CN105147389B - Include the radio frequency ablation device and its ablation method of balloon occlusion type guiding catheter - Google Patents
Include the radio frequency ablation device and its ablation method of balloon occlusion type guiding catheter Download PDFInfo
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- CN105147389B CN105147389B CN201510689867.7A CN201510689867A CN105147389B CN 105147389 B CN105147389 B CN 105147389B CN 201510689867 A CN201510689867 A CN 201510689867A CN 105147389 B CN105147389 B CN 105147389B
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Abstract
The invention discloses a kind of radio frequency ablation device and its ablation method for including balloon occlusion type guiding catheter.Wherein, radio frequency ablation device includes the balloon occlusion type guiding catheter of two-chamber or multi-cavity, also include radio frequency ablation catheter, the distal end of radio frequency ablation catheter is provided with electrode suppor, two or more electrodes are provided with electrode suppor, electrode is connected to radio-frequency signal generator by being arranged on the corresponding lead inside radio frequency ablation catheter respectively.When being melted using above-mentioned radio frequency ablation device to tube chamber peripheral nerve, the endovascular regional flow of closure balloon occlusion of the distal end of guiding catheter is arranged on by inflation；Then by the perfusing hole of guiding catheter front end to ablation site intra-arterial infusion liquid/gas, change its conductive environment and/or temperature environment, and by controlling the Different electrodes of radio frequency ablation catheter, formed between radio-frequency electrode and loop electrode and carry out RF ablation by the loop of vascular wall, there is preferable nerve ablation effect.
Description
Technical field
The present invention relates to a kind of radio frequency ablation device, more particularly to a kind of radio frequency including balloon occlusion type guiding catheter to disappear
Melt equipment, present invention simultaneously relates to the RF ablation method realized using above-mentioned radio frequency ablation device, belong to nerve ablation field.
Background technology
Neuro vegetative exception plays very important effect in the generation, differentiation and development of many diseases.In recent years,
With the development of minimally invasive interventional technique, the symptoms such as hypertension, diabetes, heart disease, cancer are treated using nerve ablation art
Clinically start gradually to apply, and achieve preferable effect.
Radio frequency ablation catheter is the capital equipment for implementing radio-frequency ablation procedure, and guiding catheter is provided in outside radio frequency ablation catheter
The body in portion, radio frequency ablation catheter, which is typically necessary, to be established under the assistance of guiding catheter from vitro to the logical of heart or the arteria renalis
Road.During ablative surgery, the major part of ablation catheter is retained in guiding catheter.
In the prior art, radio frequency ablation device includes radiofrequency melting instrument, the radio frequency ablation catheter for being provided with radio-frequency signal generator,
And the radio-frequency electrode of the output end of the wire by being arranged on inside radio frequency ablation catheter and radio-frequency signal generator connection, additionally
The loop electrode being connected including the loop end with radio-frequency signal generator.Existing for the perineural nerve ablation operation of tube chamber
In, the loop electrode of radio frequency ablation device is usually arranged as body surface patch electrode, is arranged on human external.This RF ablation is set
Standby concrete structure may refer to entitled《For carrying out system and the side of impedance measurement using conduit such as ablation catheter
Method》CN200880126859.X Chinese patents.As shown in figure 1, conduit and patch electrode system are which disclose, its
In, the positive pole of RF ablation generator (16) is electrically coupled to point electrode (28T) by source lead (46), senses connector
(32) positive pole is electrically coupled to point electrode (28T), resource loop (56 by sense lead (48)1) and sensing loop (562)
It is electrically connected respectively to the negative pole of RF ablation generator (16) and senses the negative pole of connector.Resource loop (561) and sense back
Road (562) human external is arranged on, the pumping signal that the point electrode (28T) inside tube chamber is sent is needed out of human body
Portion, whole tissue is passed through, then by resource loop (561) return to RF ablation generator (16).That is, radio-frequency current needs
From the tube chambers such as blood vessel, enter tissue by tube wall, and after whole people's body loop, return to radio frequency from human external and disappear
Melt generator, radio-frequency current is needed through whole tissue in brief.In this radiofrequency ablation procedures, radio-frequency electrode is penetrated
Frequency direction is as shown in Figure 2.It is this by whole human body form the loop of rf nerve ablation mode, during radio frequency, it is necessary to
Overcome larger human body impedance, therefore, it is necessary to using larger voltage, electric current and radio-frequency power, so as to inevitably right
Human vas causes to damage.
