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    Method and device for epicardial ablation
    3.
    发明授权
    Method and device for epicardial ablation 有权
    心外膜消融的方法和装置

    公开(公告)号：US07794454B2

    公开(公告)日：2010-09-14

    申请号：US10839979

    申请日：2004-05-04

    申请人： Marwan Abboud ,  Dan Wittenberger ,  Daniel Nahon ,  Steven G. Arless

    发明人： Marwan Abboud ,  Dan Wittenberger ,  Daniel Nahon ,  Steven G. Arless

    IPC分类号： A61B18/02

    CPC分类号： A61B18/02

    摘要： A method is disclosed for treating heart and vascular tissue with cryotreatment. A medical instrument, such as a catheter is positioned to contact a target region of cardiac tissue such as the epicardial tissue. The instrument or catheter provided includes a cryotreatment element that has thermally-transmissive properties. The cryotreatment element may be a cryochamber for enclosing the flow of a fluid refrigerant therein. The cryotreatment element is disposed at the situs of heart or vascular tissue to be treated, usually by piercing the epicardium sac via an opening in the patient's body. A refrigerant flow within the cryochamber creates endothermic cooling with respect to the targeted heart or vascular tissue, inducing hypothermia and forming iceballs proximate the tissue. The cooling may be reversible and non-permanent, or may be permanent leading to cell death, necrosis, apoptosis and/or surgical excision or ablation of tissue.

    摘要翻译： 公开了一种用冷冻治疗来治疗心脏和血管组织的方法。 诸如导管的医疗器械定位成接触诸如心外膜组织的心脏组织的靶区域。 提供的仪器或导管包括具有热传递特性的冷冻处理元件。 冷冻处理元件可以是用于封闭其中的流体制冷剂的流动的冷冻箱。 冷冻治疗元件设置在待治疗的心脏或血管组织的位置，通常通过穿过患者体内的开口刺穿心外膜。 冷冻箱内的制冷剂流动相对于目标心脏或血管组织产生吸热冷却，诱导低体温并在组织附近形成冰球。 冷却可以是可逆的和非永久性的，或者可能是永久性的导致细胞死亡，坏死，凋亡和/或手术切除或消融组织。

    Method and device for epicardial ablation
    4.
    发明授权
    Method and device for epicardial ablation 失效
    心外膜消融的方法和装置

    公开(公告)号：US07625369B2

    公开(公告)日：2009-12-01

    申请号：US11526494

    申请日：2006-09-25

    申请人： Marwan Abboud ,  Dan Wittenberger ,  Daniel Nahon ,  Steven G. Arless

    发明人： Marwan Abboud ,  Dan Wittenberger ,  Daniel Nahon ,  Steven G. Arless

    IPC分类号： A61B18/02

    CPC分类号： A61B18/02

    摘要： A method is disclosed for treating heart and vascular tissue with cryotreatment. A medical instrument, such as a catheter is positioned to contact a target region of cardiac tissue such as the epicardial tissue. The instrument or catheter provided includes a cryotreatment element that has thermally-transmissive properties. The cryotreatment element may be a cryochamber for enclosing the flow of a fluid refrigerant therein. The cryotreatment element is disposed at the situs of heart or vascular tissue to be treated, usually by piercing the epicardium sac via an opening in the patient's body. A refrigerant flow within the cryochamber creates endothermic cooling with respect to the targeted heart or vascular tissue, inducing hypothermia and forming iceballs proximate the tissue. The cooling may be reversible and non-permanent, or may be permanent leading to cell death, necrosis, apoptosis and/or surgical excision or ablation of tissue.

    摘要翻译： 公开了一种用冷冻治疗来治疗心脏和血管组织的方法。 诸如导管的医疗器械定位成接触诸如心外膜组织的心脏组织的靶区域。 提供的仪器或导管包括具有热传递特性的冷冻处理元件。 冷冻处理元件可以是用于封闭其中的流体制冷剂的流动的冷冻箱。 冷冻治疗元件设置在待治疗的心脏或血管组织的位置，通常通过穿过患者体内的开口刺穿心外膜。 冷冻箱内的制冷剂流动相对于目标心脏或血管组织产生吸热冷却，诱导低体温并在组织附近形成冰球。 冷却可以是可逆的和非永久性的，或者可能是永久性的导致细胞死亡，坏死，凋亡和/或手术切除或消融组织。

    Catheter with cryogenic and electrical heating ablation
    5.
    发明授权
    Catheter with cryogenic and electrical heating ablation 有权
    导管用低温和电加热消融

