公开(公告)号：US20070213734A1

公开(公告)日：2007-09-13

申请号：US11405859

申请日：2006-04-17

申请人： Jeffery Bleich ,  Steven Spisak ,  Vahid Saadat ,  Ronald Leguidleguid ,  Jeffery Bleam ,  Michael Drews ,  James Yurchenco

发明人： Jeffery Bleich ,  Steven Spisak ,  Vahid Saadat ,  Ronald Leguidleguid ,  Jeffery Bleam ,  Michael Drews ,  James Yurchenco

IPC分类号： A61B17/16

CPC分类号： A61B17/1659 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/1671 ,  A61B17/1757 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/3421 ,  A61B2017/00261 ,  A61B2017/00867 ,  A61B2017/32006 ,  A61B2017/3488 ,  A61B2090/08021

摘要： A method for preventing unwanted damage to tissue in a spine of a patient during a tissue modification procedure may involve: advancing at least a distal portion of at least one barrier member over at least one guide member into an epidural space of the patient's spine; positioning at least an expanded portion of the barrier member between target tissue and non-target tissue; and performing at least one tissue modification procedure on the target tissue, using at least one tissue modification device. Generally, at least part of the barrier member may be disposed between the tissue modification device and the non-target tissue to prevent unwanted damage to the non-target tissue. In various embodiments, at least part of a barrier member may be advanced through a sheath- or catheter-like delivery device and may either automatically expand or be expandable from a collapsed configuration to an expanded configuration.

摘要翻译： 一种用于防止在组织改变过程期间对患者的脊柱中的组织的不期望的损伤的方法可以包括：使至少一个阻挡构件的至少一个阻挡构件的至少一个远端部分在至少一个引导构件上前进到患者脊柱的硬膜外腔中; 将所述阻挡构件的至少扩大部分定位在目标组织和非目标组织之间; 以及使用至少一个组织修改装置对所述靶组织进行至少一个组织修饰程序。 通常，阻挡构件的至少一部分可以设置在组织修改装置和非目标组织之间，以防止对非目标组织的不必要的损坏。 在各种实施例中，阻挡构件的至少一部分可以通过护套或导管状递送装置前进，并且可以自动地膨胀或者可以从折叠构型扩展到扩张构型。

公开(公告)号：US20060095059A1

公开(公告)日：2006-05-04

申请号：US11251199

申请日：2005-10-15

申请人： Jeffery Bleich ,  Edwin Hlavka ,  Vahid Saadat ,  Steven Spisak ,  David Miller ,  James Yurchenco

发明人： Jeffery Bleich ,  Edwin Hlavka ,  Vahid Saadat ,  Steven Spisak ,  David Miller ,  James Yurchenco

IPC分类号： A61B17/32

CPC分类号： A61B17/320758 ,  A61B1/3135 ,  A61B17/149 ,  A61B17/1659 ,  A61B17/1671 ,  A61B17/29 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/32053 ,  A61B17/3401 ,  A61B17/3403 ,  A61B17/3421 ,  A61B17/3496 ,  A61B18/1477 ,  A61B18/1487 ,  A61B90/04 ,  A61B90/361 ,  A61B2017/00261 ,  A61B2017/00287 ,  A61B2017/003 ,  A61B2017/00867 ,  A61B2017/00907 ,  A61B2017/320004 ,  A61B2017/320044 ,  A61B2017/32006 ,  A61B2017/3445 ,  A61B2017/3447 ,  A61B2018/1407 ,  A61B2018/1425 ,  A61B2090/061 ,  A61B2090/08021 ,  A61F2/0045 ,  A61N1/0551 ,  A61N1/36017