In addition, in the prior art, also exist and radio-frequency electrode and loop electrode are arranged on same supporter from outside right
The equipment that sufferer tissue is melted, for example, it is entitled《A kind of Multifunctional radio-frequency cooling knife》
A kind of scissor RF ablation device that CN201210128849.8 Chinese patents are provided.As shown in figure 8, this is multi-functional
Radio frequency cooling knife includes the first branch 10, the second branch 20, connection end 30 and operation handle 40, wherein, in the first branch 10
With two bipolar radio-frequency electrodes are respectively arranged with the second branch 20, set two bipolar radio-frequency electrodes on each limb it
Between radiofrequency signal be made up of from the outside fractional radio frequency for entering organization internal and returning to outside tissue of tissue and return tissue
Road carries out RF ablation.In above-mentioned radio frequency ablation device, radio-frequency electrode and loop electrode are arranged inside of human body but are in
The outside of ablation tissue, in ablation procedure, it is not present around ablation tissue and the fluid flow blood influenceed is present to the loop of rf.
When will be provided with simultaneously on same supporter the ablation catheter directly transplanting of radio-frequency electrode and loop electrode inside tube chamber it is right
When circumvascular neuropile is melted, due to the blood of flowing in tube chamber be present, the electric conductivity of blood can be to the loop of rf
Formation impact, so as to be not easy to be formed the loop by vascular wall or extravascular tissue between two electrodes, now
Ablation is carried out to tube chamber peripheral nerve and is extremely difficult to preferable effect.
The content of the invention
Primary technical problem to be solved by this invention is to provide a kind of radio frequency for including balloon occlusion type guiding catheter
Ablation apparatus.
Another technical problem to be solved by this invention is to provide a kind of is penetrated using what above-mentioned radio frequency ablation device was realized
Frequency ablation method.
To achieve these goals, the present invention uses following technical proposals：
A kind of radio frequency ablation device, including balloon occlusion type guiding catheter, the balloon occlusion type guiding catheter include double
Chamber or multi-cavity catheter, it is provided with the outer wall of the distal end of the guiding catheter for blocking the inflatable of intravascular regional flow
Closure sacculus；The near-end of the guiding catheter is provided with first leading of being communicated with the first tube chamber inside the guiding catheter
Pipe branch, the inside of the closure sacculus are communicated with the first tube chamber inside the guiding catheter, and first conduit branch is used
Thing is inflated in being provided by first tube chamber to the closure sacculus；It is provided with the near-end of the guiding catheter and is led with described
The second conduit branch that the second tube chamber inside guiding tube communicates, the distal end of second tube chamber are provided with perfusing hole, and described
Two conduit branches are used for by the perfusing hole to ablation site intra-arterial infusion liquid/gas；
In radiofrequency ablation procedures, the closure sacculus of the distal end of the balloon occlusion type guiding catheter is arranged on by inflation
Block endovascular regional flow；By second conduit branch to ablation site intra-arterial infusion liquid/gas；And penetrating
Loop is formed between frequency electrode and loop electrode.
Wherein more preferably, in addition to the radio frequency in a certain tube chamber that is arranged on inside the balloon occlusion type guiding catheter disappears
Melt conduit, the distal end of the radio frequency ablation catheter is provided with electrode suppor, two or two are provided with the electrode suppor
Electrode more than individual, wherein, at least one electrode is connected to the output end of radio-frequency signal generator, forms the radio frequency electrical
Pole, and at least one described electrode is connected to the loop end of radio-frequency signal generator, forms the loop electrode.
Wherein more preferably, the radio frequency ablation catheter is arranged on the second tube chamber inside the balloon occlusion type guiding catheter
In.
Wherein more preferably, the distal end of the radio frequency ablation catheter is provided with one or more wall-through electrodes, the wall-through electricity
It is extremely hollow and communicated with the passage inside the radio frequency ablation catheter, for injecting fluid/gas into vascular wall.
Wherein more preferably, the wall-through electrode is arranged on the adherent position in the middle part of flap electrode suppor；Or the wall-through
Electrode is arranged on the leading portion of strip puncture needle.
Wherein more preferably, the wall-through electrode is simultaneously radio-frequency electrode or loop electrode.
