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    Catheter
    32.
    发明授权
    Catheter 有权
    导管

    公开(公告)号：US06270476B1

    公开(公告)日：2001-08-07

    申请号：US09298234

    申请日：1999-04-23

    申请人： Domenic Santoianni ,  Daniel Nahon ,  Dan Wittenberger ,  Jean-Pierre Lalonde ,  Cristian Petre

    发明人： Domenic Santoianni ,  Daniel Nahon ,  Dan Wittenberger ,  Jean-Pierre Lalonde ,  Cristian Petre

    IPC分类号： A61M3700

    CPC分类号： A61M25/0144 ,  A61B18/02 ,  A61B2017/003 ,  A61B2018/0212 ,  A61B2018/0262 ,  A61M25/00 ,  A61M25/0147

    摘要： A catheter for ablating tissue, for example to treat a cardiac arrhythmia, includes a handle, a shapeable shaft and a distal ablation segment. The shaft retains a first position until manipulated to a further position with the application of moderate manual pressure. The shaft incorporates plastically deformable elements and is shapeable to conform to an insertion path or the particular anatomy of a patient for accessing a site to be ablated. Once shaped, the shaft retains its shape as the catheter is inserted or manipulated to the predetermined tissue treatment location and the distal segment is urged into contact with the tissue site. A deflection mechanism may be provided to facilitate navigation to, or to deflect the ablation segment into conformal contact with, the tissue target. In a further or alternative embodiment, a second or auxiliary shaft member extends distally from the ablation segment, allowing the segment to be threaded by or pulled past occluding tissue to a remote target tissue site. By gripping the end of the second shaft, the flexible ablation segment may be either tensioned or pulled inward against, or flexed and pushed outward against a treatment site, such as a region of the posterior epicardial wall, thus providing more effective contact for a broad range of dispositions and tissue orientations. In another embodiment, a thermal shield extends over a portion of the ablation segment, shielding adjacent tissue from damage while still effectively exposing the target tissue to ablation energy. The shield may be rotated or moved axially to delimit an area of cryogenic contact and achieve better protection of surrounding tissue structures in occluded or remote treatment target regions.

    摘要翻译： 用于烧蚀组织的导管，例如用于治疗心律失常，包括手柄，可成形的轴和远端消融段。 轴保持第一位置，直到操纵到另一个位置，同时施加适度的手动压力。 该轴结合了可塑性变形的元件，并且可变形成符合插入路径或患者的特定解剖结构以访问要消融的部位。 一旦成形，当导管插入或操纵到预定的组织处理位置时，轴保持其形状，并且远端段被推动与组织部位接触。 可以提供偏转机构以便于导航到组织靶或使消融段与组织靶标保形接触。 在另一个或替代的实施例中，第二或辅助轴构件从消融段向远侧延伸，允许该段被螺纹穿过或者通过闭塞组织拉至远端目标组织部位。 通过夹持第二轴的端部，柔性消融段可以被张紧或者向内抵抗抵抗或弯曲并向外抵靠治疗部位（例如后心外膜壁的区域）向外拉，从而为广泛的 配置范围和组织取向。 在另一个实施例中，热屏蔽层延伸在消融段的一部分上，屏蔽相邻组织免受损伤，同时仍然有效地将目标组织暴露于消融能量。 护罩可以旋转或轴向移动以限定低温接触的区域，并且在封闭或远程治疗目标区域中实现对周围组织结构的更好保护。

    Mesh leak detection system for a medical device
    33.
    发明授权
    Mesh leak detection system for a medical device 有权
    用于医疗设备的网孔泄漏检测系统

    公开(公告)号：US08297108B2

    公开(公告)日：2012-10-30

    申请号：US12767012

    申请日：2010-04-26

    申请人： Marwan Abboud ,  Dan Wittenberger

    发明人： Marwan Abboud ,  Dan Wittenberger

    IPC分类号： G01M3/00

    CPC分类号： G01M3/02 ,  A61B18/02 ,  A61B2017/00119 ,  A61B2017/22051 ,  A61B2018/0022 ,  A61B2018/0212 ,  A61B2018/0262 ,  A61M25/0147 ,  A61M25/10 ,  A61M2205/15

    摘要： The present invention provides a surgical device including an elongate body defining a fluid flow path therethrough. An expandable element may be coupled to the elongate body and placed in fluid communication with the fluid flow path. Moreover, the surgical device may include a first leak detection element at least partially surrounding a portion of the expandable element, and a second leak detection element may be provided in fluid communication with the fluid flow path. In addition, a console may be provided, where the console may be in communication with the first and second leak detection elements. Further, a supply of cryogenic fluid as well as a vacuum source may be provided in fluid communication with the fluid flow path.

