CN114788729A - Catheter integrating ultrasonic imaging and radio frequency ablation - Google Patents

Catheter integrating ultrasonic imaging and radio frequency ablation Download PDF

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Publication number
CN114788729A
CN114788729A CN202110108278.0A CN202110108278A CN114788729A CN 114788729 A CN114788729 A CN 114788729A CN 202110108278 A CN202110108278 A CN 202110108278A CN 114788729 A CN114788729 A CN 114788729A
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China
Prior art keywords
catheter
ablation
radio frequency
integrating
frequency ablation
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CN202110108278.0A
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Chinese (zh)
Inventor
尹宗涛
刘浩
张誉籍
历志
张建
王重阳
郑雄
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General Hospital of Shenyang Military Region
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General Hospital of Shenyang Military Region
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Priority to CN202110108278.0A priority Critical patent/CN114788729A/en
Publication of CN114788729A publication Critical patent/CN114788729A/en
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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
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/361—Image-producing devices, e.g. surgical cameras
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • 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
    • A61B2018/00351—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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00595—Cauterization
    • 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
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • 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
    • A61B2018/1467—Probes or electrodes therefor using more than two electrodes on a single probe
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2063—Acoustic tracking systems, e.g. using ultrasound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046—Tracking techniques
    • A61B2034/2065—Tracking using image or pattern recognition
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound

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Abstract

The invention discloses a catheter integrating ultrasonic imaging and radio frequency ablation, which comprises a head electrode, wherein a miniature ultrasonic probe is arranged in the middle of the head electrode, and the right front area of the catheter is scanned to acquire the tissue ablation degree of the ablation catheter; the head electrode is arranged at the top end of the catheter body; ring electrodes are arranged at intervals on the catheter head of the catheter body; the catheter body comprises a controllable bending section and a main body section; wherein the controllable bending section is arranged at the front side of the main body section; a traction wire is arranged inside the catheter body; the invention scans the ablation tissues in the forward direction or the lateral direction of the catheter through the miniature ultrasonic probe arranged on the catheter, and judges the ablation degree of the ablation catheter to the focus in real time in an ultrasonic imaging mode; the traditional mode of the radio frequency ablation operation is changed, and a doctor is helped to accurately ablate ablation tissues.

