The present disclosure generally relates to a self-expandable stent system having an inner structure and an outer tube.
As a medical device to be inserted into a body, a stent delivery system having a stent can be used in treating myocardinal infarction or angina pectoris. For example, the stent delivery system is inserted into the body and the stent is caused to expand in a lesion (stenosis) of a coronary artery. In this manner, a lumen in the coronary artery can be secured by spreading out the stenosis.
A type of the above-described stent includes a self-expandable stent, which can expand by itself. A stent delivery system having this self-expandable stent has been known (refer to Japanese Patent No. 4733055).
The stent delivery system disclosed in Japanese Patent No. 4733055 has a distal tip including a scallop-processed surface, a sheath which is in close contact with the distal tip and surrounds a catheter, and a stent which is arranged in a space between the catheter and the sheath. The stent delivery system employs a structure where a gap is formed between the scallop-processed surface of the distal tip and a distal edge of the sheath.
In this case, as illustrated by an arrow in
However, a size of the gap formed between the scallop-processed surface of the distal tip and the distal edge of the sheath can be very small as compared to an inner diameter of the sheath. Consequently, a discharge amount of the air discharged from the gap is limited, and the air is less likely to be removed during the priming, thereby causing a disadvantage in that a desired object may not be achieved. In addition, since the gap is present, when a distal portion of the stent delivery system is inserted into the body, there is a possibility that the blood may flow backward into the sheath. Further, when a device such as the stent indwells in the body in advance and the distal portion of the stent delivery system passes through the inside of the device, the gap is caught on an end portion of the device, thereby causing a possibility that the end portion of the device may enter the gap.
Furthermore, the distal edge of the sheath can be exposed in a portion having the gap. Consequently, a step difference occurs between a head portion of the distal tip and the distal edge of the sheath, thereby causing a disadvantage in that the distal edge of the sheath hits against a vascular wall.
A self-expandable stent system is disclosed, which can efficiently and sufficiently discharge air outward from a gap formed between an outer tube and an inner tube (inner structure) both of which configure double tubes such as a sheath and a catheter during priming, and which can be easily and reliably inserted into a lumen without a distal edge of the outer tube hitting against a lumen inner wall of a blood vessel.
A self-expandable stent system is disclosed, which can include an inner structure, an outer tube, and a self-expandable stent arranged between the inner structure and the outer tube. A distal end of the inner structure has a distal end dilating portion, which comes into close contact with a distal end of the outer tube when a contraction state is switched over to a dilation state.
In accordance with an exemplary embodiment, before the self-expandable stent system is used, the distal end dilating portion is in a contraction state, and an opening disposed in a distal end of the outer tube is in an opened state. In this state, when priming fluid is caused to flow from a proximal side of the system to a gap formed between the outer tube and the inner structure, the fluid pushes air present in the gap outward, thereby enabling the air inside the gap to be efficiently discharged outward. In addition, before the system is inserted into a body, the distal end dilating portion is brought into the dilation state. In this manner, the opening disposed in the distal end of the outer tube is closed, and a step difference does not occur between the distal end dilating portion and a distal edge of the outer tube. Accordingly, the system can be inserted into a lumen without the distal edge of the outer tube hitting against a lumen inner wall.
In accordance with an exemplary embodiment, the distal end dilating portion may be formed from a balloon which dilates by being pressurized, or may be formed of a molded material of swellable gel which swells by absorbing liquid.
In accordance with an exemplary embodiment, the distal end dilating portion can contract so as to have a decreased size before the system is used, thereby opening the distal end of the outer tube. Accordingly, efficient priming can be realized. In addition, the distal end dilating portion is caused to inflate (dilate or swell) before the system is used. Accordingly, a step difference does not occur between the distal end dilating portion and the distal edge of the outer tube.
In accordance with an exemplary embodiment, efficient priming can be realized by disposing a large opening in the distal end of the outer tube. In addition, the distal end dilating portion closes the opening and can help eliminate the step difference with the outer tube after the priming is completed. Therefore, it becomes relatively easy to insert the system into the lumen.
Hereinafter, a self-expandable stent system according to the present disclosure will be described in detail with reference to exemplary embodiments and the accompanying drawings.
