CN109996583A

CN109996583A - For stimulating blood vessel to control, the method and apparatus for treating and/or preventing bleeding

Info

Publication number: CN109996583A
Application number: CN201780028229.8A
Authority: CN
Inventors: 维兰德.K.沙马
Original assignee: Individual
Current assignee: Individual
Priority date: 2016-03-07
Filing date: 2017-03-07
Publication date: 2019-07-09
Also published as: EP3426337A1; WO2017155916A1; EP3426337A4

Abstract

The method for preventing, treating and/or controlling bleeding in patient organ includes to artery, vein, nerve or organ walls the offer electro photoluminescence for dominating artery or vein.Device has at least one electrode, which is operably connected to stimulus generator and is placed with artery, vein, nerve or organ walls with telecommunication.Electric stimulus generator makes electro photoluminescence be applied to artery, vein, nerve or wall by least one electrode, and wherein electro photoluminescence is effective for preventing, treating and/or controlling bleeding.

Description

For stimulating blood vessel to control, the method and apparatus for treating and/or preventing bleeding

Cross reference

The application is in priority dependent on entitled " the Method and Apparatus submitted on April 27th, 2016 The U.S. Provisional Patent Application No. of for Stimulating Blood Vessels for Modulating Blood Flow " 62/328,303 and 2016 on March 7, same names submitted U.S. Provisional Patent Application No. 62/304,841.

The application is also entitled " the Method and Apparatus for Stimulating submitted on June 2nd, 2015 The continuation application of the part application of the U.S. Patent Application No. 14/728,630 of the Vascular System ", United States Patent (USP) Shen It please number 14/728,630 be to be submitted on October 8th, 2009 and public as U.S. Patent number 9,079,028 on July 14th, 2015 The continuation application of the U.S. Patent Application No. 12/575,713 of the same names of announcement, U.S. Patent Application No. 12/575,713 is excellent First dependent on the U.S. Provisional Patent Application No. 61/104,054 in the October in 2008 of the same names submitted on the 9th in power.

All above-mentioned applications are incorporated herein by reference in their entirety.

Invention field

This specification is related to adjusting blood flow using electro photoluminescence, more particularly, to by stimulating artery, vein or confession The nerve of the artery and vein of answering patient prevents, controls and/or treat bleeding.

Background of invention

The main reason for wound is 44 years old or less American deaths.Haemorrhagic shock accounts for the 30-40% of the traumatic death rate. Bleeding is also most common on battlefield to prevent the cause of the death.Application of the tourniquet in compressibility bleeding leads to limbs avascularization It substantially reduces.According to the saying of septic yanks, be not suitable for the bleeding of trunk tourniquet (truncal tourniquet) (also referred to as Non- compressibility bleeding (non-compressible hemorrhage)) it is the main reason for preventability is dead now.It is some Non- compressibility bleeding occurs due to being bleeding into body cavity (such as abdomen or chest), and it is other by trunk and four limbs or neck it Between the wound of intersection cause.

Effectively prevent blood loss in the preceding place of institute and provide the killer opportunity that rescue has the soldier of non-compressibility damage, Therefore, significant effort has been made to develop the technology for meeting this unmet demand.It is verified can by be up to several points The DC current of clock applies the inducing thrombosis in the blood vessel of clamping to be formed.Facing however, relevant thermal damage eliminates the technology Use in bed practice.

In addition, bleeding is the main reason for whole world operating room is dead.Every 10, about 4 in 000 patient with operation, and Every 10,000 6 received in the patient of anesthesia are in 30 days after surgery by fatal cardiac arrest.Bleeding accounts for these hearts Stop 33% to fight.

Therefore, it is necessary to prevent or control the quick of the bleeding situation in organ in the case where not causing tissue damage and have The method of effect.Such bleeding control is suitable for all bleedings, especially in fight and operating room scene.

Summary of the invention

Subject description discloses the arteries for using at least one and electrode prevention patient's upper limb of impulse generator telecommunication Or the method for the expection bleeding in vein, which comprises will at least one described electrode arrangement close to patient's artery or At the position on vein surface, wherein the artery is that subclavian artery, axillary artery, deep brachial artery, arteria brachialis, radial artery, ruler are dynamic Arteries and veins, arcus volaris profundus, at least one of arcus volaris superficialis or the vein are that subclavian vein, axillary vein, cephalic vein, brachial vein, oar are quiet At least one of arteries and veins, ulnar veins, arcus volaris profundus, arcus volaris superficialis, basilic vein, median basilic vein and vena mediana antebrachii, and its Described in position the expected bleeding position upstream at least 1cm；And generate the impulse generator by least one A electrode is administered to the electro photoluminescence of the artery or the vein, wherein there is pulse duration, pulse to shake for the electro photoluminescence Width and pulse frequency, and the pulse duration, the pulse amplitude and the pulse frequency are wherein selected, so that described Electro photoluminescence effectively causes the vessel retraction in the artery or the vein, to prevent the expected bleeding.

Optionally, the range in pulse duration is 1 μ sec to 500msec, the range of the pulse amplitude be 1V extremely 250V, and the range of the pulse frequency is 1Hz to 100kHz.

Optionally, at least one described electrode is cuff electrode (cuff electrode) and clamper electrode (clamp At least one of electrode), and arrange that at least one described electrode includes by the cuff electrode or clamper electricity Pole is positioned to and the position direct physical contact.

Optionally, radio frequency (RF) receiver is coupled at least one described electrode, and RF transmitter is coupled to institute It states impulse generator and is wirelessly communicated with the RF receiver, and wherein the method also includes producing the impulse generator Life will by least one described electrode apply electro photoluminescence and the electro photoluminescence is wirelessly transmitted to institute from the RF transmitter State RF receiver.

Method can also include using the microprocessor for being operably connected to the impulse generator with selective setting The pulse duration, the pulse amplitude and the pulse frequency.

This specification, which is also disclosed, prevents patient's lower limb using at least one and impulse generator with the electrode of telecommunication Artery or vein in expection bleeding method, which comprises will at least one described electrode arrangement close to described At the artery of patient or the position on vein surface, wherein the artery is femoral artery, popliteal artery, anterior tibial artery, posterior tibial artery, calf At least one of artery, arteria dorsalis pedis and vola or the vein be vena iliaca externa, femoral vein, perforating veins, great saphenous vein, small At least one of saphena, anterior tibial veins, posterior tibial veins and dorsal venous arch of foot, and wherein the position goes out in the expection The position upstream of blood at least 1cm；And make the impulse generator generate by least one electrode be administered to the artery or The electro photoluminescence of the vein wherein the electro photoluminescence has pulse duration, pulse amplitude and pulse frequency, and is wherein selected The pulse duration, the pulse amplitude and the pulse frequency are selected, so that the electro photoluminescence effectively causes the artery Or the vessel retraction in the vein, to prevent the expected bleeding.

Optionally, at least one electrode is cuff electrode or clamper electrode, and arranges that at least one described electrode includes The cuff electrode or the clamper electrode are positioned to and the position direct physical contact.

Optionally, radio frequency (RF) receiver is coupled at least one described electrode, and RF transmitter is coupled to institute It states impulse generator and is wirelessly communicated with the RF receiver, and the method also includes wanting the impulse generator generation By at least one described electrode application electro photoluminescence and the electro photoluminescence is wirelessly transmitted to the RF from the RF transmitter Receiver.

This method can also include being set using the microprocessor for being operably connected to the impulse generator with selectivity Set the pulse duration, the pulse amplitude and the pulse frequency.

This specification also discloses the method that the bleeding in patient is controlled before the surgical procedures of plan, the method packet It includes: starting to perform the operation in the abdomen area of the patient；By at least one electrode of stimulating apparatus before bleeding formation Be arranged in the blood vessel upstream in the abdomen area and to the position of the blood vessel telecommunication of the blood vessel blood supply at；By described in extremely A few electrode is connected to electric pulse generator；Bleeding is identified during the surgical procedures；And make the impulse generator The electro photoluminescence for being applied to upstream blood vessel is generated, wherein the electro photoluminescence has pulse duration, pulse amplitude and pulse frequency, And the pulse duration, the pulse amplitude and the pulse frequency are wherein selected, so that the electro photoluminescence is effectively drawn It plays the vessel retraction of the upstream blood vessel and reduces blood flow to control the bleeding of the blood vessel in the abdomen area.

Optionally, the range in the pulse duration is 1 μ sec to 500msec, and the range of the pulse amplitude is 1V To 250V, and the range of the pulse frequency is 1Hz to 100kHz.

Optionally, at least one described electrode is cuff electrode or clamper electrode, and arranges at least one described electrode Including the cuff electrode or the clamper electrode are positioned to and the position direct physical contact.

Method can also include selectively being arranged using the microprocessor for being operably connected to the impulse generator The pulse duration, the pulse amplitude and the pulse frequency.

This specification also discloses the method for preventing the bleeding in patient before the surgical procedures of plan, the method packet It includes: starting to perform the operation in the abdomen area of the patient, be defined as involved in the close operation of exposure wherein starting operation The region of blood vessel in the abdomen area；The bleeding formation before by least one electrode arrangement of stimulating apparatus with Blood vessel upstream in the abdomen area and to the position of the blood vessel telecommunication of the blood vessel blood supply at；It will at least one described electricity Pole is connected to electric pulse generator；Continue the operation；A possibility that starting expected bleeding before increased surgical technic, make The impulse generator generates the electro photoluminescence for being applied to upstream blood vessel up to the predetermined period, wherein the electro photoluminescence has arteries and veins Duration, pulse amplitude and pulse frequency are rushed, and wherein selects the pulse duration, the pulse amplitude and described Pulse frequency, so that the electro photoluminescence effectively causes the vessel retraction of the upstream blood vessel and to reduce blood flow described to prevent The bleeding of blood vessel in abdomen area；And continue the surgical technic.

Optionally, the predetermined period is equal at least about 30 seconds.

Optionally, it is applied during the surgical procedures technology electro photoluminescence at least 10 seconds.

Optionally, the electro photoluminescence is applied during the remainder before starting the surgical technic and in operation.

Optionally, at least one described electrode configuration in the abdomen area hold in range be 1 to 7 day period, And wherein the electro photoluminescence is applied after surgery to treat postoperative hemorrhage.

Subject description discloses use at least one electrode with impulse generator telecommunication to treat the dynamic of patient's upper limb The method of bleeding in arteries and veins or vein, which comprises will at least one described electrode arrangement close to patient's artery or quiet At the position on arteries and veins surface, wherein the artery be subclavian artery, axillary artery, deep brachial artery, arteria brachialis, radial artery, ulnar artery, Arcus volaris profundus, at least one of arcus volaris superficialis or the vein be subclavian vein, axillary vein, cephalic vein, brachial vein, radial vein, At least one of ulnar veins, arcus volaris profundus, arcus volaris superficialis, basilic vein, median basilic vein and vena mediana antebrachii, and wherein institute Rheme sets the position upstream at least 1cm in the expected bleeding；And generate the impulse generator by least one electricity Pole is administered to the electro photoluminescence of the artery or the vein, wherein the electro photoluminescence have the pulse duration, pulse amplitude and Pulse frequency, and the pulse duration, the pulse amplitude and the pulse frequency are wherein selected, so that the electricity thorn Swash the vessel retraction effectively caused in the artery or the vein.

Pulse duration may range from 1 μ sec to 500msec, and pulse amplitude may range from 1V to 250V, and Pulses range can be 1Hz to 100kHz.

Optionally, radio frequency (RF) receiver is coupled at least one described electrode, and RF transmitter is coupled to institute State impulse generator and wirelessly communicated with the RF receiver, and this method further include generate the impulse generator will be by It the electro photoluminescence of described at least one electrode application and the electro photoluminescence is wirelessly transmitted to the RF from the RF transmitter connects Receive device.

Optionally, this method further includes using being operably connected to the microprocessor of the impulse generator with selectivity The pulse duration, the pulse amplitude and the pulse frequency are set.

This specification, which is also disclosed, treats patient's lower limb using at least one and impulse generator with the electrode of telecommunication Artery or vein in bleeding method, which comprises will at least one described electrode arrangement close to the patient Artery or vein surface position at, wherein the artery is that femoral artery, popliteal artery, anterior tibial artery, posterior tibial artery, calf are dynamic At least one of arteries and veins, arteria dorsalis pedis and vola or the vein be vena iliaca externa, femoral vein, perforating veins, great saphenous vein, small hidden At least one of vein, anterior tibial veins, posterior tibial veins and dorsal venous arch of foot, and wherein the position in the expected bleeding Position upstream at least 1cm；And it generates the impulse generator and the artery or institute is administered to by least one electrode The electro photoluminescence of vein is stated, wherein the electro photoluminescence has pulse duration, pulse amplitude and pulse frequency, and is wherein selected The pulse duration, the pulse amplitude and the pulse frequency so that the electro photoluminescence effectively cause the artery or Vessel retraction in the vein.

Optionally, at least one described electrode is cuff electrode or clamper electrode, and arranges at least one described electrode Including the cuff electrode or the clamper electrode are positioned to be physically contacted with the position.

This specification also discloses the method prevented before the surgical procedures of plan or treat the bleeding in patient, the party Method includes: to start to perform the operation in the abdomen area of the patient；The bleeding formation before by stimulating apparatus at least one Electrode arrangement is at the blood vessel upstream in the abdomen area and to the position of the blood vessel telecommunication of the blood vessel blood supply；By institute It states at least one electrode and is connected to electric pulse generator；Bleeding is identified during the surgical procedures；And make impulse generator The electro photoluminescence for being applied to upstream blood vessel is generated, wherein electro photoluminescence has pulse duration, pulse amplitude and pulse frequency, and The pulse duration, the pulse amplitude and the pulse frequency are wherein selected, so that the electro photoluminescence effectively causes institute It states the vessel retraction of upstream blood vessel and reduces blood flow to prevent or control the bleeding of blood vessel involved in abdomen area.It is described Impulse stimulation can apply at least 30 seconds before such bleeding episodes, to reduce the frequency or severity of such bleeding.

Optionally, at least one electrode is cuff electrode or clamper electrode, and arranges that at least one described electrode includes The cuff electrode or the clamper electrode are positioned to be physically contacted with the position.

This specification also discloses the method for the bleeding in the organ for the treatment of patient, this method comprises: stimulation is filled At least one electrode arrangement set is by the proximad artery of organ blood supply, from described in the vein of organ blood supply, supply The wall of the nerve or the organ of artery or the vein；At least one described electrode is connected to electric pulse generator； And it generates impulse generator and artery, vein, nerve or the organ is administered to by least one described electrode The electro photoluminescence of wall, wherein the electro photoluminescence effectively causes vessel retraction and is reduced to the blood flow of the organ.Appoint Selection of land, the electrode of stimulating apparatus with to organ blood supply artery, from the vein of organ blood supply, the supply artery or The wall telecommunication of the nerve of the vein or the organ.

Electro photoluminescence can have the pulse vibration that range is the pulse duration of 1 μ sec-500msec, range is 1V-250V The pulse frequency that width and range are 1Hz-100kHz.

Optionally, electrode is cuff electrode or clamper electrode, and is close to artery, quiet by least one electrode arrangement Arteries and veins, the supply artery or the nerve of the vein or the wall of the organ include by the cuff electrode or the pincers Position electrode is positioned to the physical contact with the artery, vein, nerve or wall.

Optionally, device also includes the microprocessor for being operably connected to impulse generator, and at least the one of moderate stimulation A parameter is controlled by microprocessor, and wherein the method also includes using microprocessor to control the impulse generator to produce Raw electro photoluminescence.

This specification also discloses the method adjusted to the blood flow of patient organ, this method comprises: device is provided, it should Device includes at least one electrode for being operably connected to impulse generator；At least one electrode is positioned to supply with to organ The artery of blood from the vein of organ blood supply or supplies the neural telecommunication of the artery or the vein；And make pulse generation Device generates the electro photoluminescence that artery, vein or nerve are administered to by least one electrode, and wherein electro photoluminescence is effectively adjusted to organ Blood flow.

Stimulation can be effectively for shrinking artery or vein.

Optionally, which further includes the microprocessor for being operably connected to impulse generator, and moderate stimulation is at least One parameter is controlled by microprocessor, and wherein the method also includes use microprocessor control the impulse generator with Generate electro photoluminescence.

