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公开(公告)号：US4350169A
公开(公告)日：1982-09-21
申请号：US176410
申请日：1980-08-08
申请人： Robert G. Dutcher , James E. Upton
发明人： Robert G. Dutcher , James E. Upton
IPC分类号： A61N1/05
CPC分类号： A61N1/056
摘要： A body implantable lead and a stiffening stylet with a flexible tip for imparting rigidity to the lead to facilitate attachment of the lead to an internal body organ and for transmitting torque to the distal end of the lead. A flexible tip stiffening stylet is provided for insertion into a lumen in the lead extending from a pin at its proximal end along the length of the lead conductor to the electrode. A portion of the stylet wire inserted in the lumen has a thinner diameter over a portion of its length near the distal end to permit smooth transmission of torque by rotation of the stylet wire even in applications where the lead and stylet are tightly bent in the vicinity of the thinned portion of the lead.
摘要翻译： 身体可植入引线和具有柔性尖端的加强型管心针，用于赋予引线刚性，便于将引线附接到内部身体器官并将扭矩传递到引线的远端。 提供柔性尖端加强导管，用于插入到引线中的内腔中，该引线从其引线沿着引线导体的长度从电极延伸到电极。 插入管腔中的探针线的一部分在远端附近的一部分长度上具有较薄的直径，以允许通过心跳线的旋转来平稳地传递扭矩，即使在铅和探针在附近紧密弯曲的应用中 的引线的变薄部分。
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公开(公告)号：US06558366B1
公开(公告)日：2003-05-06
申请号：US08349665
申请日：1994-12-05
申请人： William J. Drasler , Robert G. Dutcher , Mark L. Jenson , Joseph M. Thielen , Emmanuil I. Protonotarios
发明人： William J. Drasler , Robert G. Dutcher , Mark L. Jenson , Joseph M. Thielen , Emmanuil I. Protonotarios
IPC分类号： A61M3100
CPC分类号： A61B17/32037 , A61B17/3203
摘要： A method of and apparatus for removing a thrombus deposit from the cardiovascular system of a patient without the need to surgically access the location of the thrombus deposit via a cut-down or other surgical procedure. A catheter is inserted percutaneously into the patient at a convenient location either directly or over a previously positioned guide wire. The distal end of the catheter is advanced under fluoroscopy to the site of the thrombus deposit. A balloon is inflated to stabilize the position of the distal end of the catheter within the center of the vessel lumen. A flexible metal tube conveys an extremely high pressure stream of sterile saline solution to at least one jet at the distal end of the catheter. At least one jet positions the thrombus deposit for emulsification by at least one other jet. By directing the jets toward the orifice of the large evacuation lumen of the catheter, a stagnation pressure is induced which propels the emulsion proximally for disposal. The rate of proximal flow of effluent is metered to correspond with the distal flow of saline solution to ensure minimal local impact on the vasculature at the site of the thrombus deposit.
摘要翻译： 一种用于从患者的心血管系统中去除血栓沉积物的方法和装置，而不需要通过切割或其它外科手术手术地进入血栓沉积物的位置。 在方便的位置，将导管经皮插入患者中，直接或超过预先定位的导丝。 导管的远端在荧光透视下前进到血栓沉积部位。 气囊膨胀以将导管的远端的位置稳定在血管内腔的中心内。 柔性金属管将非常高压的无菌盐水溶液流传送到导管远端处的至少一个射流。 至少一个喷射器通过至少一个其它喷射器将血栓沉积物定位成乳化。 通过将射流引导到导管的大抽空腔的孔口，引起停滞压力，其推动乳剂向近端处理。 流出物的近端流量计量以与盐溶液的远端流动相对应，以确保对血栓沉积部位的脉管系统的局部影响最小。
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公开(公告)号：US6096001A
公开(公告)日：2000-08-01
申请号：US351616
申请日：1994-12-08
申请人： William J. Drasler , Robert G. Dutcher , Mark L. Jenson , Joseph M. Thielen , Emmanuil I. Protonotarios
发明人： William J. Drasler , Robert G. Dutcher , Mark L. Jenson , Joseph M. Thielen , Emmanuil I. Protonotarios
CPC分类号： A61B17/32037 , A61B17/3203
摘要： A device for removing a thrombus or other tissue deposit from the cardiovascular system, natural or synthetic tubule or cavity found in the human body of a patient without the need to surgically access the location of the thrombus or other tissue deposit via a cut-down or other surgical procedure. A flexible metal or high pressure plastic tube conveys an extremely high pressure stream of sterile saline or other physiologic solution to at least one jet at the distal end of the catheter. At least one jet is directed at the opening of a large exhaust lumen or other target. The jet(s) is responsible for providing a localized negative pressure which entrains tissue into the jet from break-up of the debris. This jet(s) can also provide stagnation pressure in the exhaust lumen which drives the tissue or thrombotic debris out of the exhaust lumen. Operation of the device with tip pressure greater than 500 psi provides this device with the entrainment and exhaust characteristics which contribute to its effectiveness. The rate of exhaust of tissue debris is metered to ensure minimal local impact on the vasculature at the site of the thrombus deposit. A fluid metering means, such as a roller pump, controls the rate of exhaust such that it is in balance with the saline input or can be adjusted to be greater or less than the input. A positive displacement pump operating at steady or pulsatile flow provides the high pressure saline to the tip of the catheter.
