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公开(公告)号：US07217284B2
公开(公告)日：2007-05-15
申请号：US10669204
申请日：2003-09-23
IPC分类号： A61F2/24
CPC分类号： A61B18/00 , A61B17/0401 , A61B17/0469 , A61B17/0487 , A61B17/122 , A61B17/1285 , A61B17/29 , A61B18/1442 , A61B18/1477 , A61B18/1492 , A61B18/24 , A61B90/39 , A61B2017/00084 , A61B2017/00243 , A61B2017/00867 , A61B2017/0409 , A61B2017/0412 , A61B2017/0414 , A61B2017/0427 , A61B2017/0437 , A61B2017/044 , A61B2017/0451 , A61B2017/0454 , A61B2017/0458 , A61B2017/0461 , A61B2017/0464 , A61B2017/0496 , A61B2017/2945 , A61B2018/00023 , A61B2018/00083 , A61B2018/00214 , A61B2018/0022 , A61B2018/00232 , A61B2018/00273 , A61B2018/00369 , A61B2018/00791 , A61B2018/00797 , A61B2018/1253 , A61B2018/126 , A61B2018/1432 , A61B2018/1435 , A61B2090/064 , A61F2/2445 , A61F2/2451 , A61F2/2454 , A61N7/00 , A61N7/02
摘要： Apparatus and methods are provided for thermally and/or mechanically treating tissue, such as valvular structures, to reconfigure or shrink the tissue in a controlled manner. The apparatus comprises a catheter in communication with an end effector which induces a temperature rise in an annulus of tissue surrounding the leaflets of a valve or in the chordae tendineae sufficient to cause shrinkage, thereby causing the valves to close more tightly. Mechanical clips can also be implanted over the valve either alone or after the thermal treatment. The clips are delivered by a catheter and may be configured to traverse directly over the valve itself or to lie partially over the periphery of the valve to prevent obstruction of the valve channel. The clips can be coated with drugs or a radiopaque coating. The catheter can also incorporate sensors or energy delivery devices, e.g., transducers, on its distal end.
摘要翻译： 提供了用于热和/或机械处理组织（例如瓣结构）的设备和方法，以受控的方式重新配置或收缩组织。 该装置包括与端部执行器连通的导管，该导管引起围绕瓣膜小叶或组合腱索中的组织的环空中的温度上升，足以引起收缩，从而导致瓣膜更紧密地闭合。 机械夹子也可以单独地或在热处理之后植入阀上。 夹子由导管递送，并且可以被配置成直接在阀本身上移动或部分地位于阀的周边上以防止阀通道的阻塞。 夹子可以涂上药物或不透射线的涂层。 导管还可以在其远端上并入传感器或能量输送装置，例如换能器。
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62.发明授权公开(公告)号：US07172590B1
公开(公告)日：2007-02-06
申请号：US10906164
申请日：2005-02-04
申请人： Russell A. Houser
发明人： Russell A. Houser
CPC分类号： A61B18/1492 , A61B2018/00601 , A61B2018/1861 , A61B2218/007
摘要： A tissue cutting device includes a catheter with a window at its distal tip for admitting tissue into a catheter compartment. A cylindrical cartridge in the compartment has a cutting edge that supports an electrically conductive cutting element, e.g. a band or wire. The cutting element and adjacent tissue can be heated to a selected temperature by generating an electrical current through the cutting element. The catheter is maneuverable to position its distal end near the tissue to be cut. The catheter incorporates a dilatation balloon or other feature to urge the catheter against the tissue, so that at least part of the tissue may enter the compartment through the window. Then, the cartridge is manipulated from the catheter's proximal end to move the cutting edge across the window, cutting the tissue. According to alternative embodiments, the cartridge is either rotated or moved axially relative to the catheter and, in either event may be capable of closing the catheter window when the cut is complete. Further alternatives involve either placing an indifferent electrode on the patient and providing an RF signal via a single conductor to the cutting element for ohmic heating, or providing an RF (or a DC) current through the cutting element and two separate conductors for direct resistive heating of the cutting element.
