-
公开(公告)号：US5766164A
公开(公告)日：1998-06-16
申请号：US675698
申请日：1996-07-03
CPC分类号： A61B17/3403 , A61B18/22 , A61B2017/00247 , A61B2017/22075 , A61B2018/00392
摘要： Improved methods and devices related to laser-assisted transmyocardial revascularization (TMR), and more particularly, to improved methods and devices for creating branched TMR channels through myocardium in which a single opening is made in an epicardial surface with a plurality of channel branches, having predetermined geometries extending into and through myocardium, depending therefrom. A method of creating branched TMR channels comprises piercing an epicardial surface mechanically or with laser energy, directing laser energy through the opening in a first predetermined angular orientation with respect to the epicardial surface to create a first channel and delivering laser energy in a second predetermined angular orientation to create a second branch. A plurality of branches can thus be created in a single channel structure. A guide block device allows an opening to be made in an epicardial surface mechanically or with laser energy and provides a structure for directing laser energy into myocardium in a plurality of channels depending from the opening. Rotating guide devices and finger held devices with rotating head means include a hand held device with an elongated wand-like handle portion, a rotating head portion and a hollow guide needle means. Preferred embodiments further comprise a laser delivery means advancing mechanism and guide needle rotating means.
-
2.发明授权Contiguous, branched transmyocardial revascularization (TMR) channel, method and device 失效连续分支的经心肌血运重建（TMR）通道，方法和装置
公开(公告)号：US6066131A
公开(公告)日：2000-05-23
申请号：US92798
申请日：1998-06-05
CPC分类号： A61B17/3403 , A61B18/22 , A61B2017/00247 , A61B2017/22075 , A61B2018/00392
摘要： Improved methods and devices related to laser-assisted transmyocardial revascularization (TMR), and more particularly, to improved methods and devices for creating branched TMR channels through myocardium in which a single opening is made in an epicardial surface with a plurality of channel branches, having predetermined geometries extending into and through myocardium, depending therefrom. A method of creating branched TMR channels comprises piercing an epicardial surface mechanically or with laser energy, directing laser energy through the opening in a first predetermined angular orientation with respect to the epicardial surface to create a first channel and delivering laser energy in a second predetermined angular orientation to create a second branch. A plurality of branches can thus be created in a single channel structure. A guide block device allows an opening to be made in an epicardial surface mechanically or with laser energy and provides a structure for directing laser energy into myocardium in a plurality of channels depending from the opening. Rotating guide devices and finger held devices with rotating head means include a hand held device with an elongated wand-like handle portion, a rotating head portion and a hollow guide needle means. Preferred embodiments further comprise a laser delivery means advancing mechanism and guide needle rotating means.
摘要翻译： 改进的与激光辅助心肌血运重建（TMR）相关的方法和装置，更具体地说，涉及通过心肌产生分支TMR通道的改进方法和装置，其中在具有多个通道分支的心外膜表面中形成单个开口， 预定的几何形状延伸到心肌中并通过心肌，这取决于它们。 创建分支TMR通道的方法包括机械地或用激光能量刺穿心外膜表面，以相对于心外膜表面的第一预定角度方向引导激光能量通过开口，以产生第一通道并将激光能量传送到第二预定角度 方向创建第二个分支。 因此，可以在单个信道结构中创建多个分支。 引导块装置允许以机械方式或用激光能量在心外膜表面制造开口，并且提供用于将激光能量引导到依赖于开口的多个通道中的心肌的结构。 具有旋转头装置的旋转导向装置和手指保持装置包括具有细长的棒状手柄部分的手持装置，旋转头部分和中空导向针装置。 优选实施例还包括激光输送装置前进机构和引导针旋转装置。
-
3.发明授权Laser device with auto-piercing tip for myocardial revascularization procedures 失效具有自动穿刺尖端的激光装置用于心肌血运重建手术
公开(公告)号：US6152918A
公开(公告)日：2000-11-28
申请号：US58387
申请日：1998-04-09
IPC分类号： A61B1/018 , A61B1/267 , A61B1/313 , A61B17/00 , A61B17/22 , A61B17/34 , A61B18/20 , A61B18/22 , A61B18/24 , A61B19/00 , A61B18/18
CPC分类号： A61B17/3403 , A61B18/22 , A61B18/24 , A61B2017/00172 , A61B2017/00247 , A61B2017/22074 , A61B2017/22075 , A61B2017/22077 , A61B2018/00291 , A61B2018/00392 , A61B2018/208 , A61B90/37
摘要： The apparatus for combined mechanical/laser myocardial revascularization of a human heart includes: inserting a mechanical piercing device and an elongated flexible lasing apparatus into the chest cavity of a patient; mechanically auto-piercing, micro-tearing or spreading the epicardium of the heart; and then lasing from beneath the epicardium through the myocardium. The apparatus is guided to an area exterior to a ventricle of the patient's heart, and the distal end of the energy delivery device such as an optical fiber apparatus is placed internal to the exterior wall of the heart through an opening which has been created by mechanically piercing, micro-tearing or spreading the epicardium, so that the myocardium and not the epicardium is irradiated with laser energy to allow passage of said energy delivery device such as an optical fiber distal end or said laser energy into the left ventricular cavity without causing a laser irradiation of the epicardium which might be a cause of operative bleeding and for better allowing the sealing of the epicardium after the apparatus is removed. The apparatus includes a hand-held device controllable by the physician having a removable distal head portion with an auto-piercing mechanism and can use a vacuum source to provide a suction force at the head portion. The auto-piercing mechanism is implemented by various ways such as a spring-biased actuating member in the TMR hand-held device and an electro-mechanical operated piercing mechanism. The hand-held TMR device with handle assembly can also be controlled by a computer to provide auto- sequencing of the auto-piercing needle mechanism and the laser firing with auto-fiber advancement.
