公开(公告)号：US06689083B1

公开(公告)日：2004-02-10

申请号：US09721778

申请日：2000-11-27

申请人： Mark Gelfand ,  John J. O'Mahony ,  Howard R. Levin

发明人： Mark Gelfand ,  John J. O'Mahony ,  Howard R. Levin

IPC分类号： A61M3700

CPC分类号： A61M1/34 ,  A61M1/1611 ,  A61M1/3403 ,  A61M1/341 ,  A61M1/3609 ,  A61M1/3639 ,  A61M1/367 ,  A61M2205/3306 ,  A61M2205/3331 ,  A61M2205/3344 ,  A61M2205/3375 ,  A61M2205/50 ,  A61M2230/20

摘要： A method and system for the extracorporeal treatment of blood to remove fluid from the fluid overloaded patient is disclosed that non-invasively measures osmotic pressure across a filter membrane of a blood filter. The filter is permeable to water and electrolytes, but not to blood protein. The osmotic pressure indicates the protein concentration in the blood. Osmotic pressure is used to detect when hypotension is about to occur in a patient, as a result of excessive blood volume reduction during treatment of the blood. Using the osmotic pressure measurement as a feedback signal, the rate of fluid extraction is automatically controlled to achieve the desired clinical outcome and avoid precipitating a hypotensive crisis in the patient.

摘要翻译： 公开了一种用于体外处理血液以从流体过载的患者中去除流体的方法和系统，其非侵入性地测量穿过血液过滤器的过滤膜的渗透压。 过滤器对水和电解质是可渗透的，而不是血液蛋白质。 渗透压表示血液中的蛋白质浓度。 渗透压用于检测在治疗血液期间血容量减少过多时患者何时会出现低血压。 使用渗透压测量作为反馈信号，自动控制流体提取的速率以达到期望的临床结果，并避免引起患者的低血压危象。

公开(公告)号：US20090024070A1

公开(公告)日：2009-01-22

申请号：US12172303

申请日：2008-07-14

申请人： Mark Gelfand ,  John J. O'Mahony ,  Howard R. Levin

发明人： Mark Gelfand ,  John J. O'Mahony ,  Howard R. Levin

IPC分类号： B01D61/32 ,  B01D61/22 ,  B01D61/12 ,  A61M1/34

CPC分类号： A61M1/34 ,  A61M1/1611 ,  A61M1/3403 ,  A61M1/341 ,  A61M1/3609 ,  A61M1/3639 ,  A61M1/367 ,  A61M2205/3306 ,  A61M2205/3331 ,  A61M2205/3344 ,  A61M2205/3375 ,  A61M2205/50 ,  A61M2230/20

摘要： A device for continuously measuring osmotic pressure of blood flowing through an extracorporeal blood circuit including: a blood passage further comprising a withdrawal blood passage connectable to a blood vessel in a patient and an infusion blood passage connectable to a blood vessel in a patient; a filter further comprising a filtrate chamber, a blood chamber and a permeable membrane separating the filtrate chamber and blood chamber, wherein the blood chamber is in fluid communication with the blood passage; a pressure sensor measuring a pressure difference between the filtrate chambers and the blood chamber, and a controller receiving a pressure signal from the pressure sensor, determining an osmotic pressure across the permeable membrane of the filter, and adjusting a rate of removal of fluid from blood in the filter if the determined osmotic pressure level varies from a predetermined osmotic pressure setting.

摘要翻译： 一种用于连续测量流过体外血液循环的血液的渗透压的装置，包括：血液通道，其还包括可连接到患者血管的抽血血道和可连接到患者血管的输注血液通道; 过滤器还包括滤液室，血液室和分离滤液室和血液室的可渗透膜，其中血液室与血液通道流体连通; 测量滤液室和血液室之间的压力差的压力传感器，以及接收来自压力传感器的压力信号的控制器，确定过滤器的渗透膜上的渗透压，以及调节从血液中去除流体的速率 如果确定的渗透压水平从预定的渗透压设定变化，则在过滤器中。

