CN103393464B - A kind of RF ablation device - Google Patents
A kind of RF ablation device Download PDFInfo
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- CN103393464B CN103393464B CN201310340177.1A CN201310340177A CN103393464B CN 103393464 B CN103393464 B CN 103393464B CN 201310340177 A CN201310340177 A CN 201310340177A CN 103393464 B CN103393464 B CN 103393464B
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- 238000007674 radiofrequency ablation Methods 0.000 title claims abstract description 23
- 210000002254 renal artery Anatomy 0.000 claims abstract description 45
- 210000005036 nerve Anatomy 0.000 claims abstract description 31
- 230000002889 sympathetic effect Effects 0.000 claims abstract description 30
- 238000002679 ablation Methods 0.000 claims abstract description 13
- 230000007246 mechanism Effects 0.000 claims abstract description 10
- 210000001519 tissue Anatomy 0.000 claims description 10
- 230000005611 electricity Effects 0.000 claims description 5
- 230000005540 biological transmission Effects 0.000 claims description 4
- 230000000694 effects Effects 0.000 claims description 3
- 238000010304 firing Methods 0.000 claims description 3
- 239000000155 melt Substances 0.000 claims description 3
- 239000012528 membrane Substances 0.000 claims description 2
- 210000003205 muscle Anatomy 0.000 claims description 2
- 206010020772 Hypertension Diseases 0.000 abstract description 19
- 230000036772 blood pressure Effects 0.000 abstract description 9
- 206010022998 Irritability Diseases 0.000 abstract description 5
- 210000003734 kidney Anatomy 0.000 description 14
- 238000000034 method Methods 0.000 description 8
- 238000002844 melting Methods 0.000 description 5
- 230000008018 melting Effects 0.000 description 5
- 239000003814 drug Substances 0.000 description 4
- 230000001053 orthosympathetic effect Effects 0.000 description 4
- 210000001367 artery Anatomy 0.000 description 3
- 230000002638 denervation Effects 0.000 description 3
- 229940079593 drug Drugs 0.000 description 3
- 230000008520 organization Effects 0.000 description 3
- 206010001497 Agitation Diseases 0.000 description 2
- 208000004531 Renal Artery Obstruction Diseases 0.000 description 2
- 206010038378 Renal artery stenosis Diseases 0.000 description 2
- 239000002220 antihypertensive agent Substances 0.000 description 2
- 229940127088 antihypertensive drug Drugs 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 230000008859 change Effects 0.000 description 2
- 238000010586 diagram Methods 0.000 description 2
- 230000035487 diastolic blood pressure Effects 0.000 description 2
- 239000002934 diuretic Substances 0.000 description 2
- 230000001882 diuretic effect Effects 0.000 description 2
- 230000001939 inductive effect Effects 0.000 description 2
- 230000002687 intercalation Effects 0.000 description 2
- 238000009830 intercalation Methods 0.000 description 2
- 230000010534 mechanism of action Effects 0.000 description 2
- 210000000607 neurosecretory system Anatomy 0.000 description 2
- 230000007170 pathology Effects 0.000 description 2
- 230000008288 physiological mechanism Effects 0.000 description 2
- 210000002820 sympathetic nervous system Anatomy 0.000 description 2
- 210000003462 vein Anatomy 0.000 description 2
- 238000005303 weighing Methods 0.000 description 2
- 206010059245 Angiopathy Diseases 0.000 description 1
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- 230000017531 blood circulation Effects 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- 239000003795 chemical substances by application Substances 0.000 description 1
- 208000020832 chronic kidney disease Diseases 0.000 description 1
- 208000022831 chronic renal failure syndrome Diseases 0.000 description 1
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Abstract
The open a kind of RF ablation device of the present invention, is used for removing renal artery sympathetic nerve, reduces renal sympathetic nerve irritability, and this device includes: can part or all of cincture renal artery renal artery can carry out the ablating electrode of radio-frequency (RF) ablation operation；Control the motion of ablating electrode and realize the electrode operating-controlling mechanism to arteriorenal cincture.This device is connected to radio-frequency signal generator, by radio-frequency (RF) ablation, removes renal artery sympathetic nerve, reduce renal sympathetic nerve irritability, play the function of regulation and control obstinate hypertension blood pressure.