摘要： Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. Once the sharp tip of the needle is in the epidural space, it is converted to a blunt tipped instrument for further safe advancement. A specially designed epidural catheter that is used to cover the previously sharp needle tip may also contain a fiberoptic cable. Further embodiments of the current invention include a double barreled epidural needle or other means for placement of a working channel for the placement of tools within the epidural space, beside the epidural instrument. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. In one variation, a tissue abrasion device is provided including a thin belt or ribbon with an abrasive cutting surface. The device may be placed through the neural foramina of the spine and around the anterior border of a facet joint. Once properly positioned, a medical practitioner may enlarge the lateral recess and neural foramina via frictional abrasion, i.e., by sliding the abrasive surface of the ribbon across impinging tissues. A nerve stimulator optionally may be provided to reduce a risk of inadvertent neural abrasion. Additionally, safe epidural placement of the working barrier and epidural tissue modification tools may be further improved with the use of electrical nerve stimulation capabilities within the invention that, when combined with neural stimulation monitors, provide neural localization capabilities to the surgeon. The device optionally may be placed within a protective sheath that exposes the abrasive surface of the ribbon only in the area where tissue removal is desired. Furthermore, an endoscope may be incorporated into the device in order to monitor safe tissue removal. Finally, tissue remodeling within the epidural space may be ensured through the placement of compression dressings against remodeled tissue surfaces, or through the placement of tissue retention straps, belts or cables that are wrapped around and pull under tension aspects of the impinging soft tissue and bone in the posterior spinal canal.

公开(公告)号：US20070213733A1

公开(公告)日：2007-09-13

申请号：US11405848

申请日：2006-04-17

申请人： Jeffery Bleich ,  Vahid Saadat ,  Roy Leguidleguid ,  Jeffery Bleam

发明人： Jeffery Bleich ,  Vahid Saadat ,  Roy Leguidleguid ,  Jeffery Bleam

IPC分类号： A61B17/16

CPC分类号： A61B17/1659 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/1671 ,  A61B17/1757 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/3421 ,  A61B2017/00261 ,  A61B2017/00867 ,  A61B2017/32006 ,  A61B2017/3488 ,  A61B2090/08021

摘要： A device for modifying one or more tissues in a patient's spine may include: an elongate, at least partially flexible body having a proximal portion and a distal portion, wherein at least the distal portion has dimensions that allow it to be passed into an epidural space and between target and non-target tissues of the spine; at least one movable blade disposed along one side of the elongate body; at least one actuator coupled with the at least one blade and disposed at or near the proximal or distal portion of the body for moving the blade(s) to modify one or more target tissues, wherein the at least one actuator is configured to move the blade(s) without significantly translating the elongate body proximally or distally; and means at or near the proximal and distal portions of the elongate body for facilitating application of at least one of anchoring force and tensioning force to the body to urge the at least one blade against the target tissue.

摘要翻译： 用于修改患者脊柱中的一个或多个组织的装置可以包括：细长的至少部分柔性的身体，其具有近端部分和远端部分，其中至少远端部分具有允许其进入硬膜外腔的尺寸 和脊柱的靶和非靶组织之间; 沿着所述细长体的一侧设置的至少一个可动刀片; 至少一个致动器，其与所述至少一个叶片耦合并且设置在所述主体的近端或远端部分处或附近，用于移动所述叶片以修改一个或多个目标组织，其中所述至少一个致动器被配置成使所述至少一个致动器移动 刀片不在近侧或远端显着地平移细长体; 以及在所述细长体的近端部分和远端部分附近的装置，用于便于将至少一个锚定力和张紧力施加到身体以将至少一个刀片推向靶组织。

公开(公告)号：US20060241648A1

公开(公告)日：2006-10-26

申请号：US11375265

申请日：2006-03-13

申请人： Jeffery Bleich ,  Vahid Saadat ,  Steven Spisak ,  John Ashley

发明人： Jeffery Bleich ,  Vahid Saadat ,  Steven Spisak ,  John Ashley

IPC分类号： A61B17/58

CPC分类号： A61B17/1659 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/1671 ,  A61B17/1757 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/3421 ,  A61B2017/00261 ,  A61B2017/00867 ,  A61B2017/32006 ,  A61B2017/3488 ,  A61B2090/08021

