+

WO2019174991A1 - Fermeture temporaire de collets d'anévrisme - Google Patents

Fermeture temporaire de collets d'anévrisme Download PDF

Info

Publication number
WO2019174991A1
WO2019174991A1 PCT/EP2019/055548 EP2019055548W WO2019174991A1 WO 2019174991 A1 WO2019174991 A1 WO 2019174991A1 EP 2019055548 W EP2019055548 W EP 2019055548W WO 2019174991 A1 WO2019174991 A1 WO 2019174991A1
Authority
WO
WIPO (PCT)
Prior art keywords
aneurysm
membrane
closure device
kit according
openings
Prior art date
Application number
PCT/EP2019/055548
Other languages
German (de)
English (en)
Inventor
Pervinder BHOGAL
Hans Henkes
Hermann Monstadt
Ralf Hannes
Original Assignee
Phenox Gmbh
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 Phenox Gmbh filed Critical Phenox Gmbh
Publication of WO2019174991A1 publication Critical patent/WO2019174991A1/fr

Links

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
    • A61F2/07—Stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/1214—Coils or wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/12—Surgical instruments, devices or methods for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels or umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
    • A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
    • A61B17/12118—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm for positioning in conjunction with a stent
    • 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
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure

Definitions

  • the invention relates to a system and method for treating aneurysms, wherein occlusion agents are introduced into the aneurysm and prevented from escaping the aneurysm neck during insertion.
  • Aneurysms are usually bag-like or fusiform (fusiform) expansions of the vessel wall, which arise primarily at structurally weakened sites of the vessel wall by the constant pressure of the blood. Accordingly, the vessel inner walls of an aneurysm are correspondingly sensitive and prone to injury. The rupture of an aneurysm usually leads to significant health problems, in the case of cerebral aneurysms to neurological deficits to the death of the patient. In addition to surgical procedures in which, for example, the aneurysm is clamped by means of a clip, in particular endovascular methods for the treatment of aneurysms are known, with two approaches being pursued in the first place.
  • the aneurysm can be filled with occlusion agents, in particular so-called coils (platinum spirals).
  • the coils promote thrombus formation and thus provide closure of the aneurysm.
  • the treatment method is primarily suitable for aneurysms with a relatively narrow neck - so-called berry aneurysms - because otherwise there is a risk that the coils from a wide Aneurysmahals protrude into the blood vessel and thrombogenize there, which can lead to occlusions in the vessel.
  • a coil is completely flushed out of the aneurysm and closes vessels elsewhere.
  • other occlusion agents have also been described, for example in WO 2012/034135 A1 or WO 2017/089451 A1.
  • the occlusion means is composed of several subunits.
  • Another intravascular treatment approach relies on so-called flow diverters. These implants are similar in appearance to stents used to treat stenosis. However, since the task of the flow diverter is not the keeping open of a vessel, but the occlusion of the aneurysm access on the side of the blood vessel, the mesh size is comparatively narrow. A disadvantage of these implants is the risk that outgoing side branches in the immediate vicinity of the aneurysm to be treated sometimes covered and thereby closed medium or long term. Another disadvantage is that the use of a flow diverter usually the permanent intake of platelet aggregation inhibitors is unavoidable.
  • the occlusion of an aneurysm through the introduction of occlusion means involves the risk that it will partly exit the aneurysm and bring about the occlusion of a blood vessel in other regions of the blood vessel system.
  • This danger exists especially with relatively wide-necked aneurysms.
  • occlusive agents in usually coils, were introduced into the aneurysm, these interlock and thus interfere with each other at the exit from the aneurysm, ie after complete backfilling of the aneurysm is usually no further coverage of the aneurysm neck by the balloon needed.
  • the balloon can thus be deexpanded and removed. This technique is also referred to as jailing.
  • the balloon prevents blood flow to more distal regions. This is especially important in intracranial applications because u. U. important brain regions are temporarily cut off from the blood flow.
