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公开(公告)号：US08900219B2
公开(公告)日：2014-12-02
申请号：US12423137
申请日：2009-04-14
CPC分类号： A61B18/24 , A61B1/00087 , A61B1/00165 , A61B1/0638 , A61B1/07 , A61B5/0044 , A61B5/0075 , A61B5/0084 , A61B5/4836 , A61B5/7264 , A61B5/743 , A61B2017/00057 , A61B2018/00011 , A61B2018/00357 , A61B2018/00577 , A61B2018/00642 , A61B2018/0069 , A61B2018/00904 , A61B2018/00982 , A61B2576/023
摘要： Systems for visualizing cardiac tissue during an ablation procedure are provided. In general, the systems include an imaging module configured to measure absorbance data at first and second wavelengths wherein the ratio of these absorbance values identifies the nature of the tissue (e.g., lesion, de novo tissue, etc.). The imaging module can also include a video system having at least two chips with corresponding bandpass filters centered at the first and second target wavelengths. The system can also include a processor and/or video monitor for combining the images produced by the various chips, determining treated and non-treated tissue based on the ratio of absorbance values at the target wavelengths, and displaying images of the treatment area. Methods of visualizing cardiac treatment areas during ablation procedures are also provided herein.
摘要翻译： 提供了在消融过程中可视化心脏组织的系统。 通常，该系统包括成像模块，该成像模块被配置为测量第一和第二波长处的吸光度数据，其中这些吸光度值的比率识别组织的性质（例如病变，从头组织等）。 成像模块还可以包括具有至少两个具有以第一和第二目标波长为中心的带通滤波器的芯片的视频系统。 该系统还可以包括用于组合由各种芯片产生的图像的处理器和/或视频监视器，基于目标波长处的吸光度值的比率和显示处理区域的图像来确定处理和未处理的组织。 本文还提供了在消融过程中可视化心脏治疗区域的方法。
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公开(公告)号：US20090326320A1
公开(公告)日：2009-12-31
申请号：US12423137
申请日：2009-04-14
IPC分类号： A61B1/04
CPC分类号： A61B18/24 , A61B1/00087 , A61B1/00165 , A61B1/0638 , A61B1/07 , A61B5/0044 , A61B5/0075 , A61B5/0084 , A61B5/4836 , A61B5/7264 , A61B5/743 , A61B2017/00057 , A61B2018/00011 , A61B2018/00357 , A61B2018/00577 , A61B2018/00642 , A61B2018/0069 , A61B2018/00904 , A61B2018/00982 , A61B2576/023
摘要： Systems for visualizing cardiac tissue during an ablation procedure are provided. In general, the systems include an imaging module configured to measure absorbance data at first and second wavelengths wherein the ratio of these absorbance values identifies the nature of the tissue (e.g., lesion, de novo tissue, etc.). The imaging module can also include a video system having at least two chips with corresponding bandpass filters centered at the first and second target wavelengths. The system can also include a processor and/or video monitor for combining the images produced by the various chips, determining treated and non-treated tissue based on the ratio of absorbance values at the target wavelengths, and displaying images of the treatment area. Methods of visualizing cardiac treatment areas during ablation procedures are also provided herein.
