公开(公告)号：US20070073281A1

公开(公告)日：2007-03-29

申请号：US11385358

申请日：2006-03-20

申请人： Kevin Johnson ,  Dana Mester ,  Gregory Brucker ,  Paul Asselin ,  Robert Clapp ,  Adam Berman

发明人： Kevin Johnson ,  Dana Mester ,  Gregory Brucker ,  Paul Asselin ,  Robert Clapp ,  Adam Berman

IPC分类号： A61B18/18

CPC分类号： A61B18/24 ,  A61B18/02 ,  A61B18/1492 ,  A61B90/11 ,  A61B2017/00243 ,  A61B2018/00196 ,  A61B2018/2288

摘要： An apparatus for forming a lesion in tissue along a desired ablation path includes a guide member having a tissue-opposing surface for placement against a heart surface. A guide carriage is sized to be received within the guide member and moveable therein along a longitudinal axis. A flexible tubular member extends from a proximal end of said carriage and through a length of the guide member with the tubular member adapted to move the carriage within the guide member upon application of a force to the tubular member. A system urges the carriage to move in a path along an axis of the guide member by amount substantially identical to a displacement of a force application location on the flexible tubular member.

摘要翻译： 用于沿着期望的消融路径在组织中形成病变的装置包括具有用于放置在心脏表面上的组织相对表面的引导构件。 引导托架的尺寸被设计成被容纳在引导构件内并沿着纵向轴线在其中可移动。 柔性管状构件从所述托架的近端延伸并且穿过引导构件的长度，其中管状构件适于在对管状构件施加力时将托架移动到引导构件内。 系统促使滑架沿着引导构件的轴线的路径移动，其量基本上与柔性管状构件上的施力位置的位移相同。

公开(公告)号：US20070073277A1

公开(公告)日：2007-03-29

申请号：US11385317

申请日：2006-03-20

申请人： Kevin Johnson ,  Dana Mester ,  Gregory Brucker ,  Paul Asselin ,  Robert Clapp ,  Adam Berman

发明人： Kevin Johnson ,  Dana Mester ,  Gregory Brucker ,  Paul Asselin ,  Robert Clapp ,  Adam Berman

IPC分类号： A61B18/18

CPC分类号： A61B18/22 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/117 ,  A61B18/20 ,  A61B18/24 ,  A61B2017/00026 ,  A61B2017/00084 ,  A61B2017/00115 ,  A61B2017/00243 ,  A61B2017/00247 ,  A61B2017/0243 ,  A61B2017/306 ,  A61B2017/3488 ,  A61B2018/00011 ,  A61B2018/00196 ,  A61B2018/00392 ,  A61B2018/00577 ,  A61B2018/00636 ,  A61B2018/2288 ,  A61B2090/064

摘要： An apparatus for forming a lesion in tissue along a desired ablation path includes a guide member having a tissue-opposing surface for placement against a heart surface. A guide carriage is sized to be received within the guide member and moveable along a longitudinal axis of the guide member. A tubular member extends from a proximal end of the carriage and out a proximal end of the guide member. An ablation element is carried in the carriage for movement. The ablation member is connected to a source of ablation energy through the tubular member. A sensor is provided for sensing a safety condition. The sensor is connected to a monitor external the guide member.

摘要翻译： 用于沿着期望的消融路径在组织中形成病变的装置包括具有用于放置在心脏表面上的组织相对表面的引导构件。 导向架的尺寸被设计成被容纳在引导构件内并且可以沿着引导构件的纵向轴线移动。 管状构件从托架的近端延伸并且从引导构件的近端延伸出来。 在滑架中携带消融元件用于移动。 消融构件通过管状构件连接到消融能量源。 提供传感器用于感测安全条件。 传感器连接到引导构件外部的监视器。

公开(公告)号：US20070073280A1

公开(公告)日：2007-03-29

申请号：US11385316

申请日：2006-03-20

申请人： Kevin Johnson ,  Dana Mester ,  Gregory Brucker ,  Paul Asselin ,  Robert Clapp ,  Adam Berman

发明人： Kevin Johnson ,  Dana Mester ,  Gregory Brucker ,  Paul Asselin ,  Robert Clapp ,  Adam Berman

