公开(公告)号：US5722984A

公开(公告)日：1998-03-03

申请号：US585760

申请日：1996-01-16

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

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

IPC分类号： A61F2/00 ,  A61F2/82 ,  A61F2/88 ,  A61L29/16 ,  A61L31/16 ,  A61M36/04 ,  A61N5/10 ,  A61B17/00 ,  A61N5/00

CPC分类号： A61F2/82 ,  A61L29/16 ,  A61L31/16 ,  A61N5/1002 ,  A61F2/0077 ,  A61F2/88 ,  A61L2300/42 ,  A61L2300/44 ,  A61L2300/606

摘要： Disclosed is a coating material which has both antithrombogenic properties and contains an embedded radioisotope that makes the coating material radioactive As phosphorous 32 is emerging as the preferred isotope for vascular radioisotope stents, and phosphorylcholine has shown promise as an antithrombogenic stent coating, it is envisioned here to produce a stent with a phosphorylcholine coating with some of the phosphorous in the coating being phosphorous 32 rather than the naturally occurring, non-radioactive element phosphorous 31. In this manner one has a stent which has a single stent coating which is both antithrombogenic and radioactive. The stent could also utilize an inner layer which is both antithrombogenic and radioactive and an outer layer which is only antithrombogenic. A preferred embodiment of the invention is to produce a phosphorylcholine coated stent where some of the phosphate groups contain the radioisotope phosphorous 32.

摘要翻译： 本发明公开了一种具有抗血栓形成性质并含有放射性同位素的涂层材料，其使得涂层材料放射性，因为磷32正在出现作为血管放射性同位素支架的优选同位素，磷酸胆碱已被证明是抗凝血支架涂层的前景， 以制备具有磷酸胆碱涂层的支架，其中涂层中的一些磷是磷32而不是天然存在的非放射性元素磷31.以这种方式，具有单支架涂层的支架，其具有抗血栓形成和 放射性 支架也可以利用抗凝血和放射性的内层和仅抗血栓形成的外层。 本发明的优选实施方案是制备其中一些磷酸基团含有放射性同位素磷32的磷酰胆碱涂层的支架。

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：US5011490A

公开(公告)日：1991-04-30

申请号：US447187

申请日：1989-12-07

申请人： Robert E. Fischell ,  Tim A. Fischell

发明人： Robert E. Fischell ,  Tim A. Fischell

IPC分类号： A61B17/00 ,  A61B17/22 ,  A61B17/32 ,  A61M25/00

CPC分类号： A61B17/32075

摘要： An Endoluminal Tissue Excision Catheter (ETEC) is described which is capable of excising obstructive tissue from a vessel in a living body. The ETEC system operates by first passing a guide wire through the vessel and beyond the obstructive tissue. The ETEC catheter is then advanced over the guide wire until its distal end lies beyond the obstructive tissue. A closing catheter portion of ETEC is then pulled back from a cut/collect catheter portion of the ETEC thus exposing a cutting edge located at the proximal end of a cylindrical cutting blade located at a distal portion of the cut/collect catheter. A rotating means is then attached to the cut/collect catheters'3 s proximal end. The cut/collect catheter is then pulled back in a retrograde direction while rotating, thus cutting and collecting the excised obstructive tissue into a tissue collection chamber that is formed within the cylindrical cutting blade. The entire ETEC system including the cut/collect and closing catheters and the guide wire is then removed from the vessel. Means are provided to flush the collected tissue out of the tissue collection chamber after the ETEC catheter is outside of the living body.

公开(公告)号：US4898575A

公开(公告)日：1990-02-06

申请号：US205541

申请日：1988-06-10

申请人： Robert E. Fischell ,  Tim A. Fischell

发明人： Robert E. Fischell ,  Tim A. Fischell

IPC分类号： A61B17/22 ,  A61B18/14 ,  A61M1/00

CPC分类号： A61B17/3207 ,  A61B17/22012 ,  A61B18/14 ,  A61B2017/22038 ,  A61B2217/005

摘要： An atherectomy catheter is advanced over a guide wire in the anterograde direction to the site of an arterial stenosis. The distal end of the catheter is centered around the guide wire which has been previously advanced through the stenotic lumen. The catheter is then advanced over the guide wire with its sharpened distal end cutting through the stenosis. The atherectomy catheter can also employ rotation or vibration or an electrocautery current to enhance the catheter's cutting action. Suction applied at the catheter's proximal end is used to enhance the collection of plaque cut from the stenosis at the catheter's distal end so that the cut plaque enters a single passageway that lies between the outer surface of the guide wire and the inner surface of the cylindrical catheter.