A kind of RF ablation method, tube chamber nervus peripheralis is melted using above-mentioned radio frequency ablation device, passes through inflation
It is arranged on the endovascular regional flow of closure balloon occlusion ablation site of the distal end of the balloon occlusion type guiding catheter；Pass through
The guiding catheter changes the endovascular conductive environment of ablation site and/or temperature to ablation site intra-arterial infusion liquid/gas
Spend environment；And by controlling the Different electrodes of the radio frequency ablation catheter, formed between radio-frequency electrode and loop electrode and pass through blood
The loop of tube wall carries out RF ablation.
Wherein more preferably, the liquid/gas is the liquid/gas for reducing the endovascular electric conductivity of ablation site.
Wherein more preferably, before RF ablation, liquid/gas of the resistance for changing vascular wall is injected into vascular wall
Body.
Wherein more preferably, the liquid/gas is the liquid/gas for reducing vascular wall resistance.
Radio frequency ablation device provided by the present invention, including balloon occlusion type guiding catheter, guided by inflating blocking-up type
The closure sacculus of the distal end of conduit, can block regional flow during RF ablation, by intra-arterial infusion liquid/gas,
Endovascular temperature environment and/or conductive environment can be changed.The radio frequency ablation device, it is not necessary to use external electrode, you can
Progress RF ablation in loop is formed by vascular wall being arranged between the radio-frequency electrode on electrode suppor and loop electrode.Due to blood
Tube wall is nearer from nerve, and intracavitary is not turned on, few radio frequency loss, and has optimal RF ablation effect.Further, it is also possible to pass through
Hollow wall-through electrode can reduce the liquid/gas of local electrical resistance to vascular wall injection, pass through blood between electrode for increasing
The conducting degree of tube wall and conducting probability, and when reducing RF ablation simultaneously between electrode Endovascular conducting degree and lead
Logical probability.Moreover, local temperature, protection office can also be reduced by irrigating liquid in vessel lumen and in vascular wall
Portion's blood vessel.
Brief description of the drawings
Fig. 1 is the structural representation using body surface patch electrode as the radio frequency ablation system of loop electrode in the prior art
Figure；
Fig. 2 is radio frequency ablation system shown in Fig. 1, and radio frequency direction signal during radio frequency is discharged in tube chamber；
Fig. 3 be it is another in the prior art, for the radio frequency cooling knife sheared or melted to it outside sufferer tissue
Structural representation；
Fig. 4 is the basic structure schematic diagram of balloon occlusion type guiding catheter provided by the present invention；
Fig. 5 is the working state schematic representation that radio frequency ablation catheter passes through balloon occlusion type guiding catheter shown in Fig. 4；
Fig. 6 is to use radio frequency ablation device provided by the invention, and in the pipe intra-bladder instillation non-electrically conductive liquid of ablation site
RF ablation schematic diagram afterwards；
Fig. 7 is schematic diagram of RF ablation principle shown in Fig. 6 in vascular cross-section；
Fig. 8 is to use radio frequency ablation device provided by the invention, and after the pipe intra-bladder instillation conducting liquid of ablation site
RF ablation schematic diagram.
Embodiment
It is described in detail below in conjunction with the accompanying drawings with specific embodiment.For purposes of illustration only, it is (remote to will be close to operator below
Ablation site) one end be referred to as near-end, the one end that will be far from operator (close to ablation site) is referred to as distal end.
In order to change in the prior art, it is necessary to set body surface patch electrode to make in vitro when being melted to tube chamber nervus peripheralis
For loop electrode, the ablation mode that people's body loop carries out RF ablation, this hair are formed by body surface patch electrode and radio-frequency electrode
Bright (not the scheming including balloon occlusion type guiding catheter, radio frequency ablation catheter and radio-frequency signal generator as shown in Figure 4 and Figure 5 of providing
Show) radio frequency ablation device 300, and provide tube chamber nervus peripheralis is melted using above-mentioned radio frequency ablation device simultaneously
RF ablation method.Above-mentioned radio frequency ablation device and RF ablation method, it is such as quiet available for the radiofrequency ablation therapy of cavity tissue
The treatment of arteries and veins blood vessel, endometrium and the ablation of esophagus inwall.