摘要翻译： 提供了在消融过程中可视化心脏组织的系统。 通常，该系统包括成像模块，该成像模块被配置为测量第一和第二波长处的吸光度数据，其中这些吸光度值的比率识别组织的性质（例如病变，从头组织等）。 成像模块还可以包括具有至少两个具有以第一和第二目标波长为中心的带通滤波器的芯片的视频系统。 该系统还可以包括用于组合由各种芯片产生的图像的处理器和/或视频监视器，基于目标波长处的吸光度值的比率和显示处理区域的图像来确定处理和未处理的组织。 本文还提供了在消融过程中可视化心脏治疗区域的方法。
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公开(公告)号：US08540704B2
公开(公告)日：2013-09-24
申请号：US10865558
申请日：2004-06-10
IPC分类号： A61B18/22
CPC分类号： A61B18/1492 , A61B1/00045 , A61B1/00135 , A61B1/00165 , A61B1/00195 , A61B1/05 , A61B1/3137 , A61B18/1482 , A61B18/1815 , A61B18/22 , A61B18/24 , A61B2018/0022 , A61B2018/00351 , A61B2018/00375 , A61B2018/00577 , A61B2018/00982 , A61B2018/0212 , A61B2018/0262 , A61B2018/2261 , A61B2090/065 , A61B2090/3966 , A61N7/022 , A61N2005/1003
摘要： Guided ablation instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias, including atrial fibrillation. In one aspect of the invention, a percutaneous catheter is disclosed with an endoscope positionable in the instrument's distal end region to obtain an image. The image allows the clinician to determine whether contact has been achieved (or blood has been cleared from an ablative energy transmission path) before ablation begins or while ablation is occurring. In one embodiment, percutaneous ablation catheters are disclosed having at least one central lumen and one or more balloon structures at the distal end region of the instrument. Also disposed in the distal end region are an illuminating light source and an endoscope capable of collecting sufficient light to relay an image to the user. The instruments can further include an ablation element. The ablation element can be a contact ablation element, or a radiant energy emitter, which is preferably independently positionable within the lumen of the instrument and adapted to project ablative energy through a transmissive region of the instrument body (and/or balloon) to a target tissue site proximate to the pulmonary veins. The energy can delivered without the need for contact between the energy emitter and the target tissue so long as a clear transmission pathway is established. The endoscope element of the instrument allows the clinician to determine the position of the instrument and, if radiant energy is to be employed, see if such a pathway is clear. Moreover, because the position of the radiant energy emitter can be varied, endoscopic guidance permits the clinician to select a desired location and dose for the lesion.
摘要翻译： 公开了引导消融器械用于在组织中产生损伤，特别是用于治疗心律失常的心脏组织，包括房颤。 在本发明的一个方面，公开了一种经皮导管，其具有可置于仪器的远端区域中的内窥镜，以获得图像。 图像允许临床医生确定在消融开始之前还是在消融期间已经实现了接触（或者从消融能量传递路径中清除血液）。 在一个实施例中，公开了经皮消融导管，其在器械的远端区域具有至少一个中心腔和一个或多个气囊结构。 还设置在远端区域中的是能够收集足够的光以将图像中继给用户的照明光源和内窥镜。 仪器还可以包括消融元件。 消融元件可以是接触消融元件或辐射能发射器，其优选地可独立地定位在器械的内腔内并且适于将烧蚀能量穿过器械主体（和/或气囊）的透射区域投射到靶 靠近肺静脉的组织部位。 只要建立清晰的传输路径，能量可以传送而不需要能量发射器和目标组织之间的接触。 仪器的内窥镜元件允许临床医生确定仪器的位置，并且如果要使用辐射能量，看看这样的通路是否清晰。 此外，由于辐射能发射器的位置可以改变，所以内窥镜引导允许临床医生选择病变的期望位置和剂量。
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公开(公告)号：US08366705B2
公开(公告)日：2013-02-05
申请号：US12424757
申请日：2009-04-16
IPC分类号： A61B18/04
CPC分类号： A61B18/24 , A61B18/245 , A61B2017/00057 , A61B2017/00061 , A61B2018/0097 , A61B2018/2261 , A61B2018/2266 , A61B2018/2272 , A61B2090/065 , A61L2/10 , A61L29/085 , A61N7/02 , C08L27/12
摘要： A cardiac ablation instrument capable of removing blood from a treatment area is provided. The instrument includes a catheter configured to deliver a distal end thereof to a patient's heart. The instrument can also include an expandable element coupled to the distal end of the catheter wherein the expandable member is configured to be positioned adjacent a target area thereby defining a treatment area between the expandable member and the target area. Further, the instrument can include an irrigation mechanism configured to dispense an irrigation fluid from the catheter thereby displacing blood from the treatment area. Additionally, the instrument includes an energy emitter configured to deliver energy to tissue within the treatment area. The instrument can also include a contact sensor configured to determine the presence of such blood within the treatment area. Methods for ablating tissue are also provided.