Description

Catheter integrating ultrasonic imaging and radio frequency ablation
Technical Field
The invention relates to the field of medical instruments, in particular to a catheter integrating ultrasonic imaging and radio frequency ablation.
Background
The radio frequency ablation is a minimally invasive interventional therapy, which is characterized in that a radio frequency ablation catheter with an electrode is introduced into a focus part in a patient body under the guidance of an imaging device through a femoral artery and vein, a jugular vein and a subclavian vein, and the electrode at the head of the catheter is utilized to generate a resistance electrothermal effect in myocardial tissues to dry and necrose myocardial cells. The principle is as follows: high-frequency alternating current released by the electrode at the head of the catheter is emitted into the focal tissue, positive and negative ions in cells move rapidly due to rapid change of an electromagnetic field, the focal tissue generates high temperature, and when the temperature reaches a certain temperature (generally 60 ℃), the focal tissue is subjected to aseptic necrosis, so that the purpose of treatment is achieved.
The main image guidance means of the rf ablation include: MRI, ultrasound, and CT. The MRI guidance has the advantages that the curative effect can be better evaluated, no ionizing radiation exists, the tissue resolution is high, imaging is carried out in any direction, the range of an ablation focus is clearly displayed, but the cost is higher; the advantage of ultrasound guidance is that it can be displayed in real time, easily viewed. The color Doppler ultrasound can know the tumor blood supply condition and judge the tumor inactivation condition, the cost is low, but micro bubbles generated during ablation possibly influence the observation of deep parts, metal electrodes form artifacts, and influence the observation of the relationship between the electrodes and the focus and the conditions of the intraoperative ablation focus and the postoperative ablation focus; the advantage of CT guidance is that it can be accurately positioned, but the tissue resolution is low, it is not possible to image arbitrarily, it is not possible to observe the ablation effect in real time during the operation, CT is the same as ultrasound, and only the range of the ablation focus can be roughly estimated.
However, the radio frequency ablation catheter in the prior art cannot perform precise ablation treatment on an ablation focus of a patient only through image guidance, and the ablation degree of the ablation catheter on tissues is difficult to judge in the ablation process.
Disclosure of Invention
The present invention is directed to a catheter integrating ultrasound imaging and rf ablation, so as to solve the above problems in the prior art.
In order to achieve the purpose, the invention provides the following technical scheme:
a catheter integrating ultrasonic imaging and radio frequency ablation comprises a head electrode, wherein a miniature ultrasonic probe is arranged in the middle of the head electrode, and an area right in front of the catheter is scanned to acquire the ablation degree of the ablation catheter on tissues; the head electrode is arranged at the top end of the catheter body; and ring electrodes are arranged at intervals on the catheter head of the catheter body.
As a still further scheme of the invention: the catheter body comprises a controllable bending section and a main body section; wherein the controllable bending section is arranged at the front side of the main body section; the catheter body is internally provided with a traction wire.
A catheter integrating ultrasonic imaging and radio frequency ablation comprises a miniature ultrasonic probe; the miniature ultrasonic probes are positioned at the interval part of the two ring electrodes, the lateral area of the catheter body is scanned to obtain the tissue ablation degree of the ablation catheter, and the plurality of miniature ultrasonic probes are uniformly arranged along the circumferential direction of the catheter.
As a still further scheme of the invention: a temperature sensor is also arranged on the inner side wall of the conduit body; and a connecting lead is arranged at the bottom of the temperature sensor and is connected with an external controller through the inside of the conduit.
As a still further scheme of the invention: the temperature sensor is one that can function properly at temperatures less than 70 ℃.
As a still further scheme of the invention: the head electrode, the ring electrode, the temperature sensor and the rear side of the miniature ultrasonic probe are respectively provided with a lead, and the leads are fixedly arranged in the catheter body.
Compared with the prior art, the invention has the beneficial effects that:
the invention scans the ablation tissues in the front or side direction of the catheter by the miniature ultrasonic probe arranged on the catheter, and judges the ablation degree of the ablation catheter to the focus in real time in an ultrasonic imaging mode; the traditional mode of the radio frequency ablation operation is changed, and doctors are helped to accurately ablate the ablated tissues.
Drawings
Fig. 1 is a schematic structural diagram of a catheter integrating ultrasound imaging and radio frequency ablation.
Fig. 2 is a schematic top view of a catheter integrating ultrasound imaging and rf ablation.
Fig. 3 is a schematic structural view of another example of a catheter integrating ultrasound imaging and rf ablation.
Fig. 4 is a schematic top view of another embodiment of a catheter integrating ultrasound imaging and rf ablation.
In the figure: the probe comprises a head electrode 1, a ring electrode 2, a miniature ultrasonic probe 3, a catheter body 4 and a temperature sensor 5.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the drawings in the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be obtained by a person skilled in the art without making any creative effort based on the embodiments in the present invention, belong to the protection scope of the present invention.
Example 1
Referring to fig. 1-2, in an embodiment of the present invention, a catheter integrating ultrasound imaging and radio frequency ablation, includes a head electrode 1, a micro ultrasound probe 3 is disposed in the middle of the head electrode 1, and a region right in front of the catheter is scanned to obtain an ablation degree of the ablation catheter on a tissue; the head electrode 1 is arranged at the top end of the catheter body 4; the ring electrodes 2 are arranged at intervals at the head part of the catheter body 4.
The catheter body 4 comprises a controllable bending section and a main body section; wherein the controllable bending section is arranged at the front side of the main body section; the catheter body 4 is internally provided with a traction wire.
Example 2
Referring to fig. 3 to 4, in an embodiment of the present invention, a catheter integrating ultrasound imaging and radio frequency ablation includes a micro ultrasound probe 3; the miniature ultrasonic probes 3 are positioned at the interval parts of the two ring electrodes 2, the lateral area of the catheter body 4 is scanned to obtain the tissue ablation degree of the ablation catheter, and the miniature ultrasonic probes are uniformly arranged along the circumferential direction of the catheter.
A temperature sensor 5 is also arranged on the inner side wall of the conduit body 4; and a connecting lead is arranged at the bottom of the temperature sensor 5 and is connected with an external controller through the inside of the conduit.
The temperature sensor 5 is one of sensors that can normally operate at a temperature of less than 70 ℃.
The rear sides of the head electrode 1, the ring electrode 2, the temperature sensor 5 and the miniature ultrasonic probe 3 are all provided with wires which are fixedly arranged inside the catheter body 4.
The working principle of the invention is as follows:
when ablation is carried out, the catheter is connected with the radio frequency ablation instrument through the plug and is matched with the back electrode for use. The electrode at the head part of the catheter and the ring electrode are contacted with the ablation tissue, are heated by radio frequency current, and generate resistance electrothermal effect in the myocardial tissue by utilizing the electrode at the head part of the catheter, so that the myocardial cells are dried and necrotized, thereby achieving the purpose of treatment. When the temperature sensor detects that the temperature reaches the limited temperature, the radio frequency ablation instrument automatically reduces the power to keep the temperature within a safe range all the time.
Meanwhile, when the operation is performed, as shown in fig. 1, the micro ultrasonic probe at the head of the catheter scans the ablation tissue right in front of the head electrode 1, and the ablation degree of the radiofrequency ablation catheter on the ablation tissue is accurately judged through ultrasonic imaging real-time display, so that the accuracy and the safety of an ablation operation are improved. The miniature ultrasonic probe can work normally in an environment of less than 70 ℃.
In another example, as shown in fig. 3, the miniature ultrasonic probe in the middle of the interval between the two ring electrodes scans the ablation tissue in the lateral region of the ring electrodes, and the ablation degree of the ablation catheter on the lateral ablation tissue is judged by uniformly arranging a plurality of probes in the circumferential direction.
In another example, it is also possible to combine fig. 1 with fig. 3, i.e. to integrate a plurality of miniature ultrasound probes on a catheter in two directions. During the ablation operation, the miniature ultrasonic probe on the catheter scans the ablation tissues in the forward direction and the lateral direction of the catheter, and the ablation degree of the ablation tissues in the forward direction and the lateral direction by the ablation catheter is judged in an ultrasonic imaging mode.
It will be evident to those skilled in the art that the invention is not limited to the details of the foregoing illustrative embodiments, and that the present invention may be embodied in other specific forms without departing from the spirit or essential attributes thereof. The present embodiments are therefore to be considered in all respects as illustrative and not restrictive, the scope of the invention being indicated by the appended claims rather than by the foregoing description, and all changes which come within the meaning and range of equivalency of the claims are therefore intended to be embraced therein. Any reference sign in a claim should not be construed as limiting the claim concerned.
Furthermore, it should be understood that although the present description refers to embodiments, not every embodiment may contain only a single embodiment, and such description is for clarity only, and those skilled in the art should integrate the description, and the embodiments may be combined as appropriate to form other embodiments understood by those skilled in the art.

