摘要:
An endocardial ablation and mapping apparatus is introduced into a heart chamber for mapping to detect arrhythmogenic foci, and ablate endocardium at the arrhythmogenic foci. An inflatable, flexible porous membrane is adapted to receive an electrolytic solution, and become inflated to substantially conform a conductive surface of the membrane to the wall of the heart chamber. A membrane support is surrounded by the membrane, and includes a sealed proximal end and a sealed distal end. Each end has an aperture formed therein defining a central lumen in the membrane support that permits blood flow through the support member and the heart chamber. The membrane support is attached to the membrane and is expanded to a non-distensible state when the membrane is inflated. A catheter, with a distal end, is attached to the membrane or the membrane support. The membrane and membrane support are introduced into the heart chamber by the catheter in a non-expanded state, and become expanded to an expanded state by inflating the membrane with the electrolytic solution. A plurality of treatment electrodes, defining a circuit, are formed on an exterior surface of the membrane support. An RF power source is coupled to the treatment electrodes, and a source of electrolytic solution is coupled to the membrane.
摘要:
A transurethral needle ablation device for the treatment of the prostate of a human male using radio frequency energy wall comprising a sheath having a lumen extending therethrough. A guide tube assembly is slidably mounted in the lumen in the sheath and having a lumen extending therethrough. A needle electrode is slidably mounted in the lumen in the guide tube assembly. An insulating sheath is disposed about the needle electrode so that the distal extremity of the needle electrode is exposed. A handle adapted to be gripped by the human hand is mounted on the proximal extremity of the sheath. Levers are carried by the handle for causing bending of the distal extremity of the guide tube assembly at an angle with respect to its longitudinal axis whereby the lumen in the guide tube assembly can be directed so that it faces the urethral wall. A control is carried by the handle and coupled to the needle electrode and the insulating sleeve for advancing and retracting the needle electrode with respect to the guide tube assembly whereby when the sheath is positioned in the urethra with its distal extremity in the vicinity of the prostate, the needle electrode can be advanced through the urethral wall and into the tissue of the prostate to permit the application of radio frequency energy to the tissue of the prostate surrounding the needle electrode to form a lesion in the prostate.
摘要:
According to the present invention, an anastomosis catheter with internally mounted cam pieces holding a plurality of curved needles adjacent apertures in the side of the catheter is provided. The curved needles are attached to lengths of suture material which are installed to run along the outer surface of the central cam pieces to their distal end, where they reverse back along the inner core of the catheter. When the central cam pieces are withdrawn, and moved proximally, the cam surface forces the curved needles out the associated apertures. As the catheter is deployed in a hollow organ, such as a human urethra, the curved needles, as they are deployed, grasp the end of the urethra, which then can be held in position for suturing to the bladder. The other end of the suture materials could have straight needles attached to them to facilitate attaching the urethra to the bladder.
摘要:
A method and an apparatus is disclosed for delivering controlled heat to perform ablation to treat the benign prosthetic hypertrophy or hyperplasia (BPH). According to the method and the apparatus, the energy is transferred directly into the tissue mass which is to be treated in such a manner as to provide tissue ablation without damage to surrounding tissues. Automatic shut-off occurs when any one of a number of surrounding areas to include the urethra or surrounding mass or the adjacent organs exceed predetermined safe temperature limits. The constant application of the radio frequency energy over a maintained determined time provides a safe procedure which avoids electrosurgical and other invasive operations while providing fast relief to BPH with a short recovery time. The procedure may be accomplished in a doctor's office without the need for hospitalization or surgery.
摘要:
An RF treatment apparatus provides multi-modality treatment for tumors and other desired tissue masses, and includes an RF indifferent electrode and an RF active electrode. The RF indifferent electrode has a compacted, non-deployed state, and an expanded deployed state. In the deployed state, the RF indifferent electrode forms a helical structure with four or less coils that surround an exterior of the tumor. The indifferent electrode becomes a microwave antenna when it is coupled to a microwave source. RF ablation energy is delivered to the tumor by the RF active electrode after it has been introduced into the tumor. Both electrodes are coupled to an RF energy source. The indifferent electrode is coupled to a microwave source. Either or both of the electrodes is hollow and include fluid distribution ports for the purpose of providing a chemotherapeutic agent to the tumor site. Ablation energy is supplied to the tumor by the active electrode. The RF indifferent electrode then is switched and becomes a microwave antenna, providing hyperthermia to the tumor and surrounding area. Thereafter, a chemotherapeutic agent is supplied to the tumor site.
