CN1391489A - 支架位置传感器及其使用方法 - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
- A61B8/445—Details of catheter construction
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- 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
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- 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
- A61F2/856—Single tubular stent with a side portal passage
-
- 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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
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- 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
- A61F2002/821—Ostial stents
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0001—Means for transferring electromagnetic energy to implants
- A61F2250/0002—Means for transferring electromagnetic energy to implants for data transfer
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- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0018—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
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- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0039—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
Abstract
本发明提供了一种示例性的装置、系统和方法,它们可以在一个体腔中,特别是一个分叉的体腔中精确地输送和安置一个支架。在一个实施例中,支架输送系统(100)包括一个导管(15),该导管包括一个具有一远端,一近端,一条纵轴线(200)和一个腔的导管体。在一个实施例中为一个气囊(20)的膨胀装置,配置在该导管体远端附近,具有一个侧孔(12)的支架(10)配置在该膨胀装置上面。超声波传感器(22)配置在该导管体远端附近,用于发送和接收经该侧孔的超声波信号,以便使支架的侧孔正确地与分支脉管(16)的口对准。
Description
本申请享有1999年9月23日申请的美国临时申请60/155 611的优先权。本文引用其完整公开内容供参考。
与相关申请的相互参照
本申请与题为“局部扩张的支架(Stent)及其使用方法”的序号为__(代理人摘要号019601-000410)的美国专利申请及题为“分叉支架系统及方法”的序号为__(代理人摘要号019601-000430)的美国专利申请同时提出申请。本文引用其完整的公开内容供参考,并在同一天与其一起提出申请。
发明背景
一种普通称为支架的内假体装置,可以安置在或植入静脉、动脉或其他空心的身体器官或腔内,通过补强脉管的壁或扩张脉管来处治脉管闭塞、狭窄或动脉瘤。支架已经用于处治由冠状动脉及周边动脉的用气囊消除狭窄部分的血管形成术引起的血管壁解剖,并通过防止血管壁的弹性反弹并改变血管壁来改善消除狭窄部分的血管形成术效果。二个随机化的多中心小径,与用气囊消除狭窄部分的血管形成术单独比较,最新显示在处治冠状动脉的支架方面再变狭窄的发生率较低。(Serruys PW等人,在“新英格兰医学杂志”331期,489~495页(1994年)上的文章;和Fischman DL等人在“新英格兰医学杂志”331期,496~501页(1994年)上的文章)。支架已经成功地植入尿道、胆管、食管和气管与支气管树状分支结构中,以补强这些身体器官;尤其还植入神经导管、周边导管、冠状动脉、心脏和肾脏系统中。本申请中所使用的术语“支架”是一种装置,它可在管腔内植入身体的脉管内,以便对脉管壁的塌陷、分离、部分堵塞、削弱、病害或不正常的扩张或窄细部分给以补强。