公开(公告)号：US07399289B2

公开(公告)日：2008-07-15

申请号：US10648233

申请日：2003-08-27

申请人： Mark Gelfand ,  John J. O'Mahony ,  Howard R. Levin

发明人： Mark Gelfand ,  John J. O'Mahony ,  Howard R. Levin

IPC分类号： A61M37/00 ,  C02F1/44

CPC分类号： A61M1/34 ,  A61M1/1611 ,  A61M1/3403 ,  A61M1/341 ,  A61M1/3609 ,  A61M1/3639 ,  A61M1/367 ,  A61M2205/3306 ,  A61M2205/3331 ,  A61M2205/3344 ,  A61M2205/3375 ,  A61M2205/50 ,  A61M2230/20

摘要： A method and system for the extracorporeal treatment of blood to remove fluid from the fluid overloaded patient is disclosed that non-invasively measures osmotic pressure across a filter membrane of a blood filter. The filter is permeable to water and electrolytes, but not to blood protein. The osmotic pressure indicates the protein concentration in the blood. Osmotic pressure is used to detect when hypotension is about to occur in a patient, as a result of excessive blood volume reduction during treatment of the blood. Using the osmotic pressure measurement as a feedback signal, the rate of fluid extraction is automatically controlled to achieve the desired clinical outcome and avoid precipitating a hypotensive crisis in the patient.

摘要翻译： 公开了一种用于体外处理血液以从流体过载的患者中去除流体的方法和系统，其非侵入性地测量穿过血液过滤器的过滤膜的渗透压。 过滤器对水和电解质是可渗透的，而不是血液蛋白质。 渗透压表示血液中的蛋白质浓度。 渗透压用于检测在治疗血液期间血容量减少过多时患者何时会出现低血压。 使用渗透压测量作为反馈信号，自动控制流体提取的速率以达到期望的临床结果，并避免引起患者的低血压危象。

公开(公告)号：US08506511B2

公开(公告)日：2013-08-13

申请号：US11620438

申请日：2007-01-05

申请人： Steven J. Bernard ,  John J. O'Mahony ,  Andrew V. Halpert ,  Mark Gelfand ,  Howard R. Levin

发明人： Steven J. Bernard ,  John J. O'Mahony ,  Andrew V. Halpert ,  Mark Gelfand ,  Howard R. Levin

IPC分类号： A61M1/38

CPC分类号： A61M1/34 ,  A61M1/341 ,  A61M1/342 ,  A61M1/3431 ,  A61M1/3441 ,  A61M1/3451 ,  A61M1/36 ,  A61M1/3613 ,  A61M1/3615 ,  A61M1/3621 ,  A61M2205/15 ,  A61M2205/3331 ,  B01D61/145 ,  B01D61/22

摘要： An extracorporeal blood circuit including: a withdrawal conduit connectable to a coronary withdrawal catheter; a withdrawal pump connectable to the withdrawal conduit, wherein a pumping rate of the withdrawal pump determines a blood withdrawal rate from the coronary withdrawal catheter; a filter having an input connected to the withdrawal conduit and a blood output connected to an infusion conduit and a filtrate output connected to a filtrate conduit; a filtrate measurement device to determine an amount of filtrate removed from the blood in the filter; a fluid supplementation conduit providing a blood replacement fluid to at least one of the withdrawal conduit, filter and infusion conduit; a supplementation pump connectable to the fluid supplementation conduit, wherein a pumping rate of the supplementation pump determines a rate at which the blood replacement fluid flows into the blood flowing through the blood circuit, and a controller regulating the pumping rate of the supplementation pump such that the rate of the blood replacement fluid provides an amount of blood replacement fluid to the at least one of the withdrawal conduit, filter and infusion conduit so as to substantially match the amount of filtrate removed.