  • the treating physician must introduce the occlusion agents as quickly as possible, d. H. he is under considerable time pressure.
  • the balloon may at least partially be prematurely deexpanded, but this, in turn, involves the risk that coils or parts of coils may protrude from the aneurysm or even migrate into the main blood vessel.
  • An alternative to the use of balloons is to place a stent in front of the aneurysm neck, in addition to inserting coils into the aneurysm, to prevent the coils from exiting the aneurysm.
  • This has the advantage, compared to the use of a balloon on the one hand, that the blood flow in the main blood vessel is maintained and no (brain) regions are uncoupled from the blood flow.
  • blood continues to enter the aneurysm.
  • the introduction of coils causes injury to the aneurysm wall or even rupture of the aneurysm, the continued blood flow will cause the blood to seep out of the aneurysm into the surrounding tissue.
  • a system or kit for the treatment of aneurysms which comprises: a closure device which is in an expanded state in which it is temporarily released in the blood vessel and in a compressed state in which it enters the blood vessel inserted and removed therefrom, the closure device having a substantially cylindrical portion of struts forming a plurality of openings distributed over the lateral surface of the cylindrical portion, and the closure device being coupled to an insertion aid having a substantially cylindrical portion on the Mantle surface at least partially has a cover through a membrane and the closure device in the axial direction forms a permeable channel;
  • One or more occlusion means which are introduced through a micro catheter into the aneurysm
  • a microcatheter which serves the introduction of occlusive agents in the aneurysm.
  • the closure device By means of the closure device according to the invention, the advantages of using a balloon and a stent are combined, because on one side the blood flow in the main blood vessel is maintained, because the closure device has a lumen through which the blood can flow in the axial direction, on the other Side, however, the aneurysm of the Blood flow is decoupled because the area of the occlusive device placed in front of the aneurysm neck has a cover through a membrane.
  • the membrane may be liquid impermeable, at least allowing only a small passage of liquid through the membrane.
  • the membrane ensures that no further blood flows into the aneurysm; the risk of infiltration of larger quantities of blood into the surrounding tissue of the aneurysm is prevented in this way.
  • the running through the closure device channel, ie the lumen of the closure device should be as free as possible and allow undisturbed blood flow in the axial direction.
  • the invention can be used in principle for any aneurysms, however, the use in connection with intracranial aneurysms, d. H. Brain aneurysms.
  • the treatment is particularly critical, because on the one hand, the interruption of blood flow in the main vessel can have negative effects on more distal brain regions, on the other hand, but also in the case of aneurysm rupture or injury to the aneurysm wall by the infiltration of blood into the surrounding brain tissue can have serious consequences.
  • the kit according to the invention is particularly suitable for the treatment of wide-necked aneurysms, because in these the risk of leakage of the introduced occlusion agent is particularly large. Particularly useful is the use of the invention in sidewall aneurysms.
  • covered stents from the prior art are already known, for example from WO 2012/113581 A1, but these stents are implants that are to be permanently implanted in the blood vessel. Accordingly, they must have a detachment point at which, after insertion, a separation between the stent and the insertion wire takes place.
  • the closure device according to the invention is a device that is only temporarily introduced into the blood vessel and removed after treatment. Accordingly, no release point between insertion and closing device is provided in the rule; if necessary, a release point provided here could be used in emergencies if an actually intended removal of the closure device by withdrawal into a catheter proves to be impossible during the treatment.
  • proximal and distal are to be understood as meaning that parts which point to the attending physician when introducing the closure device are referred to as distal, parts pointing away from the attending physician are referred to as distal.
