公开(公告)号：US4273127A

公开(公告)日：1981-06-16

申请号：US175322

申请日：1980-08-04

申请人： David C. Auth ,  Robert F. Rushmer

发明人： David C. Auth ,  Robert F. Rushmer

IPC分类号： A61B17/32 ,  A61B18/20 ,  A61B18/22 ,  A61B17/36

CPC分类号： A61B17/3211 ,  A61B18/20 ,  A61B18/22 ,  A61B2018/00636

摘要： Laser radiation is coupled to an optical instrument having a relatively narrow working edge from which the radiation is emitted in a relatively narrow zone of intense radiation leakage. The working edge is placed in contact with vascularized tissues, and the laser radiation emanating from the working edge in combination with the contact between the working edge and the tissues forms an incision, and the laser radiation photocoagulates tissue adjacent the incision. The contact between the working edge and the tissues accurately positions the laser radiation with respect to the tissue, places pressure on vessels to aid hemostasis, mechanically stresses the incision line and provides the surgeon with tactile feedback. Radiation propagates from a laser to the optical instrument through a low-loss flexible fiberoptic waveguide by means of multimode optical waveguide propagation. As the radiation reaches the working edge of the optical instrument the radiation is emitted from the instrument because the incident angles of individual modes fall below the critical internal reflection angle of the instrument. Radiation leakage is further increased by the presence of blood on the working edge. The frequency of the laser radiation is selected to achieve a desired penetration depth. Deeper penetration may be necessary under some circumstances to produce a clot of sufficient size to allow adequate coagulation. A power control mounted on the handle of the optical instrument or elsewhere allows the surgeon to adjust the intensity of the radiation.

摘要翻译： 激光辐射耦合到具有相对较窄工作边缘的光学仪器，辐射在相对较窄的强辐射泄漏区域中从该工具边缘发射。 工作边缘与血管化组织接触，并且从工作边缘发出的激光辐射与工作边缘和组织之间的接触结合形成切口，并且激光辐射光凝固切口附近的组织。 工作边缘和组织之间的接触准确地将激光辐射相对于组织定位，在血管上施加压力以帮助止血，机械地强调切口线并向外科医生提供触觉反馈。 辐射通过多模光波导传播通过低损耗柔性光纤波导从激光传播到光学仪器。 当辐射到达光学仪器的工作边缘时，辐射从仪器发射，因为各个模式的入射角度低于仪器的临界内部反射角。 由于工作边缘上存在血液，辐射泄漏进一步增加。 选择激光辐射的频率以实现期望的穿透深度。 在某些情况下可能需要更深的穿透以产生足够尺寸的凝块以允许充分的凝结。 安装在光学仪器的手柄或其他地方的电源控制器允许外科医生调节辐射的强度。

公开(公告)号：US6030380A

公开(公告)日：2000-02-29

申请号：US884058

申请日：1997-06-27

申请人： David C. Auth ,  Thomas J. Clement

发明人： David C. Auth ,  Thomas J. Clement

IPC分类号： A61B17/00 ,  A61B18/14 ,  A61B17/30

CPC分类号： A61B18/1492 ,  A61B2017/00247 ,  A61B2018/00392

摘要： An RF activated catheter apparatus for performing transmyocardial revascularization. The catheter apparatus including an elongate catheter shaft having proximal and distal ends, the distal end including an RF emitter which is coupled to an RF generator for cutting channels into the myocardium of a patient's heart.