摘要翻译： 用于人体心脏联合机械/激光心肌血运重建的装置包括：将机械刺穿装置和细长的柔性激光装置插入患者的胸腔中; 机械自动穿刺，微撕裂或散布心脏的心外膜; 然后通过心肌从心外膜下射出。 该装置被引导到患者心脏的心室的外部区域，并且诸如光纤装置的能量输送装置的远端通过已经通过机械产生的开口放置在心脏的外壁内部 穿透，微裂或扩散心外膜，使得心肌而不是心外膜被激光能量照射，以允许所述能量输送装置如光纤远端或所述激光能量通过到左心室，而不引起 心外膜的激光照射可能是手术出血的原因，并且在移除装置之后更好地允许密封心包膜。 该装置包括由医师控制的手持式装置，其具有带有自动穿孔机构的可拆卸远端头部，并且可以使用真空源在头部提供吸力。 自动穿孔机构通过各种方式实现，例如TMR手持装置中的弹簧偏压致动构件和机电操作的穿孔机构。 具有手柄组件的手持式TMR装置还可以由计算机控制，以提供自动穿刺针机构的自动排序和使用自动纤维前进的激光烧制。
-
公开(公告)号：US6019756A
公开(公告)日：2000-02-01
申请号：US790193
申请日：1997-01-30
CPC分类号： A61B17/00 , A61B2017/00247 , A61B2018/00392
摘要： A laser surgery device for performing laser myocardial revascularization procedures on a human heart comprises a hand-held body portion with a forwardly extending probe member with an enlarged head end assembly including a piercing tip. A movable fiber bundle connected to a laser source extends through the body portion and the probe member with its distal tip at the head end assembly. A control button on the body portion enables the device to move the distal tip forwardly from the head end, and selectable stop members are provided on the body portion to provide different travel distances for the optical fiber bundle during a procedure. The body portion has a rotatable nose-piece with an internal ratchet mechanism which enables the device user to rotate the probe member and its head end to a selected optimum position before commencing a procedure. The head end assembly includes an easily replaceable piercing member in combination with a concave disk having a yieldable liner for cushioning the head assembly contact with the patient's heart. The device is used with a TMR procedure wherein the epicardium is initially pierced to provide access to the myocardium for the distal tip of the fiber bundle which then emits laser pulses as it is moved through the myocardium.
