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WO2005096991A1 - Sondes ureterales - Google Patents

Sondes ureterales Download PDF

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Publication number
WO2005096991A1
WO2005096991A1 PCT/GB2005/001348 GB2005001348W WO2005096991A1 WO 2005096991 A1 WO2005096991 A1 WO 2005096991A1 GB 2005001348 W GB2005001348 W GB 2005001348W WO 2005096991 A1 WO2005096991 A1 WO 2005096991A1
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WO
WIPO (PCT)
Prior art keywords
stent
ureteric
strand
proximal
retention
Prior art date
Application number
PCT/GB2005/001348
Other languages
English (en)
Inventor
Antony John Young
Original Assignee
Medevert Limited
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
Priority claimed from GB0407767A external-priority patent/GB0407767D0/en
Application filed by Medevert Limited filed Critical Medevert Limited
Publication of WO2005096991A1 publication Critical patent/WO2005096991A1/fr

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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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/20—Measuring for diagnostic purposes; Identification of persons for measuring urological functions restricted to the evaluation of the urinary system
    • 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
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/88—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure the wire-like elements formed as helical or spiral coils
    • 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
    • A61M25/00—Catheters; Hollow probes
    • 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
    • A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002—Implant devices for drainage of body fluids from one part of the body to another
    • 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
    • A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002—Implant devices for drainage of body fluids from one part of the body to another
    • A61M27/008—Implant devices for drainage of body fluids from one part of the body to another pre-shaped, for use in the urethral or ureteral tract
    • 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
    • A61F2002/048—Ureters

Definitions

  • This application relates to ureteric stents.
  • Ureteric stents are usually tubular structures, with one end positioned in the kidney and the other in the bladder. These ends may be coiled or J-shaped. The aim of this shaping is to prevent migration of the stent up or down the ureter.
  • Ureteric stents can cause a variety of severe symptoms including urgency, frequency, bladder pain and kidney pain on micturition. These symptoms are at least in part due to the fact that the stent disrupts the physiological anti reflux mechanism.
  • a one to two centimetre section of the distal ureter Prior to reaching the bladder a one to two centimetre section of the distal ureter passes through the muscular bladder wall. This acts like a one way valve allowing urine to pass from the kidney to the bladder, but not vice versa.
  • the muscular wall of the ureter can also act to a lesser extent like a sphincter.
  • Conventional ureteric stents keep both the vesicoureteric and pelviureteric junctions open. This is an unphysiological situation and allows reflux of urine from the bladder to the kidney.
  • Figure 1 shows a schematic drawing of the urinary tract with a typical prior art ureteric stent in situ. These stents are typically 4-8 mm in circumference and have holes along their length.
  • Obstruction to the urinary system can be caused by a condition known as pelviureteric junction (PUJ) obstruction.
  • POP pelviureteric junction
  • This test involves inserting a needle through the skin into the collecting system of the kidney. The collecting system is then perfused at a rate of 10mls per minute and any resulting pressure rise recorded by a transducer connected to the needle (figure 2).
  • the Whitaker test is reserved for complex cases because of its invasive nature and the fact that there is a small risk of haemorrhage, this occasionally requires surgical removal of the kidney to control it. However the Whitaker test remains the only method available to quantitatively measure the intrarenal pressures and hence the severity of the obstruction.
  • PUJ obstruction is managed by either endoscopic, percutaneous, laparoscopic or open surgical repair.
  • follow up to ensure a successful outcome is often with a repeat nuclear medicine scan or an intravenous urogram.
  • both of these provide a relatively qualitative rather than quantitative assessment of the operative result. Therefore it has been difficult to give absolute differences in outcome between different surgical methods in trials to compare different methods of treating PUJ obstruction.
  • loin pain haematuria syndrome Another condition which provides a difficult diagnostic and therapeutic problem for clinicians is the loin pain haematuria syndrome.
  • patients present with loin pain and haematuria for which no underlying cause can be found with conventional modalities of urological investigation.
  • Treatment is symptomatic but in the most severe cases leads to surgical removal of the kidney.
  • stenting has been tried to alleviate the pain, but conventional ureteric stents do not allow any detailed information about the function of the renal pelvis, ureter or bladder to be obtained.
  • US 6,656,146 (dayman et al.). This represents the closest prior art known to the applicant and the entire text of US 6,656,146 is hereby imported by reference and is intended to form an integral part of this description.
