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公开(公告)号：US08998933B2
公开(公告)日：2015-04-07
申请号：US12039629
申请日：2008-02-28
申请人： Paul T. Rothstein , Cynthia T. Clague , Michael M. Green , Damian A. Jelich , Eric A. Meyer , Mark T. Stewart , Chris M. Coppin , Rany Huynh , Mark W. Torrianni , Asha S. Nayak , John R. Liddicoat , Timothy G. Laske
发明人： Paul T. Rothstein , Cynthia T. Clague , Michael M. Green , Damian A. Jelich , Eric A. Meyer , Mark T. Stewart , Chris M. Coppin , Rany Huynh , Mark W. Torrianni , Asha S. Nayak , John R. Liddicoat , Timothy G. Laske
IPC分类号： A61B17/10 , A61B17/00 , A61B17/064 , A61B17/08
CPC分类号： A61B17/0057 , A61B17/068 , A61B2017/00243 , A61B2017/00575 , A61B2017/00623 , A61B2017/00867 , A61B2017/0649 , A61B2017/081
摘要： A surgical fastener clip for proximating tissue, the clip providing an undeflected state in which the clip comprises a center portion, a first leg, and a second leg. The center portion has a perimeter defining a circle-like shape. The legs project outwardly relative to the perimeter from a point of departure to a tip. Extension of each of the legs relative to the perimeter defines an identical wind direction that is either clockwise or counterclockwise. The clip optionally includes a linear cross-member extending across the perimeter. The surgical clip can be formed by a wire that is partially wound onto itself in a spiral-like fashion, with the center portion and the legs being co-planar in the undeflected state. During use, the clip is rotated, drawing tissue into the center portion. Systems incorporating the clip are also provided.
摘要翻译： 一种用于接近组织的手术紧固夹，所述夹提供未偏转状态，其中所述夹包括中心部分，第一腿部和第二腿部。 中心部分具有限定圆形形状的周长。 腿从出发点到尖端相对于周边向外突出。 每个腿相对于周边的延伸限定了顺时针或逆时针方向相同的风向。 夹子可选地包括跨越周边延伸的线性横向构件。 手术夹可以由线形成，该线以螺旋状的方式部分地缠绕在自身上，其中心部分和腿在非偏转状态下是共面的。 在使用过程中，夹子旋转，将纸巾拉入中心部分。 还提供了结合夹子的系统。
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公开(公告)号：US20140018791A1
公开(公告)日：2014-01-16
申请号：US14028676
申请日：2013-09-17
IPC分类号： A61B18/14
CPC分类号： A61B18/1492 , A61B2018/00357 , A61B2018/00577 , A61B2018/00678 , A61B2018/00702 , A61B2018/00875
摘要： A method of applying ablation energy to achieve transmurality including applying ablation energy at a starting power to a tissue site and monitoring the impedance of the tissue site. A power applied to the tissue site can be reduced as a function of a rate of an increase in impedance according to some embodiments.
摘要翻译： 一种施加消融能量以实现透视性的方法，包括以起始功率对组织部位施加消融能量并监测组织部位的阻抗。 根据一些实施例，施加到组织部位的功率可以根据阻抗增加的速率而减小。
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公开(公告)号：US20130072926A1
公开(公告)日：2013-03-21
申请号：US13585477
申请日：2012-08-14
IPC分类号： A61B18/12
CPC分类号： A61B18/1206 , A61B5/053 , A61B5/7203 , A61B18/14 , A61B18/1442 , A61B2017/00092 , A61B2018/0016 , A61B2018/00351 , A61B2018/00363 , A61B2018/00577 , A61B2018/00666 , A61B2018/00678 , A61B2018/00702 , A61B2018/00708 , A61B2018/00761 , A61B2018/00791 , A61B2018/00875 , A61B2018/00886 , A61B2018/1467 , A61B2218/002
摘要： A method of applying ablation energy to achieve transmurality including applying ablation energy at a starting power to a tissue site and monitoring the impedance of the tissue site. A power applied to the tissue site can be reduced as a function of a rate of an increase in impedance according to some embodiments.
摘要翻译： 一种施加消融能量以实现透视性的方法，包括以起始功率对组织部位施加消融能量并监测组织部位的阻抗。 根据一些实施例，施加到组织部位的功率可以根据阻抗增加的速率而减小。
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公开(公告)号：US08241275B2
公开(公告)日：2012-08-14
申请号：US13117690
申请日：2011-05-27
IPC分类号： A61B18/18
CPC分类号： A61B18/1206 , A61B5/053 , A61B5/7203 , A61B18/14 , A61B18/1442 , A61B2017/00092 , A61B2018/0016 , A61B2018/00351 , A61B2018/00363 , A61B2018/00577 , A61B2018/00666 , A61B2018/00678 , A61B2018/00702 , A61B2018/00708 , A61B2018/00761 , A61B2018/00791 , A61B2018/00875 , A61B2018/00886 , A61B2018/1467 , A61B2218/002
摘要： A method of applying ablation energy to achieve transmurality including applying ablation energy at a starting power to a tissue site and monitoring the impedance of the tissue site. A power applied to the tissue site can be reduced as a function of a rate of an increase in impedance according to some embodiments.