This specification also discloses the method adjusted to the blood flow of patient organ, this method comprises: device is provided, it should Device includes at least one electrode for being operably connected to impulse generator；By at least one electrode and organ walls telecommunication； And stimulus generator is set to generate the electro photoluminescence applied near wall by least one electrode, wherein electro photoluminescence is effectively adjusted and arrived The blood flow of organ.

Stimulation effectively can shrink or expand one or more blood vessels in organ walls, to change through the blood vessel Blood flow.

Optionally, radio frequency (RF) receiver is coupled at least one described electrode, and RF transmitter is coupled to institute It states impulse generator and is wirelessly communicated with the RF receiver, and the method also includes wanting the impulse generator generation By at least one described electrode application electro photoluminescence and the electro photoluminescence is wirelessly transmitted to the RF from the RF transmitter The step of receiver.

Optionally, device further includes the microprocessor for being operably connected to impulse generator, and at least the one of moderate stimulation A parameter is controlled by microprocessor, and wherein the method also includes using microprocessor to control the impulse generator to produce Raw electro photoluminescence.

This specification also discloses the method for controlling organotropic blood flow comprising following steps: by least one Electrode arrangement is the nerve close to artery, vein or Nutrient artery and vein, and activates the electrode to provide it electro photoluminescence, Wherein the electro photoluminescence effectively controls organotropic blood flow.

This specification also discloses the method for controlling organotropic blood flow, comprising the following steps: by least one electricity Pole is placed adjacent to the artery to organ blood supply, from the vein of organ blood supply or supplies the nerve of the artery or the vein, And activate the electrode to provide it the first electro photoluminescence, wherein first electro photoluminescence effectively reduces organotropic blood flow To prevent bleeding and activate the electrode to provide it the second electro photoluminescence, wherein second electro photoluminescence stimulation effectively reduce to The blood flow of organ is to treat bleeding.

This specification also discloses the method for prevention intraoperative hemorrhage, comprising the following steps: in artery, vein or Nutrient artery At least one electrode is arranged near the nerve of vein or with the nerve electrical contact of artery, vein or Nutrient artery and vein, and Activate the electrode to provide it electro photoluminescence, wherein the electro photoluminescence effectively controls the blood flow in artery or vein.

This specification also discloses the method for the treatment of intraoperative hemorrhage, comprising the following steps: is by least one electrode arrangement Close to the nerve of artery, vein or Nutrient artery and vein, and activate the electrode to provide it electro photoluminescence, wherein the electricity Blood flow in stimulation effectively control artery or vein.

This specification also discloses the method for generating the electric signal for being used for vascular stimulation, this method comprises: identification is suffered from The first electro photoluminescence threshold of reaction that person's medium vessels are shunk；Identify second threshold of reaction of thrombosis in patient；And electricity consumption is pierced Energizing signal electro photoluminescence blood vessel structure, the electrical stimulation signal are lower than second threshold of reaction of the thrombosis of the identification and are higher than Vasoconstrictive first threshold of reaction, so that stimulation generates advantage of the vessel retraction relative to thrombosis.

This specification also discloses the method that the blood flow of organ is arrived in control, by carrying out as follows: by stimulating apparatus At least one electrode arrangement at the neural or described organ with artery, vein, Nutrient artery or vein wall telecommunication； At least one described electrode is connected to electric pulse generator；And generate impulse generator by least one described electrode It is administered to the electro photoluminescence of the wall of the artery, vein, nerve or organ, wherein the electro photoluminescence effectively changes to the body The blood flow of body organ, wherein blood flow maintains at least 1 minute after electro photoluminescence stopping.

Above-mentioned general introduction of the invention is not intended to describe disclosed embodiment each of of the invention or every kind of embodiment. Exemplary implementation scheme is more particularly exemplified in following description.However, other than the embodiment that those are expressly recited Embodiment is possible, and can be identical or different with the environment and/or condition of combination exemplary implementation scheme description Environment and/or under the conditions of carry out, use and/or implementation.In the several places entirely applied, referred to by the offer of a collection of example It leads, the example can be applied in combination with various.In each case, cited list functions only as representative group, and not It should be interpreted that exclusiveness list.

The foregoing and other embodiment party of this specification will be described in the attached drawing and detailed description being presented below deeper into ground Case.

Brief description

It will be further understood that these and other features and advantages of the present invention, because when considered in conjunction with the accompanying drawings, passing through ginseng Detailed description is examined, they will become better understood:

Fig. 1 is the schematic diagram of a part of mesenteric system.

Fig. 2 is the schematic diagram for the exemplary electrode group being implanted into arteria coeliaca.

Fig. 3 is the schematic diagram for the exemplary electrode group being implanted into dorsal mesentery blood vessel.

Fig. 4 is the schematic diagram for the exemplary electrode group being implanted into mesenterium ventrale blood vessel.

Fig. 5 is the schematic diagram for the exemplary infusion system being implanted into mesenterium circulation.

Fig. 6 shows the exemplary form and configuration of electrode used in method disclosed herein；

The figure that Fig. 7 A describes shows that the Femur blood vessel of the response stimulation of the function as standardized diameter and pulse amplitude is received Contracting；

The figure that Fig. 7 B describes shows the Femur blood vessel of the response stimulation as the function in pulse amplitude and pulse duration Contraction；

The figure that Fig. 7 C describes shows the mesenterium of the response stimulation as the function in pulse amplitude and pulse duration The contraction of blood vessel；

The figure that Fig. 8 A is shown is shown in application and does not apply the blood loss from femoral artery in the case where electro photoluminescence.

The figure that Fig. 8 B is shown shows the blood loss from mesenteric artery in the case where applying and not applying electro photoluminescence.

The figure that Fig. 8 C is shown shows the vessel retraction when electro photoluminescence for applying 100 μ sec under the frequency of 10Hz.

The figure that Fig. 8 D is shown shows vessel retraction when applying electro photoluminescence 1msec under the frequency of 10Hz.

Fig. 9 A shows the artery site that the electrode for corresponding to the organ performed an operation applies；

Fig. 9 B shows the intravenous regional that the electrode for corresponding to the organ performed an operation applies；

Figure 10 A shows electric according to the exemplary card skin for providing electro photoluminescence of the various embodiments of this specification Pole；

Figure 10 B is shown according to the various embodiments of this specification for providing another exemplary card of electro photoluminescence Skin electrode；

Figure 10 C is shown according to the various embodiments of this specification for providing another exemplary card of electro photoluminescence Skin electrode；

Figure 10 D is shown according to the various embodiments of this specification for providing another exemplary card of electro photoluminescence Skin electrode；

Figure 11 shows the exemplary pincers of the various embodiments according to this specification being used for blood vessel offer electrical analogue Position electrode；

Figure 12 shows the embodiment according to this specification, for clamper electrode to be applied to the laparoscopic forceps of blood vessel (laparoscopic forcep)。

Figure 13 A shows the embodiment according to this specification, the electricity for being placed in endovascular laparoscope conduit Pole；

Figure 13 B shows the embodiment according to this specification, stretches out from the conduit of laparoscope endovascular to be placed on Expansion electrode (expanded electrode)；

Figure 14 A shows the embodiment according to this specification, the blood vessel pierced through by conduit, which has arrangement internal Stimulating electrode；

Figure 14 B shows that the conduit of Figure 14, electrode are stretched out from conduit；

Figure 14 C shows the electrode of the Figure 14 contacted with blood vessel；

Figure 14 D shows the electrode for being wired to Figure 14 of implantable impulse generator；

Figure 14 E shows the embodiment according to this specification, is applied to the electricity in people's leg with the femoral artery of obstruction Stimulation；

Figure 14 F shows the embodiment according to this specification, the artery applied after the arterial vasoconstriction in people's leg Implantation material；

Figure 14 G shows the artery and venous structures of blood vessel in people's leg；

Figure 14 H shows the embodiment according to this specification, and the conduit with expansible electrode, the expansible electrode covers Lid is located in endovascular expandable balloon (balloon)；

Figure 14 I show extend from conduit and the electrode of Figure 14 H expanded due to expansion/expansion of intravascular balloon and Sacculus；

Figure 14 J shows the electrode for being wired to Figure 14 H of implantable impulse generator；

Figure 15 A shows the embodiment according to this specification, and electro photoluminescence is to the application of uterine artery to prevent uterus from going out Blood；

Figure 15 B shows the embodiment according to this specification, and electro photoluminescence is to the application of uterine wall to prevent uterine hemorrhage；

Figure 15 C is shown according to the electro photoluminescence of another embodiment of this specification to the application of uterine cavity wall to prevent Uterine hemorrhage.

Figure 15 D shows the embodiment according to this specification, the expandable balloon conduit with expansible electrode, described Expansible electrode is for controlling bleeding.

Figure 16 shows the embodiment according to this specification, the method for treating tumour by applying electro photoluminescence；

Figure 17 A shows the section of people's liver；

Figure 17 B shows the leaf of people's liver；

Figure 17 C shows the embodiment according to this specification, controls liver bleeding by applying electro photoluminescence；

Figure 17 D shows going out by applying electro photoluminescence to control liver according to another embodiment of this specification Blood；

Figure 18 A is shown according to the embodiment of this specification for electrode cable to be maintained at endovascular anchor Fixed (anchor)；

Figure 18 B is shown according to another embodiment of this specification for electrode cable to be maintained at endovascular Anchoring；

Figure 19 A shows the embodiment according to this specification, operation device, and the operation device, which has, can be used as pincers behaviour The hinged jaw (articulating jaw) of operation, from the tip inlets of the endoscopic catheters close to the blood vessel with bleeding It is prominent；

Figure 19 B shows the electro photoluminescence that blood vessel is applied to by the hinged jaw of Figure 19 A；

Figure 20 A shows the embodiment according to this specification, for being implanted into active or passive and wireless microdevice with will be electric Stimulation is delivered to the intracorporal position of people of blood vessel；

Figure 20 B shows the embodiment according to this specification, plants for electro photoluminescence to be delivered to the exemplary of blood vessel Enter microdevice；

Figure 20 C shows the embodiment according to this specification, for activating the microdevice of implantation to deliver electro photoluminescence To the exemplary hand held remote control device of blood vessel；

Figure 20 D is shown according to another embodiment of this specification for activate the microdevice of implantation with by electricity thorn Swash another exemplary hand held remote control device for being delivered to blood vessel；

Figure 20 E shows the embodiment according to this specification, plants for electro photoluminescence to be delivered to the exemplary of blood vessel Enter microdevice；

Figure 20 F shows the embodiment according to this specification, can plant micro- dress for what electro photoluminescence was delivered to blood vessel The exemplary circuit diagram set；

Figure 20 G is shown according to another embodiment of this specification for electro photoluminescence to be delivered to the another of blood vessel The exemplary implantable microdevice of kind；

The flow chart of Figure 21 shows the embodiment according to this specification, adjusts blood by applying electro photoluminescence to blood vessel The dynamic step of liquid stream.

Figure 22 A shows the embodiment according to this specification, in patient's upper limb blood vessel provide stimulation to control The bleeding in stimulation location downstream；

Figure 22 B shows the stimulation of another embodiment according to this specification provided the blood vessel in patient's upper limb To control the bleeding in stimulation location downstream；

Figure 23 shows the embodiment according to this specification, is pierced to the stimulation that the blood vessel in patient's lower limb provides with controlling Swash the bleeding in position downstream；

Figure 24 shows the embodiment according to this specification, is pierced to the stimulation that the blood vessel in patient abdomen provides with controlling Swash the bleeding in position downstream；

The flow chart of Figure 25 shows the embodiment according to this specification, is applied by the blood vessel to bleeding part upstream Electro photoluminescence come control patient upper limb or lower limb bleeding the step of；

The flow chart of Figure 26 A shows an embodiment according to this specification, by possible bleeding part The step of blood vessel of trip applies electro photoluminescence to prevent and/or control patient's bleeding during abdominal operation.

The flow chart of Figure 26 B shows the embodiment according to this specification, by possible bleeding part upstream Blood vessel applies electro photoluminescence to prevent the step of being expected bleeding during abdominal operation in patient；With

The flow chart of Figure 27 shows the embodiment according to this specification, on a skin surface simultaneously by stimulation location positioning The step of electro photoluminescence is to control bleeding is provided.

Detailed description of the invention

The present invention provides the methods for the treatment of stomach and intestine (GI) illness.In general, treatment is related to by adjusting through gastrointestinal tract group It knits with the blood flow of organ and controls the function of gastronintestinal system.In general, passing through the blood vessel of the opposite direction road GI blood supply or controlling those The nerve of blood vessel applies stimulation to realize the control to the blood flow by the road GI.

This specification is related to multiple embodiments.Following disclosure is provided so that those of ordinary skill in the art can be real Apply the present invention.Language used in this specification should not be construed as the general negation to any one specific embodiment, or For limiting meaning of the claim beyond term used in it.Without departing from the spirit and scope of the present invention, Generic principles defined herein can be applied to other embodiments and application.In addition, used term and wording be for The purpose of exemplary implementation scheme is described, and is not considered as restrictive.Therefore, the present invention will be endowed widest model It encloses, covers and the consistent many replacements of disclosed principle and feature, modification and equivalent.For the sake of clarity, without detailed The details of known technologic material in technical field related to the present invention is described, in order to avoid unnecessarily obscure the present invention.

" treatment ", " processing " and its modification refer to the degree of one or more symptom or signs relevant to situation, frequency or Any reduction of severity.

" duration " and its modification refer to (no matter treat because situation is able to dissipate and terminate or control from start to end Treat stop for any reason) predetermined treatment time course.During treatment, it can specify that multiple treatment phases, in this phase Between to subject application it is one or more as defined in stimulation.

" period " refers to the time for the stimulation " dosage " that a part as defined treatment plan is applied to subject.

Term "and/or" refers to any two or more groups in one or all or institute's column element in institute's column element It closes.

In the description and claims of this application, each of word "comprising", " comprising " and " having " and Its form is not necessarily limited to and the member in the possible associated list of word.Herein it should be noted that unless expressly stated otherwise, tying Any feature or component for closing specific embodiment description can be used together and execute with any other embodiment.

Unless otherwise stated, "one", "an", " should/described ", "/kind or more/kind " and " at least one/ Kind " it is used interchangeably and indicates/kind or more than/kind.

For any method disclosed herein including discrete step, step can be carried out in any workable order.And And in due course, any combination of two or more steps can be carried out simultaneously.

In addition, herein, by endpoint describe numberical range include include in the range it is all number (for example, 1 It include 1,1.5,2,2.75,3,3.80,4,5 etc. to 5).Unless otherwise stated, use in the specification and in the claims Indicate that all numbers of group component, molecular weight etc. should be understood as being modified by term " about " in all cases.Therefore, unless Separately there is opposite explanation, the numerical parameter listed in the specification and in the claims is approximation, can be sought according to the present invention It seeks the desirable properties of acquisition and changes.At least and it is not intended to for doctrine of equivalents to be limited to the range of claims, every number Value parameter should at least be explained according to the number of the effective digital of report and by the common rounding-off technology of application.

Although illustrating that broad range of numberical range and parameter of the invention are approximation, the number listed in specific example Value is reported as accurately as possible.However, all numerical value inherently contain the inevitable standard deviation by finding in its each self-test measurement The range that difference generates.

Appetite regulation

Mesenterium blood supply is important the normal function performance of gastronintestinal system, and for all nutrients Digestion is important.The digestion of various nutrients, including fat digestion can be damaged by interrupting mesenteric supply, therefore can be with Facilitate the situation of management overnutrition, including such as obesity.

Various views referring now to the drawings.Fig. 1 shows a part in the road stomach and intestine (GI), including arteria coeliaca 11, intestines It is quiet under artery 12, inferior mesenteric artery 13, internal iliac artery 16, arteria iliaca externa 17, superior mesenteric vein 18 and mesenterium on mesentery Arteries and veins 19.As used herein, term " mesenteric artery " system refers to arteria coeliaca 11, superior mesenteric artery 12 and inferior mesenteric artery 13.In addition, term " mesenteric vein " system mesoduodenum upper vein 18 and inferior mesenteric vein 19.

