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公开(公告)号：US5931834A
公开(公告)日：1999-08-03
申请号：US904222
申请日：1997-07-31
申请人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Jeffrey J. Giba , Mark Roush , Fred G. Kinley
发明人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Jeffrey J. Giba , Mark Roush , Fred G. Kinley
CPC分类号： A61B18/24 , A61B2017/00247 , A61B2017/00703 , A61B2018/00392
摘要： A method of selecting laser parameters for performing laser-assisted myocardial revascularization to avoid inducing undesired cardiac arrhythmia without synchronization of delivery of laser energy and the patient's cardiac cycle, the method comprising the steps of minimizing the power level of laser energy used, thereby decreasing the overall trauma to the heart, selecting a pulse frequency as great as possible while avoiding adverse summation effects, selecting a pulse width as wide as possible to prevent excessively high peak powers per pulse and not so wide as to cause undesired thermal damage, selecting an energy flux rate, shaping the front end of each pulse of laser energy to provide efficient, non-explosive TMR channeling, and correcting the selected power level, pulse width, pulse frequency and energy flux rate for mechanical events, including method of access to the heart, position of selected portions of myocardium in the heart, temporal duration of the procedure, natural movement of the heart, specific heart geometry, pre-existing heart arrhythmia and other factors causing a predisposition to heart arrhythmia. A method for performing laser-assisted transmyocardial revascularization (TMR) and percutaneous transluminal myocardial revascularization (PTMR) using such laser energy with parameters selected to avoid inducing undesired cardiac arrhythmia, the method comprising the steps of generating laser energy having a predetermined non-square wave shape, a predetermined wavelength, a predetermined energy flux and a predetermined power level, and delivering the laser energy in a plurality of pulses, the plurality of pulses having a predetermined pulse frequency and a predetermined pulse width, to selected portions of myocardium to form TMR and PTMR channels without synchronizing delivery of the laser beam with the cardiac cycle.
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公开(公告)号：US5925012A
公开(公告)日：1999-07-20
申请号：US773872
申请日：1996-12-27
申请人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Robert Lincoln Lathrop, III , Bruce Richardson
发明人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Robert Lincoln Lathrop, III , Bruce Richardson
CPC分类号： A61B18/24 , A61B2017/00247 , A61B2018/00392
摘要： A drug delivery apparatus for dispensing predetermined volumes of drug, drug solution or other substances into an opening, such as a TMR channel in the human heart, or other laser treated area within the human body, the apparatus consisting of a bifurcated needle with a laser inlet for guiding a laser delivery means, such as an optical fiber or fiber bundle, to adjacent a surface of the human heart or other body structure for creating an opening, such as a TMR channel, or other laser treated area thereon. A drug inlet is for receiving the drug and transmitting the drug to the TMR channel or other laser treated area. Optionally, a piercing tip and/or suction device assists in positioning the apparatus adjacent the tissue to be treated. Drug is dispensed by manually or automatically actuating a piston or syringe element. A method of use is also disclosed.
摘要翻译： 用于将预定体积的药物，药物溶液或其它物质分配到诸如人心脏中的TMR通道或人体内的其它激光处理区域的开口中的药物递送装置，该装置由具有激光的分叉针 用于将诸如光纤或纤维束的激光传送装置引导到靠近人心或其他身体结构的表面以在其上形成诸如TMR通道或其他激光处理区域的开口。 药物入口用于接收药物并将药物传输到TMR通道或其他激光治疗区域。 可选地，刺穿尖端和/或抽吸装置有助于将装置定位在待处理组织附近。 通过手动或自动启动活塞或注射器元件来分配药物。 还公开了一种使用方法。
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公开(公告)号：US06620153B2
公开(公告)日：2003-09-16
申请号：US09854072
申请日：2001-05-11
IPC分类号： A61G1820
CPC分类号： A61B18/24 , A61B2017/00172 , A61B2017/00247 , A61B2017/22074 , A61B2017/22077 , A61B2018/00392 , A61B2018/208
摘要： An apparatus for stimulating revascularization of myocardium tissue in the ventricular wall of a human heart is disclosed. The apparatus includes means for moving the distal end of an optical fiber element forwardly through the epicardium of the heart and into the myocardium and emitting relatively low power bursts of laser energy from the distal end to form stimulus injury zones that promote capillary growth and tissue revascularization. Each penetration of the optical fiber element may produce multiple stimulus zones spaced radially from or in line with the axis of the optical fiber element. Apparatus for moving the optical fiber element and controlling the laser emissions in a predetermined manner is also disclosed.
