WO1999000072A1 - Apparatus for setting and removing parts such as endoprostheses - Google Patents
Apparatus for setting and removing parts such as endoprostheses Download PDFInfo
- Publication number
- WO1999000072A1 WO1999000072A1 PCT/FR1998/001307 FR9801307W WO9900072A1 WO 1999000072 A1 WO1999000072 A1 WO 1999000072A1 FR 9801307 W FR9801307 W FR 9801307W WO 9900072 A1 WO9900072 A1 WO 9900072A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- jaws
- sheath
- tool
- rod
- wire guide
- Prior art date
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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
-
- 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
- A61F2002/9528—Instruments specially adapted for placement or removal of stents or stent-grafts for retrieval of stents
Definitions
- the present invention relates to an apparatus for placing and recovering parts such as endoprostheses through a biological conduit (artery, vein, biological channel) such as bile duct, urinary canals by being guided by a wire guide previously introduced into the duct , device comprising a sheath intended to be introduced along the wire guide in the pipe to the site of the intervention, the distal end of which is equipped with an intervention tool and the proximal end is provided with a manual control handle connected to the tool by a flexible rod, forming with the flexible sheath, a Bowden cable type connection, for transmitting a relative translational movement.
- a biological conduit artery, vein, biological channel
- urinary canals by being guided by a wire guide previously introduced into the duct
- device comprising a sheath intended to be introduced along the wire guide in the pipe to the site of the intervention, the distal end of which is equipped with an intervention tool and the proximal end is provided with a manual control handle connected to the tool by a flexible rod, forming with the
- a wire guide is introduced into the femoral artery up to the site of the intervention and this guide is used to set up an endoprotesis such that '' a small tubular element (also called “stent”) in the contracted state and which is deployed inside the artery to eliminate a local narrowing (stenosis).
- a small tubular element also called “stent”
- a stent For the installation of a stent, it is fixed on a balloon catheter and on the wire guide and the assembly is pushed to the level of the lesion to be treated (stenosis). When the stent is in place, it is deployed by inflating this balloon until the stent has reached the desired shape, thereby restoring normal section of the artery. But it happens that, as a result of difficulties or incidents at the time of the intervention, this stent is not in its place or is ejected from its location, and it becomes necessary to recover it. However, the wire guide cannot be used to pull this endoprosthesis by simple traction on the wire.
- the present invention aims to remedy these drawbacks and proposes to create an apparatus allowing the installation and recovery of parts such as endoprostheses through a biological conduit (artery) by being guided by a wire guide beforehand. inserted in the pipe, to properly position this prosthesis and be able to recover it if necessary safely.
- the invention relates to an apparatus of the type defined above, characterized in that the tool of the distal end comprises: - at least two jaws pivoting, at their rear end, around a hollow joint, this tool s being opened by being pushed by the rod on a stop integral with the distal end of the sheath, housed between the two jaws and against which the jaws lean at the front of their articulation when leaving the sheath,
- the two jaws have inner jaws forming a cavity to receive a part to be put in place during the intervention and their outer surface is provided with external hooking members.
- the invention allows intervention at the location to recover a stent without the need to extract the wire guide.
- the invention uses the wire guide to reach the site of the intervention.
- this guide not only guides the distal end of the delivery device to the site of the intervention but also into the endoprosthesis. Then simply deploy the tool to hang the stent and extract it by traction.
- Two cases may arise which are resolved with the device according to the invention: in the first case, the stent is still in the retracted state; following the wire guide, the tool is introduced, not deployed, inside the stent by proceeding for example with a screwing movement or movement of this nature. Once the stent is hooked up, simply pull it out.
- the second case is that of the stent already deployed.
- the tool is driven inside the endoprosthesis and deployed to hang its external hooking members in the wall of the endoprosthesis and pull it through the pipe.
- the control rod is hollow and communicates with the passage of the tool.
- the hollow rod can be used to provide the intervention site with biological fluids such as a physiological fluid, an anticoagulant, drugs and any fluids necessary for the intervention.
- biological fluids such as a physiological fluid, an anticoagulant, drugs and any fluids necessary for the intervention.
- the presence of the wire guide makes it possible to quickly change an accessory, for example a device having a different form of tool without having to remove all of the instrumentation.
- This hollow rod can also receive the wire guide; in other words, the device is threaded and slid over the wire guide.
- the tool is connected to an auxiliary sheath forming a branch leaving the sheath behind the tool, this auxiliary sheath communicating with the front through the jaws.
