JP6046631B2 - 腎神経の検出切除装置 - Google Patents
腎神経の検出切除装置 Download PDFInfo
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- JP6046631B2 JP6046631B2 JP2013540055A JP2013540055A JP6046631B2 JP 6046631 B2 JP6046631 B2 JP 6046631B2 JP 2013540055 A JP2013540055 A JP 2013540055A JP 2013540055 A JP2013540055 A JP 2013540055A JP 6046631 B2 JP6046631 B2 JP 6046631B2
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- renal
- nerve
- renal artery
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- ablation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/0016—Energy applicators arranged in a two- or three dimensional array
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
- A61B2018/00267—Expandable means emitting energy, e.g. by elements carried thereon having a basket shaped structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00404—Blood vessels other than those in or around the heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00434—Neural system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00505—Urinary tract
- A61B2018/00511—Kidney
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00791—Temperature
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00875—Resistance or impedance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
- A61B2018/124—Generators therefor switching the output to different electrodes, e.g. sequentially
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36007—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of urogenital or gastrointestinal organs, e.g. for incontinence control
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
- A61N7/02—Localised ultrasound hyperthermia
- A61N7/022—Localised ultrasound hyperthermia intracavitary
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Plasma & Fusion (AREA)
- Medical Informatics (AREA)
- Otolaryngology (AREA)
- Physics & Mathematics (AREA)
- Cardiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Electrotherapy Devices (AREA)
Description
Claims (3)
- 刺激カテーテルであって、近位端と、遠位端と、経皮アクセス位置に対して患者の腎動脈にアクセスするのに十分な長さと、を有する可撓シャフトと、前記シャフトの前記遠位端に設けられるとともに複数の腎動脈部位に刺激手段を送達するように構成される刺激構造と、を備える刺激カテーテルと、
切除カテーテルであって、近位端と、遠位端と、経皮アクセス位置に対して患者の腎動脈にアクセスするのに十分な長さと、を有する可撓シャフトと、前記切除カテーテルのシャフトの前記遠位端に設けられる切除構造と、を備える切除カテーテルと、
前記刺激カテーテルに連結され、患者から生理学的反応を引き出すために複数の腎動脈部位に前記刺激手段を選択的に送達することを促進するように構成される第1の外部システムと、
前記切除カテーテルに連結され、標的腎動脈部位に隣接する腎神経を切除するために、生理学的反応を引き出す前記標的腎動脈部位に切除手段を送達することを促進するように構成される第2の外部システムと、
を備え、
前記生理学的反応が痛みからなり、かつ
前記刺激構造が、痛みを引き起こす第1の刺激手段と痛みを遮断する第2の刺激手段とを選択的に送達するように構成され、
前記第1の外部システムが、前記生理学的反応を引き出す腎動脈部位を特定するために、前記第1の刺激手段と前記第2の刺激手段とを選択的に送達し、選択的に痛みを引き起こすおよび痛みを遮断するように構成される、装置。 - 前記刺激構造は、電気エネルギー、光エネルギー、音響エネルギー、機械力、振動、熱エネルギー、神経伝達物質、化学薬品または薬物、圧力変化、浸透圧変化、およびpH変化からなる1つまたは複数の刺激手段を送達するように構成され、
前記切除構造は、電気エネルギー、前記標的腎動脈部位に隣接する腎神経を熱的に切除する光エネルギー、前記標的腎動脈部位に隣接する腎神経組織内に微小気泡を形成して爆縮または破裂時に腎神経組織に含まれる神経線維と神経節を機械的に破壊する光エネルギー、前記標的腎動脈部位に隣接する腎神経を熱的に切除する音響エネルギー、前記標的腎動脈部位に隣接する腎神経組織内に微小気泡を形成して爆縮または破裂時に腎神経組織に含まれる神経線維と神経節を機械的に破壊する音響エネルギー、機械的荷重または圧縮力、寒冷エネルギー、凝固、変性または壊死を生じさせるのに十分な熱エネルギー、神経毒または毒液、および壊死を生じさせるのに十分な誘発pH変化、からなる1つまたは複数の切除手段を送達することを促進するように構成される、請求項1に記載の装置。 - 前記刺激構造が、
動脈平滑筋細胞の神経活性化により一時的血管収縮を引き起こす近位腎動脈位置に第1の刺激手段を送達して、有意な血管周囲腎神経束の位置特定を促進し、
複数の遠位腎動脈位置に遮断薬を送達して遠心性神経位置の検出を促進するように構成される、請求項1に記載の装置。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US41557910P | 2010-11-19 | 2010-11-19 | |
US61/415,579 | 2010-11-19 | ||
PCT/US2011/061417 WO2012068471A1 (en) | 2010-11-19 | 2011-11-18 | Renal nerve detection and ablation apparatus and method |
Publications (3)
Publication Number | Publication Date |
---|---|
JP2013544155A JP2013544155A (ja) | 2013-12-12 |
JP2013544155A5 JP2013544155A5 (ja) | 2015-01-15 |
JP6046631B2 true JP6046631B2 (ja) | 2016-12-21 |
Family
ID=45044764
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2013540055A Expired - Fee Related JP6046631B2 (ja) | 2010-11-19 | 2011-11-18 | 腎神経の検出切除装置 |
Country Status (6)
Country | Link |
---|---|
US (1) | US20120265198A1 (ja) |
EP (1) | EP2640297B1 (ja) |
JP (1) | JP6046631B2 (ja) |
CN (1) | CN103327921B (ja) |
AU (1) | AU2011329669B2 (ja) |
WO (1) | WO2012068471A1 (ja) |
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