Mesenteric artery constitutes the major arteries blood supply of gastronintestinal system, and mesenteric vein is constituted from gastronintestinal system The Major Systems of blood are discharged.Blood flows in and out the flowing of gastronintestinal system by flat in the blood vessel of mesenteric system The nervous control shunk and relax of sliding flesh.Blood flow under fasting state maintains the vigor of gastrointestinal tract.Under in the eating state, The work of gastrointestinal tract increases, and needs to the oxygen of gastronintestinal system and the demand of nutrients to increase accordingly.By increasing to stomach The blood supply (pass through expansion mesenteric artery realize) of enteron aisle meets the increased demand to oxygen and nutrients.After feed This phenomenon for increasing gastrointestinal tract energy requirement is known as the specific dynamic effect of food.In the case where dehydration or bleeding, blood from Gastrointestinal tract is diverted to other vitals.Such reduction to the blood supply of gastrointestinal tract is real by the contraction of mesenteric artery It is existing.Due to such as atherosclerosis arterial disease in mesenteric artery have obstruction subject be likely difficult to increase to The blood supply of gastrointestinal tract, this is required for postprandial processing and digestion food.These subjects can form pain, appetite lacks Weary and weight loss.

Method described herein is related to controlling the appetite of subject, inducing satiety and/or induction weight loss, via Stimulate mesenteric system and/or supply mesenteric system nerve, by adjust to enteron aisle blood flow and It is carried out more particularly through the specific dynamic effect (increase induced to the diet of the blood supply of gastrointestinal tract) for adjusting food.

Method described herein also can be applied to treat certain cardiovascular status or indication, including angina pectoris, chest Tighten (chest tightening), unstable angina, stable angina pectoris, coronary artery disease, atherosclerosis Disease, heart failure or myocardial infarction.By reduction to the blood flow of enteron aisle and more particularly through minimum due to food Increase caused by the specific dynamic effect of object to the blood flow of gastrointestinal tract, the present invention may also help in the above-mentioned painstaking effort tubulose for the treatment of Condition.Specifically, the blood flow reduced in the mesenterium circulation or peripheral circulation of patient increases coronary artery circulation or Brain circlulation In blood flow, to reduce or eliminate symptom relevant to above-mentioned illness.

In order to reduce the blood flow to gastrointestinal tract of diet induction, by electricity, chemistry or the machine of effective treatment gastrointestinal condition Tool stimulation is applied to arteria coeliaca 11, superior mesenteric artery 12, inferior mesenteric artery 13, internal iliac artery 16, arteria iliaca externa 17, intestines Mesentery upper vein 18 or inferior mesenteric vein 19 or supply arteria coeliaca 11, superior mesenteric artery 12, inferior mesenteric artery 13, Internal iliac artery 16, arteria iliaca externa 17, superior mesenteric vein 18 or inferior mesenteric vein 19 neuropeptide 11 5 in one or more targets Position.As used herein, the stimulation of " effectively treatment gastrointestinal condition " includes being enough to cause to move on such as arteria coeliaca 11, mesenterium In arteries and veins 12, inferior mesenteric artery 13, internal iliac artery 16, arteria iliaca externa 17, superior mesenteric vein 18 or inferior mesenteric vein 19 The stimulation of the contraction of at least one or more, so that reducing blood flows into gastrointestinal tract.

Gastrointestinal function, such as digestion and absorption nutrients, such as fat can be interrupted to the reduction of the blood flow of gastrointestinal tract. Due to patient intake and therefore stimulate target position when caused by discomfort, stimulation can cause inhibit subject's appetite and/or Induce satiety, anorexia and/or the weight loss in subject.Therefore, in certain embodiments, " effectively treatment stomach and intestine shape The stimulation of condition " may include stimulation, can for example inhibit subject appetite and/or induction subject in satiety, detest Food and/or weight loss.In other embodiments, the stimulation of " effectively treatment gastrointestinal condition " may include that effective treatment is fat The secondary situation of disease, such as diabetes, hypertension, heart attack, apoplexy, dyslipidemia, sleep apnea, gram Brunswick (Pickwickian) syndrome, asthma, lower waist and disc disease, hip, knee, ankle and the weight bearing osteoarthritis of foot, thrombotic are quiet Arteries and veins inflammation and pulmonary embolism, intertrigo dermatitis, stress incontinence, gastro-esophageal reflux disease (GERD), cholelith, hardening, liver cancer, infertility (infertility), the stimulation of uterine cancer and/or breast cancer.

In one embodiment, at least one electrode group is placed on arteria coeliaca 11, superior mesenteric artery 12, intestines system Artery 13, internal iliac artery 16, arteria iliaca externa 17, superior mesenteric vein 18 or inferior mesenteric vein 19 or arteria coeliaca 11 under film Branch, superior mesenteric artery 12, inferior mesenteric artery 13, internal iliac artery 16, arteria iliaca externa 17, superior mesenteric vein 18 or intestines system In mesenterium circulation under film near one or more of vein 19.Each electrode group includes at least one active electrode (active electrode) and at least one grounding electrode (ground electrode).Electrode group can be to arteria coeliaca 11, superior mesenteric artery 12, inferior mesenteric artery 13, internal iliac artery 16, arteria iliaca externa 17, superior mesenteric vein 18 or mesenterium The branch of lower vein 19 or arteria coeliaca 11, superior mesenteric artery 12, inferior mesenteric artery 13, internal iliac artery 16, arteria iliaca externa 17, superior mesenteric vein 18 or inferior mesenteric vein 19 generate any mode of desired stimulation, for example, circular pattern, along the longitudinal axis, Scramble pattern or other positions arrangement.

In preferred embodiments, the branch of arteria coeliaca or arteria coeliaca itself or with other at least one blood vessel knots Structure combination is stimulated.In another preferred embodiment, arteria coeliaca or abdominal cavity are stimulated with SMA or SMA branch combination Arterial branch.In another preferred embodiment, while or with the combination of stimulation of predetermined order or both at least Two kinds of blood vessel structures, such as artery, vein or nerve relevant to artery or vein.Predefined sequence can be for quickly or slowly Continuously.

Fig. 2 shows an embodiment, wherein by electrode group 21 with the placement of loose lineament in arteria coeliaca 11. Device comprising impulse generator 26 transmits signal, which makes electrode group 21 deliver electro photoluminescence to arteria coeliaca 11.By device 26 are connected to for providing the power supply 28 of power supply.Device 26 is further connected to electrode group 21 by line (wire) 20 with will be electric Stimulus signal is transferred to electrode group 21.Alternatively, electrode group 21 can be used radio frequency (RF) connection, ultrasound connection, be thermally connected, magnetic company It connects, electromagnetism connection or light connects are wirelessly coupled to device 26.Stimulate arteria coeliaca 11 that can induce by electrode group 21 The vessel retraction of arteria coeliaca 11, this can then reduce the blood supply to upper gastrointestinal tract.On January 25th, 2009 beauty submitted State's Patent Application Serial No.12/359,317 (it is incorporated herein by reference in its entirety) can be used for this hair disclosed herein Bright all embodiments.

In some embodiments, stimulator device 26 can be by such as medical professional, nursing staff or subject Triggering manually.Alternatively, one group of sensing electrode 24 can detecte physiological parameter relevant to dining generate signal together with to abdomen Chamber artery 11 deliver electro photoluminescence, this can cause diet induce abdominal cavity vessel retraction, thus inhibit subject appetite and/or Induce anorexia, satiety and/or the weight loss of subject.Example physiological parameter is identified below.

Fig. 3 shows another embodiment, wherein electrode group 21 is placed on superior mesenteric artery 12 or mesenterium On one of vein 18.The first and second power supplys 38,38 ' will be connected to comprising the first and second devices of impulse generator 36,36 ' To provide power supply.As previously mentioned, device 36,36 ' is further connected to electrode group 21 by line 30.Alternatively, electrode group 21 can To be wirelessly coupled to device 36,36 ', as previously described.Stimulating electrode 21 can stimulate superior mesenteric artery 12 to cause 12 vessel retraction of superior mesenteric artery or stimulation superior mesenteric vein 18 cause superior mesenteric vein vessel retraction, thus reduction pair The blood supply of gastronintestinal system middle section.

In some embodiments, stimulator device 36,36 ' can by such as medical professional, nursing staff or by Examination person triggers manually.Alternatively, one group of sensing electrode 34 can detecte physiological parameter relevant to dining together generate signal with Cause 18 vessel retraction of superior mesenteric artery 12 or superior mesenteric vein, and reduces and the blood of gastronintestinal system middle section is supplied It answers.This can be with inducing satiety feel, satiety and/or appetite stimulator.

Fig. 4 shows another embodiment, wherein electrode group 21 is placed under inferior mesenteric artery 13 or mesenterium In one of vein 19.First device comprising impulse generator 46 is connected to and is used to provide the power supply 48 of power supply.As previously mentioned, Device 46,46 ' further can be connected to electrode group 21 by line 40.Alternatively, electrode group 21 can be wirelessly coupled To device 46,46 '.Device 46, one of 46 ' can control an electrode group 21.Alternatively, device 46, one of 46 ' can control it is super Cross an electrode group.Stimulating electrode 21 can stimulate inferior mesenteric artery 13 or inferior mesenteric vein 19, cause vessel retraction, and Reduce the blood supply to lower gastronintestinal system.

In some embodiments, stimulator device 46,46 ' can by such as medical professional, nursing staff or by Examination person triggers manually.Alternatively, one group of sensing electrode 44 can detecte physiological parameter relevant to diet together generate signal with Cause the delivering of electro photoluminescence, which can cause the vessel retraction of inferior mesenteric artery 13 or inferior mesenteric vein 19, and And blood supply of the reduction to lower gastronintestinal system.

In above-mentioned each embodiment, reduced (either into such as such as Fig. 2 to the blood supply of stomach and intestine (GI) system The upper GI system described, the intermediate GI system described in such as such as Fig. 3 or the lower GI system described in such as such as Fig. 4) it can be with Inhibit the appetite of subject and/or induces anorexia, satiety and/or the weight loss of subject.In one embodiment, if The average calorie daily, weekly, monthly, quarterly or every year of history relative to patient absorbs, patient's intake few 5% or more The calorie of (such as 10%, 20%, 30%, 40%, 50%, 60%, 70% etc.), then it is assumed that inhibit the appetite of subject or lure Lead satiety.In another embodiment, if the history relative to patient is average daily, weekly, monthly, quarterly or every year Calorie intake, threshold number of patient's intake lower than maximum calorie, then it is assumed that inhibit the appetite of subject or the full abdomen of induction Sense, wherein defining the threshold number of maximum calorie based on the desired weight loss goal of patient.In another embodiment In, if subject mitigated subject it is overweight at least 30% (by subtracting target weight from the Current body mass of subject To calculate), then subject causes sizable weight loss.In another embodiment, if subject mitigated it is tested At least 10% or more (being calculated by subtracting target weight from the Current body mass of subject) that person is overweight, then subject draws Play sizable weight loss.

Also in each embodiment, electrode group 21 can provide about 1 microampere (μ Amp) to the electro photoluminescence of about 100Amp, but It is that method described herein can be implemented by providing the electro photoluminescence except the range.In general, the amplitude of electro photoluminescence can be About 1 milliampere of (mAmp)-about 10Amp.In some embodiments, electro photoluminescence can be less than about 10Amp, such as be less than 1Amp.In certain embodiments, the amplitude of electro photoluminescence can be about 5mAmp to about 100mAmp, such as 10mAmp.And And certain treatments may include any combination of multiple electro photoluminescence with various amplitude.

Electro photoluminescence " dosage " can be accomplished continuously or intermittently provided.For example, electro photoluminescence can be provided once, electricity can be continuously provided Stimulation reaches the defined period, or can be within the defined period with a series of offer of intermittent stimulations.The defined period can be Such as about 1 millisecond (msec) to about 1 hour.Intermittent electricity thorn can be provided with regularly specified interval in treatment phase Swash.For example, the intermittent electro photoluminescence that length is 1 second can be provided, continue such as 1 hour.In other cases, can " according to Need " intermittent electro photoluminescence is provided.In addition, certain treatments may include provided by any combination of different treatment phases it is multiple Electro photoluminescence.

Electro photoluminescence can have any mode necessary to generate expected result, including square, rectangle, sinusoidal or sawtooth Shape.In addition, certain treatments may include a variety of electro photoluminescence, including any mode combinations.

The frequency of electro photoluminescence can in the range of about 1 micro- hertz (μ Hz) is to about 1 megahertz (MHz), while characterized as Method can be implemented by the electro photoluminescence of frequency of administration outside this range.In general, electro photoluminescence can have about 1mHz extremely The frequency of about 1MHz, the frequency of such as about 0.1Hz to about 10Hz.It in certain embodiments, can be with the frequency of about 1Hz Apply electro photoluminescence.In addition, certain treatments may include a variety of electro photoluminescence, including any combination of frequency.

The electrode of electrode group 21 can be placed on to arteria coeliaca 11, superior mesenteric artery 12, inferior mesenteric artery 13, ilium Interior artery 16, arteria iliaca externa 17, superior mesenteric vein 18 and/or inferior mesenteric vein 19 endangium, tunicae media vasorum, blood vessel In outer membrane and/or outer membrane.Alternatively, the electrode of electrode group 21 can be placed on supply arteria coeliaca 11, superior mesenteric artery 12, Inferior mesenteric artery 13, internal iliac artery 16, arteria iliaca externa 17, superior mesenteric vein 18 and/or inferior mesenteric vein 19 or abdominal cavity Artery 11, superior mesenteric artery 12, inferior mesenteric artery 13, internal iliac artery 16, arteria iliaca externa 17, superior mesenteric vein 18 and/ Or on the neuropeptide 11 5 of the branch of inferior mesenteric vein 19.Alternatively, the electrode of electrode group 21 can be placed on supply arteria coeliaca 11, superior mesenteric artery 12, inferior mesenteric artery 13, internal iliac artery 16, arteria iliaca externa 17, superior mesenteric vein 18 and/or intestines Under mesentery on the neuropeptide 11 5 of vein 19.The number of the electrode number in group for treating particular condition and electrode group can be by To factor, such as the size of electrode, defined stimulation amplitude, frequency and/or mode and desired placement region is big Small influence.

Fig. 6 shows exemplary electrode design, configuration and arrangement, including for example loose linear 6A, blood vessel exterior loop 6B, patch Piece 6C, blood vessel interior loop 6D, hook-type 6E and circumference 6F electrode.

Electro photoluminescence can be triggered by the transmitter of human external, and the transmitter is similar to the remote transmission of pacemaker Device.By stimulation amplitude appropriate, frequency and mode and treatment phase appropriate and duration, can treat such as fat The gastrointestinal disease of disease is without causing permanent damage to surrounding tissue or organ.

Fig. 5 shows another embodiment, wherein infusion catheter 51 is placed on arteria coeliaca 11, superior mesenteric artery In one or more of 12 or superior mesenteric vein 18, for delivering chemical stimulation rather than electro photoluminescence.It will include infusion pump 56 device is connected to reservoir (reservoir) 58, and the reservoir 58 can supply vasoactive or neural activity chemistry Substance.Vasoactive or neural activity chemical substance can be delivered to arteria coeliaca 11, superior mesenteric artery by infusion catheter 51 12 or one of superior mesenteric vein 18 or inferior mesenteric vein 19, to modify to gastrointestinal tract and/or from the blood stream of gastrointestinal tract It is dynamic.This can lead to stomach and intestine ischemic or hyperemia.

Fig. 5 also shows an embodiment, wherein infusion catheter 53 is placed on inferior mesenteric artery 13 or mesenterium In one or more of lower vein 19 to deliver chemical stimulation rather than electro photoluminescence.Device comprising infusion pump 55 is connected to Reservoir 57, the reservoir 57 can supply vasoactive or neural activity chemical substance.Infusion catheter 53 can be by blood vessel Activity or neural activity chemical substance are transported to one of inferior mesenteric artery 13 or inferior mesenteric vein 19, to modify inflow stomach and intestine Road and/or blood flow from gastrointestinal tract.This can lead to stomach and intestine ischemic or hyperemia.