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公开(公告)号：US08444639B2
公开(公告)日：2013-05-21
申请号：US13353086
申请日：2012-01-18
IPC分类号： A61B18/12
CPC分类号： A61B18/24 , A61B18/245 , A61B2017/00057 , A61B2017/00061 , A61B2018/0097 , A61B2018/2261 , A61B2018/2266 , A61B2018/2272 , A61B2090/065 , A61L2/10 , A61L29/085 , A61N7/02 , C08L27/12
摘要： A cardiac ablation instrument capable of removing blood from a treatment area is provided. The instrument includes a catheter configured to deliver a distal end thereof to a patient's heart. The instrument can also include an expandable element coupled to the distal end of the catheter wherein the expandable member is configured to be positioned adjacent a target area thereby defining a treatment area between the expandable member and the target area. Further, the instrument can include an irrigation mechanism configured to dispense an irrigation fluid from the catheter thereby displacing blood from the treatment area. Additionally, the instrument includes an energy emitter configured to deliver energy to tissue within the treatment area. The instrument can also include a contact sensor configured to determine the presence of such blood within the treatment area. Methods for ablating tissue are also provided.
摘要翻译： 提供能够从治疗区域去除血液的心脏消融器械。 仪器包括被配置为将其远端递送到患者心脏的导管。 仪器还可以包括耦合到导管的远端的可扩张元件，其中可扩张构件构造成邻近目标区域定位，从而限定可扩张构件和目标区域之间的治疗区域。 此外，仪器可以包括配置成从导管分配冲洗流体的冲洗机构，从而从处理区域移出血液。 另外，该仪器包括能量发射器，其配置成将能量传递到处理区域内的组织。 仪器还可以包括被配置为确定处理区域内这种血液的存在的接触传感器。 还提供了消融组织的方法。
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公开(公告)号：US06626900B1
公开(公告)日：2003-09-30
申请号：US09616275
申请日：2000-07-14
申请人： Edward L. Sinofsky , Norman E. Farr
发明人： Edward L. Sinofsky , Norman E. Farr
IPC分类号： A61B1818
CPC分类号： A61B18/245 , A61B2017/00061 , A61B2018/0097 , A61B2018/2266 , A61B2018/2272 , A61B2090/065
摘要： An apparatus and method for phototherapy are described in which laser light or other radiation is projected from within a catheter, through a balloon member, and toward the surface of tissue. The light reflected from body fluids or the tissue surface is captured by a collecting device located within the catheter, e.g., within the balloon member, and the intensity of the reflected light is ascertained. The apparatus and method provides for accurately positioning the apparatus against the tissue treatment site.
摘要翻译： 描述了一种用于光疗的装置和方法，其中激光或其它辐射从导管内，通过球囊构件并朝向组织的表面突出。 从体液或组织表面反射的光被位于导管内的收集装置捕获，例如在球囊构件内，并确定反射光的强度。 该装置和方法提供了将装置精确地定位在组织治疗部位上。
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公开(公告)号：US06558375B1
公开(公告)日：2003-05-06
申请号：US09616777
申请日：2000-07-14
IPC分类号： A61B1818
CPC分类号： A61B18/22 , A61B2017/00243 , A61B2018/2261 , A61B2018/2272
摘要： The present invention is directed to a hand held cardiac ablation instrument and methods for irradiating a target ablation site. The instrument can include at least one light transmitting optical fiber and a light diffusing element to create a circumferential or curvilinear lesion. A handle is provided for manual application. The handle can be substantially coaxial or otherwise aligned with the center of the circumferential housing. Light travelling through the light transmitting optical fiber or fibers is scattered in a circular pattern by the light diffusing element. The light diffusing element can include a scattering medium, a reflective end cap, and a reflective surface diametrically opposed to the target ablation site, that interact to provide a substantially uniform distribution of laser radiation throughout the circular target region.