摘要翻译： 用于在人心脏上进行激光心肌血运重建手术的激光手术装置包括具有向前延伸的探针部件的手持主体部分，其具有包括穿刺尖端的扩大的头端组件。 连接到激光源的可移动光纤束通过主体部分和探针部件延伸，其远端在头端组件上。 主体部分上的控制按钮使得设备能够从头端向前移动远侧末端，并且可选择的止动构件设置在主体部分上，以在过程期间为光纤束提供不同的行进距离。 主体部分具有带有内部棘轮机构的可旋转鼻部，其使得设备使用者能够在开始过程之前将探针构件及其头端旋转到选定的最佳位置。 头端组件包括易于更换的刺穿构件，其与具有用于缓冲头部组件与患者心脏接触的可收缩内衬的凹盘组合。 该装置与TMR方法一起使用，其中最初刺穿心外膜以提供对于纤维束的远端的心肌的通路，然后当心肌移动通过心肌时发射激光脉冲。
-
5.发明授权Controllable trocar for transmyocardial revascularization (TMR) via endocardium method and apparatus 失效通过心内膜法和器械进行经心肌血运重建（TMR）的可控套管针
公开(公告)号：US5766163A
公开(公告)日：1998-06-16
申请号：US675732
申请日：1996-07-03
CPC分类号： A61B17/3417 , A61B18/24 , A61B17/3498 , A61B2017/00247 , A61B2017/00867 , A61B2017/3488 , A61B2018/00392 , A61B2018/2238
摘要： A minimally invasive surgical apparatus for providing access to the inside of a chamber of the heart for performing TMR on anterior and posterior walls therein. A unitary or a two piece trocar assembly is positioned through the chest wall. An obturator with a tissue piercing blade at one end is used to saw, pierce or otherwise cut a hole through the epicardium into and through myocardium. Once the trocar assembly extends into the heart chamber, a laser delivery device with deflection means is introduced into the chamber. Deflection or curvature of the end of the laser delivery device can be controlled by angulation control components, such that TMR channels can be created at various positions on the anterior and posterior walls of the chamber. Rotation control components for the fiber or other laser delivery devices will allow the surgeon to rotate the fiber once a predetermined deflection or curvature has been imparted to the distal end of the laser delivery device.
摘要翻译： 一种微创外科手术装置，用于提供进入心脏室内部以在其中的前壁和后壁上进行TMR。 一体式或两片套管针组件通过胸壁定位。 在一端具有组织穿刺刀片的闭孔器用于锯切，刺穿或以其他方式切割通过心外膜通过心肌的孔。 一旦套管针组件延伸到心室中，具有偏转装置的激光输送装置被引入腔室。 可以通过角度控制部件来控制激光输送装置的端部的偏转或弯曲，使得可以在腔室的前壁和后壁上的各个位置处产生TMR通道。 一旦向激光输送装置的远端施加了预定的偏转或曲率，则用于纤维或其他激光输送装置的旋转控制部件将允许外科医生旋转纤维。
-
6.发明授权Laser device with piercing tip for transmyocardial revascularization procedures 失效具有穿刺尖端用于经心肌血运重建手术的激光装置
公开(公告)号：US5738680A
公开(公告)日：1998-04-14
申请号：US628849
申请日：1996-04-05
CPC分类号： A61B18/24 , A61B2017/00247 , A61B2017/22077 , A61B2018/00291 , A61B2018/00392
摘要： The method for combined mechanical/laser myocardial revascularization of a human heart includes: inserting a mechanical piercing device and an elongated flexible lasing apparatus into the chest cavity of a patient; mechanically piercing, micro-tearing or spreading the epicardium of the heart; and then lasing from beneath the epicardium through the myocardium. The apparatus is guided to an area exterior to a ventricle of the patient's heart, and the distal end of the optical fiber apparatus is placed internal to the exterior wall of the heart through an opening which has been created by mechanically piercing, micro-tearing or spreading the epicardium, so that the myocardium and not the epicardium is irradiated with laser energy to allow passage of said optical fiber distal end or said laser energy into the left ventricular cavity without causing a laser irradiation of the epicardium which might be a cause of operative bleeding and for better allowing the sealing of the epicardium after the apparatus is removed. The apparatus includes a hand-held device controllable by the surgeon having a removable distal head end with a replaceable piercing member and utilizing a vacuum source to provide a suction force at the head end.
摘要翻译： 人心脏联合机械/激光心肌血运重建的方法包括：将机械穿刺装置和细长的柔性激光装置插入患者的胸腔; 机械穿刺，微裂或散布心脏的心外膜; 然后通过心肌从心外膜下射出。 该装置被引导到患者心脏的心室的外部区域，并且光纤装置的远端通过开口被放置在心脏的外壁的内部，所述开口通过机械刺穿，微撕裂或 扩散心外膜，使得心肌而不是心外膜被激光能量照射以允许所述光纤远端或所述激光能量通过到左心室腔而不引起激光照射心外膜，这可能是手术的原因 出血并且更好地允许在除去装置之后密封心外膜。 该装置包括可由外科医生控制的手持式装置，其具有可移除的远端头端，其具有可更换的刺穿构件，并利用真空源在头端提供吸力。
-
公开(公告)号：USD389574S
公开(公告)日：1998-01-20
申请号：US63126
申请日：1996-11-27
-
公开(公告)号：US06620153B2
公开(公告)日：2003-09-16
申请号：US09854072
申请日：2001-05-11
IPC分类号： A61G1820
CPC分类号： A61B18/24 , A61B2017/00172 , A61B2017/00247 , A61B2017/22074 , A61B2017/22077 , A61B2018/00392 , A61B2018/208
摘要： An apparatus for stimulating revascularization of myocardium tissue in the ventricular wall of a human heart is disclosed. The apparatus includes means for moving the distal end of an optical fiber element forwardly through the epicardium of the heart and into the myocardium and emitting relatively low power bursts of laser energy from the distal end to form stimulus injury zones that promote capillary growth and tissue revascularization. Each penetration of the optical fiber element may produce multiple stimulus zones spaced radially from or in line with the axis of the optical fiber element. Apparatus for moving the optical fiber element and controlling the laser emissions in a predetermined manner is also disclosed.