As shown in figure 4, balloon occlusion type guiding catheter 310 is two-chamber or multi-cavity catheter.In the distal end of guiding catheter 310
Inflatable closure sacculus 311 is provided with the outer wall of (i.e. into one end of human body).It is (i.e. remote in the near-end of guiding catheter 310
From one end of human body) the first conduit branch 312 communicated with the first tube chamber inside guiding catheter 310 is provided with, close sacculus
311 inside communicates with the first tube chamber inside guiding catheter 310, and the first conduit branch 312 is used for by the first tube chamber to closing
Close sacculus 311 and inflation thing is provided.Specifically from being connected to the inflation equipment (not shown) of the end of the first conduit branch 312 to closure ball
Gas is sent into capsule 311 or liquid realizes the inflation effect of closure sacculus 311.The near-end of guiding catheter 310 be additionally provided with
The second conduit branch 313 that the second tube chamber (i.e. irrigation lumen) inside guiding catheter 310 communicates, sets in the distal end of irrigation lumen
Perfusing hole is equipped with, irrigation lumen is used to pass through perfusing hole to ablation site intra-arterial infusion liquid/gas.In the second conduit branch
313 end is connected with perfusion equipment (not shown), for by the second conduit branch 313, irrigation lumen and perfusing hole to disappearing
Melt position intra-arterial infusion liquid, such as：Contrast agent etc., perfusion direction may refer to the arrow inside Fig. 4 medium vesselses, in addition,
Can be to ablation site intra-arterial infusion gas, such as irrigate CO2Deng.Close the distal perfusion port of sacculus 311 and guiding catheter 1
Can be concordant, closure sacculus 311 can also keep a segment distance to set between the distal perfusion port of guiding catheter 1, so as to just
In the intravascular blood flow of blocking, and it is easy to intra-arterial infusion liquid/gas.Above-mentioned balloon occlusion type guiding catheter 310, by filling
The closure sacculus 311 of swollen distal end can block the endovascular regional flow of ablation site, by ablation site intra-arterial infusion
Liquid (for example, non-electrically conductive liquid)/gas can change the endovascular temperature environment of ablation site or conductive environment.
As shown in figure 5, radio frequency ablation catheter 320 is arranged in a certain tube chamber inside balloon occlusion type guiding catheter 310,
Such as be arranged in the second tube chamber, so as to by the gap between the tube chamber of radio frequency ablation catheter 320 and second to ablation portion
Position intra-arterial infusion liquid/gas；Radio frequency ablation catheter 320 can also be arranged on inside balloon occlusion type guiding catheter 310
Remove in other tube chambers outside the first tube chamber and the second tube chamber.The distal end of radio frequency ablation catheter 320 is provided with electrode suppor
321, two or more electrodes 322 are provided with electrode suppor 321；Electrode suppor 321 is expansible and shrinks, and works as electricity
It is part or all of adherent in multiple electrodes 322 after pole support 321 is expanded.Electrode 322 is by being arranged in radio frequency ablation catheter
The corresponding lead in portion is connected on the radio-frequency signal generator being arranged on inside radiofrequency melting instrument；Wherein, in multiple electrodes 322, extremely
A rare electrode is radio-frequency electrode 325, and radio-frequency electrode 325 is connected to the output end of radio-frequency signal generator, and at least one electricity
Pole is loop electrode 326, and loop electrode 326 is connected to the loop end of radio-frequency signal generator；Multiple radio-frequency electrodes 325 can share together
Primary Ioops electrode 326 forms loop.After internal blood vessel conduction environment changes, radio frequency is arranged on by radiofrequency melting instrument control and disappeared
The Different electrodes 322 for melting the distal end of conduit 320 turn on, and can be formed between corresponding radio-frequency electrode and loop electrode and pass through vascular wall
Loop carry out radio frequency.Therefore, body surface patch electrode need not be used to form loop in above-mentioned radio frequency ablation device.
In addition, one or more wall-through electrodes can also be set in the distal end of radio frequency ablation catheter 320.Wall-through electrode can be with
It is arranged on electrode suppor, wall-through electrode can also be set directly in the strip connecting conduit of radio frequency ablation catheter.Wall-through
Electrode is hollow and is communicated with the passage inside radio frequency ablation catheter, for injecting fluid/gas into vascular wall.For example, when electricity
Pole support is shaped as flap, and wall-through electrode can be arranged on the adherent position in the middle part of flap electrode suppor；And for example, when electrode branch
The strip that is shaped as of frame punctures aciculiform, and wall-through electrode can be arranged directly on the leading portion of strip puncture needle.When wall-through electrode is set
When on electrode suppor, wall-through electrode can be independently arranged, and wall-through electrode can also be radio-frequency electrode or loop electrode simultaneously.
Radio frequency ablation device provided by the invention and its RF ablation principle are described with reference to Fig. 6 to Fig. 8.
