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DE393834T1 - Rotierender katheter fuer atherektomiesystem. - Google Patents

Rotierender katheter fuer atherektomiesystem.

Info

Publication number
DE393834T1
DE393834T1 DE199090302792T DE90302792T DE393834T1 DE 393834 T1 DE393834 T1 DE 393834T1 DE 199090302792 T DE199090302792 T DE 199090302792T DE 90302792 T DE90302792 T DE 90302792T DE 393834 T1 DE393834 T1 DE 393834T1
Authority
DE
Germany
Prior art keywords
flexible
arterectomy
guide wire
coil
rotating
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
DE199090302792T
Other languages
English (en)
Inventor
Samuel Mundelein Ill. Shiber
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.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Publication of DE393834T1 publication Critical patent/DE393834T1/de
Pending legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular 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
    • A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320758—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a rotating cutting instrument, e.g. motor driven
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B17/320783—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • A61B18/082—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • A61B18/245—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter for removing obstructions in blood vessels or calculi
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16C—SHAFTS; FLEXIBLE SHAFTS; ELEMENTS OR CRANKSHAFT MECHANISMS; ROTARY BODIES OTHER THAN GEARING ELEMENTS; BEARINGS
    • F16C1/00—Flexible shafts; Mechanical means for transmitting movement in a flexible sheathing
    • F16C1/02—Flexible shafts; Mechanical means for transmitting movement in a flexible sheathing for conveying rotary movements
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16D—COUPLINGS FOR TRANSMITTING ROTATION; CLUTCHES; BRAKES
    • F16D7/00—Slip couplings, e.g. slipping on overload, for absorbing shock
    • F16D7/02—Slip couplings, e.g. slipping on overload, for absorbing shock of the friction type
    • 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
    • A61B2017/22038—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 with a guide wire
    • 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
    • A61B2017/22051—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 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • A61B2017/22052—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 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation eccentric
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A61B2090/031—Automatic limiting or abutting means, e.g. for safety torque limiting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00—General characteristics of surgical instruments
    • A61B2217/002—Auxiliary appliance
    • A61B2217/005—Auxiliary appliance with suction drainage system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/71—Suction drainage systems
    • A61M1/74—Suction control
    • A61M1/75—Intermittent or pulsating suction
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16C—SHAFTS; FLEXIBLE SHAFTS; ELEMENTS OR CRANKSHAFT MECHANISMS; ROTARY BODIES OTHER THAN GEARING ELEMENTS; BEARINGS
    • F16C2202/00—Solid materials defined by their properties
    • F16C2202/20—Thermal properties
    • F16C2202/28—Shape memory material
    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16C—SHAFTS; FLEXIBLE SHAFTS; ELEMENTS OR CRANKSHAFT MECHANISMS; ROTARY BODIES OTHER THAN GEARING ELEMENTS; BEARINGS
    • F16C2316/00—Apparatus in health or amusement
    • F16C2316/10—Apparatus in health or amusement in medical appliances, e.g. in diagnosis, dentistry, instruments, prostheses, medical imaging appliances

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Public Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Veterinary Medicine (AREA)
  • Vascular Medicine (AREA)
  • General Engineering & Computer Science (AREA)
  • Mechanical Engineering (AREA)
  • Physics & Mathematics (AREA)
  • Otolaryngology (AREA)
  • Plasma & Fusion (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Optics & Photonics (AREA)
  • Electromagnetism (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgical Instruments (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Claims (24)