摘要翻译： 一种用于从心血管系统去除血栓或其他组织沉积物的装置，在患者的人体中发现的天然或合成的小管或腔，而不需要经由切口或外科手术来进入血栓或其他组织沉积物的位置 其他外科手术。 柔性金属或高压塑料管将非常高压的无菌盐水或其他生理溶液流输送到导管远端处的至少一个射流。 至少一个射流指向大排气腔或其他靶的开口。 喷气机负责提供局部的负压，其将组织夹带到喷射器中从碎片的分解中。 这种喷射器还可以在排气腔中提供停滞压力，其将组织或血栓形成的碎片驱动出排出管腔。 尖端压力大于500 psi的设备的操作为该设备提供了有助于其有效性的夹带和排气特性。 计量组织碎片的排气速率，以确保局部对血栓沉积部位脉管系统的局部影响最小。 诸如辊式泵的流体计量装置控制排气速率，使其与盐水输入平衡，或者可以将其调节为大于或小于输入。 以稳定或脉动流动运行的容积式泵向导管的尖端提供高压盐水。
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公开(公告)号：US5989210A
公开(公告)日：1999-11-23
申请号：US19728
申请日：1998-02-06
CPC分类号： A61B17/32037 , A61B17/32075 , A61B2090/034
摘要： A surgical device and method for removal of tissue, such as thrombus, from a vessel in the body. The device has a first tube with a distal open end and an inward directed stop and a second tube with an outward directed stop for engaging the inward directed stop and thereby regulating the relationship between a retrograde jet and the distal open end. Thrombus is dislodged, entrained, and broken into pieces which are evacuated through the first tube.
摘要翻译： 用于从体内的血管中去除诸如血栓的组织的手术装置和方法。 该装置具有第一管，其具有远端开口端和向内指向的止动件，以及具有向外定向止动件的第二管，用于接合向内指向的止动件，从而调节逆行射流与远端开口端之间的关系。 血栓被移出，夹带并分解成通过第一管排出的碎片。
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公开(公告)号：USRE32227E
公开(公告)日：1986-08-19
申请号：US723698
申请日：1985-04-16
申请人： Robert G. Dutcher
发明人： Robert G. Dutcher
IPC分类号： A61N1/05
CPC分类号： A61N1/056
摘要： A body implantable lead having a two-piece stylet. An inner solid portion of the stylet enables a shape to be imparted to the stylet to allow proper maneuvering of the lead during implant. A second portion of the stylet is slideably located coaxially about the first portion. The second portion of the stylet permits the imposition of a torque at the distal end of the implantable lead by the turning of a knob fixedly attached to the proximal end of the second portion of the stylet. The second portion of the stylet is a helically wound coil. The two-piece stylet is inserted into the proximal end of the body implantable lead. The distal end of the body implantable lead is located in the position desired through the use of the solid inner first portion of the stylet in which a bend or other desired shape has been introduced. The body implantable lead is permanently attached to the muscle tissue by a fixation device activated through the torque supplied by the second portion of the stylet. The two portions of the stylet may be fabricated from a variety of materials.
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公开(公告)号：US4146036A
公开(公告)日：1979-03-27
申请号：US839954
申请日：1977-10-06
CPC分类号： A61N1/0573
摘要： A body-implantable, intravascular lead affixed with a pin or pins at its proximal end adapted to be connected to a pulse generator and with an electrode or electrodes at its distal end electrically connected via conductor means and adapted to be securely and permanently attached to a body organ. Electrode means in the form of an elongated member having a circumferential electrode formed on one end thereof and an opening passing therethrough from its proximal to distal end is affixed to the distal end of the conductor means. Tissue securing means extending beyond the opening in the distal end of the electrode means are provided for securing the electrode means into firm engagement with the tissue at the desired location. Movable means located in the opening in the electrode means are provided for protecting the tissue securing means from causing injury to a body vessel, heart valve, or other tissue as the lead is inserted and guided through a vessel to the desired location. Various types of stylet means may be used to move the movable means into the position for protecting the tissue securing means.
