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    Catheter systems and methods for crossing vascular occlusions
    1.
    发明申请
    Catheter systems and methods for crossing vascular occlusions 有权
    导管系统和交叉血管闭塞的方法

    公开(公告)号：US20050021002A1

    公开(公告)日：2005-01-27

    申请号：US10865231

    申请日：2004-06-10

    申请人： Robert Deckman ,  Erik Thai ,  Amiel Aguilar ,  Benjamin Clark ,  Sergio Salinas ,  Daniel Francis ,  Kurt Sparks

    发明人： Robert Deckman ,  Erik Thai ,  Amiel Aguilar ,  Benjamin Clark ,  Sergio Salinas ,  Daniel Francis ,  Kurt Sparks

    IPC分类号： A61M25/00 ,  A61M25/06

    CPC分类号： A61M25/0662 ,  A61B2017/22042 ,  A61B2017/22094 ,  A61M25/0045 ,  A61M25/005 ,  A61M2025/0681 ,  A61M2025/0687

    摘要： Interventional catheter-based systems and methods are described herein for use in generating an initial pathway through vascular occlusions. The catheter systems generally include two elements. A first element is a Blunt Dissection Catheter including a manually actuated assembly located at the distal tip of the Blunt Dissection Catheter that performs blunt dissection in the vascular occlusion to produce a dissection track, or small pathway through the occlusion. The second element is a Sheath Catheter that serves as a conduit within which the Blunt Dissection Catheter is freely advanced, retracted and rotated. The first and second elements are used in some combination to cross vascular occlusions in both the coronary and peripheral vasculature.

    摘要翻译： 本文描述介入性导管基系统和方法用于通过血管闭塞产生初始途径。 导管系统通常包括两个元件。 第一个要素是平坦解剖导管，其包括位于钝性解剖导管的远端的手动致动组件，其在血管闭塞中进行钝性解剖以产生解剖轨迹，或通过闭塞的小通路。 第二个要素是鞘鞘导管，用作导管，平头解剖导管可自由前进，缩回和旋转。 第一和第二元素被用于某种组合以在冠状动脉和外周脉管系统中交叉血管闭塞。

    Catheter system for crossing total occlusions in vasculature
    4.
    发明申请
    Catheter system for crossing total occlusions in vasculature 审中-公开
    用于穿过脉管系统中的全部闭塞的导管系统

    公开(公告)号：US20050171478A1

    公开(公告)日：2005-08-04

    申请号：US10823416

    申请日：2004-04-12

    申请人： Matthew Selmon ,  Kurt Sparks ,  Ray Betelia ,  Ben Clark ,  Jason Kaiser ,  Rob Deckman ,  Erik Thai

    发明人： Matthew Selmon ,  Kurt Sparks ,  Ray Betelia ,  Ben Clark ,  Jason Kaiser ,  Rob Deckman ,  Erik Thai

    IPC分类号： A61B17/00 ,  A61B17/22 ,  A61B19/00 ,  A61M25/01 ,  A61M5/178

    CPC分类号： A61B17/3207 ,  A61B2017/00247 ,  A61B2017/00252 ,  A61B2017/003 ,  A61B2017/22044 ,  A61B2017/22077 ,  A61B2017/22095 ,  A61B2018/00392 ,  A61B2090/3925 ,  A61M25/01 ,  A61M2025/0096

    摘要： Medical devices/methods are described that include catheter systems for crossing total occlusions in vasculature. The catheter systems are for use with numerous guide wires to direct the wires from the extraluminal or subintimal space back into a blood vessel lumen after the wire has entered the subintimal space. The catheter systems comprise a catheter body having at least one lumen configured to track over a wire. An endpiece that includes at least one port in communication with the lumen couples to the distal region of the catheter body. A working element is configured to deploy through the port for delivery from a location within the extraluminal space to locations within the vessel true lumen when advanced distally through the port. A distal region of the catheter body assumes first or second configurations when the working element is retracted into the catheter body.

    摘要翻译： 描述了医疗装置/方法，其包括用于在血管系统中穿过全闭塞的导管系统。 导管系统用于许多引导线，以在导线进入子膜内空间之后将电线从管腔内或内膜下空间引导回血管腔。 所述导管系统包括具有至少一个内腔的导管主体，所述至少一个腔被配置为在线上跟踪。 包括与腔内连通的至少一个端口的端件与导管主体的远端区域联接。 工作元件被配置为通过端口部署以从远离外部空间的位置传送到远端通过端口向前延伸到容器真腔内的位置。 当工作元件缩回到导管主体中时，导管主体的远侧区域呈现第一或第二构造。

    Methods and apparatus for pulsed electric field neuromodulation via an intra-to-extravascular approach
    6.
    发明申请
    Methods and apparatus for pulsed electric field neuromodulation via an intra-to-extravascular approach 有权
    通过血管内血管内途径进行脉冲电场神经调节的方法和装置

    公开(公告)号：US20070203549A1

    公开(公告)日：2007-08-30

    申请号：US11363867

    申请日：2006-02-27

    申请人： Denise Demarais ,  Benjamin Clark ,  Nicolas Zadno ,  Erik Thai ,  Hanson Gifford

