公开(公告)号：US20190117936A9

公开(公告)日：2019-04-25

申请号：US13643065

申请日：2012-08-22

申请人： David R. Fischell ,  Tim A. Fischell

发明人： David R. Fischell ,  Tim A. Fischell

IPC分类号： A61M25/00 ,  A61M25/06 ,  A61M25/01

摘要： A catheter-based/intravascular ablation (denervation) system includes a multiplicity of needles which expand open around a central axis to engage the wall of a blood vessel, or the wall of the left atrium, allowing the injection of a cytotoxic or/or neurotoxic solution for ablating conducting tissue, or nerve fibers around the ostium of the pulmonary vein, or circumferentially in or just beyond the outer layer of the renal artery. The expandable needle delivery system is formed with self-expanding materials and include structures, near the end portion of the needles, or using separate guide tubes. The system also includes means to limit and/or adjust the depth of penetration of the ablative fluid into the tissue of the wall of the targeted blood vessel. The preferred embodiment of the catheter delivered through the vascular system of a patient includes a multiplicity of expandable guide tubes that engage the wall of a blood vessel. Injection needles having injection egress at or near their sharpened distal end are then advanced through the guide tubes to penetrate the wall of the blood vessel to a prescribed depth. The ability to provide PeriVascular injection so as to only affect the outer layer(s) of a blood vessel without affecting the media has particular application for PeriVascular Renal Denervation (PVRD) of the sympathetic nerves which lie in the adventitia or outside the adventitia of the renal artery.

公开(公告)号：US09237925B2

公开(公告)日：2016-01-19

申请号：US13196104

申请日：2011-08-02

申请人： David R. Fischell ,  Tim A. Fischell

发明人： David R. Fischell ,  Tim A. Fischell

IPC分类号： A61M29/00 ,  A61B18/14 ,  A61B5/042 ,  A61B17/22 ,  A61B18/00 ,  A61B19/00 ,  A61M25/00

CPC分类号： A61B18/06 ,  A61B5/042 ,  A61B18/1477 ,  A61B18/1492 ,  A61B90/39 ,  A61B2017/22038 ,  A61B2017/22068 ,  A61B2018/0016 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00285 ,  A61B2018/00375 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00839 ,  A61B2018/143 ,  A61B2018/1475 ,  A61B2090/3966 ,  A61M2025/0087

摘要： At the present time, physicians often treat patients with atrial fibrillation (AF) using radiofrequency (RF) catheter systems to ablate conducting tissue in the wall of the Left Atrium of the heart around the ostium of the pulmonary veins. These systems are expensive and take time consuming to use. The present invention circular ablation system CAS includes a multiplicity of expandable needles that can be expanded around a central axis and positioned to inject a fluid like ethanol to ablate conductive tissue in a ring around the ostium of a pulmonary vein quickly and without the need for expensive capital equipment. The expansion of the needles is accomplished by self-expanding or balloon expandable structures. The invention includes centering means so that the needles will be situated in a pattern surrounding the outside of the ostium of a vein. Also included are members that limit the distance of penetration of the needles into the wall of the left atrium, or the aortic wall. The present invention also has an important application to ablate tissue around the ostium of one or both renal arteries, for the ablation of the sympathetic nerve fibers and/or other afferent or efferent nerves going to or from each kidney in order to treat hypertension.