Description
Technical field
The present invention relates to a kind of medical apparatus and instruments, be specifically related to a kind of RF ablation device, particularly relate to
A kind of renal artery that is used for removes orthosympathetic RF ablation device, reduces renal sympathetic nerve irritability, uses
In treatment intractable hypertension.
Background technology
Hypertension is the main of apoplexy, coronary heart disease, heart failure, angiopathy and chronic renal failure
Risk factor.The whole world about 1,000,000,000 adult suffers from hypertension, and the most only 1/3 obtains effectively control.Examine
Disconnected not enough and curative compliance difference is one of not good enough reason of curative effect, even if but a large amount of patient accepts optimal
Drug therapy still can not be effectively controlled.It practice, nearly 20%-30% in the clearest and the most definite clinical trial at present
Patient fail to reach target blood pressure (even if having accepted more than 3 kinds of treated with combined medications), finally develop
For intractable hypertension.
So-called intractableHypertension, 2008 American heart association (AHA) be defined as: through life
Mode is improved, and takes the antihypertensive drugs (one of which is diuretic) of 3 kinds of different mechanism of action simultaneously,
Or at least need 4 kinds of medicines could control shrinking pressure at target level with diastolic pressure
(＜ 140/90mmHg).
Although the pathology of hypertension, physiological mechanism are complicated, but neuroendocrine system is to maintain mediodespidine
The important mechanisms of weighing apparatus, it is orthosympathetic is overexcited is considered as the basic link of hypertension incidence.
Substantial amounts of zoopery and clinical research also confirm that the sympathetic nervous system impact on blood pressure, find sympathetic
Neural excitement degree is proportionate with the blood pressure level of patient.Wherein, sympathetic renal nerve system is special
It is not closest to kidney Sympathetic Nerve and the nervus centripetalis of renal artery wall, for inducing and causing systematicness high
Blood pressure plays decisive role, thus is formed and block the theory that sympathetic renal nerve can reduce blood pressure.
Based on this, the theoretical and early stage orthosympathetic experience of surgical excision, opens from 2007 Nian Qi American-European countries
Begin to explore " percutaneous catheter sympathetic renal nerve radio-frequency ablation procedure " treatment intractable hypertension, achieve
Satisfied curative effect, the treatment for intractable hypertension provides new thinking and method.The method uses
After the interventional technique femoral artery puncture that doctor is familiar with, renal artery is carried out transmural ablation and hands over to block kidney
Sense nerve signal transmission, mainly include Medtronic SymplicityTM kidney denervation system,
The OneShotTM kidney Renal denervation system of Coyidien, the Enlig HNTTM kidney of St.Jude remove kidney
The V2 kidney denervation system of nervous system and Vessix Vascular, these products have obtained CE the most
Certification, and SymplicityTM kidney denervation system also obtains TGA certification, clinical effectiveness confirms these
Product reaches not affect other abdominal paries, pelvis or lower limb nerve domination while blood pressure lowering, for intractable
The treatment of hypertension provides new thinking and method.
Although substantial amounts of clinical effectiveness is it has proven convenient that the blood of patient after using the treatment of this kind of internal medicine ablation catheter
Pressing element has the reduction of persistence, but patient itself is required higher by the method.Move as kidney can not be there is
The problems such as arteries and veins is narrow, branched renal artery；Being positioned at renal artery adventitia additionally, due to sympathetic nerve, conduit disappears
Melting and be accomplished by artery ablation transmural, this is relatively big to renal artery infringement, is easily caused renal artery stenosis；Disappear
Melting point position is not easy to hold, and these result in the limitation of its application.Therefore, Surgical laparoscope skill is used
Sympathetic nerve is directly melted from renal artery by art, can be efficiently applied to there is renal artery deformity
Patient, simultaneously can direct snap action renal artery outer wall sympathetic nerve, minimizing is to arteriorenal infringement.
Summary of the invention
It is an object of the invention to provide a kind of medical apparatus and instruments, use radio-frequency ablation technique, can be used for removing
Renal artery sympathetic nerve, reduces renal sympathetic nerve irritability, treats intractable hypertension.
The present invention provides a kind of RF ablation device, is used for removing renal artery sympathetic nerve, reduces kidney and hands over
Sense nerve excitability, this device includes: can part or all of cincture renal artery entering renal artery
The ablating electrode of row radio-frequency (RF) ablation operation；Control the motion of ablating electrode and realize electrode to arteriorenal
The operating-controlling mechanism of cincture.