摘要翻译： 可植入的血管内引线，其固定在其近端处的针或销，其适于连接到脉冲发生器，并且其远端处的电极或电极通过导体装置电连接并且适于牢固地并永久地附接到 身体器官 电极是指具有在其一端形成的周向电极的细长构件的形式，并且从其近端至远端穿过的开口被固定到导体装置的远端。 提供了延伸超过电极装置远端的开口的组织固定装置，用于将电极装置固定在所需位置与组织的牢固接合。 设置在电极装置中的开口中的可移动装置被设置成用于在引线插入并引导通过容器到期望位置时，保护组织固定装置不会对身体容器，心脏瓣膜或其他组织造成伤害。 可以使用各种类型的探针装置将可移动装置移动到用于保护组织固定装置的位置。
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公开(公告)号：US06129697A
公开(公告)日：2000-10-10
申请号：US351610
申请日：1994-12-08
申请人： William J. Drasler , Robert G. Dutcher , Mark L. Jenson , Joseph M. Thielen , Emmanuil I. Protonotarios
发明人： William J. Drasler , Robert G. Dutcher , Mark L. Jenson , Joseph M. Thielen , Emmanuil I. Protonotarios
CPC分类号： A61B17/32037 , A61B17/3203
摘要： A device for removing a thrombus or other tissue deposit from the cardiovascular system, or from a natural or synthetic tubule or cavity found in the human body of a patient without the need to surgically access the location of the thrombus or other tissue deposit via a cut-down or other surgical procedure. A flexible metal or high pressure plastic tube conveys an extremely high pressure stream of sterile saline or other physiologic solution to at least one orifice at the distal end of the catheter. At least one jet is directed at the opening of a large exhaust lumen or other target. The jet is responsible for providing a localized negative pressure which entrains tissue into the jet from break-up of the debris. This jet can also provide stagnation pressure in the exhaust lumen which drives the tissue or thrombotic debris out of the exhaust lumen. Operation of the device with tip pressure greater than 500 psi provides this device with the entrainment and exhaust characteristics which contribute to its effectiveness. The rate of exhaust of tissue debris is metered to ensure minimal local impact on the vasculature at the site of the thrombus deposit. A fluid metering means, such as a roller pump, controls the rate of exhaust such that it is in balance with the saline input or can be adjusted to be greater or less than the input. A positive displacement pump operating at steady or pulsatile flow provides the high pressure saline to the distal end of the catheter.
摘要翻译： 一种用于从心血管系统或从患者人体中发现的天然或合成的小管或腔中除去血栓或其它组织沉积物的装置，而不需要通过切口手术地进入血栓或其它组织沉积物的位置 下降或其他外科手术。 柔性金属或高压塑料管将非常高压的无菌盐水或其他生理溶液流输送到导管远端的至少一个孔口。 至少一个射流指向大排气腔或其他靶的开口。 该喷气机负责提供局部负压，其将组织夹带到喷射器中从碎片的分解中。 该射流还可以在排气腔中提供停滞压力，其将组织或血栓形成的碎屑驱出排气腔。 尖端压力大于500 psi的设备的操作为该设备提供了有助于其有效性的夹带和排气特性。 计量组织碎片的排气速率，以确保局部对血栓沉积部位脉管系统的局部影响最小。 诸如辊式泵的流体计量装置控制排气速率，使其与盐水输入平衡，或者可以将其调节为大于或小于输入。 以稳定或脉动流动运行的正排量泵将高压盐水提供给导管的远端。
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公开(公告)号：US5370609A
公开(公告)日：1994-12-06
申请号：US6076
申请日：1993-01-15
申请人： William J. Drasler , Robert G. Dutcher , Mark L. Jenson , Joseph M. Thielen , Emmanuil I. Protonotarios
发明人： William J. Drasler , Robert G. Dutcher , Mark L. Jenson , Joseph M. Thielen , Emmanuil I. Protonotarios
CPC分类号： A61B17/32037 , A61B17/3203
摘要： A method of and apparatus for removing a thrombus deposit from the cardiovascular system of a patient without the need to surgically access the location of the thrombus deposit via a cut-down or other surgical procedure. A catheter is inserted percutaneously into the patient at a convenient location either directly or over a previously positioned guide wire. The distal end of the catheter is advanced under fluoroscopy to the site of the thrombus deposit. A balloon is inflated to stabilize the position of the distal end of the catheter within the center of the vessel lumen. A flexible metal tube conveys an extremely high pressure stream of sterile saline solution to at least one jet at the distal end of the catheter. At least one jet positions the thrombus deposit for emulsification by at least one other jet. By directing the jets toward the orifice of the large evacuation lumen of the catheter, a stagnation pressure is induced which propels the emulsion proximally for disposal. The rate of proximal flow of effluent is metered to correspond with the distal flow of saline solution to ensure minimal local impact on the vasculature at the site of the thrombus deposit.