  • the occlusive device is thus typically advanced distally through a catheter.
  • axial refers to the proximal to distal longitudinal axis of the closure device, the term “radially” on perpendicular thereto planes.
  • the invention also relates to a corresponding method with the following steps, in which the system according to the invention is used: a) insertion of the microcatheter into the aneurysm; b) placing the occlusive device in expanded form in front of the neck of the aneurysm in a manner such that the cover through the membrane lies in front of the neck of the aneurysm; c) introducing occlusion agents into the aneurysm through the
  • Microcatheter and d) removing the microcatheter and occlusion device from the blood vessel.
  • the microcatheter by which the occlusive means are to be introduced into the aneurysm, is thus first introduced into the aneurysm or the neck of the aneurysm. Then the closure device is brought by means of another catheter in a position in front of the neck of the aneurysm and released there from the catheter, so that the closure device assumes its expanded form. She remains, usually at the proximal end, connected to the insertion aid, usually a guide wire. The placement of the closure device in front of the neck of the aneurysm takes place in such a way that the radially outwardly applied membrane substantially or completely prevents blood flow into and out of the aneurysm. At the same time, the blood flow through the Main blood vessel, since the closure device is hollow inside and has a corresponding lumen.
  • the occlusion means are introduced through the microcatheter into the aneurysm. Since the occlusive device is placed with its membrane in front of the neck of the aneurysm, there is no risk that individual occlusion agents will pass out of the aneurysm neck or protrude into the main blood vessel.
  • the introduction of occlusion means is carried out until the aneurysm is well filled with occlusive means which interlock with each other, so that, after complete filling of the aneurysm, the risk of leakage of occlusion agents from the aneurysm is minimized, regardless of the presence of the occlusive device.
  • the occlusion of the aneurysm with occlusion means that the blood flow in and out of the aneurysm comes to a virtual standstill and in the aneurysm thrombosis occurs, ie the aneurysm is then no longer dangerous for the patient.
  • the Microcatheter and the closure device withdrawn and removed from the blood vessel system.
  • the occlusive device is typically withdrawn into the catheter from which it was previously released at the site of the aneurysm. Subsequently, this delivery catheter can be withdrawn.
  • the closure device it is not always necessary that the entire cylindrical section has a membrane cover, but it is advantageous if at least the central region of the substantially cylindrical section has a cover on the lateral surface. Accordingly, the closure device can be placed approximately centrally in front of the Aneurysmahals, wherein the attachment of the membrane, a cover of the Aneurysmahalses is ensured.
  • the membrane in the segment of the occlusive device which ultimately comes to rest in front of the aneurysm neck; other areas of the closure device need not necessarily have a membrane.
  • the membrane is applied on the lateral surface radially over the entire circumference, so that the radial Orientation of the closure device when placing in front of the Aneurysmahals does not matter.
  • the substantially cylindrical portion of the closure device has a plurality of openings distributed over its lateral surface.
  • it is a grid or mesh structure, constructed of struts, so that arise on the lateral surface of the cylindrical base structure, a plurality of openings or meshes.
  • aperture refers to the lattice structure, regardless of whether the aperture is uncoupled from the environment by a membrane, i. H. an opening covered by a membrane is also referred to as an opening. Covering by a membrane is understood to mean any covering of a structure, irrespective of whether the membrane is applied externally or internally to the lattice structure or whether the lattice structure is embedded in a membrane.
  • the lattice structure of the closure device may be a braided structure, ie consisting of individual wires or strands of wire as struts, which are intertwined and extend at the intersection points of the wires / wire bundles and with each other.
  • a cut structure is preferred in which the lattice structure is cut out of a tube of suitable diameter with the aid of a laser.