摘要翻译： 用于执行经心肌血运重建的RF激活导管装置。 所述导管装置包括具有近端和远端的细长导管轴，所述远端包括RF发射器，其耦合到RF发生器，用于将通道切入患者心脏的心肌。

公开(公告)号：US5769880A

公开(公告)日：1998-06-23

申请号：US632516

申请日：1996-04-12

申请人： Csaba Truckai ,  David C. Auth

发明人： Csaba Truckai ,  David C. Auth

IPC分类号： A61B18/12 ,  A61B17/22 ,  A61B17/42 ,  A61B18/14 ,  A61M1/00 ,  A61M16/04 ,  A61F2/00

CPC分类号： A61B18/1485 ,  A61M16/0481 ,  A61B2017/22051 ,  A61B2017/4216 ,  A61B2018/126 ,  A61B2090/065

摘要： An apparatus and method for use in performing ablation of organs and other tissue includes an electrode carrying member which is substantially absorbent and/or permeable to moisture. The electrode carrying member is mounted to the distal end of an elongate shaft, and an array of electrodes is mounted to the surface of the electrode carrying member. Following placement of the ablation device into contact with the tissue to be ablated, an RF generator is used to deliver RF energy to the electrodes and to thereby induce current flow from the electrodes to tissue to be ablated. As the current heats the tissue, moisture (such as water vapor or liquid) leaves the tissue causing the tissue to dehydrate. The moisture permeability and/or absorbency of the electrode carrying member allows the moisture to leave the ablation site so as to prevent the moisture from providing a path of conductivity for the current.

摘要翻译： 用于进行器官和其他组织的消融的装置和方法包括基本吸收和/或可渗透水分的电极承载构件。 电极承载构件安装到细长轴的远端，并且电极阵列安装到电极承载构件的表面。 在将消融装置放置成与要消融的组织接触之后，使用RF发生器将RF能量递送到电极并且由此感应电流从电极流向要消融的组织。 当电流加热组织时，水分（例如水蒸气或液体）离开组织，导致组织脱水。 电极承载构件的透湿性和/或吸收性允许水分离开消融部位，以防止水分为电流提供导电路径。

公开(公告)号：US4990134A

公开(公告)日：1991-02-05

申请号：US378741

申请日：1989-07-11

申请人： David C. Auth

发明人： David C. Auth

IPC分类号： A61B17/22 ,  A61B17/32

CPC分类号： A61B17/320758 ,  A61B17/22031 ,  A61B2017/320004

摘要： An abrasive tipped rotating cutting tool for use in removing abnormal deposits within a patient's vessels is described. The tip is preferably covered with a material such as diamond grit, and rotated at high speed to pulverize any abnormal deposits contained within the vessel.In a preferred embodiment of the invention, the tip is ellipsoidal in shape, and the coarseness of the abrasive material on the tip is varied from most coarse adjacent the distal end of the tip to finest adjacent the portion of the tip which has the widest diameter. Preferably, there is no abrasive on the widest part of the tip in order to prevent the tip from injuring a patient's vessel in the event that the tip is allowed to remain in one place for an extended period of time. In addition, there may be radial openings formed in the tip which permit water to be pumped therethrough in order to act as a lubricant for assisting in the cutting action of the tip.The invention may use either an autraumatic tip or a preformable guide wire to guide the cutting tip through a patient's vessel.

摘要翻译： 描述了一种用于去除患者血管内的异常沉积物的磨料旋转切削工具。 尖端优选用诸如金刚石砂粒的材料覆盖，并高速旋转以粉碎容器内所含的任何异常沉积物。 在本发明的优选实施例中，尖端是椭圆形的，并且尖端上的研磨材料的粗糙度从邻近尖端的远端的最粗糙度变化到邻近尖端部分具有最宽直径的部分 。 优选地，在尖端的最宽部分上没有研磨剂，以便在尖端被允许在一个地方长时间保持的情况下防止尖端损伤患者的血管。 此外，在尖端中可能存在径向开口，其允许水被泵送通过其中，以用作辅助尖端的切割动作的润滑剂。 本发明可以使用自体创伤的尖端或预先形成的导丝来引导切割尖端通过患者的血管。