摘要翻译： 一种用于从患者的心血管系统中去除血栓沉积物的方法和装置，而不需要通过切割或其它外科手术手术地进入血栓沉积物的位置。 在方便的位置，将导管经皮插入患者中，直接或超过预先定位的导丝。 导管的远端在荧光透视下前进到血栓沉积部位。 气囊膨胀以将导管的远端的位置稳定在血管内腔的中心内。 柔性金属管将非常高压的无菌盐水溶液流传送到导管远端处的至少一个射流。 至少一个喷射器通过至少一个其它喷射器将血栓沉积物定位成乳化。 通过将射流引导到导管的大抽空腔的孔口，引起停滞压力，其推动乳剂向近端处理。 流出物的近端流量计量以与盐溶液的远端流动相对应，以确保对血栓沉积部位的脉管系统的局部影响最小。
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公开(公告)号：US5217028A
公开(公告)日：1993-06-08
申请号：US912321
申请日：1992-07-13
申请人： Robert G. Dutcher , John C. Hill , Robert J. Scott
发明人： Robert G. Dutcher , John C. Hill , Robert J. Scott
CPC分类号： A61N1/375 , A61N1/0587
摘要： A bi-polar cardiac lead for transmitting electric current to the heart and/or sensing and monitoring electrical activity of the heart has elongated electrical conductors connected to a head. The lead has a first electrode mounted on the head having a helical wire connected to one conductor adapted to be turned into heart tissue. The helical wire is coated with platinum black particles which decrease electrical losses at the electrode-tissue interface. A second annular electrode having an irregular outer surface configuration is mounted on the head around the first electrode. A plug impregnated with a drug is located within a recess in the head adjacent the electrodes. The drug migrates from the plug to the stimulation site.
摘要翻译： 用于将电流传输到心脏和/或感测和监测心脏的电活动的双极心脏引线具有连接到头部的细长电导体。 引线具有安装在头部上的第一电极，其具有连接到适于被转换成心脏组织的一个导体的螺旋线。 螺旋线涂有白金黑色颗粒，减少电极 - 组织界面处的电损耗。 具有不规则外表面构造的第二环形电极安装在围绕第一电极的磁头上。 浸渍有药物的塞子位于与电极相邻的头部的凹部内。 药物从塞子迁移到刺激部位。
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公开(公告)号：US4381014A
公开(公告)日：1983-04-26
申请号：US195987
申请日：1980-10-10
CPC分类号： A61N1/056
摘要： A structure for use as an electrode on a pacing lead to be located some distance proximal to the distal end of the pacing lead. Two short lengths of wire having high electrical conductivity are cut to size. The coils of the outer conductor are welded together at the desired location of the ring electrode of the lead. The two short lengths of wire are welded to the outer conductor of the lead at the desired location of the ring electrode. An insulating sheath having an inside diameter close to the outside diameter of the outer conductor is slid over the outer conductor. The flexibility of the insulating sheath is sufficient to permit encasing of the two short lengths of wire, though the insulating sheath is caused to protrude at the two places directly over and corresponding to the two short lengths of wire. A conductive ring having an inside diameter sufficient to permit sliding over the insulating sheath and two points of protrusion is placed around the insulating sheath at the desired location of the ring electrode. The conductive ring is swaged to an outside diameter approximating that of the insulating sheath. The forces produced cause the two short lengths of wire to pierce the insulating sheath and come in contact with the conductive ring which thereby creates an electrically conductive path between the outer conductor and the conductive ring.
摘要翻译： 用作起搏导线上的电极的结构位于起搏引线的远端附近一定距离处。 将具有高导电性的两根短的导线切割成尺寸。 外导体的线圈在引线的环形电极的期望位置焊接在一起。 两条短的线材在环形电极的所需位置焊接到引线的外导体。 具有接近外导体的外径的内径的绝缘护套在外导体上滑动。 绝缘护套的灵活性足以允许封装两根短的电线，尽管使绝缘护套在两个位置上直接突出并对应于两根短的电线。 具有足以允许在绝缘护套上滑动的内径和两个突出点的导电环放置在环形电极的期望位置处的绝缘护套周围。 将导电环锻造成与绝缘护套相近的外径。 产生的力导致两根短的导线刺穿绝缘护套并与导电环接触，从而在外导体和导电环之间形成导电路径。
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