DE19537084A1 - Catheter for transmyocardial revasculation with guidable multi=ID main catheter - Google Patents

Catheter for transmyocardial revasculation with guidable multi=ID main catheter

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Publication number
DE19537084A1
DE19537084A1 DE1995137084 DE19537084A DE19537084A1 DE 19537084 A1 DE19537084 A1 DE 19537084A1 DE 1995137084 DE1995137084 DE 1995137084 DE 19537084 A DE19537084 A DE 19537084A DE 19537084 A1 DE19537084 A1 DE 19537084A1
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Patent type
Prior art keywords
catheter
unit
auxiliary
catheters
fixation
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Withdrawn
Application number
DE1995137084
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German (de)
Inventor
Hans-Hinrich Prof Dr M Sievers
Wolfgang Kloess
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SIEVERS HANS HINRICH PROF DR M
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SIEVERS HANS HINRICH PROF DR M
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/3203Fluid jet cutting instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00022Sensing or detecting at the treatment site
    • A61B2017/00106Sensing or detecting at the treatment site ultrasonic
    • A61B2017/0011Sensing or detecting at the treatment site ultrasonic piezo-electric
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238Type of minimally invasive operation
    • A61B2017/00243Type of minimally invasive operation cardiac
    • A61B2017/00247Making holes in the wall of the heart, e.g. laser Myocardial revascularization
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00041Heating, e.g. defrosting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00214Expandable means emitting energy, e.g. by elements carried thereon
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00273Anchoring means for temporary attachment of a device to tissue
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • A61B2018/00392Transmyocardial revascularisation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/1253Generators therefor characterised by the output polarity monopolar
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/126Generators therefor characterised by the output polarity bipolar
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/36Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37Surgical systems with images on a monitor during operation
    • A61B2090/378Surgical systems with images on a monitor during operation using ultrasound
    • A61B2090/3782Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument
    • A61B2090/3784Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument both receiver and transmitter being in the instrument or receiver being also transmitter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00Ultrasound therapy
    • A61N7/02Localised ultrasound hyperthermia

Abstract

The catheter has a main catheter (10) and multiple auxiliary catheters (12, 14). At least two of the auxiliary catheters are provided with a unit (16) for fixation at the inner wall of the heart. Some of the auxiliary catheters at least are provided with piezoelectric elements in the region of their distal ends, to be controlled across the catheter, for the transmission and the reception of ultrasonic energy. The piezoelectric element of the fixation catheter is designed as a piezofoil (20), surround annularly the fixation unit (16). The auxiliary catheter (14) has a unit (18) for piercing a fine hole in the inner wall of the heart. This unit is a laser beam unit.

Description

Die Erfindung betrifft einen Katheter zur transmyokar dialen Revaskularisation mit einem lenkbaren, mehrlumi gen Mutterkatheter und einer Mehrzahl von von dem Mut terkatheter geführten, einzeln lenkbaren Tochterkathe tern, wobei wenigstens zwei der Tochterkatheter an ihrem distalen Ende mit einer Einrichtung zu des sen Fixation an der Innenwandung des Herzens versehen ist und ein weiteres der Tochterkatheter mit einer Einrichtung zum Einbringen eines feinen Lochs in die Innenwandung des Herzens versehen ist. The invention relates to a catheter for transmyokar Dialen revascularization with a steerable, mehrlumi gen mother catheter and a plurality of terkatheter by the courage guided individually steerable daughter Kathe tern, wherein at least two of the daughter catheter at its distal end with means for the sen fixation on the inner wall of the heart is provided and another daughter catheter with a device for introducing a fine hole is provided in the inner wall of the heart.

In der EP 0 515 867 A2 wird ein Katheter beschrieben, das zur transmyokardialen Revaskularisation dient, also zur Einbringung von Löchern in die Innenwandung des Her zens. In EP 0515867 A2, a catheter is described which is used for transmyocardial revascularization, that for the introduction of holes in the inner wall of Her zen.

Die Einbringung von Löchern in die Myokardwand kann be wirken, daß minder durchblutete Herzmuskelbezirke mit Sauerstoff aus der linken Herzkammer versorgt werden. The incorporation of holes in the myocardial wall may act be that less perfused heart muscle districts are supplied with oxygen from the left ventricle. Ein solcher Eingriff kann in vielen Fällen ansonsten er forderliche Bypassoperationen oder Ballondilatationen langfristig vermeiden lassen. Such interference can be avoided otherwise he ford variable bypass surgery or balloon dilations in the long term in many cases.

