Apparatus and method for stent graft extraction

Abstract

The present invention provides a device for extracting intravascular stent grafts from blood vessels. [Solution] The intravascular stent graft extraction device 25 includes a cylindrical body 30 and an opening 50 formed in the cylindrical body. The cylindrical body has a first open end 34, a second open end 38, and a side wall 42 surrounding a hollow bore 43 of the cylindrical body. The opening is formed in the side wall between the first open end and the second open end, forming a first ring portion 54 of the first open end and a second ring portion 58 of the second open end. Furthermore, the thickness of the side wall at the first open end tapers toward the opening, and the thickness of the side wall at the second open end tapers toward the opening, so that the hollow bore is narrower at each end than at the opening.

Description

Technical Field

[0001] Cross - reference to related applications This application claims priority to U.S. Patent Application No. 17 / 088,102, filed on November 3, 2020 the content of which is incorporated herein by reference.

[0002] The present invention generally relates to the field of endovascular stent - graft removal, and more particularly, to devices and methods for non - traumatic stent - graft removal.

Background Art

[0003] Endovascular stent - grafts can be used for various vascular - related pathologies, but most commonly they can be used to reinforce weak points within arteries, known as aneurysms. Over time, due to blood pressure and other factors, this weak area can bulge and eventually expand and rupture. The stent - graft is implanted so as to form a tight seal between the arteries above and below the aneurysm. The graft is stronger than the weakened artery and allows blood to pass through the graft without pushing on the bulge.

[0004] In some cases, removal of the stent - graft may be necessary due to infection or the initial implant not functioning as intended. Since stent - grafts typically include prongs that engage the vessel wall, removal of the device can cause significant damage to the tissue with which the device is engaged. The explantation of stent - grafts is known to be associated with high mortality rates resulting from a combination of multiple factors. Damage to the vessel wall during the removal process is one factor contributing to high mortality.

Summary of the Invention

[0005] Therefore, there is a need for a device that facilitates the non-traumatic removal of stent grafts from blood vessels. It is being done.

[0006] At least one embodiment is a device for extracting an intravascular stent graft from a blood vessel. The apparatus includes a cylindrical body and an opening formed in the cylindrical body. It has a first open end, a second open end, and side walls surrounding the hollow bore of the cylindrical body. The opening is formed in the side wall between the first open end and the second open end, and the first open end The ring portion and the second ring portion of the second open end are formed. Furthermore, the first open end The thickness of the side wall in is tapered toward the opening, and the thickness of the side wall at the second open end is, The hollow bore tapers towards the opening, and therefore narrows at each end compared to the opening. It will get worse.

[0007] Another embodiment relates to a method for removing an intravascular stent graft from a blood vessel. The procedure includes the step of inserting an extraction device into the blood vessel. The extraction device comprises a cylindrical body and a cylindrical body The cylindrical body includes an opening formed in the body. The cylindrical body has a first open end and a second open end, and a cylindrical shape It has side walls surrounding the hollow bore of the main body. The opening is between the first open end and the second open end. Formed on the side wall, the first ring portion of the first open end and the second ring portion of the second open end A tapering portion is formed. Furthermore, the thickness of the side wall at the first open end tapers toward the opening. The thickness of the side wall at the second open end tapers toward the opening, and therefore the hollow A narrows at each end compared to the opening. The method is such that the first opening is against the vascular wall. It slides against the stent graft, compressing the stent graft inside the first ring portion. Thus, the extraction device is slid over the stent graft, and the extraction device is slid over the stent Slide the extraction device over the stent graft until the graft prongs are released from the vascular wall. The step of continuing to move, and the side wall being at least partially between the stent graft and the vascular wall. While being positioned, at least one of the stent graft and the extraction device is pulsed. The further step includes removing it from the pipe.

[0008] This overview is merely illustrative and should not be considered limiting.

[0009] The advantages and features constituting this disclosure, as well as the typical mechanisms provided using this disclosure. A clear concept of the structure and operation is shown in the drawings attached to this specification, which form part thereof. Furthermore, this will become more readily apparent by referring to illustrative, and therefore non-limiting, embodiments. In drawings, similar reference numerals indicate the same element in several drawings. [Brief explanation of the drawing]

