公开(公告)号：US08409191B2

公开(公告)日：2013-04-02

申请号：US10983072

申请日：2004-11-04

申请人： Boaz Avitall ,  Joe Koblish

发明人： Boaz Avitall ,  Joe Koblish

IPC分类号： A61B18/14

CPC分类号： A61B18/1492 ,  A61B5/6852 ,  A61B2017/00318 ,  A61B2017/00323 ,  A61B2017/00331 ,  A61B2017/00867 ,  A61B2018/00375 ,  A61M25/0041 ,  A61M25/0144 ,  A61M25/0147 ,  A61M25/0152 ,  A61M2025/0161 ,  C08L2201/12

摘要： Catheters and methods are provided for performing medical procedures, such as tissue ablation, adjacent the ostia of anatomical vessels, such as pulmonary veins. The catheter comprises an elongated flexible integrated catheter body having proximal and distal shaft portions and at least one operative element carried by the distal shaft portion. The distal shaft portion has a proximal section configured to be internally actuated (e.g., using a steering mechanism or pre-shaping the proximal section) to form a simple curve with an apex that can be inserted into the vessel ostium, an intermediate section pre-shaped to form a curve that bends opposite the simple curve, and a distal section configured to be placed into a non-radial relationship (tangential or oblique) with the vessel ostium when the apex of the simple curve is inserted into the vessel ostium. By this arrangement, the operative element is configured to be placed firmly in contact with tissue at a predefined radial location relative to the vessel ostium when the apex of the simple curve is inserted into the vessel ostium.

公开(公告)号：US20060095030A1

公开(公告)日：2006-05-04

申请号：US10983072

申请日：2004-11-04

申请人： Boaz Avitall ,  Joe Koblish

发明人： Boaz Avitall ,  Joe Koblish

IPC分类号： A61B18/18

CPC分类号： A61B18/1492 ,  A61B5/6852 ,  A61B2017/00318 ,  A61B2017/00323 ,  A61B2017/00331 ,  A61B2017/00867 ,  A61B2018/00375 ,  A61M25/0041 ,  A61M25/0144 ,  A61M25/0147 ,  A61M25/0152 ,  A61M2025/0161 ,  C08L2201/12

摘要： Catheters and methods are provided for performing medical procedures, such as tissue ablation, adjacent the ostia of anatomical vessels, such as pulmonary veins. The catheter comprises an elongated flexible integrated catheter body having proximal and distal shaft portions and at least one operative element carried by the distal shaft portion. The distal shaft portion has a proximal section configured to be internally actuated (e.g., using a steering mechanism or pre-shaping the proximal section) to form a simple curve with an apex that can be inserted into the vessel ostium, an intermediate section pre-shaped to form a curve that bends opposite the simple curve, and a distal section configured to be placed into a non-radial relationship (tangential or oblique) with the vessel ostium when the apex of the simple curve is inserted into the vessel ostium. By this arrangement, the operative element is configured to be placed firmly in contact with tissue at a predefined radial location relative to the vessel ostium when the apex of the simple curve is inserted into the vessel ostium.

公开(公告)号：US20120029512A1

公开(公告)日：2012-02-02

申请号：US13193338

申请日：2011-07-28

申请人： Martin R. Willard ,  Joe Koblish ,  Roger Hastings

发明人： Martin R. Willard ,  Joe Koblish ,  Roger Hastings

IPC分类号： A61B18/14

CPC分类号： A61B18/1492 ,  A61B2017/00026 ,  A61B2017/00092 ,  A61B2018/00011 ,  A61B2018/00023 ,  A61B2018/00047 ,  A61B2018/00095 ,  A61B2018/00148 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00642 ,  A61B2018/00702 ,  A61B2018/00744 ,  A61B2018/00779 ,  A61B2018/00791 ,  A61B2018/00797 ,  A61B2018/00821 ,  A61B2018/00875 ,  A61B2018/0212