公开(公告)号：US4691703A

公开(公告)日：1987-09-08

申请号：US856573

申请日：1986-04-25

申请人： David C. Auth ,  Dale M. Lawrence ,  Tim R. Majoch

发明人： David C. Auth ,  Dale M. Lawrence ,  Tim R. Majoch

IPC分类号： A61B17/00 ,  A61B18/08 ,  A61B17/36

CPC分类号： A61B18/08 ,  A61B2017/00128 ,  A61B2018/087

摘要： A thermal cautery system having an endoscopically deliverable probe connected to a power supply and display unit. The power supply and display unit, when triggered by a footswitch, energizes a voltage regulator having a current limited output that supplies power to the probe. The current limiting function of the voltage regulator is disabled for a predetermined period that power is initially applied to said probe to minimize the heating time of said probe. The current through said probe is sensed and used to increase the voltage at the output of the voltage regulator as the current increases to compensate for the voltage drop in the conductors connecting the probe to the power supply. A manually selected portion of the sensed current through the probe is also integrated and used to terminate the flow of current through the probe when the integral of the current with respect to time has reached a predetermined value. A tone generator provides an audible indication when power is being applied to the probe and for a predetermined period thereafter to allow the probe to cool before the absence of the tone signals the removal of the probe from tissue being coagulated. The probe is heated by current flowing through an internal diode having a predetermined breakdown voltage at a predetermined temperature. The temperature of the probe is self-regulated by applying a voltage to the probe that is substantially equal to said predetermined voltage so that the current through the probe is reduced at said predetermined temperature.

摘要翻译： 一种具有连接到电源和显示单元的内窥镜可传送探头的热灼烧系统。 电源和显示单元在由脚踏开关触发时，为具有电流限制输出的电压调节器供电，为探头供电。 电压调节器的电流限制功能在最初施加到所述探针的预定时段被禁用，以最小化所述探针的加热时间。 通过所述探头的电流被感测并用于在电流增加时增加电压调节器输出端的电压，以补偿将探头连接到电源的导体中的电压降。 当电流相对于时间的积分达到预定值时，通过探头的感测电流的手动选择部分也被整合并用于终止通过探针的电流流动。 当电源被施加到探针上时，音调发生器提供可听见的指示，并且在此之后的预定时间段期间，在不存在音调信号之前使探针冷却，使得探针从被凝固的组织中移除。 通过流过预定击穿电压的内部二极管的电流在预定温度下对探头进行加热。 通过向探针施加基本上等于所述预定电压的电压来自动调节探针的温度，使得通过探针的电流在所述预定温度下降低。

公开(公告)号：US4449528A

公开(公告)日：1984-05-22

申请号：US285366

申请日：1981-07-20

申请人： David C. Auth ,  Dale M. Lawrence ,  Tim R. Majoch

发明人： David C. Auth ,  Dale M. Lawrence ,  Tim R. Majoch

IPC分类号： A61B17/32 ,  A61B18/00 ,  A61B18/08 ,  A61B18/14 ,  A61B17/36

CPC分类号： A61B18/08 ,  A61B18/082 ,  A61B17/3203 ,  A61B18/1492 ,  A61B2018/00404 ,  A61B2018/00761 ,  A61B2018/0097 ,  A61B2018/087

摘要： A miniaturized, endoscopically deliverable thermal cautery probe for cauterizing internal vessels. The probe is applied to tissues cold, and a large number of electric heating pulses of equal energy are then applied to an internal heating element in the probe. The probe has an internal heating element in direct thermal contact with an active heat-transfer portion that has a low heat capacity to insure quick heating and subsequent cooling, thereby adequately coagulating tissue while minimizing heat penetration and resulting tissue damage. The electrical power applied to the probe is continuously measured and is terminated when the energy delivered reaches a preset value. The number of such pulses applied to the probe (and hence the total energy delivered) may be preset while the duration of the period during which the pulses were applied is displayed. Alternatively, the duration of the period during which such pulses are applied to the probe may be preset while the number of pulses applied (and hence the total energy delivered) is displayed. The heating element for the probe is a controlled breakdown diode which has a breakdown voltage that is a function of its temperature so that the temperature can be controlled. The heating element has a resistance of greater than 0.5 ohm to provide adequate power dissipation with relatively low currents. A washing fluid, preferably flowing along the outside of the probe toward its tip, cleans blood from the tissue to be coagulated to make the source of blood more readily visible.

