CN103190950A - 用于使用可扩张天线治疗组织的系统和方法 - Google Patents

用于使用可扩张天线治疗组织的系统和方法 Download PDF

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CN103190950A
CN103190950A CN2013100009266A CN201310000926A CN103190950A CN 103190950 A CN103190950 A CN 103190950A CN 2013100009266 A CN2013100009266 A CN 2013100009266A CN 201310000926 A CN201310000926 A CN 201310000926A CN 103190950 A CN103190950 A CN 103190950A
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A·C·李
K·S·博恩
M·N·普拉卡什
F·罗塞托
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Abstract

本发明涉及的修复脉管内壁的方法包括以下步骤：将微波消融装置的至少一部分插入至脉管内。微波消融装置包括布置于外导体内并且限定纵向轴线的内导体。方法还包括以下步骤：将修复密封材料插入至脉管内以使得修复密封材料布置于脉管内壁和外导体之间，以及使外导体的至少一部分相对于纵向轴线扩张以迫使修复密封材料的至少一部分进入脉管内壁内。方法还包括以下步骤：输送能量至内导体和外导体中的至少一个以激活修复密封材料，从而修复脉管内壁。

Description

用于使用可扩张天线治疗组织的系统和方法
技术领域
本发明涉及电外科消融装置及其方法。更具体地，本发明涉及使用能够被扩张的可展开天线进行组织治疗。
背景技术
在治疗诸如癌症的疾病中，已经发现某些类型的癌症细胞在升高的温度下变性，所述升高的温度稍低于通常来说对健康细胞有损伤的温度。普遍已知为热疗的这些治疗类型通常利用电磁辐射将疾病细胞加热至41℃以上的温度，与此同时将周围的健康细胞维持在不发生不可逆细胞破坏的较低温度。利用电磁辐射加热组织的其他手术还包括组织消融和凝结。这些微波消融手术（例如用于月经过多的微波消融手术）通常被用来消融并且凝结目标组织以使其变性或死亡。本领域的技术人员已知利用电磁辐射疗法的许多手术和装置类型。这些微波疗法通常被用于诸如前列腺、心脏和肝脏的组织和器官的治疗中。
一种非侵入性手术一般包含通过使用微波能量治疗皮肤以下的组织（例如肿瘤）。微波能量能够非侵入性地穿透皮肤以到达在下方的组织。然而，这种非侵入性手术可能导致对健康组织的不必要加热。因此，微波能量的非侵入性使用需要大量的控制。这是为什么一直在寻找实施微波辐射的更加直接和精确方法的一部分原因。
当前，存在若干类型在用的微波探针，例如单级的、双极的、和螺旋的。一种类型为单级天线探针，其包括暴露于探针端部处的单个细长微波导体。探针有时被电介质套围绕。第二种常用的微波探针类型为包括共轴结构的双极天线，所述共轴结构具有内导体以及外导体，其中电介质将内导体的一部分与外导体的一部分分开。在单级和双极天线探针中，微波能量一般垂直于导体的轴线辐射。
由于微波能量辐射的垂直样式，因此传统的天线探针通常设计为被直接地插入至待被辐射的组织内，诸如肿瘤。然而，这种典型的天线探针通常不能提供围绕探针的有效长度在轴向上和/或在径向上均匀的加热。
常常难以估计微波能量将辐射至周围组织内的程度，即难以确定待被消融的周围组织的区域和体积。此外，当传统的微波天线被直接地插入至诸如癌组织的组织内时，存在以下可能性：在插入、安放、或移除天线探针过程中将癌细胞沿天线主体拖拉或牵拉至身体的其他部位内。
在某些情况下，有利的是创造相对大的消融区域，这常常需要插入至患者体内的多个消融器械。
发明内容
本文所使用的术语“远端”指的是微波消融装置或其部件的与使用者较远的部分，与此同时，术语“近端”指的是微波消融装置或其部件的靠近使用者的部分。