Chemical stimulation " dosage " can be accomplished continuously or intermittently provided.For example, chemical stimulation can be provided once, can continuously mention For reach the defined period, or can within the defined period with a series of intermittent stimulations offer.The defined period can be all Such as example, about 0.1 μ L/hr to about 1L/min, such as 0.1-10 μ L/min.Can in treatment phase regularly to provide between Every the intermittent chemical stimulation of offer.For example, intermittent chemical stimulation can be with the rate of 0.1 μ L/min offer 30 minutes.At it It, can the intermittent chemical stimulation of offer " as needed " in the case of him.In addition, certain treatments may include by different treatment phases Any combination provide a variety of chemical stimulations.

In some embodiments, it delivers vasoactive or the signal of neural activity chemical substance can be special by such as medicine Industry personnel, nursing staff or subject trigger manually.Alternatively, one group of sensing electrode can detecte physiological parameter relevant to diet Generate signal together to cause the delivering of chemical stimulation, this can influence the blood supply to gastrointestinal tract.However, triggering is passed Send the vasoactive or neural activity chemical substance of vasoactive or the adjustable delivering of the signal of neural activity chemical substance The time and/or duration of volume, frequency and/or mode and chemical stimulation.Defined chemical stimulation can inhibit tested The appetite of person and/or anorexia, satiety and/or the weight loss for inducing subject.

Chemical stimulation can be triggered by the transmitter of human external, and the transmitter is similar to the long-range hair of pacemaker Emitter.By dosage appropriate, frequency and mode and treatment phase appropriate and duration, such as obesity can treat Gastrointestinal disease is without causing possible permanent damage to surrounding tissue or organ.

Over time, stimulation (either continuous or interval, either electric or chemistry) can be with For adjusting the smooth muscle of mesenteric system.It utilizes enough tension (tone), it is possible to reduce or eliminate further thorn Swash.Therefore, it is possible to use enterogastric diseases are successfully treated in the treatment of various durations.For example, certain situations can be used Single therapy successful treatment, and other situations can need more extended treatment, such as one week, 1 month, 6 weeks, 1 year, or Person in some cases, can need long-term (including for example lifelong) treatment.

With reference to Fig. 2 to Fig. 4, in some embodiments, device 26,36,46,56 can by microprocessor 22,32, 42,52 control.In some embodiments, microprocessor 22,32,42,52 can be operatively attached to signal generator simultaneously And it can be programmed in various treatment phases and/or control in the duration length of the electric signal generated by device 26,36,46,56 Degree, power and frequency.In other embodiments, microprocessor 22,32,42,52 can be operatively attached to pump, and can Be programmed in various treatment phases and/or controlled in the duration chemical signal generated by device 26,36,46,56 length, Volume and frequency.

In an exemplary embodiment, subject can be used remote control RF signal transduction device and issue meal ingestion Signal.Based on the desired weight loss of subject, the microprocessor being implanted into signal generation device can prolong in the preset time Multiple row pulse is sent after late.It weighs oneself in such as expectation 150 and mitigation and suggests that the male of daily 1000 calorie diets is tested In the case where person, the preset time for starting mesenteric stimulation be can be from 10 minutes for starting to feed.Typical stimulation ginseng Number can have the bursts (burst) of such as 6 rectangular pulses, and the rectangular pulse has the duration of such as 2msec Such as the pulse amplitude of 10mAmp.The duration of each of 6 pulses list bursts can be such as 200msec and have There is the frequency of 1 bursts for example per second.Train of pulse (pulse train) can be interrupted by the quiescent phase of such as 800msec. It polarizes again for example, quiescent phase can permit mesenteric musculature.Train of pulse can induce such as arteria coeliaca and intestines The contraction of artery on mesentery causes blood to flow to the physiology obstruction of stomach and intestines.This can cause uncomfortable and/or pain, cause by The early satiety and/or anorexia of examination person.

Stimulation can continue until that subject stops feed, and stimulation stops later.Alternatively, sensor can be implanted into stomach and intestine In road, perception food intake simultaneously triggers microprocessor, the microprocessor then trigger signal generator with to abdominal cavity and intestines Artery delivering stimulation on mesentery.Sensor also can detecte the end of intake and shutdown signal be transferred to microprocessor, described Microprocessor will then close stimulator.

Lasting heat limitation based on subject, the physician of subject can be used external remote and adjust stimulation mould Formula, without additional operation.After reaching desired weight loss, can remotely close stimulator, and if subject open Begin to restore weight, then it can be with Remote Open stimulator.

In certain embodiments, neural stimulation system can be used to implement in method described herein, and the nerve pierces Swashing system has at least one electrode group, at least one power supply and the extension that power supply is connected to electrode group.Electrode can collect At into conducting wire, wherein conducting wire is small conductor, wherein being integrated with more than one electrode.In one embodiment, it can be used Perform the operation implantation conducting wire, including for example 3587A RESUME II conducting wire, 3986RESUME TL conducting wire, 3998SPECIFY conducting wire, 3999Hinged SPECIFY conducting wire, 3982SYMMIX conducting wire and/or 3987On-Point PNS conducting wire (both are from Medtronic, Inc., Minneapolis, Minn.) or any other four polar conductor with plate electrode, the plate electricity Pole can create a variety of stimulation combinations in extensive cacesthesia region.

In one embodiment, device 26,36,36 ', 46,56 can be planting with Noninvasive programmability Enter battery powered nerve stimulator, such as ITREL 3, SYNERGY, SYNERGYPLUS⁺Or SYNERGYCOMPACT⁺ (both being from Medtronic, Inc., Minneapolis, Minn.).Alternatively, device 26,46 ', 55 includes radio frequency (RF) system, Its receiver that may include implantation, the receiver is from external power supply or transmitter such as MATTRIX transmitter (Medtronic, Inc., Minneapolis, Minn.) detects percutaneous radiofrequency signal.

In another embodiment, extension can be the small conductor of power electric connection to conducting wire.Exemplary extension Portion includes low profile (profile), Low ESR extension and/or bifurcated, low profile, Low ESR extension.

As shown in Figures 2 to 4, the present invention can optionally include other sensing electrode 24,34,44,54, they are placed on In gastrointestinal tract or close to supply gastrointestinal tract or the nerve of vascular system.Sensing electrode 24,34,44,54 can sense one kind Or a variety of physiological stimulations, such as esophagus wriggling, esophageal pH, esophagus impedance, esophageal pressure, esophagus be electroactive, lower esophagus includes About flesh (LES) pressure, LES be electroactive, peristole, gastric electrical activity, stomach chemical activity, gastric hormone activity, stomach temperature, gastric pressure, Stomach impedance stomach function regulating pH, duodenum are wriggled, duodenum is electroactive, duodenum chemical activity, duocrinin activity, ten Two duodenum 12 temperature, Duodenal pressure, duodenum impedance and duodenum pH, blood chemistry activity, Blood Hormone activity, fan It walks nerve or other GI nerves activity, sialochemistry activity, bile pressure, biliary tract is electroactive, biliary tract chemical activity, pancreas Pressure, pancreatic electrical activity, pancreas chemical activity, pancreatic sphincter pressure, pancreatic sphincter be electroactive, sphincter muscle of bile duct pressure or Sphincter muscle of bile duct is electroactive, mesenteric pressure, mesenteric flows and/or mesenteric content of chemical substances.

When sensing physiological stimulation appropriate, sensing electrode 24,34,44,54 can be via line or conducting wire 29,39,49,59 Signal is transmitted to device 26,36,46,56 with processor 22,32,42,52.Then, device 26,36,46,56 can start, tie up Hold, adjust or stop the electrical stimulation signal for being sent to electrode group 21.Therefore, method described herein can more respond subject Particular biological status and accurately adjust mesenteric system at least part, thus a part of mesenterium system Or all can shrink or relax, so that adjusting blood flows into gastrointestinal tract.The transmitter of the external pacemaker of closing can also be passed through Realize that control blood flows into gastrointestinal tract.As known in the art, stimulating electrode group 21 can combine with other pacing electrode and make With to treat gastrointestinal motility or function illness.It should be appreciated that sensing electrode can be wrapped in any embodiment of the invention It includes and is realized in those embodiments shown in Fig. 3-5.

Routine operation, celioscopy, endoscopy, radiology or other minimally-invasive vasculars and surgical technic can be passed through Any stimulation or sensing electrode group are placed, desired one or more devices are placed on and want in structure associated with it or attached It communicates closely or with the structure.Conventional electrodes stimulating apparatus can be used for implementing method described herein.

It should be appreciated that the period of stimulation can be than treating in the case where treating such as anginal cardiovascular status To inducing satiety or inhibit in the relevant situation of the appetite of subject persistently it is much longer.It in one embodiment, can be with By stimulating both abdominal cavity and SMA artery up to a few houres simultaneously after diet as described above, such as 2,3,4,5,6 or more when The anginal treatment of Duan Shixian.

The present invention is illustrated by following embodiment.It should be appreciated that specific embodiment, material, amount and program should be according to such as The scope and spirit of the invention described herein carry out extensive interpretation.

Embodiment 1

By mesenterium egersimeter in laparoscope implantation adult male subjects.Stimulator wires are implanted into abdominal cavity and intestines The outer surface of artery on mesentery, and microcontroller is implanted into the bag of preceding stomach wall.

Using remote signal, microcontroller sends 10 rectangle arteries and veins in the predetermined time delay started away from diet after ten minutes Multiple bursts of punching.Microcontroller sends the electricity thorn with pulse amplitude 10mAmp and bursts frequency 2 bursts per second Swash.Train of pulse is interrupted by 500 milliseconds (msec) of quiescent phase.It is stimulated until patient stops feeding, stimulation stops later.

Embodiment 2

In acute experiment, mesenteric is stimulated and is implanted into the mesenteric system of pig.Stimulator wires are planted Enter on abdominal cavity and the outer surface of superior mesenteric artery, and controlled by external microcontroller.Typical stimulation parameter can have 10 The bursts of a pulse, the bursts frequency of pulse amplitude and 0.5 bursts per second with 20mAmp.10 pulses The duration of each bursts is 400msec, quiescent phase 1600msec, to allow the repolarization of mesenteric flesh. Train of pulse will induce the contraction in abdominal cavity and superior mesenteric artery, and blood is caused to flow to the physiology obstruction of stomach and intestines.It can be used more The general reduction for strangling flowmeter measurement blood flow amount.

Embodiment 3

Chronic survival is tested, it will be in the mesenteric vasculature of stimulator implantation pig.Stimulator wires are implanted into abdomen On the outer surface of chamber and superior mesenteric artery, and microcontroller is implanted into the bag of preceding stomach wall or is worn on jacket or takes.Allusion quotation The stimulation parameter of type can have the bursts of 10 pulses, the duration of pulse amplitude, 400msec with 10mAmp With the bursts frequency of 0.5 bursts per second.Bursts are interrupted by the quiescent phase of 1600msec to allow mesenteric The repolarization of muscle.It is random to open and close stimulator, and the food intake during the unlatching phase is compared with closed-down period, it demonstrate,proves Bright stimulator lower food and calorie intake when opening.Furthermore, it is possible to continuously open stimulator.Allow animal freely into Food.Compared with the free nutrition purposes, especially for feeding animals for being not turned on stimulator, continuous measured body weight shows that less weight gain or weight subtract Gently.

Prevent, treat and/or control bleeding

In various embodiments, present description provides be expected to treat bleeding or prevention for adjusting blood flow The method of blood.In general, the mind of those blood vessels is controlled through the blood vessel to blood supply or controlled by the blood flow of artery and vein It is realized through applying stimulation.Blood vessel or nerve can directly or indirectly be stimulated.In various embodiments, by the one of stimulating apparatus A or multiple electrodes are placed close to the artery to organ blood supply, the vein for supplying the blood from organ, supply The wall of the neural or described organ of the artery or the vein, or with their telecommunications.In various embodiments In, close to or with ... telecommunication be defined as with to organ blood supply target artery, supply the quiet of the blood from organ The wall of the neural or described organ of arteries and veins, the supply artery or the vein is the position for the distance that range is 0 to 5cm It sets.In various embodiments, position is also the position upstream at least 1cm on bleeding or the expected blood vessel that bleeding occurs.Change speech It, in various embodiments, preferred stimulation location is at nearside or the upstream at least 1cm of damage or operative site.

In one embodiment, present description provides the methods for adjusting organotropic blood flow, by leaning on It is close to apply electrode corresponding to artery, vein or the Nutrient artery of organ and the nerve of vein, and active electrode is to provide contraction The electro photoluminescence of artery or vein carries out.In various embodiments, providing electro photoluminescence can be used for treating bleeding, control/stopping Bleeding and treatment tumour.

In some embodiments, the presently disclosed method for treating, controlling or preventing bleeding is only suffered from high risk Implement in person, including the patient with hepatopathy, the patient with coagulation disorders or relies on anticoagulation medicine, such as aspirin, Plavix, can close fixed (Coumadin) and/or Xarelto patient.In some embodiments, presently disclosed method is being drawn It rises in the higher certain operations of risk of bleeding and implements, the operation includes that (it is with arteria hepatica and/or portal vein for hepatobiliary surgery The risk of bleeding), splenectomy (its risk with splenic vein bleeding), vascular tumor excision (it is with blood supply tumour artery The risk of bleeding), Whipple program (its risk with arteria pancreaticoduodenalis bleeding) ,-popliteal of stock bypass (femoral- Popliteal bypass) (its risk with femoral artery bleeding) and dissection of aorta (aortic dissection) (its tool There is the bleeding risk in aorta).Implement method disclosed herein to be listed above to minimize, prevent, control or treat The bleeding occurred in each artery or venous locations.

Microsecond or millisecond electric pulse can the induction of vascular contractions in both artery and vein in several seconds.It is terminated in stimulation When, blood vessel expands back its original size in a few minutes.Such reversible vessel retraction can be repeated without causing any tissue Damage.In stronger stimulation, permanent blood block, complete occluding vascular chamber can be formed.Reversible vessel retraction and can not Both inverse blood coagulations provide the bleeding prevention in non-compressible wound and/or the powerful approach of control.Can by change amplitude, Pulse duration and pulse recurrence rate control perfusion degree.

The treatment basis of electrosurgery is to generate heat in cellular level.Flow through tissue > high frequency of 100KHz (about 350KHz) Exchange generates heat, and the working cycles (duty cycle) of electric current are used to create the expectation tissue effect of cutting or solidification. 104 °F of temperature leads to reversible cell trauma, and 120 °F of temperature leads to irreversible cell trauma.Higher temperature is led Dedicate one's life to being further change in for body tissue.For example, 158 °F cause to solidify, 212 °F cause to cut effect, and 392 °F cause to be carbonized Fulguration.However, generating nerve stimulation without generating heat with lower frequency (< 100KHz) electric current stimulation tissue.

The conventional thermocoagulation of blood vessel usually requires tens of watts of the power delivered by electric cautery or RF coagulator.Such technology Cause significant tissue damage, and is not effective in the solidification of big blood vessel.In general, big blood vessel needs machine in the case where directly showing Tool ligation.Newer technology such as Ligasure can be to heat seal biggish artery, but they need huge power supply, good Blood vessel show and enter blood vessel from each side so that surgical probe is accurately positioned, it is all these all to prevent this technology in the neck Use in domain.Further, since the limitation of these technologies, there is significant delay in bleeding control, cause may be implemented adequately Significant blood loss before bleeding control, then results in the need for blood transfusion and relevant risk.

On the contrary, low-power (a few mW) electricity vessel retraction helps to reduce blood flow without causing thermal damage to tissue, and And it may not be needed well showing to position tool for damaged blood vessels.Since such stimulation needs low-down power, can incite somebody to action Small disposable apparatus, device with electrode described with reference to Figure 6 is placed in wound area, to reduce or prevent part Bleeding.Can before bleeding or during bleeding apparatus for placing to prevent or treat bleeding.In addition, blood is good electricity Conductor, therefore the perfect contact between electrode and blood vessel may not be necessary to abundant bleeding control.Furthermore, it is possible to stimulate remote Artery, vein or nerve from damage location is to realize bleeding control.It is real in a few seconds that reversible vessel retraction scheme can be used The temporary reduction of existing hemoperfusion, its original size is returned in blood vessel dilatation in several minutes after stimulation terminates.This mode can be used for Non-destructive bleeding control in operation and during Wound care.It realizes when then vessel retraction starts blood coagulation and permanently goes out Blood stasis.In addition, therapy can be repeated as many times to treat the delayed bleeding from position.