通常的支架的缺点之一是难以安置。一般,安置支架包括将支架移至所希望的位置,然后在支架展开时,保持在该位置。精确定位对支架正常工作是很关键的。例如,使用这种支架在脉管的分叉点(分支点)处或其附近,来处治有病的脉管就需要非常精确的定位;否则,有可能损害主脉管和/或其分支,或分叉点的开放程度。如果处治主脉管的结果是次优的,则损害分叉点的问题就限制了将一个分支支架插入侧边分支的能力。次优的结果可能是由几个机理作用的结果造成的,例如:有病组织的移动、斑块转移、脉管痉挛、带有或不带有血管内膜皮片的分离、血栓形成和栓塞。
考虑到上述问题,希望特别是当用在分叉的体腔时,能提供一种方法、装置和/或系统,来提高支架的定位精度。
发明概要
本发明提供了一种示例性的装置、系统和方法,它们可在一个体腔中,特别是一个分叉的体腔中精确地输送和安置一个支架。在一个实施例中,本发明的支架输送系统包括一个导管。该导管包括一个具有一个远端,一个近端,一条纵轴线和一个腔的导管体。 在一个实施例中为一个气囊的膨胀装置安置在该导管体远端附近。具有一个侧孔的支架安置在该膨胀装置上面。超声波传感器安置在该导管体远端附近,用于发送和接收经该侧孔的超声波信号。这样,可以使用一个血管内的超声波导管和系统来正确地安置支架和使支架的侧孔正确地与分支脉管的口对准。
超声波传感器安置在该膨胀装置内,或者在另一个实施例中,安置在膨胀装置和支架之间。最好,该超声波传感器可以沿着该纵轴线轴向移动,和/或相对于该纵轴线转动。这样,可以利用该超声波传感器使周围体液和组织产生图象,以保证支架正确对准。
在某些实施例中,支架输送系统还包括一个与传感器连接的传感器壳体。该壳体具有远端、近端和在其中穿过的通道。在一个实施例中,导向丝部分地安置在该通道中。壳体的近端与一条驱动缆索连接。在一个实施例中,该驱动缆索使该壳体相对于导管远端转动。可以包括一个与传感器连接的控制器,以便于系统工作。
本发明还提供了安置具有一个侧孔的支架的方法。在一个实施例中,该方法包括:提供一个如本文所述的支架输送系统,将该支架输送系统安置在一个体腔中,用该传感器生成该体腔的图象,以确定分支脉管口的位置,并使支架侧孔与该口对准。这样,使用超声波成象便于使支架侧孔正确地与分支脉管口对准。
在一个实施例中,超声波传感器可相对于该纵轴线转动。成象方法还包括使传感器转动,使该体腔横截面产生图像。同样,在一个实施例中,使支架侧孔对准的方法包括使该支架沿着该纵轴线作轴向移动,和/或使支架围绕着该纵轴线转动。在一些实施例中,引入一条体腔导向丝,并且该导管沿该导向丝前移至分支脉管附近。
在一个实施例中,支架输送系统通常是成套器械的一部分。该成套器械包括用来规定将支架安置在分叉体腔中使其侧孔基本上与分支脉管口对准的方法的指示。
根据下面的详细说明、所附的权利要求书和附图中,可以更充分地了解本发明的其他目的、特点和优点。
附图简要说明
图1表示安置在一个体腔中的本发明的支架的总图;
图2表示本发明的支架输送装置的总图;
图3A和3B分别为图2所示的装置的侧视纵截面图和正视的横截面图;
图4A和4B分别表示本发明的一种超声波成象装置的总图和侧视的纵截面图;
图5A和5B表示安置在一个体腔中的本发明的支架输送系统的简图;
图5C和5D画出根据图5A和5B安置的支架输送系统的发送和接收的超声波能量信号与时间的函数关系;
图6A和6B表示在一个体腔内的支架的超声波图象;
图7A~7C表示其中安置了本发明的支架输送系统的脉管的简化的横截面图象;
图8A~8C表示安置在一个体腔中与图7A~7C所示的图象相适应的位置上的支架输送系统的简图;
图9表示本发明的支架输送系统的简化的示意图;
图10表示用在本发明中的成象导管电子系统的简化的原理图;和
图11表示成套器械,包括本发明的装置和使用指示。
具体实施例说明
图1为表示安置在主脉管14内的支架10的简图。主脉管14可以包括动脉、静脉或各种各样的希望配置支架10的体腔。支架10包括一个侧孔12,它与分支脉管16的口对准。在许多情况下,希望侧孔12与分支脉管16的口对准,以便例如将一个分支支架或第二个支架(没有示出)导入分支脉管16中。侧孔12与分支脉管16对准,对于支架10的正确使用是很关键的。先前的对准方法有许多问题。本发明的装置、系统和方法的目的,部分地是通过在支架10上使用一个成象传感器或导管,正确地使侧孔12与分支脉管16对准。