摘要翻译： 一种施加消融能量以实现透视性的方法，包括以起始功率对组织部位施加消融能量并监测组织部位的阻抗。 根据一些实施例，施加到组织部位的功率可以根据阻抗增加的速率而减小。
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公开(公告)号：US20120101434A1
公开(公告)日：2012-04-26
申请号：US13343815
申请日：2012-01-05
IPC分类号： A61M25/10
CPC分类号： A61B17/00234 , A61B2017/00252 , A61M25/10
摘要： A medical system for introduction through a septum separating a first heart chamber from a second heart chamber includes a guide catheter with a distal segment and a guide catheter lumen adapted to receive a mapping/ablation catheter. The guide catheter includes a deployable retention mechanism that engages the septum and inhibits advancement or retraction of the guide catheter through the septum. The system also includes an ablation device for delivering ablation energy to tissue. The ablation device is positioned in a heart chamber via the guide catheter lumen.
摘要翻译： 通过将第一心室与第二心室隔开的隔膜引入的医疗系统包括具有远端段的引导导管和适于接收映射/消融导管的引导导管腔。 引导导管包括可展开的保持机构，其接合隔膜并阻止引导导管穿过隔膜的前进或缩回。 该系统还包括用于将消融能量传递给组织的消融装置。 消融装置通过引导导管管腔定位在心室中。
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公开(公告)号：US07824399B2
公开(公告)日：2010-11-02
申请号：US11355465
申请日：2006-02-16
申请人： David E. Francischelli , Eduardo N. Warman , Rahul Mehra , Mark T. Stewart , James R. Skarda , Harry Puryear , David Schwartzman
发明人： David E. Francischelli , Eduardo N. Warman , Rahul Mehra , Mark T. Stewart , James R. Skarda , Harry Puryear , David Schwartzman
IPC分类号： A61B18/18
CPC分类号： A61B18/1445 , A61B5/04 , A61B18/12 , A61B2018/00065 , A61B2018/00363 , A61B2018/00577 , A61B2018/00654 , A61B2018/00702 , A61B2018/00755 , A61B2018/00779 , A61B2018/00791 , A61B2018/00839 , A61B2018/00875 , A61B2018/1226 , A61B2018/1253 , A61B2018/126 , A61B2018/1467 , A61B2018/1472 , A61B2218/002 , A61N1/403
摘要： A system and method for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the depolarization signal in a local electrogram taken using electrodes located adjacent the tissue to be ablated. Following onset of application of ablation energy to heart tissue, the local electrogram is measured with electrodes located adjacent tissue to be ablated so that the ablation energy to ablation elements can be selectively reduced or terminated when transmurality is detected.
摘要翻译： 用于创建病变并评估其完整性或透视性的系统和方法。 病变透壁度的评估是通过使用邻近待消融组织的电极拍摄的局部电描记图来监测去极化信号来实现的。 在开始将消融能量施加到心脏组织之后，用邻近待组织的组织的电极测量局部电描记图，以便当检测到透视时，消融元件的消融能量可被选择性地减少或终止。
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公开(公告)号：US07367972B2
公开(公告)日：2008-05-06
申请号：US10657987
申请日：2003-09-09
IPC分类号： A61B18/18
CPC分类号： A61B18/1206 , A61B18/1445 , A61B2018/0016 , A61B2018/00351 , A61B2018/00363 , A61B2018/00577 , A61B2018/00702 , A61B2018/00761 , A61B2018/00791 , A61B2018/00875 , A61B2018/00886 , A61B2018/1467 , A61B2218/002
摘要： A system for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the impedance of the tissue to be ablated. Rather than attempting to detect a desired drop or a desired increase impedance, completeness of a lesion is detected in response to the measured impedance remaining at a stable level for a desired period of time, referred to as an impedance plateau. The mechanism for determining transmurality of lesions adjacent individual electrodes or pairs may be used to deactivate individual electrodes or electrode pairs, when the lesions in tissue adjacent these individual electrodes or electrode pairs are complete, to create an essentially uniform lesion along the line of electrodes or electrode pairs, regardless of differences in tissue thickness adjacent the individual electrodes or electrode pairs.