As described in the previous section of this specification, with electric current impulse stimulation blood vessel cause femoral artery and mesenteric artery and The local contraction of vein.Have been observed that each stage continues 1 millisecond, the electric current of the repetitive rate of amplitude and 10Hz with 250V Two-phase (symmetrical, the-the first rectangle of anode) current impulse leads to femoral artery and mesenteric artery and vein very in seconds Apparent local contraction.Fig. 7 A shows the degree that response is shunk with the Femur blood vessel of long stimulations in 10 seconds of 1Hz repetitive rate, as thorn The function of exciting width and blood vessel diameter.Figure 70 2 shows the contraction of femoral artery, in which: curve 704 indicates micro- when providing stimulation 1 The contraction when second, curve 706 indicate the contraction when providing stimulates 10 microsecond, and curve 708 is indicated when offer stimulates 100 microsecond Contraction, and curve 710 indicate when provide stimulate 1000 microsecond when contraction.Similarly, Figure 71 2 shows the receipts of femoral vein Contracting, in which: curve 714 indicates the contraction when providing stimulates 1 microsecond, and curve 716 indicates the receipts when providing stimulates 10 microsecond Contracting, curve 718 indicates the contraction when providing stimulates 100 microsecond, and curve 720 is indicated when providing stimulates 1000 microsecond It shrinks.

Such as from Fig. 7 A as can be seen that for both artery and vein, vessel retraction with higher pulse amplitude and compared with The long duration and increase.Further Fig. 7 A shows that blood vessel diameter subtracts along sigmoid curve as pulse amplitude increases It is small, there is response lag in lower end, and reach on high-end the minimum dimension of the about 20-25% of green diameter.Fig. 7 B is shown The degree shunk as the Femur blood vessel of boost pulse amplitude and the function in pulse duration.The curve 730 and 732 of Figure 73 1 25% and 50% corresponded respectively in femoral artery is shunk.The curve 734 and 736 of Figure 73 5 corresponds respectively in femoral artery 25% and 50% shrinks.In various embodiments, the vessel retraction percentage of blood vessel (such as artery or vein) can define For the make percent of realization, by subtracted in the unstructured diameter that never stimulates the contraction through stimulating diameter and should Difference is calculated divided by the not contracted diameter not stimulated, and can be by using Doppler's research or angiogram or ability Any other method known to domain measures.

It is such as proved by Fig. 7 B, the strength-duration dependence of 25% and 50% collapse threshold can be relied on by power Property (power dependence) " t2a " takes approximation, wherein the value of " a " is about 0.3 for femoral artery and vein.In addition, such as Shown in Fig. 7 A and 7B, for all pulse durations, need lower voltage to reach class in the artery compared with vein Like contraction, although difference reduces when stimulation applies longer duration.

Fig. 7 C shows the degree that response is shunk with the mesenteric of long stimulations in 10 seconds of 1Hz repetitive rate, as stimulation The function of amplitude and blood vessel diameter.Figure 74 2 shows the contraction of mesenteric artery, and wherein curve 744 indicates micro- when providing stimulation 1 The contraction when second, and curve 746 indicates the contraction when providing stimulates 100 microsecond.Similarly, Figure 74 8 shows mesenterium The contraction of vein, wherein curve 750 indicates the contraction when providing stimulates 1 microsecond, and curve 752 indicates to work as and provides stimulation Contraction when 100 microsecond.Mesenteric shows the response of type similar to the response of femoral artery and vein.For identical arteries and veins Parameter is rushed, the vessel retraction degree ratio in mesenteric artery is high in femoral artery, and difference increases with biggish amplitude. For example, compared with 49% in femoral artery reduces, mesenteric artery shrinks 76% at 200V in the case where 1 μ s pulse.Intestines system Film vein is shunk more under short arc than femoral vein, and this ratio reverses under higher amplitude.

In experimental setup, cut the femoral artery and mesenteric artery of test subject, then in these it is some into Row electro photoluminescence.The experiment proves that the blood from the electro photoluminescence by predefined amplitude up to the cutting artery of predefined period damages It loses much smaller than the blood loss from untreated cutting artery.The figure that Fig. 8 A is shown, which is shown, to be applied and is not applying electro photoluminescence In the case where the blood loss from femoral artery.Curve 802 indicates the blood loss when the femoral artery of unused electro photoluminescence processing cutting.Curve 804 indicate the femoral artery for stimulating cutting in 30 seconds with 100 microsecond pulses of 30V at 1 hz, and curve 806 is indicated in 10Hz Lower 100 microsecond pulses with 150V stimulate the femoral artery of cutting in 30 seconds.The figure that Fig. 8 B is shown is shown in application and does not apply electricity From the blood loss of mesenteric artery in the case where stimulation.Curve 808 indicates that the mesenterium of unused electronic stimulation cutting is dynamic Blood loss when arteries and veins, and curve 810 indicates that the mesenterium of the cutting with the 100 microsecond pulses stimulation 30 seconds of 40V at 1 hz is dynamic Arteries and veins.In both vascular groups, treatment causes bleeding reduction or even completely stopping after stimulation, and in untreated artery Observe continuous bleeding.

Fig. 8 C shows a series of figures, and which show blood vessels when applying 200 microsecond of electro photoluminescence under the frequency of 10Hz to receive Contracting.Curve group 820,822,824 and 826 respectively illustrates mesenteric artery, mesenteric vein, ileum-femoral artery and ileum-stock The contraction of vein.As indicated, all not shunk in any blood vessel when applying no-voltage, i.e. baseline voltage and they being 100% opening.When increasing the voltage applied in the range of 0V to 100V with the interval of 10V-50V, stabilization of vascular is shunk.Cause This, figure is shown when increasing the voltage applied, and the contraction of blood vessel increases.In addition, it can be seen that dynamic with ileum-stock from Fig. 8 C Arteries and veins and vein 824,826 are compared, and are applied voltage and are caused greatly to shrink in mesenteric artery and vein 820,822.

Fig. 8 D shows a series of figures, and which show the vessel retractions under the frequency of 10Hz when application electro photoluminescence 1ms.It is bent Line group 830,832,834 and 836 respectively illustrates mesenteric artery, mesenteric vein, ileum-femoral artery and ileum-femoral vein Contraction.As indicated, all not shunk in any blood vessel when applying no-voltage, i.e. baseline voltage and they being 100% Open.When increasing the voltage applied in the range of 0V to 100V with the interval of 10V-50V, blood vessel increasingly stabilized contraction. Therefore, figure is shown when increasing the voltage applied, and the contraction of blood vessel increases.In addition, it can be seen that with ileum-stock from Fig. 8 D Artery is compared with vein 834,836, is applied voltage and is caused greatly to shrink in mesenteric artery and vein 830,832. Can by stimulation arteria carotis or its branch, subclavian artery or vein or its branch, jugular vein or its branch or any other The nerve of artery or vein or Nutrient artery or vein realizes similar result.

In various embodiments, the electrode that electrode such as, but not limited to, refers to Fig. 6 description can be used for providing thorn for blood vessel Swash to treat bleeding situation.Electrode can be used for applying electro photoluminescence to control blood loss when performing the operation to organ.? In various embodiments, it is that the pulse of 1 μ sec-500msec is held that the electro photoluminescence for being supplied to blood vessel, nerve or organ walls, which has range, The pulse frequency that the pulse amplitude and range that continuous time, range are 1V-250V are 1Hz-100kHz.In various embodiments, System for treating bleeding includes at least one electrode that (wired or wireless) is communicated with impulse generator.Optionally, system Also comprising the microprocessor for being operably connected to IPG, control is generated by IPG and is joined by the stimulation that at least one electrode applies Number.

Fig. 9 A shows the artery site that the electrode for corresponding to the organ performed an operation applies.It is dynamic by arteria coeliaca or abdominal cavity Arteries and veins branch is to Stomach duodenum, gall-bladder and liver blood supply；Pass through arteria coeliaca and superior mesenteric artery or arteria coeliaca or intestines system Arterial branch is to head of pancreas blood supply on film；By the branch of superior mesenteric artery or superior mesenteric artery to jejunum and ileum and appendix Blood supply；By superior mesenteric artery, inferior mesenteric artery or mesenterium up or down arterial branch to colon blood supply；Pass through arteria linenalis Or arteria linenalis branch is to spleen blood supply；By being moved in the arteria renalis, arteria iliaca communis, internal iliac artery or the arteria renalis, arteria iliaca communis and ilium Arteries and veins branch is to urogenital system blood supply.Therefore, it can place an electrode in left arteria gastrica 902 to provide electro photoluminescence, thus Vasoconstriction simultaneously adjusts the adjacent part that blood flows to stomach and esophagus；It is placed in arteria linenalis 904 to provide electro photoluminescence, to receive Contracting blood vessel simultaneously adjusts blood and flows to spleen, stomach and pancreas；It is placed in arteria hepatica communis 906 to provide electro photoluminescence, thus vasoconstriction And it adjusts blood and flows to liver, gall-bladder, duodenum and pancreas；It is placed in superior mesenteric artery 908 to provide electro photoluminescence, from And vasoconstriction and adjust blood flows to pancreas, small intestine, appendix and large intestine preceding 2/3rds；It is placed on inferior mesenteric artery To provide electro photoluminescence in 910, to vasoconstriction and adjust the last one third that blood flows to large intestine；It is placed on lower phrenicartery To provide electro photoluminescence in 912, to vasoconstriction and adjust diaphragm and lower part that blood flows to esophagus；It is placed on arteria suprarenalis To provide electro photoluminescence in 914, to vasoconstriction and adjust blood and flow to adrenal gland；It is placed in the arteria renalis 916 to provide electricity Stimulation, to vasoconstriction and adjust blood and flow to kidney；It is placed in arteria genitalis 918 to provide electro photoluminescence, to receive Contracting blood vessel simultaneously adjusts blood and flows to testis or ovary；And it is placed in lumbar arteries 920 to provide electro photoluminescence, thus vasoconstriction And it adjusts blood and flows to vertebra, spinal cord, stomach wall and lumbar region.

Fig. 9 B shows the intravenous regional that the electrode for corresponding to the organ performed an operation applies.Blood passes through portal vein, intestines system Film upper vein or its branch guide from Stomach duodenum, gall-bladder and liver and head of pancreas；By superior mesenteric vein or its branch from Jejunum and the guidance of ileum and appendix；It is guided by superior mesenteric vein, inferior mesenteric vein or its branch from colon；It is quiet by spleen Arteries and veins or its branch guide from spleen；And pass through renal vein, gonad vein internal iliac vein or its branch from urogenital system Guidance.Therefore, can place an electrode in vena hepatica 930 to provide electro photoluminescence, thus vasoconstriction and adjust come from liver Blood flow；It is placed in gonad vein 932 to provide electro photoluminescence, thus the blood of vasoconstriction and adjusting from gonad Liquid stream is dynamic；It is placed in lumbar veins 934 to provide electro photoluminescence, thus the blood stream of vasoconstriction and adjusting from spinal cord and body wall It is dynamic；It is placed in vena phrenica 936 to provide electro photoluminescence, thus the blood flow of vasoconstriction and adjusting from diaphragm；It is placed on To provide electro photoluminescence in adrenal veins 938, thus vasoconstriction and adjust come from adrenal blood flow；It is quiet to be placed on kidney To provide electro photoluminescence in arteries and veins 940, thus the blood flow of vasoconstriction and adjusting from kidney；And it is placed on the right side 942 or left To provide electro photoluminescence in 944 internal iliac veins, thus vasoconstriction and adjust from pelvic muscles, skin, pelvic viscera, perineum and The blood flow of seat area.

In one embodiment, desired stimulation is provided to blood vessel using cuff electrode.Figure 10 A shows exemplary card Skin electrode.Spiral cuff electrode 1000 is wrapped in around blood vessel, and since it is from curl characteristics, by its diameter adjustment to blood vessel Size.In some embodiments, spiral cuff electrode 1000 by two layers of combined silicone resin, plastics orSubstrate lamella 1002,1004 forms.Such as platinum foil band of metal tape 1006 is placed between layer 1002,1004, to mention For the electrical contact with blood vessel (not shown).Band 1006 is welded to conducting wire 1008, for example, the multiply of Teflon insulation is stainless Steel conducting wire, for being electrically connected.In some embodiments, 1010 width about 1mm of window, and the cylinder inscribe above platinum band 1006 It cuts, to be in electrical contact with vascularization.

Figure 10 B is shown can be used for providing the another exemplary cuff electrode of electro photoluminescence in the embodiment of this specification Design.In some embodiments, cuff electrode 1020 is made of dimethyl silicone polymer (PDMS) or polyimides, and Almost completely around blood vessel during operation.Cuff electrode 1020 includes the cylindrical part 1021 for being configured to winding blood vessel, the circle Cylindrical section 1021 has for cuff electrode 1020 to be placed on circumvascular notch (cut-out) 1022.By multiple electricity Pole 1023 be placed in cylindrical part 1021 with during operation with contacts blood.In various embodiments, via by company Wiring 1008,1028 is connect with impulse generator provides electro photoluminescence energy to the cuff electrode 1000,1020 of Figure 10 A and 10B respectively Amount.In other embodiments, using radio frequency (RF) connection, ultrasonic connection, thermal connection, magnetic connects, electromagnetism connection or light connects Cuff electrode 1000,1020 is wirelessly coupled to impulse generator.Figure 10 C shows as known in the art in this explanation The another exemplary cuff electrode 1030 of electro photoluminescence is provided in the embodiment of book.Cuff electrode 1030 is during operation around blood Pipe.Cuff electrode 1030 includes cylindrical part 1031 and the electrode 1033 that positions in pairs of length along cylindrical part 1031, The cylindrical part 1031 has for cuff electrode 1030 to be placed on circumvascular notch 1032.Figure 10 D is shown For providing another exemplary cuff electrode 1040 of electro photoluminescence in the embodiment of this specification.Cuff electrode 1040 is in hand Around blood vessel during art.Cuff electrode 1040 is longitudinal including cylindrical part 1041 and positioned at the length along cylindrical part 1041 Electrode 1043 in the cylindrical segment of short, the separated exposure of distribution, the cylindrical part 1041, which has, to be used for card skin Electrode 1040 is placed on circumvascular notch 1042.

In various embodiments, the cuff electrode of this specification is configured to apply the pressure for being less than 100mm Hg on blood vessel Power, so that electrode and vascular wall are physically contacted, without mechanically significantly blocking blood flow.

In another embodiment, desired stimulation is provided to blood vessel using clamper electrode.Figure 11 show for The exemplary clamper electrode of blood vessel offer electro photoluminescence.Clamper electrode 1100 includes upper plate 1102, lower plate 1104, limiter (clipper) 1106, knob 1108, connector 1110, nut 1112 and battery plate (electro plate) 1114.In addition company Connect the downside that device (not shown) is located at lower plate 1104.In one embodiment, passed through using clamper electrode 1100 by connection Line 1118 connect to provide electro photoluminescence with impulse generator 1116.In another embodiment, clamper electrode 1100 uses nothing Line frequency (RF) connection, ultrasonic connection, thermal connection, magnetic connects, electromagnetism connection or light connects are wirelessly coupled to impulse generator 1116.Clamper electrode 1100 is spring-actuated around the pivoting point 1103 of coupling upper plate 1102 and lower plate 1104.In user's pressing The rear surface of plate 1102 and lower plate 1104, to open clamper electrode 1100 around pivoting point 1103.Upper plate 1102 and lower plate 1104 Front end or distal end 1102d, 1104d be located in around blood vessel, and user from rear surface remove pressure, allow distal end 1102d, 1104d are moved by spring-actuated around pivoting point 1103 close to blood vessel.

Figure 12 shows the embodiment according to this specification, the abdominal cavity for being placed on clamper electrode 1202 on blood vessel Mirror pincers 1200.In other embodiments, it can be used for clamper electrode to be placed on endovascular any suitable device. Laparoscopic forceps 1200 include shaft portion 1204 and clasper 1202, and the clasper 1202 is used for medical device (such as clamper Electrode) it is applied to the intracorporal desired locations of body.As it is known, be similar to laparoscopic forceps 1200 pincers can by mouth, nose or its In his body orifice (such as, but not limited to anus) insertion body, or it can be inserted by laparoscopic trocar.In other implementations In scheme, it is implanted into expansible electrode (expandable electrode) in the blood vessels using laparoscopic forceps 1200.

