CN101594907A - 用于稳定血管内导线的螺旋结构 - Google Patents
用于稳定血管内导线的螺旋结构 Download PDFInfo
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- A—HUMAN NECESSITIES
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- A61N1/00—Electrotherapy; Circuits therefor
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- A61N1/04—Electrodes
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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Abstract
描述了一种从邻近血管对神经、肌肉或其它组织进行经血管刺激的医用电导线。所述导线包括具有一个或多个螺旋的可膨胀远侧部,所述远侧部用于将所述导线固定及稳定在所述血管内。
Description
技术领域
本发明涉及用于神经或肌肉刺激的医用电导线及其结构。本发明尤其涉及使得导线稳定在邻近待刺激神经的血管内位置的医用电导线结构。
背景技术
现今已对包括左右迷走神经、交感神经和副交感神经、膈神经、骶神经及海绵体神经在内的多种神经的直接或非直接刺激有了相当多的研究,以治疗多种医学、精神病学及神经学上的失调或病症。最近,已提出将迷走神经的刺激作为对多种包括心衰在内的多种心脏疾病的治疗方法。
过去,神经刺激电极一般套在待刺激神经上与之直接接触。很少采用创伤法来使用血管内导线经由邻近的静脉来刺激神经。包括一或多个电极的导线插入患者的脉管系统并且被传递至邻近待刺激神经的血管内的位置。然而,在静脉内没有用于稳定导线的其他装置的情况下,导线会移动及/或旋转,导致电极离开刺激位置。
由此,需要开发一种使导线移动和旋转最小化,并且能够可靠进行长期治疗机构。
发明内容
根据本发明的一实施例,本发明为用于刺激神经的医用电导线。所述导线适于传递至靠近待刺激神经的血管内的刺激位置,所述导线包括:适于连接至脉冲生成器的近侧端;包括可膨胀远侧部的导线体,该可膨胀远侧部将所述导线固定及稳定在所述刺激位置;及一或多个位于所述远侧部上的电极。所述远侧部包括第一螺旋、第二螺旋及所述第一螺旋与第二螺旋之间的大致直的部分。所述螺旋具有预定有效外径并且适于膨胀且与至少一个管壁摩擦卡合。所述位于所述远侧部上的一或多个电极适于将电脉冲经血管传递至所述神经。当所述远侧部膨胀时,至少一个电极靠近所述待刺激神经。
根据另一实施例,本发明为用于刺激神经的医用电导线。所述导线适于传递至位于靠近待刺激神经的血管内的刺激位置,所述导线包括:适于连接至脉冲生成器的近侧端;包括可膨胀远侧部的导线体,该可膨胀远侧部将所述导线固定及稳定在所述刺激位置;及一或多个位于所述远侧部上的电极。所述远侧部包括至少一个具有预定有效外径的螺旋,其中所述螺旋形成为膨胀且与至少一个管壁摩擦卡合。所述位于所述远侧部上的一或多个电极适于将电脉冲经血管传递至所述神经。当所述远侧部膨胀时,至少一个电极靠近所述待刺激神经。
根据本发明的再一实施例,本发明为一种使用包括可膨胀远侧部的血管内医用电导线从相邻血管进行神经或肌肉刺激的方法,所述远侧部具有一或多个螺旋,用于将所述导线固定及稳定在所述刺激位置。所述方法包括:收缩所述远侧部;将所述导线的远侧部传递至位于靠近所述神经的血管内的刺激位置;及刺激所述相邻的神经。所述导线连接至脉冲生成器并且包括一或多个位于所述远侧部的电极。至少一个所述电极适于将电脉冲经血管地传递至待刺激神经或肌肉。