Claims (7)

1. A catheter integrating ultrasonic imaging and radio frequency ablation is characterized by comprising a head electrode (1), wherein a miniature ultrasonic probe (3) is arranged in the middle of the head electrode (1), and an area right in front of the catheter is scanned to acquire the ablation degree of the ablation catheter to tissues; the head electrode (1) is arranged at the top end of the catheter body (4); the catheter head of the catheter body (4) is provided with ring electrodes (2) at intervals.
2. A catheter integrating ultrasound imaging and radio frequency ablation according to claim 1, wherein the catheter body (4) comprises a controllable bending section and a main body section; wherein the controllable bending section is arranged at the front side of the main body section; the catheter body (4) is internally provided with a traction wire.
3. A catheter integrating ultrasonic imaging and radio frequency ablation is characterized by comprising a miniature ultrasonic probe (3); the miniature ultrasonic probes (3) are positioned at the interval part of the two ring electrodes (2), the lateral area of the catheter body (4) is scanned to obtain the ablation degree of the ablation catheter on tissues, and the miniature ultrasonic probes are uniformly arranged along the circumferential direction of the catheter.
4. The catheter integrating ultrasonic imaging and radio frequency ablation according to claim 3, wherein a temperature sensor (5) is further arranged on the inner side wall of the catheter body (4); and a connecting lead is arranged at the bottom of the temperature sensor (5) and is connected with an external controller through the inside of the conduit.
5. A catheter integrating ultrasound imaging and radio frequency ablation according to claim 3, characterized in that the temperature sensor (5) is one of the sensors that can work normally in temperatures less than 70 ℃.
6. The catheter integrating ultrasonic imaging and radio frequency ablation according to claim 1, wherein wires are arranged on the back sides of the head electrode (1), the ring electrode (2) and the micro ultrasonic probe (3) and are fixedly arranged inside the catheter body (4).
7. The catheter integrating ultrasonic imaging and radio frequency ablation as claimed in claim 3, wherein a lead is arranged at the rear side of the temperature sensor (5) and fixedly arranged inside the catheter body (4).
CN202110108278.0A 2021-01-24 2021-01-24 Catheter integrating ultrasonic imaging and radio frequency ablation Pending CN114788729A (en)

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CN202110108278.0A CN114788729A (en) 2021-01-24 2021-01-24 Catheter integrating ultrasonic imaging and radio frequency ablation

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CN114788729A true CN114788729A (en) 2022-07-26

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2024055927A1 (en) * 2022-09-15 2024-03-21 上海微创医疗器械（集团）有限公司 Medical catheter

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2024055927A1 (en) * 2022-09-15 2024-03-21 上海微创医疗器械（集团）有限公司 Medical catheter

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