摘要翻译： 组织切割装置包括在其远侧末端具有窗口的导管，用于将组织导入导管室。 隔室中的圆柱形盒具有支撑导电切割元件的切割边缘，例如， 乐队或电线。 可以通过产生通过切割元件的电流将切割元件和相邻组织加热到所选择的温度。 导管是可操纵的，以将其远端定位在待切割组织附近。 该导管结合有扩张球囊或其它特征以将导管推向组织，使得组织的至少一部分可通过窗口进入隔室。 然后，从导管的近端操作药筒以使切割边缘移过窗口，切割组织。 根据替代实施例，筒相对于导管旋转或轴向移动，并且在任一情况下，当切割完成时，可以能够关闭导管窗口。 另外的替代方案包括将无关电极放置在患者身上，并通过单个导体向切割元件提供RF信号用于欧姆加热，或提供通过切割元件的RF（或DC）电流和用于直接电阻加热的两个分开的导体 的切割元件。
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公开(公告)号：US06887249B1
公开(公告)日：2005-05-03
申请号：US09721158
申请日：2000-11-21
CPC分类号： A61F2/064 , A61B17/11 , A61B17/32053 , A61B2017/00867 , A61B2017/1107 , A61B2017/1135 , A61B2017/306 , A61F2/91
摘要： Anastomosis systems include fittings and compression mechanisms for effecting end-end or end-side couplings of biological or synthetic bypass grafts to vessel locations. The fittings are tubular and surround end regions of the graft. In some applications an end region of the graft is everted and surrounds an exterior of the fitting, in which case the preferred compression mechanism is a retaining ring. A tool is used to evert the graft end region. In other applications, the fitting has an interior groove that receives an expandable retaining ring that urges the graft end region radially outwardly against the fitting. A graft deploying and securing system includes a needle for puncturing vessel tissue, a dilator, and a sheath adapted for containing a graft/fitting combination and guiding the combination into the vessel through an opening formed by the needle and dilator.
摘要翻译： 吻合系统包括用于实现生物或合成旁路移植物到血管位置的端端或端侧耦合的配件和压缩机构。 配件是移植物的管状和环绕端部区域。 在一些应用中，移植物的端部区域是绕过的并且围绕配件的外部，在这种情况下，优选的压缩机构是保持环。 一个工具用于翻转移植物端区域。 在其他应用中，配件具有内部凹槽，该内部凹槽容纳可扩张的保持环，其将接枝端部区域向外径向向外抵靠配件。 移植物展开和固定系统包括用于穿刺血管组织的针，扩张器和适合于容纳移植物/装配组合的护套，并通过由针和扩张器形成的开口将组合引导到血管中。
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公开(公告)号：US06843795B1
公开(公告)日：2005-01-18
申请号：US09721405
申请日：2000-11-21
CPC分类号： A61F2/064 , A61B17/11 , A61B17/32053 , A61B2017/00867 , A61B2017/1107 , A61B2017/1135 , A61B2017/306 , A61F2/91
摘要： Anastomosis systems include fittings and compression mechanisms for effecting end—end or end-side couplings of biological or synthetic bypass grafts to vessel locations. The fittings are tubular and surround end regions of the graft. In some applications an end region of the graft is everted and surrounds an exterior of the fitting, in which case the preferred compression mechanism is a retaining ring. A tool is used to evert the graft end region. In other applications, the fitting has an interior groove that receives an expandable retaining ring that urges the graft end region radially outwardly against the fitting. A graft deploying and securing system includes a needle for puncturing vessel tissue, a dilator, and a sheath adapted for containing a graft/fitting combination and guiding the combination into the vessel through an opening formed by the needle and dilator.
摘要翻译： 吻合系统包括用于实现生物或合成旁路移植物到血管位置的端端或端侧耦合的配件和压缩机构。 配件是移植物的管状和环绕端部区域。 在一些应用中，移植物的端部区域是绕过的并且围绕配件的外部，在这种情况下，优选的压缩机构是保持环。 一个工具用于翻转移植物端区域。 在其他应用中，配件具有内部凹槽，该内部凹槽容纳可扩张的保持环，其将接枝端部区域向外径向向外抵靠配件。 移植物展开和固定系统包括用于穿刺血管组织的针，扩张器和适合于容纳移植物/装配组合的护套，并通过由针和扩张器形成的开口将组合引导到血管中。
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公开(公告)号：US06740101B2
公开(公告)日：2004-05-25
申请号：US09329503
申请日：1999-06-10
IPC分类号： A61B1708
CPC分类号： A61F2/064 , A61B17/11 , A61B17/32053 , A61B2017/00867 , A61B2017/1107 , A61B2017/1135 , A61B2017/306 , A61F2/91
摘要： Anastomosis systems include fittings and compression mechanisms for effecting end-end or end-side couplings of biological or synthetic bypass grafts to vessel locations. The fittings are tubular and surround end regions of the graft. In some applications an end region of the graft is everted and surrounds an exterior of the fitting, in which case the preferred compression mechanism is a retaining ring. A tool is used to evert the graft end region. In other applications, the fitting has an interior groove that receives an expandable retaining ring that urges the graft end region radially outwardly against the fitting. A graft deploying and securing system includes a needle for puncturing vessel tissue, a dilator, and a sheath adapted for containing a graft/fitting combination and guiding the combination into the vessel through an opening formed by the needle and dilator.