As illustrated in
For example, a balloon-type distal tip (distal end dilating portion) 16 which dilates by pressure generated when a contrast medium is injected to serve as balloon pressurizing fluid is disposed in the distal portion of the shaft 14. The balloon-type distal tip 16 is in a contraction state before use, as in a state before the medical package is unpacked. The balloon-type distal tip 16 dilates before being inserted into a body. Hereinafter, description will be made on the assumption that the balloon-type distal tip 16 side is the distal side of the self-expandable stent system 10 and a second hub 24 side (to be described later) is the proximal side of the self-expandable stent system 10.
A self-expandable stent 18 which can expand by itself is arranged in a portion (gap 34 to be described later) between the shaft 14 and the sheath 12. A first hub 20 extending in the axial direction is fixed to the proximal side of the sheath 12, and a first fluid injection port 22 communicating with a space, for example, a gap formed between the sheath 12 and the shaft 14 is disposed integrally with the first hub 20. As will be described later, the shaft 14 internally has a balloon pressurizing lumen 26 and a guidewire lumen 30 (refer to
An intermediate portion of the shaft 14 is inserted into the first hub 20 so as to be movable along the axial direction. In contrast, in accordance with an exemplary embodiment, the proximal portion of the shaft 14 can be fixed to the second hub 24. A second fluid injection port 28 communicating with the balloon pressurizing lumen 26 (refer to
As illustrated in
The balloon pressurizing lumen 26 is configured to include an axial hole portion 38 which extends in the axial direction of the shaft 14, and a radial hole portion 40 which communicates with the axial hole portion 38 and extends outward in the radial direction of the shaft 14.
Next, the balloon-type distal tip 16 will be described. As shown in
Next, an operation and an advantageous effect of the self-expandable stent system 10 according to the first embodiment configured as described above will be described.
As illustrated in
Next, as illustrated in
As a result, as illustrated in
Moreover, the opening 36 is closed by the balloon-type distal tip 16 and the distal edge 44 of the sheath 12 coming into close contact with each other. As a result, when the self-expandable stent system 10 is inserted into the body, blood can be prevented from flowing backward into the sheath 12.
As illustrated by a two-dot chain line in
In accordance with an exemplary embodiment, the present embodiment employs an over-the-wire structure (OTW structure) in which the guidewire lumen 30 extends to the second hub 24. However, the present embodiment may employ a rapid exchange structure (RX structure) in which the opening 36 is disposed in the middle of the sheath 12 and the proximal end of the guidewire lumen 30 of the shaft 14 is caused to communicate with the outside of the shaft 14 via the opening 36 of the sheath 12.
In this modification example, the same reference numerals are given to configuration elements which are the same as those in the first embodiment, and detailed description thereof will be omitted.
Therefore, in this modification example, an opening 45 is formed in the middle of the sheath 12. In contrast, an opening 46, which has a smaller diameter than the opening 45, is formed in the middle of the shaft 14. Furthermore, an opening 47 facing the inside of the balloon-type distal tip 16 is formed on the distal side of the shaft 14, and an axial hole portion 48 communicating with the opening 47 is disposed thereon.
In this modification example, the guidewire 32 is inserted from the opening 45, is passed through the opening 46, and is exposed outward from the distal portion of the shaft 14 through the guidewire lumen 30. In contrast, the axial hole portion 48 and the opening 47 are used in injecting liquid such as a contrast medium and the like therethrough.
According to this modification example, an operation effect, which is the same as that in the first embodiment can also be obtained.
Incidentally, the self-expandable stent system 10 employs the balloon-type distal tip 16. In accordance with an exemplary embodiment, a distal tip is disclosed for achieving an operation effect, which is the same as that of the balloon-type distal tip 16 by employing a molded material of swellable gel, which can swell by absorbing fluid, particularly liquid. Next, the above configuration will be described as a second embodiment.
A self-expandable stent system 50 according to the second embodiment will be described with reference to
As illustrated in
The self-expandable stent system 50 according to the second embodiment is configured as described above. Next, an operation effect of the self-expandable stent system 50 will be described.