  • US 6,656,146 describes a ureteric stent having a flexible tail made up of multiple filaments. This so-called tail lies, in use, only in the lower part of the ureter and in the bladder, unlike the stent of the present invention where a single strand or filament may be used to connect various tubular portions of the device, especially in the region of the pelviureteric junction. Summary of the invention
  • an indwelling ureteric catheter comprised of a flexible tube with an upper end section, a substantially straight middle section and a lower end section. These three sections may run in continuity or may be connected by at least one thin flexible strand.
  • the proximal or upper end section is designed and may be adapted to be sited in the renal pelvis.
  • the strands connecting this section to the middle section cross the pelviureteric junction causing minimal disruption to the normal physiology of the pelviureteric junction.
  • the lower or distal end section is located in the bladder.
  • the strands connecting this section to the middle section cross the vesicoureteric junction causing minimal disruption to the normal physiology of the vesicoureteric junction.
  • a central lumen runs along the upper, middle and lower end sections.
  • distal refers to the end of the stent which, in use, is closest to the outside of the body. Generally this is the end nearest the patient's bladder.
  • proximal refers to the end of the stent which is higher up the system and which, in use, is furthest into the body. Generally this is the end in the kidney.
  • the upper section is preferable coiled.
  • the lower end section may be coiled in the bladder, or may be bought out straight either along the urethra, or for example through the bladder suprapubically.
  • the catheter contains a number of electrodes and/or pressure sensors or pressure transducers which can be present in any of the 3 main sections. These electrodes/transducers may be connected electrically via the strands connecting the upper and lower ends to the middle section. In the upper, middle or lower sections of the stent the cabling for the electrodes/transducers may run along the central lumen of the stent. In another embodiment of the stent this cabling may run in specific channels/tunnels in the wall of the stent.
  • the electrodes allow peristalsis to be stimulated for diagnostic or therapeutic applications.
  • the pressure sensors/transducers allow the intra luminal pressure to be measured.
  • the strands crossing the pelviureteric junction and the vesicoureteric junction do not disrupt the normal physiological state of these areas or obstruct the outflow, so the pressures measured reflect those that would be measured in a Whitaker test, but without the need to place a nephrostomy tube into the kidney.
  • the catheter may also contain a battery supply and a telemetry system to transmit the recorded signals to the outside.
  • the power supply can be external, and the recordings from the transducers conducted externally rather than transmitted via telemetry.
  • a ureteric stent having a proximal end and a distal end, said stent comprising: (i) a proximal retention end portion positioned at the proximal end of the stent, said proximal retention end portion being adapted to retain said proximal portion in the renal pelvis of the patient; (ii) at least one strand portion wherein said strand portion(s) has an outside diameter significantly less than the outside diameter of the distal retention end portion; characterised in that the strand portion(s) are located along the length of the stent such that, in use, the strand portion(s) are located across the pelviureteric junction and/or the vesicoureteric junction of the patient.
  • the proximal retention end portion takes the form of a pre-formed coil. Coils are a well known method for keeping this type of stent in place but many other methods are possible.
  • the proximal retention end may be formed from a tubular material having a hollow lumen.
  • This form of construction is similar to known ureteric stents.
  • the distal end of said stent comprises a distal end retention portion adapted to retain said distal end in bladder of the patient.
  • the distal end retention portion takes the form, of a pre-formed coil. Again, this is only one form of retention means which can be used. It is intended that this invention should include any suitable retention means for this purpose, both known and those yet to be discovered.
  • distal retention end portion is formed from a tubular material having a hollow lumen.
  • the stent incorporates an intermediate portion, intermediate between the distal end retention portion, if present, and the proximal end retention portion, said intermediate portion being connected to adjacent portions by strands.
  • This arrangement ensures that strands or filaments are present whenever the device passes through a sphincter muscle.
  • said intermediate portion is formed from a tubular material having a hollow lumen.
  • the stent further comprises one or more pressure transducers. Including one or more pressure transducers means that the pressure within the urinary tract can be measured at various points on a continuous or intermittent basis.
  • one or more pressure transducers are positioned in one or more of the distal portion, the intermediate portion and/or the proximal portion of the stent.
  • signals from the pressure transducer(s) are transmitted from the stent via the strand portion(s).
  • said stent further comprises stimulating electrodes.
  • one or more electrodes are positioned in one or more of the distal portion, intermediate portion and/or the proximal portion of the stent. This enables the physician to stimulate various regions of the urinary tract as required.
  • a stimulating electrode is positioned on the stent and a return electrode is positioned elsewhere on the patent's body.
  • a stimulating electrode and a return electrode are both positioned on the stent.
  • a strand portion is secured to the adjacent portion of larger diameter by use of securing means.
  • securing means A wide variety of strand securing means are envisaged, as would be determined by the materials specialist.