[0010] [Figure 1A] This is a perspective view of an endovascular stent graft for use in the abdominal aorta, according to one exemplary embodiment. [Figure 1B] This is a close-up view of the intravascular stent graft shown in Figure 1, which was implanted in the abdominal aorta. [Figure 2] This is a perspective view of an endovascular stent graft extraction device according to an exemplary embodiment. [Figure 3] Figure 2 is a rear view of the intravascular stent graft extraction device. [Figure 4] This is a cross-sectional view of the endovascular stent graft extraction device shown in Figure 3, along line 4-4. [Figure 5A]It is a cutaway view of a side wall close to the first end of the intravascular stent graft extraction device of FIG. 4. [Figure 5B] It is a cutaway view of a side wall close to the second end of the intravascular stent graft extraction device of FIG. 4. [Figure 6A] It is a perspective view of the intravascular stent graft extraction device of FIG. 2, which is used in a method for extracting an intravascular stent graft according to an exemplary embodiment. [Figure 6B] It is a perspective view of the intravascular stent graft extraction device of FIG. 2, which is used in a method for extracting an intravascular stent graft according to an exemplary embodiment. [Figure 6C] It is a perspective view of the intravascular stent graft extraction device of FIG. 2, which is used in a method for extracting an intravascular stent graft according to an exemplary embodiment. [Figure 6D] It is a perspective view of the intravascular stent graft extraction device of FIG. 2, which is used in a method for extracting an intravascular stent graft according to an exemplary embodiment. [Figure 6E] It is a perspective view of the intravascular stent graft extraction device of FIG. 2, which is used in a method for extracting an intravascular stent graft according to an exemplary embodiment. [Figure 7] It is a perspective view of a second intravascular stent graft extraction device according to another embodiment. [Figure 8] It is a perspective view of a third intravascular stent graft extraction device according to another embodiment. [Figure 9] It is a perspective view of a fourth intravascular stent graft extraction device according to another embodiment. [Figure 10] It is a perspective view of a fifth intravascular stent graft extraction device according to another embodiment.

Mode for Carrying Out the Invention

[0011] The foregoing features and other features of the present disclosure will become apparent from the following description taken in conjunction with the accompanying drawings and the appended claims. These drawings show several Only embodiments are shown, and therefore, it is considered that the scope is limited. With the understanding that this is not the case, the attached drawings can be used to further specify this disclosure. I will also explain in detail.

[0012] The following detailed description refers to the attached drawings which form part of this specification. In the drawings, text Unless otherwise indicated by the pulse, similar symbols usually indicate similar components. Exemplary embodiments described in the detailed description, drawings, and claims are identified. It is not intended to be restrictive. It does not deviate from the intent or scope of the subject matter presented herein. Other embodiments may be used and other modifications may be made, as long as they do not deviate from this specification. The aspects of this disclosure, as generally described in this document and shown in the figures, are arranged in a wide variety of configurations. They may be replaced, combined, and designed, all of which are clearly intended and It is easy to understand why this would be included as part of the disclosure.

[0013] Referring to the figures in general, this specification describes endovascular stent graft removal. This is the extraction device. The intravascular stent graft extraction device proceeds from the first opening to the second opening. It includes an extending cylindrical body and side walls surrounding a hollow bore of the cylindrical body. The first open end is The first aperture is defined, and the second open end defines the second aperture. The side wall defines the first It is positioned between the first and second open ends, and has an opening that coincides with the bend of the cylindrical body. It also includes the side wall from the point adjacent to the first aperture of the first open end to the opening, From the second aperture at the second open end to the opening, there is a taper (for example, the inner diameter of the cylindrical body). (Enlargement) further includes. Furthermore, the side walls are blunt or rounded at the first and second openings. It further includes the edges.

[0014] When in use, the intravascular stent graft extraction device first opens either the first or second opening. So that it can be received into the blood vessel, the blood vessel (for example, one or more parts of the aorta, one or It is inserted into multiple arteries, etc. Once inserted, the endovascular stent graft extraction device The first open end slides between the vascular wall and the stent graft, and inside the first ring portion The stent graft is compressed by sliding it on and around the stent graft. Next, the intravascular stent graft extraction device is used, and the device is positioned at the prongs of the stent graft. The stent graft is continuously slid over the vessel until it is freed from the vessel wall. The internal stent graft extraction device and stent graft are removed during the removal of the intravascular stent graft. The side wall of the stent extraction device is at least partially present between the stent graft and the blood vessel. It is removed from the blood vessels.

[0015] Referring to Figures 1A and 1B, the intravascular stent graft 10 is shown. The tent graft 10 is a human, for example, a patient with an aneurysm, and one or more different movements It is configured to be embedded in the blood vessel and reinforce the arterial wall. In some embodiments, it is used in blood The intravascular stent graft 10 specifically targets the abdominal aorta and the intestines branching from the abdominal aorta. It is configured for use in bone arteries (Figure 1B). To do so, an intravascular stent is used. The foot 10 has multiple prongs 12, an aortic portion 16A, and one or more arterial portions It includes a frame 14 having parts (for example, branching parts) 16B and 16C. Each part is Each central axis (not shown) may further be included, along which the frame extends. Frame 14 can be made from various materials configured to be embedded within an artery. Furthermore, it provides a support to reinforce the arterial wall to prevent rupture. To fix the intravascular stent graft 10, it is folded along each central axis. It can be configured to expand (for example, the length of frame 14 can change), but It may be configured to be biased to behave rigidly or firmly in the radial direction relative to the central axis. (For example, the diameter of multiple parts of frame 14 does not change.) In this way, frame 14 It supports the arterial wall (for example, the abdominal aorta and the iliac arteries branching from the abdominal aorta), It can be expanded and contracted for implantation. Similarly, frame 14 is the aortic portion. 16A (relatively broad portion) and one or more arterial portions 16B and 16C (relatively (Narrow portion) and. In other embodiments, the frame 14 includes the intravascular stent graft 10 Depending on where it will be used, other parts (for example, more branching, fewer) It may include (for example, the absence of a bifurcation or aortic portion).

