公开(公告)号：US20100106156A1

公开(公告)日：2010-04-29

申请号：US12648242

申请日：2009-12-28

申请人： Michael D. Laufer ,  Brian E. Farley ,  Grace Y. Schulz ,  Arthur W. Zikorus ,  Mark P. Parker

发明人： Michael D. Laufer ,  Brian E. Farley ,  Grace Y. Schulz ,  Arthur W. Zikorus ,  Mark P. Parker

IPC分类号： A61B18/14

CPC分类号： A61B18/08 ,  A61B18/1492 ,  A61B2017/22051 ,  A61B2017/22097 ,  A61B2018/00083 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00267 ,  A61B2018/00285 ,  A61B2018/00404 ,  A61B2018/00488 ,  A61B2018/00755 ,  A61B2018/00797 ,  A61B2018/00875 ,  A61B2018/1253 ,  A61B2018/126 ,  A61B2018/1465 ,  A61B2018/1497

摘要： A catheter delivers an electrode within a vein for a minimally invasive treatment of varicose veins and venous insufficiency using RF energy. The catheter is introduced into a patient and positioned within the section of the vein to be treated. The electrode radiates high frequency energy towards the vein, and the surrounding venous tissue becomes heated and begins to shrink. The catheter includes a controllable member for limiting the amount of shrinkage of the vein to the diameter of the member. The electrode remains active until there has been sufficient shrinkage of the vein. The extent of shrinkage of the vein may be detected by fluoroscopy. After treating one section of the vein, the catheter and the electrode can be repositioned intraluminally within the vein to treat different sections of the vein until all desired venous sections and valves are repaired and rendered functionally competent.

摘要翻译： 导管在静脉内输送电极，以便使用RF能量进行静脉曲张和静脉功能不全的微创治疗。 将导管引入患者并定位在待治疗的静脉的部分内。 电极向静脉辐射高频能量，周围的静脉组织变热并开始收缩。 导管包括可控制的构件，用于限制静脉的收缩量与构件的直径。 电极保持活动，直到静脉充分收缩。 静脉收缩的程度可以通过荧光透视法检测。 在治疗静脉的一部分后，导管和电极可以在静脉内腔内重新定位，以处理静脉的不同部分，直到所有期望的静脉部分和瓣膜被修复并且具有功能上的能力。

公开(公告)号：US20090125009A1

公开(公告)日：2009-05-14

申请号：US12264170

申请日：2008-11-03

申请人： Arthur W. Zikorus ,  Russell B. Thompson ,  Fiona M. Sander ,  Mark P. Parker

发明人： Arthur W. Zikorus ,  Russell B. Thompson ,  Fiona M. Sander ,  Mark P. Parker

IPC分类号： A61B18/04 ,  A61B19/00 ,  A61M25/00

CPC分类号： A61B18/08 ,  A61B18/1492 ,  A61B2018/0022 ,  A61B2018/00404 ,  A61B2018/046

摘要： One embodiment comprises an apparatus for applying energy to a hollow anatomical structure having an inner wall. The apparatus comprises an elongate shaft having a distal end and a proximal end opposite the distal end; and a capacitive treatment element located near the distal end. The capacitive treatment element is sized for insertion into the hollow anatomical structure and placement near the inner wall. The capacitive treatment element is configured to create an electric field that extends at least partially into the inner wall. Other devices and methods for treatment of hollow anatomical structures are disclosed as well.

摘要翻译： 一个实施例包括用于向具有内壁的中空解剖结构施加能量的装置。 该装置包括细长轴，其具有远端和与远端相对的近端; 以及位于远端附近的电容性治疗元件。 电容治疗元件的尺寸适于插入中空的解剖结构并且放置在内壁附近。 电容性治疗元件构造成产生至少部分延伸到内壁的电场。 还公开了用于治疗中空解剖结构的其它装置和方法。

公开(公告)号：US06258084B1

公开(公告)日：2001-07-10

申请号：US09267127

申请日：1999-03-10

申请人： Mitchel P. Goldman ,  Robert A. Weiss ,  Arthur W. Zikorus ,  James G. Chandler

发明人： Mitchel P. Goldman ,  Robert A. Weiss ,  Arthur W. Zikorus ,  James G. Chandler