根据本发明的另一个方面，提供一种修复脉管内壁的方法。方法包括以下步骤：将微波消融装置的至少一部分插入至脉管内以用于治疗病症，诸如但不限于大血管病变。微波消融装置包括布置于外导体内的内导体。内导体限定纵向轴线。方法还包括以下步骤：将修复密封材料插入至脉管内，以使得修复密封材料布置于脉管内壁和外导体之间，以及使外导体的至少一部分相对于纵向轴线扩张以迫使修复密封材料的至少一部分进入脉管内壁内。方法还包括以下步骤：输送能量至内导体和外导体中的至少一个以激活修复密封材料，从而修复脉管内壁。
方法可以进一步包括以下步骤：使外导体的已扩张的部分朝向纵向轴线收缩、将微波消融装置在脉管内相对于修复密封材料移动、重复扩张步骤、并且重复输送步骤。
替代地或额外地，方法的插入步骤可以基本上同时发生。
替代地或额外地，修复密封材料可以包括网孔矩阵，所述网孔矩阵构造用于在方法的插入步骤之前接合外导体的至少一部分。
方法可以包括以下步骤：使外导体的已扩张的部分朝向纵向轴线收缩并且从脉管撤回微波消融装置的已插入的部分。
替代地或额外地，方法的扩张步骤可以引起外导体沿其至少一部分分为多个导体。
替代地或额外地，修复密封材料可以由方法的输送步骤产生的热量激活。
根据本发明的进一步的方面，提供一种微波治疗系统。系统包括电外科能量源以及操作地连接至电外科能量源的微波天线组件。微波天线组件包括构造用于将能量从能量源输送至患者组织的辐射部分。辐射部分具有外导体以及延伸穿过外导体的内导体。内导体布置于外导体内并且限定纵向轴线。内导体和外导体中的一个能够相对于另一个移动以引起外导体的至少一部分在径向上相对于纵向轴线扩张。
替代地或额外地，外导体和内导体中的至少一个可以终止于构造用于刺入组织的远端尖端。
替代地或额外地，远端尖端可以为绝缘的。
替代地或额外地，外导体可以包括多个可展开的导体，所述多个可展开的导体至少部分地沿外导体的长度布置并且构造用于在径向上相对于纵向轴线扩张。
替代地或额外地，多个可展开的导体可以构造用于机械地切割穿过组织。
替代地或额外地，多个可展开的导体可以构造用于在来自电力源的能量的帮助下切割穿过组织。
替代地或额外地，外导体的至少一部分可以为柔性的。
替代地或额外地，当外导体在径向上相对于纵向轴线被扩张时外导体和内导体之间的距离可以限定消融区域。
替代地或额外地，外导体和内导体可以被构造为一旦致动就形成在消融区域内的电磁场。
替代地或额外地，外导体相对于内导体的向远端移动可以引起外导体的至少一部分在径向上相对于纵向轴线扩张。
替代地或额外地，内导体相对于外导体的向近端移动可以引起外导体的至少一部分在径向上相对于纵向轴线扩张。
根据本发明的进一步的方面，提供一种修复脉管的方法。方法包括以下步骤：将消融装置的至少一部分插入至脉管内。消融装置包括布置于外导体内的内导体。方法还包括以下步骤：将修复密封材料插入至脉管内，以使得修复密封材料布置于脉管和外导体之间。方法还包括以下步骤：使外导体的至少一部分朝向脉管扩张，并且输送能量至内导体和外导体中的至少一个以激活修复密封材料，从而修复脉管内壁。
方法还可以包括以下步骤：将外导体的已扩张的部分远离脉管收缩、在脉管内移动消融装置、以及重复扩张和输送步骤。
附图说明
本发明的各种实施例参考附图在本文进行描述，其中：
图1示出根据本发明的实施例的微波天线组件的图示；
图2为连接至高频电刀的图1的微波天线组件的示意图；
图3为沿图2的截面线3-3截出的剖视图；
图4为图1-3的微波天线组件的远端部分的侧视图；
图5为图1-4的微波消融装置的远端部分的立体图；
图6A为未扩张并且布置于脉管内的图1-5的微波消融装置的远端部分的侧视图；以及
图6B为已扩张并且布置于脉管内的图1-6的微波消融装置的远端部分的侧视图。
具体实施方式
参考附图详细说明当前公开的微波消融装置的实施例，其中在若干附图中的每一个中类似的附图标记代表相同或相对应的元件。
根据本发明的消融装置（例如微波消融装置）在附图中指的是附图标记10。首先参考图1，微波消融装置10包括手柄部分13以及具有轴或馈线（feedline）14的微波天线12。馈线14包括外导体20以及限定纵向轴线X-X的内导体18。电力传输绳21被示出为将微波消融装置10连接至适合的高频电刀22（electrosurgical generator）（见图2）。额外地，根据本发明的各种实施例的致动元件7在图1中说明。
