摘要:
Techniques are described for treating an occlusion in a patient. In one example, a system includes an atherectomy device configured to remove an occlusion from a body lumen and a positioning device that positions the atherectomy device adjacent to the occlusion. The positioning device includes a tubular body having first and second ends and defining a lumen therebetween, at least two fins engaged to the tubular body, wherein in a deployed state, the fins extend radially outward from the tubular body, and wherein in an undeployed state, the at least two fins wrap about one another and about the tubular body, a guide wire extending through the lumen, and first and second stopper members, each of the first and second stopper members engaged to the guide wire, wherein the first stopper member and the second stopper member substantially prevent movement of the tubular body along the guide wire.
摘要:
Systems and methods are disclosed for navigating a surgical device toward a target organ in the body of a patient. An example method includes providing a surgical needle and a guide wire, the surgical needle configured for insertion into a vein or a beating heart. The method also includes holding the guide wire within the surgical needle while the surgical needle is inserted into the vein or the beating heart. The method also includes generating output in two modes, the output based on at least one medical positioning system (MPS) sensor on the guide wire, the output corresponding to a position of the surgical needle and the guide wire for navigating the surgical needle and the guide wire toward a target in the vein or the heart. The methods can be carried out directly by a physician or via a computer processor-based surgical system.
摘要:
An attachment mechanism and method for attaching or coupling a guide wire to a catheter for re-canalization or opening a passage through an occlusion in a blood vessel is provided. The attachment mechanism generates friction forces against the guide wire to couple the guide wire to a catheter, which design permits a greater force to be used on the guide wire during a re-canalization procedure. The invention also encompasses use of the attachment mechanism in conjunction with active catheters, which have vibration-generating means to oscillate the distal end of the catheter or a component in the distal end of the catheter, to add vibration motion, preferably axial vibration motion, to the increased force that may be applied to the guide wire for purposes of penetrating an occlusion. The methods of the invention relate to methods of attaching the guide wire to the catheter and methods of treating a vessel having a partial or total occlusion.
摘要:
A wireguide set is provided for changing access between two access sites. The wireguide set includes a wireguide and a catheter. The wireguide passes through one access site while the catheter passes through another access site. The wireguide and catheter are connectable to each other inside the patient's body. Once connected, the catheter can pull the wireguide through the access site of the catheter. The wireguide set may be used to treat peripheral arterial disease occlusions in the lower leg where it is difficult or impossible to gain access through the occlusion from a femoral site.
摘要:
Techniques are described for treating an occlusion in a patient. In one example, a system comprises an atherectomy device configured to remove an occlusion from a body lumen and a positioning device that positions the atherectomy device adjacent to the occlusion. The positioning device comprises a tubular body having first and second ends and defining a lumen therebetween, at least two fins engaged to the tubular body, wherein in a deployed state, the fins extend radially outward from the tubular body, and wherein in an undeployed state, the at least two fins wrap about one another and about the tubular body, a guide wire extending through the lumen, and first and second stopper members, each of the first and second stopper members engaged to the guide wire, wherein the first stopper member and the second stopper member substantially prevent movement of the tubular body along the guide wire.
摘要:
A device is described that may be positioned at a location in an intervertebral disc for diagnosis or treatment of the disc. Treatment may include, for example, applying energy or removing material, and may decrease intradiscal pressure. Radiofrequency energy may be applied. A percutaneous method of repairing a fissure in the annulus pulposus comprises placing an energy source adjacent to the fissure and providing sufficient energy to the fissure to raise the temperature to at least about 45-70° C. and for a sufficient time to cause the collagen to weld. An intervertebral fissure also can be treated by placing a catheter with a lumen adjacent to the fissure and injecting sealant into the fissure via the catheter, thereby sealing the fissure. An intervertebral fissure additionally can be treated by providing a catheter having a distal end, a proximal end, a longitudinal axis, and an intradiscal section at the catheter's distal end on which there is at least one functional element. The next step is applying a force longitudinally to the proximal of the catheter which is sufficient to advance the intradiscal section through the nucleus pulposus and around an inner wall of an annulus fibrosus, but which force is insufficient to puncture the annulus fibrosus. Next the functional element is positioned at a selected location of the disc by advancing or retracting the catheter and optionally twisting the proximal end of the catheter. Then the functional unit treats the annular fissure. Optionally, there is an additional step of adding a substance to seal the fissure. An externally guidable intervertebral disc apparatus also is disclosed.
摘要:
A percutaneous method treats degenerate disc disease characterized by a circumferential bulge. The method provides a catheter having a distal end, a proximal end, and a longitudinal axis, the distal end having an intradiscal section with at least one energy delivery device. The next step is applying a force longitudinally to the proximal end of the catheter which is sufficient to advance the intradiscal section through a nucleus pulposus and around an inner wall of an annulus, but which force is insufficient for the intradiscal section to puncture the annulus fibrosus. Next the energy delivery device is positioned at a selected location of the annulus by advancing or retracting the catheter and optionally twisting the proximal end of the catheter. The thermal energy delivery device is positioned adjacent the annulus and used to heat and stiffen the disc. Optionally, there is an additional step of adding a substance to reinforce the area. Optionally, access to the disc is provided by an introducer having an introducer lumen with an opening at a terminus of the introducer. An externally guidable intervertebral disc apparatus also is disclosed.
摘要:
An attachment mechanism and method for attaching or coupling a guide wire to a catheter for re-canalization or opening a passage through an occlusion in a blood vessel is provided. The attachment mechanism generates friction forces against the guide wire to couple the guide wire to a catheter, which design permits a greater force to be used on the guide wire during a re-canalization procedure. The invention also encompasses use of the attachment mechanism in conjunction with active catheters, which have vibration-generating means to oscillate the distal end of the catheter or a component in the distal end of the catheter, to add vibration motion, preferably axial vibration motion, to the increased force that may be applied to the guide wire for purposes of penetrating an occlusion. The methods of the invention relate to methods of attaching the guide wire to the catheter and methods of treating a vessel having a partial or total occlusion.
摘要:
A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. In this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion and by appropriately maneuvering each member, a continuous channel is created. Additional elements such as capture devices, dilators and injection catheters are also disclosed.
摘要:
A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. In this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion and by appropriately maneuvering each member, a continuous channel is created. Additional elements such as capture devices, dilators and injection catheters are also disclosed.