IPC分类号： A61B1804

CPC分类号： G02F1/134363 ,  A61B18/1492 ,  A61B2017/22038 ,  A61B2017/22051 ,  A61B2017/22067 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00404 ,  A61B2018/00488 ,  A61B2018/00589 ,  A61B2018/00898 ,  A61B2018/124 ,  A61B2018/1253 ,  A61B2018/126 ,  A61B2090/3782 ,  A61B2218/002 ,  G02F1/136213 ,  G02F1/136259 ,  G02F2201/12

摘要： An electrode catheter is introduced into a hollow anatomical structure, such as a vein, and is positioned at a treatment site within the structure. Tumescent fluid is injected into the tissue surrounding the treatment site to produce tumescence of the surrounding tissue which then compresses the vein. The solution may include an anesthetic, and may further include a vasoconstrictive drug that shrinks blood vessels. The tumescent swelling in the surrounding tissue causes the hollow anatomical structure to become compressed, thereby exsanguinating the treatment site. Energy is applied by an electrode catheter in apposition with the vein wall to create a heating effect. The heating effect causes the hollow anatomical structure to become molded and durably assume the compressed dimensions caused by the tumescent technique. The electrode catheter can be moved within the structure so as to apply energy to a large section of the hollow anatomic structure. In a further aspect, the location of the electrodes is determined by impedance monitoring. Also, temperature sensors at the treatment site are averaged to determine the site temperature.

摘要翻译： 将电极导管引入到诸如静脉的中空解剖结构中，并且位于结构内的治疗部位。 将肿胀流体注射到处理部位周围的组织中，以产生周围组织的肿胀，然后压缩静脉。 溶液可以包括麻醉剂，并且还可以包括收缩血管的血管收缩药物。 周围组织的肿胀肿胀导致中空的解剖结构变得压缩，从而使治疗部位脱垂。 能量通过电极导管与静脉壁一起施加以产生加热效果。 加热效果使得中空的解剖结构变得模制并且持久地承受由肿胀技术引起的压缩尺寸。 电极导管可以在结构内移动，以将能量施加到中空解剖结构的大部分。 在另一方面，通过阻抗监测确定电极的位置。 此外，将处理部位的温度传感器平均以确定现场温度。

公开(公告)号：US06237606B1

公开(公告)日：2001-05-29

申请号：US09267756

申请日：1999-03-10

申请人： Arthur W. Zikorus ,  Mark P. Parker ,  Christopher S. Jones ,  Douglas M. Petty ,  Brian E. Farley ,  Joseph M. Tartaglia

发明人： Arthur W. Zikorus ,  Mark P. Parker ,  Christopher S. Jones ,  Douglas M. Petty ,  Brian E. Farley ,  Joseph M. Tartaglia

IPC分类号： A61B1900

CPC分类号： A61B18/1492 ,  A61B2017/00084 ,  A61B2017/22038 ,  A61B2017/22051 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00404 ,  A61B2018/124 ,  A61B2018/1253 ,  A61B2018/126 ,  A61B2018/1475 ,  A61B2090/3782 ,  A61B2218/002

摘要： A catheter includes a plurality of primary leads to deliver energy for ligating a hollow anatomical structure. Each of the primary leads includes an electrode located at the working end of the catheter. Separation is maintained between the primary leads such that each primary lead can individually receive power of selected polarity. The primary leads are constructed to expand outwardly to place the electrodes into apposition with an anatomical structure. High frequency energy can be applied from the leads to create a heating effect in the surrounding tissue of the anatomical structure. The diameter of the hollow anatomical structure is reduced by the heating effect, and the electrodes of the primary leads are moved closer to one another. Where the hollow anatomical structure is a vein, energy is applied until the diameter of the vein is reduced to the point where the vein is occluded. In one embodiment, a secondary lead is surrounded by the primary leads, and extends beyond the primary leads. The secondary lead includes an electrode at the working end of the catheter. The secondary lead can have a polarity opposite to the polarity of the primary leads in a bipolar configuration. The polarity of the leads can be switched and the catheter can be moved during treatment to ligate an extended length of the vein. The catheter can include a lumen to accommodate a guide wire or to allow fluid delivery.

