002 to 4006 occur with all four devices remaining in the patient’s body.
  • Steps 4008 to 4014 occur with the sheath, dilator, and catheter remaining in the patient’s body.
  • Method 6000 begins at step 6002, where the devices are introduced into the patient and delivered to the hepatic vein. Using micro-puncture access techniques known by those skilled in the art, an 0.035” wire guide is introduced into the inferior vena cava via the jugular vein.
  • the needle is then removed, and a flexible wire guide is then inserted through the catheter and advanced further into the portal vein.
  • the wire guide tracks into the portal vein far enough so that access is not lost throughout the procedure, approximately 5 centimeters, shown in FIG. 5C.
  • Another option for tracking into the portal vein involves inserting a 0.014” wire guide through the needle lumen after portal vein access is confirmed.
  • the 0.014” wire guide can be advanced deeper into the portal vein to ensure access is not lost.
  • the needle can be removed, and the catheter can be advanced over the 0.014” wire guide deeper into the portal vein.
  • the catheter can be advanced far enough, the 0.014” can be removed and a 0.035” wire guide can be inserted through the catheter to act as a rail for the remainder of the procedure.
  • Steps 6008 to 6018 are substantially the same as steps 4008 to 4018.
  • This method uses a telescoping assembly 1000 that includes solid needle 400’, lOFr steerable sheath 100, lOFr dilator 200 with aspiration capabilities, 6Fr catheter 300 with aspiration, and a 0.035” wire guide 500.
  • the solid needle is removed and the physician aspirates through the catheter while also retracting the catheter proximally.
  • a syringe with contrast agent may be attached to the proximal end of the catheter, and the catheter is retracted proximally while the syringe is also pulled back, creating suction. The catheter is retracted until blood is observed in the syringe, which confirms the distal end of the catheter is in the portal vein.
  • a flexible wire guide is then inserted through the catheter and advanced further into the portal vein.
  • the wire guide is advanced far enough so that access is not lost throughout the procedure, approximately 5 centimeters into the portal vein, shown in FIG. 5C.
  • the wire guide remains in the portal vein throughout the procedure and does not dislodge as other devices are exchanged and moved along the wire guide.
  • puncture device 400 may be an RF wire 401.
  • RF wire 401 may be similar to the Baylis PowerWire® disclosed in US Patent 11,234,761.
  • a method of performing a TIPS procedure using an RF wire is disclosed in US Patent 11,324,548, which is hereby incorporated by reference. While this type of wire may be used for the puncture, in some cases this wire may not be flexible enough at the distal end to track into the portal vein after the puncture, and thus may need to be exchanged for a mechanical 0.035” guidewire. The mechanical guidewire then tracks into the portal vein.
  • One embodiment of the RF wire disclosed in US 11,234,761 has a relatively rigid distal end that, in some instances, may be incapable of tracking into the portal vein.
  • the portal vein diameter is relatively small (average of 10mm, but can also be as small as approximately 4-5mm in diameter), the rigid (5 mm) distal end of the RF wire may not be able to turn from the parenchyma tract into the portal vein in some cases.
  • the parenchyma tract and portal vein may also be at approximately 90-degree angles in some cases.
  • the distal end of the RF wire must be relatively short and rigid. It must be rigid enough for the puncture and short enough so that the wire can curve/turn into the portal vein. For example, an RF wire with 5 mm rigid distal end may not curve into the portal vein which may only be 5 mm in diameter.
  • Existing mechanical guidewires have a rigid distal end of 1-1.5mm long. These wires are flexible enough to make the turn from the tract to the portal vein.
  • the Baylis PowerWire® has a core wire, first insulation layer, second insulation layer, marker band, heat shield, and active electrode tip, which is formed from the core wire onto a support structure, for example a tantalum puck.
  • Marker band is approximately 2 mm in length
  • heath shield is approximately 2.5 mm
  • the electrode tip is approximately 0.5 mm long, creating a 5.0 mm rigid distal region.
  • the RF Wire has an inner PTFE layer, an FEP heat shrink layer, and an outer PTFE layer.
  • a first solution involves an RF wire 401 comprising a flexible distal end. To make a portion of the distal end flexible, the dimensions of the rigid features at the distal tip can be modified and still retain the thermal protection properties necessary to safely use an RF wire to puncture through the liver. To maintain the thermal protection properties, the RF wire requires a heat shield and insulation.
  • RF wire 401 comprises several modifications to reduce the overall length of the rigid distal region.
  • a first modification is to remove the 2.0 mm marker band and reduce the length of the heat shield.
  • Heat shield is in the range of 1.0 to 1.5 mm long.
  • the distal tip (energy delivery component) is approximately 0.5 mm.
  • the total length of the rigid distal region is approximately 2.0 mm, which would enable the RF wire 401 to track into the portal vein after the puncture is performed.
  • core wire comprises a reduced diameter region, which is larger than the distal end of tapered region.
  • reduced diameter region has an outer diameter of 0.010” (10 thou) and a longitudinal length of approximately 1.5 mm.
  • the heat shield surrounds the reduced diameter region.