公开(公告)号：US08070707B2

公开(公告)日：2011-12-06

申请号：US12172303

申请日：2008-07-14

申请人： Mark Gelfand ,  John J. O'Mahony ,  Howard R. Levin

发明人： Mark Gelfand ,  John J. O'Mahony ,  Howard R. Levin

IPC分类号： A61M37/00 ,  C02F1/44 ,  C02F1/00

CPC分类号： A61M1/34 ,  A61M1/1611 ,  A61M1/3403 ,  A61M1/341 ,  A61M1/3609 ,  A61M1/3639 ,  A61M1/367 ,  A61M2205/3306 ,  A61M2205/3331 ,  A61M2205/3344 ,  A61M2205/3375 ,  A61M2205/50 ,  A61M2230/20

摘要： A device for continuously measuring osmotic pressure of blood flowing through an extracorporeal blood circuit including: a blood passage further comprising a withdrawal blood passage connectable to a blood vessel in a patient and an infusion blood passage connectable to a blood vessel in a patient; a filter further comprising a filtrate chamber, a blood chamber and a permeable membrane separating the filtrate chamber and blood chamber, wherein the blood chamber is in fluid communication with the blood passage; a pressure sensor measuring a pressure difference between the filtrate chambers and the blood chamber, and a controller receiving a pressure signal from the pressure sensor, determining an osmotic pressure across the permeable membrane of the filter, and adjusting a rate of removal of fluid from blood in the filter if the determined osmotic pressure level varies from a predetermined osmotic pressure setting.

摘要翻译： 一种用于连续测量流过体外血液循环的血液的渗透压的装置，包括：血液通道，其还包括可连接到患者血管的抽血血道和可连接到患者血管的输注血液通道; 过滤器还包括滤液室，血液室和分离滤液室和血液室的可渗透膜，其中血液室与血液通道流体连通; 测量滤液室和血液室之间的压力差的压力传感器，以及接收来自压力传感器的压力信号的控制器，确定过滤器的渗透膜上的渗透压，以及调节从血液中去除流体的速率 如果确定的渗透压水平从预定的渗透压设定变化，则在过滤器中。

公开(公告)号：US07163520B2

公开(公告)日：2007-01-16

申请号：US10653100

申请日：2003-09-03

申请人： Steven J. Bernard ,  John J. O'Mahony ,  Andrew J. Halpert ,  Mark Gelfand ,  Howard R Levin

发明人： Steven J. Bernard ,  John J. O'Mahony ,  Andrew J. Halpert ,  Mark Gelfand ,  Howard R Levin

IPC分类号： A61M37/00 ,  C02F1/44 ,  B01D24/00 ,  B01D35/22

CPC分类号： A61M1/34 ,  A61M1/341 ,  A61M1/342 ,  A61M1/3431 ,  A61M1/3441 ,  A61M1/3451 ,  A61M1/36 ,  A61M1/3613 ,  A61M1/3615 ,  A61M1/3621 ,  A61M2205/15 ,  A61M2205/3331 ,  B01D61/145 ,  B01D61/22

摘要： An extracorpeal blood circuit for removal of contrast from human blood using a filter and withdrawal filter pump and a by-pass pump. The withdrawal filter blood pump operates when a contrast bolus has been detected. Otherwise the bypass blood pump maintains physiological blood flow from the coronary sinus preventing the need for deflation and re-inflation of the balloon catheter. When contrast is detected blood the bypass blood pump is stopped to prevent contrast from leaking back into the patients circulatory system via the bypass pump and CS blood flow is maintained at its physiological blood flow resulting in the heart being oblivious to the transition by the prefilter blood pump.

摘要翻译： 使用过滤器和抽出式过滤器泵和旁通泵除去人血液对比度的傍晚血液回路。 当检测到对比剂时，抽出式过滤器血泵运行。 否则，旁路血液泵维持来自冠状窦的生理血流，防止气囊导管的放气和再充气的需要。 当检测到对比血液时，旁路血液泵停止，以防止对比通过旁路泵泄漏回患者循环系统，并且CS血流保持在其生理血流，导致心脏不被预过滤血液过渡 泵。

公开(公告)号：US20190000545A1

公开(公告)日：2019-01-03

申请号：US16019380

申请日：2018-06-26

申请人： Denise Zarins ,  Andrew Wu ,  Hanson Gifford, III ,  Mark Deem ,  Mark Gelfand ,  Howard R. Levin

发明人： Denise Zarins ,  Andrew Wu ,  Hanson Gifford, III ,  Mark Deem ,  Mark Gelfand ,  Howard R. Levin

IPC分类号： A61B18/14 ,  A61N7/02 ,  A61F7/12 ,  A61M5/142 ,  A61M5/172 ,  A61N1/28 ,  A61N1/32 ,  A61N1/36 ,  A61N1/40 ,  A61N5/04 ,  A61B18/00 ,  A61N7/00 ,  A61N1/362

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. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.