摘要翻译： 导管包括多个主引线以传递用于结扎中空解剖结构的能量。 每个主引线包括位于导管工作端的电极。 在主引线之间保持分离，使得每个主引线可以分别接收所选极性的功率。 主引线被构造成向外扩展以使电极与解剖结构相配合。 可以从引线施加高频能量以在解剖结构的周围组织中产生加热效果。 中空解剖结构的直径由于加热效应而降低，并且主引线的电极彼此靠近地移动。 当中空解剖结构为静脉时，施加能量直到静脉的直径减小到静脉闭塞的位置。 在一个实施例中，次级引线被主引线包围，并且延伸超出主引线。 次级引线包括在导管的工作端的电极。 次级引线可以具有与双极配置中的主引线的极性相反的极性。 可以切换引线的极性，并且可以在治疗期间移动导管以连接延长的静脉长度。 导管可以包括用于容纳导丝或者允许流体输送的内腔。

公开(公告)号：US06231507B1

公开(公告)日：2001-05-15

申请号：US08867131

申请日：1997-06-02

申请人： Arthur W. Zikorus ,  John D'Angelo ,  Brian E. Farley

发明人： Arthur W. Zikorus ,  John D'Angelo ,  Brian E. Farley

IPC分类号： A61B800

CPC分类号： A61B17/135 ,  A61B8/04 ,  A61B17/1325

摘要： A pressure tourniquet having a window transparent to ultrasound is wrapped around a leg or another anatomical structure containing veins. An ultrasound transducer is placed in contact with the window of the tourniquet. The window is adjacent the anatomical structure and the transducer probes a dilated vein with ultrasound. The transducer can measure the size of the vein and detect reflux. A pneumatic bladder on the tourniquet is inflated to apply pressure to the anatomical structure so that the vein is compressed by the tissue of the surrounding anatomical structure. As pressure from the tourniquet reduces the diameter of the vein, competency of the vein valve can be temporarily restored to indicate the proper reduced diameter required to restore venous function. An electrode catheter is introduced into the vein to apply energy for durably molding the vein to the reduced diameter.

摘要翻译： 具有对超声波透明的窗口的压力止血带缠绕在包含静脉的腿部或另外的解剖结构上。 将超声换能器放置成与止血带的窗口接触。 窗口与解剖结构相邻，传感器用超声波探测扩张的静脉。 传感器可以测量静脉的大小并检测回流。 止血带上的充气气囊被充气以向解剖结构施加压力，使得静脉被周围解剖结构的组织压缩。 由于止血带的压力降低了静脉的直径，静脉瓣的能力可以暂时恢复，以指示恢复静脉功能所需的适当减小的直径。 将电极导管引入静脉以施加能量以持久地模制静脉直径减小。

公开(公告)号：US06179832B2

公开(公告)日：2001-01-30

申请号：US09138472

申请日：1998-08-21

申请人： Christopher S. Jones ,  Arthur W. Zikorus ,  Mark P. Parker ,  Brian E. Farley ,  Joseph M. Tartaglia

发明人： Christopher S. Jones ,  Arthur W. Zikorus ,  Mark P. Parker ,  Brian E. Farley ,  Joseph M. Tartaglia

IPC分类号： A61B1804

CPC分类号： A61B18/1492 ,  A61B2017/22038 ,  A61B2017/22051 ,  A61B2017/22067 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00404 ,  A61B2018/00488 ,  A61B2018/00589 ,  A61B2018/00898 ,  A61B2018/124 ,  A61B2018/1253 ,  A61B2018/126 ,  A61B2090/3782 ,  A61B2218/002

摘要： A catheter includes a first plurality of expandable leads and a second plurality of expandable leads separate and longitudinally spaced-apart from the first plurality to deliver energy to a hollow anatomical structure, such as vein, fallopian tube, hemorrhoid, esophageal varix, to effectively ligate that structure. Each of the leads includes an electrode located at the distal end of the respective electrode lead. Polarizations of the leads may be selected to achieve the power distribution desired. Each electrode lead includes an outward bend such that when a movable sheath is moved out of contact with the leads, they expand outwardly into apposition with an inner wall of the structure to be ligated. High frequency energy can be applied from the leads to create a heating effect in the surrounding tissue of the anatomical structure. The diameter of the hollow anatomical structure is reduced by the heating effect, and the electrodes are freely moved inward by the shrinking structure while still maintaining apposition with the inner wall of the shrinking structure.