摘要： A catheter arrangement includes a flexible shaft and a balloon disposed at a distal end of the shaft and configurable for deployment within a target vessel of the body, such as a renal artery. Ablation electrodes, supported by a balloon wall, are arranged in a predefined pattern. The electrodes deliver electrical energy sufficient to ablate target tissue, such as perivascular renal nerves, proximate the target vessel wall when the balloon is in a deployed configuration. A cooling arrangement is encompassed at least in part by the balloon and provides cooling to at least the electrodes during ablation such that a location at which steady-state ablative heating begins is translated from an electrode-tissue interface at the target vessel wall to a location a predetermined distance away from the electrode-tissue interface.

摘要翻译： 导管装置包括柔性轴和设置在轴的远端处的球囊，并且可配置用于展开在诸如肾动脉的身体的靶容器内。 由气球壁支撑的消融电极以预定图案排列。 当气囊处于展开配置时，电极传递足以消融目标组织（例如血管周围肾神经）的电能，靠近目标血管壁。 冷却装置至少部分地由气球包围，并且在消融期间至少提供电极的冷却，使得开始稳态烧蚀加热的位置从目标血管壁处的电极 - 组织界面平移到位置 距离电极组织界面预定的距离。

公开(公告)号：US08128617B2

公开(公告)日：2012-03-06

申请号：US12127287

申请日：2008-05-27

申请人： Bob Bencini ,  Frank Ingle ,  Joe Koblish ,  Rebecca Tin ,  Jim Mazzone ,  Byron Chun ,  David Lawrence

发明人： Bob Bencini ,  Frank Ingle ,  Joe Koblish ,  Rebecca Tin ,  Jim Mazzone ,  Byron Chun ,  David Lawrence

IPC分类号： A61B18/02

CPC分类号： A61B18/02 ,  A61B5/0422 ,  A61B2018/00017 ,  A61B2018/00023 ,  A61B2018/0022 ,  A61B2018/00714 ,  A61B2018/00791 ,  A61B2018/00797 ,  A61B2018/0212 ,  A61B2018/0262

摘要： In some implementations, a method of ablating body tissue includes (a) locating an inflatable balloon portion of a cryotherapy balloon catheter at a treatment site internal to a patient's body, and inflating the inflatable balloon portion; (b) employing electrodes that are disposed on an expandable surface of the inflatable balloon portion to electrically characterize body tissue at the treatment site; (c) ablating the body tissue by supplying a cryotherapy agent to the inflatable balloon portion to cool the body tissue to a therapeutic temperature; (d) employing the electrodes to determine whether the ablating caused desired electrical changes in the body tissue; and (e) repeating (c) and (d) when it is determined that the ablating did not cause the desired electrical changes.

摘要翻译： 在一些实施方式中，一种消融身体组织的方法包括（a）将冷冻治疗气囊导管的可充气球囊部分定位在患者身体内部的治疗部位，并使可充气球囊部分膨胀; （b）使用设置在所述可膨胀气囊部分的可膨胀表面上的电极来电性地表征所述治疗部位的身体组织; （c）通过向所述可充气球囊部分供应冷冻治疗剂来将所述身体组织冷却至治疗温度来烧蚀所述身体组织; （d）使用电极来确定烧蚀是否引起人体组织中所需的电变化; 和（e）重复（c）和（d）当确定烧蚀没有引起所需的电气变化时。

公开(公告)号：US09060756B2

公开(公告)日：2015-06-23

申请号：US13413533

申请日：2012-03-06

申请人： Bob Bencini ,  Frank Ingle ,  Joe Koblish ,  Rebecca Tin ,  Jim Mazzone ,  Byron Chun ,  David Lawrence

发明人： Bob Bencini ,  Frank Ingle ,  Joe Koblish ,  Rebecca Tin ,  Jim Mazzone ,  Byron Chun ,  David Lawrence