First embodiment
As shown in fig. 6, the radio frequency ablation device includes guiding catheter 310, radio frequency ablation catheter 320, in addition to for controlling
The radiofrequency melting instrument (not shown) of radio frequency process processed, radio frequency ablation catheter 320 are connected with radiofrequency melting instrument.Radio frequency ablation catheter
320 include the connecting conduits of strip, are arranged on the electrode suppor 321 of connecting conduit distal end, and to be arranged on connecting conduit near
The joystick at end.In use, joystick is connected by composite cable with radiofrequency melting instrument, use is provided with composite cable
In connection Different electrodes and a plurality of wire of radio-frequency signal generator.Multiple electrodes 322 are provided with electrode suppor 321, work as radio frequency
After the front end of ablation catheter 320 is stretched out from guiding catheter 310, and multiple electrodes 322 are adherent in the presence of the joystick,
The Different electrodes 322 for being arranged on the front end of radio frequency ablation catheter 320 can be controlled to carry out radio frequency release respectively by radiofrequency melting instrument.
After change ablation site endovascular conductive environment, during radio frequency release, it is by the vascular wall between Different electrodes
It may make up loop and carry out RF ablation.Body surface patch electrode need not be used in the radio frequency ablation device.
As shown in Figure 6 and Figure 7, after the blocking of closure sacculus 311 ablation site of inflation endovascular regional flow, lead to
The second conduit branch 313 is crossed to after ablation site pipe intra-bladder instillation contrast agent or other non-electrically conductive liquids, control radio-frequency electrode patch
Wall, then radio-frequency electrode 325 and loop electrode 326 can pass through vascular wall formation loop progress radio frequency.Now, as shown in fig. 7, portion
Point radio-frequency current can be from the intravasation wall 400 of radio-frequency electrode 325 inside tube chamber, and from vascular wall inner surface 401 and appearance
After vascular wall 400 is flowed through between face 402, the loop electrode 326 that returns to inside tube chamber；Meanwhile portion radio frequency electric current can be from blood
The inner surface 401 of tube wall, which enters through, passes through vascular wall outer surface 402 after vascular wall 400, and from vascular wall outer surface 402
Outside is entered back into vascular wall 400, is then flowed through vascular wall 400 and is returned to loop electrode 326.In this process, radio-frequency current
The part flowed through between vascular wall inner surface 401 and outer surface 402 and radio-frequency current enter back into vascular wall after passing through vascular wall
Part between ratio determined by the conductivity difference of vascular wall and vascular wall peripheral organization.
Now, because contrast agent is non-conductor, resistance is very high, and intracavitary belongs to non-conductive environment, and intracavitary is not turned on, now
Vascular wall need not be passed through by external electrode, between electrode mutual electron motion can be achieved and carry out radio frequency.It is different by controlling
The order of mutual radio frequency between electrode, you can the direction of the launch of radio frequency between coordination electrode, realize the nerve of the outer different parts of vascular wall
The RF ablation of tissue.When using such scheme, vascular wall is conductor, because vascular wall is nearer from nerve, few radio frequency loss,
RF ablation nerve effect is perfect condition.Therefore, the liquid of the intra-arterial infusion reduction intracavitary electric conductivity to blocking blood flow is passed through
Body, such as it is suitable that non-electrically conductive liquid, which carries out ablation, can there is preferable nerve ablation effect.Also, it is poured in blood vessel pipe
The non-electrically conductive liquid of intracavitary can also reduce the temperature of local tube chamber, protect local vascular.It is of course also possible to by block blood
The intra-arterial infusion gas of stream realizes identical purpose.
As shown in figure 8, can be filled with liquid or gas into closure sacculus 311 by the first conduit branch 312, realization is closed
The inflation effect of sacculus 311 is closed, so as to block endovascular blood flow.Can be to ablation site blood by the second conduit branch 313
Perfusion physiological saline in pipe.When by the way that the second conduit branch 313 is to ablation site intra-arterial infusion physiological saline or other are conductive
After property liquid, during the adherent radio frequency of radio-frequency electrode, because physiological saline is conductive, intracavitary is conductive environment, belongs to intracavitary phase
Logical, electronics freely activity in the blood vessels, forms pipe inner looping in electrode.In partial nerve ablative surgery, it is necessary to lumen of vessels
Interior perfusion physiological saline, at this point it is possible to reduce the liquid/gas of vascular wall local electrical resistance by being injected into vascular wall so that
Vascular wall has the relative preferable electric conductivity of intracavitary, so as to formed in vascular wall and its outside organization be similar to Fig. 6 and
Ablation loop shown in Fig. 7, reach the effect of ablation nerve fiber.
