摘要:
A working end of a catheter includes at least one therapeutic element, such as a resistive heating element, usable to deliver energy for ligating, or reducing the diameter of, a hollow anatomical structure. In certain examples, the catheter includes a lumen to accommodate a guide wire or to allow fluid delivery. In certain embodiments, a balloon is inflated to place resistive element(s) into apposition with a hollow anatomical structure and to occlude the structure. Indexing devices and methods are also disclosed for successively treating portions of the hollow anatomical structure. In certain examples, marks along the catheter shaft provide visual verification to the physician of the relative position of the therapeutic element of the catheter. Embodiments of indexing devices may include pairs of rings and/or hinged arms that move a catheter a desired indexed position between successive treatments.
摘要:
The disclosure relates to the use of subcutaneous illumination during phlebectomy procedures, and to devices and methods for performing hook phlebectomy while visualizing veins and surrounding tissue using light emitted subcutaneously and beneath the surgical area. An apparatus comprises, in one embodiment, a handle, an illuminator portion extending distally from the handle, the illuminator portion comprising an elongate member configured for insertion into subcutaneous tissue, the illuminator portion comprising an elongate electroluminescent device extending along the illuminator portion, the electroluminescent device being configured to generate and emit light primarily in a generally radial direction, outward and away from a longitudinal axis of the illuminator portion. Furthermore, a phlebectomy hook is provided that comprises, in one embodiment, a shaft, a bend extending generally laterally from the shaft, the bend terminating in a tip of the phlebectomy hook, and an illuminator, the illuminator configured to propagate a visible light beam near the bend, generally outward relative to a longitudinal axis of the shaft.
摘要:
A treatment system for occluding a hollow anatomical structure comprises a treatment device sized for insertion into a hollow anatomical structure. The treatment device comprises a therapeutic element configured to treat the hollow anatomical structure. The system comprises a sensor configured to sense a first treatment parameter. A controller is in communication with the treatment device and with the sensor. The controller is configured to determine a second treatment parameter based on the first treatment parameter and output the second treatment parameter.
摘要:
A catheter includes multiple primary leads to deliver energy for ligating a hollow anatomical structure. Each of the primary leads includes a resistive element located at the working end of the catheter. Separation is maintained between the leads such that each lead can individually receive power. The catheter can include a lumen to accommodate a guide wire or to allow fluid delivery. Energy is applied until the diameter of the hollow anatomical structure is reduced to the point where occlusion is achieved. In one embodiment, a balloon is inflated to place the resistive elements into apposition with a hollow anatomical structure and to occlude the structure before the application of energy. The inflated balloon impairs blood flow and facilitates the infusion of saline, or medication, to the hollow anatomical structure in order to reduce the occurrence of coagulation and to improve the heating of the structure by the catheter.
摘要:
One embodiment comprises an apparatus for applying energy to a hollow anatomical structure having an inner wall. The apparatus comprises an elongate shaft having a distal end and a proximal end opposite the distal end; and a capacitive treatment element located near the distal end. The capacitive treatment element is sized for insertion into the hollow anatomical structure and placement near the inner wall. The capacitive treatment element is configured to create an electric field that extends at least partially into the inner wall. Other devices and methods for treatment of hollow anatomical structures are disclosed as well.
摘要:
An energy delivering probe is used for thermally coagulating and/or constricting hollow anatomical structures (HAS) including, but not limited to, blood vessels such as perforator veins. The probe includes a shaft and at least two electrodes where at least one of the electrodes has a perimeter that increases as it extends proximally.
摘要:
A method of treating a perforator vein comprises applying ultrasound to the perforator vein and occluding the perforator vein with the ultrasound. An apparatus for treating blood vessels comprises an ultrasound emitter, wherein the ultrasound emitter is configured to emit ultrasound at multiple therapeutic ultrasound frequencies during a treatment cycle. The apparatus further comprises an acoustic coupler in sonic communication with the emitter, wherein the acoustic coupler has an acoustic coupling surface configured to contact a patient and facilitate delivery of ultrasound to the patient and wherein the acoustic coupler provides a conduction path for ultrasound from the emitter to the acoustic coupling surface. The apparatus further comprises an acoustic coupler containing a displaceable acoustic coupling material. The apparatus further comprises an acoustic coupler configured to vary the length of the conduction path in accordance with variation in the thickness of the acoustic coupling material disposed between the emitter and the acoustic coupling surface.
摘要:
An energy delivering probe is used for thermally coagulating and/or constricting hollow anatomical structures (HAS) including, but not limited to, blood vessels such as perforator veins. The probe includes a shaft and at least two electrodes where at least one of the electrodes has a generally spherical or toroidal geometry.
摘要:
An electrode catheter is introduced into a hollow anatomical structure, such as a vein, and is positioned at a treatment site within the structure. Tumescent fluid is injected into the tissue surrounding the treatment site to produce tumescence of the surrounding tissue which then compresses the vein. The solution may include an anesthetic, and may further include a vasoconstrictive drug that shrinks blood vessels. The tumescent swelling in the surrounding tissue causes the hollow anatomical structure to become compressed, thereby exsanguinating the treatment site. Energy is applied by an electrode catheter in apposition with the vein wall to create a heating effect. The heating effect causes the hollow anatomical structure to become molded and durably assume the compressed dimensions caused by the tumescent technique. The electrode catheter can be moved within the structure so as to apply energy to a large section of the hollow anatomic structure. In a further aspect, the location of the electrodes is determined by impedance monitoring. Also, temperature sensors at the treatment site are averaged to determine the site temperature.
摘要:
An electrode catheter is introduced into a hollow anatomical structure, such as a vein, and is positioned at a treatment site within the structure. Tumescent fluid is injected into the tissue surrounding the treatment site to produce tumescence of the surrounding tissue which then compresses the vein. The solution may include an anesthetic, and may further include a vasoconstrictive drug that shrinks blood vessels. The tumescent swelling in the surrounding tissue causes the hollow anatomical structure to become compressed, thereby exsanguinating the treatment site. Energy is applied by an electrode catheter in apposition with the vein wall to create a heating effect. The heating effect causes the hollow anatomical structure to become molded and durably assume the compressed dimensions caused by the tumescent technique. The electrode catheter can be moved within the structure so as to apply energy to a large section of the hollow anatomic structure. In a further aspect, the location of the electrodes is determined by impedance monitoring. Also, temperature sensors at the treatment site are averaged to determine the site temperature.