IPC分类号： A61B18/12 ,  A61B18/02 ,  A61B5/042 ,  A61B18/00

CPC分类号： A61B18/02 ,  A61B5/0422 ,  A61B2018/00017 ,  A61B2018/00023 ,  A61B2018/0022 ,  A61B2018/00714 ,  A61B2018/00791 ,  A61B2018/00797 ,  A61B2018/0212 ,  A61B2018/0262

摘要： In some implementations, a method of ablating body tissue includes (a) locating an inflatable balloon portion of a cryotherapy balloon catheter at a treatment site internal to a patient's body, and inflating the inflatable balloon portion; (b) employing electrodes that are disposed on an expandable surface of the inflatable balloon portion to electrically characterize body tissue at the treatment site; (c) ablating the body tissue by supplying a cryotherapy agent to the inflatable balloon portion to cool the body tissue to a therapeutic temperature; (d) employing the electrodes to determine whether the ablating caused desired electrical changes in the body tissue; and (e) repeating (c) and (d) when it is determined that the ablating did not cause the desired electrical changes.

摘要翻译： 在一些实施方案中，消融身体组织的方法包括（a）将冷冻治疗气囊导管的可充气球囊部分定位在患者身体内部的治疗部位处，并使可膨胀气囊部分膨胀; （b）使用设置在所述可膨胀气囊部分的可膨胀表面上的电极来电性地表征所述治疗部位的身体组织; （c）通过向所述可充气球囊部分供应冷冻治疗剂来将所述身体组织冷却至治疗温度来烧蚀所述身体组织; （d）使用电极来确定烧蚀是否引起人体组织中所需的电变化; 和（e）重复（c）和（d）当确定烧蚀不引起所需的电气变化时。

公开(公告)号：US20090299355A1

公开(公告)日：2009-12-03

申请号：US12127287

申请日：2008-05-27

申请人： Bob Bencini ,  Frank Ingle ,  Joe Koblish ,  Rebecca Tin ,  Jim Mazzone ,  Byron Chun ,  David Lawrence

发明人： Bob Bencini ,  Frank Ingle ,  Joe Koblish ,  Rebecca Tin ,  Jim Mazzone ,  Byron Chun ,  David Lawrence

IPC分类号： A61B18/02

CPC分类号： A61B18/02 ,  A61B5/0422 ,  A61B2018/00017 ,  A61B2018/00023 ,  A61B2018/0022 ,  A61B2018/00714 ,  A61B2018/00791 ,  A61B2018/00797 ,  A61B2018/0212 ,  A61B2018/0262

摘要： In some implementations, a method of ablating body tissue includes (a) locating an inflatable balloon portion of a cryotherapy balloon catheter at a treatment site internal to a patient's body, and inflating the inflatable balloon portion; (b) employing electrodes that are disposed on an expandable surface of the inflatable balloon portion to electrically characterize body tissue at the treatment site; (c) ablating the body tissue by supplying a cryotherapy agent to the inflatable balloon portion to cool the body tissue to a therapeutic temperature; (d) employing the electrodes to determine whether the ablating caused desired electrical changes in the body tissue; and (e) repeating (c) and (d) when it is determined that the ablating did not cause the desired electrical changes.

摘要翻译： 在一些实施方式中，一种消融身体组织的方法包括（a）将冷冻治疗气囊导管的可充气球囊部分定位在患者身体内部的治疗部位，并使可充气球囊部分膨胀; （b）使用设置在所述可膨胀气囊部分的可膨胀表面上的电极来电性地表征所述治疗部位的身体组织; （c）通过向所述可充气球囊部分供应冷冻治疗剂来将所述身体组织冷却至治疗温度来烧蚀所述身体组织; （d）使用电极来确定烧蚀是否引起人体组织中所需的电变化; 和（e）重复（c）和（d）当确定烧蚀没有引起所需的电气变化时。