现参照图2,3A,3B,4A和4B来说明本发明的一个示例性支架输送系统15。图中所示的支架10处在没有膨胀的状态,卷缩在气囊20的周围。当支架10安置在体腔内一个所希望的位置上时,气囊20构成使支架10膨胀的一个机构。熟悉该技术的人知道,使支架10膨胀的其他方法都在本发明的范围以内。系统15还包括一个传感器22,它具有成象能力,可协助正确地定位侧孔12。传感器22一般包括压电材料,用于将电气信号转换为机械能量,更具体地说是转换为声能。如图3A所清楚地表示那样,传感器22与一个壳体24连接。在一个实施例中,壳体24配置在气囊20内,如图4A所示。将传感器壳体24安置成使由传感器22发出的超声波信号通过侧孔12,进入周围的体液或组织中。利用这种方法,如下面还要进行说明那样,可以利用传感器22来指示,侧孔12何时与面对主脉管14的壁相反,正确地与分支脉管16对准。在另一个实施例(没有示出)中,传感器22安装在气囊25的外表面上,或安置在气囊25与支架10之间。例如,传感器22可以安装在气囊25上,在侧孔12内。在一个实施例中,导向丝18穿过气囊20,用来将支架输送系统引导至体腔内的一个所希望的区域。
图3B表示沿着图2中的3B-3B线所取的横截面图。支架10包括许多形成所希望的关系的撑杆26。熟悉该技术的人懂得,在本发明范围内,支架撑杆26的精确结构形状是可以作很大改变的。另外,本发明可以使用在序号为__(代理人摘要号为19601-000410)的美国专利申请,和序号为__(代理人摘要号为19601-000430)的美国专利中所说明的支架结构。这些专利的全部公开内容已在前面已被引用供参考。包括撑杆26的支架10,卷缩在气囊20周围。包括传感器22的成象导管安置在气囊25内的气囊腔30内。成象装置具有一个外零件32和一个内零件34,在它们之间形成一个导线腔38。在内零件34内形成一个通道40。导线腔38用于保持传感器导线36,该导线将传感器22的相对的表面与一个控制器(没有示出)连接起来。在一个实施例中,通道40构成导向丝18穿过的导向丝腔40。这样,导向丝18穿过上述壳体24,使传感器22与支架10容易正确对准。
传感器壳体24可以沿着纵轴线200,在轴向方向移动。在一个实施例中,传感器壳体24相对于支架10作轴向移动。另一种方式是,气囊20和传感器壳体24平行移动,保持传感器22相对于侧孔12的正确位置。
图4A和4B表示传感器22和壳体24的详细结构。在一个实施例中,驱动缆索44与壳体24的一个近端连接。图4A还表示了穿过壳体24的通道40。在一个实施例中,驱动缆索44包括由不锈钢、镍钛诺等制成的二条反绕的缆索。这样一种驱动缆索便于将它导入曲折的脉管系中。驱动缆索44还可允许壳体24转动,因而也是传感器22的转动。最好,这种转动是相对于纵轴线200的转动。
图4B为成象导管的一部分的纵截面侧视图。如图所示,可以使用任选的外壳46来封闭驱动缆索44。外壳46用于在驱动缆索44转动过程中,保护气囊20。另外,对于成象装置相对于气囊20和/或支架10轴向移动的实施例,外壳46提供了一个基本上光滑的外表面。外壳46可包括聚乙烯,以及各种各样的其他材料。在一个实施例中,外壳46、驱动缆索44和内套筒48相应于图3B所示的外零件32。
驱动缆索44形成一个传感器导线36安置其中的导线腔38。内零件34使传感器导线36保持在导线腔38内。另外,内零件34形成一个导向丝18可以穿过的通道40。在另一个实施例中,导向丝18穿过邻近驱动缆索44或外壳46的气囊腔30。
图5A和5B表示带有传感器22的一个体腔的图象的简图。同样,图5C和5D表示当传感器22在图5A和5B分别所示的位置起作用时,发送的和反射的信号强度。例如,在图5A中,将一个电压加在传感器22的两端,以产生超声波信号42。该超声波信号从传感器22发送至周围的体液和组织中。当信号42碰到介质改变,更具体地说是信号通过的材料密度改变时,至少该信号42的一部分反射回传感器22。传感器22接收反射的信号,并将一个相应的电压,通过导线36传送至控制器(没有示出)中进行处理。当传感器22如图5A所示那样安置时,信号42在被脉管壁、堵塞等反射出来之前,沿着分支脉管16的一部分行进。又从图5C可看出,反射信号在相对于初始的信号脉冲一段时间滞后以后被接收到。另外,反射信号的行进时间造成许多声能在血液或其他体液中损失。因此,返回至传感器22的信号较弱。相应地,如图5B所示,如果传感器22安置在邻近脉管壁80处,则反射信号被迅速得多地接收到,其强度比图5A所示的信号强度大。图5D表示了该较强的回声或返回信号。这样,可以利用超声波成象,包括计算出的原始脉冲与反射信号之间的时间滞后来确定,传感器22是否与分支脉管16对准。
图6A和6B表示安置在一个体腔中的支架的超声波图象的横截面。图6A为一个二维图象,它表示安置在一个中心导管或传感器22周围的支架撑杆26。传感器22产生的图象揭示了血液斑点68、导向丝18和导向丝阴影64,以及血小板66或其他脉管壁缺陷。图6A表示了一个基本上均匀的撑杆26结构,它可以表示一个没有侧孔的支架的横截面图,或者是当传感器22没有与侧孔12对准时的支架10的横截面图。例如,传感器22可以位于靠近侧孔12或远离侧孔12的地方。图6B除了表示成象传感器22与侧孔12对准以外,它是与图6A所示相同的图。结果,在撑杆26样式中可看到一个间隙62。根据本发明的一个实施例,该间隙62的图象可帮助使侧孔12与分支脉管16对准。