[0016] Prong 12 is connected to the aortic portion 16A, and prong 12 presses against the arterial wall, inside the blood vessel The deployment position of the stent graft 10 hinders its movement, and the prongs 12 do not press against the arterial wall, thus preventing blood flow. The stent graft 10 inside the tube is configured to move selectively between a non-deployed position and a non-deployed position that does not hinder its movement. In some embodiments, the prongs are coupled to other parts of the frame 14. In the open position (Figures 1A and 1B), prong 12 is slightly away from the central axis of the aortic portion 16A. At most, they extend radially outward in part, pressing against the wall of the aorta (or artery), causing intravascular suction This prevents the tent graft 10 from moving. By doing so, the prongs 12 will pierce through. This can be done, or it can provide frictional force to keep the intravascular stent graft 10 in place. This can be done. To do this, and while embedded, the prong 12 is moved to the deployed position. Special equipment may be required to perform this. In the non-deployed position (not shown), the front G12 does not extend radially outward or contact the aortic wall. By doing so, The intravascular stent graft 10 moves to ensure it is correctly positioned to cover the aneurysm. It can move around within the pulse. Once positioned in place, prong 12 is deployed. It can be selectively moved and "implanted" within the aorta. At this point, the aorta (or artery) To prevent the wall of the vascular tissue from rupturing, an intravascular stent graft 10 is inserted without moving for a long period of time. It can be left in the aorta for a period of time (for example, permanently, for several years).

[0017] Next, referring to Figures 2 to 4, we see an exemplary embodiment of intravascular stent graft extraction. Device 25 is shown. The intravascular stent graft 10 is used in the aorta for a long period of time (and Although it is configured to remain inside the artery, the intravascular stent graft 10 is removed. Various complications may occur that require treatment (e.g., infection, intravascular stenting). (Fut 10 does not deploy properly, arterial swelling, plaque buildup, rupture, etc.) Therefore The intravascular stent graft extraction device 25 is inserted into the artery, and the intravascular stent graft Remove 10 non-traumatically (for example, with little or no damage to the artery itself). It is configured to be used for this purpose. To do this, an intravascular stent graft extraction device 25 includes a cylindrical body 30, the cylindrical body 30 having a first aperture 35 The open end 34, the second open end 38 having a second aperture 39, and the inside of the cylindrical body 30 Side walls extending between the first open end 34 and the second open end 38 to define the empty bore 43 Includes 42. The cylindrical body 30 is made of surgical / medical grade steel, stainless steel, and Various rigid materials suitable for sterilization, such as surgical / medical grade plastics. In some embodiments, the cylindrical body 30 is made by 3D printing (for example, stereolithography (S LA), Selective Laser Sintering (SLS), Fused Deposition Modeling (FDM), Direct Metal Laser Sintering ( It may be manufactured using DMLS or other conventional 3D printing methods. By doing so, the device operates based on a specific aorta or artery in which it is operating. Based on the specific intravascular stent graft 10 that has been removed, One or more dimensions of the tograft extraction device 25 (for example, the diameter of the side wall 42, the diameter of the side wall 42) Length, etc., can be easily changed or updated. The aorta and arteries are usually specific. While the diameter and length are common in patients of the same age and size, they are of a genetic nature. This may vary depending on previous surgeries and other environmental factors. Or, to allow for quick and easy updates of various dimensions in hospital settings, In some cases, the intravascular stent graft extraction device 25 may be manufactured using 3D printing.

[0018] When used (for example, to remove intravascular stent graft 10), the intravascular stent The raft extraction device 25 has a large first open end 34 or a second open end 38 (or both). It is inserted into the aorta or artery so as to be positioned within or within the arterial wall. Percha 35 and the second aperture 39 are larger than the diameter of the aortic wall or arterial wall. The outer diameter is sized relative to the aorta or artery so that it is at least partially smaller. It can include. For example, the diameter of aperture 35 and 39 is approximately 15-30 millimeters. (mm) may be between. In some embodiments, the first aperture 35 and the second aperture It has a different outer diameter than aperture 39. For example, the first aperture 35 is approximately 24-26 mm. The second aperture 39 may have an outer diameter between 18 and 20 mm. It may be inserted into the aorta or artery, and the intravascular stent graft extraction device 25 The intravascular stent graft extraction device 25 approaches the frame 14 of the intravascular stent graft 10. It can slide along the wall of the aorta until it reaches this point (e.g., being pushed, moved, etc.). In this regard, as will be further discussed herein, the side wall 42 is between the wall of the aorta and the frame 14. It can come into this position, and therefore the frame 14 is positioned within the hollow bore 43. The side wall 42 adjacent to aperture 35 or the second aperture 39 reaches the prong 12. Then, the intravascular stent graft extraction device 25 moves the prongs 12 from the deployed position to the undeployed position. It can be configured to move to this position. At this point, the intravascular stent graft extraction device 25 is used The user can remove the intravascular stent graft 10.