Second embodiment
In this embodiment, the structure of radio frequency ablation device and first embodiment are essentially identical, including above-mentioned balloon occlusion
Type guiding catheter, radio frequency ablation catheter and the radiofrequency melting instrument being connected with radio frequency ablation catheter.Second embodiment is real with first
The difference for applying example is：The distal end of radio frequency ablation catheter is additionally provided with hollow wall-through electrode, and wall-through electrode is hollow and disappears with radio frequency
The inner passage for melting conduit communicates, and for injecting the liquid of the resistance for changing vascular wall into vascular wall, such as can be
Low-resistance physiological saline drops.Wall-through electrode can be provided in radio-frequency electrode or loop electrode on electrode suppor, also may be used
To be the electrode dedicated for injection set in addition.
Wall-through electrode is provided with outlet in its distal end, and wall-through electrode is provided with import, import and RF ablation in its near-end
The inner passage of conduit communicates.The intrusion pipe communicated with its inner passage, intrusion pipe are provided with the rear end of radio frequency ablation catheter
For being connected with perfusion equipment.By hollow wall-through electrode and intrusion pipe, physiological saline etc. can be used to reduce by perfusion equipment
The material of vascular wall local electrical resistance is injected directly into the tube wall tissue near RF ablation point, is passed through for increasing between electrode
The conducting degree of vascular wall and conducting probability, and when reducing RF ablation simultaneously between electrode Endovascular conducting degree and
Turn on probability.
Therefore, in radiofrequency ablation procedures, the closure balloon occlusion blood vessel of the distal end of guiding catheter is arranged on by inflation
Interior regional flow；Liquid/gas by guiding catheter to intra-arterial infusion for reducing intracavitary electric conductivity；And pass through simultaneously
Hollow wall-through electrode injects the liquid for reducing local electrical resistance into vascular wall tissue, then by controlling RF ablation to lead
The Different electrodes of pipe, it can be formed between radio-frequency electrode and loop electrode and carry out RF ablation, nerve by the loop of vascular wall
Ablation effect is better than first embodiment.
Specifically, the wall-through electrode of the distal end of radio frequency ablation catheter 2 is arranged on, can be arranged in the middle part of flap radio-frequency electrode
Adherent position, the leading portion of strip puncture needle radio-frequency electrode can also be arranged on.Moreover, wall-through electrode front end is arranged to sharp keen
Acute angle, there can be sword, profile is cone, rhombus etc., the length range of wall-through electrode, is preferably：0.01~20mm, wall-through electricity
The diameter range of pole, preferably 0.01~2.0mm.
3rd embodiment
In this embodiment, in order to realize the liquid injected into the vascular wall of ablation site for reducing local electrical resistance,
Hollow puncture needle is provided with the front end of radio frequency ablation catheter, for substituting the injection of hollow wall-through electrode in second embodiment
Function.The wall-through electrode or ordinary electrode set in this embodiment only has the function of RF ablation, or wall-through electrode
Can be simultaneously with hollow structure with function of injection.Wherein, after wall-through electrode passes inside or through vascular wall, can directly to
Neuropile near vascular wall releases energy, so as to reduce damage of the radio frequency process to vascular wall, the introduction on wall-through electrode
It may refer to the introduction in the application for a patent for invention CN201310049148.X of the applicant.In this embodiment, RF ablation
Remaining structure and second embodiment of equipment are essentially identical, including above-mentioned balloon occlusion type guiding catheter, radio frequency ablation catheter with
And the radiofrequency melting instrument being connected with radio frequency ablation catheter.
In the radio frequency ablation catheter that the present embodiment provides, the liquid cavity connected with puncture needle is provided with, and by leading
Pipe branch is connected with the perfusion equipment of outside.By conduit branch and puncture needle, perfusion equipment can reduce physiological saline etc.
The material of vascular wall local electrical resistance is injected directly into the tube wall tissue near RF ablation point, is passed through for increasing between electrode
The conducting degree of vascular wall and conducting probability, and when reducing RF ablation simultaneously between electrode Endovascular conducting degree and
Turn on probability.