    发明人： Denise Demarais ,  Benjamin Clark ,  Nicolas Zadno ,  Erik Thai ,  Hanson Gifford

    IPC分类号： A61N1/32

    CPC分类号： A61B18/1477 ,  A61B18/1206 ,  A61B2018/0022 ,  A61B2018/00267 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00613 ,  A61B2018/126 ,  A61M5/14 ,  A61M37/00 ,  A61N1/05 ,  A61N1/0514 ,  A61N1/0551 ,  A61N1/321 ,  A61N1/327 ,  A61N1/36007

    摘要： Methods and apparatus are provided for pulsed electric field neuromodulation via an intra-to-extravascular approach, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation and other conditions in target neural fibers. In some embodiments, the ITEV PEF system comprises an intravascular catheter having one or more electrodes configured for intra-to-extravascular placement across a wall of patient's vessel into proximity with target neural fibers. With the electrode(s) passing from an intravascular position to an extravascular position prior to delivery of the PEF, a magnitude of applied voltage or energy delivered via the electrode(s) and necessary to achieve desired neuromodulation may be reduced relative to an intravascular PEF system having one or more electrodes positioned solely intravascularly. The methods and apparatus of the present invention may, for example, be used to modulate one or more target neural fibers that contribute to renal function.

    摘要翻译： 提供了通过血管外途径进行脉冲电场神经调节的方法和装置，例如，以实现不可逆的电穿孔或电融合，坏死和/或诱导细胞凋亡，基因表达的改变，细胞因子上调的变化以及目标中的其他条件 神经纤维。 在一些实施方案中，ITEV PEF系统包括具有一个或多个电极的血管内导管，其配置用于穿过患者血管的壁进行血管外放置，使其与目标神经纤维接近。 随着电极在PEF递送之前从血管内位置传递到血管外位置，可以相对于血管内PEF减少施加的电压或通过电极传递并且达到所需神经调节所必需的能量的大小 系统具有仅位于血管内的一个或多个电极。 本发明的方法和装置可以例如用于调节一种或多种有助于肾功能的靶神经纤维。

    Methods and apparatus for intravascularly-induced neuromodulation
    7.
    发明申请
    Methods and apparatus for intravascularly-induced neuromodulation 有权
    血管内诱导神经调节的方法和装置

    公开(公告)号：US20060142801A1

    公开(公告)日：2006-06-29

    申请号：US11266993

    申请日：2005-11-04

    申请人： Denise Demarais ,  Nicolas Zadno ,  Benjamin Clark ,  Erik Thai

    发明人： Denise Demarais ,  Nicolas Zadno ,  Benjamin Clark ,  Erik Thai

    IPC分类号： A61N1/00

    CPC分类号： A61B18/1492 ,  A61B17/12136 ,  A61B2018/00083 ,  A61B2018/00285 ,  A61B2018/00434 ,  A61B2018/00613 ,  A61M25/0108 ,  A61M25/10 ,  A61N1/327 ,  A61N1/36007 ,  A61N1/36121 ,  A61N1/36182 ,  A61N1/37205 ,  A61N1/40

    摘要： Methods and apparatus are provided for intravascularly-induced neuromodulation using a pulsed electric field, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation, etc., in target neural fibers. In some embodiments, the intravascular PEF system comprises a catheter having a pair of bipolar electrodes for delivering the PEF, with a first electrode positioned on a first side of an impedance-altering element and a second electrode positioned on an opposing side of the impedance-altering element. A length of the electrodes, as well as a separation distance between the first and second electrodes, may be specified such that, with the impedance-altering element deployed in a manner that locally increases impedance within a patient's vessel, e.g., with the impedance-altering element deployed into contact with the vessel wall at a treatment site within the patient's vasculature, a magnitude of applied voltage delivered across the bipolar electrodes necessary to achieve desired neuromodulation is reduced relative to an intravascular PEF system having similarly spaced electrodes but no (or an undeployed) impedance-altering element. In a preferred embodiment, the impedance-altering element comprises an inflatable balloon configured to locally increase impedance within a patient's vasculature. The methods and apparatus of the present invention may be used to modulate a neural fiber that contributes to renal function.

    摘要翻译： 提供了使用脉冲电场进行血管内诱导的神经调节的方法和装置，例如，在靶神经纤维中实现不可逆的电穿孔或电融合，坏死和/或诱导细胞凋亡，基因表达的改变，细胞因子上调的变化等 。 在一些实施例中，血管内PEF系统包括导管，其具有用于传送PEF的一对双极电极，第一电极位于阻抗改变元件的第一侧上，第二电极位于阻抗变换元件的相对侧上， 改变元素 可以规定电极的长度以及第一和第二电极之间的间隔距离，使得以阻抗变化元件部署的方式，其局部地增加患者血管内的阻抗，例如阻抗 - 改变元件被部署成与病人血管系统中的治疗部位处的血管壁接触，相对于具有类似间隔开的电极而没有（或一个或多个）的血管内PEF系统，减少了实现所需神经调节所需双极电极的施加电压的大小 未部署）阻抗变化元件。 在优选实施例中，阻抗改变元件包括构造成在患者的脉管系统内局部增加阻抗的可充气球囊。 本发明的方法和装置可用于调节有助于肾功能的神经纤维。