尽管业已揭露了多个实施例,本技术领域的技术人员通过下文描述本发明示范实施例的详细描述可清楚本发明的其它实施例。因此,这些附图和详述应认为是说明性的而非用于限制。
附图说明
图1为根据本发明一实施例的展开在患者的颈内静脉中靠近迷走神经的位置的导线的示意图;
图2为根据本发明一实施例的图1所示的展开在患者颈内静脉中的导线的放大示意图;
图3为根据本发明另一实施例的通过高进入位置插入而展开在患者颈内静脉中的导线的示意图;
图4为根据本发明另一实施例的展开在患者头臂静脉中的导线的示意图;
图5为根据本发明另一实施例的展开在患者上腔静脉中的导线的示意图;
图6为根据本发明一实施例的导线的立体图;
图7A-7B示出了根据本发明多个实施例的导线的远侧部的侧视图;
图8为根据本发明一实施例的展开在血管中的导线的远侧部的放大示意图;
图9为根据本发明一实施例的导线的远侧部的侧视图;
图10为根据本发明另一实施例的导线的远侧部的侧视图;
图11为根据本发明一实施例的展开在血管中的图9所示的导线的远侧部的放大示意图。
尽管可将本发明修改为多种变化和代替形式,下文通过附图中的例子示出并且详细描述了具体实施方式。然而,本发明并不限于所描述的具体实施方式。相反,本发明意欲覆盖所有落入所附权利要求范围内的修改、等同物及替换。
具体实施方式
尽管本文描述的实施例主要涉及通过左或右锁骨下静脉将导线放入右颈内静脉,下文所述的本发明的多种实施例可在患者脉管系统内的多个位置进行。任何有可能从刺激获益的神经、肌肉或脑组织附近的血管内位置为刺激的可能位置。术语“血管”包括循环系统的所有静脉和动脉。此外,该术语“血管”包括淋巴系统的多种结构,包括淋巴结、淋巴管、毛细淋巴管、淋巴道。类似地,如文中所用的,该术语“血管”还包括肠胃系统的多种管状结构。在此使用的表述“神经”或“神经纤维”包括单神经元、神经、神经末梢,或神经束。术语“血管内”表示在静脉或动脉循环系统之内,包括各种类型和种类的血管。当在本发明实施例的描述中称为“血管内刺激”时,系指来自循环系统内部的、导致受益神经、肌肉或组织的(经血管的)刺激的刺激。术语“经血管的”系指穿过血管或血管壁。“刺激”系指通常为电的刺激,这一刺激导致例如通过流入细胞的钙和钠、或者细胞两端的膜电位变化测得的一个细胞或多个细胞或一个细胞的一部分的去极化、收缩、激励。
已知其相邻处或附近有神经延伸的、直径足够让导管进入的血管可作为合适的候选可能刺激位置。位置的例子包括但不限于:左右颈内静脉、奇静脉、头臂(无名)静脉、锁骨下静脉、上腔静脉、肺动脉、心脏支血管。其它可能的刺激位置包括但不限于:胸导管、胆管、沿上胃肠道及下胃肠道的位置。待刺激神经的例子包括但不限于左右迷走神经、膈神经、副交感神经、交感神经及骶神经。
图1示出了患者的脉管系统2的立体图,导线6展开在系统2中。图2为展开在系统2中的导线6的分解图。一般地,如图所示,脉管系统2包括右颈外静脉10和左颈外静脉14、右颈内静脉18和左颈内静脉22、右锁骨下静脉26和左锁骨下静脉30,所述脉管系统的一部分与右迷走神经34和左迷走神经38大致对齐。如图1和2所示,导线6通过左锁骨下静脉30插入患者的脉管系统,并且插入右颈内静脉18。根据一实施例,如图3所示,导线6可通过颈内静脉18中的高位40借助经皮棒(percutaneous stick)插入。或者,导线6可从低位借助经皮棒插入。最终,导线6被插入,并且使用同侧法(same sideapproach)经由右锁骨下静脉26前进入脉管系统。导线6定位在靠近右迷走神经34的右颈内静脉18中。
图4及5示出了根据本发明实施例的导线6,其展开在患者脉管系统中的其他替代位置上以刺激迷走神经34。根据一实施例,如图4所示,导线6通过左锁骨下静脉30插入,并且展开在头臂静脉43内。迷走神经34的靠近头臂静脉43的部分由图4中的虚线表示。根据另一实施例,如图5所示,导线6通过左锁骨下静脉30插入,并且展开及固定在上腔静脉44中。迷走神经34靠近上腔静脉44的部分由图5中的虚线表示。
