公开(公告)号：US5782823A

公开(公告)日：1998-07-21

申请号：US628456

申请日：1996-04-05

申请人： Richard L. Mueller

发明人： Richard L. Mueller

IPC分类号： A61B18/20 ,  A61B17/00 ,  A61B17/02 ,  A61B17/30 ,  A61B18/22 ,  A61F9/008 ,  A61N5/06 ,  A61B17/36

CPC分类号： A61B18/22 ,  A61B2017/00247 ,  A61B2017/0243 ,  A61B2017/306 ,  A61B2018/00291 ,  A61B2018/00392

摘要： An apparatus for performing a laser myocardial revascularization of a human heart comprises a hand-held device with an elongated flexible lasing assembly including an axially movable fiber bundle which can be placed into the chest cavity of a patient. At the distal head end of the device laser energy from the distal end of the fiber bundle is initially reduced to form a relatively small opening in the epicardium of the heart. The fiber bundle is moved through the opening so that lasing with full laser power takes place beneath the epicardium to form a larger channel through the myocardium that extends into the left ventricular cavity. After the channel has been formed, the optical fiber bundle is retracted from the channel and back through the small epicardium opening so as to minimize operative bleeding and allow sealing of the epicardium after the apparatus is removed.

摘要翻译： 用于执行人心脏激光心肌血运重建的装置包括具有细长柔性激光组件的手持装置，其包括可放置在患者胸腔中的可轴向移动的纤维束。 在设备的远端头端处，来自纤维束的远端的激光能量最初被减小以在心脏的心外膜中形成相对较小的开口。 纤维束通过开口移动，使得具有全激光功率的激光发生在心外膜下方，以形成通过延伸到左心室腔的心肌的较大通道。 在通道形成之后，光纤束从通道退回并通过小的心外膜开口返回，以便最小化手术渗出并且允许在移除装置之后密封心外膜。

公开(公告)号：US5312425A

公开(公告)日：1994-05-17

申请号：US44131

申请日：1993-04-07

申请人： Michael Evans ,  Richard L. Mueller

发明人： Michael Evans ,  Richard L. Mueller

IPC分类号： A61B17/22 ,  A61B17/32

CPC分类号： A61B17/320783 ,  A61B2017/22054 ,  A61B2017/320052

摘要： An atherectomy catheter includes a catheter body having a cylindrical housing at its distal end. The cylindrical housing includes an elongate cutting aperture on one side thereof and a mechanism for severing atheroma which enters within the opening. In a first embodiment, the cutting mechanism comprises a circular cutting blade which is advanced over an elongate guide member which defines a path for the blade. Use of the guide means helps assure that the cutting blade will not be lost from the housing during use. In a second embodiment, a rotatable helical cutting blade is mounted within the housing. In that particular embodiment, the helical cutting blade can serve as the guide member for the circular cutting blade.

摘要翻译： 粥样斑块切除术导管包括在其远端具有圆柱形壳体的导管体。 圆柱形壳体在其一侧上包括细长的切割孔，以及用于切断进入开口内的动脉粥样化的机构。 在第一实施例中，切割机构包括圆形切割刀片，该切割刀片在限定刀片的路径的细长引导部件上前进。 使用导向装置有助于确保切割刀片在使用过程中不会从外壳中损失。 在第二实施例中，可旋转的螺旋切割刀片安装在壳体内。 在该特定实施例中，螺旋切割刀片可以用作圆形切割刀片的引导构件。

公开(公告)号：US5092873A

公开(公告)日：1992-03-03

申请号：US486675

申请日：1990-02-28

申请人： John B. Simpson ,  Richard L. Mueller

发明人： John B. Simpson ,  Richard L. Mueller

IPC分类号： A61B17/22 ,  A61F2/958 ,  B29C65/00 ,  B29C65/18 ,  B29C65/48

CPC分类号： A61B17/320783 ,  B29C65/18 ,  B29C65/305 ,  B29C65/48 ,  B29C66/532 ,  B29C66/61 ,  B29C66/81455 ,  A61B2017/22052 ,  A61B2017/22054 ,  A61B2017/22075 ,  A61M25/1002 ,  A61M25/1011 ,  B29L2031/7542

摘要： A vascular catheter includes a flexible catheter body having proximal and distal ends and an elongate housing secured to the distal end of the catheter body. An interactional device is disposed on one side of the housing, and at least two spaced-apart inflatable chambers are located on the other side of the housing generally at its proximal and distal ends, respectively. The inflatable chambers may be expanded simutaneously or separately, and the spaced-apart positioning of the chambers provides for stable positioning of the housing during atherectomy procedures imaging procedures, and the like.

