公开(公告)号：US07004173B2

公开(公告)日：2006-02-28

申请号：US10010410

申请日：2001-12-05

申请人： Kurt D. Sparks ,  Jeffrey L. Emery ,  Brent D. Seybold ,  David J. Kupiecki ,  C. Danielle Pinson ,  Allen W. Madsen ,  Michael D. Keleher ,  Sergio Salinas ,  Benjamin J. Clark ,  Matthew R. Selmon

发明人： Kurt D. Sparks ,  Jeffrey L. Emery ,  Brent D. Seybold ,  David J. Kupiecki ,  C. Danielle Pinson ,  Allen W. Madsen ,  Michael D. Keleher ,  Sergio Salinas ,  Benjamin J. Clark ,  Matthew R. Selmon

IPC分类号： A61B19/00

CPC分类号： A61B17/320783 ,  A61B17/3207 ,  A61B90/37 ,  A61B2017/00252 ,  A61B2017/22077 ,  A61B2017/22094 ,  A61B2017/22095 ,  A61B2090/378 ,  A61B2090/3782

摘要： A catheter system and corresponding methods are provided for accessing a blood vessel true lumen from a sub-intimal plane of the vessel. The catheter system includes visualization elements for determining the orientation of the true lumen with respect to the sub-intimal plane at an identified entry site from a position in the sub-intimal plane. The entry site is distal to a chronic total occlusion (CTO). The catheter system also includes a system for physically securing tissue of the sub-intimal plane at the entry site to the catheter system. The attaching system reduces or eliminates catheter float within the sub-intimal space. The catheter system further includes re-entry devices to establish and maintain a path from the sub-intimal plane back into the vessel true lumen.

公开(公告)号：US08702679B2

公开(公告)日：2014-04-22

申请号：US10865231

申请日：2004-06-10

申请人： Robert K. Deckman ,  Erik Thai ,  Amiel R. Aguilar ,  Benjamin J. Clark ,  Sergio Salinas ,  Daniel E. Francis ,  Kurt D. Sparks

发明人： Robert K. Deckman ,  Erik Thai ,  Amiel R. Aguilar ,  Benjamin J. Clark ,  Sergio Salinas ,  Daniel E. Francis ,  Kurt D. Sparks

IPC分类号： A61M25/00

CPC分类号： A61M25/0662 ,  A61B2017/22042 ,  A61B2017/22094 ,  A61M25/0045 ,  A61M25/005 ,  A61M2025/0681 ,  A61M2025/0687

摘要： Interventional catheter-based systems and methods are described herein for use in generating an initial pathway through vascular occlusions. The catheter systems generally include two elements. A first element is a Blunt Dissection Catheter including a manually actuated assembly located at the distal tip of the Blunt Dissection Catheter that performs blunt dissection in the vascular occlusion to produce a dissection track, or small pathway through the occlusion. The second element is a Sheath Catheter that serves as a conduit within which the Blunt Dissection Catheter is freely advanced, retracted and rotated. The first and second elements are used in some combination to cross vascular occlusions in both the coronary and peripheral vasculature.

摘要翻译： 本文描述介入性导管基系统和方法用于通过血管闭塞产生初始途径。 导管系统通常包括两个元件。 第一个要素是平坦解剖导管，其包括位于钝性解剖导管的远端的手动致动组件，其在血管闭塞中进行钝性解剖以产生解剖轨迹，或通过闭塞的小通路。 第二个要素是鞘鞘导管，用作导管，平头解剖导管可自由前进，缩回和旋转。 第一和第二元素被用于某种组合以在冠状动脉和外周脉管系统中交叉血管闭塞。

公开(公告)号：US08777942B2

公开(公告)日：2014-07-15

申请号：US12910631

申请日：2010-10-22

申请人： Andrew Wu ,  Benjamin J. Clark ,  Denise Zarins ,  Erik Thai

发明人： Andrew Wu ,  Benjamin J. Clark ,  Denise Zarins ,  Erik Thai

IPC分类号： A61B18/14 ,  A61B18/18 ,  A61B18/00 ,  A61B19/00 ,  A61B18/24 ,  A61N7/00 ,  A61B18/02 ,  A61B17/00

CPC分类号： A61B18/1492 ,  A61B18/02 ,  A61B18/1206 ,  A61B18/18 ,  A61B18/24 ,  A61B90/39 ,  A61B2017/003 ,  A61B2018/00172 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00648 ,  A61B2018/00791 ,  A61B2018/00875 ,  A61M25/0141 ,  A61N2007/003

摘要： Apparatus, systems, and methods for achieving thermally-induced renal neuromodulation by intravascular access are disclosed herein. One aspect of the present application, for example, is directed to apparatuses, systems, and methods that incorporate a treatment device comprising an elongated shaft. The elongated shaft is sized and configured to deliver a thermal element to a renal artery via an intravascular path. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers.