In the self-expandable stent system 50, when a saline solution is caused to flow into the gap 34 during priming as illustrated by an arrow (A), the saline solution comes into contact with the swellable distal tip 52, and the swellable distal tip 52 starts to swell by absorbing the saline solution. As a result, as illustrated in
As illustrated in
In the self-expandable stent system 50 described with reference to
A self-expandable stent system 60 according to a third embodiment in which a shape of the distal tip is changed in the self-expandable stent system 10 according to the first embodiment will be described with reference to
In accordance with an exemplary embodiment, in the self-expandable stent system 60 according to the third embodiment, the distal tip 62 has a tapered portion 64 whose distal side has an acuminate shape, and can include a balloon portion (distal end dilating portion) 68 in which a middle portion in the axial direction forms a body portion 66 and which extends from the body portion 66 to the proximal side. The proximal portion of the balloon portion 68 can extend from the distal edge 44 of the sheath 12 to the inside of the sheath 12, and is fixedly attached to a peripheral wall of the shaft 14 on the proximal side relative to the distal edge 44. The proximal portion of the balloon portion 68 may be fixedly attached to the peripheral wall of the shaft 14 located at the same position as the distal edge 44. A space portion 70 is formed inside the balloon portion 68. The space portion 70 communicates with the radial hole portion 40. For example, the balloon portion 68 may be configured to include materials of nylon, nylon elastomer, polyester such as polyethylene terephthalate, and the like, polyester elastomer, polyolefin such as polyethylene, polypropylene, and the like, polyurethane, a silicone rubber, or the like.
In the above-described configuration, the saline solution is caused to flow into the gap 34 between the sheath 12 and the shaft 14 through the first fluid injection port 22, and the air inside the gap 34 is discharged outward from the opening 36, thereby performing the priming. Thereafter, as illustrated by an arrow (B), liquid such as a contrast medium and the like is injected through the second fluid injection port 28, passes through the axial hole portion 38 and the radial hole portion 40 of the balloon pressurizing lumen 26, and flows into the space portion 70 inside the balloon portion 68.
As a result, as illustrated in
In the self-expandable stent system 50 (refer to
In accordance with an exemplary embodiment, for example, the shape of the distal tip 82 is the same as that of the tapered portion 64 and the body portion 66 which are described according to the third embodiment. However, this embodiment is different from the third embodiment in that the swelling portion 84 extending to the proximal side is disposed in a terminal end portion of the body portion 66. The swelling portion 84 can include a tapered portion 86 which extends from the distal edge 44 of the sheath 12 to the inside of the sheath 12 and which is fixedly attached to the outer peripheral surface of the shaft 14. In accordance with an exemplary embodiment, the proximal end of the swelling portion 84 may serve as the distal edge 44.
For example, the tapered portion 64 and the body portion 66 which are integrated with each other may be configured to include materials of nylon, nylon elastomer, polyester such as polyethylene terephthalate, and the like, polyester elastomer, polyolefin such as polyethylene, polypropylene, and the like, polyurethane, a silicone rubber, or the like. In addition, for example, the swelling portion 84 may be configured to include materials of polyvinyl alcohol, polyethylene glycol, sodium polyacrylate, or the like.
In the self-expandable stent system 80 described according to the fourth embodiment configured as described above, when the saline solution is caused to flow into the gap 34 during the priming as illustrated by an arrow (A), the saline solution discharges the air outward via the gap 34, and a part of the saline solution partially comes into contact with the swelling portion 84. In this manner, the swelling portion 84 starts to swell by absorbing the saline solution. As a result, as illustrated in
The swelling portion 84 is the same as those in the other embodiments in that the swelling portion 84 may swell outward beyond the outer diameter dimension of the sheath 12.
The detailed description above describes a self-expandable stent system. The invention is not limited, however, to the precise embodiments and variations described. Various changes, modifications and equivalents can effected by one skilled in the art without departing from the spirit and scope of the invention as defined in the accompanying claims. It is expressly intended that all such changes, modifications and equivalents which fall within the scope of the claims are embraced by the claims.
This application is a continuation of International Application No. PCT/JP2013/051334 filed on Jan. 23, 2013, the entire content of which is incorporated herein by reference.
Number | Date | Country | |
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Parent | PCT/JP2013/051334 | Jan 2013 | US |
Child | 14796660 | US |