摘要翻译： 用于烧灼内部血管的小型化，内窥镜可输送的热灼烧探头。 将探针施加到组织冷，然后将大量相等能量的电加热脉冲施加到探针中的内部加热元件。 探针具有与主动传热部分直接热接触的内部加热元件，其具有低热容量以确保快速加热和随后的冷却，从而充分凝固组织，同时最小化热穿透并导致组织损伤。 连续测量施加到探头的电力，并且当所传送的能量达到预设值时终止。 施加到探针的这种脉冲的数量（并且因此传送的总能量）可以被预设，同时显示施加脉冲的周期的持续时间。 或者，可以在施加脉冲的数量（并且因此传送的总能量）的情况下预设这种脉冲施加到探针的期间的持续时间。 用于探针的加热元件是受控击穿二极管，其具有作为其温度的函数的击穿电压，从而可以控制温度。 加热元件具有大于0.5欧姆的电阻，以相对较低的电流提供足够的功率消耗。 洗涤液优选地沿着探针的外侧向其尖端流动，从待凝结的组织中清除血液，使得血液源更容易可见。

公开(公告)号：US5827229A

公开(公告)日：1998-10-27

申请号：US449203

申请日：1995-05-24

申请人： David C. Auth ,  Lucas S. Gordon ,  Lauri J. DeVore

发明人： David C. Auth ,  Lucas S. Gordon ,  Lauri J. DeVore

IPC分类号： A61B17/22 ,  A61M1/00 ,  A61M25/00 ,  A61M29/02 ,  A61M5/00

CPC分类号： A61M25/0068 ,  A61B17/22 ,  A61M25/0082 ,  A61B17/22031 ,  A61B2017/22039 ,  A61B2217/005 ,  A61M2025/0183 ,  A61M25/0029 ,  A61M25/0032

摘要： An improved system for removing thrombus from blood vessels comprising a catheter shaft having proximal and distal ends, designed to be advanced through a hemostasis valve and guide catheter and over a guidewire for placement of its distal end at a point proximal to a thrombus, the catheter shaft defining at least one longitudinally-extending lumen, the catheter having a guidewire retainer which retains the guidewire within the catheter in a peripheral or non-centered part of the catheter cross-section, the distal tip of the catheter being angled back from the guidewire retainer to allow the catheter to follow the guidewire around tight bends and across restrictions easily; a suction device in fluid communication with the proximal end of the catheter for providing vacuum down the catheter lumen to the distal tip, for drawing thrombus into the lumen; and the lumen terminating in an angled tip at the distal end, the angled tip improving the removal of thrombus adhering to the vessel wall and reducing clogging of the hole with thrombus.

摘要翻译： 一种用于从血管中去除血栓的改进系统，包括具有近端和远端的导管轴，设计成通过止血阀和引导导管并在导线上方延伸，用于将其远端放置在靠近血栓的点处，导管 所述导管限定至少一个纵向延伸的内腔，所述导管具有导丝保持器，所述导丝保持器将所述导丝保持在所述导管横截面的周边或非中心部分内，所述导管的远端从所述导丝 保持器以允许导管沿着紧线弯曲并且容易地跨越限制; 与所述导管的近端流体连通的抽吸装置，用于将所述导管内腔提供给所述远侧末端的真空，用于将血栓吸入所述内腔中; 并且在远端终止于倾斜尖端的内腔，倾斜的尖端改善了粘附到血管壁上的血栓的移除并减少了孔与血栓的堵塞。