摘要翻译： 导管包括第一多个可扩展引线和与第一多个分开并纵向间隔开的第二多个可扩展引线，以将能量传递到中空解剖结构，例如静脉，输卵管，痔疮，食管静脉曲张，以有效地连接 那个结构。 每个引线包括位于相应电极引线的远端处的电极。 可以选择引线的极化以实现所需的功率分配。 每个电极引线包括向外的弯曲部，使得当可移动护套移动离开与引线接触时，它们向外扩展成与要连接的结构的内壁相配合。 可以从引线施加高频能量以在解剖结构的周围组织中产生加热效果。 中空解剖结构的直径由于加热效应而减小，并且电极通过收缩结构自由地向内移动，同时仍然保持与收缩结构的内壁的配合。

公开(公告)号：US09616246B2

公开(公告)日：2017-04-11

申请号：US12860708

申请日：2010-08-20

申请人： Hoa D. Nguyen ,  Arthur W. Zikorus ,  Stephen W. Lee

发明人： Hoa D. Nguyen ,  Arthur W. Zikorus ,  Stephen W. Lee

IPC分类号： A61B18/04 ,  A61N1/40 ,  A61B18/08

CPC分类号： A61N1/403 ,  A61B18/082

摘要： A method of performing therapy on tissue using a medical apparatus. The apparatus includes a shaft configured for insertion into a hollow anatomical structure (HAS) and has a tissue sensor and a therapeutic energy application device both located on the shaft. The method comprises: receiving electrical power at a first power level and directing the first-level power to the tissue sensor and not to the therapeutic energy application device, thereby enabling tissue sensing with the tissue sensor; receiving electrical power at a second power level higher than the first-level power; and, in response to receipt of the second-level power, directing the second-level power to the therapeutic energy application device, thereby enabling performance of therapy on the tissue with the therapeutic energy application device. Additional methods and apparatus are disclosed as well.

公开(公告)号：US08267931B2

公开(公告)日：2012-09-18

申请号：US12258358

申请日：2008-10-24

申请人： Brian E. Farley ,  Christopher S. Jones ,  Mark P. Parker ,  Joseph M. Tartaglia ,  Arthur W. Zikorus

发明人： Brian E. Farley ,  Christopher S. Jones ,  Mark P. Parker ,  Joseph M. Tartaglia ,  Arthur W. Zikorus

IPC分类号： A61B18/12

CPC分类号： A61B18/1492 ,  A61B2017/00084 ,  A61B2017/22038 ,  A61B2017/22051 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00404 ,  A61B2018/124 ,  A61B2018/1253 ,  A61B2018/126 ,  A61B2018/1475 ,  A61B2090/3782 ,  A61B2218/002

摘要： A catheter includes a plurality of expandable primary leads to deliver energy to a fallopian tube, a vein such as a hemorrhoid or an esophageal varix, or another hollow anatomical structure requiring ligation or occlusion. Each of the primary leads includes an electrode located at the working end of the catheter. Separation is maintained between the primary leads such that the leads can receive power of selected polarity. The primary leads are constructed to expand outwardly to place the electrodes into apposition with a hollow anatomical structure. High frequency energy can be applied from the leads to create a heating effect in the surrounding tissue of the anatomical structure. The diameter of the hollow anatomical structure is reduced by the heating effect, and the electrodes of the primary leads are moved closer to one another.

摘要翻译： 导管包括多个可扩张的主要引线，用于向输卵管，诸如痔疮或食管静脉曲张的静脉或需要结扎或闭塞的另一中空解剖结构输送能量。 每个主引线包括位于导管工作端的电极。 在主引线之间保持分离，使得引线可以接收所选极性的功率。 主引线被构造成向外扩展以使电极与中空的解剖结构相配合。 可以从引线施加高频能量以在解剖结构的周围组织中产生加热效果。 中空解剖结构的直径由于加热效应而降低，并且主引线的电极彼此靠近地移动。

公开(公告)号：US20110160813A1

公开(公告)日：2011-06-30

申请号：US12875951

申请日：2010-09-03

申请人： Arthur W. Zikorus ,  Ralph G. DePalma ,  Christopher S. Jones ,  Brian E. Farley ,  James G. Chandler

发明人： Arthur W. Zikorus ,  Ralph G. DePalma ,  Christopher S. Jones ,  Brian E. Farley ,  James G. Chandler

IPC分类号： A61N5/06

CPC分类号： A61B18/1492 ,  A61B34/20 ,  A61B2017/00867 ,  A61B2017/22038 ,  A61B2018/00273 ,  A61B2018/00404 ,  A61B2018/00797 ,  A61B2018/00815 ,  A61B2018/00821 ,  A61B2018/00875 ,  A61B2018/1253 ,  A61B2018/1467 ,  A61B2018/1475 ,  A61B2034/2051 ,  A61M25/01 ,  C08L2201/12