Described ablating electrode is made up of electrode member, electrode tip holder and temperature sensor.
Described electrode member is bipolar electrode pair, can act on after pairing；Wherein electrode member is electricity
Device or the combinations such as polar filament, electrode retaining collar or electrode slice.
Described electrode tip holder is that the collet of electrode member supports, and supports electrode member thereon.
Described temperature sensor is thermoelectricity resistance type or thermocouple type.
Described thermal resistance or thermocouple can provide feedback signal, are used for measuring the tissue around sensor
Temperature, wherein feedback signal is proportional to surveyed tissue temperature.
Zone of ablation renal artery temperature can be controlled appointing in the range of 37-200 DEG C by described temperature sensor
What temperature range.Preferably, temperature range controls in 45-65 DEG C.
When temperature is less than 45 DEG C, signal is fed back to radio-frequency signal generator by temperature sensor, and radio frequency occurs
Device continuous firing, radio-frequency (RF) energy persistently passes to renal artery, it is to avoid renal artery temperature is too low；Temperature is high
In 65 DEG C time, radio-frequency signal generator stops transmission energy, it is to avoid renal artery temperature is too high.
Described ablating electrode has Multiple Shape, for point-like, pliers shape, annular, ellipse, spiral type
Or rake, or difform combination.
Described ablating electrode acts on outside renal artery blood vessel, Muscle membrane.Ablating electrode is permissible when working
Block renal artery blood flow, it is also possible to keep renal artery unimpeded.
Described operating-controlling mechanism, can control ablating electrode motion so that it is around or partially surround kidney move
Arteries and veins；And be connected with radio-frequency signal generator, by transmission of radio-frequency energy to ablating electrode.
For the patient of intractable hypertension, under laparoscopically assistance, by leading to that perforator is set up
Road, uses this RF ablation device, and the renal artery sympathetic nerve of patient is carried out radio-frequency ablation procedure,
Remove the sympathetic nerve on renal artery, reduce renal sympathetic nerve irritability, control/reduce patients' blood,
Treatment intractable hypertension.Can once melt, it is also possible to repeatedly melt, act in the middle part of renal artery.
The advantage of this invention is, is directly melted the EV sympathetic nerve of renal artery by peritoneoscope,
Operation is quick and precisely；Melting without transmural, renal artery blood vessel injury is little；Without using developing agent and X
Ray, reduces the murder by poisoning to kidney and the radiation injury to human body；Clinical selected patients's expanded range,
The patient even with branched renal artery or renal artery stenosis may be used without this mode.
Accompanying drawing explanation
Fig. 1 is the overall schematic of one embodiment of RF ablation device of the present invention.
Fig. 2 a and Fig. 2 b is the structural representation of the oval ablating electrode of the present invention.
Fig. 3 a is the structural representation of the pliers shape ablating electrode of the present invention.
Fig. 3 b is the structural representation of the spiral type ablating electrode of the present invention.
Fig. 3 c is the structural representation of the rake ablating electrode of the present invention.
Fig. 4 a and Fig. 4 b is the schematic diagram of the operating-controlling mechanism of the present invention.
Detailed description of the invention
Structure and the work side of the RF ablation device of the present invention are described in detail in detail below in conjunction with drawings and Examples
Formula.
2008 American heart association (AHA) by intractableHypertensionIt is defined as: change through life style
Kind, take the antihypertensive drugs (one of which is diuretic) of 3 kinds of different mechanism of action simultaneously, or at least
Need 4 kinds of medicines could control shrinking pressure at target level (＜ 140/90mmHg) with diastolic pressure.
Although the pathology of hypertension, physiological mechanism are complicated, but neuroendocrine system is to maintain mediodespidine
The important mechanisms of weighing apparatus, orthosympathetic to be overexcited be considered as the basic link of hypertension incidence.Greatly
Zoopery and the clinical research of amount also confirm that the sympathetic nervous system impact on blood pressure, find sympathetic god
The excitement degree of warp is proportionate with the blood pressure level of patient.Wherein, sympathetic renal nerve system is special
It is closest to kidney Sympathetic Nerve and the nervus centripetalis of renal artery wall, for inducing and causing systemic high blood
Pressure plays decisive role, thus is formed and block the theory that sympathetic renal nerve can reduce blood pressure.
The RF ablation device of the present invention, is used for melting removal renal periarterial sympathetic nerve, reduces kidney
Sympathetic excitability, thus reach to treat the purpose of intractable hypertension.