根据本发明,图6A和6B所示的图象可以用几种方法产生。在上述的一个实施例中,利用驱动缆索44使传感器22围绕着纵轴线200转动。这样,单一一个传感器22可以产生一个二维的、360°的平面图象,如图6A和6B所示那样。在另一个实施例中,在导管的远端安置着一个传感器元件的圆环(没有示出)。该传感器元件的圆环不需要转动(虽然,在另外的实施例中,传感器元件可以回转),即可产生一个二维的、360°平面图象。传感器元件的固定圆环可以放置在气囊25和支架10之间的气囊25的外表面上。最好,这种实施例中至少有一些传感器元件安置在气囊25上,而侧孔12则位于这些传感器元件上。这样,如图6B所示,一些传感器元件将产生间隙62。在另外一种可供选择的实施例中,传感器元件的圆环安置在与图3B所示的外零件32相似的外壳的外表面上。在这个实施例中,传感器元件的圆环安置在气囊腔30内。在又一个实施例中,不利用传感器元件的圆环来产生如图6A和6B所示的图象,但可以根据结合图10的讨论,利用该圆环来引导侧孔与分支脉管对准。
现在利用图7和图8来说明本发明的方法。图7A~7C表示安置在一个体腔(例如主脉管14)内的支架输送装置的超声波图象的横截面简图。图7A~7C所示的图象与图8A~8C中所示的支架和超声波传感器22的位置相适应。例如,图7A和8A表示安置在主脉管14内的支架10,该支架不邻近分支脉管16或不与后者对准。因此,图7A的图象表示不邻近分叉点的基本上均匀的主脉管壁80。结果,与侧孔12相应的间隙62不与分支脉管16对准。在这种情况下,希望沿轴向移动传感器22和支架10,继续搜索所希望的分支脉管16。
图7B和8B表示支架10在轴向或纵向与分支脉管16对准,但侧孔12与分支脉管16的口偏离。图7B所示的图象有一个延长的区域70,它与信号至少部分地沿着分支脉管16行进所产生的信号返回滞后相适应。换句话说,在传感器22处可以看见分支脉管16的口。然而,如图7B所示,间隙62仍面对着主脉管壁80。在这种情况下,希望转动支架10,使侧孔12与分支脉管16的口正确对准。图7C和8C表示侧孔12与分支脉管16的口对准的情况。图7C表示间隙62与延长区域70对准。这种图象相应于侧孔12与分支脉管16的口对准,如图8C所示那样。这样,利用超声波成象可容易使侧孔12与分支脉管16对准。最好,超声波传感器22总是与侧孔12对准,使超声波信号通过侧孔12发送给传感器22和从传感器22送出。这样,在超声波图象上可以看见间隙62。另一种方案是,传感器22可以相对于支架10自由运动。在这种实施例中,希望首先利用传感器22产生图象,再参考图6A和6B的图象作为指导,确定侧孔12的位置。
图9表示根据本发明的一个示例性支架输送系统100。输送系统100包括一个具有一个控制器120和一个显示器130的操纵面板110。控制器120与一个驱动电机140连接,该电机在一个实施例中用来使超声波传感器180转动。传感器180与先前附图中所述的传感器22相同。另外,如上所述,传感器180可以是一组传感器。如图9所示,导管150具有一个近端152和一个远端154。传感器180与远端154连接。输送根据本发明的支架的导管在下列美国专利申请中有详细说明:①序号为__(代理人摘要号为19601-000320),题为“带有侧面外壳的导管及方法”;②序号为__代理人摘要号为19601-000120),题为“可伸长的支架装置”。本文引用其完整公开内容供参考。
如图9所示,输送系统100包括一根导向丝190,气囊170和支架160安置在导向丝上。如图10所示的控制电路,用于将从一个电压源产生的电气信号,传送给传感器180,产生成象的超声波信号。这种方法是技术上众所周知的。再利用传感器180来安置支架160,使支架160的侧孔(没有示出)正确地与分支脉管的口对准。
图10为用于本发明中的控制电路300的一个实施例的简化原理图。高电压源310与一个射频(RF)脉冲发生器320连接,该发生器产生一个电脉冲,再通过发送/接收开关340,将该脉冲传送至传感器330。传感器330接收作为加在其二个相对表面上的电压的电气信号。传感器材料(最好是压电材料)产生从传感器330表面传播的声波。如上所述,声波反射出介质(例如脉管壁)密度的变化,而一部分信号则返回至传感器330。然后,传感器330将接收到的信号传送至发送/接收开关340和一个接收装置滤波器350。时间控制和逻辑电路360协调RF脉冲发生器320、发送/接收开关340和接收装置滤波器350的工作。