公开(公告)号：US08398630B2

公开(公告)日：2013-03-19

申请号：US13620173

申请日：2012-09-14

申请人： Denise Demarais ,  Hanson Gifford, III ,  Mark Deem ,  Nicolas Zadno ,  Benjamin J. Clark ,  Andrew Wu ,  Kenneth J. Michlitsch

发明人： Denise Demarais ,  Hanson Gifford, III ,  Mark Deem ,  Nicolas Zadno ,  Benjamin J. Clark ,  Andrew Wu ,  Kenneth J. Michlitsch

IPC分类号： A61B18/12

摘要： Methods and apparatus are provided for non-continuous circumferential treatment of a body lumen. Apparatus may be positioned within a body lumen of a patient and may deliver energy at a first lengthwise and angular position to create a less-than-full circumferential treatment zone at the first position. The apparatus also may deliver energy at one or more additional lengthwise and angular positions within the body lumen to create less-than-full circumferential treatment zone(s) at the one or more additional positions that are offset lengthwise and angularly from the first treatment zone. Superimposition of the first treatment zone and the one or more additional treatment zones defines a non-continuous circumferential treatment zone without formation of a continuous circumferential lesion. Various embodiments of methods and apparatus for achieving such non-continuous circumferential treatment are provided.

公开(公告)号：US20130012844A1

公开(公告)日：2013-01-10

申请号：US13620043

申请日：2012-09-14

申请人： Denise Demarais ,  Nicolas Zadno ,  Benjamin J. Clark ,  Erik Thai ,  Howard R. Levin ,  Mark Gelfand

发明人： Denise Demarais ,  Nicolas Zadno ,  Benjamin J. Clark ,  Erik Thai ,  Howard R. Levin ,  Mark Gelfand

IPC分类号： A61N7/02

CPC分类号： A61N7/022 ,  A61B18/02 ,  A61B18/04 ,  A61B18/12 ,  A61B18/1492 ,  A61B2018/0022 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61F7/007 ,  A61F7/12 ,  A61F7/123 ,  A61F2007/126 ,  A61M5/44 ,  A61M2210/1082 ,  A61N1/28 ,  A61N1/36007 ,  A61N1/403 ,  A61N5/00 ,  A61N5/025 ,  A61N5/045 ,  A61N5/0603 ,  A61N7/00 ,  A61N7/02 ,  A61N2007/003 ,  A61N2007/0078

摘要： Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues.

摘要翻译： 提供了用于热诱导的肾神经调节的方法和装置。 热诱导的肾神经调节可以通过直接和/或通过间接施加热能来加热或冷却有助于肾功能的神经纤维或者供给或灌注神经纤维的血管结构来实现。 在一些实施例中，神经纤维，非目标组织或热能递送元件的参数可以经由一个或多个传感器来监测，以控制热诱导的神经调节。 在一些实施方案中，可以提供保护元件以减少在非靶组织中诱导的热损伤程度。

公开(公告)号：US20120172837A1

公开(公告)日：2012-07-05

申请号：US13417044

申请日：2012-03-09

申请人： Denise Demarais ,  Nicolas Zadno ,  Benjamin J. Clark ,  Erik Thai ,  Howard R. Levin ,  Mark Gelfand

发明人： Denise Demarais ,  Nicolas Zadno ,  Benjamin J. Clark ,  Erik Thai ,  Howard R. Levin ,  Mark Gelfand

IPC分类号： A61M5/158 ,  A61F7/12

CPC分类号： A61N7/022 ,  A61B18/02 ,  A61B18/04 ,  A61B18/12 ,  A61B18/1492 ,  A61B2018/0022 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61F7/007 ,  A61F7/12 ,  A61F7/123 ,  A61F2007/126 ,  A61M5/44 ,  A61M2210/1082 ,  A61N1/28 ,  A61N1/36007 ,  A61N1/403 ,  A61N5/00 ,  A61N5/025 ,  A61N5/045 ,  A61N5/0603 ,  A61N7/00 ,  A61N7/02 ,  A61N2007/003 ,  A61N2007/0078

摘要： Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues.

