公开(公告)号：US07257450B2

公开(公告)日：2007-08-14

申请号：US11004634

申请日：2004-12-02

申请人： David C. Auth ,  Dean T. Corcoran ,  Mark A. Tempel ,  Joseph E. Eichinger

发明人： David C. Auth ,  Dean T. Corcoran ,  Mark A. Tempel ,  Joseph E. Eichinger

IPC分类号： A61N1/05 ,  A61N1/18

CPC分类号： A61B18/1492 ,  A61B2017/00575 ,  A61B2018/00291 ,  A61B2018/00351 ,  A61B2018/00619 ,  A61N1/06 ,  A61N1/403

摘要： Methods and systems for securing tissues, e.g., cardiovascular tissues, are disclosed. A method in accordance with one embodiment of the invention includes inserting a portion of a catheter into an opening between a first portion of cardiovascular tissue and a second portion of cardiovascular tissue. The method can further include drawing the first and second portions of the cardiovascular tissue into contact with each other by drawing a vacuum in a region adjacent to the first and second portions of cardiovascular tissue via the catheter while the catheter is positioned between the first and second portions. The tissue portions can be fused by heating the tissue from within the opening, e.g., via radio frequency energy. This technique, and associated catheter system, can be used to close a patent foramen ovale or other openings in cardiovascular tissue.

摘要翻译： 公开了用于确保组织例如心血管组织的方法和系统。 根据本发明的一个实施例的方法包括将导管的一部分插入心血管组织的第一部分和心血管组织的第二部分之间的开口中。 该方法可以进一步包括通过在导管位于第一和第二部分之间的同时在与心血管组织的第一和第二部分相邻的区域中抽取真空而将心血管组织的第一和第二部分相互接触 部分。 组织部分可以通过例如通过射频能量从开口内加热组织来融合。 该技术和相关的导管系统可用于闭合心脏组织中的卵孔或其他开口的专利。

公开(公告)号：US20090118726A1

公开(公告)日：2009-05-07

申请号：US12246361

申请日：2008-10-06

申请人： David C. Auth ,  Ryan E. Kaveckis ,  Larry B. Kulesa ,  Joseph E. Eichinger ,  David A. Herrin ,  Mark A. Tempel ,  Robert S. Schwartz

发明人： David C. Auth ,  Ryan E. Kaveckis ,  Larry B. Kulesa ,  Joseph E. Eichinger ,  David A. Herrin ,  Mark A. Tempel ,  Robert S. Schwartz

IPC分类号： A61B18/18 ,  A61B18/14

CPC分类号： A61B18/1492 ,  A61B17/0057 ,  A61B2017/00575 ,  A61B2017/22038 ,  A61B2018/00208 ,  A61B2018/00214 ,  A61B2018/00279 ,  A61B2018/00285 ,  A61B2018/00351 ,  A61B2018/00898 ,  A61B2018/144

摘要： Systems and methods for transeptal cardiac procedures are disclosed. A patient treatment device in accordance with a particular embodiment includes a catheter having a proximal end, a distal end, a working portion toward the distal end, and an electrical energy path coupleable to a source of electrical energy. The device can further include a tissue penetrating member carried by the catheter and an electrode device carried by the working portion of the catheter and movable along the tissue penetrating member. The electrode device can include a collapsible stranded conductive material coupled to the electrical signal path and being changeable between a deployed position and a stowed position. The conductive material can be elongated along a deployment axis when in the stowed position, and can be contracted along the deployment axis and expanded transverse to the deployment axis when in the deployed position.