如前所述,从分支脉管发出的回声接收到的信号的时间滞后,比主脉管壁接收到的信号的时间滞后大。在一个实施例中,可以利用接收装置滤波器350,来给系统100的使用者提示,侧孔11是否与分支脉管14对准了。例如,可以使用一个或多个指示灯380来指示侧孔对准(绿色灯)或没有对准(红色灯)。在一些实施例中,电路300不产生体腔的可视图象。利用从传感器330接收到的信号去指示侧孔与分支脉管对准。电源370保证单个电气元件的工作。
如图11所示,支架、导管和/或系统410可以方便地作为成套器械400的一部分包括进去。成套器械400包括一些指示420,它们规定展开支架10的各种程序,和利用上述任何一种技术采用传感器22成象的方法。使用指示420可以为书写形式或机器可阅读的形式。另外,成套器械400还可包括本文所述的任何其他零件,例如成象导管15,气囊20等。指示420还说明任何其他零件的使用方法。
为了清楚地了解本发明,现已对本发明作了详细说明。然而,在所附权利要求书范围内,可以作一些改变和改进。例如,虽然将传感器22概括地描写成与驱动缆索44连接,以便于传感器转动,但传感器22也可以相对于支架10固定。在这种实施例中,传感器22包括从侧面看面对传感器的侧孔12。这样,传感器22与侧孔12对准,以便于侧孔12与分支脉管16对准。这种结构产生的图象与图6B所示的图象相同,但图象包括一个馅饼形状部分。转动支架10可使传感器22转动,而传感器22保持紧盯着侧孔12。
Claims (21)
1.一种支架输送系统,它包括:
一个包括导管体的导管,该导管体具有一个远端、一个近端、一条纵轴线和一个腔;
一个配置在该导管体远端附近的膨胀装置;
具有一个侧孔的支架,该支架配置在该膨胀装置上面;和
一个超声波传感器,它配置在该导管体远端附近,并用于传送和接收经所述侧孔的超声波信号。
2.如权利要求1所述的支架输送系统,其特征为,所述膨胀装置包括一个气囊。
3.如权利要求1所述的支架输送系统,其特征为,所述超声波传感器配置在所述膨胀装置内。
4.如权利要求1所述的支架输送系统,其特征为,所述超声波传感器配置在所述膨胀装置和所述支架之间。
5.如权利要求1所述的支架输送系统,其特征为,所述超声波传感器可以沿着所述纵轴线轴向移动。
6.如权利要求1所述的支架输送系统,其特征为,所述超声波传感器可相对于所述纵轴线转动。
7.如权利要求1所述的支架输送系统,其特征在于,它还包括一个与所述传感器连接的传感器壳体,所述壳体具有一个远端,一个与驱动缆索连接的近端,和一个在所述近端和远端之间穿过所述壳体的通道。
8.如权利要求7所述的支架输送系统,其特征为,所述驱动缆索使所述壳体相对于所述导管远端转动。
9.如权利要求1所述的支架输送系统,其特征在于,它还包括一条至少部分地配置在所述腔中的导向丝。
10.如权利要求7所述的支架输送系统,其特征在于,它还包括一条至少是部分地配置在所述腔中并通过所述通道的导向丝。
11.如权利要求1所述的支架输送系统,其特征在于,它还包括一个与所述传感器连接的控制器。
12.一种支架输送系统,所述系统包括:
一个导管,该导管包括具有一个远端、一个近端和一个腔的导管体;
一个配置在所述导管体远端附近的气囊;
一个具有一侧孔的支架,所述支架放置在所述气囊上面;
一个超声波传感器壳体,该壳体具有一个远端,一个近端和一个在所述远端和近端之间穿过所述壳体的通道,所述壳体与传感器连接;和
一条至少是部分地配置在所述导管腔中的定位导向丝,所述导向丝穿过所述传感器壳体的通道。
13.一种安置具有一个侧孔的支架的方法,该方法包括:
提供一个支架输送系统,该系统包括:
一个包括一导管体的导管,该导管体具有一个远端、一个近端、一条纵轴线和一个腔;
一个配置在该导管体远端附近的膨胀装置;
一个具有一侧孔的支架,所述支架配置在该膨胀装置上面;和
一个超声波传感器,它配置在该导管体远端附近,用于发送和接收经所述侧孔的超声波信号;
将所述支架输送系统安置在一个体腔中;
利用所述传感器使所述体腔产生图象,以确定分支脉管口的位置;和
使所述支架的侧孔与所述的口对准。
14.如权利要求13所述的方法,其特征为,所述传感器配置在所述膨胀装置中。
15.如权利要求13所述的方法,其特征为,所述超声波传感器可相对于所述纵轴线转动,所述成象方法还包括转动所述传感器,使所述体腔的横截面产生图象。
16.如权利要求13所述的方法,其特征为,所述对准方法包括沿轴向移动所述支架。
17.如权利要求13所述的方法,其特征为,所述对准方法包括使所述支架围绕所述纵轴线转动。
18.如权利要求13所述的方法,其特征在于还包括:
将一条体腔导向丝导入所述体腔;和
使所述导管沿该导向丝前移,并通过所述体腔到达所述分支脉管附近。
19.如权利要求18所述的方法,其特征为,所述传感器与具有一个所述导向丝穿过的通道的壳体连接,所述前移还使所述传感器壳体前进至所述分支脉管附近。