  • the material is usually a metal, but can also be a plastic. It must have sufficient elasticity to permit contraction to the diameter of a conventional catheter and, on release from the catheter, expansion to the desired diameter. In addition, it makes sense to subject the grid structure to electropolishing to make it smoother and more rounded and thus less traumatic.
  • the struts or wires may have a round, oval, square, rectangular or trapezoidal cross-section, wherein in the case of a square, rectangular or trapezoidal cross-section a Rounding the edges is beneficial. It is also possible to use flat webs / wires in the form of thin strips, in particular metal strips.
  • nitinol binary nickel-titanium alloys
  • chromium-doped alloys ternary nickel-titanium-chromium alloys
  • the number of openings that are adjacent to each other orthogonally to the longitudinal axis of the closure device on the lateral surface is at least 2, but preferably 3 to 5. With adjacent openings those openings are meant that in a cut-open and flat-spreading structure orthogonal to the longitudinal axis of the closure device side by side would lie.
  • the correct selection of openings depends u. a. on the size of the blood vessel in which the closure device is to be used. The larger the diameter of the blood vessel, the larger will usually be the number of adjacent openings, since the closure device in the expanded state must cover a total of a larger peripheral surface.
  • a smaller number of openings causes a more flexible device, which may be advantageous if the closure device must be moved within tightly wound blood vessels.
  • the size of the openings should be chosen so that the struts bounding the openings can sufficiently support the membrane.
  • insertion aid and closure device are normally firmly connected to one another.
  • the connection usually does not provide for a detachment option.
  • the closure device differs from prior art membrane-coated stents intended for permanent implantation.
  • a corresponding closure device which is placed only temporarily during the placement of occlusion devices in an aneurysm in front of the Aneurysmahals and removed after completion of the introduction of occlusion agents, has not been described in the prior art. It is meaningful that a proximal section adjoins the substantially cylindrical section in the proximal direction and this proximal section is coupled to the insertion aid. Due to the proximal connection, the
  • Closure device well controlled by the insertion in particular moved back and forth, without the introducer itself in any way affects the actual function of the closure device in front of the aneurysm.
  • the introducer is preferably a guidewire as is well known in the art.
  • the introducer may be coupled to the proximal portion of the closure device at one or more coupling points.
  • the struts of the occlusive device converge in the direction of the introducer in the proximal portion.
  • the one or more coupling points are arranged to the centrally extending longitudinal axis of the closure device in the direction of the lateral surface, d. H. radially outside.
  • Such an eccentric arrangement of the coupling point has the advantage that the blood flow in the main blood vessel is disturbed as little as possible. In the discharged from the microcatheter state, the coupling point can thus lie on the vessel wall.
  • the coupling points may be simple welding points at which
  • Insertion guide / guidewire and proximal portion of the closure device are brought together.
  • the guide wire can be made in one piece, ie it is ultimately a continuous wire.
  • the advantageous properties of different materials with one another, for example the part of the guide wire made of stainless steel with good pushability, the distal part of the guide wire of a nickel-titanium alloy such as Nitinol with high flexibility to manufacture.
  • a distal section made of a nickel-titanium alloy also has the advantage that the risk of kinking is minimized.
  • the use of a stiffer material such as stainless steel is advantageous because it allows the transmission of torques, which is advantageous for the ability to be advanced.
  • the term insertion aid is to be understood broadly and does not necessarily mean a classic guidewire in each case. Also conceivable, for example, elongated insertion aids with an internal Flohlraum.
  • the closure device it makes sense for the closure device to have one or more radiopaque markings in order to enable the attending physician to visualize it.