公开(公告)号：US5364393A

公开(公告)日：1994-11-15

申请号：US175943

申请日：1993-12-30

申请人： David C. Auth ,  Thomas J. Clement ,  Michael J. Intlekofer

发明人： David C. Auth ,  Thomas J. Clement ,  Michael J. Intlekofer

IPC分类号： A61B17/00 ,  A61B17/22 ,  A61B18/00 ,  A61B18/14 ,  A61B17/39

CPC分类号： A61B18/1492 ,  A61B17/22 ,  A61B2017/00292 ,  A61B2017/22044 ,  A61B2017/22094 ,  A61B2018/00196 ,  A61B2018/00345 ,  A61B2018/0041 ,  A61B2018/00422 ,  A61B2018/1417 ,  A61B2018/144 ,  A61B2018/1475 ,  A61M2205/32

摘要： The invention relates to an RF-activated guidewire to electrosurgically pass through occlusive material to allow the use of other vescular therapeutic devices to traverse the guidewire through the occlusive material. More particularly, the invention relates to a catheter system for penetrating occulsive tissue in an arterial lumen, comprising:a substantially tubular sheath means;an electrically conductive guidewire, said guidewire having an electrosurgical tip and passing through said sheath means; anda voltage generating means electrically connected to said electrically conductive guidewire to activate said electrosurgical tip.

摘要翻译： 本发明涉及一种射频激活的导丝，用于电外科手术通过闭塞性材料，以允许使用其他囊状治疗装置穿过闭塞性材料穿过导丝。 更具体地，本发明涉及一种用于穿透动脉腔中的囊状组织的导管系统，包括：基本上管状的护套装置; 导电导丝，所述导丝具有电外科尖端并穿过所述护套装置; 以及电连接到所述导电导丝以激活所述电外科尖端的电压产生装置。

公开(公告)号：US5314407A

公开(公告)日：1994-05-24

申请号：US917923

申请日：1992-07-21

申请人： David C. Auth ,  Michael J. Intlekofer ,  Michael W. Slota ,  John S. Hinchcliffe ,  Thomas J. Clement

发明人： David C. Auth ,  Michael J. Intlekofer ,  Michael W. Slota ,  John S. Hinchcliffe ,  Thomas J. Clement

IPC分类号： A61B17/22

CPC分类号： A61B17/320758

摘要： The present invention is a clinically practical, rotational angioplasty system which employs a unique rotary ablative device for mechanically abrading, and thereby removing, lesions from within a patient's vessels. The device has a gas driven prime mover connected, via a hollow helical drive assembly, to an ellipsoidal, rotating, ablative burr which is used for the actual recanalization of the patient's vessel. The burr is provided with a central opening therethrough, which, together with the hollow drive assembly, permits the burr and drive assembly to be threaded over a guide wire similar to the type conventionally used in a catheterization procedure. The drive assembly is located within a hollow sheath which prevents the rotating drive assembly from contacting the inner walls of a patient's vessel.

摘要翻译： 本发明是一种临床实用的旋转血管成形术系统，其采用独特的旋转烧蚀装置，用于机械研磨，从而从病人血管内去除病变。 该装置具有通过中空螺旋驱动组件连接到用于患者血管的实际再通的椭圆形，旋转，烧蚀性毛刺的气体驱动原动机。 毛刺具有穿过其的中心开口，该中心开口与中空驱动组件一起允许毛刺和驱动组件穿过类似于在导管插入程序中常规使用的类型的导丝。 驱动组件位于中空护套内，防止旋转驱动组件接触患者血管的内壁。

公开(公告)号：US4829999A

公开(公告)日：1989-05-16

申请号：US74808

申请日：1987-07-17

申请人： David C. Auth

发明人： David C. Auth

IPC分类号： A61B19/00 ,  A61M25/01 ,  A61M25/02 ,  A61M25/08

CPC分类号： A61M25/09041 ,  A61M25/013 ,  Y10T24/39

摘要： The guidewire gripping device is usable in connection with guidewires of the type used in medical application, i.e., for guiding catheters. The guidewire gripping device is constructed from a spring loaded, slitted cylindrical body.

摘要翻译： 导线夹持装置可用于医疗应用中使用的类型的导线，即用于引导导管。 导丝夹持装置由弹簧加载的切割圆柱体构成。