  • said securing means comprises one or more knots tied in the strand. Knots are easy to form and can be concealed within the tubular portion of the section to which the strand is attached.
  • the strand portion takes the form of a loop and is knotted to itself through the adjacent portion. Once again, the knot can be concealed and accommodated within the tubular part of the stent.
  • the securing means comprises heat sealing or crimping.
  • the stent comprises a proximal retention portion and a strand portion, the strand portion being dimensioned such that it may be brought directly to the outside of the body along the ureter, through the bladder and along the urethra.
  • the proximal retention end portion is adapted to retain said proximal portion in the bladder of the patent rather than in the renal pelvis.
  • the kidney is not affected and the stent only goes a far as the bladder.
  • the construction remains the same, including provision of pressure transducer(s) and electrical stimulating electrodes.
  • the invention comprises a ureteric stent which has a proximal retention portion, which is typically a coiled region, and a strand portion which extends, in use, through the pelviureteric function and/or through the vesicoureteric junction. There may also be a distal retention portion to retain the device in the bladder.
  • the stent may comprise one or more tubular portions connected by flexible strands or, if required, substantially the entire length of the stent may be formed from a strand of material providing the other features described above are present, including at least one proximal retention portion.
  • the present invention also extends to include methods of performing a modified Whitaker diagnostic test using a stent according to the present invention, and to methods of treatment and diagnostics of animal or human patients using such a device.
  • this invention includes methods of manufacturing stents according to the present invention. Certain suitable manufacturing methods are described in US 6,656,146, the text of which is incorporated herein by reference.
  • Fig. 1 is a schematic drawing of the human urinary tract with a prior art stent in-situ;
  • Fig. 2 depicts a schematic drawing of the human urinary tract during the Whitaker test
  • FIG. 3 shows one preferred embodiment of the invention
  • Fig. 4 shows diagrammatic cross sectional drawings from cross sections A, B and C as shown in Figure 3;
  • Fig. 5 shows a further preferred embodiment of the present invention
  • Fig. 6 shows a further preferred embodiment of the present invention comprising a coiled region and a strand portion only.
  • a prior art ureteric stent 100 is depicted in situ with an upper or distal end 110 in the renal pelvis, a middle or intermediate section 120 in the ureter and a tail or proximal end 130 in the bladder 140.
  • the stent crosses and keeps open the pelviureteric junction 150 and the vesicoureteric junction 160. As a consequence this allows reflux of urine from the bladder to the kidney, and causes partial obstruction to the outflow from the kidney.
  • the distal end of the stent 130 may be either curled in the bladder with attached strings 170, which pass along the urethra 180 and allow the stent to be pulled out when desired, or it may be straight and pass along the urethra to the outside of the body.
  • the right ureteric orifice 190 which is unstented is also shown.
  • the curled regions of the stent serve as a retention means to retain the stent in either the renal pelvis or bladder of the patient, or both.
  • a coil is just one form of suitable retention means which could be used, but is not the only form which could be employed.
  • a flared portion could be used as described in US 2004/0249470 (Willet Whitmore III), the entire text of which is hereby incorporated by reference, and is intended to form an integral part of this disclosure.
  • FIG 2 a schematic diagram of the set up for the Whitaker test is depicted.
  • a cannula 200 has been inserted into the kidney.
  • the cannula 200 is connected to a fluid reservoir 210 which perfuses the kidney at a rate of 10mls per minute.
  • the cannula is also connected to a pressure transducer/recorder system 220.
  • the stent comprises a proximal retention end portion positioned at the proximal end of the stent, the proximal retention end portion being adapted to retain the proximal end of the stent in the renal pelvis of the patient.
  • the proximal retention end portion is then connected to a strand portion which in turn is connected to an intermediate portion 310.
  • This in turn is connected to a further strand portion 350 and this strand portion is in turn attached to a distal end retention portion 320 adapted to retain the distal end of the stent in the bladder of the patient.
  • the strand portions are so located along the length of the stent such that, in use, the strand portions are located across the pelviureteric junction and the vesicoureteric junction of the patient.
  • the tubular regions may incorporate several openings in the wall of each section, shown as 370 and 371 in Figure 3. These openings may be arranged in various geometries (e.g. axial, circumferential, spiral). The entirety of the tubular portions of the stent may incorporate these openings if required.
  • the distal, proximal and intermediate portions may be formed from suitable material as selected by the materials specialist.
  • suitable material include any conventional stent material which is typically a biocompatible polymeric plastics material, a coated plastic, or silicone, with a tubular cross-section and a hollow lumen. Typical dimensions for these tubular sections are 4 to 10 French which approximates to an outside diameter in the region of 1 mm to 3mm. Such measurements are approximate but give an indication of the general scale of the cross-section of such stents.