Figure 13 A shows expansible electrode 1302, has conducting wire 1306 in conduit 1304, for being placed on blood vessel It is interior.As indicated, being inserted into conduit 1304 with the extensible electrode 1302 that conducting wire 1306 is coupled, for electrode 1302 to be placed on blood In pipe.Figure 13 B shows the electrode 1302 of Figure 13 A, stretches out in expanded configuration and from conduit 1304 to be placed on blood vessel It is interior.Conducting wire 1306 also extends conduit 1304 and electrode 1302 is stretched to contact vascular wall.Conduit 1304 is similar to this The known conduit for into vascular system or placement cardiac pacemaker wire in field.

Figure 14 A shows the conduit 1404 according to the embodiment of this specification, have be located at blood vessel 1408 in can Expand electrode 1402.As indicated, being inserted into conduit 1404 with the extensible electrode 1402 that conducting wire 1406 is coupled, it is used for electrode 1402 are placed in blood vessel 1408.Conduit 1404 is for piercing through blood vessel 1408 to place wherein electrode 1402.In various realities It applies in scheme, blood vessel 1408 can be any artery or vein for needing treatments for bleeding.Figure 14 B shows the electrode of Figure 14 A 1402, extend from conduit 1404 and in 1408 intramedullary expansion of blood vessel.As shown in Figure 14B, electrode 1402 extends conduit 1404 Distally 1410 and expand.Figure 14 C shows the embodiment according to this specification, the electrode 1402 in blood vessel 1408.Electricity The tip 1402a and 1402b of pole 1402 are expanded to contact wall 1408a, the 1408b of blood vessel 1408, and conduit 1404 from comprising The body cavity of blood vessel 1408 removes, and leaves conducting wire 1406 so that electrode 1402 is connected to impulse generator.Figure 14 D shows Figure 14 C Electrode 1402, implantable impulse generator (IPG) 1411 is connected to by conducting wire 1406.Once electrode 1402 is located At making the tip 1402a and 1402b of electrode 1402 contact the wall 1408a of blood vessel 1408,1408b, conducting wire 1404 is connected to IPG.Therefore, electrode 1402 can be used for providing the electro photoluminescence of expected frequency/amplitude up to the phase to blood vessel 1408 with desired interval The period of prestige.In some embodiments, microprocessor 1412 is operably connected to IPG 1411 and controls and generated by IPG And the stimulation parameter applied by electrode 1402.

In one embodiment, electro photoluminescence can be used for before carrying out artery transplantation drawing in blood vessel (such as artery) Play vessel retraction.Figure 14 E shows the electro photoluminescence for being applied in people's leg the femoral artery with obstruction.As indicated, obstruction 1420 is deposited It is in the femoral artery 1422 of 1426 Zhong popliteal artery of people's leg, 1424 nearside.Electrode 1428 is placed in femoral artery 1422 and Desired time interval, the electric signal are reached via the electric current that electric signal generator (ESG) 1430 supplies expectation amplitude and frequency Generator (ESG) 1430 is also connected to be applied to the ground mat (grounding pad) 1432 of the skin close to femoral artery 1422. Ground mat provides the return path of the electric current applied by electrode 1402, eliminates the needs that second electrode is placed to intra-arterial.Through Cause the vessel retraction of femoral artery 1422 by the electro photoluminescence that electrode 1428 is applied to femoral artery 1422, and works as femoral artery 1422 Cutting when application skins based upon bidding implantation material to prevent from its bleeding.Figure 14 F shows the stock in people's leg 1426 as described in reference Figure 14 E The arterial graft 1434 applied after the vessel retraction of artery 1422.Blood vessel is realized by the electro photoluminescence to femoral artery 1422 It shrinks, the electro photoluminescence is provided by the electrode 1428 for being connected to the also ESG 1430 with ground mat 1432.Once blood vessel occurs Shrink, using connection 1422 He popliteal artery 1424 of femoral artery arterial implant 1434 with around obstruction 1420, without allow from The significant blood loss of femoral artery 1422.At the end of operation, stops electro photoluminescence and restore the blood supply under vascular access.

Figure 14 G shows the artery and venous structures of blood vessel in people's leg.As indicated, people's leg includes that 1450, popliteal of femoral artery is dynamic Arteries and veins 1452, anterior tibial artery 1454, posterior tibial artery 1456, arteria peronea 1458, arteria dorsalis pedis 1460 and arch of foot 1462.People's leg also includes Vena iliaca externa 1464, femoral vein 1466, perforating veins 1468, great saphenous vein 1470, small saphenous vein 1472, anterior tibial veins 1474, shin Vein 1476 and dorsal venous arch of foot 1478 afterwards.It, can be by placing an electrode within institute in Figure 14 G as described in referring to Figure 14 A to 14F Any nearby (within or) applies electro photoluminescence to cause vessel retraction and prevent from blood vessel knot in the artery and vein shown The blood loss of structure.

It in another embodiment, can be any in artery shown in Figure 14 G and vein by placing an electrode within Neighbouring (within or) is planted to apply electro photoluminescence to cause vasodilation and the blood flow in these blood vessel structures of increase to treat The low blood flow disease such as peripheral artery disease.Figure 14 H shows the conduit 1401 according to the embodiment of this specification, The expansible electrode 1403 of its expandable balloon 1405 that there is covering to be located in blood vessel 1407.As indicated, even with conducting wire 1409 The extensible electrode 1403 of connection is inserted by conduit 1401 with sacculus 1405 together, so that when sacculus 1405 is in a deflated state (as shown in fig. 14h), electrode 1403 is unexpanded to allow for electrode 1403 and sacculus 1405 to be placed in blood vessel 1407.Using leading Pipe 1401 pierces through blood vessel 1407 so that electrode 1403 and sacculus 1405 to be placed in blood vessel 1407.In various embodiments, blood Pipe 1407 can be any artery or vein for needing treatments for bleeding.

Figure 14 I shows the electrode 1403 of Figure 14 H, extends from conduit 1401 and due to the sacculus in blood vessel 1407 1405 expansion/expansion and expand.As shown in Figure 14 I, sacculus 1405 is extended the distal end 1413 of conduit 1401 and expand/it is swollen It is swollen, expand electrode 1403 also around sacculus 1405.Figure 14 J shows the embodiment according to this specification, is placed in blood vessel The electrode 1403 in expansion state and extension of covering sacculus 1405 in 1407.The sacculus 1405 of expansion will cover sacculus 1405 Electrode 1403 be placed in and contacted with the wall of blood vessel 1407, to deliver electro photoluminescence.Once sacculus 1405 and electrode 1403 are in blood vessel Conduit 1401 is just removed from the body cavity comprising blood vessel 1407, leaves conducting wire 1409 to connect electrode 1403 by 1407 intramedullary expansions To implantable impulse generator (IPG) 1415.It can such as find out in Figure 14 I and 14J, the expansion of the sacculus 1405 in blood vessel 1407 Limit blood is opened in flowing wherein, and the mechanical means for preventing the bleeding in blood vessel 1407 is provided.In addition, using expansion electrode 1403 to provide the electro photoluminescence of expected frequency/amplitude up to the desired period to blood vessel 1407 with desired time interval, thus Further prevent blood flow.

Abnormal uterine bleeding (being formerly referred to as dysfunctional uterine bleeding or DUB) is to lack identifiable pelvic cavity pathology The Irregular uterine bleeding learned, occurred in the case where general medicine disease or gestation.It reflects the row to endometrium lining The destruction of the normal cyclic pattern of ovum hormonal stimulation.Bleeding is all uncertain in many aspects.It may be overweight or kicks the beam, It and may be extended, frequent or random.

The blood supply in uterus is derived mainly from uterine artery.These artery origins are swung in hypogastric artery and to uterus, These uterine arteries are divided into descending branch and ascending branch at uterus.Descending branch is run down along uterine neck and vaginal sidewall.Ascending branch by uterus to Upper transmitting is simultaneously continued below in fallopian tubal.Vagina, uterine neck and uterus are branched into before and after frequent.In an embodiment In, present description provides the methods for the treatment of uterine hemorrhage, by near hypogastric artery, uterine artery or uterine artery branch Apply electro photoluminescence or applies electro photoluminescence to the nerve of supply hypogastric artery or uterine artery to prevent uterine hemorrhage from carrying out.Each In kind embodiment, can apply accomplished continuously or intermittently is stimulated.In one embodiment, the stimulation applied is gone out by prediction menstruation The algorithm control that blood starts, and apply before or during menstrual bleeding to prevent uterine hemorrhage.Figure 15 A shows dynamic to uterus Arteries and veins 1504 applies electro photoluminescence to prevent uterine hemorrhage.As indicated, electrode 1502 is applied to uterine artery 1504, the uterus is dynamic Arteries and veins 1504 is connected to artery in ileum (internal ileac artery) 1506 and by blood supply to uterus 1508.It will be electric Pole 1502 is connected to impulse generator 1510 to provide electro photoluminescence, so as to cause uterine artery contraction by connecting wire 1512 1504.In some embodiments, patient triggers stimulation using her menstrual cycle figure.In other embodiments, all As smart phone mobile device on the menstrual cycle of the software application that runs or external equipment prediction patient beginning simultaneously And the beginning of triggering stimulation.In other embodiments, any one of the premenstrual symptom of patient or first time bleeding generation can For triggering stimulation.Since most of DUB occurred near the time of patient's menorrhea bleeding, such timing stimulation will disappear Except the needs stimulated during non-" risky " phase.

In another embodiment, uterine hemorrhage is controlled by applying electro photoluminescence to uterine wall.Figure 15 B is shown pair Uterine wall 1536 applies electro photoluminescence to prevent uterine hemorrhage.Via vagina 1530, the external orifice 1528 of cervix opening, uterine neck 1534 The electrode 1520 being coupled with conducting wire 1522 is inserted into uterus 1526 with the inner openings 1532 of cervix opening, the conducting wire 1522 after And it is coupled with impulse generator 1524 to provide electro photoluminescence.In uterus 1526, by electrode 1520 expand with uterine wall 1536 Contact, to provide electro photoluminescence to wall 1536, to control uterine hemorrhage.Then identical electrode can be used in later time Heat therapy is provided for uterine cavity, without removing electrode.

It in one embodiment, will be as known in the art with the inflatable ball ductus bursae intron of surface electrode It in uterine cavity, is then inflated, so that electrode is contacted with uterine wall.Electro photoluminescence is applied to prevent to uterine wall by surface electrode Uterine hemorrhage.Figure 15 C, which is shown, applies electro photoluminescence to uterine cavity wall 1546 using foley's tube 1540 to prevent uterine hemorrhage.Such as It is shown, the foley's tube 1540 with multiple surface electrodes 1542 is placed in uterine cavity 1544, and sacculus 1540 is expanded , so that electrode 1542 is contacted with uterine wall 1546.In one embodiment, non-thermal electric current is applied to electrode 1542 to draw Play solidification of the vessel retraction without leading to hemostasis or blood flow reduction.It can be applied by identical electrode 1542 additional Coagulating current is stopped blooding with further help.In some embodiments, by balloon expandable to certain pressure, wherein in addition to electric blood vessel It also causes the filling of uterine hemorrhage except shrinking and stopping blooding.It is then possible to later time using identical electrode come for Uterine cavity provides heat therapy, without removing electrode.

Figure 15 D shows the expandable balloon conduit 1550 according to the embodiment of this specification, has for controlling The expansible electrode 1552 of bleeding.Sacculus 1550 includes bipolar electrode 1552, is expanded in sacculus 1550 to contact body surface When expand.Sacculus 1550 is shown in Figure 15 D with unexpanded state.Once (such as being peeped via interior by any suitable device Mirror) insertion body is intracavitary, sacculus 1550 expanded to fill cavity, to make electrode 1552 and body lumen wall be physically contacted, such as such as Shown in Figure 15 C.In various embodiments, sacculus is by latex, silicone, flexible polyvinyl chloride (PVC), PTFE, ePTFE, polyester (PET), polyethylene terephthalate, crosslinked polyethylene, nylon or PET or other materials known in the art composition.Various In embodiment.Electrode is by gold, platinum, iridium, titanium, stainless steel, cobalt-base alloys or combinations thereof or any other electricity known in the art Pole material composition.In various embodiments, the volume of sacculus is between 1cc and 500cc.

In one embodiment, present description provides treat the side of tumour by adjusting the blood flow to tumour Method.The situation of referred to as ischemia-reperfusion leads to the damage of normal organ, especially with the organ of high metabolic rate.It can reasonable assumption Ischemia-reperfusion can also lead to the damage to having the very cancerous cells of high metabolic rate.However, using usually irreversible Standard Embolization therapy is difficult to generate reversible ischemia, then Reperfu- sion.Therefore, it is intended that reversibly controlling the blood stream to tumour Dynamic, so as to cause ischemic, then Reperfu- sion is to generate tumor cell damage and cell death.In addition, with normal surrounding tissue phase Higher metabolic rate than cancerous cells can permit the selective injury to cancerous cells, and to being supplied by same vessel The damage of surrounding non-cancerous cell is smaller.Intermittent mechanical has been displayed and clamps (clamping) protection tumour from accelerating tumour life It is long.Intermittent mechanical clamps the protection also resulted in for the hepatic injury as caused by ischemic or Reperfu- sion.However, intermittent mechanical presss from both sides Tight process is trouble and time-consuming during operation.By reliably and reversibly controlling organotropic blood flow come electro photoluminescence The clamping that the reversible electricity of blood vessel mediates may be implemented in blood vessel structure.In one embodiment, present description provides swollen Tumor adjusts organotropic blood flow method during performing the operation applies electro photoluminescence by organotropic blood vessel to cause blood vessel Power changes to carry out.In one embodiment, this specification additionally provides during adjusting hepatobiliary surgery to the blood stream of liver Dynamic method, by applying electro photoluminescence to arteria hepatica to cause arteria hepatica tension variation to carry out.

The nerve supply electro photoluminescence to the blood vessel to tumor feeding or the blood vessel to Zhi Peixiang tumor feeding can be passed through To adjust or change blood flow.In the case where cancerous cells, blood supply can be changed to the different duration, then Allow normal blood flow, leads to tumour Reperfu- sion and the damage to cancerous cells.By selecting the duration as follows: limiting Cancerous cells are caused to damage the duration of the blood flow of required ischemic or change and cause non-cancerous cellular damage The duration of required ischemic or the blood flow of change, and stimulate blood vessel to reach and be located in two determining duration Duration with selective destruction cancerous cells.Figure 16 is shown according to the embodiment of this specification by applying electricity thorn Swash to treat the tumour in liver.The tumour in liver 1604 can be treated by applying electro photoluminescence to arteria hepatica 1606 1602, the arteria hepatica 1606 is to 1604 blood supply of liver.Electrode 1608 is connected to impulse generator via connecting wire 1612 1610 in order to provide electro photoluminescence.In various embodiments, electrode is placed on the inside of arteria hepatica and is in electrical contact or is placed in liver with inner membrance It is in electrical contact on artery with one of outer membrane or hepatic arterial branch or the hepatic arterial nerve of supply.In various embodiments, it uses Laparoscopy inspection, radiology, endoscopy or horseley-Clarke technique place electrode.It in various embodiments, will be electric In irritation therapy and chemotherapy, radiotherapy, arterial embolism, chemoembolization or radiation embolism (radio-embolization) It is any or combination combine.The embolism that the effect of changing improvement can be helped to need with use of electro photoluminescence and embolism The size of grain.

For studying and providing the purpose of therapeutic treatment, by liver segmentation at multiple sections.Figure 17 A shows people's liver Section.Liver 1700 includes the right front upper and lower part 1708s between right hepatic veins 1704 and intermediate vena hepatica 1706, Upper and lower part 1702s, 1702i behind 1708i and the accordingly right side.In addition, liver 1700 is divided into the upper and lower part in left side 1710s, 1710i, middle section 1712 and shape of tail protrusion (caudate process) 1713.It can also be by limiting various portions Point or leaf treat liver.Figure 17 B shows the leaf of people's liver.Liver 1700 includes lobus sinister 1714 and lobus dexter 1716, close to gall-bladder The caudate lobe 1722 of 1720 rectangular leaf 1718 and close inferior caval vein 1724.