摘要翻译： 血管导管包括具有近端和远端的柔性导管主体和固定到导管主体的远端的细长外壳。 交互装置设置在壳体的一侧上，并且至少两个间隔开的可充气腔室分别位于壳体的另一侧，大致在其近端和远端。 可膨胀的腔室可以同时或分开地扩张，腔室的间隔开的定位在动脉粥样硬化切除术过程成像过程等期间提供壳体的稳定定位。

公开(公告)号：US5047040A

公开(公告)日：1991-09-10

申请号：US312108

申请日：1989-02-16

申请人： John B. Simpson ,  Richard L. Mueller ,  Peter S. Brown ,  James R. Kermode

发明人： John B. Simpson ,  Richard L. Mueller ,  Peter S. Brown ,  James R. Kermode

IPC分类号： A61B17/22

CPC分类号： A61B17/3207 ,  A61B17/320758 ,  A61B2017/320064

摘要： An atherectomy device for removing stenosis materials from a vascular vessel is provided. The atherectomy device includes a flexible tubular member, a flexible drive means disposed within the tubular member, and a cutting assembly carried by the distal extremity of the tubular member. The cutting assembly includes a collection chamber which receives a cutting bit carried by the drive means. The cutting bit is rotated to remove materials from the stenosis and cause the removed materials to be withdrawn into the collection chamber as the bit is advanced. A second embodiment of the atherectomy device includes an anchor member coaxially mounted within a tubular cutting blade at the distal end of the catheter. The anchor member is first advanced into a region of stenosis where it becomes embedded, and the tubular blade is subsequently advanced over the anchor member to sever the stenosis. The tubular blade and anchor member may be retracted within the catheter and thus used to withdraw the several material from the blood vessel.

摘要翻译： 提供了一种用于从血管容器中移除狭窄物质的粥样斑块切除装置。 粥样斑块切除装置包括柔性管状构件，设置在管状构件内的柔性驱动装置和由管状构件的远端支承的切割组件。 切割组件包括收集室，该收集室容纳由驱动装置承载的切割钻头。 旋转切削刀头以从狭窄中移除材料，并且使得被移除的材料在钻头前进时被抽出到收集腔中。 粥样斑块切除装置的第二实施例包括同轴地安装在导管远端的管状切割刀片内的锚定构件。 锚固构件首先进入狭窄区域，在其中嵌入，并且管状刀片随后在锚固构件上前进以切断狭窄。 管状刀片和锚定构件可以缩回到导管内，并且因此用于从血管中抽出多种材料。

公开(公告)号：US06908435B1

公开(公告)日：2005-06-21

申请号：US09706583

申请日：2000-11-03

申请人： Richard L. Mueller ,  U. Hiram Chee

发明人： Richard L. Mueller ,  U. Hiram Chee

IPC分类号： A61B5/02 ,  A61B5/024 ,  A61B17/00 ,  A61B18/24 ,  A61N7/02

CPC分类号： A61B5/681 ,  A61B5/02438 ,  A61B18/24 ,  A61B2017/00247 ,  A61B2018/00392 ,  A61N7/02

摘要： Various methods and devices for treating a patient who has lost, or is at risk of losing cardiac function by cardiac ischemia are disclosed. Treatment includes first imaging a patient's heart, or a portion thereof, to identify underperfused regions of cardiac muscle, and a source of oxygenated blood that is proximate to the underperfused region. Between the underperfused regions and the oxygenated blood source, a target area is selected where thermal or mechanical injury is introduced, and optionally reintroduced, to convert initial capillary blush, resulting from the injury.

摘要翻译： 公开了用于治疗由于心脏缺血而失去或有丧失心脏功能风险的患者的各种方法和装置。 治疗包括首先对患者的心脏或其一部分进行成像以识别心肌的不足灌注区域，以及接近欠灌注区域的充氧血液源。 在欠灌注区域和氧合血液源之间，选择引入热或机械损伤的目标区域，并且可选地重新引入，以转化由损伤引起的初始毛细血管腮红。

公开(公告)号：US06589232B1

公开(公告)日：2003-07-08

申请号：US09550932

申请日：2000-04-17

申请人： Richard L. Mueller

发明人： Richard L. Mueller

IPC分类号： A61B1818

CPC分类号： A61B18/00 ,  A61B17/320016 ,  A61B17/320068 ,  A61B17/3203 ,  A61B17/32075 ,  A61B18/14 ,  A61B18/24 ,  A61B2017/00247 ,  A61B2017/2905 ,  A61B2017/2927 ,  A61B2018/00392 ,  A61B2090/064