摘要翻译： 公开了用于经心脏心脏手术的系统和方法。 根据特定实施例的患者治疗装置包括具有近端，远端，朝向远端的工作部分和可耦合到电能源的电能路径的导管。 该装置还可以包括由导管携带的组织穿透构件和由导管的工作部分携带并可沿着组织穿透构件移动的电极装置。 电极装置可以包括耦合到电信号路径的可折叠绞合的导电材料，并且可在展开位置和收起位置之间改变。 当处于收起位置时，导电材料可以沿着展开轴线伸长，并且当处于展开位置时，导电材料可以沿展开轴线收缩并横向于展开轴线膨胀。

公开(公告)号：US08021359B2

公开(公告)日：2011-09-20

申请号：US10754790

申请日：2004-01-08

申请人： David C. Auth ,  Robert L. Barry ,  Joseph E. Eichinger ,  Bryan A. Kinsella ,  Roger A. Sahm ,  Robert S. Schwartz ,  Robert A. Van Tassel

发明人： David C. Auth ,  Robert L. Barry ,  Joseph E. Eichinger ,  Bryan A. Kinsella ,  Roger A. Sahm ,  Robert S. Schwartz ,  Robert A. Van Tassel

IPC分类号： A61B18/14

CPC分类号： A61B18/1492 ,  A61B2017/00575 ,  A61B2018/00029 ,  A61B2018/0022 ,  A61B2018/00261 ,  A61B2018/00351 ,  A61B2018/00619 ,  A61B2018/1407

摘要： The present invention provides for therapeutic treatment methods, devices, and systems for the partial or complete closure or occlusion of a patent foramen ovale (“PFO”). In particular, various methods, devices, and systems for joining or welding tissues, in order to therapeutically close a PFO are described. In yet another aspect of the invention, various methods, devices, and systems for the penetration of the interatrial septum enabling left atrial access are also provided.

摘要翻译： 本发明提供用于部分或完全闭合或闭塞卵泡孔的治疗方法，装置和系统（“PFO”）。 特别地，描述了用于接合或焊接组织的各种方法，装置和系统，以便治疗闭合PFO。 在本发明的另一方面，还提供了用于穿透房间隔使得能够进行左心房通路的各种方法，装置和系统。

公开(公告)号：US20090118729A1

公开(公告)日：2009-05-07

申请号：US11936748

申请日：2007-11-07

申请人： David C. Auth ,  Alexander Lebedev ,  Michael J. Connolly

发明人： David C. Auth ,  Alexander Lebedev ,  Michael J. Connolly

IPC分类号： A61B18/14

CPC分类号： A61B18/1492 ,  A61B8/12 ,  A61B18/1815 ,  A61B2018/00791 ,  A61B2018/1213 ,  A61B2018/1472 ,  A61B2018/1475 ,  A61B2090/3784 ,  A61B2218/002 ,  A61B2218/007

摘要： A catheter for insertion into and treatment of tissue in a patient comprises a radio frequency (RF) electrode having an elongated body that conducts electrical RF energy to a conductive tip. An insulating sleeve surrounding the elongated body prevents leakage of RF energy from the elongated body when the catheter is being inserted into the tissue of the patient. In a first mode of operation, the conductive tip is exposed outside the insulating sleeve and the RF electrode delivers first RF energy capable of producing sparks that erode the tissue of the patient and create a tunnel through which the catheter can advance into the tissue of the patient. In a second mode of operation, the insulating sleeve is retracted to expose a portion of the RF electrode. Second RF energy is delivered to the volume of tissue around the catheter to necrotize the tissue by heating without producing sparks.

摘要翻译： 用于插入和治疗患者组织的导管包括射频（RF）电极，其具有将电RF能量传导到导电尖端的细长主体。 围绕细长主体的绝缘套管防止当导管插入到患者组织中时，来自细长体的RF能量的泄漏。 在第一操作模式中，导电尖端暴露在绝缘套管外部，并且RF电极提供能够产生火花的第一RF能量，该火花侵蚀患者的组织并产生通道，导管可穿过该通道进入组织中 患者。 在第二操作模式中，绝缘套管缩回以暴露RF电极的一部分。 将第二RF能量传递到导管周围的组织体积，以通过加热而不产生火花来坏死组织。