摘要翻译： 提供了用于热诱导的肾神经调节的方法和装置。 热诱导的肾神经调节可以通过直接和/或通过间接施加热能来加热或冷却有助于肾功能的神经纤维或者供给或灌注神经纤维的血管结构来实现。 在一些实施例中，神经纤维，非目标组织或热能递送元件的参数可以经由一个或多个传感器来监测，以控制热诱导的神经调节。 在一些实施方案中，可以提供保护元件以减少在非靶组织中诱导的热损伤程度。

公开(公告)号：US20120136417A1

公开(公告)日：2012-05-31

申请号：US13279327

申请日：2011-10-23

申请人： Naomi Buckley ,  Benjamin J. Clark ,  Michael Cummins ,  Danny Donovan ,  Luke Hughes ,  Brian Kelly ,  Gary Kelly ,  Grace Kelly ,  John Kelly ,  Seamus Ledwith ,  Gwenda McMullin ,  Karun D. Naga ,  Stephen Nash ,  Francesco Piccagli ,  Eric Ryba ,  Fiachra Sweeney ,  Vincenzo Tilotta ,  Roman Turovskiy ,  Lana Woolley ,  Denise Zarins ,  Mark Gelfand ,  Mark S. Leung ,  Barry Mullins

发明人： Naomi Buckley ,  Benjamin J. Clark ,  Michael Cummins ,  Danny Donovan ,  Luke Hughes ,  Brian Kelly ,  Gary Kelly ,  Grace Kelly ,  John Kelly ,  Seamus Ledwith ,  Gwenda McMullin ,  Karun D. Naga ,  Stephen Nash ,  Francesco Piccagli ,  Eric Ryba ,  Fiachra Sweeney ,  Vincenzo Tilotta ,  Roman Turovskiy ,  Lana Woolley ,  Denise Zarins ,  Mark Gelfand ,  Mark S. Leung ,  Barry Mullins

IPC分类号： A61F7/12

CPC分类号： A61B18/02 ,  A61B2017/22054 ,  A61B2017/22067 ,  A61B2018/00023 ,  A61B2018/00166 ,  A61B2018/0022 ,  A61B2018/00232 ,  A61B2018/0025 ,  A61B2018/00261 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/0212 ,  A61B2018/0262

摘要： Neuromodulation cryotherapeutic devices and associated systems and methods are disclosed herein. A cryotherapeutic device configured in accordance with a particular embodiment of the present technology can include an elongated shaft having distal portion and a supply lumen along at least a portion of the shaft. The shaft can be configured to locate the distal portion intravascularly at a treatment site proximate a renal artery or renal ostium. The supply lumen can be configured to receive a liquid refrigerant. The cryotherapeutic device can further include a cooling assembly at the distal portion of the shaft. The cooling assembly can include an applicator in fluid communication with the supply lumen and configured to deliver cryotherapeutic cooling to nerves proximate the target site when the cooling assembly is in a deployed state.

公开(公告)号：US20120136344A1

公开(公告)日：2012-05-31

申请号：US13279321

申请日：2011-10-23

申请人： Naomi Buckley ,  Benjamin J. Clark ,  Michael Cummins ,  Danny Donovan ,  Luke Hughes ,  Brian Kelly ,  Gary Kelly ,  Grace Kelly ,  John Kelly ,  Gwenda McMullin ,  Karun D. Naga ,  Stephen Nash ,  Eric Ryba ,  Fiachra Sweeney ,  Vincenzo Tilotta ,  Lana Woolley ,  Denise Zarins ,  Mark Gelfand ,  Mark S. Leung ,  Barry Mullins

发明人： Naomi Buckley ,  Benjamin J. Clark ,  Michael Cummins ,  Danny Donovan ,  Luke Hughes ,  Brian Kelly ,  Gary Kelly ,  Grace Kelly ,  John Kelly ,  Gwenda McMullin ,  Karun D. Naga ,  Stephen Nash ,  Eric Ryba ,  Fiachra Sweeney ,  Vincenzo Tilotta ,  Lana Woolley ,  Denise Zarins ,  Mark Gelfand ,  Mark S. Leung ,  Barry Mullins

IPC分类号： A61B18/02

CPC分类号： A61B18/02 ,  A61B2017/22054 ,  A61B2017/22067 ,  A61B2018/00023 ,  A61B2018/00166 ,  A61B2018/0022 ,  A61B2018/00232 ,  A61B2018/0025 ,  A61B2018/00261 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/0212 ,  A61B2018/0262

摘要： Neuromodulation cryotherapeutic devices and associated systems and methods are disclosed herein. A cryotherapeutic device configured in accordance with a particular embodiment of the present technology can include an elongated shaft having distal portion and a supply lumen along at least a portion of the shaft. The shaft can be configured to locate the distal portion intravascularly at a treatment site proximate a renal artery or renal ostium. The supply lumen can be configured to receive a liquid refrigerant. The cryotherapeutic device can further include a cooling assembly at the distal portion of the shaft. The cooling assembly can include an applicator in fluid communication with the supply lumen and configured to deliver cryotherapeutic cooling to nerves proximate the target site when the cooling assembly is in a deployed state.