[0019] Regarding other dimensions, the cylindrical body 30 is approximately 90-120 mm or approximately 107 mm. The height from the first aperture 35 to the second aperture 39 (along the vertical axis in Figure 4) It may include a diameter of approximately 100-150 mm. The distance from aperture 34 to the second aperture 39 is approximately 120 mm (for example, a circle). The length includes the center of the arc / along the center of the side wall 42. As described herein, the first Aperture 35 has an outer diameter of approximately 24-26 mm or approximately 25 mm, and approximately 14 It can have an inner diameter of ~20 mm or approximately 17 mm. Similarly, the second aperture 39 has an outer diameter of approximately 18-20mm or 19mm and approximately 10-14mm or 12mm It may have an inner diameter and an inner diameter larger than the inner and outer diameters of the second aperture 39. Having a first aperture 35 with diameter and outer diameter, the intravascular stent graph The extraction device 25 is better used with various aortic or artery sizes. If one aperture is too large or too small, an endovascular stent graft is removed. The user of device 25 can use the opposite end.

[0020] Further reference to Figures 2 to 4 shows that the cylindrical body 30 has a circular cross-section. Therefore, the cylindrical body 30 includes a diameter and length, and the cylindrical body 30 is an arc The cylindrical body 30 is curved along its length to form a curved shape. Furthermore, the first open end 3 The side wall 42 between 4 and the second open end 38 forms the curved section of the cylindrical body 30. The opening 50 is defined along the same. In some embodiments, the opening 50 and the cylindrical body 30 They are curved to include a radius of curvature of approximately 50-90 / mm or 70 / mm In other embodiments, the opening 50 is formed in the side wall 42 at the curved portion of the cylindrical body 30. Therefore, the opening 50 is formed in the concave or convex portion of the main body. The opening 50 is Of the cylindrical body 30, the side wall 42 defines a nearly semi-cylindrical shape (for example, the side wall is approximately the same as the bore 43). This is the portion that extends only around half of the vascular stent. The user of the raft extraction device 25 accesses the hollow bore 43 of the cylindrical body 30 through the opening 50. Access to the hollow bore 43 allows for the construction of an intravascular stent. The user of the graft extraction device 25 inserts an intravascular graft through the hollow bore 43 and through the opening 50. Pulling / extracting the graft 10 (when it is moved to its non-deployed position) This is beneficial because it makes it possible. For example, the user can access the hollow bore 43 of the cylindrical body 30. Insert an intravascular stent graft (for example, using a clamp, medical device, machine, etc.). 0 holds frame 14 (when frame 14 is positioned inside the hollow bore 43) Then, the intravascular stent graft 10 can be removed. By doing so, The intravascular stent graft 10 did not come into contact with the aortic wall or arterial wall during removal, and was located on the side wall 42. In this way, the opening 50 allows for the use of the intravascular stent graft extraction device 25. A location is provided where the patient can easily visualize and remove the intravascular stent graft 10. It can be done.

[0021] By including the opening 50 along the curved portion of the cylindrical body 30, the side wall 42 is the cylindrical body 30 contains two ring portions (for example, a first ring portion 54 and a second ring portion 58) The first ring portion 54 and the second ring portion 58 are opposite each other with respect to the opening 50. Located on the side, it includes its own respective length, central axis, inner diameter, and outer diameter. Ratio of opening 50 In comparison, the ring portions 54 and 58 have side walls 42 that form part of a cylinder (for example, a semicircle of the opening 50). This is the place where a complete cylinder is formed, not a tube. The first ring portion 54 is the first open end 3 The second ring portion extends from 4 to the opening 50, and the second ring portion extends from the second open end 38 to the opening 50. Furthermore, since the cylindrical body 30 is curved, in some embodiments, the first The center line of the ring portion 54 is at an angle of approximately 30 to 60 degrees or approximately 45 degrees from the center line of the second ring portion 58. There may be cases where it is offset by a degree.

[0022] Next, referring to Figures 5A to 5B, the stent graft is removed from the intravascular stent graft extraction device 25. The first ring portion 5 (for example, adjacent to the first aperture 35 and opening 50) 4, and a portion of the side wall 42 of the second ring portion 58 are shown. The side wall 42 is side The width of wall 42 changes from where it is close to the first aperture 35 to where it is close to the opening 50. It is shown to include a tapered shape that narrows (i.e., the hollow bore 43 to the opening 50) (It narrows closer to the first aperture 35 than it does in close proximity.) In this embodiment, the side wall 42 of the first ring portion 54 is on the side adjacent to the first aperture 35. The width of the wall is approximately 3-5 mm or approximately 4 mm, and the width of the side wall adjacent to the opening 50 is approximately 2-3 m It includes a taper such as m or about 2.8 mm. In some embodiments, a second phosphorus The side wall of section 58 also has an opening 5 from where the width of the side wall 42 is close to the second aperture 39. It includes a taper that narrows towards zero. In some embodiments, the second The side wall 42 of the ring portion 58 has a width of approximately 3-5 mm in the side wall adjacent to the second aperture 39. Alternatively, it is approximately 4 mm, and the width of the side wall adjacent to the opening 50 is approximately 2-3 mm or approximately 2.8 mm. It includes a taper such as the first aperture 35 and the second aperture 39. By increasing the diameter of the hollow bore 43 to 50, the first ring portion 54 and the second The ring portion 58 is more efficient than the frame 14 and prongs 12 of the intravascular stent graft 10. It receives well. For example, frame 14 is the first ring portion 54 or the second ring portion As the diameter of the hollow bore 43 increases as it is received by 58, the frame 14 and The contact with the side wall 42 is reduced, and the drag or friction between the frame 14 and the side wall 42 is reduced. It decreases. This is because (friction is reduced, or drag is reduced) The intravascular stent graft 10 can more easily access the first ring portion 54 or the second ring portion This allows for sliding to 58, preventing unexpected movement of the intravascular stent graft 10. This is effectively prevented. In some embodiments, the first aperture 35 and the second aperture The width of the side wall 42 decreases from the corner 39 to the opening 50, but the outer diameter of the side wall 42 remains the same. The inner diameter of the side wall 42 decreases or tapers (i.e., the hollow bore 43 approaches the opening 50) It is narrower when it is closer to the second aperture 39 and the first aperture 35 than when it is further away. (It becomes smaller). As a result, the diameter of the portion of the side wall 42 that contacts the aortic wall does not change, The diameter of the portion of the side wall 42 that contacts the stent graft 10 is reduced.