  • the radiopaque markers may, for. B. from platinum, palladium, platinum-iridium, tantalum, gold, tungsten or other radiopaque metals. They allow the attending physician to recognize whether the occlusive device is correctly placed relative to the thrombus to be removed and, if necessary, make corrections. It is also conceivable, at least some areas of
  • Closure device with a coating of a radiopaque material to provide, for example with a gold coating.
  • This can, for. B. have a thickness of 1 to 6 pm.
  • the coating with a radiopaque material need not cover the entire closure device. However, even when providing a radiopaque coating, it may be useful to additionally attach one or more radiopaque markers. Another possibility is to coat individual struts with a helix or a wire of a radiopaque material such as platinum.
  • Such substances are for. B. known as a contrast agent in X-ray technology.
  • the occlusion means are usually occlusion coils or occlusion coils known from the prior art. These are short pieces of wire that take the form of a wire helix or assume such shape when released in the aneurysm. Together with other occlusion coils, they form a wire ball in the aneurysm and are accordingly able to close it and induce thrombus formation. Occlusion coils are mostly made of platinum. However, it is also conceivable to use alternative occlusion agents, such as those described in WO 2012/034135 A1 or WO 2017/089451 A1. In the context of the invention, one or more occlusive agents may be used in a treatment, ie Use of the plurals includes a single, appropriately shaped occlusive agent.
  • an insertion aid designed as a guide wire can connect proximally to an occlusion device.
  • the occlusive means may be in communication with the introducer via a release site prior to insertion.
  • a separation between insertion aid and occlusion device This can be z.
  • electrolytic detachment points are known from the prior art, in which by applying an electrical voltage, an electrolytic corrosion is induced, which causes an at least partial dissolution of the detachment point and thus destroys the firm connection between insertion aid and occlusive means.
  • the closure device may be attached to the grid structure internally or externally, i. H. the membrane may be located on the inside and / or outside of the struts forming the openings.
  • the grid structure is embedded in the membrane. This can be achieved by initially introducing a grid structure which is subsequently braided or braided with fibers such that a membrane with embedded grid structure results. Corresponding methods are well known from the prior art, for example the so-called electrospinning.
  • a membrane As far as according to the invention of a membrane is mentioned, it should be made clear that this can also be understood as more than one membrane. It may therefore be a continuous membrane, the larger areas of the lateral surface covering the cylindrical portion of the closure device, but it is also possible to use a plurality of individual membranes that cover areas of the lateral surface. These individual membranes may be contiguous to form a unitary surface, but it is also possible for gaps to remain between the membranes as long as the goal associated with the closure device of achieving temporary coverage of the aneurysm neck is ensured.
  • a membrane may have multiple layers. If a plurality of membranes or membrane layers are arranged one above the other, this too is to be understood as a membrane in the sense of the invention as a whole.
  • Electrospinning membranes are very uniform.
  • the membrane is tough and mechanically strong and can be pierced mechanically, without the opening becomes the starting point for further cracks.
  • the thickness of the fibrils as well as the degree of porosity can be controlled by selecting the process parameters.
  • the membrane can also be made via a dipping or spraying process, such as spraycoats.
  • the membrane can be constructed in one or more layers.
  • the total layer thickness of the membrane is preferably 10 to 400 ⁇ m, in particular 10 to 100 ⁇ m.
  • the membrane may be made of a polymeric material such as polytetrafluoroethylene, polyesters, polyamides, polyurethanes or polyolefins. Particularly preferred are polycarbonate urethanes (PCU), which can be applied, for example, in a solvent such as chloroform.
  • PCU polycarbonate urethanes
  • an integral connection of the membrane to the lattice structure is desirable.
  • the membrane (s) should be fixed to the struts so that no free edges of the membrane remain.