摘要翻译： 目前，医生经常使用射频（RF）导管系统治疗房颤患者，以消融肺静脉周围心脏左心房壁的导电组织。 这些系统是昂贵的并且花费耗时的使用。 本发明的圆形消融系统CAS包括多个可扩展的针，其可以围绕中心轴线扩张并且被定位成像乙醇一样注入流体，以便快速地在肺静脉的口周围环绕环中的导电组织，而不需要昂贵的 资本设备。 针的膨胀通过自膨胀或球囊可膨胀结构来实现。 本发明包括定心装置，使得针头将位于围绕静脉口的外侧的图案中。 还包括限制针穿入左心房壁或主动脉壁的距离的构件。 本发明还具有重要的应用，用于消除一个或两个肾动脉周围的组织，用于消除去往或来自每个肾脏的交感神经纤维和/或其他传入或传出神经以治疗高血压。

公开(公告)号：US20140358079A1

公开(公告)日：2014-12-04

申请号：US13643065

申请日：2012-08-22

申请人： David R. Fischell ,  Tim A. Fischell

发明人： David R. Fischell ,  Tim A. Fischell

IPC分类号： A61M25/00 ,  A61M25/01 ,  A61M25/06

摘要： A catheter-based/intravascular ablation (denervation) system includes a multiplicity of needles which expand open around a central axis to engage the wall of a blood vessel, or the wall of the left atrium, allowing the injection of a cytotoxic or/or neurotoxic solution for ablating conducting tissue, or nerve fibers around the ostium of the pulmonary vein, or circumferentially in or just beyond the outer layer of the renal artery. The expandable needle delivery system is formed with self-expanding materials and include structures, near the end portion of the needles, or using separate guide tubes. The system also includes means to limit and/or adjust the depth of penetration of the ablative fluid into the tissue of the wall of the targeted blood vessel. The preferred embodiment of the catheter delivered through the vascular system of a patient includes a multiplicity of expandable guide tubes that engage the wall of a blood vessel. Injection needles having injection egress at or near their sharpened distal end are then advanced through the guide tubes to penetrate the wall of the blood vessel to a prescribed depth. The ability to provide PeriVascular injection so as to only affect the outer layer(s) of a blood vessel without affecting the media has particular application for PeriVascular Renal Denervation (PVRD) of the sympathetic nerves which lie in the adventitia or outside the adventitia of the renal artery.

摘要翻译： 基于导管的/血管内消融（去神经支配）系统包括多个针，其围绕中心轴线开放，以与血管的壁或左心房的壁接合，允许注射细胞毒性和/或神经毒性 用于烧蚀导管组织的解决方案，或在肺静脉口周围的神经纤维，或在肾动脉的外层周向或刚好超出肾动脉的外层。 可扩展针递送系统由自膨胀材料形成，并且包括在针的端部附近的结构，或者使用单独的导管。 该系统还包括限制和/或调节烧蚀液体渗透到目标血管壁的组织中的深度的装置。 通过患者的血管系统递送的导管的优选实施例包括接合血管壁的多个可扩张的导管。 然后在其尖锐的远端处或其附近具有注射出口的注射针穿过引导管，以将血管的壁穿透到规定的深度。 提供血管周围注射以仅影响血管的外层而不影响培养基的能力特别适用于位于外膜或外膜外侧的交感神经的血管外肾去神经（PVRD） 肾动脉。

公开(公告)号：US08663190B2

公开(公告)日：2014-03-04

申请号：US13092363

申请日：2011-04-22

申请人： David R. Fischell ,  Tim A. Fischell

发明人： David R. Fischell ,  Tim A. Fischell

IPC分类号： A61M31/00

CPC分类号： A61B18/1492 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00375 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/143 ,  A61M5/00

摘要： At the present time, physicians often treat patients with atrial fibrillation (AF) using radiofrequency (RF) catheter systems to ablate conducting tissue in the wall of the Left Atrium of the heart around the ostium of the pulmonary veins. These systems are expensive and take time consuming to use. The present invention circular ablation system CAS includes a multiplicity of expandable needles that can be expanded around a central axis and positioned to inject a fluid like ethanol to ablate conductive tissue in a ring around the ostium of a pulmonary vein quickly and without the need for expensive capital equipment. The expansion of the needles is accomplished by self-expanding or balloon expandable structures. The invention includes centering means so that the needles will be situated in a pattern surrounding the outside of the ostium of a vein. Also included are members that limit the distance of penetration of the needles into the wall of the left atrium. The present invention also has application to ablating tissue around the ostium of a renal artery for the treatment of hypertension.