摘要翻译： 动脉粥样硬化切除术导管沿横行方向前进到导管位于动脉狭窄部位。 导管的远端围绕先前通过狭窄管腔前进的引导线居中。 然后将导管推过导丝，其尖锐的远端切穿狭窄。 粥样斑块切除术导管还可以采用旋转或振动或电灼电流来增强导管的切割动作。 在导管的近端施加的吸力用于增强从导管远端的狭窄切割的斑块的收集，使得切割的斑块进入位于导丝的外表面和圆柱形内表面之间的单个通道 导管。

公开(公告)号：US08535294B2

公开(公告)日：2013-09-17

申请号：US13150308

申请日：2011-06-01

申请人： Robert E. Fischell ,  Timothy J. Lynch ,  Tim A. Fischell

发明人： Robert E. Fischell ,  Timothy J. Lynch ,  Tim A. Fischell

IPC分类号： A61M25/00

CPC分类号： A61M25/0054 ,  A61M25/0045 ,  A61M25/005

摘要： The present invention is a carotid sheath that has a proximal portion that is stiffer than the distal portion of the sheath as a result of the proximal portion having a higher durometer of the outer plastic coating of the sheath's proximal portion with a lower durometer for the plastic coating on the more flexible distal portion of the sheath. Another means to increase the flexibility of the sheath's distal portion compared to a stiffer proximal portion is by having a slightly smaller outside diameter for the outer plastic coating of the distal portion of the sheath. A more flexible distal portion of the sheath allows easier access for angiography, angioplasty or stenting when the sheath is used to access the tortuous path encountered when entering the carotid arteries.

摘要翻译： 本发明是一种颈动脉鞘，其具有比鞘的远端部更硬的近端部分，因为近端部分具有较高硬度的护套近端部分的塑料涂层，其中较低的硬度计用于塑料 涂覆在护套的更柔性的远端部分上。 与较硬的近端部分相比，增加护套远端部分的灵活性的另一种手段是通过对鞘的远侧部分的外部塑料涂层具有略小的外径。 当护套用于进入进入颈动脉期间遇到的曲折路径时，鞘的更柔性的远侧部分允许更容易地进行血管造影，血管成形术或支架置入。

公开(公告)号：US5167644A

公开(公告)日：1992-12-01

申请号：US656591

申请日：1991-02-19

申请人： Robert E. Fischell ,  Tim A. Fischell

发明人： Robert E. Fischell ,  Tim A. Fischell

IPC分类号： A61M39/06 ,  A61M39/20

CPC分类号： A61M39/20 ,  A61M39/06

摘要： A sheath for percutaneous insertion into an artery includes a manually insertable sealing tab having a flexible hinge molded onto the sheath near its proximal end. The tab includes a cylindrically shaped stopper that can be inserted into the sheath's proximal end to prevent blood loss when there is no catheter inserted into the sheath. The stopper design allows a guide wire to remain in place or be advanced or pulled out of the sheath when the stopper is in place to seal the sheath's proximal end.

摘要翻译： 用于经皮插入动脉的鞘包括可手动插入的密封片，其具有在其近端附近模制到护套上的柔性铰链。 翼片包括一个圆柱形的止动器，可以插入护套的近端，以防止当没有导管插入护套时失血。 止动器设计允许导线保持在适当位置，或者当止动器就位以密封护套的近端时，引导线保持在适当位置或被推进或拉出护套。

公开(公告)号：US5059166A

公开(公告)日：1991-10-22

申请号：US448691

申请日：1989-12-11

申请人： Robert E. Fischell ,  Tim A. Fischell

发明人： Robert E. Fischell ,  Tim A. Fischell

IPC分类号： A61B17/00 ,  A61F2/00 ,  A61F2/82 ,  A61F2/88 ,  A61K51/12 ,  A61L31/14 ,  A61M36/00 ,  A61M36/04 ,  A61N5/10

CPC分类号： A61F2/82 ,  A61F2/0077 ,  A61F2/88 ,  A61K51/1282 ,  A61L31/14 ,  A61N5/1002 ,  A61F2210/0095

摘要： Intra-arterial stents are frequently used subsequent to balloon angioplasty to maintain arterial patency. The most frequent cause for failure to maintain patency is the rapid growth of the injured arterial tissue through the openings in the stent, which rapid growth is called "intimal hyperplasia." Since irradiation from a radioisotope source is capable of selectively inhibiting the growth of hyperproliferating cells as compared with normal cells, a radioisotope material which forms part of the stent can be used to decrease the rate of arterial reclosure. The radioisotope could be placed inside the stent, alloyed into the metal from which the stent is made, or preferably, it can be coated onto the stent's exterior surface. Beta emitting radioisotopes having a half-life between 1 and 100 days would be best suited as a stent coating because of their comparatively short range of action within human tissue, and because of their comparatively short half-life. An anti-thrombogenic coating placed on the outer surface of the radioisotope stent would further reduce arterial reclosure by decreasing stent thrombogenicity.

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。