[0023] Furthermore, the first open end 34 and the end of the side wall 42 immediately adjacent to the opening 50 are blunt ( It includes an edge 70 (for example, smooth, rounded, etc.). When in use, the blunt edge 70 is embedded in the blood vessel. It becomes the first to come into contact with the implanted intravascular stent graft 10. As a result, M14, the vascular wall, and / or the prongs 12 may get caught or entangled with them. To prevent potentially sharp contrast, the edges are dull. It is important that 70 is blunt or rounded. In some embodiments, the blunt edge 7 0 includes a radius of curvature of approximately 1-3 / mm or approximately 2 / mm. By doing so, blunt The edge 70 naturally comes into contact with the prong 12, and either catches on the prong 12 or the prong 1 Move them from the deployed position to the undeployed position without intertwining with 2. Similarly, opening 5 The side wall 42 immediately adjacent to 0 has a second blunt edge 7 (for the same reasons as the first blunt edge 70). It can also contain 0. In this case, prong 12 will thereby become an intravascular stent. The entire graft extraction device 25 may be pulled away from the opening 50. When moving, it does not get caught on the side wall 42. Similar to the side wall 42 of the first open end 34, the second The side wall 42 of the open end 38 is also blunt (similar to the blunt edge 70 of the first open end 34) or includes a rounded edge 70.

[0024] Next, referring to Figures 6A to 6E, a blood vessel 254 (for example) according to an exemplary embodiment. Intravascular stent graph from one or more parts of the aorta, one or more arteries, etc. A method 200 for extracting a stent (for example, stent graft 10) is shown. Method 200 This involves using a clamp (e.g., forceps) to grasp a portion of the intravascular stent graft 10. It begins with step 204. The clamp is a portion of the intravascular stent graft 10 (even if Grasp one or more parts of the frame 14 and place on the intravascular stent graft 10 To keep the intravascular stent graft 10 in place while the extraction device 25 is being moved. Later (after prong 12 was moved to the un-extended position), intravascular stent graft 1 Used to extract 0. In some embodiments, before step 604, the method To prevent the vessel 254 from moving during 200, the vessel 254 itself is fixed or clamped In other embodiments, multiple devices are used to grasp a portion of the intravascular stent graft 10. A number of clamps may be used. In another embodiment, blood (for example, near the side wall 42) A clamp may be used to grasp the intravascular stent graft extraction device 25.

[0025] Once the intravascular stent graft 10 is grasped by the clamp 258, method 200 proceeds, An extraction device (for example, an intravascular stent graft extraction device 25) is inserted into the blood vessel 254. Proceed to step 208. The intravascular stent graft extraction device 25 is inserted into one of the blood vessels 254. Alternatively, it can be inserted into the blood vessel 254 through multiple incisions and fitted inside the blood vessel 254. It can be configured as follows (for example, before 3D printing the intravascular stent graft extraction device 25) (The dimensions may be changed). In other embodiments, the intravascular stent graph is also used before use. The user of the stent extraction device 25 determines the diameter of the blood vessel 254, and then inserts an intravascular stent graft. This specification allows for the determination of which end of the extraction device 25 to insert into the blood vessel 254. As discussed, the first open end 34 and the second open end 38 have different outer diameters (and inner diameters). This includes allowing the user to determine which is more appropriate for use on blood vessel 254. In one embodiment, the diameter of the blood vessel 254 may be approximately 26 mm, and therefore it can be used. The user inserts the first opening 34 (compared to the second opening 38) into the blood vessel 254. You can choose this option.