摘要翻译： 公开了一种用于刺激人心脏心室壁心肌组织血运重建的装置。 该装置包括用于将光纤元件的远端向前移动通过心脏心外膜并进入心肌的装置，并且从远端发射相对低功率的激光能量脉冲以形成促进毛细血管生长和组织血运重建的刺激性损伤区域 。 光纤元件的每次穿透可以产生与光纤元件的轴线径向间隔开或与光纤元件的轴线成间隔的多个刺激区域。 还公开了用于移动光纤元件并以预定方式控制激光发射的装置。
-
公开(公告)号：US5999678A
公开(公告)日：1999-12-07
申请号：US773430
申请日：1996-12-27
申请人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Bruce Richardson
发明人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Bruce Richardson
CPC分类号： A61B18/24 , A61B2017/00247 , A61B2018/00392
摘要： A drug delivery apparatus for dispensing a predetermined amount of one or more drugs into a laser created opening in the human body, the apparatus consisting of a laser delivery means such as an optical fiber or fiber bundle, a drug conduit which transfers the one or more drugs, drug solutions or other substances to the distal end of the laser delivery means, and the laser delivery means disposed essentially coaxially with the drug conduit. Laser delivery means is used to create a TMR channel or other opening in the body. Dispensed drug or other substance travels through the drug conduit and emanates from the drug conduit to be delivered into the TMR channel or other laser created opening. Drug is dispensed by manually or automatically activating an electric motor which actuates a piston element. A method of use is also disclosed.
摘要翻译： 一种用于将预定量的一种或多种药物分配到人体内的激光产生开口中的药物输送装置，该装置由诸如光纤或纤维束的激光输送装置组成，药物导管将一个或多个 药物，药物溶液或其它物质，并且激光输送装置基本上与药物导管同轴地设置。 激光输送装置用于在体内产生TMR通道或其他开口。 分配的药物或其他物质通过药物导管，并从药物导管发出，以被输送到TMR通道或其他激光产生的开口中。 药物通过手动或自动激活致动活塞元件的电动机来分配。 还公开了一种使用方法。
-
公开(公告)号：US06551302B1
公开(公告)日：2003-04-22
申请号：US09697672
申请日：2000-10-26
申请人： Michael J. Rosinko , Alexander Khairkhahan , Michael Horzewski , Stuart D. Harman , Richard L. Mueller , Douglas R. Murphy-Chutorian
发明人： Michael J. Rosinko , Alexander Khairkhahan , Michael Horzewski , Stuart D. Harman , Richard L. Mueller , Douglas R. Murphy-Chutorian
IPC分类号： A61M3100
CPC分类号： A61M25/0147 , A61B8/06 , A61B8/12 , A61M25/0084 , A61M25/0136 , A61M2025/0089
摘要： A steerable percutaneous catheter for guiding at least one functional device to selected surfaces of a body for treatment thereon, particularly adapted for laser-assisted Percutaneous Transmyocardial Revascularization (PTMR). The steerable catheter has a handle portion at its proximal end and a controllably deflectable end portion at its distal end. The distal end of the catheter and the distal end of the functional device maintain alignment automatically during deflection. The invention also includes a surface contact detection system to detect contact with an interior body surface, such as the heart wall.
摘要翻译： 一种可导向的经皮导管，用于将至少一个功能装置引导到身体的选定表面上用于在其上进行治疗，特别适用于激光辅助经皮心肌血运重建术（PTMR）。 可操纵的导管在其近端处具有手柄部分，在其远端具有可控制地偏转的端部。 导管的远端和功能装置的远端在偏转期间自动保持对准。 本发明还包括一个表面接触检测系统，用于检测与诸如心脏壁的内部身体表面的接触。
-
-
-
-
-
-
-
-
-
搜索结果
64 条记录 (耗时 0.035 秒)