摘要翻译： 目前，医生经常使用射频（RF）导管系统治疗房颤患者，以消融肺静脉周围心脏左心房壁的导电组织。 这些系统是昂贵的并且花费耗时的使用。 本发明的圆形消融系统CAS包括多个可扩展的针，其可以围绕中心轴线扩张并且被定位成像乙醇一样注入流体，以便快速地在肺静脉的口周围环绕环中的导电组织，而不需要昂贵的 资本设备。 针的膨胀通过自膨胀或球囊可膨胀结构来实现。 本发明包括定心装置，使得针头将位于围绕静脉口的外侧的图案中。 还包括限制针头进入左心房壁的距离的成员。 本发明还可用于消除肾动脉口周围的组织用于治疗高血压。

公开(公告)号：US07801596B2

公开(公告)日：2010-09-21

申请号：US11130110

申请日：2005-05-17

申请人： David R. Fischell ,  Jonathan Harwood ,  Steven R. Johnson ,  Tim A. Fischell

发明人： David R. Fischell ,  Jonathan Harwood ,  Steven R. Johnson ,  Tim A. Fischell

IPC分类号： A61B5/0452

CPC分类号： A61N1/37247 ,  A61N1/36557

摘要： A programmer is provided for an implantable medical device capable of detecting cardiac events in a human patient. The programmer has a two-way wireless data communication mechanism with the implantable medical device and a graphical user interface is included which has a display and input mechanism designed for use in programming patient specific parameters for the detection of ST shift related cardiac events.

摘要翻译： 提供了一种能够检测人类患者心脏事件的可植入医疗装置的编程器。 程序员具有可植入医疗装置的双向无线数据通信机制，并且包括图形用户界面，其具有设计用于编程患者特定参数以用于检测ST移位相关心脏事件的显示和输入机制。

公开(公告)号：US09056185B2

公开(公告)日：2015-06-16

申请号：US13342521

申请日：2012-01-03

申请人： David R. Fischell ,  Tim A. Fischell

发明人： David R. Fischell ,  Tim A. Fischell

IPC分类号： A61M31/00 ,  A61M25/00 ,  A61M5/46 ,  A61M25/06 ,  A61B5/00

CPC分类号： A61M5/46 ,  A61B5/6848 ,  A61M25/0026 ,  A61M25/0084 ,  A61M25/0097 ,  A61M25/0662 ,  A61M2025/0039 ,  A61M2025/0085 ,  A61M2025/0086 ,  A61M2025/0681 ,  A61M2202/0007 ,  A61M2205/0266 ,  A61M2210/12

摘要： A catheter-based/intravascular fluid injection system with application to renal denervation includes a multiplicity of needles which expand open around a central axis to engage the wall of a blood vessel, or the wall of the left atrium, allowing the injection of a cytotoxic and/or neurotoxic solution for ablating conducting tissue, or nerve fibers around the ostium of the pulmonary vein, or circumferentially in or just beyond the outer layer of the renal artery. The expandable delivery system includes expandable components that facilitate positioning of a multiplicity of injection needles against the inside wall of a blood vessel from where they can be advanced. The system also includes means to limit and/or adjust the depth of penetration of the ablative fluid into the tissue of the wall of the targeted blood vessel.