[0026] When the intravascular stent graft extraction device 25 is inserted into the blood vessel 254, method 200 proceeds as follows: The first open end 34 slides over the stent graft 10, and the side wall 42 is on the stent graft 1 The stent is positioned between the wall of the vessel 254 and the first ring portion 54. The intravascular stent graft extraction device 25 compresses the stent graft 1. The process proceeds to step 212, where it is slid over 0. The first open end 34 is a stent graft When it comes into contact with the frame 14, the blunt edge 70 and taper of the side wall 42 cause the frame M14 slides easily (for example, with little or no resistance) into the hollow cavity 43. Therefore, the first aperture 35 receives the stent graft 10. Having an inner diameter large enough to do so is helpful. (The second opening 38 is first in the vascular 254 In some embodiments (inserted into), the intravascular stent graft extraction device 25 is the The open end 38 of 2 slides over the stent graft 10, and the side wall 42 is on the stent graft 10 The stent is positioned between the wall of the blood vessel 254 and the inside of the second ring portion 58. The stent graft 10 is slid over the stent graft 10 in a manner that compresses it.

[0027] The lateral wall 42 is positioned between the stent graft 10 and the wall of the blood vessel 254. After the internal stent graft extraction device 25 has been slid, method 200 is performed to extract the intravascular stent The raft extraction device 25 (for example, the blunt edge 70 of the side wall 42) is prong (for example, prong 12) Release the vessel 254 from the wall (for example, move it from an expanded position to an unexpanded position). The intravascular stent graft extraction device 25 slides further over the stent graft 10 until Then proceed to step 216. To do this, the blunt edge 70 of the side wall 42 is radially The prongs 12 can be pushed inward and into the hollow bore 43, and thus the side wall 42 It is located between the wall of prong 12 and vascular 254. To remove prong 12 nontraumatically It is important that the prong 12 does not get caught on the side wall 42, and therefore the side wall 4 2 includes a blunt edge 70 and opens from the first aperture 35 and the second aperture 39. It tapers to a mouth 50. In other embodiments, other endovascular stent graft extraction device 25 The components may be configured to remove the prongs 212 from the wall of the blood vessel 254.

[0028] When prong 12 is released from the wall of vascular 254, method 200 is used to insert an intravascular stent. The side wall 42 of the stent extraction device 25 is at least partially connected to the stent graft 10 and the blood vessel 254. The stent graft 10 and the intravascular stent graft extraction device are positioned between them. The procedure proceeds to step 220, where the implants 25 are completely removed from the blood vessels 254, either simultaneously or sequentially. Hmm. In step 220, use a clamp to remove the stent graft 10 and Grasp at least one of the endovascular stent graft extraction devices 25. This can be done (for example, a clamp is used to extract or remove one of them). In some embodiments, and also in step 220, the stent graft extraction device 25 is pro The prong 212 was pushed radially inward, preventing the prong 25 from engaging with the blood vessel 254. In this state, the stent graft 10 and the stent graft extraction device 25 are removed together. At this position, both the stent graft 10 and the stent graft extraction device 25 It is removed from the blood vessel 254. In this embodiment, the stent graft 10 is removed after It can be extracted from inside the hollow bore 43 through the opening 50. In other embodiments, stenting The raft 10 may be removed first, and therefore the stent graft 10 is in the hollow bore 4 From 3 (for example, located at least partially within the hollow bore 43), and also the opening 50 The stent graft 10 and the intravascular stent graft extraction device 25 are removed through the stent graft. They were removed nontraumatically from vascular 254, and therefore they left almost no trace of vascular 254 itself. It does not cause any damage at all. When both are removed from the blood vessel 254, the side wall 42 is stainless Since it is positioned between the graft 10 and the blood vessel 254, the blood vessel 254 is stented It does not come into contact with (or has minimal contact with) the raft 10, providing better protection from damage. Compared to a stent graft 10 including prongs 12, the endovascular stent graft extraction device The side wall 42 of the vessel 25 is relatively smooth and therefore does not pull on the wall of the vessel 254, or It does not attach to the wall of blood vessel 254.

[0029] Next, referring to Figure 7, we see an alternative embodiment of the intravascular stent graft extraction device 300. This is shown. The endovascular stent graft extraction device 300 extracts endovascular stent grafts. Apparatus 25 may be similar, and therefore similar components may be given the same reference number. In some cases, this may occur. For example, the intravascular stent graft extraction device 300 has a first open end 3 It includes a cylindrical body 330 extending from 34 to a second open end 338. Compared to the thrombus extraction device 25, the device 300 is shown to not include the opening 50. Therefore, the user can only access the side wall 34 from the first open end 334 or the second open end 338. The hollow bore 343 defined by 2 can be accessed. The user of the intravascular stent graft extraction device 300 can easily access the hollow bore 343. Although this may be hindered, by not including the opening 50, the improvement of the side wall 342 Enhanced strength and rigidity can be provided.

[0030] Next, referring to Figure 8, we see an alternative embodiment of the intravascular stent graft extraction device 400. This is shown. The intravascular stent graft extraction device 400 extracts intravascular stent grafts. Apparatus 25 may be similar, and therefore similar components may be given the same reference number. In some cases, this may occur. For example, the intravascular stent graft extraction device 400 has a first open end 43 It includes a cylindrical body 430 extending from 4 to a second open end 438. Intravascular stent graph Compared to the extraction device 25, the device 400 does not include an opening 50 and has one or more grips It is shown to further include grip 460 and not include blunt edge 70. Grip 460 is From the side wall 442 radially (for example, as part of the side wall 442), and the cylindrical body 430 Along a portion of its length (for example, from near the first aperture 435 to the central portion) It extends (to a point close to the vessel 25). In some embodiments, the grip 460 is located near the vessel 25 4 engages better and is better received by vascular 254, vascular 254 ( It is configured to contact the wall of an artery (for example, the aorta, arteries, etc.) in some embodiments. The grip 460 allows the intravascular stent graft extraction device 400 to move along the wall of the blood vessel 254. This allows for smoother sliding. In another embodiment, the grip 460 allows for, The endovascular stent graft extraction device 400 is used during the procedure (with or without clamps). This allows the user to grip it more effectively.

