摘要:
Methods and apparatus for treatment of layered tissue defects having a majority of the surfaces of the defect layers in contact generally involve use of a catheter having at least one energy transmission member at its distal end. The distal end of the apparatus also typically has a force applying member which can apply a force to the tissue defect. Often this force is a lateral force or vacuum which helps the tissue to appose itself. An exemplary method of closing a patent foramen ovale (PFO) involves positioning a closure device between layers of the PFO. Energy is then applied to the layered tissue defect with the closure device so as to substantially close the tissue defect. The energy is often monopolar or bipolar radiofrequency energy. A force may also be applied by the closure device to the layered tissue defect so as to bring the layered tissue defect together.
摘要:
Methods and apparatus for treatment of layered tissue defects such as a patent foramen ovale provide for applying energy to tissues adjacent to the PFO with a closure device that substantially closes the PFO. Apparatus generally includes an elongate flexible member having a proximal end and a distal end and an energy transmission member deployable from the elongate flexible member. The energy transmission member applies energy to the layered tissue defect at a first position and a second position adjacent to the first position so as to substantially close the layered tissue defect along at least a portion of the defect. Applied energy may be monopolar or bipolar radiofrequency energy or any other suitable energy, such as laser, microwave, ultrasound, resistive heating, direct heat energy, cryogenic or the like. PFO closure via energy-based approaches of the invention may help prevent stroke, treat migraine headache, and possibly treat or prevent other medical conditions.
摘要:
Methods for treating anatomic tissue defects such as a patent foramen ovale generally involve positioning a distal end of a catheter device at the site of the defect, exposing a housing and energy transmission member from the distal end of the catheter, engaging the housing with tissues at the site of the defect, applying suction or other approximating tool to the tissue via the housing to bring the tissue together, and applying energy to the tissue with the energy transmission member or to deliver a clip or fixation device to substantially close the defect. Apparatus generally include a catheter body, a housing extending from a distal end of the catheter body for engaging tissue at the site of the defect, and further adapted to house a fusing or fixation device such as an energy transmission member adjacent a distal end of the housing, or a clip or fixation delivery element.
摘要:
The invention provides a system, devices, and methods for ablating abnormal epithelial tissue of the uterine cervix. Embodiments of an ablation device include an operative head with a support surface adapted to conformably engage and therapeutically contact the cervix, and an energy delivery element on the support surface. The energy delivery element is configured to deliver energy, such as RF energy, to the tissue in a manner that controls the surface area and depth of ablation. The device may further include a shaft and a handle to support the ablation device, and may further include a speculum to facilitate access to the cervix. A system to support the operation of the ablation device includes a generator to deliver energy to the energy delivery element. Embodiments of a method for ablating abnormal cervical tissue include inserting an ablation device intravaginally to contact the cervix, aligning an energy delivery element support surface conformably against a region of the cervix with abnormal tissue, and ablating the tissue.
摘要:
A catheter with several independent lumens extending longitudinally through the catheter for accepting probes and for introducing fluid through the catheter and into a body cavity is disclosed. The cathater outer body has a cross-sectional maximum outer dimension. The first lumen is circular in cross-section, and has a cross-sectional dimension of approximately half the maximum outer dimension of the catheter body. The first lumen is capable of accepting various probes, as well as allowing simultaneous fluid flow through the lumen. The second lumen is crescent-shaped in cross-section and occupies at least a quarter of an arc around the cross-section of the catheter body. The large cross-section of the second lumen allows for a high fluid flow rate through the lumen. The third lumen allows for inflation of an inflation balloon (when present), and the fourth lumen allows for the passing of a portion of an instrument along the length of the lumen.
摘要:
A catheter adapted to perform electrophysiological procedures comprises a body member, a manipulation handle attached to the proximal end of the body member for applying torque to the body member, the handle having a control knob adapted for control movements in a first plane and in a second plane simultaneously. A deflection control line is attached at its distal end to the distal portion of the catheter and its proximal end attached to the control device of the handle so that tension applied to the control line by sliding the control knob causes deflection of the distal portion of the catheter. A stiffening member is disposed within the body member of the catheter and is slidable, said stiffening member providing increased rigidity to the portion of the body member in which the stiffening member is located. Rotation of the control knob controls the position of the stiffening member in the body member. In a further aspect, a stiffening member in accordance with one embodiment includes a tapered distal end section with a ball formed on the distal tip, the tapered section terminating at the ball. In accordance with another aspect, the torsional rigidity of the catheter body is increased by use of a layer of aramid fibers mixed with an epoxy. In yet another feature, the handle and rotatable sliding element are symmetrically shaped to facilitate complete single-handed operation of the handle by the physician of all position control aspects of the catheter.
摘要:
A method of sequentially analyzing various body conditions with a plurality of probes is disclosed. Also disclosed, is a catheter which can be used to practice the method. The catheter has several independent lumens extending longitudinally therethrough for accepting probes and for introducing fluid therethrough and into a body cavity. The catheter outer body has a cross-sectional maximum outer dimension. The first lumen is circular in cross-section, and has a cross-sectional dimension of approximately half the maximum outer dimension of the catheter body. The first lumen is capable of accepting various probes, as well as allowing simultaneous fluid flow through the lumen. The second lumen is crescent-shaped in cross-section and occupies at least a quarter of an arc around the cross-section of the catheter body. The large cross-section of the second lumen allows for a high fluid flow rate through the lumen. The third lumen allows for inflation of an inflation balloon (when present), and the fourth lumen allows for the passing of a portion of an instrument along the length of the lumen.
摘要:
Methods and endovascular catheters for assessing, and treating patients having sympathetically mediated disease, involving augmented peripheral chemoreflex and heightened sympathetic tone by reducing chemosensor input to the nervous system via transmural carotid body ablation.
摘要:
A single transducer element that is capable of oscillation at a plurality of natural resonant frequencies may be used in an ultrasonic imaging catheter assembly including a catheter body configured to be inserted and guided through the vascular system of a living being, a lumen and a rotatable imaging core adapted to pass through the lumen, the imaging core including a flexible drive-shaft. Because the transducer element is capable of oscillation at a plurality of natural resonant frequencies, a user can switch from one frequency to another in order to improve the depth of field or resolution without having to switch out the catheter or imaging core.
摘要:
A method of controlling electrosurgical power delivery based on a comparison of sensed tissue impedance to various impedance threshold values is provided. Energy is delivered to tissue in a sealing cycle as a series of pulses. An initial pulse has a profile with a preset energy starting value that increases at a ramping rate to a preset end value. Sensed impedance data are monitored throughout each pulse and compared to each of an impedance threshold value for RF setpoint, an impedance threshold value for cumulative time, and an impedance threshold value for energy cutback. Based on sensed impedance during a pulse, the profile of a subsequent pulse can be modified. In the event of a high impedance event that reflects low tissue presence, energy may be cutback. A sealing cycle is stopped when a cumulative amount of time with an impedance value over the impedance cumulative time threshold value reaches a sealing cycle duration limit.