  1. Ansprüche
    1 . In ein menschliches Blutgefäß einführbares Arterektomie-System zum Ausschneiden und Entfernen einer darin enthaltenen Obstruktion, umfassend in Kombination:
    einen in das Blutgefäß einführbaren flexiblen Führungsdraht ,
    einen einen ununterbrochenen Durchgang definierenden und drehbar angeordneten sowie über den flexiblen Führungsdraht verschiebbaren flexiblen rotierenden Katheter, der ein proximales und ein distales Ende aufweist,
    ein an dem distalen Ende gelegenes rotierendes Ausschneidemittel zum Schneiden und Aufnehmen von Obstruktionsmaterial ,
    an seinem proximalen Ende gelegene Kupplungsmittel zum Drehen des flexiblen rotierenden Katheters um den flexiblen Führungsdraht,
    in dem flexiblen rotierenden Katheter eingebaute Mittel zur Durchmesserstabilisierung und Mittel zur Drehmomentübertragung.
  2. 2. Arterektomie-System nach Anspruch 1 , worin der flexible rotierende Katheter drehbar in einer Hülse angeordnet ist.
  3. 3. Arterektomie-System nach Anspruch 1, worin die Mittel zur Durchmesserstabilisierung des flexiblen rotierenden Katheters eine Reihe von mittels der Drehmomentübertragungsmittel untereinander verbundener Reifenelemente umfassen.
  4. 4. Arterektomie-System nach Anspruch 3, worin die Reifenelemente jeweils durch Streifen miteinander verbundene, gerollte Streifen sind.
  5. 5. Arterektomie-System nach Anspruch 3, worin die Reifenelemente eng beabstandete Windungen sind, die miteinander jeweils durch eine weit beabstandete Windung verbunden sind.
  6. 6. Arterektomie-System nach Anspruch 1, worin die Mittel zur Durchmesserstabilisierung des flexiblen rotierenden Katheters aus einer Wendel bestehen.
  7. 7. Arterektomie-System nach Anspruch 6, worin die Wendel in Richtung der Rotation gewunden ist und ein die Ausdehnung der Wendel begrenzendes Glied aufweist, wobei die Wendel wenigstens einen Teil des durch den flexiblen rotierenden Katheter übertragenen Drehmomentes aufnimmt.
  8. 8. Arterektomie-System nach Anspruch 7, worin das externe Begrenzungsglied aus einer entgegen der Richtung der Rotation gewundenen Wendel besteht.
  9. 9. Arterektomie-System nach Anspruch 6, mit einer einen für Fluide geeigneten Kanal durch den flexiblen rotierenden Katheter definierenden Kunststoffwand.
  10. 10. Arterektomie-System nach Anspruch 9, worin die Kunststoffwand Glieder zur Durchmesserbegrenzung beinhaltet.
  11. 11. Arterektomie-System nach Anspruch 1, worin das rotierende Ausschneidemittel integraler Bestandteil der Mittel zur Durchmesserstabilisierung des flexiblen rotierenden Katheters ist.
  12. 12. Arterektomie-System nach Anspruch 1, worin das rotierende Ausschneidemittel integraler Bestandteil der Mittel zur Drehmomentübertragung ist.
  13. 13. In ein menschliches Blutgefäß einführbares Arterektomie-System zum Ausschneiden und Entfernen einer darin enthaltenen Obstruktion, umfassend in Kombination:
    einen in das Blutgefäß einführbaren flexiblen Führungsdraht ,
    einen einen ununterbrochenen Durchgang definierenden und drehbar angeordneten sowie über den flexiblen Führungsdraht verschiebbaren flexiblen rotierenden Katheter, der ein proximales und ein distales Ende aufweist,
    ein an dem distalen Ende gelegenes rotierendes Ausschneidemittel zum Schneiden und Aufnehmen von Obstruktionsmaterial ,
    an seinem proximalen Ende gelegene Kupplungsmittel zum Drehen des flexiblen rotierenden Katheters um den flexiblen Führungsdraht,
    schiefe Ebenen in dem ununterbrochenen Durchgang zur Unterstützung der Bewegung des Obstruktionsmaterials darin.
    -H-
  14. 14. Arterektomie-System nach Anspruch 13, worin der flexible rotierende Katheter drehbar in einer Hülse angeordnet ist.
  15. 15. Arterektomie-System nach Anspruch 14, worin der flexible rotierende Katheter eine Wendel umfaßt.