IPC分类号： A61B18/18

CPC分类号： A61B18/24 ,  A61B90/11 ,  A61B2018/00023 ,  A61B2018/00196 ,  A61B2018/2288

摘要： An apparatus for forming a lesion in tissue along a desired ablation path includes a guide member having a tissue-opposing surface for placement against a heart surface. A guide carriage is sized to be received within the guide member and moveable therein along a longitudinal axis. The carriage is configured to receive an optical fiber extending substantially axially within the carriage and bend the fiber for a discharge tip of the fiber to aim through a bottom wall of the guide member. The carriage is further configured to bend the fiber toward said discharge tip with a curved portion subject to mechanical stress and a straight portion at the fiber discharge tip. The straight portion is selected to have a length to dissipate thermal stress arising from reflectance of light from the tissue back into the discharge tip.

摘要翻译： 用于沿着期望的消融路径在组织中形成病变的装置包括具有用于放置在心脏表面上的组织相对表面的引导构件。 引导托架的尺寸被设计成被容纳在引导构件内并沿着纵向轴线在其中可移动。 滑架被构造成接收在滑架内基本上轴向延伸的光纤，并且弯曲光纤以使纤维的放电尖端瞄准穿过引导构件的底壁。 托架进一步构造成使纤维朝着所述排出端弯曲，具有受到机械应力的弯曲部分和在纤维排出端部处的直线部分。 直线部分被选择为具有消散由来自组织的光的反射率引起的放电尖端的热应力的长度。

公开(公告)号：US20070073278A1

公开(公告)日：2007-03-29

申请号：US11422367

申请日：2006-06-06

申请人： Kevin Johnson ,  Paul Asselin ,  Dana Mester

发明人： Kevin Johnson ,  Paul Asselin ,  Dana Mester

IPC分类号： A61B18/18 ,  A61B18/04

CPC分类号： A61B18/24 ,  A61B17/2202 ,  A61B18/02 ,  A61B18/1492 ,  A61B90/11 ,  A61B2017/00243 ,  A61B2018/00196 ,  A61B2018/0212 ,  A61B2018/2288

摘要： A method and apparatus for applying energy to a target path on a tissue surface includes moving a proximal end of an energy source in a first direction by a first distance. During a first portion of the first distance, the source is in a non-energized mode. During a second portion of the first distance, the source in an energized mode. The proximal end is moved in a second direction along the path opposite the first direction and by a distance less than the first distance. During a first portion of the second direction, the source in a non-energized mode. During a second portion of the second direction, the source in an energized mode. The method compensates for a hysteresis between movement of a distal tip of the energy source and the proximal end.

摘要翻译： 将能量施加到组织表面上的目标路径的方法和装置包括将能量源的近端沿第一方向移动第一距离。 在第一距离的第一部分期间，源处于非通电模式。 在第一距离的第二部分期间，源处于通电模式。 近端沿着与第一方向相反的路径沿第二方向移动一小于第一距离的距离。 在第二方向的第一部分期间，源处于非通电模式。 在第二方向的第二部分期间，源处于通电模式。 该方法补偿能量源的远侧末端的移动与近端之间的滞后。

公开(公告)号：US20060084960A1

公开(公告)日：2006-04-20

申请号：US11228108

申请日：2005-09-16

申请人： Dana Mester ,  Kenneth Grace ,  Gregory Brucker ,  Steven Savage

发明人： Dana Mester ,  Kenneth Grace ,  Gregory Brucker ,  Steven Savage

IPC分类号： A61B18/18

CPC分类号： A61B18/22 ,  A61B5/053 ,  A61B5/0538 ,  A61B5/117 ,  A61B18/20 ,  A61B18/24 ,  A61B2017/00026 ,  A61B2017/00243 ,  A61B2017/00247 ,  A61B2017/0243 ,  A61B2017/306 ,  A61B2017/3488 ,  A61B2018/00196 ,  A61B2018/00392 ,  A61B2018/00636

摘要： A method and apparatus for treating a body tissue in situ (e.g., an atrial tissue of a heart to treat atrial fibrillation) include a lesion formation tool is positioned against the heart surface. The apparatus includes a guide member having a tissue-opposing surface for placement against a heart surface. The guide member also has interior surfaces and a longitudinal axis. A guide carriage is sized to be received with the guide member and moveable therein along the longitudinal axis. An optical fiber is positioned within the guide carriage with the carriage retaining the fiber. The carriage receives the fiber with an axis substantially parallel to the longitudinal axis and bends the fiber to a distal tip with an axis of said fiber at said distal tip at least 45 degrees to the longitudinal axis and aligned for discharge of laser energy through the tissue opposing surface.