[0031] Next, referring to Figure 9, we see an alternative embodiment of the intravascular stent graft extraction device 500. This is shown. The endovascular stent graft extraction device 500 extracts endovascular stent grafts. Apparatus 25 may be similar, and therefore similar components may be given the same reference number. In some cases, this may occur. For example, the intravascular stent graft extraction device 500 has a first open end 53 It includes a cylindrical body 530 extending from 4 to a second open end 538. Intravascular stent graph Compared to the extraction device 25, the device 500 is a relatively straight (non-curved) cylinder. The form includes a main body 530, but does not include an opening 50, and further includes one or more grips 560. , does not include a blunt edge 70. (It may be similar to grip 460) Grip 560 is From the side wall 542 radially (for example, as part of the side wall 542), and the cylindrical body 530 It extends along the entire length. Furthermore, the device 500 is located near the center of the device 500. From the second open end 538 to the bellowed portion 570 For example, it has an enlarged outer diameter. In one embodiment, the bellows portion 570 has a second open end 538 It extends approximately 30 mm toward the first open end 534 (i.e., the length of the bellows portion 570). (It is 30 mm). The bellows section 570 contacts the wall of the blood vessel 254 and expands it. This configuration can be achieved. In this way, the bellows portion 570 pulses the frame 14 of the stent graft 10. Separated from the wall of pipe 254, then the frame 14 of the stent graft 10 is in the hollow bore 543 It can be received more effectively internally. In some embodiments, the bellows portion 570 is open end Section 538 can have an outer diameter of approximately 36-40 mm or approximately 38 mm, and the bellows section 5 The smaller end of the 70 can have an outer diameter of approximately 28-32 mm or approximately 33 mm.

[0032] Next, referring to Figure 10, we see an alternative embodiment of the intravascular stent graft extraction device 60. 0 is shown. The endovascular stent graft extraction device 600 is an endovascular stent graft extraction device. The output device 25 may be similar, and therefore similar components can be given the same reference number. This may occur. For example, the intravascular stent graft extraction device 600 has a first open end 6 It includes a cylindrical body 630 extending from 34 to a second open end 638. Compared to the futon extraction device 25, the device 600 is a relatively straight (non-curved) cylindrical shape. Including the main body 630, but not including the opening 50, further including one or more grips 660, It does not include a blunt edge 70. (It may be similar to grip 460) Grip 660 is side From the wall 642 radially (for example, as part of the side wall 642), and also from the cylindrical body 630 It extends along the entire length (or most of it). Furthermore, the device 600 extends within the device 600 From near the center to the second open end 638, the bellows portion 670 (for example, an enlargement of the outer diameter) It has. The bellows portion 670 is less conspicuous than the bellows portion 570, but it is still the wall of the blood vessel 254. It may be configured to contact and expand the bellows portion 670. 8 can have an outer diameter of approximately 21 mm, and the smaller end of the bellows section 570 is approximately 20 mm. It can have an outer diameter of m. In this way, the bellows portion 670 is of the stent graft 10 The frame 14 is separated from the wall of the blood vessel 254, and then the frame 14 of the stent graft 10 is It can be better received inside the hollow bore 643.

[0033] Notwithstanding the embodiments described above in relation to each figure, various modifications to these embodiments and The inclusion of and inclusion is intended and considered within the scope of this disclosure.

[0034] The configuration and arrangement of the elements of the system and method shown in the representative embodiment are simply It should be understood that these are illustrative examples. Only a few embodiments of this disclosure will be described in detail. However, as long as it does not substantially deviate from the novel teachings and merits of the disclosed subject matter, many The ability to modify (for example, the size, dimensions, structure, shape, and proportions of various elements) Variations in parameters, mounting mechanisms, material usage, color, orientation, etc., may be confirmed in this disclosure. This will be easily understood by those skilled in the art.

[0035] Therefore, all such modifications are intended to be included within the scope of this disclosure. Any means-plus-function clauses shall be deemed to perform the functions described herein. The specification includes structures as described in the specification, and is intended to include not only structural equivalents but also equivalent structures. This is the case unless it deviates from the scope of this disclosure or the scope of the attached claims. Other substitutions, modifications, and changes to the design, operating conditions, and configuration of preferred other exemplary embodiments. , and omissions may also be made.

[0036] The use of substantially any plural and / or singular term herein is permitted. In this regard, a person skilled in the art would know to change the plural form to the singular form as appropriate to the context and / or use. , and / or can be converted from singular to plural. To clarify, various singular forms can be converted from singular to plural. Numerical / plural substitutions may be explicitly stated herein.