摘要： A method for modifying tissue in a patient may involve one or more of the following steps: advancing at least a distal portion of at least one elongate, at least partially flexible tissue modification device into a patient and between one or more target tissues and one or more non-target tissues; positioning at least one tissue modifying member of the tissue modification device adjacent the target tissue such that the tissue modifying member(s) face the target tissue and do not face the non-target tissue; applying an anchoring force to the tissue modification device at or near the distal portion or a proximal portion of the device; applying a tensioning force to the tissue modification device at or near an opposite end of the device relative to the end to which anchoring force is applied, while maintaining the anchoring force, to urge the tissue modifying member(s) against the target tissue; and modifying the target tissue, using the tissue modifying member(s), while preventing the tissue modifying member(s) from extending significantly beyond the target tissue toward the proximal or distal portion of the tissue modification device during tissue modification.

摘要翻译： 用于修改患者组织的方法可以涉及一个或多个以下步骤：将至少一个细长的，至少部分柔性的组织改变装置的至少远端部分推进到患者体内，并将一个或多个靶组织与一个或多个靶组织 更多的非靶组织; 将所述组织改变装置的至少一个组织修改构件定位成邻近所述目标组织，使得所述组织修改构件面向所述靶组织并且不面向所述非靶组织; 在组件修改装置的远端部分或近端部分处或附近施加锚定力; 在保持锚固力的同时相对于施加锚定力的端部在装置的相对端处或附近施加张力，以促使组织修改构件抵靠目标组织; 以及在组织改变期间，使组织改变部件改变目标组织，同时防止组织改变部件显着地超出目标组织向组织改变装置的近端或远端部分延伸。

公开(公告)号：US20110098708A9

公开(公告)日：2011-04-28

申请号：US11406486

申请日：2006-04-17

申请人： Vahid Saadat ,  Jeffery Bleich ,  Kenneth Michlitsch ,  John Ashley

发明人： Vahid Saadat ,  Jeffery Bleich ,  Kenneth Michlitsch ,  John Ashley

IPC分类号： A61B17/00

CPC分类号： A61B17/1659 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/1671 ,  A61B17/1757 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/3421 ,  A61B2017/00261 ,  A61B2017/00867 ,  A61B2017/32006 ,  A61B2017/3488 ,  A61B2090/08021

摘要： A device for modifying tissue in a spine may include: a shaft having a proximal portion and a distal portion, the distal portion having dimensions which allow it to be passed into an epidural space of the spine and between target and non-target tissues; at least one distal force application member extending from the distal portion of the shaft and configured to facilitate application of at least one of anchoring force and tensioning force to the shaft; at least one movable tissue modifying member coupled with the shaft at or near its distal portion; at least one drive member coupled with the at least one tissue modifying member to activate the at least one tissue modifying member; and at least one power transmission member coupled with the at least one drive member to deliver power to the at least one drive member.

摘要翻译： 用于修改脊柱中的组织的装置可以包括：具有近端部分和远侧部分的轴，所述远端部分具有允许其进入脊柱的硬膜外腔中以及靶和非靶组织之间的尺寸; 至少一个远端力施加构件，其从所述轴的远侧部分延伸并且构造成便于将锚固力和张紧力中的至少一个施加到所述轴; 至少一个可动组织修改构件，其在远端部分处或其附近与所述轴联接; 至少一个驱动构件与所述至少一个组织修改构件联接以激活所述至少一个组织修改构件; 以及与所述至少一个驱动构件联接的至少一个动力传递构件，以向所述至少一个驱动构件输送动力。

公开(公告)号：US20070213735A1

公开(公告)日：2007-09-13

申请号：US11406486

申请日：2006-04-17

申请人： Vahid Saadat ,  Jeffery Bleich ,  Kenneth Michlitsch ,  John Ashley

发明人： Vahid Saadat ,  Jeffery Bleich ,  Kenneth Michlitsch ,  John Ashley

IPC分类号： A61B17/00

CPC分类号： A61B17/1659 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/1671 ,  A61B17/1757 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/3421 ,  A61B2017/00261 ,  A61B2017/00867 ,  A61B2017/32006 ,  A61B2017/3488 ,  A61B2090/08021

摘要： A device for modifying tissue in a spine may include: a shaft having a proximal portion and a distal portion, the distal portion having dimensions which allow it to be passed into an epidural space of the spine and between target and non-target tissues; at least one distal force application member extending from the distal portion of the shaft and configured to facilitate application of at least one of anchoring force and tensioning force to the shaft; at least one movable tissue modifying member coupled with the shaft at or near its distal portion; at least one drive member coupled with the at least one tissue modifying member to activate the at least one tissue modifying member; and at least one power transmission member coupled with the at least one drive member to deliver power to the at least one drive member.