  • the wire may also comprise a coil covering a portion of the reduced diameter region and/or tapered region of the core wire. The coil may add to the overall diameter to maintain compatibility with the catheter, while also maintaining flexibility.
  • any of all of the first, second, or third modifications described herein ensure that the RF wire 401 is flexible enough to curve to turn from the parenchyma tract into the portal vein 14, in other words track into the portal vein.
  • the RF wire 401 comprises a flexible distal end having a rigid distal region of approximately 2.0 mm.
  • RF wire 401’ comprises a pre-curved distal end 402’ and the assembly further comprises a sleeve 600 with a rigid distal region 602.
  • sleeve 600 is an elongate member flexible enough to traverse a patient’s vascular, including into vessels necessary for a TIPS procedure, and also configured to deflect the pre-curved distal end 402’ end of RF wire 401 ’ into a straight configuration.
  • sleeve 600 has a uniform stiffness throughout its body.
  • the rigid distal region 602 may be stiffer than other parts of the sleeve body.
  • sleeve 600 comprises one or more locking features to secure the sleeve to the catheter 300 and/or RF wire 401 ’.
  • sleeve 600 comprises a sleeve hub 604.
  • Sleeve hub 604 may comprise a luer-connector, or similar mechanism, configured to couple catheter hub 304 with sleeve 600, thereby allowing the catheter 300 and sleeve 600 to move as a single device.
  • sleeve 600 may comprise a second locking feature to couple RF wire 401 ’ and sleeve 600.
  • the second locking feature may comprise a pushbutton 606, or other mechanism, to couple and uncouple RF wire 401’ and sleeve 600.
  • catheter 300 is floppy at least at the distal end, and as sleeve 600 is retracted, both the RF wire 401’ and the catheter 300 adopt a curved configuration.
  • sleeve 600 and catheter 300 may be coupled together and RF wire 401 ’ is advanced (or sleeve-catheter is retracted) such that RF wire 401’ wire adopts a curved configuration.
  • RF wire 401 ’ and sleeve 600 may be secured together such that they can be advanced as a singe device, and advanced in a substantially straight orientation for the puncture.
  • the RF wire 401 ’ and sleeve 600 can be uncoupled, such that the RF wire 401’ advances out of the sleeve 600.
  • RF wire 401’ may track into the portal vein by adopting a curved orientation.
  • RF wire 401 has a substantially straight configuration and angled catheter 300” has a curved distal end 326”.
  • the curved distal end 326” of angled catheter 300” is flexible such that when the RF wire 401 is received within and/or extends out of the angled catheter 300”, both devices have a substantially straight configuration as shown in FIG.10A.
  • angled catheter 300” advances further over RF wire 401 (or if RF wire 401 is retracted), angled catheter 300” adopts a curved configuration at the distal end, as shown in FIG. 10B.
  • the two devices can be secured together (described herein) with the RF wire 401 slightly protruding out of the distal end of angled catheter 300”.
  • the puncture through the liver can be performed in a straight configuration.
  • the angled catheter 300 is advanced such that it tracks into the portal vein 14.
  • steerable catheter 301 may be used to track into the portal vein 14. After a puncture is made, steerable catheter is advanced into the portal vein 14. The puncture device may be removed, and a steering mechanism on the steerable catheter 301, for example actuator 307, may be used to deflect the distal end of the catheter, such that it tracks into the portal vein 14. At which point, wire guide 500 may be advanced further into the portal vein 14.
  • a steering mechanism on the steerable catheter 301 for example actuator 307
  • the method begins at step 1102, where the devices are introduced into the patient and delivered to the hepatic vein.
  • an 0.035” wire guide or the 0.035” RF wire 401 is introduced into the inferior vena cava via the jugular vein.
  • the telescoping assembly, including the sheath, dilator, and catheter are introduced and, using steering features on the steerable sheath, the assembly is advanced to the hepatic vein, as shown in FIG. 12 A. (FIG. 12A shows guide wire 500, but in some examples, RF wire 401 may be used)
  • the assembly is in the hepatic vein, if the 0.035” wire guide was used, it can be removed and the RF wire is introduced into the assembly.
  • the puncture is made to create a tract from the hepatic vein, through the liver, to the portal vein.
  • the steerable sheath can be used to aim the assembly towards portal vein.
  • the RF wire punctures and advances through the hepatic vein wall, through the liver, and into the portal vein, shown in FIG. 12B. If a precurved RF wire is used, the puncture is performed with at least the sleeve and RF-wire, such that the RF-wire has a substantially straight configuration. (NOTE: sleeve and catheter not shown in FIG. 12B)
  • Steps 1108 to 1118 are substantially the same as steps 4008 to 4018, and the RF wire is used as a rail and not of the 0.035” wire guide. (Note, refer to FIGS. 12D to 12F)
  • the RF wire is configured to perform the puncture through the liver, and to track into the portal vein.
  • the catheter is configured to confirm portal vein access, to measure pressure in the portal vein, to inject contrast fluid into the portal vein, and to determine the tract length using a visual indicator.
  • the dilator is configured to dilate the tract, to measure pressure in the hepatic vein, and to inject contrast fluid in the hepatic vein.
  • the sheath is configured to steer the assembly, measure pressure in the hepatic vein, and inject contrast fluid into the hepatic vein.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
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  • Gastroenterology & Hepatology (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