公开(公告)号：US09463062B2

公开(公告)日：2016-10-11

申请号：US13188677

申请日：2011-07-22

申请人： Scott Smith ,  Joe Koblish ,  Mark L. Jenson ,  Roger Hastings

发明人： Scott Smith ,  Joe Koblish ,  Mark L. Jenson ,  Roger Hastings

IPC分类号： A61B18/18 ,  A61B18/14 ,  A61B18/00

CPC分类号： A61B18/1492 ,  A61B2018/00029 ,  A61B2018/00035 ,  A61B2018/00065 ,  A61B2018/0016 ,  A61B2018/0022 ,  A61B2018/00238 ,  A61B2018/00285 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00821 ,  A61B2018/1472

摘要： A catheter includes a flexible shaft having a lumen arrangement and a length sufficient to access a target vessel of a patient. A balloon at the distal end of the shaft is fluidly coupled to the lumen arrangement. The balloon body comprises a first material and a second material different from the first material. The second material comprises a hydrophilic polymer that becomes electrically conductive in response to absorption of the conductive fluid. The fluid conductive regions facilitate perfusion of the conductive fluid through the balloon body to an inner wall of the target vessel during ablation of perivascular tissues. A cooling arrangement is configured for one of receiving a thermal transfer fluid from the lumen arrangement or facilitating perfusion of blood passing through the target vessel to cool the balloon body during ablation of the perivascular tissues.

摘要翻译： 导管包括柔性轴，其具有管腔布置和足以进入患者的目标血管的长度。 在轴的远端处的气囊流体地联接到管腔装置。 球囊体包括第一材料和与第一材料不同的第二材料。 第二种材料包括响应于导电流体的吸收变得导电的亲水性聚合物。 流体导电区域便于在血管周围组织消融期间将导电流体通过球囊体灌注到目标血管的内壁。 冷却装置构造成用于接收来自管腔装置的热转移流体，或者促进血液通过靶血管的灌注，以在血管周围组织消融期间冷却球囊体。

公开(公告)号：US20120029511A1

公开(公告)日：2012-02-02

申请号：US13188677

申请日：2011-07-22

申请人： Scott Smith ,  Joe Koblish ,  Mark L. Jenson ,  Roger Hastings

发明人： Scott Smith ,  Joe Koblish ,  Mark L. Jenson ,  Roger Hastings

IPC分类号： A61B18/14

CPC分类号： A61B18/1492 ,  A61B2018/00029 ,  A61B2018/00035 ,  A61B2018/00065 ,  A61B2018/0016 ,  A61B2018/0022 ,  A61B2018/00238 ,  A61B2018/00285 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00821 ,  A61B2018/1472

摘要： A catheter includes a flexible shaft having a lumen arrangement and a length sufficient to access a target vessel of a patient. A balloon at the distal end of the shaft is fluidly coupled to the lumen arrangement. The balloon body comprises a first material and a second material different from the first material. The second material comprises a hydrophilic polymer that becomes electrically conductive in response to absorption of the conductive fluid. The fluid conductive regions facilitate perfusion of the conductive fluid through the balloon body to an inner wall of the target vessel during ablation of perivascular tissues. A cooling arrangement is configured for one of receiving a thermal transfer fluid from the lumen arrangement or facilitating perfusion of blood passing through the target vessel to cool the balloon body during ablation of the perivascular tissues.

摘要翻译： 导管包括柔性轴，其具有管腔布置和足以进入患者的目标血管的长度。 在轴的远端处的气囊流体地联接到管腔装置。 球囊体包括第一材料和与第一材料不同的第二材料。 第二种材料包括响应于导电流体的吸收变得导电的亲水性聚合物。 流体导电区域便于在血管周围组织消融期间将导电流体通过球囊体灌注到目标血管的内壁。 冷却装置构造成用于接收来自管腔装置的热转移流体，或者促进血液通过靶血管的灌注，以在血管周围组织消融期间冷却球囊体。