    摘要翻译： 本发明提供一种手术装置，其包括限定通过其中的流体流动通道的细长主体。 可膨胀元件可以联接到细长主体并且被放置成与流体流动路径流体连通。 此外，手术装置可以包括至少部分地围绕可膨胀元件的一部分的第一泄漏检测元件，并且第二泄漏检测元件可以设置成与流体流动路径流体连通。 此外，可以提供控制台，其中控制台可以与第一和第二泄漏检测元件通信。 此外，可以提供与流体流动路径流体连通的低温流体以及真空源的供应。

    CATHETER WITH CRYOGENIC AND ELECTRICAL HEATING ABLATION
    35.
    发明申请
    CATHETER WITH CRYOGENIC AND ELECTRICAL HEATING ABLATION 有权
    具有低温和电加热的导管

    公开(公告)号：US20070299432A1

    公开(公告)日：2007-12-27

    申请号：US11768259

    申请日：2007-09-10

    申请人： Steven Arless ,  Fredric Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    发明人： Steven Arless ,  Fredric Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    IPC分类号： A61B18/18

    CPC分类号： A61B18/02 ,  A61B18/1492 ,  A61B18/18 ,  A61B2017/00243 ,  A61B2018/0212 ,  A61B2018/0268

    摘要： A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen, allowing greater versatility of operation and enhancing the lesion size, speed or placement of multi-lesion treatment or single lesion re-treatment cycles. In one embodiment a microwave energy source operates at a frequency to extend beyond the thermal conduction depth, or to penetrate the cryogenic ice ball and be absorbed in tissue beyond an ice boundary, thus extending the depth and/or width of a single treatment locus. In another embodiment, the cooling and the application of RF energy are both controlled to position the ablation region away from the surface contacted by the electrode, for example to leave surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth. The driver or RF energy source may supply microwave energy at a frequency effective to penetrate the ice ball which develops on a cryocatheter, and different frequencies may be selected for preferential absorption in a layer of defined thickness at depth in the nearby tissue. The catheter may operate between 70 and minus 70 degrees Celsius for different tissue applications, such as angioplasty, cardiac ablation and tissue remodeling, and may preset the temperature of the tip or adjacent tissue, and otherwise overlay or delay the two different profiles to tailor the shape or position where ablation occurs or to speed up a treatment cycle.

    摘要翻译： 导管包括具有用于加热组织的电驱动消融组件的冷冻消融尖端。 冷冻消融尖端可以用冷却室来实现，通过该冷却室可控制地注入的冷却剂循环以降低尖端温度，并且在其远端具有RF电极。 RF电极可以被操作以加热低温冷却的组织，或者可以控制冷却剂以与RF治疗方案协调地导电地冷却组织，从而允许操作的更大的通用性和增强病变大小，速度或放置多病变 治疗或单次病变再治疗周期。 在一个实施例中，微波能量源的频率以超出热传导深度的频率运行，或者穿透低温冰球并被吸收在超过冰界的组织中，从而延长单个处理轨迹的深度和/或宽度。 在另一个实施例中，RF能量的冷却和应用都被控制以将消融区域远离与电极接触的表面，例如在深度消融时留下表面组织而不受伤害，或者提供具有更大均匀性的消融带， 增加深度。 驱动器或RF能源可以以有效穿透在低温导管上形成的冰球的频率提供微波能量，并且可以选择不同的频率用于在附近组织的深度处的限定厚度的层中的优先吸收。 对于不同的组织应用（例如血管成形术，心脏消融和组织重建），导管可以在70摄氏度和零下70度之间运行，并且可以预设尖端或相邻组织的温度，否则叠加或延迟两个不同的轮廓以定制 消融发生的形状或位置或加速治疗周期。

    Shape modification system for a cooling chamber of a medical device
    38.
    发明授权
    Shape modification system for a cooling chamber of a medical device 有权
    用于医疗器械冷却室的形状修改系统

    公开(公告)号：US09039712B2

    公开(公告)日：2015-05-26

    申请号：US11476408

    申请日：2006-06-28

    申请人： Marwan Abboud ,  Dan Wittenberger

    发明人： Marwan Abboud ,  Dan Wittenberger

    IPC分类号： A61F11/00 ,  A61M25/10

    CPC分类号： A61M25/10181 ,  A61B2018/0212 ,  A61M2025/1068

    摘要： The present invention provides a medical device having an catheter body defining proximal and distal portions, and a guidewire lumen at least partially disposed within and movable within the catheter body. The medical device may include an expandable element defining a proximal end and a distal end, wherein the proximal end is coupled to the distal portion of the catheter body and the distal end is coupled to the guidewire lumen. In addition, an actuator element may be coupled to the guidewire lumen for longitudinal movement thereof, and a tensioning element may further be coupled to the guidewire lumen to bias the guidewire lumen and/or the expandable element towards a particular geometric configuration.