[0037] Generally, this specification, and in particular the appended claims (e.g., the body of the appended claims) The terminology used is generally intended to be "open" and accessible to those skilled in the art. It should be understood (for example, the term "including" means "~including" It should be interpreted as "having, but not limited to," and the term "having" should be interpreted as "having, but not limited to." g) should be interpreted as "having at least ~", and the term "includes" e) should be interpreted as "including but not limited to ~" etc. If a specific number of the claimed items is intended, this intention must be clearly stated in the claim. If such a statement is not included, it is clear to those skilled in the art that such an intention does not exist. To be understood, for example, the attached claims below are To introduce the information to be included in the system, the introductory phrases "at least one" and "one or more" are used. This may include the use of the introductory phrase "one or more" or Even when it includes "at least one" and an indefinite article such as "a" or "an", The use of the phrase indicates that the claim is introduced by the indefinite article "a" or "an". As a result, any specific claim containing the claim details introduced in this manner may be... This should be interpreted as suggesting that the invention is limited to one of the following descriptions. There is no such thing (for example, "a" and / or "an" usually mean "at least one"). (This should be interpreted as meaning "one or more"). The same applies to claims. This also applies when using the definite article to introduce information. Even if a specific number of the claimed items is clearly stated, such statements are not valid. It should be interpreted that, in the usual sense, this means at least the number stated. It will be recognized (for example, the mere phrase "two entries" without any other modifiers) (The term "description" usually means at least two items, or two or more items.) Similarly, unless otherwise specified, the phrase "based on" is a restrictive expression. It should not be interpreted as such, and therefore should be understood as "at least partially based on ~". It should be done. Furthermore, notation similar to "at least one of A, B, and C" When used, such structures are generally understood by those skilled in the art to understand this notation. Intended (for example, "a system having at least one of A, B, and C") "Mu" refers to a system having only A, a system having only B, a system having only C, A system having both A and B, a system having both A and C, a system having both B and C This includes, but is not limited to, systems, and / or systems that have A, B, and C together. (This will not be determined.) A table similar to "at least one of A, B, or C, etc." When such notation is used, generally, the meaning is that a person skilled in the art should understand this notation. It is intended to be (for example, "a system having at least one of A, B, or C) "Tem" refers to a system having only A, a system having only B, or a system having only C. A system having both A and B, a system having both A and C, a system having both B and C This includes systems that have A, B and C together, and / or systems that have A, B and C together, but these (This means it will not be limited.) Furthermore, it is not limited to presenting two or more selectable terms. The separating words and / or separating phrases may be present in the specification, claims, or drawings. and the possibility of including one of those terms, either of those terms, or both of those terms. Those skilled in the art will understand that this should be understood as having sexual intent. For example, The phrase "A or B" includes the possibility of "A" or "B", or "A and B". It will be understood as such. Furthermore, unless it is mentioned that this is not the case, "about", "approximately" The use of words such as "percentage" and "effectively" is a plus or minus 10 percent. It means...

[0038] Furthermore, although the diagram shows a specific sequence of steps in the process, the sequence of steps is not shown. It may be different from the above. Also, two or more processes may be performed simultaneously or partially simultaneously. This may also be done. All such variations are within the scope of this disclosure.

Claims

1. A device for removing intravascular stent grafts from blood vessels, A ring having a first open end and a second open end, The second open end of the ring has a side wall that extends away from the ring, Includes, The side wall is curved along the length of the device, The side wall extends along only a portion of the circumferential direction of the second open end of the ring, thereby defining the open portion. The thickness of the ring at the first open end is greater than the thickness at the second open end. The ring and the side wall are rigid. Device.

2. The apparatus according to claim 1, wherein the diameter of the first open end is in the range of 24 to 26 millimeters, and the diameter of the second open end is in the range of 18 to 20 millimeters.

3. The apparatus according to claim 2, wherein the diameter of the first open end is approximately 25 millimeters, and the diameter of the second open end is approximately 19 millimeters.

4. The apparatus according to claim 1, wherein the diameter of the first open end is at least 30 millimeters, and the diameter of the second open end is about 27 millimeters.

5. The apparatus according to claim 1, wherein the length of the side wall is approximately 100 to 150 millimeters.

6. The apparatus according to claim 1, wherein at least one edge of the first open end and the second open end of the ring is rounded to provide a smooth edge.

7. The apparatus according to claim 6, wherein the edge of the first open end of the ring is rounded and has a radius of curvature of about 1 to 3 mm.

8. The apparatus according to claim 1, wherein the ring and the side wall are formed from surgical / medical grade plastic or stainless steel.

9. A device for removing intravascular stent grafts from blood vessels, A ring having a first open end and a second open end, The second open end of the ring has a side wall that extends away from the ring, Includes, The side wall is curved along the length of the device such that the side wall intersects with the central axis of the ring. The thickness of the ring at the first open end is greater than the thickness at the second open end. The ring and the side wall are rigid. Device.

10. The apparatus according to claim 9, wherein the side wall extends along only a portion of the circumferential direction of the second open end of the ring, thereby defining the open portion.

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