摘要： A method for treating myocardium using at least one mechanical or electromagnetic energy functional device for forming a network of branched, interconnecting passages in a boundary between endocardium and myocardium, thereby enhancing blood flow into the treated zone, and a device for selectively treating ischemic myocardium tissue comprising a tube having proximal end and distal end, and at least one hollow lumen and defining an axis, at least two mechanical or electromagnetic energy functional devices disposed within the tube, the at least two mechanical or electromagnetic energy functional devices each having a distal end disposed adjacent the distal end of the central tube, and a deflecting member adjacent the distal portion of the central tube for deflecting the distal end of each of the at least two mechanical or electromagnetic energy functional devices away from the axis, for enabling treatment of selective areas of ischemic or hibernating myocardium tissue.

摘要翻译： 一种使用至少一个机械或电磁能量功能装置治疗心肌的方法，用于在心内膜和心肌之间的边界中形成分支互连通道的网络，从而增强进入治疗区域的血液流动，以及用于选择性治疗缺血性心肌组织的装置 包括具有近端和远端的管，以及限定轴的至少一个中空腔，设置在所述管内的至少两个机械或电磁能量功能装置，所述至少两个机械或电磁能量功能装置，每个具有远端 邻近中心管的远端设置的偏转构件和邻近中心管的远端部分的偏转构件，用于使至少两个机械或电磁能量功能装置中的每一个的远端远离轴线偏转，以使得能够治疗选择性 局部缺血或冬眠心肌组织。

公开(公告)号：US06171251B2

公开(公告)日：2001-01-09

申请号：US09115458

申请日：1998-07-14

申请人： Richard L. Mueller ,  Michael J. Rosinko

发明人： Richard L. Mueller ,  Michael J. Rosinko

IPC分类号： A61B502

CPC分类号： A61B18/22 ,  A61B5/021 ,  A61B5/026 ,  A61B5/145 ,  A61B2017/00247 ,  A61B2018/00392 ,  A61F2/06 ,  A61F2/064

摘要： Computer controlled apparatus and method for enhancing myocardial revascularization using direct vessel implants includes a probe for insertion into a proposed graft site to determine the condition of the site using criteria such as oxygen levels, contractility and pressure/flow rate differentials in conjunction with the parameters of the selected vessel graft. Transmyocardial revascularization procedures are performed to increase flow rates when needed and to supplement graft treatment where desired. A coring device creates the opening for the graft and correlates the size of the opening with contractility conditions and vessel conditions. Reinforcement sleeves may be placed around grafts, particularly vein grafts, to avoid excess compression of the graft. Graft site preparation and TMR treatment enhance angiogenesis and collateralization of the implant, and angiogenic drugs may be used to increase such effects.

摘要翻译： 使用直接血管植入物增强心肌血运重建的计算机控制装置和方法包括用于插入建议的移植部位的探针，以使用诸如氧水平，收缩性和压力/流速差的标准来确定部位的状况，结合参数 选择的血管移植物。 进行心肌血运重建手术以在需要时增加流速，并根据需要补充移植物治疗。 取芯装置为移植物创建开口，并将开口的尺寸与收缩条件和容器状况相关联。 加强套管可以放置在移植物周围，特别是静脉移植物周围，以避免移植物过度压缩。 移植部位制备和TMR治疗可增强植入物的血管生成和抵押，并且血管生成药物可用于增加这种作用。

公开(公告)号：US6162214A

公开(公告)日：2000-12-19

申请号：US183757

申请日：1998-10-30

申请人： Richard L. Mueller ,  Alexander Khairkhahan

发明人： Richard L. Mueller ,  Alexander Khairkhahan

IPC分类号： A61B18/22 ,  A61B18/18

CPC分类号： A61B18/22

摘要： Apparatus and method for creating pathways in tissue and destroying the cored tissue to avoid release of the cored tissue within the body. The apparatus has a coring mechanism and a tissue vaporization mechanism. The apparatus is useful in creating revascularization pathways in the myocardium. The apparatus and methods are adaptable for either surgical or percutaneous procedures.

