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:
A vascular nerve ablation (denervation) system includes a multiplicity of expandable needles which open around a central axis to engage the wall of a blood vessel allowing the injection of a cytotoxic or neurotoxic solution for ablating conducting tissue in and near the vessel wall of a renal artery or pulmonary vein. The expandable needles are formed of self-expanding materials and include structures which limit the distance of penetration of the injection needles into the tissue of the wall of the blood vessel.
摘要:
A thin-walled introducer sheath is described. In some embodiments, the introducer sheath includes structural support components, such as wires, used in connection with a polymeric inner coating, a polymeric outer coating, or both. Further, in some embodiments, the wire components are annealed to reduce cold-work-related stresses and hardness. Use of annealed components may enable a reduction in the thickness of the polymeric outer coating in some applications.
摘要:
Disclosed are methods for detecting an acute myocardial infarction (i.e., a heart attack) at the earliest possible time and promptly warning the patient that he should immediately seek medical care. The present invention includes an implantable electronic system that can sense a change in the patient's electrogram that is indicative of a heart attack. If a heart attack is sensed, the device would then cause an implantable and/or externally located alarm to be actuated to warn the patient of his condition and a medical practitioner at a remote diagnostic center would receive the patient's electrogram for analysis. The patient or a caretaker would then be informed to self-inject medication through a subcutaneous, pass-through drug port that can be a separate device or integrated into the implanted device that is designed for the early detection of a heart attack. The methods of the present invention include determining if a human patient is likely to have a heart attack and, if he is, then implanting within that patient a device that can sense when a heart attack occurs and alarm the patient to take appropriate actions if a heart attack does occur.
摘要:
A system for providing alerts with regard to a patient's heart. An implanted medical device includes a sensor as well as a processor configured to detect a cardiac event. An internal alarm is configured for producing an alarm signal. An internal transceiver acting in cooperation with an external transceiver within an external device is provided. The processor is configured to determine whether the external and internal transceivers are able to communicate with each other and send a command to the internal alarm if there is no communication.
摘要:
Disclosed is a system for the detection of cardiac events that includes an implanted device called a cardiosaver, a physician's programmer and an external alarm system. The system is designed to provide early detection of cardiac events such as acute myocardial infarction or exercise induced myocardial ischemia caused by an increased heart rate or exertion. The system can also alert the patient with a less urgent alarm if a heart arrhythmia is detected. Using different algorithms, the cardiosaver can detect a change in the patient's electrogram that is indicative of a cardiac event within five minutes after it occurs and then automatically warn the patient that the event is occurring. To provide this warning, the system includes an internal alarm sub-system (internal alarm means) within the cardiosaver and/or an external alarm system (external alarm means) which are activated after the ST segment of the electrogram exceeds a preset threshold.
摘要:
A method for implanting a balloon expandable stent at a site within a passageway of a curved coronary article. The stent includes at least two longitudinally spaced apart circumferential rings. At least one longitudinally extending connector extends between adjacent rings. The connector has at least one turn back portion that can expand or contract in length while being passed through a curved passageway. The stent is disposed on a stent delivery catheter having an inflatable balloon. The stent delivery catheter and the stent is delivered through the passageway to the site of implementation with the connector member expanding or contracting in length to facilitate delivery and placement of the stent. The stent is expanded at the site of implantation by inflating the balloon to force the stent radially outward against the wall of the coronary artery.
摘要:
A stent which is adapted for placement in the vessels of a human body is provided. The stent may be in the form of a thin-walled metal cylinder having a longitudinal axis. The stent has a proximal end and a distal end and includes a number of circumferentially relatively rigid portions. The relatively rigid portions are joined to each other by one or more longitudinals which extend in a substantially longitudinal direction. At least a portion of at least one of the longitudinals has an undulating shape where a first relatively rigid portion is located at the proximal end of the stent and a second relatively rigid portion is located at the distal end of the stent.
摘要:
Disclosed is a completely implantable system that can detect the occurrence of a myocardial infarction, i.e., a heart attack, and automatically inject a thrombolytic and/or anti-thrombogenic agent into the bloodstream to promptly dissolve the thrombus that caused the myocardial infarction and prevent the formation of additional thrombi. It is well known that a myocardial infarction can be detected from a patient's electrocardiogram by noting an ST segment voltage deviation as compared to the voltage of the patient's TP or PQ segments. Upon detection of a myocardial infarction, an ST segment deviation electronic detection circuit within the implanted device can produce an output signal that can cause a thrombolytic and/or anti-thrombogenic agent contained within an implanted, pressurized reservoir to immediately and automatically release medications into the patient's bloodstream. A patient warning system is provided by an audio alarm or an electrical tickle within the human body indicating that a myocardial infarction has been detected. The implanted system can also send a radio message to an externally located receiver that automatically dials an emergency rescue team to take the patient to a hospital for continuing treatment of his myocardial infarction. An implantable defibrillator or pacemaker that includes the capability for informing the patient that myocardial infarction has been detected is also disclosed. Still further, this invention could also be used without a defibrillator or pacemaker but as an implanted system (without medications) whose only function would be the detection and warning of myocardial infarction at the earliest possible time.
摘要:
The temporary radioisotope stent catheter system of the present invention includes a temporary radioisotope stent that is situated at a distal portion of two, co-axially situated, thin-walled tubes. The catheter system can be delivered into a vessel of a human body either as a stand-alone device or it can be used in conjunction with an elongated cylindrical sheath which is a form of delivery catheter. If used as a stand-alone device, the temporary radioisotope stent is first percutaneously advanced through a guiding catheter and is then placed at the site of a stenotic dilatation. An operating means located at a proximal portion of the catheter system is then used to increase the diameter of the temporary radioisotope stent to be approximately equal to the inside diameter of the dilated stenosis. The temporary radioisotope stent is then retained at that position for an irradiation time period that is determined by the level of radioactivity of the stent, by the diameter of the dilated stenosis, and by the dose of radiation that is prescribed for application to that portion of the artery. At the conclusion of the irradiation time period, the operating means at the proximal portion of the catheter system is used to decrease the diameter of the temporary radioisotope stent to its minimum value, and then the catheter system is removed from the patient's body.