公开(公告)号：US4532924A

公开(公告)日：1985-08-06

申请号：US373652

申请日：1982-04-30

申请人： David C. Auth ,  Eric A. Opie ,  Dale M. Lawrence

发明人： David C. Auth ,  Eric A. Opie ,  Dale M. Lawrence

IPC分类号： A61B17/00 ,  A61B18/14 ,  A61M3/02 ,  A61B17/39

CPC分类号： A61B18/14 ,  A61B18/1402 ,  A61B2017/00292 ,  A61B2018/1497 ,  A61B2018/1861 ,  A61B2218/002 ,  A61M3/0279

摘要： A multipolar electrosurgical device is described for use in neurosurgery or through the channel of an endoscope or other precision surgery procedures. The device is formed with an insulative probe body, which, in the described embodiment, is sized to pass through a channel of an endoscope to enable the electrocoagulation of blood vessels such as may be needed in the treatment of a gastrointestinal ulcer. The probe body is provided with electrically separate conductors which are formed of a plurality of electrodes distributed over the peripheral surface of the probe body. The electrically separate conductors are so sized in width W and spaced from each other by a distance S as to establish a ratio of W:S which enables effective bipolar treatment of tissue independent of probe body orientation relative to the tissue and without sticking of the probe body to coagulated material. A plurality of at least six electrodes which can form six bipolar electric fields are formed which in one embodiment are aligned longitudinally on the probe body. The electrodes extend onto the probe body's distal end to provide an omnidirectionally effective electrosurgical device. A central conductive wash channel is provided for electrical connection to a set of electrodes at the distal end of the probe body while also providing a passage for fluid to enhance the visibility of the target area for subsequent precise electrocoagulation of the bleeding site. Several embodiments are shown and described.

摘要翻译： 描述了用于神经外科手术或通过内窥镜通道或其他精密手术程序的多极电外科装置。 该装置形成有绝缘探针体，其在所描述的实施例中的尺寸适于穿过内窥镜的通道，使得能够电凝凝血管，例如可能需要治疗胃肠溃疡。 探针体设置有电分离的导体，其由分布在探针主体的外周表面上的多个电极形成。 电分离的导体的宽度尺寸设置为W，并且彼此间隔开距离S，以便建立W：S的比率，这使得能够相对于组织而独立于探头本体取向的组织进行有效的双极治疗，并且不粘附探针 身体凝固材料。 形成可形成六个双极电场的多个至少六个电极，其在一个实施例中在探针主体上纵向排列。 电极延伸到探针主体的远端，以提供全向有效的电外科装置。 提供中心导电清洗通道用于电连接到在探针主体的远端处的一组电极，同时还为流体提供通道以增强目标区域的可视性，以便随后精确地凝固出血部位。 显示和描述了几个实施例。

公开(公告)号：US4445509A

公开(公告)日：1984-05-01

申请号：US345656

申请日：1982-02-04

申请人： David C. Auth

发明人： David C. Auth

IPC分类号： A61B17/00 ,  A61B17/22 ,  A61M1/00 ,  A61B17/32

CPC分类号： A61B17/320758 ,  A61B17/22031 ,  A61B2017/22074 ,  A61B2217/005 ,  A61B2217/007

摘要： A device for safe removal of abnormal deposits, primarily in the human body, where differential cutting properties provide for fracture of hard matter while safely preserving soft tissue. The device includes a rotating cutting tool having spirally shaped cutting flutes having hardness-differential cutting properties. The tool is driven from outside the body by means of a flexible drive shaft at greater than 2000 revolutions per minute. A channel is incorporated in the drive shaft for adding or removing chemical matter from the internal body space to provide systematic removal of cutting debris from abnormal deposits. The cutting tool has fluid ports which communicate with the drive shaft channel. The fluid ports may be at the nose of the tool as well as around its cicumference. In the latter instance, the ports extend from in front of a cutting flute into a center cavity with a circumferential component so that rotation tends to force blood into these ports. External mass transfer machines aid in injecting or withdrawing material, such as cutting debris. Auxiliary instrumentation, such as fluoroscopy and pressure measuring apparatus, are helpful in the clinical procedure. Multiple operational cycles are easily implemented to gradually dissect the deposit while periodically reestablishing physiological viability, such as blood flow in vessels.