Fig. 1 shows an illustrative schematic diagram of the renal artery ablating device of the present invention, and this melts dress
Put 100 to include: 1) partly or entirely around renal artery, and renal artery can be carried out radio-frequency (RF) ablation
The ablating electrode 101 of operation；2) motion of ablating electrode can be controlled, and realize electrode to renal artery
The operating-controlling mechanism 102 of all or part of cincture.
Fig. 2 a and Fig. 2 b showing, ablating electrode 101 is by electrode member 201, electrode tip holder 202 and temperature
Sensor 203 is constituted.Fig. 2 a and Fig. 2 b is respectively the front view of the signal of ablating electrode 101 and complete
Entirely launch top view, select two wire electrodes as in electrode member 201 parallel intercalation electrode seat 202,
Form electrode pair.In temperature sensor 203 also intercalation electrode seat, the electric discharge of regulation and control electrode member 201
Whether, reach to control the purpose of zone of ablation temperature.Preferably, in the range of temperature is set in 45-65 DEG C,
When temperature less than 45 DEG C time, radio-frequency signal generator continuous firing, it is provided that radio-frequency (RF) energy, electrode to electric discharge,
Melt the sympathetic nerve on renal artery pipe；When temperature is higher than 65 DEG C, radio-frequency signal generator quits work,
Electrode is to quitting work, and anti-hemostatic tube is excessively ablated.
Ablating electrode can be variously-shaped, oval, as shown in Figure 3 a as shown in Figure 2 a and 2 b
Pliers shape, as shown in Figure 3 b spiral type, as shown in Figure 3 c rake.When ablating electrode works, make
With pliers shape ablating electrode shown in Fig. 3 a, renal artery is blocked；Use Fig. 2 a and Fig. 2 b, Fig. 3 b,
Shown in 3c during ablating electrode, renal artery keeps unimpeded.
Operating-controlling mechanism shown in Fig. 4 a and Fig. 4 b is handle type controlling organization.Wherein, the hands of Fig. 4 a signal
Handle controlling organization is class pistol shape, by handle control, can make ablating electrode outside renal artery.
Fig. 4 b handle type controlling organization is round bar shape, by the control of lever knob, makes front end with melting electricity
The serpentine pipe of pole is wrapped in outside renal artery.Its concrete structure and operation principle can be by multiple existing skills
Art realizes, and does not repeats them here.
Although having been described for multiple embodiment, it will be appreciated by the person skilled in the art that countless changes
Change and/or amendment can be made without departing from the broadly described spirit and scope of the present invention.Therefore, originally
Inventive embodiment is the most all merely exemplary rather than restrictive.
The present invention is not limited to the particular content described in embodiment.Ground of the present invention renal artery
Ablating device goes in addition to the purposes of renal artery sympathetic nerve treatment hypertension except being applied to radio-frequency (RF) ablation, also
Can be used for the nerve ablation art of other blood vessel/tissue.
Claims (10)
1. a RF ablation device, is used for removing renal artery sympathetic nerve, reduces renal sympathetic nerve emerging
Putting forth energy property, it is characterised in that this device includes:
Can be partly or entirely around renal artery and renal artery can be carried out radio-frequency (RF) ablation operation and melt electricity
Pole；
Control the motion of ablating electrode and realize the electrode operating-controlling mechanism to arteriorenal cincture；
Wherein, described ablating electrode includes electrode member, temperature sensor, support described electrode unit
Part and the electrode tip holder of temperature sensor；
Described electrode member is bipolar electrode pair, pairing effect.
RF ablation device the most according to claim 1, it is characterised in that described electrode unit
Part is one or a combination set of wire electrode, electrode retaining collar or electrode slice.
RF ablation device the most according to claim 1, it is characterised in that described temperature passes
Sensor is thermal resistance or thermocouple.
RF ablation device the most according to claim 3, it is characterised in that described thermal resistance
Or thermocouple is arranged to measure the temperature of the tissue around sensor, it is provided that feedback signal, described feedback
Signal and the temperature proportional being surveyed tissue.
RF ablation device the most according to claim 4, it is characterised in that described temperature passes
Sensor is configured to the temperature range temperature of zone of ablation tissue controlled in the range of 37-200 DEG C.
RF ablation device the most according to claim 5, it is characterised in that described humidity province
Between be 45-65 DEG C.