摘要： An electrode catheter is introduced into a vein or other hollow anatomical structure, and is positioned at a treatment: site within the structure. The end of the catheter is positioned near a junction formed in the structure. This junction can be the sapheno-femoral junction. The position of the catheter near the junction is determined based on a signal from a device associated with the catheter within the structure. A fiber optic filament which emits light is used with the catheter or a guide wire over which the catheter is advanced. The light is visible externally from the patient. The light dims and may no longer externally visible at the sapheno-femoral junction where the catheter moves past the deep fascia and toward the deep venous system. The position of the catheter can be determined based on this external observation. The position of the catheter can also be determined based on measured parameters such as temperature or flow rate within the structure, and the measured changes in one or more of these parameters as the catheter nears the junction. The hollow anatomical structure can be compressed for this procedure. The position of the catheter can also be determined mechanically by including a hook-shaped tip on the catheter or guide wire which would physically engage the junction.

摘要翻译： 将电极导管引入静脉或其他中空的解剖结构中，并且被定位在结构内的治疗部位。 导管的端部位于结构中形成的结处附近。 该结可以是隐静脉 - 股骨交界处。 基于来自与结构内的导管相关联的装置的信号来确定导管附近的导管位置。 使用发光的光纤丝与导管或引导线一起使用，导管在其上前进。 灯从病人外面可见。 光线变暗，并且可能在导管移动穿过深筋膜并向深静脉系统的隐窝股骨交界处可能不再外部可见。 可以基于该外部观察来确定导管的位置。 导管的位置也可以基于测量参数（例如结构内的温度或流速）以及随着导管接近连接处的这些参数中的一个或多个而测量的变化来确定。 为此程序可以压缩中空的解剖结构。 导管的位置也可以通过将导管或引导线上的钩状尖端包括在物理上接合连接处而机械地确定。

公开(公告)号：US06769433B2

公开(公告)日：2004-08-03

申请号：US09866517

申请日：2001-05-25

申请人： Arthur W. Zikorus ,  Mark P. Parker ,  Christopher S. Jones ,  Douglas M. Petty ,  Brian E. Farley ,  Joseph M. Tartaglia

发明人： Arthur W. Zikorus ,  Mark P. Parker ,  Christopher S. Jones ,  Douglas M. Petty ,  Brian E. Farley ,  Joseph M. Tartaglia

IPC分类号： A61F556

CPC分类号： A61B18/1492 ,  A61B2017/00084 ,  A61B2017/22038 ,  A61B2017/22051 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00404 ,  A61B2018/124 ,  A61B2018/1253 ,  A61B2018/126 ,  A61B2018/1475 ,  A61B2090/3782 ,  A61B2218/002

摘要： A catheter includes a plurality of primary leads to deliver energy for ligating a hollow anatomical structure. Each of the primary leads includes an electrode located at the working end of the catheter. Separation is maintained between the primary leads such that each primary lead can individually receive power of selected polarity. The primary leads are constructed to expand outwardly to place the electrodes into apposition with an anatomical structure. High frequency energy can be applied from the leads to create a heating effect in the surrounding tissue of the anatomical structure. The diameter of the hollow anatomical structure is reduced by the heating effect, and the electrodes of the primary leads are moved closer to one another. Where the hollow anatomical structure is a vein, energy is applied until the diameter of the vein is reduced to the point where the vein is occluded. In one embodiment, a secondary lead is surrounded by the primary leads, and extends beyond the primary leads. The secondary lead includes an electrode at the working end of the catheter. The secondary lead can have a polarity opposite to the polarity of the primary leads in a bipolar configuration. The polarity of the leads can be switched and the catheter can be moved during treatment to ligate an extended length of the vein. The catheter can include a lumen to accommodate a guide wire or to allow fluid delivery.

摘要翻译： 导管包括多个主引线以传递用于结扎中空解剖结构的能量。 每个主引线包括位于导管工作端的电极。 在主引线之间保持分离，使得每个主引线可以分别接收所选极性的功率。 主引线被构造成向外扩展以使电极与解剖结构相配合。 可以从引线施加高频能量以在解剖结构的周围组织中产生加热效果。 中空解剖结构的直径由于加热效应而降低，并且主引线的电极彼此靠近地移动。 当中空解剖结构为静脉时，施加能量直到静脉的直径减小到静脉闭塞的位置。 在一个实施例中，次级引线被主引线包围，并且延伸超出主引线。 次级引线包括在导管的工作端的电极。 次级引线可以具有与双极配置中的主引线的极性相反的极性。 可以切换引线的极性，并且可以在治疗期间移动导管以连接延长的静脉长度。 导管可以包括用于容纳导丝或者允许流体输送的内腔。