摘要翻译： 用于修改脊柱中的组织的装置可以包括：具有近端部分和远侧部分的轴，所述远端部分具有允许其进入脊柱的硬膜外腔中以及靶和非靶组织之间的尺寸; 至少一个远端力施加构件，其从所述轴的远侧部分延伸并且构造成便于将锚固力和张紧力中的至少一个施加到所述轴; 至少一个可动组织修改构件，其在远端部分处或其附近与所述轴联接; 至少一个驱动构件与所述至少一个组织修改构件联接以激活所述至少一个组织修改构件; 以及与所述至少一个驱动构件联接的至少一个动力传递构件，以向所述至少一个驱动构件输送动力。

公开(公告)号：US20120078253A9

公开(公告)日：2012-03-29

申请号：US11405848

申请日：2006-04-17

申请人： Jeffery Bleich ,  Vahid Saadat ,  Roy Leguidleguid ,  Jefferey Bleam

发明人： Jeffery Bleich ,  Vahid Saadat ,  Roy Leguidleguid ,  Jefferey Bleam

IPC分类号： A61B17/16

CPC分类号： A61B17/1659 ,  A61B17/00234 ,  A61B17/02 ,  A61B17/1671 ,  A61B17/1757 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/3421 ,  A61B2017/00261 ,  A61B2017/00867 ,  A61B2017/32006 ,  A61B2017/3488 ,  A61B2090/08021

摘要： A device for modifying one or more tissues in a patient's spine may include: an elongate, at least partially flexible body having a proximal portion and a distal portion, wherein at least the distal portion has dimensions that allow it to be passed into an epidural space and between target and non-target tissues of the spine; at least one movable blade disposed along one side of the elongate body; at least one actuator coupled with the at least one blade and disposed at or near the proximal or distal portion of the body for moving the blade(s) to modify one or more target tissues, wherein the at least one actuator is configured to move the blade(s) without significantly translating the elongate body proximally or distally; and means at or near the proximal and distal portions of the elongate body for facilitating application of at least one of anchoring force and tensioning force to the body to urge the at least one blade against the target tissue.

摘要翻译： 用于修改患者脊柱中的一个或多个组织的装置可以包括：细长的至少部分柔性的身体，其具有近端部分和远端部分，其中至少远端部分具有允许其进入硬膜外腔的尺寸 和脊柱的靶和非靶组织之间; 沿着所述细长体的一侧设置的至少一个可动刀片; 至少一个致动器，其与所述至少一个叶片耦合并且设置在所述主体的近端或远端部分处或附近，用于移动所述叶片以修改一个或多个目标组织，其中所述至少一个致动器被配置成使所述至少一个致动器移动 刀片不在近侧或远端显着地平移细长体; 以及在所述细长体的近端部分和远端部分附近的装置，用于便于将至少一个锚定力和张紧力施加到身体以将至少一个刀片推向靶组织。

公开(公告)号：US08192435B2

公开(公告)日：2012-06-05

申请号：US11251199

申请日：2005-10-15

申请人： Jeffery L. Bleich ,  Edwin J. Hlavka ,  Vahid Saadat ,  Steven A. Spisak ,  David R. Miller ,  James Yurchenco

发明人： Jeffery L. Bleich ,  Edwin J. Hlavka ,  Vahid Saadat ,  Steven A. Spisak ,  David R. Miller ,  James Yurchenco