摘要翻译： 本发明涉及手持式心脏消融仪和用于照射目标消融部位的方法。 仪器可以包括至少一个透光光纤和光漫射元件以产生圆周或曲线损伤。 手柄用于手动应用。 手柄可以与周向壳体的中心基本上同轴或以其它方式对准。 穿过光传输光纤或光纤的光通过光漫射元件以圆形图案散射。 光散射元件可以包括散射介质，反射端盖和与目标消融部位直径相对的反射表面，其相互作用以提供贯穿整个圆形目标区域的激光辐射的基本上均匀的分布。
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公开(公告)号：US08025661B2
公开(公告)日：2011-09-27
申请号：US10357156
申请日：2003-02-03
IPC分类号： A61B18/04
CPC分类号： A61B18/24 , A61B18/245 , A61B2017/00057 , A61B2017/00061 , A61B2018/0097 , A61B2018/2261 , A61B2018/2266 , A61B2018/2272 , A61B2090/065 , A61L2/10 , A61L29/085 , A61N7/02 , C08L27/12
摘要： A cardiac ablation instrument includes a catheter body and a tear-shaped balloon that is connected to the catheter body. The instrument further includes a radiant energy emitter that is axially movable within a central lumen of the catheter body. A radiant energy transparent body surrounds the energy emitter and includes a plurality of illumination fibers disposed circumferentially about the energy emitter. A detector communicates with a contact sensing element and is configured to determine an amount of at least one color component of the reflected light The amount of the at least one color component being indicative of contact between the balloon and a target tissue site.
摘要翻译： 心脏消融仪器包括导管主体和连接到导管主体的泪状气囊。 仪器还包括辐射能发射器，其可在导管主体的中心腔内轴向移动。 辐射能透明体围绕能量发射器并且包括围绕能量发射器周向设置的多个照明光纤。 检测器与接触检测元件通信，并且被配置为确定反射光的至少一种颜色成分的量。所述至少一种颜色成分的量指示气囊和目标组织部位之间的接触。
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公开(公告)号：US06572609B1
公开(公告)日：2003-06-03
申请号：US09602420
申请日：2000-06-23
IPC分类号： A61B1820
CPC分类号： A61B18/245 , A61B2017/00061 , A61B2018/0097 , A61B2018/2266 , A61B2018/2272 , A61B2090/065
摘要： Methods and apparatus are disclosed for forming annular lesions in tissue. The methods include introduction of an optical apparatus proximate to a tissue site, via, for example, a catheter. The optical apparatus includes a pattern-forming optical waveguide in communication with a light transmitting optical fiber. Energy is transmitted through the optical fiber, such that radiation is propagated through the optical fiber and the waveguide projects an annular light pattern, e.g., a circle or a halo.
摘要翻译： 公开了用于在组织中形成环形损伤的方法和装置。 这些方法包括通过例如导管引入靠近组织部位的光学装置。 光学装置包括与光传输光纤连通的图案形成光波导。 能量通过光纤传输，使得辐射通过光纤传播，并且波导投射环形光图案，例如圆形或光晕。
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公开(公告)号：US08241272B2
公开(公告)日：2012-08-14
申请号：US11481204
申请日：2006-07-05
IPC分类号： A61B18/22
CPC分类号： A61B18/24 , A61B18/245 , A61B2017/00057 , A61B2017/00061 , A61B2018/0097 , A61B2018/2261 , A61B2018/2266 , A61B2018/2272 , A61B2090/065 , A61L2/10 , A61L29/085 , A61N7/02 , C08L27/12
摘要： A method of treating atrial fibrillation includes the step of positioning a distal portion of an ablation instrument in proximity to one or more pulmonary veins. The instrument has a hollow housing and an independently axially positionable energy emitter within the distal portion The energy emitter is configured and the distal portion is shaped such that a distance a beam of ablative energy travels from the energy emitter to the portion of the distal portion in contact with target tissue changes based on the energy emitter's location along the length of the instrument while the distal portion maintains its shape The energy emitter is a light emitting element and a beam-forming optical waveguide that receives light from the light emitting element. The waveguide projects onto the distal portion a hollow cone of radiation.
摘要翻译： 治疗房颤的方法包括将消融器械的远侧部分定位在一个或多个肺静脉附近的步骤。 仪器具有中空壳体和在远端部分内的独立轴向定位的能量发射器。能量发射器被配置并且远端部分成形为使得消融能量束从能量发射器传播到远端部分的距离的距离 基于沿着仪器长度的能量发射器位置的目标组织变化的接触，而远侧部分保持其形状。能量发射器是从发光元件接收光的发光元件和束形成光波导。 波导将远端部分投射到中空的辐射锥体上。
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