In one embodiment, the bleeding in hepatic region section control as follows can be passed through: one of opposite section blood supply or Multiple blood vessels apply electro photoluminescence, to stop bleeding.Figure 17 C shows the embodiment according to this specification, by applying electricity Stimulation is to control liver bleeding.As shown in Figure 17 C, by a pair of electrodes 1730 be disposed adjacent to by blood supply to section 1702s, The blood vessel 1732 of 1702i, 1708s and 1708i.Electrode 1730 is disposed adjacent to bleeding section and supplies their blood vessel 1732, And impulse generator 1736 is coupled to apply electro photoluminescence to blood vessel 1734, to control in hepatic region section via conducting wire 1734 Bleeding.

In another embodiment, the appearance in hepatic region section control as follows can also be passed through: by one or more electrodes It is placed on the surface of one or more sections of liver or applies electro photoluminescence in essence and to the blood vessel in liver parenchyma to stop Only bleeding.Figure 17 D shows another embodiment according to this specification, controls liver bleeding by applying electro photoluminescence. As shown in figure 17d, a pair of electrodes 1740 is placed on the surface of the liver section 1708s of active bleeding or in essence, to apply To generate electric field, which then stimulates liver section by being connected to the conducting wire 1742 of impulse generator 1744 for power-up stimulation Blood vessel in 1708s, to control bleeding.

Figure 18 A is shown for electrode cable 1804 to be maintained at endovascular anchoring 1802.In various embodiments, The electrode being coupled with conducting wire insertion is intravascular intravascular to place an electrode within, such as shown in Figure 14 A-14D.Blood vessel can be with It is any artery or vein for needing treatments for bleeding.Figure 18 A shows anchoring 1802, is used for the conducting wire 1804 of electrode 1806 It keeps in the blood vessels and close to the desired locations of vascular wall, to prevent the grumeleuse on conducting wire wall from being formed.Conducting wire 1804 terminates at Connector 1807 for connecting with impulse generator (not shown) applies electro photoluminescence to blood vessel to realize.

In various embodiments, the electrode 1806 being coupled with conducting wire 1804 is inserted into catheter in blood vessel, by electrode 1806 place in the blood vessels.Blood vessel is pierced through using conduit electrode 1806 to be placed in it.In one embodiment, anchor Fixed 1802 also include patch 1808, and the patch 1808 is used to enter sealing site of puncture at the position in blood vessel in conduit, with Prevent bleeding or hemotoncus from being formed.In various embodiments, patch is by PTFE, silicone resin (silicone) or known in the art Other materials for creating endovascular stent implantation material forms.In various embodiments, patch size range is intravascular 2 times to 200 times of conduit diameter, this then determines the size for puncturing opening.

Figure 18 B shows another embodiment for electrode cable 1824 to be maintained to endovascular anchoring 1850. The conducting wire 1824 of electrode 1826 is maintained in endovascular desired locations using anchoring 1850.In various embodiments, Anchoring 1850 be partially or completely covered with PTFE 1851 or for blood vessel implant similar material and in positioning lead body And it is functioned in sealing site of puncture.Conducting wire 1824 terminates at the connector for connecting with impulse generator (not shown) 1827, electro photoluminescence is applied to blood vessel to realize.

In one embodiment, electro photoluminescence is provided to blood vessel using hinged jaw, to control the bleeding of blood vessel.It can Pass through the electrical stimulation device with hinged jaw via endoscope in patient's body, and blood vessel knot can be disposed adjacent to Structure, to apply electro photoluminescence to blood vessel structure.Figure 19 A shows the operation device 1902 with hinged jaw 1904, described hinged Jaw 1904 can be used as pincers operation, diathermy biopsy's pincers (hot biopsy forcep) operation is similar to, from endoscope The opening 1906 at 1910 tip 1908 is prominent, close to the blood vessel 1912 with bleeding.The operation device 1902 of electro photoluminescence is provided It can be monopole or bipolar, and in one embodiment, including impedance transducer, measure impedance to control to blood vessel 1912 electro photoluminescence delivering.

Figure 19 B shows the embodiment according to this specification, and the electro photoluminescence of blood vessel is applied to via hinged jaw 1904. Electro photoluminescence causes the vessel retraction of blood vessel 1912 in noncondensing situation.In one embodiment, it can also be received in blood vessel Additional coagulating current is applied to blood vessel 1912 with seal blood vessels structure after contracting.In various embodiments, coagulating current has There is > the frequency of 100kHz, and preferably in the range of 300kHz to 3MHz.As shown in Figure 19 B, using hinged jaw 1904 Blood vessel structure is caught to cause mechanical filling before applying electro photoluminescence, so that secondary vessel is shunk.

In various embodiments, by one or more active or passive and wireless microdevices in the blood vessel for supplying limbs of patient Permanent implantation near structure.In the case where the traumatic damage to limbs, with external device (ED) (such as hand-held remote control device) Starter, to deliver electro photoluminescence, thus bleeding of the control from blood vessel structure, as this specification previous section is explained.Each In kind embodiment, can plant microdevice includes inert passive device as known in the art or active micro stimulator.Figure 20 A is aobvious The embodiment according to this specification is shown, for being implanted into the intracorporal position of active or passive and wireless microdevice people.As indicated, Microdevice 2002 and 2004 is implanted near (or in it) right subclavian vein 2006, and by microdevice 2008 in left lock (or in it) implantation nearby of vein 2010 under bone.Similarly, by microdevice 2012 near right femoral vein 2014 (or at it It is interior) it is implanted into, the right femoral vein 2014 extends from right vena iliaca externa 2016, and by microdevice 2018 in left vena iliaca externa 2020 Nearby (or in it) it is implanted into.Such as it will be apparent to one skilled in the art that the implantation of the microdevice shown in Figure 20 A Position is merely exemplary, and can by be used to provide in the microdevice implantation human body of electro photoluminescence multiple other are intravascular. Figure 20 B shows the embodiment according to this specification, for electro photoluminescence to be delivered to the exemplary implantable microdevice of blood vessel 2019.Needle 2021 can be used and be implanted into microdevice 2019.

Figure 20 C is shown according to the embodiment of this specification for activate the microdevice being implanted into deliver electro photoluminescence To the exemplary hand held remote control device 2022 of blood vessel.Hand-held remote control unit can be by receiving the patient or another person of electro photoluminescence Operation.Figure 20 D is shown according to the another embodiment of this specification for activate the microdevice being implanted into pass electro photoluminescence It is sent to another exemplary hand held remote control device 2024 of blood vessel.In one embodiment, remote control device 2024 can be Smart phone with predefined application, the predefined application are used to activate the microdevice of the implantation run on it. As seen in fig. 2 od, in some embodiments, the screen of remote control device 2024 shows each plant of the different zones positioned at body The list of the microdevice entered, and the position based on damage can activate specific microdevice via remote control device 2024 to incite somebody to action Electro photoluminescence is delivered to defined body region.

Figure 20 E shows planting for electro photoluminescence to be delivered to the exemplary of blood vessel according to the embodiment of this specification Enter microdevice 2030.Microdevice 2030 includes communication antenna 2032 for communicating with hand-held remote control device, such as Figure 20 C and Shown in 20D those, to activate microdevice 2030.By communication antenna 2032 and battery 2034 or any machine of storage energy System, such as the capacitor coupling for powering for microdevice 2030.The electronic circuit of microdevice 2030 includes and charge coil 2038 coupling magnetic sensors 2036, the charge coil 2038 then with one or more biotic potentials and temperature sensor 2040 couplings, they are all located on ASCI chip 2042, the ASCI chip 2042 and artificial capacitor 2044 and simulation electrode and Communication antenna 2046 is coupled.Figure 20 F is shown according to the embodiment of this specification for electro photoluminescence to be delivered to blood vessel The exemplary circuit diagram 2050 of microdevice.

Figure 20 G shows another example for being used to for electro photoluminescence being delivered to blood vessel of the embodiment according to this specification Property implantable microdevice 2060.Microdevice 2060 includes the silicon base 2062 of elongation, and it includes be individually positioned in proximally and distally Stimulating electrode 2064 and reference electrode 2066.The part of substrate 2062 between the proximal and distal ends includes electronic circuit, example Such as channel capacitor (tank capacitor) 2068, with recycling coil antenna 2072 be coupled power conditioning circuitry 2070, with And output stage 2074 and control electronic device 2076, with such as show hybrid charge storage chip capacitor (hybrid Charge storage chip capacitor) 2078 couplings.It will include all electrodes 2064,2066 and all electronic circuits Entire substrate 2062 be encapsulated in glass capsules packet 2080 or any other gas-tight seal packaging.

The flow chart of Figure 21 shows adjusting by applying electro photoluminescence to blood vessel according to the embodiment of this specification The step of blood flow.In step 2102, by least one electrode arrangement artery, vein, Nutrient artery or vein nerve Or near organ walls.In various embodiments, any electrode described with reference to Fig. 6 and Figure 10 A to 14D can be used.In step Rapid 2104, electric pulse generator is connected the electrodes to, reaches the desired duration to provide the electric pulse of expected frequency and amplitude. In one embodiment, the vasoconstrictive first electro photoluminescence threshold of reaction is predefined.In addition, also predefining in subject Second threshold of reaction of thrombosis.In one embodiment, the amplitude of electric pulse is predetermined lower than thrombosis The threshold of reaction, but it is higher than the vasoconstrictive threshold of reaction, so that stimulation generates advantage of the vessel retraction relative to thrombosis.

In step 2106, active electrode is to provide electro photoluminescence, for adjusting the blood to the organ supplied by artery or vein Liquid stream is dynamic.In one embodiment, it active electrode and is run via on the computing device being coupled with electric pulse generator Algorithm control electro photoluminescence.In one embodiment, algorithm can be showed only in corresponding artery, vein or organ Ability stimulating electrode when blood.In another embodiment, algorithm can be applied the first stimulation with evoked electrode and bleeding occurs Under the second stimulation, first stimulation causes artery/vein to be shunk so that maintain be greater than maximum blood flow 50% or 75% or 90% baseline blood flowing, second stimulation reduce blood flow to maximum blood flow less than 50%, 25% or 10%.In other embodiments, apply electro photoluminescence and reach certain duration, wherein after electro photoluminescence stopping, by blood The dynamic variation of liquid stream maintains at least 1 minute.In other embodiments, apply electro photoluminescence and reach another duration, wherein in electricity After stimulation stops, the variation of blood flow is maintained at least 5 minutes.In other embodiments, intermittent to open and close electricity Stimulation is to maintain the abundant control to blood flow, to allow adequately hemostasis without damaging by the work of the organ of vascularity Power.Duty cycle range in such cases is 1%-99%.In some embodiments, ideal duty cycle range is 10%-90%.In other embodiments, the stimulation parameter including particular duty cycle is configured to generate vasodilation.

In one embodiment, present description provides treated out by applying electro photoluminescence at pre-qualified position The method of blood, wherein bleeding part is in the downstream of stimulation sites.It can be by placing electrode near vessels (or in the blood vessels) (being connected to electric pulse generator) provides electro photoluminescence, to adjust the blood flow in bleeding part downstream.

In various embodiments, the electric current for being up to 1000KHz with frequency can be used for stimulating blood vessel without to blood vessel Wall or solidification cause thermal damage.Electro photoluminescence higher than 1000KHz, which generally produces certain, may damage the heat of blood vessel.Implement at one In scheme, the blood vessel of supply organ can be applied electrostimulation to, causes vessel retraction to prevent during surgical procedures Hemorrhagic situation in organ.In embodiments, it is non-therapeutic less than 25% vessel retraction, and uses 25% Vessel retraction between to 50% prevents hemorrhagic situation.In addition, treating bleeding using the vessel retraction greater than 50%.

In various embodiments, each stimulation location serves the different bleeding parts in stimulation location downstream.In example Property embodiment in, stimulation location in patient's upper limb is used to adjust the blood stream in the entire limbs in upper limb stimulation location downstream Dynamic (thus treating hemorrhagic situation).Similarly, the stimulation location in patient's lower limb is used to adjust lower limb stimulation location downstream Blood flow (thus treating hemorrhagic situation) in entire limbs.

Figure 22 A shows the embodiment according to this specification, provides stimulation to the blood vessel in patient's upper limb to control thorn Swash the bleeding in position downstream.As described earlier, the nerve for supplying blood vessel is also possible to realize the thorn of identical desired therapeutic effect Swash.As indicated, upper limb or arm 2200 include blood vessel, as subclavian artery 2202, axillary artery 2204, deep brachial artery 2206, the upper arm are dynamic Arteries and veins 2208, radial artery 2210, ulna artery 2212, arcus volaris profundus 2214 and arcus volaris superficialis 2216.In one of blood vessel in arm 2200 Bleeding in the case where the exemplary bleeding in arteria brachialis 2208 such as shown in FIG. 22 A, is being located at 2218 upstream of bleeding Electro photoluminescence is applied to blood vessel at position.In an exemplary embodiment, by axillary artery 2204 or being placed around via leading Stimulation is applied to axillary artery 2204 by line 2221 and the electrode 2220 of implantable impulse generator 2222 coupling.Via pulse generation The electrode 2220 that device 2222 activates provides electro photoluminescence to shrink axillary artery 2204 and adjust and flow downstream into arteria brachialis 2208 The blood of bleeding 2218.In embodiments, electrode 2220 can be placed at the position close to 2218 upstream of bleeding part Any promoting blood circulation pipe.In one embodiment, identify from blood vessel be 0.5 to 5cm range with a distance from palpable area vasculosa Domain is to place electrode 2220, and wherein electrode places position and separates out at least 1cm of blood position 2218.

Figure 22 B shows another embodiment according to this specification, in patient's upper limb blood vessel provide stimulation with Control the bleeding in stimulation location downstream.As indicated, upper limb or arm 2230 include blood vessel, such as subclavian vein 2232, axillary vein 2234, cephalic vein 2236, brachial vein 2238, radial vein 2240, ulna vein 2242, arcus volaris profundus 2244, arcus volaris superficialis 2246, expensive want Vein 2248, center ulnar vein 2250 and vena mediana antebrachii 2252.The bleeding in one of blood vessel of arm 2230, such as schemed In the case where exemplary bleeding 2258 in basilic vein 2248 shown in 22B, at the position for being located at 2258 upstream of bleeding Electro photoluminescence is applied to blood vessel.In an exemplary embodiment, by axillary vein 2234 or being placed around via conducting wire 2261 Stimulation is applied to axillary vein 2234 with the electrode 2260 of implantable impulse generator 2262 coupling.Pass through impulse generator 2262 The electrode 2260 of activation provides electro photoluminescence to shrink axillary vein 2234 and adjust the bleeding flowed downstream into basilic vein 2248 2258 blood.In embodiments, electrode 2260 can be placed in any at the position close to 2258 upstream of bleeding part Promoting blood circulation pipe.In one embodiment, palpable blood of the identification between the 0.5 and 5cm from skin surface with a distance from range Area under control domain is to place electrode 2260, and wherein electrode places position and separates out at least 1cm of blood position 2258.

Figure 23 shows the embodiment according to this specification, provides stimulation oversaturation to the blood vessel in patient's lower limb to control thorn Swash the bleeding in position downstream.As indicated, lower limb or leg 2300 include blood vessel, including both artery and vein, such as femoral artery 2302, popliteal artery 2304, anterior tibial artery 2306, posterior tibial artery 2307, arteria peronea 2308, arteria dorsalis pedis 2310 and arch of foot 2312, Vena iliaca externa 2314, femoral vein 2316, perforating veins 2318, great saphenous vein 2320, small saphenous vein 2322, anterior tibial veins 2324, shin Vein 2326 and dorsal venous arch of foot 2328 afterwards.Bleeding in one of blood vessel in leg 2300, such as such as Figure 23 Zhong Suo Shi popliteal In the case where exemplary bleeding 2330 in artery 2304, the blood at the position positioned at 2330 upstream of bleeding is applied electrostimulation to Pipe.