Therefore, in radiofrequency ablation procedures, the closure balloon occlusion blood vessel of the distal end of guiding catheter is arranged on by inflation
Interior regional flow；Liquid/gas by guiding catheter to intra-arterial infusion for changing intravascular electric conductivity, is preferably reduced
The liquid/gas of electric conductivity, change the endovascular conductive environment of ablation site and temperature environment；And simultaneously by puncture needle to blood
The liquid for reducing vascular wall local electrical resistance is injected in tube wall tissue, then by controlling the difference of radio frequency ablation catheter electric
Pole, it can be formed between radio-frequency electrode and loop electrode and carry out RF ablation by the loop of vascular wall, nerve ablation effect is same
Sample is better than first embodiment.
In summary, the radio frequency ablation device provided by the present invention for including balloon occlusion type guiding catheter, passes through inflation
The closure sacculus of the distal end of balloon occlusion type guiding catheter, the endovascular regional flow of ablation site can be blocked, by disappearing
Melt position intra-arterial infusion to be used to change intravascular conductive environment or the liquid/gas of temperature environment, and by controlling radio frequency to disappear
Melt the Different electrodes of conduit, loop can be formed by vascular wall or its peripheral organization between radio-frequency electrode and loop electrode and carried out
Radio frequency.Using the radio frequency ablation device of above-mentioned guiding catheter, it is not necessary to external electrode, you can pass through the hair of radio frequency between coordination electrode
Direction is penetrated, forming loop by vascular wall between different electrodes carries out RF ablation.It is this electric in radio-frequency electrode and loop
The loop by vascular wall that interpolar is formed belongs to the shape in regional area for the loop formed by whole human body
Into loop, it is necessary to overcome human body impedance few.And because vascular wall is nearer from nerve, intracavitary is not turned on, few radio frequency loss can
With with preferable nerve ablation effect.
Further, it is also possible to the liquid of local electrical resistance can be reduced to vascular wall perfusion by hollow wall-through electrode or puncture needle
Body, for increasing by the conducting degree and conducting probability of vascular wall between electrode, and when reducing RF ablation simultaneously electrode it
Between Endovascular conducting degree and conducting probability.Moreover, by irrigating liquid in vessel lumen and in vascular wall pipe
Injecting fluid in wall tissue, while local temperature can also be reduced, protect local vascular.
The radiofrequency melting instrument that the present invention uses possesses multi-channel rf output function, can be achieved to pass through vascular wall between multiple electrodes
Form loop, radiofrequency melting instrument by the various form electrodes of ablation catheter RF energy is loaded into the blood vessel being bonded therewith,
On muscle, nerve, then radio-frequency current returns to radiofrequency melting instrument by vascular wall and by loop electrode, forms radio frequency and is loaded back into
Road.Radio-frequency current produces ion high speed vibration in the tissue being bonded therewith, and produces temperature rise to reach ablation purpose.
In technical scheme provided by the invention, above-mentioned radiofrequency melting instrument passes through vascular wall structure between can realizing electrode two-by-two
Into fractional radio frequency's current loop, RF energy only is discharged between two electrodes in loop are formed, and produces temperature, is significantly reduced
The more RF energies of human body impedance loss.
In two applications for a patent for invention having been filed on《201410035836.5 for nerve ablation RF ablation method and
Radio frequency ablation system》With《201310530007.X have temp sensing function concurrently and survey the radio-frequency electrode and ablatograph of impedance function》In
The operation principle of radiofrequency melting instrument is elaborated, will not be repeated here.
Above to the radio frequency ablation device and its ablation method provided by the present invention for including balloon occlusion type guiding catheter
It is described in detail.To those skilled in the art, to its institute on the premise of without departing substantially from true spirit
Any obvious change done, will all form to infringement of patent right of the present invention, will undertake corresponding legal liabilities.