图6为根据本发明一个实施例的导线6的立体图。如图6所示,导线6包括具有近侧部46和远侧部50的导线体42,远侧部50包括一或多个电极52。此外,导线6包括适于与脉冲生成器或其它可植入医疗装置连接的近侧端。导线体42为挠性,但基本无法沿其长度进行压缩,并且截面为圆形。
根据本发明的一实施例,导线体42包括多个传导件。所述传导件可为电线、线圈、线缆,或它们的组合。所述多种传导件包括单独的电线。这些电线可为绝缘的导线、线圈和线缆,以及/或者与诸如硅、聚氨酯、乙烯四氟乙烯之类的绝缘体或其它生物相容绝缘聚合物在适当位置成型在一起。或者,根据本发明的另一实施例,导线体42为共径(co-radial)的设计。这一实施例中,各单独的传导件使用套管等独立地进行绝缘,然后平行卷绕在一起以形成单个的线圈。或者,导线体42为共轴。根据本发明的再一实施例,各传导件适于以“一对一(one-to-one)”的方式连接至单个电极52,以使得可对各电极52进行单独的编址。本方面的另一实施例中,导线体42包括适于容纳导丝、或通管丝之类导向件的内腔,用于使得导线的远侧部50收缩(部分地或完全地)并且导向至血管内的刺激位置。最终,导线体42具有业界公知的结构。
根据本发明的另一实施例,远侧部50的刚性大于包括近侧部46在内的导线体42的刚性。名称为“具有近侧张力减缓的经血管导线”的、经共同转让的第11/669,039号美国共同未决专利申请揭露了这一结构的示范实施例,通过引用将其合并在此。
此外,远侧部50适于在收缩形态和膨胀形态之间转换,该收缩形态适于导线6通过患者脉管系统插入收缩,该膨胀形态适于将导线6的远侧部50固定且稳定在血管中。导管或导丝之类的导向件适于插入远侧部50中以使远侧部50收缩并且能够通过脉管系统前进至目标刺激位置。
根据本发明的一个实施例,远侧部50包括超弹性材料。所述超弹性材料的例子包括镍钛诺(Nitinol)和MP35N。
如图7A~7B所最佳地示出的,导线6的远侧部50包括一或多个螺旋形的回转而形成螺旋64。螺旋64的回转可以以顺时针或逆时针方向旋转。回转的次数范围可为1/2回转~多个回转。螺距可用于描述螺旋上两点之间的距离。所述螺距可沿着螺旋64变化,范围为0cm(套索结构)~5cm,或者保持一常数。此外,螺旋64具有预定的有效外径。螺旋64的有效外径选择为稍大于所述螺旋64在其中展开的血管的内径。根据本发明的一实施例,螺旋64的有效外径的范围为5~约50mm。根据本发明的另一实施例,螺旋64的有效外径的范围为约10~约35mm。此外,螺旋64可采用多种截面形状。根据一实施例,螺旋64具有圆形的截面。圆形截面使得方位不会发生偏移,以使当该导线在静脉中旋转时,螺旋64呈现不会偏向至某个特定方位的特性。根据本发明的另一实施例,螺旋64具有椭圆的截面形状。可根据导线6的远侧部50在其中展开的血管的尺寸、直径和形状来选择螺旋64的总体尺寸、直径和截面形状。根据本发明的一个实施例,根据患者身体的解剖学需要,螺旋64的总长的范围为约30mm~约200mm。更具体地,螺旋64的总长的范围为约40mm~约80mm。
根据本发明的再一实施例,螺旋64的直径从其近端直至其远端逐渐增大,以形成从螺旋64的远端朝向螺旋64的近端逐渐变细的预定形状。或者,螺旋64的直径可为从其近端直至其远端逐渐减小,形成从螺旋64的近端朝向螺旋64的远端逐渐变细的预定形状。
图8为在靠近右迷走神经34的右颈内静脉18中展开的导线6的远侧部50的放大示意图。在患者脉管中展开时,螺旋64形成为径向膨胀,这样其与管壁72和74的内表面接触并摩擦卡合,以将导线6的远侧部50固定和稳定在该血管内的刺激位置。该刺激位置可为如前所述的在靠近神经或肌肉的血管内的位置,该位置使得穿过管壁而对该神经或肌肉的电刺激最大化。根据本发明的一实施例,螺旋64在管壁72和74上施加足够的横向力而不发生损伤,从而导致螺旋64偏出管壁72和74而朝向待刺激神经34。从而,任何在螺旋64上的电极52放置成与神经34靠得很近。一实施例中,电极52放置在离待刺激神经34的距离小于2mm的地方。本发明的另一实施例中,螺旋64使得管壁72和74与神经34直接接触。