摘要翻译： 应用于肾去神经支配的基于导管的/血管内流体注射系统包括多个针，其围绕中心轴线敞开，以与血管的壁或左心房的壁接合，允许注射细胞毒性和 或用于烧蚀导管组织的神经毒性溶液，或肺静脉口周围的神经纤维，或在肾动脉的外层周围或周边。 可扩展递送系统包括可扩展部件，其有助于将多个注射针定位在血管的内壁上，从而可以将其推进。 该系统还包括限制和/或调节烧蚀液体渗透到目标血管壁的组织中的深度的装置。

公开(公告)号：US4699615A

公开(公告)日：1987-10-13

申请号：US796409

申请日：1985-11-08

申请人： David R. Fischell ,  Tim A. Fischell

发明人： David R. Fischell ,  Tim A. Fischell

IPC分类号： A61M5/142 ,  A61M1/00

CPC分类号： A61M5/16877 ,  A61M5/1424 ,  A61M2005/14264 ,  Y10S128/12

摘要： A Finger Actuated Medication Infusion System (FAMIS) for delivering a dosage of medication into a living body. The FAMIS is fully mechanical and comprises a reservoir, a pump and connecting catheters. The reservoir includes a sealed bellows portion which contains a pressurant and exerts a substantially constant pressure on the medication in the reservoir, regardless of the amount of medication therein. The pump includes a bellows assembly disposed within an equalizing pressure chamber, and will deliver medication through the bellows assembly at a predetermined flow rate independent of ambient temperature, ambient pressure or the amount of medication remaining in the reservoir. The FAMIS design also provides safeguards against inadvertant overdosing, transmission of bacteria into the body and prevents gas bubbles within the reservoir from impeding the flow of medication through an outlet flow restrictor which forms part of the FAMIS pump.

摘要翻译： 手指致动药物输注系统（FAMIS），用于将一定剂量的药物输送到活体内。 FAMIS是完全机械的，包括一个储存器，一个泵和连接导管。 储存器包括密封的波纹管部分，其包含加压剂并对储存器中的药物施加基本恒定的压力，而不管其中的药物量。 泵包括设置在均压压力室内的波纹管组件，并且将以与环境温度，环境压力或储存器中剩余的药物量无关的预定流速将药物通过波纹管组件输送。 FAMIS设计还提供了防止意外过量的细菌传播到身体中并防止储存器内的气泡阻止药物流过形成FAMIS泵的一部分的出口限流器的保护装置。

公开(公告)号：US07494458B2

公开(公告)日：2009-02-24

申请号：US11974712

申请日：2007-10-15

申请人： Robert E. Fischell ,  David R. Fischell ,  Adrian R. M. Upton

发明人： Robert E. Fischell ,  David R. Fischell ,  Adrian R. M. Upton

IPC分类号： A61N2/04

CPC分类号： A61N2/02

摘要： Disclosed is a system and method for treating headaches. The system employs a self-contained, battery operated, readily portable and easy-to-operate head-mounted magnetic depolarizer to generate a transient or time-varying high-intensity magnetic field into and around the user's head or neck. The magnetic depolarizer system can be used to depolarize the neurons of the brain and/or the trigeminal nerve. This type of neuronal depolarization has the capability for terminating migraine or other types of headaches.

摘要翻译： 公开了一种治疗头痛的系统和方法。 该系统采用独立的电池供电，易于携带和易于操作的头戴磁性去极化器，以在用户的​​头部或颈部内和周围产生瞬时或时变的高强度磁场。 磁去极化系统可用于去极化脑和/或三叉神经的神经元。 这种类型的神经元去极化具有终止偏头痛或其他类型头痛的能力。

公开(公告)号：US06427086B1

公开(公告)日：2002-07-30

申请号：US09557168

申请日：2000-04-21

申请人： Robert E. Fischell ,  David R. Fischell ,  Adrian R. M. Upton ,  Dennis R. Potts ,  Benjamin D. Pless

发明人： Robert E. Fischell ,  David R. Fischell ,  Adrian R. M. Upton ,  Dennis R. Potts ,  Benjamin D. Pless