L'invention concerne un procédé et un système pour effectuer une procédure de dérivation portosystémique intrahépatique transjugulaire (TIPS). La présente invention concerne un ensemble dispositif médical comprenant une pluralité de dispositifs, agencés dans un agencement télescopique, comprenant un dispositif de perforation et une pluralité d'éléments allongés, plusieurs dispositifs étant conçus pour effectuer de multiples étapes d'une procédure TIPS qui sont généralement réalisées par un seul dispositif. Diverses étapes de la procédure peuvent être effectuées tout en maintenant la configuration de l'ensemble dispositif médical à l'intérieur du corps d'un patient.
PCT/IB2024/059286 2023-10-02 2024-09-24 Dispositifs et procédés pour procédures de dérivation portosystémique intrahépatique transjugulaire Pending WO2025074196A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US202363587274P 2023-10-02 2023-10-02
US63/587,274 2023-10-02

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WO2025074196A1 true WO2025074196A1 (fr) 2025-04-10

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PCT/IB2024/059286 Pending WO2025074196A1 (fr) 2023-10-02 2024-09-24 Dispositifs et procédés pour procédures de dérivation portosystémique intrahépatique transjugulaire

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090182360A1 (en) * 1995-10-13 2009-07-16 Medtronic Vascular, Inc. Device, System and Method for Interstitial Transvascular Intervention
US20210275211A1 (en) * 2019-01-02 2021-09-09 Indian Wells Medical, Inc. Steerable endoluminal punch
US20220226043A1 (en) * 2015-08-21 2022-07-21 Baylis Medical Company Inc. Transvascular Electrosurgical Devices and Systems and Methods of using the same
WO2023006072A1 (fr) * 2021-07-30 2023-02-02 北京迈迪斯医疗技术有限公司 Système de ponction
US20230095107A1 (en) * 2012-05-17 2023-03-30 Boston Scientific Scimed, Inc. Methods and devices for access across adjacent tissue layers

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090182360A1 (en) * 1995-10-13 2009-07-16 Medtronic Vascular, Inc. Device, System and Method for Interstitial Transvascular Intervention
US20230095107A1 (en) * 2012-05-17 2023-03-30 Boston Scientific Scimed, Inc. Methods and devices for access across adjacent tissue layers
US20220226043A1 (en) * 2015-08-21 2022-07-21 Baylis Medical Company Inc. Transvascular Electrosurgical Devices and Systems and Methods of using the same
US20210275211A1 (en) * 2019-01-02 2021-09-09 Indian Wells Medical, Inc. Steerable endoluminal punch
WO2023006072A1 (fr) * 2021-07-30 2023-02-02 北京迈迪斯医疗技术有限公司 Système de ponction

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