螺旋64适于在收缩形态和膨胀形态之间转换。在其膨胀形态中,螺旋64具有预定的有效直径,并且适于与远侧部50的血管在其中展开的至少一个侧壁摩擦卡合。根据本发明的一实施例,由于螺旋64在其中展开的血管的壁会限制螺旋64的完全膨胀,因此当允许在血管内膨胀时,螺旋64不会达成其预定有效直径。这样,螺旋64在该血管壁上施加径向膨胀力,提供了将导线6的远侧部50稳定在该血管中的机构。一实施例中,该有效直径的范围为比其中放置有导线6的远侧部50的血管的内径大约5%~约50%。
根据本发明的一实施例,该导线体可包括适于容纳导丝、或通管丝之类导向件的内腔,其有助于将远侧部50传递至血管内的刺激位置。或者,可设置导管将远侧部50传递至血管内的刺激位置。单独或者互相组合的该通管丝、导丝或导管用于将包括螺旋64的远侧部50从膨胀形态收缩(弯全地或部分地)至收缩形态(完全的或部分的),并且将该导线的远侧部50导向通过患者的脉管系统。一旦收缩,远侧部50可插入患者的脉管系统并且被导向至血管内的刺激位置。当已到达该刺激位置时,取出该导向件,以允许远侧部50从收缩形态转换至膨胀形态。
根据本发明的另一实施例,使用导管将导线6的远侧部50传递至血管内的刺激位置。一旦位于目标血管的内部,该远侧部从该导管部分展开并且旋转,或者进行其它操控。位于该远侧部的电极可用于短暂刺激,并且由此测试可能的刺激位置。一旦使用由短暂刺激获得的信息而选定刺激位置,该导管可以完全回缩并且该远侧部展开,以将该远侧部固定及稳定在该血管内的刺激位置,这样可在该目标刺激位置发生刺激。
根据本发明的另一实施例,螺旋64为可变地膨胀。即螺旋64适于在与管壁卡合并保持摩擦力的同时根据管壁的尺寸和直径的自然变化而膨胀。例如,当位于颈内静脉中,颈内静脉的内部几何形状(直径和内部形状)会随着血流和血压变化。类似地,当患者处于直立位置时,血管的直径小于患者处于仰卧或俯卧位置时的直径。螺旋64通过膨胀解决管径不同的问题,以保持管壁上的摩擦力,从而将远侧部50固定和稳定在血管中。
根据本发明的另一实施例,远侧部50包括一或多个位于螺旋64上的电极52。至少一个电极52适于将电脉冲经血管地传递至待刺激的神经或肌肉。此外,根据本发明的另一实施例,至少一个电极52为感测电极。至少一个电极52的方位为朝向该待刺激神经或肌肉。再一实施例中,螺旋64的圆形截面使得电极52的方位易于朝向相邻的该待刺激神经或肌肉。由于圆形截面的螺旋没有特别的方位偏向,可对该螺旋进行旋转或其它操控,而使得穿过管壁到达相邻神经的电刺激最大。由于螺旋64在血管内膨胀,如图8所示,电极52被抵靠着管壁72和74向上推动,以使得迷走神经34的经血管刺激最大。一实施例中,以足够横向力抵靠着管壁72和74向上推动螺旋64,以使螺旋64偏出该管壁而使得至少一个电极52离该相邻神经更近。更具体地,螺旋64在管壁72和74上施加足够的径向膨胀力,这样在不损坏管壁72和74的情况下,螺旋64的回转偏出管壁72和74的原始边界并朝向待刺激神经34。从而,任何位于螺旋64上的电极52更靠近神经34。
该螺旋偏出管壁的原始边界不会造成管壁的损坏,也不会使得该螺旋蚀穿管壁。经过一段较长时间后,整个螺旋上形成组织鞘,这样其变得被封在管壁之内。该血管的外几何形状改变,使得位于血管内部的螺旋的外轮廓可见。
根据本发明的另一实施例,如图9-10所示,导线6的远侧部50包括一或多组螺旋形回转,形成一或多个螺旋76。如图9所示,各螺旋76的螺旋形回转可沿相同的方向卷绕,或者如图10所示地以相反方向卷绕。根据本发明的再一实施例,螺旋76由导线体42的基本直的部分80中断。基本直的部分80形成为其与待刺激神经平行地延伸。电极52可位于其中一个螺旋76上、位于两个螺旋76上、位于直的部分80上、或者位于它们的组合上。
