摘要:
A catheter adapted to perform electrophysiological procedures comprises a body member, a manipulation handle attached to the proximal end of the body member for applying torque to the body member, the handle having a control knob adapted for control movements in a first plane and in a second plane simultaneously. A deflection control line is attached at its distal end to the distal portion of the catheter and its proximal end attached to the control device of the handle so that tension applied to the control line by sliding the control knob causes deflection of the distal portion of the catheter. A stiffening member is disposed within the body member of the catheter and is slidable, said stiffening member providing increased rigidity to the portion of the body member in which the stiffening member is located. Rotation of the control knob controls the position of the stiffening member in the body member. In a further aspect, a stiffening member in accordance with one embodiment includes a tapered distal end section with a ball formed on the distal tip, the tapered section terminating at the ball. In accordance with another aspect, the torsional rigidity of the catheter body is increased by use of a layer of aramid fibers mixed with an epoxy. In yet another feature, the handle and rotatable sliding element are symmetrically shaped to facilitate complete single-handed operation of the handle by the physician of all position control aspects of the catheter.
摘要:
A steerable catheter comprising a flexible elongate tubular member having proximal and distal extremities. A handle is secured to the proximal extremity. The tubular member has a lumen extending therethrough. A mandrel is slidably mounted in the lumen and extends into the distal extremity. A pull wire extends through the tubular member for causing bending of the distal extremity with respect to the mandrel disposed therein.
摘要:
A steerable catheter includes control handle having a generally tubular housing with a longitudinal slot therein in which an axially or longitudinally movable two-part slideblock resides, and a generally cylindrical, rotatably mounted thumbwheel surrounding a distal portion of the tubular housing, for controlling the axial translation of the slideblock. The pullwire passes into the distal end of the control handle and is only secured to the proximal part of the two-part slideblock so as to prevent the user from placing the pullwire under compression. A tip radius adjusting wire is attached to and extends distally from a slide actuator in the control handle into and through the main catheter shaft portion. The free distal end of the tip radius adjusting wire is selectably Iocatable at different positions. The radius of curvature of the tip portion, when deflected, depends upon how far distally into the deflectable tip portion the radius adjusting wire has been advanced by the user. The electrode catheter thus has a deflectable tip whose radius of curvature is adjustable over a relatively wide range.
摘要:
A medical probe device of this invention comprising a catheter having a control end and a probe end. The probe end includes a stylet guide housing having at least one stylet port and stylet guide means for directing a flexible stylet outward through at least one stylet port and through intervening tissue to targeted tissues. A stylet is positioned in at least one of said stylet guide means, the stylet comprising a non-conductive sleeve having a RF electrode lumen and an optional a fluid supply lumen and a temperature sensor lumen therein. At least one portion of an opposed surface of the electrode lumen and the electrode can be spaced apart to define a liquid supply passageway for delivery of medicament liquid. The RF electrode enclosed within the non-conductive sleeve has a distal length optionally having at least one current focusing groove means thereon and a distal tip shaped to focus current crowding on its terminal end, whereby Rf current passing therefrom into surrounding tissue forms a lesion extending outward from the groove and tip. The focusing groove means can be a plurality of annular focusing grooves or a spiral focusing groove thereon.
摘要:
A medical probe device including a catheter having a stylet guide housing with one or more stylet ports in a side wall thereof and a for directing a flexible stylet outward through the stylet port and through intervening tissue at a preselected, adjustable angle to a target tissue. The total catheter assembly includes a stylet guide lumen communicating with the stylet port and a stylet positioned in said stylet guide lumen for longitudinal movement from the port through intervening tissue to a target tissue. The stylet can be an electrical conductor enclosed within a non-conductive layer, the electrical conductor being a radio frequency electrode. During the ablation operation, the tissue immediately adjacent the stylet can become desiccated, thereby necessitating an increase of current flow and a loss of ablation efficiency. A forward and reverse movement of the non-conductive sleeve on the stylet during an operation frees the stylet from sticking tissue and creates a space around the electrode to allow the tissue to rehydrate.