Claims (6)
- A kind of 1. radio frequency ablation device, it is characterised in that：Including balloon occlusion type guiding catheter, the balloon occlusion type guiding catheter includes two-chamber or multi-cavity catheter, is led described The inflatable closure sacculus for blocking intravascular regional flow is provided with the outer wall of the distal end of guiding tube；In the guiding The near-end of conduit is provided with the first conduit branch communicated with the first tube chamber inside the guiding catheter, the closure sacculus Internal the first tube chamber with inside the guiding catheter communicates, and first conduit branch is used to pass through first tube chamber to institute State closure sacculus and inflation thing is provided；It is provided with and the second tube chamber phase inside the guiding catheter in the near-end of the guiding catheter The second logical conduit branch, the distal end of second tube chamber are provided with perfusing hole, and second conduit branch is used for by described Perfusing hole is to ablation site intra-arterial infusion liquid or gas；Also include the radio frequency ablation catheter being arranged in a certain tube chamber inside the balloon occlusion type guiding catheter, penetrated described The distal end of frequency ablation catheter is provided with electrode suppor, and two or more electrodes are provided with the electrode suppor, its In, at least one electrode is connected to the output end of radio-frequency signal generator, forms radio-frequency electrode, and at least one described electricity Pole is connected to the loop end of radio-frequency signal generator, forms loop electrode；In radiofrequency ablation procedures, the closure balloon occlusion of the distal end of the balloon occlusion type guiding catheter is arranged on by inflation Endovascular regional flow；By second conduit branch to ablation site intra-arterial infusion liquid or gas；And described Loop is formed between radio-frequency electrode and the loop electrode；The distal end of the radio frequency ablation catheter is provided with one or more wall-through electrodes, and the wall-through electrode is hollow and is penetrated with described Passage inside frequency ablation catheter communicates, for the injecting fluid into vascular wall or gas.
- 2. radio frequency ablation device as claimed in claim 1, it is characterised in that：The radio frequency ablation catheter is arranged in the second tube chamber inside the balloon occlusion type guiding catheter.
- 3. radio frequency ablation device as claimed in claim 1, it is characterised in that：The wall-through electrode is arranged on the adherent position in the middle part of flap electrode suppor；Or the wall-through electrode is arranged on strip The leading portion of puncture needle.
- 4. radio frequency ablation device as claimed in claim 1, it is characterised in that：The wall-through electrode is simultaneously radio-frequency electrode or loop electrode.
- 5. radio frequency ablation device as claimed in claim 1, it is characterised in that：The liquid or gas injected into vascular wall are liquid or gas for reducing the resistance of vascular wall.
- 6. radio frequency ablation device as claimed in claim 1, it is characterised in that：It is the liquid from the liquid for reducing the endovascular electric conductivity of ablation site to ablation site intra-arterial infusion or gas Body or gas.
Priority Applications (6)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201510689867.7A CN105147389B (en) | 2015-10-22 | 2015-10-22 | Include the radio frequency ablation device and its ablation method of balloon occlusion type guiding catheter |
| US16/064,934 US20190008585A1 (en) | 2015-10-22 | 2016-10-22 | Radio frequency ablation device comprising balloon blocking catheter and ablation method therefor |
| PCT/CN2016/102980 WO2017067517A1 (en) | 2015-10-22 | 2016-10-22 | Radio frequency ablation device comprising balloon blocking catheter and ablation method therefor |
| EP16856948.1A EP3366246B1 (en) | 2015-10-22 | 2016-10-22 | Radio frequency ablation device comprising balloon blocking catheter and ablation method therefor |
| ES16856948T ES2951175T3 (en) | 2015-10-22 | 2016-10-22 | Radiofrequency ablation device comprising a balloon locking catheter and an ablation method therefor |
| US17/929,592 US20230181245A1 (en) | 2015-10-22 | 2022-09-02 | Radio frequency ablation device comprising balloon blocking catheter and ablation method therefor |
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| WO2017067517A1 (en) * | 2015-10-22 | 2017-04-27 | 上海魅丽纬叶医疗科技有限公司 | Radio frequency ablation device comprising balloon blocking catheter and ablation method therefor |
| CN106725838B (en) * | 2016-02-11 | 2024-03-29 | 上海魅丽纬叶医疗科技有限公司 | Catheter with balloon dilation and radio frequency ablation functions and ablation method thereof |
| WO2018081323A1 (en) * | 2016-10-26 | 2018-05-03 | Boston Scientific Scimed Inc. | Stenosis prevention and ablation delivery system |
| CN107374725B (en) * | 2017-08-31 | 2023-11-03 | 苏州信迈医疗器械有限公司 | Multipole ablation device |
| CN109464186B (en) | 2017-09-08 | 2023-12-22 | 泽丹医疗股份有限公司 | Device and method for treating lung tumors |
| JP7461606B2 (en) * | 2018-12-20 | 2024-04-04 | 東レ株式会社 | Esophageal fluid delivery catheters and intermediate parts for manufacturing esophageal fluid delivery catheters |
| CN111494004A (en) * | 2020-06-02 | 2020-08-07 | 吉紫嫣 | Be used for not having nerve radio frequency ablation equipment and system of wound |
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