    公开(公告)号：US07896870B2

    公开(公告)日：2011-03-01

    申请号：US11768259

    申请日：2007-09-10

    申请人： Steven G. Arless ,  Fredric L. Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    发明人： Steven G. Arless ,  Fredric L. Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    IPC分类号： A61B18/02 ,  A61B18/12 ,  A61B18/18

    CPC分类号： A61B18/02 ,  A61B18/1492 ,  A61B18/18 ,  A61B2017/00243 ,  A61B2018/0212 ,  A61B2018/0268

    摘要： A catheter includes a cryoablation tip with an ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber and have an RF electrode at its distal end. The electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled in combination with an RF treatment regimen to enhance the lesion size, speed or placement of multi-lesion or single lesion cycles. In one embodiment a microwave energy source operates to extend beyond the thermal conduction depth, or penetrate the ice ball and be absorbed in tissue beyond an ice boundary, thus extending a dimension of treatment. Also, the cooling and application of RF energy can be controlled to position the ablation region away from the surface contacted by the electrode thereby leaving surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth.

    摘要翻译： 导管包括具有用于加热组织的消融组件的冷冻消融尖端。 冷冻消融尖端可以用冷却室实现，并且在其远端具有RF电极。 可以操作电极以温热低温冷却的组织，或者可以与RF治疗方案结合控制冷却剂，以增强病变大小，速度或多损伤或单个病变周期的放置。 在一个实施例中，微波能量源的作用是延伸超过热传导深度，或者穿透冰球并被吸收在超过冰界的组织中，从而延伸处理的尺寸。 此外，可以控制RF能量的冷却和施加，以使消融区域远离与电极接触的表面，从而在深度消融时使表面组织不受伤害，或者提供具有更高均匀度的消融带，并且随着深度增加。

    Catheter with cryogenic and electrical heating ablation
    7.
    发明授权
    Catheter with cryogenic and electrical heating ablation 有权
    导管用低温和电加热消融

    公开(公告)号：US07951140B2

    公开(公告)日：2011-05-31

    申请号：US11971582

    申请日：2008-01-09

    申请人： Steven G. Arless ,  Fredric L. Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    发明人： Steven G. Arless ,  Fredric L. Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    IPC分类号： A61B18/02

    CPC分类号： A61B18/02 ,  A61B18/1492 ,  A61B18/18 ,  A61B2017/00243 ,  A61B2018/0212 ,  A61B2018/0268

    摘要： A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen, allowing greater versatility of operation and enhancing the lesion size, speed or placement of multi-lesion treatment or single lesion re-treatment cycles.

    摘要翻译： 导管包括具有用于加热组织的电驱动消融组件的冷冻消融尖端。 冷冻消融尖端可以用冷却室来实现，通过该冷却室可控制地注入的冷却剂循环以降低尖端温度，并且在其远端具有RF电极。 RF电极可以被操作以加热低温冷却的组织，或者可以控制冷却剂以与RF治疗方案协调地导电地冷却组织，从而允许操作的更大的通用性和增强病变大小，速度或放置多病变 治疗或单次病变再治疗周期。

    Catheter with cryogenic and electrical heating ablation
    9.
    发明授权
    Catheter with cryogenic and electrical heating ablation 有权
    导管用低温和电加热消融

    公开(公告)号：US07465300B2

    公开(公告)日：2008-12-16

    申请号：US11219061

    申请日：2005-09-02

    申请人： Steven G. Arless ,  Fredric L. Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    发明人： Steven G. Arless ,  Fredric L. Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    IPC分类号： A61B18/02 ,  A61B18/04

    CPC分类号： A61B18/02 ,  A61B18/1492 ,  A61B18/18 ,  A61B2017/00243 ,  A61B2018/0212 ,  A61B2018/0268

    摘要： A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen, allowing greater versatility of operation and enhancing the lesion size, speed or placement of multi-lesion treatment or single lesion re-treatment cycles. In one embodiment a microwave energy source operates at a frequency to extend beyond the thermal conduction depth, or to penetrate the cryogenic ice ball and be absorbed in tissue beyond an ice boundary, thus extending the depth and/or width of a single treatment locus. In another embodiment, the cooling and the application of RF energy are both controlled to position the ablation region away from the surface contacted by the electrode, for example to leave surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth. The driver or RF energy source may supply microwave energy at a frequency effective to penetrate the ice ball which develops on a cryocatheter, and different frequencies may be selected for preferential absorption in a layer of defined thickness at depth in the nearby tissue. The catheter may operate between 70 and minus 70 degrees Celsius for different tissue applications, such as angioplasty, cardiac ablation and tissue remodeling, and may preset the temperature of the tip or adjacent tissue, and otherwise overlay or delay the two different profiles to tailor the shape or position where ablation occurs or to speed up a treatment cycle.