  • the strand portion is constructed from any suitable filament or fibre material as selected by the materials specialist.
  • An important feature of this invention is that the strand portion has an outside diameter which is significantly less than the portions of the stent described above. Typical outside diameters for the strand portion are less than 1mm and preferably 0.1mm to 0.7mm and more preferably 0.2mm to 0.6mm.
  • the strands may be formed from a plastics material monofilament such as nylon or other biocompatible polymers. Alternatively, a multifilament thread or wire could be used. Where it is required to conduct electrical signals from pressure sensors or electrical impulses to electrodes, then a conducting core may be included in these strands. Typically such a conducting core would be made from a metal such as copper or silver.
  • the upper end may contain at least one electrode preferably a ring electrode in type 330. There may be more than one electrode present. In the situation where there are multiple electrodes, one could be used as the cathode and one the anode, alternatively one or more could be used as stimulating electrodes with the return electrode positioned somewhere else on the patients body. Miniature electrodes of this type are known per se, and their construction will be specified by the appropriate materials specialist. Furthermore, electrical controllers to stimulate the amount, frequency and pulse length of such electrical stimulation are also well known.
  • pressure transducers 340 are located at various locations in the upper middle and lower sections of the stent. Although shown as present in all sections of the stent in another embodiment of the stent pressure transducers may only be present in one section if desired.
  • at least one flexible strand 350 is present between the upper and middle sections and between the middle and lower sections. In one preferred embodiment this strand carries wires which allow conduction of the signal from the pressure transducer, or stimulus to pass to the electrodes.
  • the stent may also contain one or more holes 360 along its length.
  • Miniature pressure transducers of a suitable size and pressure measuring range are available from a number of suppliers.
  • One such supplier is Gaeltec Limited of Dunvegan, Isle of Skye, Scotland, IV55 8GU.
  • a typical pressure measuring range is from 0 to 400 mm H 2 O.
  • FIG 4 cross sections of the invention are shown at the levels of A,B and C as shown in figure 3.
  • Figure 4A shows a cross section of a ring electrode 400, this may be hollow in the centre as shown in the figure or may be solid.
  • Figure 4B shows a cross section of a pressure transducer 410 and figure 4C shows the channels 420 that wires may run along within the stent wall. Alternatively the wires 430 may run along the central lumen of the catheter.
  • a guide wire can be passed along it, allowing the stent to be accurately positioned in the urinary tract, so that the strands between the upper and middle sections cross the pelviureteric junction and the strands between the middle and lower section cross the vesicoureteric junction.
  • the lumen through the stent is obscured by electrical/signal conducting wires and/or a strand or strands or strand securing means, or the lumen is not large enough to pass a guide wire, then the stent may be sited with the aid of a ureteric sheath.
  • FIG 5 a further embodiment of the present invention is shown.
  • the upper end 500 is connected to the middle 510 and lower 520 sections by at least one thin flexible strand 550.
  • This strand or these strands may contain electrical wires for conducting the signals to/from the electrodes 530 and pressure transducers 540.
  • the wires pass along the centre of the stent.
  • the middle 510 and lower 520 end sections are continuous and would be brought to the outside of the body, preferably along the urethra.
  • the upper 500 and middle 510 sections may be continuous and the lower end 520 section connected to the middle section via a fine strand or filament.
  • the strands may be of variable length.
  • the strand 550 may run from the renal pelvis to the bladder or be even longer and run along the urethra to the outside of the body.
  • the strand(s) essentially replace the previous middle and lower sections.
  • the strand(s) may also replace the middle section, for example in Figure 3 the middle section 310 would be replaced by a continuous strand connecting the upper end 300 to the lower end 320. Replacing the flexible tube sections of the stent with strand(s) has the advantage of minimising the obstruction to the urinary system.
  • radio opaque markers may be placed along any of the sections of the stent to allow accurate placement of the stent in vivo.
  • the strand is secured to the tubular portion of the stent using a strand securing means.
  • the strand when single may preferably be knotted with the knot on the inside of the lumen and the strand passing through a small hole in the wall of the tube to the outside of the stent.
  • the other end of the strand may be secured in a similar fashion.
  • both ends of the strand may be secured to the stent by another method such as heat sealing or crimping. In this way multiple single strands may be used.
  • the strand may be looped or doubled back on itself. The two ends of the single strand can then be tied together forming a loop.
  • the knot would be positioned so that it is inside the lumen of the stent.