图11为导线6的远侧部50的示意图,所述远侧部包括一或多个在靠近待刺激神经的血管中展开的螺旋76。根据本发明的一实施例,电极52位于导线体42的直部80上。螺旋76使得导线6的远侧部50稳定,并且抵靠着导线6的远侧部50在其中展开的血管壁向上推动电极52,这样电极52与相邻的待刺激神经水平对齐并且与该神经靠得很近。
如图6-10所示,根据本发明多个实施例的导线6包括多个位于远侧部50上的电极52。电极52位于一或多个螺旋64或76上、位于大致直的部分80上,或位于它们的组合上。电极52可与待刺激神经平行对齐。根据本发明的再一实施例,电极52位于互相平行的平面上。所述平行平面垂直于该待刺激神经。
多个电极使得导线6的远侧部50可灵活地经血管放置。并非所有的电极52都需定向为朝着相邻神经或肌肉组织的方位以使得形成最大的经过管壁的刺激。类似地,螺旋64的圆形或椭圆形截面使得螺旋64可在血管内旋转以保证至少一个电极能够将通过管壁传递足够的电刺激脉冲。此外,可通过导线体将电极连接至多个单独的传导体以使所述电极可单独编址。根据本实施例,可适于选择电极,从而控制刺激方向。可在相同螺旋64上的单个电极52之间、不同的螺旋76及/或直部80之间发生刺激,以更好地控制电流场和刺激方向,以及允许刺激和感测有多种选择。
电极52的可为业界中公知的任何电极形态。根据本发明的一个实施例,至少一个电极52为环形结构。根据本发明的另一实施例,至少一个电极52为部分环形电极。根据本发明的再一实施例,电极包括暴露的电极部和绝缘的电极部。根据本实施例,电极52通过掩膜刻在螺旋64或76的内周面上或者通过其他绝缘方式设置在其上。暴露的电极部位于螺旋64或76的外周面。名称为“经血管神经刺激的电极结构”的第11/688,957号美国共同未决专利申请揭露了这种类型的示范电极,通过引用将其合并在此。导线体42旋转为使得该曝露电极部朝向相邻的待刺激神经、肌肉或组织的方位。该曝露电极部形成为其适于将电流密度指向或集中到刺激目标。该绝缘电极部位于导线体42上与该暴露电极表面相反的位置。该绝缘电极部用作防护,以免不为刺激目标的相邻或靠近神经或肌肉受到不需要的刺激。
可通过使用导线体42的远侧区域中的缝线将导线6进一步稳定在颈内静脉34中。一实施例中,通过在将导线6的远侧部50植入颈内静脉之后让患者穿戴一段时间的护颈支架来进一步固定导线6。另一实施例中,导线6包括业界公知的固定结构,例如位于远侧区域的硅齿尖(silicon tine)或螺丝锥形(corkscrew-shaped)固定结构(未示),以将导线6稳定在颈内静脉34中。其它实施例中,固定结构可位于导线6的远侧端。导线6还可包括在导线体42上的促进组织内部生长的区域。一实施例中,该区域包括导线体上的经粗糙处理的聚合物表面。另一实施例中,该区域包括在导线体42内、在电极内、或在导线体42与电极之间的阶梯直径区或插入直径区。其它实施例中,该区域包括达可纶网(Dacron mesh)之类的聚合物网、不锈钢或镍钛诺网之类的金属网、或者生物可吸收网。生物可吸收网的例子包括聚乙醇酸、聚乳酸和聚对二氧环己酮。导线6可包括缝线、固定装置、组织内部生长区域的、或者提高其在颈内静脉34中稳定性的护颈支架的组合。