摘要翻译： 吻合系统包括用于实现生物或合成旁路移植物到血管位置的端端或端侧耦合的配件和压缩机构。 配件是移植物的管状和环绕端部区域。 在一些应用中，移植物的端部区域是绕过的并且围绕配件的外部，在这种情况下，优选的压缩机构是保持环。 一个工具用于翻转移植物端区域。 在其他应用中，配件具有内部凹槽，该内部凹槽容纳可扩张的保持环，其将接枝端部区域向外径向向外抵靠配件。 移植物展开和固定系统包括用于穿刺血管组织的针，扩张器和适合于容纳移植物/装配组合的护套，并通过由针和扩张器形成的开口将组合引导到血管中。
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公开(公告)号：US06540761B2
公开(公告)日：2003-04-01
申请号：US09804009
申请日：2001-03-12
申请人： Russell A. Houser
发明人： Russell A. Houser
IPC分类号： A61B1732
CPC分类号： A61B18/1492 , A61B2018/00601 , A61B2018/1861 , A61B2218/007
摘要： A tissue cutting device includes a catheter with a window at its distal tip for admitting tissue into a catheter compartment. A cylindrical cartridge in the compartment has a cutting edge that supports an electrically conductive cutting element, e.g. a band or wire. The cutting element and adjacent tissue can be heated to a selected temperature by generating an electrical current through the cutting element. The catheter is maneuverable to position its distal end near the tissue to be cut. The catheter incorporates a vacuum feature that urges tissue into the compartment prior to cutting or severing and assists in holding the tissue during the cutting or severing process. Then, the cartridge is manipulated from the catheter's proximal end to move the cutting edge across the window, cutting the tissue. According to alternative embodiments, the cartridge is either rotated or moved axially relative to the catheter and, in either event may be capable of closing the catheter window when the cut is complete. Further alternatives involve either placing an indifferent electrode on the patient and providing an RF signal via a single conductor to the cutting element for ohmic heating, or providing an RF (or a DC) current through the cutting element and two separate conductors for direct resistive heating of the cutting element. Additional feature of the device include therapeutic infusion before, during or after the cut.
摘要翻译： 组织切割装置包括在其远侧末端具有窗口的导管，用于将组织导入导管室。 隔室中的圆柱形盒具有支撑导电切割元件的切割边缘，例如， 乐队或电线。 可以通过产生通过切割元件的电流将切割元件和相邻组织加热到所选择的温度。 导管是可操纵的，以将其远端定位在待切割组织附近。 该导管结合真空特征，其在切割或切断之前促使组织进入隔室，并有助于在切割或切断过程期间保持组织。 然后，从导管的近端操作药筒以使切割边缘移过窗口，切割组织。 根据替代实施例，筒相对于导管旋转或轴向移动，并且在任一情况下，当切割完成时，可以能够关闭导管窗口。 另外的替代方案包括将无关电极放置在患者身上，并通过单个导体向切割元件提供RF信号用于欧姆加热，或提供通过切割元件的RF（或DC）电流和用于直接电阻加热的两个分开的导体 的切割元件。 该装置的附加特征包括切割之前，期间或之后的治疗输液。
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公开(公告)号：US06494889B1
公开(公告)日：2002-12-17
申请号：US09654216
申请日：2000-09-01
IPC分类号： A61B1708
CPC分类号： A61B17/11 , A61B17/064 , A61B17/32053 , A61B2017/00867 , A61B2017/1107 , A61B2017/1135 , A61B2017/306
摘要： This invention is related to devices and systems for creating sutureless anastomoses. In particular, this invention is related to devices for deploying and securing the ends of bypass grafts designed to provide a fluid flow passage between at least two vessels or tubular structures. A variety of compressible, expandable fittings, loading and delivery sheaths, tools, and other devices for creating end-end and end-side anastomoses, as well as methods for their use, are disclosed. In addition, robotic, remotely operable systems and devices for creating sutureless anastomoses in minimally invasive applications are disclosed. The systems of this invention do not require stopping or re-routing blood flow to perform an anastomosis between a bypass graft and a host vessel. Accordingly, this invention describes sutureless anastomosis systems that do not require cardiopulmonary bypass support when treating coronary artery disease.