  • Endoleak which is understood as an endoleak, ie a leak between the aneurysm and temporarily introduced closure device.
  • the liability of Membrane on the struts forming the lattice structure can be further improved by silanizing the struts.
  • the membrane used is advantageously substantially liquid-impermeable or has only a low permeability to liquids, in particular blood. Accordingly, the membrane is able to cut off the aneurysm completely or at least to a large extent from the blood flow. Some permeability of the membrane may be acceptable in this regard as long as the goal of extensive cutting of the aneurysm from blood flow is maintained.
  • the closure device according to the invention usually has a length (without insertion aid) between 5 mm and 40 mm and a diameter between 1, 5 mm and 7 mm, wherein the dimensions of the dimension of the diseased vessel segment on the one hand and the nature of the aneurysm result.
  • the figures relate to the free, relaxed state of the closure device, d. H. without exerting an external constraint through the catheter.
  • the struts forming the closure device can, for. B. have a width or a diameter between 20 and 60 pm.
  • FIG. 2 a the closure device in a side view
  • Fig. 2 b the closure device in one
  • closure device 1 in Figure 1, is shown in an unrolled form.
  • the illustration is merely illustrative, of course, the closure device 1 is actually in a rolled-up and generally radially closed shape, which has a cylindrical shape over a majority of the length.
  • the dotted lines indicate how the closure device 1 continues on the opposite side.
  • the closure device 1 is composed essentially of a cylindrical portion 2 and a proximal portion 3.
  • the proximal portion 3 narrows proximally and is connected to an insertion aid at its proximal end.
  • the cylindrical portion 2 is composed of a plurality of struts 4, between which openings 5 result. Furthermore, the cylindrical portion 2 has a cover by a membrane 6, d. H. the cylindrical portion 2 is radially substantially liquid impermeable.
  • the closure device is shown in side view, as it corresponds to the closure device 1 in reality.
  • the cylindrical section 2 and the proximal section 3 which is connected via a coupling point 9 with the insertion aid 7, usually a guide wire.
  • the coupling point 9 is located at the periphery of the closure device 1, d. H.
  • the coupling point 9 is located at or near the vessel inner wall.
  • the cylindrical portion 2 has a cover by a membrane 6, wherein the struts 4 between two or more membrane layers 6 are embedded.
  • FIG. 2 b shows a view of the closure device 1 from the distal front. It can be seen that, due to the membrane 6, the cylindrical section 2 is substantially impermeable to liquids in the radial direction, but forms a permeable channel 8 in the axial direction.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Pulmonology (AREA)
  • Reproductive Health (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Gastroenterology & Hepatology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un kit pour traiter des anévrismes, comprenant un dispositif de fermeture (1) qui est présent dans un état déployé, dans lequel il est libéré temporairement dans le vaisseau sanguin, et dans un état comprimé, dans lequel il est introduit dans le vaisseau sanguin et retiré de ce dernier, le dispositif de fermeture (1) possédant une partie sensiblement cylindrique (2) composée d'entretoises (4), qui forment une pluralité d'ouvertures (5) divisées sur la surface externe de la partie cylindrique (2), et le dispositif de fermeture (1) étant accouplé à un auxiliaire d'introduction (7), la partie sensiblement cylindrique (2) possédant au moins en partie un couvercle à travers une membrane (6) sur la surface externe, et le dispositif de fermeture (1) formant un canal transparent (8) dans la direction axiale ; des moyens d'occlusion, qui peuvent être introduits dans l'anévrisme au moyen d'un micro-cathéter et un micro-cathéter, qui sert à introduire les moyen d'occlusion dans l'anévrisme. Selon l'invention, le système empêche la sortie de moyens d'occlusion hors de l'anévrisme et désaccouple simultanément l'anévrisme du flux sanguin, pendant que le flux sanguin est maintenu dans le vaisseau principal.
PCT/EP2019/055548 2018-03-12 2019-03-06 Fermeture temporaire de collets d'anévrisme WO2019174991A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102018105679.6 2018-03-12
DE102018105679.6A DE102018105679A1 (de) 2018-03-12 2018-03-12 Temporärer Verschluss von Aneurysmenhälsen