公开(公告)号：US20150282877A1

公开(公告)日：2015-10-08

申请号：US14737254

申请日：2015-06-11

申请人： Denise Zarins ,  Andrew Wu ,  Hanson Gifford, III ,  Mark Deem ,  Mark Gelfand ,  Howard R. Levin

发明人： Denise Zarins ,  Andrew Wu ,  Hanson Gifford, III ,  Mark Deem ,  Mark Gelfand ,  Howard R. Levin

IPC分类号： A61B18/14 ,  A61N7/02 ,  A61N1/28

CPC分类号： A61B18/1492 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00642 ,  A61F7/123 ,  A61F2007/126 ,  A61M5/14276 ,  A61M5/1723 ,  A61M2210/1082 ,  A61N1/28 ,  A61N1/32 ,  A61N1/326 ,  A61N1/36007 ,  A61N1/36017 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/3627 ,  A61N1/403 ,  A61N5/045 ,  A61N7/02 ,  A61N2007/003

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. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.

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。 在一些实施方案中，热诱导的肾神经调节通过脉冲热疗法的递送来实现。

公开(公告)号：US20140324016A1

公开(公告)日：2014-10-30

申请号：US14221536

申请日：2014-03-21

申请人： Mark Gelfand ,  Howard R. Levin

发明人： Mark Gelfand ,  Howard R. Levin

IPC分类号： A61M5/145 ,  A61K9/70 ,  A61K9/00 ,  A61L29/14

CPC分类号： A61K31/529 ,  A61K9/0004 ,  A61K9/0012 ,  A61K9/7007 ,  A61K31/135 ,  A61K31/52 ,  A61K45/06 ,  A61L29/146 ,  A61M5/14276 ,  A61M5/145 ,  A61M5/1723 ,  A61M2005/14513 ,  A61M2205/05 ,  A61M2205/50 ,  A61M2210/1082 ,  A61N1/0551 ,  A61N1/326 ,  A61N1/36007 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/3627

摘要： A method and apparatus for treatment of cardiac and renal diseases associated with the elevated sympathetic renal nerve activity by implanting a device to block the renal nerve signals to and from the kidney. The device can be a drug pump or a drug eluding implant for targeted delivery of a nerve-blocking agent to the periarterial space of the renal artery.

摘要翻译： 一种用于通过植入用于阻断肾脏和/或从肾脏的肾神经信号的装置来治疗与交感神经肾神经活动升高相关的心脏和肾脏疾病的方法和装置。 该装置可以是药物泵或药物迂回植入物，用于将神经阻断剂靶向递送至肾动脉的动脉周围空间。

公开(公告)号：US20140228739A1

公开(公告)日：2014-08-14

申请号：US14258802

申请日：2014-04-22

申请人： Mark E. Deem ,  Hanson Gifford, III ,  Denise Zarins ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

发明人： Mark E. Deem ,  Hanson Gifford, III ,  Denise Zarins ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

IPC分类号： A61B18/12 ,  A61B18/14 ,  A61M5/14

CPC分类号： A61N1/36007 ,  A61B8/0891 ,  A61B8/12 ,  A61B18/1206 ,  A61B18/1233 ,  A61B18/1492 ,  A61B18/18 ,  A61B2018/00071 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00267 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00613 ,  A61B2018/00642 ,  A61B2018/00904 ,  A61B2018/126 ,  A61B2018/1467 ,  A61M5/14 ,  A61M25/0023 ,  A61N1/0412 ,  A61N1/05 ,  A61N1/0551 ,  A61N1/18 ,  A61N1/205 ,  A61N1/326 ,  A61N1/327 ,  A61N1/36017 ,  A61N1/36057 ,  A61N1/3606 ,  A61N1/36103 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/36139 ,  A61N5/00 ,  A61N7/00 ,  A61N2007/0021 ,  A61N2007/003

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 percutaneous intravascular 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用于经皮血管内递送脉冲电场以实现这种神经调节。