摘要翻译： 用于原位治疗身体组织的方法和装置（例如，心脏的心房组织来治疗心房颤动）包括病变形成工具抵靠心脏表面定位。 该装置包括具有用于放置在心脏表面上的组织相对表面的引导构件。 引导构件还具有内表面和纵向轴线。 导向架的尺寸被设计成能够与导向件接收并且沿着纵向轴线在其中可移动。 光纤被定位在引导托架内，托架保持光纤。 托架接收具有基本上平行于纵向轴线的轴线的纤维，并且将纤维弯曲到远侧末端，所述远端尖端处的所述纤维的轴线与纵向轴线至少45度并对准以将激光能量排出组织 相对的表面。

公开(公告)号：US20050182392A1

公开(公告)日：2005-08-18

申请号：US11102091

申请日：2005-04-08

申请人： Gregory Brucker ,  Adam Berman ,  Damian Jelich ,  Dana Mester ,  Robert Clapp

发明人： Gregory Brucker ,  Adam Berman ,  Damian Jelich ,  Dana Mester ,  Robert Clapp

IPC分类号： A61B17/00 ,  A61B17/30 ,  A61B18/00 ,  A61B18/18 ,  A61B18/20 ,  A61B18/22 ,  A61B18/24

CPC分类号： A61B18/22 ,  A61B18/20 ,  A61B18/24 ,  A61B2017/00026 ,  A61B2017/00243 ,  A61B2017/00247 ,  A61B2017/306 ,  A61B2018/00196 ,  A61B2018/00392 ,  A61B2018/00636

摘要： A method and apparatus for treating a body tissue in situ (e.g., an atrial tissue of a heart to treat) atrial fibrillation include a lesion formation tool is positioned against the heart surface. The lesion formation tool includes a guide member having a tissue-opposing surface for placement against a heart surface. An ablation member is coupled to the guide member to move in a longitudinal path relative to the guide member. The ablation member has an ablation element for directing ablation energy in an emitting direction away from the tissue-opposing surface. The guide member may be flexible to adjust a shape of the guide member for the longitudinal path to approximate the desired ablation path while maintaining the tissue-opposing surface against the heart surface. In one embodiment, the ablation member includes at least one radiation-emitting member disposed to travel in the longitudinal pathway. In another embodiment, the guide member has a plurality of longitudinally spaced apart tissue attachment locations with at least two being separately activated at the selection of an operator to be attached and unattached to an opposing tissue surface. Various means are described for the attachment including vacuum and mechanical attachment. The guide member may have a steering mechanism to remotely manipulate the shape of the guide member.

摘要翻译： 一种用于原位处理身体组织（例如，心脏的心房组织以治疗）心房颤动的方法和装置包括将病变形成工具定位在心脏表面上。 损伤形成工具包括具有用于放置在心脏表面上的组织相对表面的引导构件。 消融构件联接到引导构件以相对于引导构件在纵向路径中移动。 消融构件具有消融元件，用于将发射方向上的消融能量远离组织相对表面。 引导构件可以是柔性的，以调节用于纵向路径的引导构件的形状以接近所需的消融路径，同时将组织相对表面保持抵靠心脏表面。 在一个实施例中，消融构件包括设置成在纵向通路中行进的至少一个辐射发射构件。 在另一个实施例中，引导构件具有多个纵向间隔开的组织附接位置，其中至少两个组织附接位置在选择要附接并未附接到相对组织表面的操作者处被单独激活。 描述了用于附件的各种装置，包括真空和机械附件。 引导构件可以具有用于远程地操纵引导构件的形状的转向机构。