摘要翻译： 公开了一种用于刺激人心脏心室壁心肌组织血运重建的装置。 该装置包括用于将光纤元件的远端向前移动通过心脏心外膜并进入心肌的装置，并且从远端发射相对低功率的激光能量脉冲以形成促进毛细血管生长和组织血运重建的刺激性损伤区域 。 光纤元件的每次穿透可以产生与光纤元件的轴线径向间隔开或与光纤元件的轴线成间隔的多个刺激区域。 还公开了用于移动光纤元件并以预定方式控制激光发射的装置。
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公开(公告)号：US5999678A
公开(公告)日：1999-12-07
申请号：US773430
申请日：1996-12-27
申请人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Bruce Richardson
发明人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Bruce Richardson
CPC分类号： A61B18/24 , A61B2017/00247 , A61B2018/00392
摘要： A drug delivery apparatus for dispensing a predetermined amount of one or more drugs into a laser created opening in the human body, the apparatus consisting of a laser delivery means such as an optical fiber or fiber bundle, a drug conduit which transfers the one or more drugs, drug solutions or other substances to the distal end of the laser delivery means, and the laser delivery means disposed essentially coaxially with the drug conduit. Laser delivery means is used to create a TMR channel or other opening in the body. Dispensed drug or other substance travels through the drug conduit and emanates from the drug conduit to be delivered into the TMR channel or other laser created opening. Drug is dispensed by manually or automatically activating an electric motor which actuates a piston element. A method of use is also disclosed.
摘要翻译： 一种用于将预定量的一种或多种药物分配到人体内的激光产生开口中的药物输送装置，该装置由诸如光纤或纤维束的激光输送装置组成，药物导管将一个或多个 药物，药物溶液或其它物质，并且激光输送装置基本上与药物导管同轴地设置。 激光输送装置用于在体内产生TMR通道或其他开口。 分配的药物或其他物质通过药物导管，并从药物导管发出，以被输送到TMR通道或其他激光产生的开口中。 药物通过手动或自动激活致动活塞元件的电动机来分配。 还公开了一种使用方法。
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公开(公告)号：US06706011B1
公开(公告)日：2004-03-16
申请号：US09288251
申请日：1999-04-08
申请人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Bruce Richardson
发明人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Bruce Richardson
IPC分类号： A61M3100
CPC分类号： A61B18/24 , A61B2017/00247 , A61B2018/00392
摘要： A drug delivery apparatus for dispensing predetermined volumes of drug, drug solution or other substances into an opening, such as a TMR channel in the human heart, or other laser treated area within the human body, the apparatus consisting of a bifurcated needle with a laser inlet for guiding a laser delivery means, such as an optical fiber or fiber bundle, to adjacent a surface of the human heart or other body structure for creating an opening, such as a TMR channel, or other laser treated area thereon. A drug inlet is for receiving the drug and transmitting the drug to the TMR channel or other laser treated area. Optionally, a piercing tip and/or suction device assists in positioning the apparatus adjacent the tissue to be treated. Drug is dispensed by manually or automatically actuating a piston or syringe element. A method of use is also disclosed.
摘要翻译： 用于将预定体积的药物，药物溶液或其它物质分配到诸如人心脏中的TMR通道或人体内的其它激光处理区域的开口中的药物递送装置，该装置由具有激光的分叉针 用于将诸如光纤或纤维束的激光传送装置引导到靠近人心或其他身体结构的表面以在其上形成诸如TMR通道或其他激光处理区域的开口。 药物入口用于接收药物并将药物传输到TMR通道或其他激光治疗区域。 可选地，刺穿尖端和/或抽吸装置有助于将装置定位在待处理组织附近。 通过手动或自动启动活塞或注射器元件来分配药物。 还公开了一种使用方法。
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6.发明授权
公开(公告)号：US5713894A
公开(公告)日：1998-02-03
申请号：US607782
申请日：1996-02-27
CPC分类号： A61B18/245 , A61B2017/00247 , A61B2018/00392
摘要： The method for combined mechanical/laser myocardial revascularization of a human heart includes: inserting a mechanical piercing device and an elongated flexible lasing apparatus into the chest cavity of a patient; mechanically piercing, micro-tearing or spreading the epicardium of the heart; and then lasing from beneath the epicardium through the myocardium. The apparatus is guided to an area exterior to a ventricle of the patient's heart, and the distal end of the optical fiber apparatus is placed internal to the exterior wall of the heart through an opening which has been created by mechanically piercing, micro-tearing or spreading the epicardium, so that the myocardium and not the epicardium is irradiated with laser energy to allow passage of said optical fiber distal end or said laser energy into the left ventricular cavity without causing a laser irradiation of the epicardium which might be a cause of operative bleeding and for better allowing the sealing of the epicardium after the apparatus is removed.