Publications (1)

Publication Number Publication Date
WO2019174991A1 true WO2019174991A1 (fr) 2019-09-19

Family

ID=65955159

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2019/055548 WO2019174991A1 (fr) 2018-03-12 2019-03-06 Fermeture temporaire de collets d'anévrisme

Country Status (2)

Country Link
DE (1) DE102018105679A1 (fr)
WO (1) WO2019174991A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10888414B2 (en) 2019-03-20 2021-01-12 inQB8 Medical Technologies, LLC Aortic dissection implant

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102022125942A1 (de) 2022-10-07 2024-04-18 Acandis Gmbh Medizinische Vorrichtung, Set mit einer medizinischen Vorrichtung und Verfahren zur Herstellung
DE102023114781A1 (de) 2023-06-06 2024-12-12 Acandis Gmbh Hydrogelzusammensetzung mit humanem Protein zur Behandlung von Gefäßmissbildungen

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2806030A1 (de) 1978-02-14 1979-08-16 Inst Textil & Faserforschung Verfahren zur herstellung von kuenstlichen blutgefaessprothesen und kuenstliche blutgefaessprothese
WO2008049386A1 (fr) 2006-10-26 2008-05-02 Nonwotecc Medical Gmbh Structure plane et procédé de fabrication d'une structure plane
WO2012034135A1 (fr) 2010-09-10 2012-03-15 Maria Aboytes Dispositifs et méthodes utilisés pour le traitement d'anomalies vasculaires
WO2012113581A1 (fr) 2011-02-25 2012-08-30 Phenox Gmbh Implant équipé de non-tissé
WO2016020922A2 (fr) * 2014-08-07 2016-02-11 Perflow Medical Ltd. Dispositif et méthode de traitement de l'anévrisme
EP3092958A1 (fr) * 2015-05-11 2016-11-16 Cook Medical Technologies LLC Ensemble et dispositif médical
WO2017089451A1 (fr) 2015-11-26 2017-06-01 Phenox Gmbh Moyen d'occlusion en forme de bande
WO2017165833A1 (fr) * 2016-03-24 2017-09-28 Covidien Lp Constructions à paroi mince pour déviation d'écoulement vasculaire

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2806030A1 (de) 1978-02-14 1979-08-16 Inst Textil & Faserforschung Verfahren zur herstellung von kuenstlichen blutgefaessprothesen und kuenstliche blutgefaessprothese
WO2008049386A1 (fr) 2006-10-26 2008-05-02 Nonwotecc Medical Gmbh Structure plane et procédé de fabrication d'une structure plane
WO2012034135A1 (fr) 2010-09-10 2012-03-15 Maria Aboytes Dispositifs et méthodes utilisés pour le traitement d'anomalies vasculaires
WO2012113581A1 (fr) 2011-02-25 2012-08-30 Phenox Gmbh Implant équipé de non-tissé
WO2016020922A2 (fr) * 2014-08-07 2016-02-11 Perflow Medical Ltd. Dispositif et méthode de traitement de l'anévrisme
EP3092958A1 (fr) * 2015-05-11 2016-11-16 Cook Medical Technologies LLC Ensemble et dispositif médical
WO2017089451A1 (fr) 2015-11-26 2017-06-01 Phenox Gmbh Moyen d'occlusion en forme de bande
WO2017165833A1 (fr) * 2016-03-24 2017-09-28 Covidien Lp Constructions à paroi mince pour déviation d'écoulement vasculaire

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10888414B2 (en) 2019-03-20 2021-01-12 inQB8 Medical Technologies, LLC Aortic dissection implant

Also Published As

Publication number Publication date
DE102018105679A1 (de) 2019-09-12

Similar Documents

Publication Publication Date Title
EP2613743B1 (fr) Implant destiné à influencer le débit sanguin en cas de malformations artérioveineuses
EP2134302B1 (fr) Implant pour agir sur le flux sanguin
EP3265038B1 (fr) Système d'introduction d'un implant
EP3389511B1 (fr) Implant
EP3474756B1 (fr) Implant comportant un mécanisme de séparation
WO2019174988A1 (fr) Dispositif de thrombectomie
WO2021028161A1 (fr) Ensemble médical pour traiter des anévrismes, procédé de fabrication et système médical pour traiter des anévrismes
DE102013014523A1 (de) Einführ- und Ablösesystem für Implantate
EP1903952A1 (fr) Implant endovasculaire pour l'obturation d'un vaisseau sanguin
WO2019174991A1 (fr) Fermeture temporaire de collets d'anévrisme
WO2021122877A1 (fr) Ensemble médical, système médical et dispositif de recouvrement destiné au traitement de l'anévrisme
DE102013006503A1 (de) Implantat
EP4081135A2 (fr) Implant pour traiter des anévrismes
WO2021074219A1 (fr) Implant pour le traitement d'anévrismes
EP4164554A1 (fr) Implant pour traiter des anévrismes
DE102020115600A1 (de) Implantat zur Behandlung von Aneurysmen
WO2021250282A2 (fr) Système d'introduction pour implants conçus pour traiter des anévrismes de bifurcation
EP3781088B1 (fr) Dispositif d'introduction d'implants
DE102021132725A1 (de) Implantat zur Behandlung von Aneurysmen im Bereich von Bifurkationen

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 19714099

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 19714099

Country of ref document: EP

Kind code of ref document: A1

点击 这是indexloc提供的php浏览器服务，不要输入任何密码和下载