摘要:
A medical probe device including a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and guide means for directing a flexible stylet outward through the stylet port and through intervening tissue to a target tissue. The catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radio frequency electrode. In normal action, the stylet and its surrounding sleeve are deployed out from the stylet port in the catheter into the desired target tissue. A sharpened tip on the stylet electrode facilitates the penetration of the intervening tissue, such as a urethra. If, however, the stylet is deployed into a dense or fibrous area of tissue or into an area of scar tissue in the urethra, the sharpened tip of the stylet might not immediately penetrate the urethra wall until sufficient pressure is applied to the stylet. By heating the stylet prior to extension of the stylet from the stylet port in the catheter, the passage of the stylet through the intervening tissue is facilitated. Once the stylet is in position in the target tissue, the normal operation of the stylet in emitting electromagnetic current for tissue ablation is commenced.
摘要:
A method of this invention for treating body tissues containing cancerous cells or non-malignant tumors with RF ablation, alone or in combination with systemic or localized chemotherapy comprising introducing a stylet comprising an electrode surface and a sleeve longitudinally moveable thereon into the vicinity of the body tissues, retracting the sleeve from a portion of the electrode surface, and supplying RF power to the electrode surface sufficient to heat the tissue to a temperature of above about 45.degree. C. for a time to cause reduction of tissue mass in the vicinity of the electrode. The RF power supplied to the electrode surface is sufficient to effect a desiccated fluid diffusion barrier capsule surrounding the body tissue being treated. The stylet can include a hollow tube having fluid distribution ports therein, and the method can include the step of passing fluid through one or more distribution ports into the body tissue being treated. The fluid can be saline or a chemotherapeutic fluid such as liquid or gas containing a cytotoxic agent, for example. The fluid can be administered in a variety of procedures. The fluid can be passed through a distribution port into the body tissue before, during and/or after the RF power is supplied to the electrode surface, for example. Preferably, the fluid is introduced after a barrier capsule has been formed. The devices comprises electrodes having a hollow core and a closed sharpened distal tip. The electrode has a plurality of fluid distribution ports therein for distribution of fluid treatment agents into the tissue.
摘要:
A medical probe device comprising a catheter having a stylet guide housing with at least one stylet port in a side thereof and stylet guide means for directing a flexible stylet outward through at least one stylet port and through intervening tissue to targeted tissues. The stylet guide housing has an optical viewing means positioned for viewing the stylet and adjacent structure which includes a fiber optic channel means for receiving a fiber optic viewing device. The fiber optic channel means can include a guide port means for directing longitudinal movement of a fiber optic device with respect to the stylet guide means in a viewing zone and a flushing liquid channel in the stylet guide housing having an exit port positioned to direct flushing liquid issuing therefrom across the end of a fiber optic device when positioned in the viewing zone. The optical viewing means can comprise a viewing window positioned in the stylet guide housing for viewing the stylet when it is directed outward from its respective stylet port. The optical viewing means can include a fiber optic channel in the stylet guide housing for receiving the a fiber optic viewing device and aligning the viewing end thereof with the viewing window. Windowed devices can include a flushing liquid channel in the stylet guide housing having an exit port positioned to direct flushing liquid issuing therefrom across a surface of the viewing window.
摘要:
A medical probe device comprises a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a stylet guide for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue. The total catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radiofrequency electrode. Preferably, the non-conductive layer is a sleeve which is axially moveable on the electrical conductor to expose a selected portion of the electrical conductor surface in the target tissue. The stylet can also be a microwave antenna. The stylet can also be a hollow tube for delivering treatment fluid to the target tissue. It can also include a fiber optic cable for laser treatment. The catheter can include one or more inflatable balloons located adjacent to the stylet port for anchoring the catheter or dilation. Ultrasound transponders and temperature sensors can be attached to the probe end and/or stylet. The stylet guide can define a stylet path from an axial orientation in the catheter through a curved portion to a lateral orientation at the stylet port.
摘要:
An angioplasty catheter system is disclosed which allows insertion and removal of a guidewire through the inner member of the catheter, yet which inner member includes a portion which is smaller than the cross-section of portions of the guidewire. Advancement and removal of the guidewire are achieved by forming the first portion of the inner member of the catheter shaft from material which is expandable, or which is sufficiently thin to be folded and temporarily secured in place using several techniques.