可使用常规技术将根据本发明多种实施例的导线6传送至靠近待刺激神经、肌肉或组织的血管内的刺激位置。根据本发明的另一实施例,导线6可通过直接进入患者颈内静脉的经皮棒插入患者的脉管系统,以对迷走神经进行治疗。根据本发明的另一实施例,使用导管将导线6的远侧部50收缩并且传递至刺激位置。一旦到达该刺激位置,取出该导管,位于导线6的远侧部50的螺旋膨胀以与所述螺旋在其中展开的血管的管壁接触并摩擦卡合。类似地,可将通管丝或一或多个导丝插入导线内腔以使远侧部50从其预定形状变直。然后将该远侧部通过脉管系统导向至血管内的刺激位置。一旦到达该刺激位置,取出该导丝或通管丝,以使得导线6的远侧端50恢复至其预定形状,一般为螺旋形。然后,远侧部50膨胀以与所述远侧部在其中展开的血管的管壁接触并摩擦卡合。螺旋64可在该血管内旋转以使得电极52朝向该刺激位置的方位。此外,可进一步旋转导线体42或对其定位,直至获得通过管壁到邻近待刺激神经或肌肉的电刺激为最大或最优。可使用外部或内部装置对由电极传送的刺激脉冲进行测量。此外,可通过在血管内旋转导线体42或者将导管或导丝之类的导向部件重新导入,以使得线6的远侧部50变直从而在该血管内重新定位该导线。然后,可重新对导线6定位及/或将其从该血管中取出。根据本发明的再一实施例,该远侧部可从导管部分地展开,以暂时刺激电极。一旦辨识了合适的刺激位置,该导管退回并且远侧部50在该刺激位置处在该血管内完全展开。
可对所描述的示范实施例作出多种修改和附加而不脱离本发明的范围。例如,尽管上述实施例提及具体的特征,然而本发明的范围还包括具有不同特征组合的实施例和不包括所述特征的实施例。因此,本发明的范围意欲涵盖所有落入权利要求及其等价物范围之内的这种代替、修改及变化。
Claims (24)
1、一种用于刺激神经的医用电导线,其中所述导线适于传递至位于靠近待刺激神经的血管内的刺激位置,所述导线包括:
适于连接至脉冲生成器的近侧端;
导线体,包括适于在收缩形态和膨胀形态之间转换的远侧部,所述远侧部用于将所述导线固定及稳定在所述刺激位置,其中所述远侧部包括第一螺旋、第二螺旋及所述第一螺旋与第二螺旋之间的大致直的部分,其中所述螺旋具有预定有效外径并且适于与至少一个管壁摩擦卡合;及
一个或多个位于所述远侧部上的电极,所述电极适于将电脉冲经血管传递至所述待刺激神经,其中当所述远侧部膨胀时,至少一个电极放置成靠近所述待刺激神经。
2、如权利要求1所述的医用电导线,其中所述血管选自颈内静脉、上腔静脉和头臂静脉,并且所述神经为迷走神经。
3、如权利要求2所述的医用电导线,其中所述电极与所述迷走神经之间的距离小于2mm。
4、如权利要求1所述的医用电导线,其中所述螺旋的预定外径的范围为大于所述远侧部展开于其中的所述血管的内径约5%~约50%。
5、如权利要求1所述的医用电导线,其中所述第一螺旋以第一方向卷绕,所述第二螺旋以相反的第二方向卷绕。
6、如权利要求1所述的医用电导线,其中至少两个电极与所述待刺激神经平行对齐。
7、如权利要求1所述的医用电导线,其中所述远侧部包括超弹性材料,所述超弹性材料选自镍钛诺和MP35N。
8、一种用于刺激神经的医用电导线,其中所述导线适于传递至位于靠近待刺激神经的血管内的刺激位置,所述导线包括:
适于连接至脉冲生成器的近侧端;
导线体,包括适于在收缩形态和膨胀形态之间转换的远侧部,所述远侧部用于将所述导线固定及稳定在所述刺激位置,其中所述远侧部包括至少一个具有预定有效外径的螺旋,其中所述螺旋的预定有效外径稍大于所述导线的远侧部展开于其中的所述血管的内径,并且当所述远侧部处于膨胀形态时,所述螺旋适于与至少一个管壁摩擦卡合;及
一个或多个位于所述远侧部上的电极,所述电极适于将电脉冲经血管传递至所述待刺激神经,其中当所述远侧部膨胀时,至少一个电极靠近所述待刺激神经。
9、如权利要求8所述的医用电导线,其中所述血管选自颈内静脉、上腔静脉和头臂静脉,并且所述神经为迷走神经。
10、如权利要求9所述的医用电导线,其中所述一或多个电极与所述迷走神经之间的距离小于2mm。
11、如权利要求8所述的医用电导线,其中所述至少一个螺旋的预定外径的范围为大于所述远侧部展开于其中的所述血管的内径约5%~约50%。
12、如权利要求8所述的医用电导线,其中所述远侧部包括两个螺旋及所述两个螺旋之间的大致直的部分,其中所述大致直的部分配置成与所述待刺激神经平行地延伸。
13、如权利要求12所述的医用电导线,还包括位于所述大致直的部分上的至少一个电极。
