摘要:
This invention is methods and apparatus for occluding blood flow within a blood vessel (22). In a first series of embodiments, the present invention comprises a plurality of embolic devices (16) deployable through the lumen (12) of a conventional catheter (10) such that when deployed, said embolic devices (16) remain resident and occlude blood flow at a specific site within the lumen of the blood vessel (22). Such embolic devices (16) comprise either mechanical embolic devices that become embedded within or compress against the lumen of the vessel or chemical vaso-occlusive agents that seal off blood flow at a given site. A second embodiment of the present invention comprises utilization of a vacuum/cauterizing device capable of sucking in the lumen of the vessel about the device to maintain the vessel in a closed condition where there is then applied a sufficient amount of energy to cause the tissue collapsed about the device to denature into a closure. In a third series of embodiments, the present invention comprises the combination of an embolization facilitator coupled with the application of an energy force to form an intraluminal closure at a specified site within a vessel.
摘要:
Catheter devices, systems and methods for penetrating from one location within a patient's body to another location. An elongate catheter (12) is insertable into a natural or man-made lumen within the body of a patient. A penetrator (30) is advanceable from the catheter (12) to a target location outside of the lumen in which the catheter (12) is positioned. An optical imaging or tissue characterization apparatus (100) (e.g., an optical coherence tomography apparatus) is useable to image the anatomy and/or sense variables within tissue so as to locate the target location relative to indicia of the trajectory on which the penetrator (30) will advance from the catheter. The operator may then adjust the position and/or rotational orientation of the catheter (12) such that when the penetrator (30) is subsequently advanced, the penetrator (30) will enter the target location.
摘要:
A catheter device that is useable to penetrate from a blood vessel in which the catheter device is positioned to a target location comprises a flexible catheter advanceable into the first blood vessel, a tissue penetrator lumen adapted to receive an operative tissue penetrator which is usable to penetrate from the blood vessel to the target location when properly aimed. Further said catheter including an imaging transducer fixedly mounted on or within the catheter body to provide an imaging signal from which an image of the target location can be obtained. The catheter device may include an imageable marker on the catheter to form on the image obtainable from the imaging signal a penetrator path indication that indicates the path that will be followed by the tissue penetrator when the tissue penetrator exits from the catheter. Alternatively, or addition thereto, the imaging transducer may comprise a plurality of imaging elements which are located so that the penetrator path indication can be obtained. A method of utilizing such a catheter device to bypass an arterial obstruction is also disclosed.
摘要:
This invention is methods and apparatus for direct coronary revascularization wherein a transmyocardial passageway (10) is formed between a chamber of the heart (LV) and a coronary blood vessel (CBV) to permit blood to flow therebetween. In some embodiments, the transmyocardial passageway (10) is formed between a chamber of the heart (LV) and a coronary vein (CV). The invention includes unstent transmyocardial passageways (10), as well as transmyocardial passageways (10) wherein protrusive stent devices (90) extend from the transmyocardial passageway (10) into an adjacent coronary vessel (CBV) or chamber of the heart (LV). The apparatus of the present invention includes protrusive stent devices (90) for stent of transmyocardial passageways (10), intraluminal valve devices (40) for valving of transmyocardial passageways (10), intra-cardiac valve devices (80) for valving of transmyocardial passageways (10), endogenous tissue valves (50) for valving of transmyocardial passageways (10), and ancillary apparatus for use in conjunction therewith.
摘要:
This invention is methods, devices, and systems for re-vascularization, and/or performing other medical procedures at a vascular or non-vascular intra-corporeal locations within a mammalian body. The methods generally comprise the formation of at least one extravascular passageway from a blood vessel to a vascular or non-vascular target location. In the re-vascularization methods the extravascular passageway is utilized as a conduit for accessing or performing procedures at the vascular or non-vascular target location. Also disclosed are catheter devices (100, 103) and systems (138) which are usable to form the extravascular passageways of the invention, as well as apparatus for modifying, maintaining and/or closing such extravascular passageways.
摘要:
This invention is methods, devices, and systems for re-vascularization, and/or performing other medical procedures at a vascular or non-vascular intra-corporeal locations within a mammalian body. The methods generally comprise the formation of at least one extravascular passageway from a blood vessel to a vascular or non-vascular target location. In the re-vascularization methods the extravascular passageway is utilized as a conduit for accessing or performing procedures at the vascular or non-vascular target location. Also disclosed are catheter devices (100, 103) and systems (138) which are usable to form the extravascular passageways of the invention, as well as apparatus for modifying, maintaining and/or closing such extravascular passageways.
摘要:
Method and apparatus for utilizing the vascular system as a conduit to reach other vascular and extravascular locations within the body. Included are methods for revascularization wherein the extravascular passageways are formed to permit blood flow between vascular locations. Also included are methods for performing transvascular interstitial surgery (TVIS) wherein extravascular passageways are formed from a blood vessel to another vascular or non-vascular intracorporeal location. Also disclosed are devices usable for forming extravascular passageways in accordance with the invention, or for modifying, valving, maintaining or closing such passageways.
摘要:
A trans-vascular system (10) for delivering a drug to a tissue region from a blood vessel, such as a coronary vein, includes a catheter (12) having a distal portion (26) with puncturing (14), orientation (16), drug delivery (62), and imaging elements (18). The puncturing element (14) is deployed for penetrating the vessel wall to access the tissue region. The orientation element (16), e.g., a 'cage' including a plurality of struts (38, 40), and/or a radiopaque marker has a predetermined relationship with the location of the orientation element (16) with respect to the tissue region to orient the puncturing element (14). The catheter (12) is percutaneously introducing into the vessel, the puncturing element (14) is oriented towards the tissue region, the puncturing element (14) is deployed to access the tissue region, and the drug is delivered to the tissue region. An ablation device (230) may also be deployed to create a cavity in the tissue region for receiving the drug therein, or an indwelling catheter (214) may be advanced into, and left in the tissue region. An implanted reservoir device (350) is also disclosed, including an enclosed membrane (354) on an expandable frame (352) that defines a reservoir, and includes a porous region. The reservoir device may be deployed, expanded within a blood vessel, and may be filled in situ or pre-filled with a drug that passes through the porous region. Alternatively, a pair of expandable endovascular blockers may be used to isolate a section of a blood vessel which may be filled with a drug that may be absorbed by the surrounding tissue.
摘要:
Methods and apparatus for direct coronary revascularization wherein a transmyocardial passageway is formed between a chamber of the heart and a coronary blood vesel to permit blood to flow therebetween. In some embodiments, the transmyocardial passageway is formed between a chamber of the heart and a coronary vein. The invention includes unstented transmyocardial passageways, as well as transmyocardial passageways wherein protrusive stent devices extend from the transmyocardial passageway into an adjacent coronary vessel or chamber of the heart. The apparatus of the present invention include protrusive stent devices for stenting of transmyocardial passageways, intraluminal valving devices for valving of transmyocardial passageways, intracardiac valving devices for valving of transmyocardial passageways, endogenous tissue valves for valving of transmyocardial passageways, and ancillary apparatus for use in conjunction therewith.