摘要翻译： 一种用于安全去除异常沉积物的装置，主要在人体中，其中不同的切割性质提供硬质物质的断裂，同时安全地保存软组织。 该装置包括具有硬度差分切割性能的螺旋状切割槽的旋转切削工具。 该工具通过柔性驱动轴以大于2000转每分钟从外部驱动。 一个通道被结合在驱动轴中，用于从内部空间添加或除去化学物质，以提供系统地从异常沉积物中去除切屑。 切割工具具有与驱动轴通道连通的流体端口。 流体端口可以在工具的鼻子处以及其周围。 在后一种情况下，端口从切割槽的前面延伸到具有周向部件的中心空腔中，使得旋转倾向于迫使血液进入这些端口。 外部传质机器有助于注入或取出材料，如切割碎屑。 辅助仪器，如荧光透视和压力测量仪器，有助于临床过程。 容易实施多个操作周期，以逐步解剖沉积物，同时周期性地重新建立生理活力，如血管中的血流。

公开(公告)号：US4273127A

公开(公告)日：1981-06-16

申请号：US175322

申请日：1980-08-04

申请人： David C. Auth ,  Robert F. Rushmer

发明人： David C. Auth ,  Robert F. Rushmer

IPC分类号： A61B17/32 ,  A61B18/20 ,  A61B18/22 ,  A61B17/36

CPC分类号： A61B17/3211 ,  A61B18/20 ,  A61B18/22 ,  A61B2018/00636

摘要： Laser radiation is coupled to an optical instrument having a relatively narrow working edge from which the radiation is emitted in a relatively narrow zone of intense radiation leakage. The working edge is placed in contact with vascularized tissues, and the laser radiation emanating from the working edge in combination with the contact between the working edge and the tissues forms an incision, and the laser radiation photocoagulates tissue adjacent the incision. The contact between the working edge and the tissues accurately positions the laser radiation with respect to the tissue, places pressure on vessels to aid hemostasis, mechanically stresses the incision line and provides the surgeon with tactile feedback. Radiation propagates from a laser to the optical instrument through a low-loss flexible fiberoptic waveguide by means of multimode optical waveguide propagation. As the radiation reaches the working edge of the optical instrument the radiation is emitted from the instrument because the incident angles of individual modes fall below the critical internal reflection angle of the instrument. Radiation leakage is further increased by the presence of blood on the working edge. The frequency of the laser radiation is selected to achieve a desired penetration depth. Deeper penetration may be necessary under some circumstances to produce a clot of sufficient size to allow adequate coagulation. A power control mounted on the handle of the optical instrument or elsewhere allows the surgeon to adjust the intensity of the radiation.

摘要翻译： 激光辐射耦合到具有相对较窄工作边缘的光学仪器，辐射在相对较窄的强辐射泄漏区域中从该工具边缘发射。 工作边缘与血管化组织接触，并且从工作边缘发出的激光辐射与工作边缘和组织之间的接触结合形成切口，并且激光辐射光凝固切口附近的组织。 工作边缘和组织之间的接触准确地将激光辐射相对于组织定位，在血管上施加压力以帮助止血，机械地强调切口线并向外科医生提供触觉反馈。 辐射通过多模光波导传播通过低损耗柔性光纤波导从激光传播到光学仪器。 当辐射到达光学仪器的工作边缘时，辐射从仪器发射，因为各个模式的入射角度低于仪器的临界内部反射角。 由于工作边缘上存在血液，辐射泄漏进一步增加。 选择激光辐射的频率以实现期望的穿透深度。 在某些情况下可能需要更深的穿透以产生足够尺寸的凝块以允许充分的凝结。 安装在光学仪器的手柄或其他地方的电源控制器允许外科医生调节辐射的强度。

公开(公告)号：US6030380A

公开(公告)日：2000-02-29

申请号：US884058

申请日：1997-06-27

申请人： David C. Auth ,  Thomas J. Clement

发明人： David C. Auth ,  Thomas J. Clement

IPC分类号： A61B17/00 ,  A61B18/14 ,  A61B17/30

CPC分类号： A61B18/1492 ,  A61B2017/00247 ,  A61B2018/00392

摘要： An RF activated catheter apparatus for performing transmyocardial revascularization. The catheter apparatus including an elongate catheter shaft having proximal and distal ends, the distal end including an RF emitter which is coupled to an RF generator for cutting channels into the myocardium of a patient's heart.