摘要翻译： 用于在组织中产生途径并破坏核心组织以避免体内的核心组织释放的装置和方法。 该装置具有取芯机构和组织蒸发机构。 该装置可用于在心肌中产生血运重建途径。 该装置和方法适用于手术或经皮手术。

公开(公告)号：US6156029A

公开(公告)日：2000-12-05

申请号：US978036

申请日：1997-11-25

申请人： Richard L. Mueller

发明人： Richard L. Mueller

IPC分类号： A61B18/20 ,  A61B17/00 ,  A61B17/22 ,  A61B17/28 ,  A61B17/32 ,  A61B17/34 ,  A61B18/00 ,  A61B18/14 ,  A61B18/24 ,  A61B19/00 ,  A61M25/00 ,  A61N5/06 ,  A61B18/18

CPC分类号： A61B18/00 ,  A61B17/320016 ,  A61B17/320068 ,  A61B17/3203 ,  A61B17/32075 ,  A61B18/14 ,  A61B18/24 ,  A61B2017/00247 ,  A61B2017/2905 ,  A61B2017/2927 ,  A61B2018/00392 ,  A61B2090/064

摘要： A method for treating myocardium using at least one mechanical or electromagnetic energy functional device for forming a network of branched, interconnecting passages in a boundary between endocardium and myocardium, thereby enhancing blood flow into the treated zone, and a device for selectively treating ischemic myocardium tissue comprising a tube having proximal end and distal end, and at least one hollow lumen and defining an axis, at least two mechanical or electromagnetic energy functional devices disposed within the tube, the at least two mechanical or electromagnetic energy functional devices each having a distal end disposed adjacent the distal end of the central tube, and a deflecting member adjacent the distal portion of the central tube for deflecting the distal end of each of the at least two mechanical or electromagnetic energy functional devices away from the axis, for enabling treatment of selective areas of ischemic or hibernating myocardium tissue.

公开(公告)号：US6067988A

公开(公告)日：2000-05-30

申请号：US773778

申请日：1996-12-26

申请人： Richard L. Mueller

发明人： Richard L. Mueller

IPC分类号： A61B17/00 ,  A61B17/22 ,  A61B18/08 ,  A61B17/36

CPC分类号： A61B18/08 ,  A61B2017/00247 ,  A61B2017/22082 ,  A61B2018/00392

摘要： An apparatus and method for creating drug-filled pockets within muscle tissue, such as myocardium of the heart for increasing angiogenesis. More particularly, the apparatus has an excising assembly with a dilator tip for penetrating and advancing through the surface and body of a muscle or organ, such as the heart. Preferably, the dilator tip has a low level laser optical fiber emission to ease the passage of the excising assembly and provide thermal damage which also stimulates angiogenesis. More preferably, the dilator tip also disperses a pharmacologically active substance as the apparatus is passed through the tissue and/or creates pockets. The excising assembly is connected to a hand-held control device from which the operator pushes a switch to activate a punching mechanism within the excising assembly. The punching mechanism cuts a discrete piece of muscle tissue and traps it within the excising assembly leaving a pocket in the remaining muscle tissue. The excising assembly may also optionally release a bolus of the pharmacologically active substance into the pocket so created. Most preferably, there is a timing mechanism to measure the contraction of the heart, and the timing mechanism is synchronized with the operator's switch on the hand-held device to ensure that the punching occurs at maximum contraction of systole. A measurement guide determines how much excised tissue is trapped in the reservoir of the excising assembly. At a threshold level of filling, the surgeon will remove the excising assembly from the hand-held control device and open the punching mechanism for release of tissue. More preferably, the threshold level of filling will automatically turn off the switch to the punching mechanism to indicate to the surgeon the need to empty the excising assembly of tissue.

摘要翻译： 用于在肌肉组织内产生药物填充袋的装置和方法，例如用于增加血管生成的心脏心肌。 更具体地，该装置具有带有扩张器尖端的切除组件，该扩张器尖端用于穿过并穿过诸如心脏的肌肉或器官的表面和身体。 优选地，扩张器尖端具有低水平的激光光纤发射以便于切除组件的通过并且提供也刺激血管发生的热损伤。 更优选地，当装置通过组织和/或产生袋时，扩张器尖端还分散药理活性物质。 切除组件连接到手持控制装置，操作者从该手持式控制装置推动开关以激活切割组件内的冲压机构。 冲孔机构切割离散的肌肉组织并将其捕获在切除组件内，留下剩余的肌肉组织中的口袋。 切除组件还可以任选地将药物活性物质的推注物释放到如此产生的口袋中。 最优选地，存在测量心脏收缩的定时机构，并且定时机构与手持装置上的操作者开关同步，以确保在收缩最大收缩时发生冲孔。 测量指南确定在切除组件的储存器中多少切除的组织被捕获。 在阈值的灌注水平下，外科医生将从手持控制装置移除切除组件，并打开用于释放组织的冲压机构。 更优选地，填充的阈值水平将自动关闭切换到冲压机构以向外科医生指示需要清空组织的切除组件。