如图2中所见，远端尖端30布置成邻近于或联接至内导体18和/或外导体20的远端端部。在说明的实施例中，馈线14的近端端部包括联接器19，所述联接器19通过电力传输绳21将天线12电联接至高频电刀22。正如以下将进一步讨论的，外导体20包括远端部分23，所述远端部分23构造用于在径向上相对于纵向轴线X-X扩张，以使得一旦致动元件7致动，远端部分23就分为多个可在径向上展开的导体（例如导体20a、20b、20c、20d、和20e）。
微波消融装置10可以通过直的、弓形的、不可展开的和/或可展开的施放装置（applicator）或引入器被引入至治疗部位。在实施例中，尖端30构造用于刺入组织以便于将微波消融装置10引入至治疗部位。尖端30可以为绝缘的和/或由电介质材料形成。
如上所述并且如图2和3所示，馈线14可以采取共轴缆索的形式。馈线14的部分可以为柔性的并且由围绕内导体18的外导体20形成。内导体18和/或外导体20可以由可为半刚性或柔性的适合导电金属制成，例如铜、金、或者具有类似电导率值的其他导电金属。替代地，内导体18和外导体20的部分也可以由可额外地电镀有其他材料（例如其他导电材料）的不锈钢制成，以改进其特性，例如改善电导率或减少能量损失等。
继续参考图3，天线12的馈线14被示出包括至少围绕内导体18的长度的一部分的电介质材料28以及至少围绕电介质材料28和/或内导体18的长度的一部分的外导体20和/或导体20a-20e。即，电介质材料28插在内导体18和外导体20之间以提供其之间的绝缘并且可以包括任何适合的电介质材料。
当前参考图4和5，外导体20的远端部分23被分为多个可在径向上展开的外导体20a、20b、20c、20d、和20e。导体20a-20e仅为说明性的，原因在于外导体20的远端部分23可以被分为任意两个或更多个可在径向上展开的导体。外导体20可以至少部分地由柔性材料形成，其中在制造过程中通过在环绕远端部分23的外周的多个位置处沿外导体20的远端部分23的至少一部分切割或切削穿过柔性材料，可以实现将外导体20的远端部分23分为导体20a-20e。远端尖端30与每一个导体20a-20e或内导体18机械协作。在一个实施例中，内导体18能够通过致动元件7（见图1）的平移相对于外导体20移动，如以下所详细描述的。在另一个实施例中，外导体20能够相对于内导体18和尖端30移动，如以下所详细描述的。在一些实施例中，远端尖端30也与外导体20a-20e或内导体18电连通。
致动元件7（见图1）的平移引起内导体18相对于外导体20（基本上沿纵向轴线X-X）的移动，或反之亦然。更具体地，致动元件7的向远端平移引起内导体18在箭头“A”的方向上向远端移动，并且致动元件7的向近端平移引起内导体18在箭头“B”的方向上向近端移动。响应于内导体18的向近端移动，外导体20的远端部分23在箭头“C”的方向上（见图4和5）在径向上相对于纵向轴线X-X被强迫或扩张，以使得外导体20分为导体20a-20e。因此，当导体20a-20e和内导体18之间的距离变得更大时，由导体20a-20e的边界限定的消融区域40（包括导体20a-20e和内导体18之间的区域）被扩张（比如，增宽）。响应于内导体18的向远端移动，导体20a-20e在与箭头“C”相反的方向上朝向纵向轴线X-X收缩。
在实施例中，每一个导体20a-20e的至少一部分为柔性的以便于导体20a-20e相对于纵向轴线X-X的径向扩张。消融区域40可以为由内导体18（例如阳极）相对于导体20a-20e（例如阴极）的相反极性产生的电磁场，以用于消融布置于消融区域40内的组织。
在一个实施例中，致动元件7（见图1）的平移引起外导体20相对于内导体18和远端尖端30（基本上沿纵向轴线X-X）的移动。在这个实施例中，内导体18和远端尖端30为沿纵向轴线X-X静止的。更具体地，致动元件7的向远端平移引起外导体20在箭头“A”的方向上向远端移动，并且致动元件7的向近端平移引起外导体20在箭头“B”的方向上向近端移动。响应于外导体20的向远端移动，外导体20的远端部分23在箭头“C”的方向上（见图4和5）在径向上相对于纵向轴线X-X被强迫或扩张，以使得外导体20分为导体20a-20e。响应于外导体20的向近端移动，导体20a-20e在与箭头“C”相反的方向上朝向纵向轴线X-X收缩。