IPC分类号： A61B17/00

CPC分类号： A61B17/320758 ,  A61B1/3135 ,  A61B17/149 ,  A61B17/1659 ,  A61B17/1671 ,  A61B17/29 ,  A61B17/320016 ,  A61B17/32002 ,  A61B17/32053 ,  A61B17/3401 ,  A61B17/3403 ,  A61B17/3421 ,  A61B17/3496 ,  A61B18/1477 ,  A61B18/1487 ,  A61B90/04 ,  A61B90/361 ,  A61B2017/00261 ,  A61B2017/00287 ,  A61B2017/003 ,  A61B2017/00867 ,  A61B2017/00907 ,  A61B2017/320004 ,  A61B2017/320044 ,  A61B2017/32006 ,  A61B2017/3445 ,  A61B2017/3447 ,  A61B2018/1407 ,  A61B2018/1425 ,  A61B2090/061 ,  A61B2090/08021 ,  A61F2/0045 ,  A61N1/0551 ,  A61N1/36017

摘要： Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures. The current invention includes specific tools that enable safe tissue modification in epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. In one variation, a tissue abrasion device is provided including a thin belt or ribbon with an abrasive cutting surface. The device optionally may be placed within a protective sheath that exposes the abrasive surface of the ribbon only in the area where tissue removal is desired.

摘要翻译： 提供了用于选择性手术去除组织的方法和装置，例如用于扩大患病的脊柱结构。 本发明包括能够在硬膜外腔中进行安全组织修复的特定工具，包括将相邻易受伤的神经和血管结构发生组织修饰的区域分开的屏障。 在一个实施例中，提供了一种组织磨损装置，其包括具有研磨切割表面的薄带或带。 该装置可选择地放置在保护套内，仅在期望组织移除的区域中暴露带的研磨表面。

公开(公告)号：US09254090B2

公开(公告)日：2016-02-09

申请号：US13278820

申请日：2011-10-21

申请人： Jason Paul Watson ,  Vahid Saadat

发明人： Jason Paul Watson ,  Vahid Saadat

IPC分类号： A61B6/00 ,  A61B5/00 ,  A61B1/04

CPC分类号： A61B5/0084 ,  A61B1/043 ,  A61B5/0071 ,  A61B5/6852

摘要： Tissue contrast imaging systems are described which detect differences in tissue contrasts to obtain images of the tissue region. The systems may be used to obtain images of the cardiac tissues particularly in a blood-filled environment.

摘要翻译： 描述组织对比成像系统，其检测组织对比度的差异以获得组织区域的图像。 该系统可用于获得心脏组织的图像，特别是在充满血液的环境中。

公开(公告)号：US08814845B2

公开(公告)日：2014-08-26

申请号：US13365914

申请日：2012-02-03

申请人： Vahid Saadat ,  Sekhar S. Rao

发明人： Vahid Saadat ,  Sekhar S. Rao

IPC分类号： A61M31/00

CPC分类号： A61B1/00165 ,  A61B1/00089 ,  A61B1/00096 ,  A61B1/00147 ,  A61B1/015 ,  A61B1/05 ,  A61B1/12 ,  A61B5/0084 ,  A61B5/6882 ,  A61B5/7282 ,  A61M25/0074 ,  A61M25/0082 ,  A61M25/0084

摘要： The delivery of biological compounds to ischemic and/or infarcted tissue are described herein where such a system may include a deployment catheter and an attached imaging hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. Additionally, any number of therapeutic tools can also be passed through the deployment catheter and into the imaging hood for performing any number of procedures on the tissue for identifying, locating, and/or accessing ischemic and/or infarcted tissue.

摘要翻译： 在本文中描述了将生物化合物递送至缺血和/或梗死组织，其中这样的系统可以包括展开导管和可展开成扩展构型的附接成像罩。 在使用中，成像罩被放置在通常填充有不透明体液如血液的体腔中的待成像组织区域附近或邻近。 半透明或透明的液体（例如盐水）可被泵送到成像罩中，直到流体移动任何血液，从而留下通过展开导管中的成像元件成像的组织的清晰区域。 此外，任何数量的治疗工具也可以通过展开导管并进入成像罩，以在组织上执行任何数量的程序，用于识别，定位和/或获取缺血和/或梗死组织。