20.如权利要求13所述的方法,其特征为,所述支架输送系统还包括一个控制器,该控制器与所述传感器连接,控制所述成象过程。
21.成套器械,包括:
如权利要求1所述的一个支架输送系统;和
用来规定将所述支架安置在一个分叉体腔中使所述侧孔基本上与分支脉管的口对准的方法的一些指示。
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2000
- 2000-09-22 US US09/669,060 patent/US6689156B1/en not_active Expired - Fee Related
- 2000-09-25 KR KR1020027003778A patent/KR20020064880A/ko not_active Application Discontinuation
- 2000-09-25 CA CA002383620A patent/CA2383620C/en not_active Expired - Fee Related
- 2000-09-25 NZ NZ517946A patent/NZ517946A/en not_active IP Right Cessation
- 2000-09-25 AU AU77162/00A patent/AU777017B2/en not_active Ceased
- 2000-09-25 CN CN00815877A patent/CN1391489A/zh active Pending
- 2000-09-25 WO PCT/US2000/026382 patent/WO2001021244A1/en active IP Right Grant
- 2000-09-25 JP JP2001524666A patent/JP2003532447A/ja active Pending
- 2000-09-25 EP EP00966881A patent/EP1233807A4/en not_active Withdrawn
- 2000-09-25 IL IL14865700A patent/IL148657A0/xx unknown
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2002
- 2002-11-27 HK HK02108559.4A patent/HK1046871A1/zh unknown
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2004
- 2004-01-16 US US10/758,020 patent/US7585317B2/en not_active Expired - Fee Related
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2014194675A1 (zh) * | 2013-06-06 | 2014-12-11 | 武汉杨森生物技术有限公司 | 脉管腔内覆膜支架开窗方法及脉管腔内覆膜支架开窗设备 |
WO2023160306A1 (zh) * | 2022-02-22 | 2023-08-31 | 上海科罡医疗技术有限公司 | 一种医用导管 |
Also Published As
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EP1233807A1 (en) | 2002-08-28 |
NZ517946A (en) | 2004-07-30 |
US6689156B1 (en) | 2004-02-10 |
AU7716200A (en) | 2001-04-24 |
AU777017B2 (en) | 2004-09-30 |
KR20020064880A (ko) | 2002-08-10 |
US20040148006A1 (en) | 2004-07-29 |
CA2383620C (en) | 2009-09-29 |
US7585317B2 (en) | 2009-09-08 |
JP2003532447A (ja) | 2003-11-05 |
HK1046871A1 (zh) | 2003-01-30 |
IL148657A0 (en) | 2002-09-12 |
WO2001021244A1 (en) | 2001-03-29 |
EP1233807A4 (en) | 2003-06-25 |
WO2001021244A9 (en) | 2002-10-03 |
CA2383620A1 (en) | 2001-03-29 |
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