  • a single strand 350 is shown. When this is looped the strand would pass from the inside of the curled part of the stent 300, to the outside. It would then pass from the outside of the straight part of the stent 310 to the inside. The two ends which are both inside can be knotted.
  • the strand whether looped or linear may be of any length. Typically the strand(s) would be long enough to allow the separated parts of the stent to be 2-4cm apart, although a length of separation of 1mm to more than 1m may be used.
  • the strand may be bought directly to the outside of the body along the ureter, through the bladder and along the urethra.
  • the stent would only consist of the upper curl which would be located in the renal collecting system e.g. the renal pelvis.
  • the pressure measured in the renal pelvis may be directly conducted along wires as already described.
  • a transmitter is incorporated into the upper curl the pressure signal could be directly transmitted to a receiver/recorder on the outside of the body.
  • the curl may alternatively be placed in the bladder and the strand(s) pass from the bladder along the urethra to the outside of the body. In this circumstance pressure within the bladder alone could be measured.
  • the shape of the upper or lower ends does not have to be limited to a single curl. There may be more than one curl or different shapes to curls may be formed at the upper and lower ends. The aim is the same, that the shape formed by the stent at the upper and lower ends helps to keep the stent in position.
  • the stent is shown as a cylindrical tube, other shapes of tube are envisaged.
  • the stent may have a ribbed or rippled surface, or may be solid, i.e. non-tubular, and may be of the same or similar diameter to the strand portion (see above). That is to say, the stent may be formed from a strand, or strands, with a proximal retention portion and pressure sensors/electrical stimulators positioned strategically along its length. A distal retention portion may be incorporated as necessary.
  • the proximal end of the stent may be provided with a retaining means to keep the stent in the renal pelvis.
  • a strand may then be attached to the distal portion and that strand may lead directly out of the patient along the ureter, through the bladder and along the urethra.
  • a middle section lying within the ureter may be incorporated if desired.
  • the strand may pass from the lower or proximal curl along the urethra and out of the patient.
  • the distal extension end portion may be adapted to fit into the bladder, in which case the kidney and ureter are unaffected.
  • Electrodes and/or pressure transducers may be located at any suitable points along the length of the stent.
  • an indwelling ureteric catheter comprised of a flexible tube with an upper or distal end section, a substantially straight middle or intermediate section and a lower or proximal end section. These three sections may run in continuity or may be connected by at least one thin flexible strand.
  • the upper end section is sited in use in the renal pelvis and the lower end section is located in use in the bladder.
  • the catheter may contain a number of electrodes and/or pressure sensors which can be present in any of the 3 main sections. These electrodes/transducers may be connected electrically via fine wires running along the catheter. When strands are used to connect the sections with pressure transducers/electrodes in situ, the wires may pass along these strands. It will be appreciated that the electrodes and/or pressure transducers an be positioned anywhere along the length of the stent. It is not necessary that the electrodes/transducers have to be placed on a tubular portion of the stent. They could equally well be positioned along a strand portion or at a strand/tubular portion interface.
  • the catheter may also contain a battery supply and a telemetry system to transmit the recorded signals to the outside and provide electrical stimulation.
  • a battery supply and a telemetry system to transmit the recorded signals to the outside and provide electrical stimulation.
  • the power supply can be external and the recordings from the transducers conducted externally rather than transmitted via telemetry.

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Abstract

La présente invention concerne une sonde urétérale qui présente une extrémité proximale et une extrémité distale, ladite sonde comprenant: (i) une partie d'extrémité de retenue proximale (300) disposée à son extrémité proximale, et conçue pour retenir ladite partie proximale dans le bassinet rénal du patient; (ii) au moins une partie étroite (350), lesdites parties étroites ayant un diamètre extérieur significativement inférieur à celui de la partie d'extrémité de retenue proximale. L'invention se caractérise en ce que la/les partie(s) étroite(s) est/sont disposée(s) sur la longueur de la sonde de sorte que, au cours de l'utilisation, la/les partie(s) étroite(s) traverse(nt) la jonction pelvi-urétérale et/ou la jonction vésico-urétérale du patient.
PCT/GB2005/001348 2004-04-06 2005-04-06 Sondes ureterales WO2005096991A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
GB0407767.3 2004-04-06
GB0407767A GB0407767D0 (en) 2004-04-06 2004-04-06 Ureteric stent
GB0415086A GB0415086D0 (en) 2004-04-06 2004-07-06 Ureteric stent
GB0415086.8 2004-07-06

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KR102307346B1 (ko) * 2021-03-10 2021-09-29 이애리 요관 스텐트 양방향 연결장치
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