Surgery – Instruments – Means for inserting or removing conduit within body
Reexamination Certificate
2000-08-15
2003-03-25
Shaver, Kevin (Department: 3732)
Surgery
Instruments
Means for inserting or removing conduit within body
C623S001110, C623S001230
Reexamination Certificate
active
06537284
ABSTRACT:
TECHNICAL FIELD
The present invention relates to a device for advantageously guiding appliances to be implanted which belong to the field of medical devices, particularly for guiding artificial blood vessels.
BACKGROUND ART
With the recent progress of medical technique, the art enabling transvascular use of a variety of appliances such as artificial blood vessels without ventrotomy has reached the clinical stage. Specific examples of such art include a method of transferring and fixing an artificial blood vessel using a catheter which has been invented by the inventor of the instant invention and disclosed in literature A (for example, PCT/JP96/01347 which has been published with International Publication No. WO96/36387). This method includes: inserting a catheter into a human body through an inguinal artery to position the leading end thereof near an affected part in which an aneurysm or a like pathological change is present; inserting in a collapsed condition a tubular artificial blood vessel imparted with collapsible/restorable elasticity into the catheter; transferring the artificial blood vessel to a predetermined location near the affected part by the use of a transferring device or a hauling device; and releasing the artificial blood vessel from the catheter, thereby positioning the artificial blood vessel in the affected vascular part having the aneurysm.
An artery has a branched part at which a branch blood vessel extends from the main vessel. Where an aneurysm is present in such a branched part, it is impossible to apply the above method simply. In an attempt to enable a transvascular treatment for an aneurysm in such a case, the inventor of the instant invention has also proposed in the above literature a method including: forming a branched artificial blood vessel comprising a main body and a branch portion; transferring the artificial blood vessel in the main blood vessel to a branched part thereof; and drawing the branch portion of the artificial blood vessel into a branch blood vessel branching from the main blood vessel, thereby positioning the artificial blood vessel conformally to the branched configuration of the subject blood vessel.
In the latter method, the artificial blood vessel is accompanied by an auxiliary hauling device adapted to drag the branch portion of the artificial blood vessel independently when the artificial blood vessel is transferred in the main vessel to the branched part by a transferring device, and the hauling device is drawn into the branch blood vessel by catching it using a catcher inserted from the branch side and taken out of the body so as to be operated for drawing the branch portion of the artificial blood vessel into the branch blood vessel. However, if the subject main blood vessel is an artery that terminates in peripheral blood vessels such as the celiac artery, it is difficult for any appliance to reach a desired part from a surface of the body. In such a case, it becomes impossible to insert the catcher from the outside of the body or take the hauling device out of the body, thus resulting in a disadvantage that the proposed method cannot be used.
DISCLOSURE OF INVENTION
To solve the foregoing problem, the present invention provides a device for guiding a branched appliance having a tubular main body with collapsible/restorable elasticity and a branch portion with collapsible/restorable elasticity which branches from a part of the main body with its internal space communicating with the main body, which appliance has been transferred as collapsed in a main blood vessel to a branched part branching a branch blood vessel from the main blood vessel, the device being utilized in inserting the branch portion of the appliance into the branch blood vessel, characterized by comprising an operating rod inserted into the main body from a trailing open end thereof and operable for rotation by hand, a guiding rod continuously connected to the operating rod so as to be capable of turning around with rotation of the operating rod and having a leading end extending to an open end of the branch portion, and mooring means for releasably mooring the branch portion by a portion adjacent the open end thereof to the guiding rod, wherein when the main body is moved backward with the guiding rod made to assume a predetermined position by turning, the branch portion accompanying the guiding rod is capable of advancing into the branch blood vessel together with the guiding rod.
Preferred embodiments of the present invention include such an arrangement that the operating rod and the guiding rod are formed by turning up a flexible wire rod into a loop having a trailing side forming the operating rod and a leading side forming the guiding rod.
For more reliable turning of the guiding rod by the force applied to the operating rod, it is desired that the leading side and the trailing side of the loop be in contact with each other and the contact portion be fixed.
For easy removal of the wire rod after the appliance has been guided, the fixing of the contact portion is releasably made using a snare wire.
A feature such that at least a portion of the loop protrudes beyond a leading open end of the main body is effective for preventing the wire rod from receiving an unexpected flexing force.
To enhance the guiding ability of the guiding rod, it is desired that the guiding rod comprise a tube and a guiding wire retractably accommodated in the tube with its leading end protruding from a leading end of the tube.
In another aspect, the present invention provides a device for guiding an appliance comprising an operating rod inserted into the main body from a trailing open end thereof and operable for rotation by hand, a guiding rod continuously connected to the operating rod so as to be capable of turning around with rotation of the operating rod and having a leading end extending to an open end of the branch portion, and mooring means for releasably mooring the branch portion by a portion adjacent the open end thereof to the guiding rod, wherein when the main body is moved forward with the guiding rod made to assume a predetermined position by turning, the branch portion accompanying the guiding rod is inserted into the branch blood vessel together with the guiding rod.
Specific embodiments of this case include an arrangement wherein the operating rod and the guiding rod are formed by bending a flexible wire rod into a curve having a trailing side forming the operating rod and a leading side forming the guiding rod.
In this case also, the guiding rod preferably comprises a tube having a guiding wire accommodating bore, and a guiding wire retractably accommodated in the guiding wire accommodating bore of the tube with its leading end protruding from a leading end of the tube.
For simultaneous releasing of the appliance from a moored state and from a collapsed state, it is desired that a mooring wire serving also as collapsing means for maintaining the branch portion of the appliance in the collapsed state be provided. By drawing out the mooring wire, restoration of the branch portion can be accomplished simultaneously with the releasing of the appliance from the moored state.
An advantageous embodiment of the mooring means comprises a mooring wire forming an openable closed circuit in cooperation with the tube, the mooring wire being capable of mooring the branch portion when the closed circuit is formed by inserting the mooring wire into a portion of the branch portion and capable of releasing the mooring state when the closed circuit is opened by drawing the mooring wire out of the branch portion, wherein at least a portion of the mooring wire that extends from a location adjacent the mooring portion toward a trailing side of the tube is positioned out of the guiding wire accommodating bore.
Specific examples of this arrangement include: one in which the tube has a portion provided with a window exposing the guiding wire accommodating bore and a mooring wire passing portion formed on an outer periphery of the tube at a location away from the window towar
Banner & Witcoff , Ltd.
Priddy Michael B.
Shaver Kevin
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