In an exemplary embodiment, by femoral artery 2302 or being placed around via conducting wire 2333 and implantable arteries and veins Stimulation is applied to femoral artery 2302 by the electrode 2332 for rushing the coupling of generator 2334.The electrode activated via impulse generator 2334 2332 offer electro photoluminescence are to shrink femoral artery 2302 and adjust the blood of downstream bleeding 2330 of the Liu into popliteal artery 2302. In embodiments, electrode 2332 can be placed in and any promoting blood circulation pipe telecommunication at the position of 2330 upstream of bleeding part. In one embodiment, identify the accessible angiosomes between skin surface 0.5 and 5cm with a distance from range to place Electrode 2332, wherein electrode places position apart from at least 1cm of bleeding part 2330.

Bleeding in one of vein in leg 2300, it is exemplary in great saphenous vein 2320 such as shown in Figure 23 In the case where bleeding 2336, the blood vessel at the position for being located at 2336 upstream of bleeding applies electro photoluminescence.

In an exemplary embodiment, by vena iliaca externa 2314 or being placed around via conducting wire 2341 and implantable Stimulation is applied to vena iliaca externa 2314 by the electrode 2342 that impulse generator 2340 is coupled.It is activated via impulse generator 2340 Electrode 2342 provides electro photoluminescence to shrink vena iliaca externa 2314 and adjust the bleeding 2336 that downstream flows into great saphenous vein 2320 Blood.In embodiments, electrode 2342 can be placed in and any promoting blood circulation pipe electricity at the position of 2336 upstream of bleeding part Communication.In one embodiment, the accessible angiosomes between skin surface 0.5 and 5cm with a distance from range are identified To place electrode 2342, wherein electrode places position apart from at least 1cm of bleeding part 2336.

Effectively treat with reference to the embodiment described of Figure 22 A, 22B and 23 occur after upper limb and lower limb trauma respectively out Blood, such as the bleeding as caused by accident.

Figure 24 shows the embodiment according to this specification, provides stimulation to the blood vessel in patient abdomen to control stimulation The bleeding in position downstream.As indicated, via blood vessel such as phrenicartery 2402, arteria coeliaca 2404, arteria hepatica 2406, coronaria ventriculi 2408, arteria suprarenalis 2410, the arteria renalis 2411, arteria genitalis 2412, lumbar arteries 2414, sacra media 2416, abdomen active Arteries and veins 2418, arteria linenalis 2420, left gastric artery 2422, superior mesenteric artery 2424, inferior mesenteric artery 2426 and arteria iliaca communis 2428 pairs of 2400 blood supplies of abdomen.The bleeding in one of blood vessel in abdomen 2400, such as of fig. 24 in lumbar arteries 2414 Exemplary bleeding 2430 in the case where, apply electrostimulation to the blood vessel at the position positioned at 2430 upstream of bleeding.In example In property embodiment, by superior mesenteric artery 2424 or being placed around via conducting wire 2433 and implantable impulse generator Stimulation is applied to superior mesenteric artery 2424 by the electrode 2432 of coupling.The electrode 2432 activated by impulse generator 2434 mentions For electro photoluminescence to shrink the blood that superior mesenteric artery 2424 and adjusting flows downstream into bleeding 2430 in lumbar arteries 2414.? In embodiment, any promoting blood circulation pipe for electrode 2432 being placed at the position close to 2430 upstream of bleeding part.Implement at one In scheme, identify the accessible angiosomes between skin surface 0.5 and 5cm with a distance from range to place electrode 2342, Wherein electrode places position apart from at least 1cm of bleeding part 2430.

It is observed in abdomen area since bleeding is typically due to surgical procedures, in embodiments, in surgical procedures The electrode for being used to provide electro photoluminescence is placed on to one or more pre-positions in abdominal cavity of patients before.In the surgical procedures phase Between, it can be by activating the electrode for being placed on any near vessels positioned at bleeding upstream to control to provide electro photoluminescence from blood The blood loss of pipe, as explained with reference to Figure 24.Therefore, in embodiments, for control blood loss by applying to blood vessel The vessel retraction that electro photoluminescence is realized functions as real-time electronic tourniquet, and for preventing hemorrhagic during operation Situation.Such method relative in real time using physical clamp be preferably as it faster and can be easier adjust.

The flow chart of Figure 25 shows the embodiment according to this specification, is applied by the blood vessel to bleeding part upstream Electro photoluminescence come control patient upper limb or lower limb bleeding the step of.In step 2502, the blood vessel with upper limb or lower limb is assessed In bleeding patient irritation therapy.In step 2504, at least one electrode is disposed adjacent to bleeding vessel upstream and is supplied Answer the blood vessel surface of bleeding vessel.In various embodiments, electrode is placed at at least 1cm of bleed site upstream.Various In embodiment, blood vessel is artery or vein, and the artery includes subclavian artery, axillary artery, deep brachial artery, arteria brachialis, oar At least one of artery, ulnar artery, arcus volaris profundus and arcus volaris superficialis, the vein include subclavian vein, axillary vein, cephalic vein, In brachial vein, radial vein, ulnar veins, deep palmar arch, arcus volaris superficialis, basilic vein, center ulnar vein and vena mediana antebrachii at least One.In other embodiments, blood vessel is artery or vein, and the artery includes femoral artery, popliteal artery, anterior tibial artery, shin At least one of artery, arteria peronea, arteria dorsalis pedis and arch of foot, the vein include vena iliaca externa, femoral vein, wear it is quiet At least one of arteries and veins, great saphenous vein, small saphenous vein, anterior tibial veins, posterior tibial veins and dorsal venous arch of foot.It, will in step 2506 Electrode is connected to electric pulse generator.In step 2508, impulse generator generates the electro photoluminescence for being applied to the supply blood vessel of upstream With vasoconstriction and control the bleeding in bleeding vessel.Electro photoluminescence has pulse duration, pulse amplitude and pulse frequency, choosing It selects so that electro photoluminescence effectively causes the vessel retraction in the artery or the vein.

The flow chart of Figure 26 A shows the embodiment according to this specification, passes through the blood to possible bleeding part upstream The step of pipe applies electro photoluminescence to prevent and/or control patient's bleeding during abdominal operation.In step 2602, in the abdomen of patient Start to perform the operation in region.In step 2604, at least one electrode is disposed adjacent to blood vessel upstream involved in the abdominal operation And for should blood vessel blood vessel.In step 2606, electric pulse generator is connected the electrodes to.Operation journey is identified in step 2608 Bleeding during sequence.In step 2610, impulse generator generates the electro photoluminescence for being applied to supplied upstream blood vessel with vasoconstriction simultaneously During operation control downstream blood vessel in bleeding to prevent and/or control bleeding, wherein electro photoluminescence have the pulse duration, Pulse amplitude and pulse frequency, and wherein strobe pulse duration, pulse amplitude and pulse frequency make electro photoluminescence effective Cause vessel retraction.

The flow chart of Figure 26 B shows the embodiment according to this specification, by possible bleeding part upstream Blood vessel applies electro photoluminescence come the step of preventing the expection bleeding during abdominal operation in patient.In step 2620, in the patient Abdomen area in start to perform the operation, wherein starting the region that operation is defined as exposing near vessels involved in the operation.? Step 2622, before bleeding formation, by least one electrode arrangement of stimulating apparatus on the blood vessel in the abdomen area Swim and to the position of the blood vessel telecommunication of the blood vessel blood supply at.In step 2624, at least one described electrode is connected to electricity Impulse generator.Then, continue to perform the operation in step 2626.Before starting the expected increased surgical technic of bleeding possibility, Step 2628, impulse generator, which generates, is applied to the electro photoluminescence that upstream blood vessel reaches the predetermined period, and wherein electro photoluminescence has Have pulse duration, pulse amplitude and pulse frequency, and wherein select the pulse duration, the pulse amplitude and The pulse frequency, so that electro photoluminescence effectively causes the vessel retraction of upstream blood vessel and reduces blood flow, thus prevention or control The bleeding of blood vessel involved in abdomen area processed.Then, continue surgical technic in step 2630.

In various embodiments, the predetermined period that electro photoluminescence is applied before surgical technic is equal at least about 30 Second.In some embodiments, it is applied electro photoluminescence at least 10 seconds during surgical technic.In some embodiments, starting Electro photoluminescence is applied before the surgical technic and in the duration of the remainder of operation.In addition, in some embodiments, Such as under some high risk conditions, at least one described electrode configuration is that duration ranges are in the abdomen area for be maintained at patient 1 to 7 day period and after surgery apply electro photoluminescence to treat postoperative hemorrhage.

The flow chart of Figure 27 is shown stimulation location positioning according to the embodiment of this specification on a skin surface And provide the step of electro photoluminescence is to control bleeding.In step 2702, physician identifies accessible angiosomes, the area vasculosa Skin surface 0.5 of the domain from patient is to 5cm, and from bleeding part at least 1cm.In step 2704, at least one electrode is set In close to the palpable angiosomes.In step 2706, electric pulse generator is connected the electrodes to.In step 2708, pulse Generator generates the electro photoluminescence for being applied to accessible angiosomes with vasoconstriction and controls bleeding.

In other embodiments, it may be desirable that the blood flow increased in blood vessel is related to blood flow reduction to treat Situation or disease, such as peripheral artery disease, Raynaud's disease, coronary artery disease, cranial vascular disease etc..In various embodiment party In case, this is achieved by the following procedure: the working cycles of modification stimulation algorithm, so that the working cycles with > 25% deliver electro photoluminescence To blood vessel, and number of days > 25% delivering therapy.

Above example only illustrates many applications of the system of this specification.Although only describing several realities of the invention herein Scheme is applied, it is to be understood that without departing from the spirit or scope of the present invention, the present invention can be with many other specific Form is implemented.It is therefore contemplated that this example and embodiment are exemplary and not limiting, and the present invention can be appended It modifies in the range of claims.

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Claims

1. being gone out using the expection at least one artery or vein with electrode prevention patient's upper limb of impulse generator telecommunication The method of blood, which comprises

By at least one described electrode arrangement at the position close to patient's artery or vein surface, wherein the artery is clavicle At least one of lower artery, axillary artery, deep brachial artery, arteria brachialis, radial artery, ulnar artery, arcus volaris profundus and arcus volaris superficialis are described Vein is subclavian vein, axillary vein, cephalic vein, brachial vein, radial vein, ulnar veins, arcus volaris profundus, arcus volaris superficialis, basilic vein, elbow At least one of median vein and vena mediana antebrachii, and wherein the position the expected bleeding position upstream extremely Few 1cm；And

The impulse generator is set to generate the electro photoluminescence for being administered to the artery or the vein by least one electrode, wherein The electro photoluminescence has pulse duration, pulse amplitude and pulse frequency, and wherein selects the pulse duration, institute Pulse amplitude and the pulse frequency are stated, so that the electro photoluminescence effectively causes the blood vessel in the artery or the vein to be received Contracting, to prevent the expected bleeding.

2. the method for claim 1 wherein the range in the pulse duration is 1 μ sec to 500msec, the pulse amplitude Range be 1V to 250V, and the range of the pulse frequency be 1Hz to 100kHz.

3. the method for claim 1 wherein at least one described electrode is cuff electrode (cuff electrode) and clamper electricity At least one of pole (clamp electrode), and wherein arrange that at least one described electrode includes by the card skin electricity Pole or the clamper electrode are positioned to and the position direct physical contact.

4. the method for claim 1 wherein radio frequency (RF) receiver is coupled at least one described electrode, and RF is emitted Device is coupled to the impulse generator and wirelessly communicates with the RF receiver, and wherein the method also includes making the arteries and veins Rush generator generate will by least one described electrode apply electro photoluminescence and by the electro photoluminescence from the RF transmitter without Line is transferred to the RF receiver.

5. method of claim 1 further includes using the microprocessor for being operably connected to the impulse generator to select The pulse duration, the pulse amplitude and the pulse frequency is arranged in selecting property.

6. using at least one and impulse generator with pre- in artery or vein of the electrode of telecommunication to prevent patient's lower limb The method of phase bleeding, which comprises

By at least one described electrode arrangement at the artery of the close patient or the position on vein surface, wherein the artery It is at least one of femoral artery, popliteal artery, anterior tibial artery, posterior tibial artery, arteria peronea, arteria dorsalis pedis and vola or the vein It is in vena iliaca externa, femoral vein, perforating veins, great saphenous vein, small saphenous vein, anterior tibial veins, posterior tibial veins and dorsal venous arch of foot At least one, and wherein position upstream at least 1cm of the position in the expected bleeding；And

7. method for claim 6, wherein the range in the pulse duration is 1 μ sec to 500msec, the pulse amplitude Range be 1V to 250V, and the range of the pulse frequency be 1Hz to 100kHz.

8. method for claim 6, wherein at least one described electrode is cuff electrode or clamper electrode, and arrangement is described extremely A few electrode includes being positioned to the cuff electrode or the clamper electrode and the position direct physical contact.

9. method for claim 6 wherein radio frequency (RF) receiver is coupled at least one described electrode, and RF is emitted Device is coupled to the impulse generator and wirelessly communicates with the RF receiver, and the method also includes sending out the pulse Raw device generates the electro photoluminescence to be applied by least one described electrode and wirelessly passes the electro photoluminescence from the RF transmitter It is defeated to arrive the RF receiver.

10. method for claim 6 further includes using the microprocessor for being operably connected to the impulse generator to select The pulse duration, the pulse amplitude and the pulse frequency is arranged in selecting property.

11. controlling the method for the bleeding in patient before the surgical procedures of plan, which comprises

Start to perform the operation in the abdomen area of the patient；

The bleeding formation before by least one electrode arrangement of stimulating apparatus on the blood vessel in the abdomen area Swim and to the position of the blood vessel telecommunication of the blood vessel blood supply at；

At least one described electrode is connected to electric pulse generator；

Bleeding is identified during the surgical procedures；And

The impulse generator is set to generate the electro photoluminescence for being applied to upstream blood vessel, wherein when the electro photoluminescence has pulse persistance Between, pulse amplitude and pulse frequency, and wherein select the pulse duration, the pulse amplitude and the pulse frequency Rate, so that the electro photoluminescence effectively causes the vessel retraction of the upstream blood vessel and reduces blood flow to control the abdomen part The bleeding of the blood vessel in domain.

12. the method for claim 11, wherein the range in the pulse duration is 1 μ sec to 500msec, the pulse vibration The range of width is 1V to 250V, and the range of the pulse frequency is 1Hz to 100kHz.

13. the method for claim 11, wherein at least one described electrode is cuff electrode or clamper electrode, and described in arrangement At least one electrode includes being positioned to the cuff electrode or the clamper electrode and the position direct physical contact.

14. the method for claim 11 wherein radio frequency (RF) receiver is coupled at least one described electrode, and RF is sent out Emitter is coupled to the impulse generator and wirelessly communicates with the RF receiver, and the method also includes making the pulse generation Device generates the electro photoluminescence to be applied by least one described electrode and is wirelessly transferred the electro photoluminescence from the RF transmitter To the RF receiver.

15. the method for claim 11 further includes being come using the microprocessor for being operably connected to the impulse generator The pulse duration, the pulse amplitude and the pulse frequency is arranged in selectivity.

16. preventing the method for the bleeding in patient before the surgical procedures of plan, which comprises

Start to perform the operation in the abdomen area of the patient, be defined as involved in the close operation of exposure wherein starting operation The region of blood vessel in the abdomen area；

At least one described electrode is connected to electric pulse generator；

Continue the operation；

A possibility that starting expected bleeding before increased surgical technic, the impulse generator generation is made to be applied to upstream blood The electro photoluminescence of pipe reaches the predetermined period, wherein the electro photoluminescence has pulse duration, pulse amplitude and pulse frequency, And the pulse duration, the pulse amplitude and the pulse frequency are wherein selected, so that the electro photoluminescence is effectively drawn It plays the vessel retraction of the upstream blood vessel and reduces blood flow to prevent the bleeding of the blood vessel in the abdomen area；And

Continue the surgical technic.

17. the method for claim 16, wherein the predetermined period is equal at least about 30 seconds.

18. the method for claim 16, wherein applying the electro photoluminescence during the surgical procedures technology at least 10 seconds.

19. the method for claim 16, wherein being applied during remainder before starting the surgical technic and in operation The electro photoluminescence.

20. the method for claim 16, wherein at least one described electrode configuration in the abdomen area hold in range be 1 To 7 days periods, and wherein the electro photoluminescence was applied after surgery to treat postoperative hemorrhage.