- the wire guide is outside the sheath of the device and the tube forming the control rod is completely available for the passage of a physiological fluid.
- FIG. 1 is a view in axial section on a much enlarged scale of the distal end of the delivery device
- FIG. 1A is a variant of FIG. 1
- FIG. 2 is a partial view in axial section corresponding to FIG. 1 but showing the tool deployed
- the invention relates to an apparatus for placing and recovering stents through a biological conduit such as an artery (not shown).
- This device is guided to the site of the intervention, along a wire guide 1 previously placed in the conduit.
- the apparatus consists of a sheath 2 introduced into the conduit, along the wire guide 1.
- the sheath 2 ends at the distal end by a nozzle 3 provided with a transverse stop 4 which bars the opening of the tip 3.
- the tip is of circular or flat section.
- the proximal end of the device is not shown; located on the left, according to FIG. 1, at the end of the sheath 2, it is provided with control handles fixed to the sheath 2 and acting on a rod controlling the tool to create a relative translational movement between the sheath and the rod to activate the tool.
- control handles fixed to the sheath 2 and acting on a rod controlling the tool to create a relative translational movement between the sheath and the rod to activate the tool.
- the sheath remains stationary and the rod advances and controls the tool; reverse movement is also possible.
- the tool which will be described below, is connected to the preferably hollow rod 5 fixed in a hollow tip 6 forming part of the tool.
- This tubular end piece 6 ends with a hollow articulation 7, on which two jaws 8, 9 of the tool pivot by forming a clamp.
- the tool opens and closes under the effect of its translation relative to the sheath by cooperating with the orifice of the endpiece and the stop guiding the movement of exit and re-entry of the jaws by forcing them to open and close.
- the shape of the surfaces 81, 91 corresponds to this cylindrical or spherical shape.
- the jaws Before the articulation 7, the jaws have inner edges 84, 95 to cooperate with the stop 4 and outer edges 85, 95 to cooperate with the edge or edges 31, 32 of the end piece 3.
- the jaws 8, 9 have internal jaws 82, 92 and external hooking members 83, 93.
- the internal jaws 82, 92 form a cavity 10 adapted to the shape of the part to be received like the stent 11 (FIG. 2).
- the cavity 10 may not exist on the jaws whose internal and / or external shape is limited to jaws or hooking means.
- each jaw 8, 9 is articulated in an elastic manner around a respective articulation 86, 96 represented diagrammatically by a point.
- This elastic articulation allows the ends of the jaws to be placed parallel to the axis of the tool (represented by the wire guide so as to put the end of the jaws substantially parallel to one another.
- the tool is shown in Figure 1 in the closed position and in the open position in Figure 2.
- the clamp In the closed position, the clamp is retracted, that is to say pulled to the left (according to FIG. 1), inside the end piece 3 of the sheath 2.
- the articulation 7 is crossed by a passage 71 just as the end of the endpiece 6 is provided with a passage 61 in which the front end 51 of the hollow rod 5 is engaged.
- This hollow rod 5 opens into the passage 71 through an orifice 62 bypassing a branch 12 connected to the part 6.
- the branch 12 is continued by an auxiliary sheath leaving the sheath 2 which is then the main sheath, by a passage 14 allowing the relative movement of the tool, always controlled by the rod 5 and the main sheath 2, the auxiliary sheath receiving the wire guide 1.
- the branch 12 and the auxiliary sheath 13 are not necessary when the wire guide passes through the hollow rod 5.
- FIG. 1A is a figure similar to FIG. 1, with the same references but without the auxiliary sheath 13.
- the guide cable exits directly from the sheath 2 through the passage 14. Likewise, it leaves the hollow endpiece 6 through a lateral passage 63.
- the passage 71 of the hollow joint 7 continues through the channel 13 formed between the jaws 8, 9 of the clamp. This channel joins the channel 41 crossing the stop 4 and, finally, the cavity 10 or the gap left between the jaws 8, 9.
- the endpiece 6, fixed to the end of the control rod 7, is provided with the branch 12 connected to the auxiliary sheath 13 extending to the left to the distal end of the device.
- This auxiliary sheath is in fact used for the passage of the wire guide 1 which will not pass under these conditions the control tube 5 left free for the passage of physiological fluid.
- the closing movement of the clamp which is the reverse of the opening movement, is controlled by the sliding support of the cam surfaces 85, 95 from the outside of the jaws 8, 9 against the edges 31, 32 from the mouthpiece.
- Figures 3, 4, 5 show a variant nozzle according to the invention.