每一个导体20a-20e可以构造用于机械地和/或在能量（例如射频能量、热能、电阻能量等）的帮助下刺入或切削穿过组织。在导体20a-20e能够机械地刺入或切削穿过组织的实施例中，导体20a-20e可以足够薄以在施加预定量（例如在内导体18收缩和/或导体20a-20e径向扩张时产生的力的量）的力时刺入或切削穿过组织。换言之，当导体20a-20e相对于纵向轴线X-X布置为非扩张平行的构造并且随后导体20a-20e被扩张以刺入并通过组织时，天线12定位于组织内。因此，组织被嵌入消融区域40内以用于治疗。额外地或替代地，导体20a-20e可以构造用于传导例如来自高频电刀22的能量以切削或刺入通过组织。导体20a-20e的展开也帮助相对于肿瘤固定天线12并且在治疗过程中维持天线12就位。
具体地参考图4，导体20a-20e被示出在将天线12插入至组织“T”之前相对于纵向轴线X-X在径向上被扩张。在这种情况下，在箭头“A”方向上施加于天线12的向远端力引起导体20a-20e切削通过组织“T”，以使得组织“T”的至少一部分布置于消融区域40内。
具体地参考图5，天线12被示出在导体20a-20e相对于纵向轴线X-X径向扩张之前被插入至且通过组织“T”。在这种情况下，在箭头“B”的方向上施加于天线12的向近端力引起导体20a-20e切削通过组织“T”，以使得组织“T”的至少一部分布置于消融区域40内。
如上所述，导体20a-20e可以构造用于机械地和/或在来自高频电刀22的能量的帮助下刺入或切削穿过组织。在导体20a-20e利用来自高频电刀22的能量的帮助以刺入或切削穿过组织的情况下，导体20a-20e可以在接合组织“T”之前或替代地基本上与之同时被供能。
通过在手术过程中收缩和扩张导体20a-20e，天线12的有效长度和阻抗被改变，因此改变天线12的性能。通过这种方式，天线12可以在手术过程中被主动地进行调谐。
当前参考图6A和6B，馈线14被示出布置于脉管“V”内。脉管修复密封材料50（例如纤维蛋白或弹性/胶原基质）布置于脉管“V”的内壁和外导体20之间并且构造用于一旦被恰当展开则修复脉管“V”的内壁。密封材料50可以为例如套和/或网孔矩阵（mesh matrix），所述套和/或网孔矩阵构造用于在馈线14的至少一部分上滑动，以使得一旦将馈线14展开于脉管“V”内，则密封材料50布置于脉管“V”的内表面和馈线14的至少一部分之间。如图6A中所说明的，馈线14被插入至脉管“V”内，与此同时导体20a-20e相对于纵向轴线X-X布置为非扩张或收缩的状态。一旦馈线14相对于密封材料50定位在脉管“V”内，致动元件7就在箭头“F”的方向上向近端平移以收缩内导体18，由此向近端牵拉远端尖端30以迫使导体20a-20e在径向上相对于纵向轴线X-X扩张。如上所述，在某些实施例中，致动元件7可以在箭头“E”的方向上向远端平移，以向远端移动外导体20以接合远端尖端30,，由此迫使导体20a-20e在径向上相对于纵向轴线X-X扩张。
在任一情况下，导体20a-20e的径向扩张迫使密封材料50接合脉管“V”的内壁，以修复脉管“V”中的裂痕或受损区域，如图6B中所示。在实施例中，一旦密封材料50接合脉管“V”的内壁，则高频电刀22构造用于有选择地向导体20a-20e供给能量（例如RF或微波能量）以通过产生热量激活密封材料或使密封材料起效。即，密封材料50可以为具有布置于其上的脉管修复凝胶或胶原的网孔矩阵，所述网孔矩阵构造用于一旦施加由穿过导体20a-20e和/或内导体18的能量供给引起的热量，则滤（leach）至脉管“V”的内壁。这些脉管修复密封材料的示例包括但不限于
Figure BDA00002695900700091
液体纤维蛋白密封材料以及
Figure BDA00002695900700092
FS系统。
一旦密封材料50的所需部分被施加于脉管“V”的内壁，则导体20a-20b可以通过致动元件7的致动在径向上朝向纵向轴线X-X被收缩，以使得天线12能够在脉管“V”内向近端移动（箭头“F”）或向远端移动（箭头“E”）以用于从其移除或用于相对于密封材料50移动，如图6A中所示。通过这种方式，外导体20的远端部分23可以被定位或重新定位成与密封材料50的如下部分基本上对齐：所述密封材料50的该部分尚未被迫与脉管“V”的内壁接合和/或已经通过施加由穿过导体20a-20e和/或内导体18的能量供给产生的热量被激活或起效。