    摘要翻译： 本发明提供一种医疗装置，其具有限定近端部分和远端部分的导管主体，以及至少部分地设置在导管主体内并在导管主体内可移动的导丝管腔。 医疗装置可以包括限定近端和远端的可扩张元件，其中近端联接到导管主体的远端部分，并且远端联接到导丝管腔。 此外，致动器元件可以联接到导丝管腔以用于其纵向运动，并且张紧元件可以进一步联接到导丝管腔，以将导丝管腔和/或可扩张元件朝向特定的几何构型偏置。

    Catheter with cryogenic and electrical heating ablation
    39.
    发明授权
    Catheter with cryogenic and electrical heating ablation 有权
    导管用低温和电加热消融

    公开(公告)号：US07896870B2

    公开(公告)日：2011-03-01

    申请号：US11768259

    申请日：2007-09-10

    申请人： Steven G. Arless ,  Fredric L. Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    发明人： Steven G. Arless ,  Fredric L. Milder ,  Marwan Abboud ,  Dan Wittenberger ,  Sean Carroll

    IPC分类号： A61B18/02 ,  A61B18/12 ,  A61B18/18

    CPC分类号： A61B18/02 ,  A61B18/1492 ,  A61B18/18 ,  A61B2017/00243 ,  A61B2018/0212 ,  A61B2018/0268

    摘要： A catheter includes a cryoablation tip with an ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber and have an RF electrode at its distal end. The electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled in combination with an RF treatment regimen to enhance the lesion size, speed or placement of multi-lesion or single lesion cycles. In one embodiment a microwave energy source operates to extend beyond the thermal conduction depth, or penetrate the ice ball and be absorbed in tissue beyond an ice boundary, thus extending a dimension of treatment. Also, the cooling and application of RF energy can be controlled to position the ablation region away from the surface contacted by the electrode thereby leaving surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth.

    摘要翻译： 导管包括具有用于加热组织的消融组件的冷冻消融尖端。 冷冻消融尖端可以用冷却室实现，并且在其远端具有RF电极。 可以操作电极以温热低温冷却的组织，或者可以与RF治疗方案结合控制冷却剂，以增强病变大小，速度或多损伤或单个病变周期的放置。 在一个实施例中，微波能量源的作用是延伸超过热传导深度，或者穿透冰球并被吸收在超过冰界的组织中，从而延伸处理的尺寸。 此外，可以控制RF能量的冷却和施加，以使消融区域远离与电极接触的表面，从而在深度消融时使表面组织不受伤害，或者提供具有更高均匀度的消融带，并且随着深度增加。

    Mesh leak detection system for a medical device
    40.
    发明授权
    Mesh leak detection system for a medical device 有权
    用于医疗设备的网孔泄漏检测系统

    公开(公告)号：US07716966B2

    公开(公告)日：2010-05-18

    申请号：US11476405

    申请日：2006-06-28

    申请人： Marwan Abboud ,  Dan Wittenberger

    发明人： Marwan Abboud ,  Dan Wittenberger

    IPC分类号： G01M3/04

    CPC分类号： G01M3/02 ,  A61B18/02 ,  A61B2017/00119 ,  A61B2017/22051 ,  A61B2018/0022 ,  A61B2018/0212 ,  A61B2018/0262 ,  A61M25/0147 ,  A61M25/10 ,  A61M2205/15

    摘要： The present invention provides a surgical device including an elongate body defining a fluid flow path therethrough. An expandable element may be coupled to the elongate body and placed in fluid communication with the fluid flow path. Moreover, the surgical device may include a first leak detection element at least partially surrounding a portion of the expandable element, and a second leak detection element may be provided in fluid communication with the fluid flow path. In addition, a console may be provided, where the console may be in communication with the first and second leak detection elements. Further, a supply of cryogenic fluid as well as a vacuum source may be provided in fluid communication with the fluid flow path.

    摘要翻译： 本发明提供一种手术装置，其包括限定通过其中的流体流动通道的细长主体。 可膨胀元件可以联接到细长主体并且被放置成与流体流动路径流体连通。 此外，手术装置可以包括至少部分地围绕可膨胀元件的一部分的第一泄漏检测元件，并且第二泄漏检测元件可以设置成与流体流动路径流体连通。 此外，可以提供控制台，其中控制台可以与第一和第二泄漏检测元件通信。 此外，可以提供与流体流动路径流体连通的低温流体以及真空源的供应。