摘要翻译： 用于执行经心肌血运重建的RF激活导管装置。 所述导管装置包括具有近端和远端的细长导管轴，所述远端包括RF发射器，其耦合到RF发生器，用于将通道切入患者心脏的心肌。

公开(公告)号：US5769880A

公开(公告)日：1998-06-23

申请号：US632516

申请日：1996-04-12

申请人： Csaba Truckai ,  David C. Auth

发明人： Csaba Truckai ,  David C. Auth

IPC分类号： A61B18/12 ,  A61B17/22 ,  A61B17/42 ,  A61B18/14 ,  A61M1/00 ,  A61M16/04 ,  A61F2/00

CPC分类号： A61B18/1485 ,  A61M16/0481 ,  A61B2017/22051 ,  A61B2017/4216 ,  A61B2018/126 ,  A61B2090/065

摘要： An apparatus and method for use in performing ablation of organs and other tissue includes an electrode carrying member which is substantially absorbent and/or permeable to moisture. The electrode carrying member is mounted to the distal end of an elongate shaft, and an array of electrodes is mounted to the surface of the electrode carrying member. Following placement of the ablation device into contact with the tissue to be ablated, an RF generator is used to deliver RF energy to the electrodes and to thereby induce current flow from the electrodes to tissue to be ablated. As the current heats the tissue, moisture (such as water vapor or liquid) leaves the tissue causing the tissue to dehydrate. The moisture permeability and/or absorbency of the electrode carrying member allows the moisture to leave the ablation site so as to prevent the moisture from providing a path of conductivity for the current.

摘要翻译： 用于进行器官和其他组织的消融的装置和方法包括基本吸收和/或可渗透水分的电极承载构件。 电极承载构件安装到细长轴的远端，并且电极阵列安装到电极承载构件的表面。 在将消融装置放置成与要消融的组织接触之后，使用RF发生器将RF能量递送到电极并且由此感应电流从电极流向要消融的组织。 当电流加热组织时，水分（例如水蒸气或液体）离开组织，导致组织脱水。 电极承载构件的透湿性和/或吸收性允许水分离开消融部位，以防止水分为电流提供导电路径。

公开(公告)号：US4990134A

公开(公告)日：1991-02-05

申请号：US378741

申请日：1989-07-11

申请人： David C. Auth

发明人： David C. Auth

IPC分类号： A61B17/22 ,  A61B17/32

CPC分类号： A61B17/320758 ,  A61B17/22031 ,  A61B2017/320004

摘要： An abrasive tipped rotating cutting tool for use in removing abnormal deposits within a patient's vessels is described. The tip is preferably covered with a material such as diamond grit, and rotated at high speed to pulverize any abnormal deposits contained within the vessel.In a preferred embodiment of the invention, the tip is ellipsoidal in shape, and the coarseness of the abrasive material on the tip is varied from most coarse adjacent the distal end of the tip to finest adjacent the portion of the tip which has the widest diameter. Preferably, there is no abrasive on the widest part of the tip in order to prevent the tip from injuring a patient's vessel in the event that the tip is allowed to remain in one place for an extended period of time. In addition, there may be radial openings formed in the tip which permit water to be pumped therethrough in order to act as a lubricant for assisting in the cutting action of the tip.The invention may use either an autraumatic tip or a preformable guide wire to guide the cutting tip through a patient's vessel.

摘要翻译： 描述了一种用于去除患者血管内的异常沉积物的磨料旋转切削工具。 尖端优选用诸如金刚石砂粒的材料覆盖，并高速旋转以粉碎容器内所含的任何异常沉积物。 在本发明的优选实施例中，尖端是椭圆形的，并且尖端上的研磨材料的粗糙度从邻近尖端的远端的最粗糙度变化到邻近尖端部分具有最宽直径的部分 。 优选地，在尖端的最宽部分上没有研磨剂，以便在尖端被允许在一个地方长时间保持的情况下防止尖端损伤患者的血管。 此外，在尖端中可能存在径向开口，其允许水被泵送通过其中，以用作辅助尖端的切割动作的润滑剂。 本发明可以使用自体创伤的尖端或预先形成的导丝来引导切割尖端通过患者的血管。