公开(公告)号：US08145316B2

公开(公告)日：2012-03-27

申请号：US11189563

申请日：2005-07-25

申请人： Mark Deem ,  Denise Demarais ,  Douglas Sutton ,  Hanson Gifford, III ,  Howard R. Levin ,  Mark Gelfand ,  Benjamin J. Clark

发明人： Mark Deem ,  Denise Demarais ,  Douglas Sutton ,  Hanson Gifford, III ,  Howard R. Levin ,  Mark Gelfand ,  Benjamin J. Clark

IPC分类号： A61N1/00 ,  A61N1/30

CPC分类号： A61N1/36117 ,  A61B18/1492 ,  A61B2018/00267 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00613 ,  A61B2018/00702 ,  A61B2018/00779 ,  A61B2018/00791 ,  A61B2018/00875 ,  A61B2018/00982 ,  A61B2018/1435 ,  A61N1/0551 ,  A61N1/32 ,  A61N1/327 ,  A61N1/36007 ,  A61N1/36017 ,  A61N1/36128 ,  A61N5/00

摘要： Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for extravascular delivery of pulsed electric fields to achieve such neuromodulation.

摘要翻译： 提供使用脉冲电场进行肾神经调节以实现电穿孔或电融合的方法和装置。 预期肾脏神经调节（例如去神经支配）可以减少急性心肌梗塞的扩张，减少或预防与充血性心力衰竭有关的形态学变化的发生，和/或有效治疗 晚期肾脏疾病。 本发明的实施例被配置为用于实现这种神经调节的脉冲电场的血管外递送。

公开(公告)号：US20110200171A1

公开(公告)日：2011-08-18

申请号：US13009748

申请日：2011-01-19

申请人： Robert J. Beetel ,  Neil C. Barman ,  Benjamin J. Clark ,  Paul Friedrichs ,  Kenneth J. Michlitsch ,  Karun D. Naga ,  Andrew Wu ,  Denise Zarins

发明人： Robert J. Beetel ,  Neil C. Barman ,  Benjamin J. Clark ,  Paul Friedrichs ,  Kenneth J. Michlitsch ,  Karun D. Naga ,  Andrew Wu ,  Denise Zarins

IPC分类号： A61N5/10

CPC分类号： A61N5/1042 ,  A61B6/506 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61N5/1067 ,  A61N7/02 ,  A61N2005/1061

摘要： The present disclosure describes methods and apparatus for renal neuromodulation via stereotactic radiotherapy for the treatment of hypertension, heart failure, chronic kidney disease, diabetes, insulin resistance, metabolic disorder or other ailments. Renal neuromodulation may be achieved by locating renal nerves and then utilizing stereotactic radiotherapy to expose the renal nerves to a radiation dose sufficient to reduce neural activity. A neural location element may be provided for locating target renal nerves, and a stereotactic radiotherapy system may be provided for exposing the located renal nerves to a radiation dose sufficient to reduce the neural activity, with reduced or minimized radiation exposure in adjacent tissue. Renal nerves may be located and targeted at the level of the ganglion and/or at postganglionic positions, as well as at pre-ganglionic positions.

摘要翻译： 本公开描述了通过立体定向放射治疗高血压，心力衰竭，慢性肾脏疾病，糖尿病，胰岛素抵抗，代谢紊乱或其它疾病的肾神经调节的方法和装置。 肾神经调节可以通过定位肾神经，然后利用立体定向放射治疗来将肾神经暴露于足以减少神经活动的辐射剂量来实现。 可以提供用于定位目标肾神经的神经定位元件，并且可以提供立体定向放射治疗系统，用于将位于所述肾神经的辐射剂量暴露于足以减少或最小化相邻组织中的辐射暴露的神经活动的辐射剂量。 肾神经可能位于神经节水平和/或神经节后位置以及神经节前位置。