14、如权利要求12所述的医用电导线,其中所述第一螺旋以第一方向卷绕,并且所述第二螺旋以相反的第二方向卷绕。
15、如权利要求8所述的医用电导线,其中所述远侧部包括一个或多个与所述待刺激神经平行对齐的电极。
16、如权利要求8所述的医用电导线,其中所述远侧部包括超弹性材料,所述超弹性材料选自镍钛诺和MP35N。
17、一种使用连接至电脉冲生成器的血管内医用电导线从相邻血管进行神经刺激的方法,所述方法包括:
设置医用电导线,所述电导线包括导电的导线体、包括一或多个螺旋的可膨胀远侧部、及至少一个位于所述远侧部上的电极,所述远侧部将所述电极固定及稳定在位于靠近迷走神经的血管中的刺激位置;
收缩所述远侧部;
使得所述导线的远侧部前进至位于靠近所述迷走神经的所述血管内的所述刺激位置;
允许所述远侧部膨胀,这样所述螺旋将所述导线的所述远侧部固定及稳定在所述血管中以使所述至少一个电极设为靠近所述迷走神经;及
刺激所述迷走神经。
18、如权利要求17所述的方法,还包括检测最优刺激阈值。
19、如权利要求17所述的方法,还包括旋转所述导线体,以使所述至少一个电极朝向所述待刺激的神经或肌肉的方位。
20、如权利要求17所述的方法,还包括重定位所述导线。
21、如权利要求17所述的方法,还包括旋转所述导线体,直至达到最优刺激阈值。
22、如权利要求17所述的方法,其中位于所述迷走神经附近的所述血管
23、如权利要求17所述的方法,其中位于所述迷走神经附近的所述血管是头臂静脉。
24、如权利要求17所述的方法,其中位于所述迷走神经附近的所述血管是右颈内静脉。
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- 2007-01-30 US US11/668,926 patent/US8244378B2/en not_active Expired - Fee Related
- 2007-11-30 WO PCT/US2007/086127 patent/WO2008094349A1/en active Application Filing
- 2007-11-30 EP EP07865026.4A patent/EP2125106B1/en not_active Not-in-force
- 2007-11-30 JP JP2009547238A patent/JP2010516386A/ja active Pending
- 2007-11-30 AU AU2007345606A patent/AU2007345606B2/en not_active Ceased
- 2007-11-30 CN CNA2007800506577A patent/CN101594907A/zh active Pending
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Also Published As
Publication number | Publication date |
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US20080183259A1 (en) | 2008-07-31 |
AU2007345606B2 (en) | 2011-12-15 |
AU2007345606A1 (en) | 2008-08-07 |
WO2008094349A1 (en) | 2008-08-07 |
JP2010516386A (ja) | 2010-05-20 |
EP2125106A1 (en) | 2009-12-02 |
EP2125106B1 (en) | 2013-06-12 |
US8244378B2 (en) | 2012-08-14 |
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