    摘要翻译： 导管包括具有用于加热组织的电驱动消融组件的冷冻消融尖端。 冷冻消融尖端可以用冷却室来实现，通过该冷却室可控制地注入的冷却剂循环以降低尖端温度，并且在其远端具有RF电极。 RF电极可以被操作以加热低温冷却的组织，或者可以控制冷却剂以与RF治疗方案协调地导电地冷却组织，从而允许操作的更大的通用性和增强病变大小，速度或放置多病变 治疗或单次病变再治疗周期。 在一个实施例中，微波能量源的频率以超出热传导深度的频率运行，或者穿透低温冰球并被吸收在超过冰界的组织中，从而延长单个处理轨迹的深度和/或宽度。 在另一个实施例中，RF能量的冷却和应用都被控制以将消融区域远离与电极接触的表面，例如在深度消融时留下表面组织而不受伤害，或者提供具有更大均匀性的消融带， 增加深度。 驱动器或RF能源可以以有效穿透在低温导管上形成的冰球的频率提供微波能量，并且可以选择不同的频率用于在附近组织的深度处的限定厚度的层中的优先吸收。 对于不同的组织应用（例如血管成形术，心脏消融和组织重建），导管可以在70摄氏度和零下70度之间运行，并且可以预设尖端或相邻组织的温度，否则叠加或延迟两个不同的轮廓以定制 消融发生的形状或位置或加速治疗周期。

    Catheter with cryogenic and heating ablation
    10.
    发明授权
    Catheter with cryogenic and heating ablation 有权
    导管用低温和加热消融

    公开(公告)号：US07097641B1

    公开(公告)日：2006-08-29

    申请号：US09457958

    申请日：1999-12-09

    申请人： Steven G. Arless ,  Frederic L. Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    发明人： Steven G. Arless ,  Frederic L. Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    IPC分类号： A61B18/18

    CPC分类号： A61B18/02 ,  A61B18/1492 ,  A61B18/18 ,  A61B2017/00243 ,  A61B2018/0212 ,  A61B2018/0268

    摘要： A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen, allowing greater versatility of operation and enhancing the lesion size, speed or placement of multi-lesion treatment or single lesion re-treatment cycles. In one embodiment a microwave energy source operates at a frequency to extend beyond the thermal conduction depth, or to penetrate the cryogenic ice ball and be absorbed in tissue beyond an ice boundary, thus extending the depth and/or width of a single treatment locus. In another embodiment, the cooling and the application of RF energy are both controlled to position the ablation region away from the surface contacted by the electrode, for example to leave surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth. The driver or RF energy source may supply microwave energy at a frequency effective to penetrate the ice ball which develops on a cryocatheter, and different frequencies may be selected for preferential absorption in a layer of defined thickness at depth in the nearby tissue. The catheter may operate between 70 and minus 70 degrees Celsius for different tissue applications, such as angioplasty, cardiac ablation and tissue remodeling, and may preset the temperature of the tip or adjacent tissue, and otherwise overlay or delay the two different profiles to tailor the shape or position where ablation occurs or to speed up a treatment cycle.

    摘要翻译： 导管包括具有用于加热组织的电驱动消融组件的冷冻消融尖端。 冷冻消融尖端可以用冷却室来实现，通过该冷却室可控制地注入的冷却剂循环以降低尖端温度，并且在其远端具有RF电极。 RF电极可以被操作以加热低温冷却的组织，或者可以控制冷却剂以与RF治疗方案协调地导电地冷却组织，从而允许操作的更大的通用性和增强病变大小，速度或放置多病变 治疗或单次病变再治疗周期。 在一个实施例中，微波能量源的频率以超出热传导深度的频率运行，或者穿透低温冰球并被吸收在超过冰界的组织中，从而延长单个处理轨迹的深度和/或宽度。 在另一个实施例中，RF能量的冷却和应用都被控制以将消融区域远离与电极接触的表面，例如在深度消融时留下表面组织而不受伤害，或者提供具有更大均匀性的消融带， 增加深度。 驱动器或RF能源可以以有效穿透在低温导管上形成的冰球的频率提供微波能量，并且可以选择不同的频率用于在附近组织的深度处的限定厚度的层中的优先吸收。 对于不同的组织应用（例如血管成形术，心脏消融和组织重建），导管可以在70摄氏度和零下70度之间运行，并且可以预设尖端或相邻组织的温度，否则叠加或延迟两个不同的轮廓以定制 消融发生的形状或位置或加速治疗周期。