摘要:
A medical probe apparatus comprising a catheter having a stylet guide housing with one or more stylet ports therein and stylet guides for directing one or more flexible stylets outward through respective stylet ports and through intervening tissue to target tissue. The active stylets emit radio frequency RF energy which establishes an RF current in the patient. The current, being densest at the stylet tips, causes heating of the surrounding tissue to initiate ablation of the target tissue. One aspect of the invention includes temperature sensing stylets at the location of the RF emitting stylets to monitor the temperature of the tissue being ablated. This allows the surgeon to have increased knowledge about the abating action under way in order to control the intensity of the applied RF current, or to adjust the amount of time the current is applied, or both. Further included herein is a plurality of temperature sensors mounted on an ultrasound probe to be used to monitor tissue temperature at the ultrasound probe while allowing the ultrasound device to monitor the position and orientation of the medical probe apparatus of the present invention.
摘要:
A medical probe for the treatment by radio frequency ablation of a target volume in tissue of a human having a urethral channel extending into the base of a bladder along a longitudinal axis. The probe comprises an elongate probe member having proximal and distal extremities and is sized so that it can be introduced into the urethra. The elongate probe member has a passage extending from the proximal extremity to the distal extremity. Guide cannulae are mounted in the passage of the elongate probe member and have proximal and distal extremities with the distal extremities of the guide cannulae being in the vicinity of the distal extremity of the elongate probe member. Each of the guide cannulae have a lumen extending therethrough from the proximal extremity to the distal extremity. A radio frequency conductive electrode is disposed in each lumen. An insulating sleeve is coaxially disposed on each radio frequency electrode. A control handle is secured to the proximal extremity of the elongate probe member. The control handle is connected to each radio frequency electrode and each insulating sleeve so that each radio frequency electrode and each insulating sleeve can be advanced and retracted.
摘要:
A medical ablation device comprising a flexible RF electrode wire or tube, the terminal portion thereof extending through an insulating sleeve axially moveable thereon. The electrode and surrounding sleeve extend through a portion of a rigid tube having a distal end adapted to be inserted into the body of a patient. Tabs are attached to the proximal end of the sleeve and electrode for advancing them together from the terminal end of the tube, for retracting the sleeve from the distal end of the electrode to expose a predetermined area of electrode surface, and for retracting them together into the terminal end of the tube. The electrode can also be a hollow tube, the proximal end thereof being adapted to be connected to a suction source for aspiration of tissue adjacent its distal end or it can optionally contain a fiber optic, the end thereof being enclosed within the tube and closely adjacent its distal end. In one embodiment, the electrode is a hollow electrode tube of highly flexible memory metal, preformed to have a curved memory configuration. The portion of the electrode tube and its surrounding sleeve extending beyond the distal end of the outer tube adopts the curved memory configuration, causing it to follow a curved path when extended through intervening tissue to reach a target tissue to be ablated.
摘要:
An apparatus for mapping the wall of a chamber of the heart having blood therein. The apparatus includes a flexible elongate tubular member having proximal and distal extremities and at least one lumen extending therethrough. A basket assembly is carried by the distal extremity of the flexible elongate tubular member and is movable between contracted and expanded positions. The basket assembly has a plurality of elongate flexible circumferentially spaced-apart arms with proximal and distal extremities. A plurality of longitudinally spaced-apart electrodes are carried by each arm for engaging the wall of the heart. Spacing members coupled to the arms and extending between the arms are provided for establishing a desired substantially uniform circumferential spacing between the arms when the basket assembly is in expanded position in engagement with the wall of the heart. Openings are provided between the arms and the spacing members through which blood can flow.
摘要:
A flexible catheter having an integral curvature control mechanism is disclosed. This mechanism allows the curvature of the catheter to be changed while at least part of the catheter is in a patient, thereby facilitating positioning of the catheter within the patient.