本发明描述的实施例意为说明性的而非约束性的，而且并非意欲代表本发明的每一个实施例。能够做出各种修改和变化而不脱离以下权利要求字面地阐述以及法律认可的等效物阐述的本发明的精神和领域。

Claims (20)

1.一种修复脉管内壁的方法，所述方法包括以下步骤：
将微波消融装置的至少一部分插入至脉管内，微波消融装置包括布置于外导体内并且限定纵向轴线的内导体；
将修复密封材料插入至脉管内，以使得修复密封材料布置于脉管内壁和外导体之间；
使外导体的至少一部分相对于纵向轴线扩张以迫使修复密封材料的至少一部分进入脉管内壁内；以及
输送能量至内导体和外导体中的至少一个以激活修复密封材料，从而修复脉管内壁。
2.根据权利要求1所述的方法，进一步包括以下步骤：
使外导体的已扩张的部分朝向纵向轴线收缩;
将微波消融装置在脉管内相对于修复密封材料移动;
重复扩张步骤；并且
重复输送步骤。
3.根据权利要求1所述的方法，其中插入步骤基本上同时发生。
4.根据权利要求1所述的方法，其中修复密封材料包括网孔矩阵，所述网孔矩阵构造用于在插入步骤之前接合外导体的至少一部分。
5.根据权利要求1所述的方法，进一步包括以下步骤：
使外导体的已扩张的部分朝向纵向轴线收缩；并且
从脉管撤回微波消融装置的已插入的部分。
6.根据权利要求1所述的方法，其中扩张步骤引起外导体沿其至少一部分分为多个导体。
7.根据权利要求1所述的方法，其中修复密封材料由输送步骤产生的热量激活。
8.一种微波治疗系统，包括：
电外科能量源；
操作地连接至电外科能量源的微波天线组件，微波天线组件包括：
构造用于将能量从能量源输送至患者组织的辐射部分，辐射部分具有外导体以及延伸穿过外导体的内导体，内导体布置于外导体内并且限定纵向轴线；
其中内导体和外导体中的一个能够相对于另一个移动以引起外导体的至少一部分在径向上相对于纵向轴线扩张。
9.根据权利要求8所述的微波治疗系统，其中外导体和内导体中的至少一个终止于构造用于刺入组织的远端尖端。
10.根据权利要求9所述的微波治疗系统，其中远端尖端为绝缘的。
11.根据权利要求8所述的微波治疗系统，其中外导体包括多个可展开的导体，所述多个可展开的导体至少部分地沿外导体的长度布置并且构造用于在径向上相对于纵向轴线扩张。
12.根据权利要求11所述的微波治疗系统，其中多个可展开的导体构造用于机械地切割穿过组织。
13.根据权利要求11所述的微波治疗系统，其中多个可展开的导体构造用于在来自电力源的能量的帮助下切割穿过组织。
14.根据权利要求11所述的微波治疗系统，其中外导体的至少一部分为柔性的。
15.根据权利要求11所述的微波治疗系统，其中当外导体在径向上相对于纵向轴线被扩张时外导体和内导体之间的距离限定消融区域。
16.根据权利要求15所述的微波治疗系统，其中外导体和内导体被构造为一旦致动就形成在消融区域内的电磁场。
17.根据权利要求8所述的微波治疗系统，其中外导体相对于内导体的向远端移动引起外导体的至少一部分在径向上相对于纵向轴线扩张。
18.根据权利要求8所述的微波治疗系统，其中内导体相对于外导体的向近端移动引起外导体的至少一部分在径向上相对于纵向轴线扩张。
19.一种修复脉管的方法，所述方法包括以下步骤：
将消融装置的至少一部分插入至脉管内，消融装置包括布置于外导体内的内导体；
将修复密封材料插入至脉管内，以使得修复密封材料布置于脉管和外导体之间；
使外导体的至少一部分朝向脉管扩张；并且
输送能量至内导体和外导体中的至少一个以激活修复密封材料，从而修复脉管内壁。
20.根据权利要求19所述的方法，进一步包括以下步骤：
将外导体的已扩张的部分远离脉管收缩；
在脉管内移动消融装置；
重复扩张步骤；以及
重复输送步骤。
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US9681916B2 (en) 2017-06-20
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US20170284400A1 (en) 2017-10-05
US20130178843A1 (en) 2013-07-11
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