IPC分类号： A61N136

CPC分类号： A61B5/6814 ,  A61B5/0476 ,  A61B5/4094 ,  A61N1/36017 ,  A61N1/36025 ,  A61N1/3605 ,  A61N1/36064 ,  A61N1/37235

摘要： Disclosed is a means and method for placing an implantable neurostimulator control module into a place in the cranium where cranial bone has been removed. The method for accomplishing this cranial implantation is by first removing a patient's hair over the site of the implant, then cutting the scalp at that site and pulling it back to expose the cranium. A neurosurgeon would then remove a portion of the cranial bone to accept a control module to be implanted within that hole. The control module would then be placed into that hole. It is also conceived that the control module would be fixed in place by the use of one or more attachment devices such as a multiplicity of bone screws placed through holes in one or more flanges that extend over the cranium beyond the control module. The implantation could also include a fairing placed around the control module to provide a smooth contour under the patient's scalp. Also described is a spacer shim placed under the flange(s) to adjust the position of the control module so that its bottom surface does not put pressure on the dura mater lying directly over the brain tissue at the bottom of the hole. It is also envisioned that a resorbable disk could be placed under the bottom surface of the control module to further protect the brain and/or to elute an anti-biotic or anti-inflammatory substance to reduce the possibility of infection and/or inflammation.

摘要翻译： 公开了一种用于将可植入的神经刺激器控制模块放置在颅骨已被移除的头颅中的位置的手段和方法。 完成这种颅骨植入的方法是首先将患者的头发去除植入物的部位，然后在该部位切割头皮并将其拉回以暴露颅骨。 然后，神经外科医生将去除颅骨的一部分以接受待植入该孔内的控制模块。 然后将控制模块放入该孔中。 还可以想到，控制模块将通过使用一个或多个附接装置固定在适当的位置，例如通过一个或多个凸缘中的孔布置的多个骨螺钉，所述多个骨螺钉在颅骨上延伸超过控制模块。 植入还可以包括放置在控制模块周围的整流罩，以在患者的头皮下面提供平滑的轮廓。 还描述了放置在凸缘下方的间隔垫片，以调节控制模块的位置，使得其底部表面不对直接位于孔底部的脑组织的硬脑膜施加压力。 还可以设想，可再吸收的盘可以放置在控制模块的底表面下方以进一步保护大脑和/或洗脱抗生素或抗炎物质以减少感染和/或炎症的可能性。

公开(公告)号：US6061593A

公开(公告)日：2000-05-09

申请号：US65739

申请日：1998-04-24

申请人： Robert E. Fischell ,  David R. Fischell ,  Adrian R. M. Upton

发明人： Robert E. Fischell ,  David R. Fischell ,  Adrian R. M. Upton

IPC分类号： A61N1/36 ,  A61D5/0476

CPC分类号： A61B5/0476 ,  A61B5/4094 ,  A61B5/6814 ,  A61N1/3605 ,  A61N1/36025 ,  A61N1/36082 ,  A61N1/37211

摘要： Disclosed herein is a multiple electrode, closed-loop system for the treatment of certain neurological disorders such as epilepsy, migraine headaches and Parkinson's disease. Specifically, the present invention combines a multi-electrode array with sophisticated signal processing techniques to achieve reliable detection of the onset of a neurological event (such as an epileptic seizure or migraine headache) typically originating from a focus of limited spatial extent within the brain. It is highly desirable to detect an epileptic seizure at least 5 seconds before the onset of clinical symptoms. Since there is often a d-c shift in the EEG voltage more than 5 seconds before the seizure, disclosed herein is a means for utilizing the d-c shift of the EEG for early detection of the seizure.

摘要翻译： 本文公开了用于治疗某些神经障碍如癫痫，偏头痛和帕金森病的多电极闭环系统。 具体地，本发明将多电极阵列与复杂的信号处理技术相结合，以实现通常来自脑内有限空间范围内的焦点的神经系统事件（例如癫痫发作或偏头痛头痛）的发作的可靠检测。 在临床症状发作前至少5秒检测癫痫发作是非常需要的。 由于在癫痫发作前超过5秒脑电图经常发生d-c偏移，所以这里公开了利用脑电图的d-c位移来早期检测癫痫发作的手段。