  16. 16. Arterektomie-System nach Anspruch 15, worin die Wendel in Richtung der Rotation gewunden ist.
  17. 17. Arterektomie-System nach Anspruch 16, worin ein Mittel zur Begrenzung des Durchmessers die Wendel zurückhält.
  18. 18. Arterektomie-System nach Anspruch 17, worin das Begrenzungsmittel aus einer entgegen der Richtung der Rotation gewundenen externen Wendel besteht.
  19. 19. Arterektomie-System nach Anspruch 17, worin das Begrenzungsmittel aus einer Kunststoffwand besteht.
  20. 20. Arterektomie-System nach Anspruch 19, worin die Wand Mittel zur Durchmesserbegrenzung beinhaltet.
  21. 21 . Verfahren zum Entfernen eines weichen Blutgerinsels aus einem menschlichen Blutgefäß, umfassend die folgenden Schritte:
    Einführen eines flexiblen Führungsdrahtes in das Blutgefäß und Vorschieben in das Blutgerinsel,
    Einführen eines ein distales und ein proximales Ende aufweisenden flexiblen rotierenden Katheters über den flexiblen Führungsdraht, Vorschieben des distalen
    Endes zur mechanischen Einwirkung auf das Blutgerinsel und zu dessen Abtragung, während am proximalen Ende Unterdruck angewendet wird, um das Blutgerinsel in das distale Ende aufzunehmen,
    Entfernen des Systems mit dem Blutgerinsel aus dem Blutgefäß.
  22. 22. Verfahren nach Anspruch 21, worin mindestens ein Abschnitt des flexiblen Führungsdrahtes wie ein Bohrer geformt ist.
  23. 23. Verfahren zum Entfernen einer aus einem auf einem arterosklerotischen Belag gebildeten weichen Blutgerinsels bestehenden Obstruktion aus einem menschliehen Blutgefäß, umfassend die folgende Schritte:
    Einführen eines flexiblen Führungsdrahtes in das Blutgefäß und vorschieben in die Obstruktion,
    Einführen eines flexiblen rotierenden Katheters, der ein proximales und ein distales Ende mit daran angeordneten rotierenden Ausschneidemitteln hat, über den flexiblen Führungsdraht,
    Vorschieben des distalen Endes zur mechanischen Einwirkung und Abtragung des Blutgerinsels, während am proximalen Ende Unterdruck angewendet wird zur Aufnahme des Blutgerinsels in das distale Ende,
    Drehen und Vorschieben der rotierenden Ausschneidemittel zum Schneiden und Aufsaugen des arterosklerotischen Belags,
    Entfernen des Systems mit dem Blutgerinsel und dem arterosklerotischen Belag aus dem Blutgefäß.
  24. 24. Verfahren nach Anspruch 23, worin wenigstens ein Abschnitt des flexiblen Führungsdrahtes wie ein Bohrer geformt ist.
DE199090302792T 1989-03-16 1990-03-15 Rotierender katheter fuer atherektomiesystem. Pending DE393834T1 (de)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US07/324,616 US5007896A (en) 1988-12-19 1989-03-16 Rotary-catheter for atherectomy

Publications (1)

Publication Number Publication Date
DE393834T1 true DE393834T1 (de) 1991-04-11

Family

ID=23264367

Family Applications (2)

Application Number Title Priority Date Filing Date
DE199090302792T Pending DE393834T1 (de) 1989-03-16 1990-03-15 Rotierender katheter fuer atherektomiesystem.
DE69026860T Expired - Fee Related DE69026860T2 (de) 1989-03-16 1990-03-15 Rotierender Katheter für Atherektomiesystem

Family Applications After (1)

Application Number Title Priority Date Filing Date
DE69026860T Expired - Fee Related DE69026860T2 (de) 1989-03-16 1990-03-15 Rotierender Katheter für Atherektomiesystem

Country Status (3)

Country Link
US (1) US5007896A (de)
EP (2) EP0393834B1 (de)
DE (2) DE393834T1 (de)

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EP0393834A3 (de) 1991-01-09
US5007896A (en) 1991-04-16
EP0680730A3 (de) 1996-01-24
EP0393834B1 (de) 1996-05-08
EP0680730A2 (de) 1995-11-08
EP0393834A2 (de) 1990-10-24
DE69026860D1 (de) 1996-06-13
DE69026860T2 (de) 1996-10-10

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