摘要翻译： 本发明涉及用于创建无缝合吻合的装置和系统。 特别地，本发明涉及用于部署和固定旁路移植物的末端的装置，其设计成在至少两个血管或管状结构之间提供流体流动通道。 公开了各种可压缩，可扩张的配件，装载和传送护套，工具和用于创建端端和端侧吻合的其它装置，以及用于其使用的方法。 此外，公开了用于在微创应用中创建无缝合吻合的机器人，可远程操作的系统和装置。 本发明的系统不需要停止或重新路由血流来执行旁路移植物和宿主血管之间的吻合。 因此，本发明描述了当治疗冠状动脉疾病时不需要体外循环支持的无缝合吻合系统。
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公开(公告)号：US06293955B1
公开(公告)日：2001-09-25
申请号：US09415776
申请日：1999-10-08
IPC分类号： A61B1708
CPC分类号： A61F2/2424 , A61B17/11 , A61B17/34 , A61B2017/00247 , A61B2017/00252 , A61B2017/1107 , A61B2017/1135 , A61B2018/00392 , A61F2/0009 , A61F2/064 , A61F2/07 , A61F2/90 , A61F2002/30098 , A61F2002/30583 , A61F2210/0033 , A61F2210/0085 , A61F2230/0078 , A61M29/02
摘要： A bypass graft incorporates fixation mechanisms at its opposite ends, for securing these ends to different locations along a blood vessel, or alternatively to different locations wherein one of the locations is a different vessel or an organ defining a cavity. Mechanical fixation features such as collets or grommets can be employed, enhanced by delivery of an electrical current sufficient to heat surrounding tissue to form a thermal bond. A graft deployment system includes a tissue dilator and a needle for perforating tissue, mounted coaxially within the dilator. Intralumenal systems further include a catheter for containing the dilator.
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公开(公告)号：US06217585B1
公开(公告)日：2001-04-17
申请号：US08911838
申请日：1997-08-15
IPC分类号： A61F1100
CPC分类号： A61F2/958 , A61B2017/1205 , A61F2/95 , A61M29/02
摘要： A deployment device for stents and grafts includes a catheter, an expansion framework or cage near the catheter distal end, and a means for controlling expansion from a proximal end of the catheter. The cage is formed of a plurality of elongate strands coupled at opposite ends to the catheter and to the control device. Axial movement of the control device relative to the catheter either elongates the strands to radially collapse the cage, or axially reduces the distance between the strand ends for radial enlargement. In one embodiment the control device is a stylet contained in a lumen of the catheter and extending beyond the catheter distal end. The strands are fixed at their opposite ends to the catheter distal end and the stylet distal end. In another embodiment, the strands are coupled to proximal and distal rings along the catheter, with one of the rings being axially movable by a wire to radially expand and reduce the cage.
摘要翻译： 用于支架和移植物的展开装置包括在导管远端附近的导管，扩张框架或笼子，以及用于控制从导管的近端膨胀的装置。 保持架由在导管和控制装置的相对端处联接的多个细长线形成。 控制装置相对于导管的轴向运动可以伸长股线以使笼子径向折叠，或者轴向地减小股线端之间的距离用于径向放大。 在一个实施例中，控制装置是包含在导管的内腔中并延伸超过导管远端的探针。 股线在其相对端固定到导管远端和管心针远端。 在另一个实施例中，股线沿着导管联接到近端和远端环，其中一个环可通过线轴向移动以径向扩张并减小笼。
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公开(公告)号：US5860920A
公开(公告)日：1999-01-19
申请号：US931229
申请日：1997-09-16
CPC分类号： A61B5/6855 , A61B18/1492 , A61B5/0422 , A61N1/08 , A61N1/3686 , A61N1/403 , A61B2017/003 , A61B2018/00148 , A61B2018/00952 , A61B2018/1407 , A61B2018/1435 , A61B2018/1861 , A61B5/6857 , A61B5/6858
摘要： Systems and methods sense electrical events about a selected annulus region of the heart to identify the location of an accessory pathway. The systems and methods establish a contact site between heart tissue along the selected annulus and a multi-electrode array having a generally circular shape that conforms to the circumferential geometry of the selected annulus region. The systems and methods maintain the site of contact between the electrode array and heart tissue, while conveying signals representing electrical events sensed by bipolar pairs of the electrodes in the selected annulus region, The systems and methods display the signals as graphic information that represents the time differences between the atrial and ventricular electrogram complexes sensed by bipolar pairs of the electrodes on the selected annulus region. The bipolar pair of electrodes displaying the least time separation between the atrial and ventricular complexes identifies the region of the accessory pathway. With this information, the systems and methods convey energy to one or more of the electrodes of the selected pair to ablate tissue in the selected annulus region.
摘要翻译： 系统和方法检测关于心脏的选定环区的电事件以识别附件通路的位置。 系统和方法建立沿所选择的环的心脏组织之间的接触位置，以及具有符合所选择的环面区域的圆周几何形状的大致圆形形状的多电极阵列。 系统和方法保持电极阵列和心脏组织之间的接触部位，同时传送表示由所选择的环带区域中的电极的双极对感测的电气事件的信号。系统和方法将信号显示为表示时间的图形信息 通过所选择的环面区域上的电极的双极对检测心房和心室电描记图复合体之间的差异。 显示心房和心室复合体之间的最小时间间隔的双极电极对识别辅助通路的区域。 利用该信息，系统和方法将能量传送到所选择的一对的电极中的一个或多个以消除所选择的环带区域中的组织。
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