RF ablation device the most according to claim 6, it is characterised in that temperature sensor is joined
Being set to when the temperature of described tissue is less than 45 DEG C, signal is fed back to one by described temperature sensor
Radio-frequency signal generator, radio-frequency signal generator continuous firing, radio-frequency (RF) energy persistently passes to described tissue, it is to avoid
The temperature of tissue is too low；When temperature is higher than 65 DEG C, radio-frequency signal generator stops transmission energy, it is to avoid described
The temperature of tissue is too high.
RF ablation device the most according to claim 1, it is characterised in that described melts electricity
Extremely point-like, pliers shape, annular, ellipse, spiral type or rake.
RF ablation device the most according to claim 8, it is characterised in that described melts electricity
Pole acts on outside renal artery blood vessel, Muscle membrane.
RF ablation device the most according to claim 1, it is characterised in that described manipulation
Mechanism is arranged to be connected with a radio-frequency signal generator, gives described ablating electrode by transmission of radio-frequency energy.
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201310340177.1A CN103393464B (en) | 2013-08-01 | 2013-08-01 | A kind of RF ablation device |
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| CN201310340177.1A CN103393464B (en) | 2013-08-01 | 2013-08-01 | A kind of RF ablation device |
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| CN103393464A CN103393464A (en) | 2013-11-20 |
| CN103393464B true CN103393464B (en) | 2016-08-10 |
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Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP3692906B1 (en) | 2013-03-15 | 2024-01-10 | Medtronic Holding Company Sàrl | A system for treating tissue |
| CN110897712A (en) * | 2019-12-28 | 2020-03-24 | 苏州海普特斯医疗科技有限公司 | Cold saline perfusion radio frequency ablation forceps with controllable clamping force |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6325796B1 (en) * | 1999-05-04 | 2001-12-04 | Afx, Inc. | Microwave ablation instrument with insertion probe |
| CN101027009A (en) * | 2004-05-14 | 2007-08-29 | 卡帝玛股份有限公司 | A system and method for multi-channel RF energy delivery with coagulum reduction |
| CN102274074A (en) * | 2011-05-03 | 2011-12-14 | 上海微创电生理医疗科技有限公司 | Multi-electrode open-type radio frequency ablation catheter |
| CN202821618U (en) * | 2012-09-12 | 2013-03-27 | 屈百鸣 | Peritoneoscope renal artery sympathetic denervation ablation catheter |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7850685B2 (en) * | 2005-06-20 | 2010-12-14 | Medtronic Ablation Frontiers Llc | Ablation catheter |
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2013
- 2013-08-01 CN CN201310340177.1A patent/CN103393464B/en active Active
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6325796B1 (en) * | 1999-05-04 | 2001-12-04 | Afx, Inc. | Microwave ablation instrument with insertion probe |
| CN101027009A (en) * | 2004-05-14 | 2007-08-29 | 卡帝玛股份有限公司 | A system and method for multi-channel RF energy delivery with coagulum reduction |
| CN102274074A (en) * | 2011-05-03 | 2011-12-14 | 上海微创电生理医疗科技有限公司 | Multi-electrode open-type radio frequency ablation catheter |
| CN202821618U (en) * | 2012-09-12 | 2013-03-27 | 屈百鸣 | Peritoneoscope renal artery sympathetic denervation ablation catheter |
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Address after: 101312 No.5, Zhuyuan 2nd Street, Shunyi District, Beijing (Tianzhu Comprehensive Bonded Zone) Patentee after: Beijing medipeak Medical Technology Co.,Ltd. Address before: 101312 No.5, Zhuyuan 2nd Street, Shunyi District, Beijing (Tianzhu Comprehensive Bonded Zone) Patentee before: BEIJING MED ZENITH MEDICAL SCIENTIFIC Co.,Ltd. |
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| IP01 | Partial invalidation of patent right | ||
| IP01 | Partial invalidation of patent right |
Commission number: 4W113972 Conclusion of examination: Declare partial invalidity of invention No. 201310340177.1, and continue to maintain the validity of the patent on the basis of claims 1-9 submitted by the patentee on May 16, 2022 Decision date of declaring invalidation: 20221101 Decision number of declaring invalidation: 58923 Denomination of invention: A radiofrequency ablation device Granted publication date: 20160810 Patentee: Beijing medipeak Medical Technology Co.,Ltd. |