摘要翻译： 人心脏联合机械/激光心肌血运重建的方法包括：将机械穿刺装置和细长的柔性激光装置插入患者的胸腔; 机械穿刺，微裂或散布心脏的心外膜; 然后通过心肌从心外膜下射出。 该装置被引导到患者心脏的心室的外部区域，并且光纤装置的远端通过开口被放置在心脏的外壁的内部，所述开口通过机械刺穿，微撕裂或 扩散心外膜，使得心肌而不是心外膜被激光能量照射以允许所述光纤远端或所述激光能量通过到左心室，而不引起激光照射心外膜，这可能是手术的原因 出血并且更好地允许在除去装置之后密封心外膜。
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公开(公告)号：USD389574S
公开(公告)日：1998-01-20
申请号：US63126
申请日：1996-11-27
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公开(公告)号：US06551302B1
公开(公告)日：2003-04-22
申请号：US09697672
申请日：2000-10-26
申请人： Michael J. Rosinko , Alexander Khairkhahan , Michael Horzewski , Stuart D. Harman , Richard L. Mueller , Douglas R. Murphy-Chutorian
发明人： Michael J. Rosinko , Alexander Khairkhahan , Michael Horzewski , Stuart D. Harman , Richard L. Mueller , Douglas R. Murphy-Chutorian
IPC分类号： A61M3100
CPC分类号： A61M25/0147 , A61B8/06 , A61B8/12 , A61M25/0084 , A61M25/0136 , A61M2025/0089
摘要： A steerable percutaneous catheter for guiding at least one functional device to selected surfaces of a body for treatment thereon, particularly adapted for laser-assisted Percutaneous Transmyocardial Revascularization (PTMR). The steerable catheter has a handle portion at its proximal end and a controllably deflectable end portion at its distal end. The distal end of the catheter and the distal end of the functional device maintain alignment automatically during deflection. The invention also includes a surface contact detection system to detect contact with an interior body surface, such as the heart wall.
摘要翻译： 一种可导向的经皮导管，用于将至少一个功能装置引导到身体的选定表面上用于在其上进行治疗，特别适用于激光辅助经皮心肌血运重建术（PTMR）。 可操纵的导管在其近端处具有手柄部分，在其远端具有可控制地偏转的端部。 导管的远端和功能装置的远端在偏转期间自动保持对准。 本发明还包括一个表面接触检测系统，用于检测与诸如心脏壁的内部身体表面的接触。
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公开(公告)号：USD389578S
公开(公告)日：1998-01-20
申请号：US63101
申请日：1996-11-27
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公开(公告)号：US5742718A
公开(公告)日：1998-04-21
申请号：US696301
申请日：1996-08-13
申请人： Stuart D. Harman , Mark Roush
发明人： Stuart D. Harman , Mark Roush
CPC分类号： G02B6/3813 , A61B18/24 , G02B6/4296 , A61B2017/00123 , A61B2017/00247 , A61B2017/00725 , A61B2018/00392 , A61B2018/00988 , G02B2006/4297 , G02B6/3869 , G02B6/3887
摘要： A laser connector and electronic security system for a laser delivery system controls connection of the delivery system to a source of laser energy for medical procedures by storing encrypting codes to allow access by authorized, unused, delivery assemblies. The connector is specially dimensioned to further control delivery system access to the source, and the electronic security system utilizes EEPROM memory to allow storage and accumulation of information about the laser parameters used in the medical procedure. The connector and electronic security system is particularly suitable for pulsed laser transmyocardial revascularization (TMR) procedures and enables automatic power level calibration in accordance with the connected delivery system specifications, maximum time of usage settings, storage of the number/power level of the pulses delivered, and storage of the total number of TMR channels created.
摘要翻译： 用于激光传送系统的激光连接器和电子安全系统通过存储加密代码来控制传送系统与用于医疗过程的激光能量源的连接，以允许经授权的未使用的传送组件访问。 该连接器的尺寸被特别设计以进一步控制对源的传送系统访问，并且电子安全系统利用EEPROM存储器来允许存储和累积关于在医疗过程中使用的激光参数的信息。 连接器和电子安全系统特别适用于脉冲激光心肌血运重建（TMR）程序，并能够根据所连接的输送系统规格进行自动功率电平校准，最大使用时间设置，存储发送的脉冲数/功率电平 ，并存储创建的TMR频道总数。
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