摘要翻译： 创建病变并评估其完整性或透明度的系统。 通过监测要消融的组织的阻抗来评估病变的透壁性。 不是试图检测到期望的下降或期望的增加阻抗，而是响应于被测量的阻抗保持在稳定的电平，在期望的时间段（被称为阻抗平台）来检测损伤的完整性。 当邻近这些单独的电极或电极对的组织中的损伤完成时，用于确定邻近各个电极或对的损伤的透壁性的机制可用于使单个电极或电极对失活，以产生沿电极线或基本均匀的病变 电极对，而不管邻近各个电极或电极对的组织厚度的差异。
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公开(公告)号：US06949097B2
公开(公告)日：2005-09-27
申请号：US10414800
申请日：2003-04-16
CPC分类号： A61B18/1492 , A61B2017/00044 , A61B2017/00243 , A61B2017/00867 , A61B2018/00214 , A61B2018/1407 , A61B2018/1435
摘要： A catheter body of a catheter assembly includes a proximal portion, an intermediate portion extending from the proximal portion, a distal portion extending from the intermediate portion, and a locating device including a distal tip extending from the distal portion of the catheter body. The intermediate portion defines a longitudinal axis and the distal portion forms a loop including one or more loop segments formed around a central loop axis. The central loop axis is substantially parallel with the longitudinal axis and the one or more loop segments include at least one ablation electrode coupled thereto and adapted to create a lesion, the lesion electrically isolating a vessel from a chamber for treatment of a cardiac arrhythmia. The distal tip of the locating device is substantially parallel with the central loop axis.
摘要翻译： 导管组件的导管主体包括近端部分，从近侧部分延伸的中间部分，从中间部分延伸的远侧部分和定位装置，该定位装置包括从导管主体的远端部分延伸的远侧末端。 中间部分限定纵向轴线，并且远侧部分形成包括围绕中心环轴线形成的一个或多个环形部分的环。 中心回路轴线基本上与纵向轴线平行，并且一个或多个环路段包括耦合到其上的适于产生病变的至少一个消融电极，所述损伤使血管与腔室电隔离以治疗心律失常。 定位装置的远端基本上与中心环轴平行。
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公开(公告)号：US06663627B2
公开(公告)日：2003-12-16
申请号：US10132392
申请日：2002-04-24
申请人： David E. Francischelli , Eduardo N. Warman , Rahul Mehra , Mark T. Stewart , James R. Skarda , Harry Puryear , David Schwartzman
发明人： David E. Francischelli , Eduardo N. Warman , Rahul Mehra , Mark T. Stewart , James R. Skarda , Harry Puryear , David Schwartzman
IPC分类号： A61B1818
CPC分类号： A61B18/1445 , A61B5/04 , A61B18/12 , A61B2018/00065 , A61B2018/00363 , A61B2018/00577 , A61B2018/00654 , A61B2018/00702 , A61B2018/00755 , A61B2018/00779 , A61B2018/00791 , A61B2018/00839 , A61B2018/00875 , A61B2018/1226 , A61B2018/1253 , A61B2018/126 , A61B2018/1467 , A61B2018/1472 , A61B2218/002 , A61N1/403
摘要： A system and method for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the depolarization signal amplitude in a local electrogram taken using electrodes located adjacent the tissue to be ablated. Following onset of application of ablation energy to heart tissue, the amplitude of a local electrogram measured with electrodes located adjacent tissue to be ablated first gradually drops and then stabilizes, indicating that the tissue being monitored has ceased making any contribution to the sensed electrogram. The amplitude drop and/or the following amplitude plateau may be used alone or together as indicators of transmurality. Detection of a rapid drop in amplitude may be employed as an indicator that the ablation process is proceeding too quickly and may be employed to trigger a reduction in the power of applied ablation energy. Detection of an insufficiently rapid drop in amplitude may be employed as an indicator that the ablation process is proceeding too slowly and may be employed to trigger an increase in the power of applied ablation energy.
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公开(公告)号：US08801707B2
公开(公告)日：2014-08-12
申请号：US13584932
申请日：2012-08-14
CPC分类号： A61B18/14 , A61B17/2202 , A61B18/02 , A61B18/04 , A61B18/06 , A61B18/149 , A61B18/1492 , A61B18/18 , A61B18/1815 , A61B18/20 , A61B2018/0022 , A61B2018/00267 , A61B2018/00273 , A61B2018/00285 , A61B2018/00291 , A61B2018/00351 , A61B2018/00357 , A61B2018/00363 , A61B2018/00577 , A61B2018/00839 , A61B2018/00982 , A61B2018/0212 , A61B2018/1405 , A61B2018/1472 , A61B2018/1861 , A61M5/14 , A61N7/022
摘要： Apparatus and method for ablating target tissue including a non-linear area of tissue in the left atrium of a patient. The method can include selecting an ablation apparatus having an ablator with a tissue engagement section, penetrating a chest cavity of the patient, and identifying the target tissue. The method can also include positioning the ablation apparatus adjacent to the target tissue so that the tissue engagement section can transfer ablation energy to the target tissue. The method can further include energizing the tissue engagement section with ablation energy in order to create a footprint on the non-linear area of tissue in the left atrium and to reduce an overall mass of excitable tissue in the left atrium.
摘要翻译： 用于消融包括患者左心房中组织的非线性区域的靶组织的装置和方法。 该方法可以包括选择具有消融器的消融装置，其具有组织接合部分，穿透患者的胸腔并识别目标组织。 该方法还可以包括将消融设备定位成邻近目标组织，使得组织接合部分可以将消融能量传递到目标组织。 该方法还可以包括用消融能激发组织接合部分，以便在左心房的组织的非线性区域上产生足迹并且减小左心房中的可兴奋组织的整体质量。
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