- the end piece 6A has, as before, a lateral passage 63A. At the front, it ends with two legs 64A, 65A each provided with an orifice 651A, 641A to receive an element of axis 66A, 67A leaving a free interval I for the passage of the wire guide 1.
- the elements of axis 66A, 67A have exactly the same role of stop as the transverse stop 4 of the previous embodiment.
- the apparatus according to the invention is designed to place and retrieve parts such as prostheses and more generally foreign bodies in the body, remove prostheses or temporary implants, or implants that are badly placed.
Abstract
Description
Claims
Priority Applications (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002264648A CA2264648A1 (en) | 1997-06-25 | 1998-06-23 | Apparatus for setting and removing parts such as endoprostheses |
EP98933679A EP0938278A1 (en) | 1997-06-25 | 1998-06-23 | Apparatus for setting and removing parts such as endoprostheses |
AU83420/98A AU8342098A (en) | 1997-06-25 | 1998-06-23 | Apparatus for setting and removing parts such as endoprostheses |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
FR97/07957 | 1997-06-25 | ||
FR9707957A FR2765098A1 (en) | 1997-06-25 | 1997-06-25 | APPLIANCE FOR LAYING AND RECOVERING PARTS SUCH AS ENDOPROTHESES |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1999000072A1 true WO1999000072A1 (en) | 1999-01-07 |
Family
ID=9508432
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/FR1998/001307 WO1999000072A1 (en) | 1997-06-25 | 1998-06-23 | Apparatus for setting and removing parts such as endoprostheses |
Country Status (5)
Country | Link |
---|---|
EP (1) | EP0938278A1 (en) |
AU (1) | AU8342098A (en) |
CA (1) | CA2264648A1 (en) |
FR (1) | FR2765098A1 (en) |
WO (1) | WO1999000072A1 (en) |
Families Citing this family (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2005037361A2 (en) * | 2003-10-22 | 2005-04-28 | Colin Charles Didcott | Dilators and dilator assemblies |
US7347868B2 (en) * | 2004-10-26 | 2008-03-25 | Baronova, Inc. | Medical device delivery catheter |
US9532871B2 (en) | 2012-05-04 | 2017-01-03 | St. Jude Medical, Cardiology Division, Inc. | Delivery system deflection mechanism |
US9277990B2 (en) | 2012-05-04 | 2016-03-08 | St. Jude Medical, Cardiology Division, Inc. | Hypotube shaft with articulation mechanism |
WO2014130160A1 (en) * | 2013-02-21 | 2014-08-28 | St. Jude Medical, Cardiology Division, Inc. | Transapical passive articulation delivery system design |
US9566153B2 (en) | 2013-09-12 | 2017-02-14 | St. Jude Medical, Cardiology Division, Inc. | Alignment of an implantable medical device |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3416531A (en) * | 1964-01-02 | 1968-12-17 | Edwards Miles Lowell | Catheter |
EP0423916A1 (en) * | 1989-10-17 | 1991-04-24 | Cook Incorporated | Percutaneous stent |
US5098440A (en) * | 1990-08-14 | 1992-03-24 | Cordis Corporation | Object retrieval method and apparatus |
US5474563A (en) * | 1993-03-25 | 1995-12-12 | Myler; Richard | Cardiovascular stent and retrieval apparatus |
-
1997
- 1997-06-25 FR FR9707957A patent/FR2765098A1/en not_active Withdrawn
-
1998
- 1998-06-23 WO PCT/FR1998/001307 patent/WO1999000072A1/en not_active Application Discontinuation
- 1998-06-23 EP EP98933679A patent/EP0938278A1/en not_active Withdrawn
- 1998-06-23 CA CA002264648A patent/CA2264648A1/en not_active Abandoned
- 1998-06-23 AU AU83420/98A patent/AU8342098A/en not_active Abandoned
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3416531A (en) * | 1964-01-02 | 1968-12-17 | Edwards Miles Lowell | Catheter |
EP0423916A1 (en) * | 1989-10-17 | 1991-04-24 | Cook Incorporated | Percutaneous stent |
US5098440A (en) * | 1990-08-14 | 1992-03-24 | Cordis Corporation | Object retrieval method and apparatus |
US5474563A (en) * | 1993-03-25 | 1995-12-12 | Myler; Richard | Cardiovascular stent and retrieval apparatus |
Also Published As
Publication number | Publication date |
---|---|
CA2264648A1 (en) | 1999-01-07 |
AU8342098A (en) | 1999-01-19 |
FR2765098A1 (en) | 1998-12-31 |
EP0938278A1 (en) | 1999-09-01 |
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