Bei einem solchen Eingriff sind die Kontrolle und die Steuerung des Ortes und der Tiefe des in das Myokard einzubringenden Loches von großer Bedeutung: Die Löcher sind in einem vorgegebenen Bereich mit möglichst regel mäßigen Abständen einzubringen, die Tiefe der Löcher ist der Dicke des Myokard entsprechend zu bestimmen, wobei ein Durchdringen des Myokards zuverlässig ausgeschlossen sein muß. In such a procedure, the control and the control of the location and depth of the to be introduced into the myocardium hole are of great importance: The holes are to be introduced in a predetermined range with regular as possible regular intervals, the depth of the holes is the thickness of the myocardium according to determine where penetration of the myocardium must be reliably excluded.

Der Erfindung liegt damit die Aufgabe zugrunde, ein Kat heter zur transmyokardialen Revaskularisation zu schaf fen, bei der eine bessere Kontrolle des Ortes und der Tiefe der in das Myokard eingebrachten Löcher möglich ist. The invention is thus based on the object, a cat heter transmyocardial revascularization to sheep fen in which a better control of the location and depth of the holes introduced into the myocardium is possible.

Erfindungsgemäß wird diese Aufgabe dadurch gelöst, daß wenigstens einige der Tochterkatheter im Bereich ihrer distalen Enden mit über das Katheter anzusteuernden pie zoelektrischen Elementen zum Aussenden und zum Empfangen von Ultraschallenergie versehen sind. According to the invention this object is achieved in that at least some of the daughter catheters are provided in the area of ​​their distal ends about to be driven, the catheter pie zoelektrischen elements for emitting and receiving ultrasonic energy.

Dabei können die piezoelektrischen Elemente der Fixati onskatheter, aber auch des Lochungskatheters als die Fi xationseinrichtung bzw. die Lochungseinrichtung ringför mig umgebende Piezofolie ausgebildet sein. The piezoelectric elements of the Fixati onskatheter, but also the Lochungskatheters than the Fi can xationseinrichtung or the punching means may be formed ringför mig surrounding piezo foil.

Die Ausgestaltung der Fixationseinrichtung ist nicht Ge genstand der Erfindung, es kann sich dabei beispielswei se um einen Bohrhaken handeln oder aber um einen Saug kopf. The design of the fixation device is not subject-matter of the invention, this may be beispielswei se be a bolts or head to a suction. Auch die Ausgestaltung der Lochungseinrichtung ist nicht Gegenstand der Erfindung, dabei kann es sich um eine Laserfiber, eine Nadel, einen Heizdraht oder einen Hochdruckstrahl handeln. The configuration of the punching is not the subject of the invention, there may be a laser fiber, a needle, a heating wire or a high-pressure jet.

Die Erfindung wird im folgenden anhand einer Zeichnung erläutert. The invention is explained below with reference to a drawing. Dabei zeigt: In which:

Fig. 1 eine schematische Darstellung des Katheters, Fig. 1 is a schematic illustration of the catheter,

Fig. 2 eine vergrößerte Schnittansicht durch das Kat heter, Fig. 2 is an enlarged sectional view through the heter Kat,

Fig. 3 eine vergrößerte Darstellung des distalen Tei les des Katheters, wobei anders als bei dem in den Fig. 1 und 2 dargestellten Katheter 3 Fixations-Tochterkatheter vorgesehen sind, und Fig. 3 is an enlarged view of the distal Tei les of the catheter, 3 fixation daughter catheters are different from the example shown in Figs. 1 and 2 catheter is provided, and

Fig. 4 einen zur Darstellung dienenden PC. Fig. 4 a serving PC to display.

Das in Fig. 1 gezeigte Katheter besteht aus einem Mut terkatheter 10 , das drei Tochterkatheter 12 , 14 führt. The catheter shown in Fig. 1 consists of a courage terkatheter 10 which performs three daughter catheter 12, 14. Die beiden Tochterkatheter 12 sind an ihrem distalen En de mit einem Bohrhaken 16 versehen, der zur Fixation des freien Endes des Katheters an der Innenwandung des Her zens dient. The two daughter catheter 12 are provided at their distal En de with bolts 16, which serves for fixation of the free end of the catheter to the inner wall of Her zen. Das dritte Tochterkatheter 14 ist an seinem freien Ende mit einer Einrichtung 18 versehen, die dazu in der Lage ist, ein feines Loch in die Innenwandung des Herzens einzubringen. The third daughter catheter 14 is provided at its free end with a device 18, which is able to incorporate a fine hole in the inner wall of the heart. Bei dem dargestellten Ausführungs beispiel kann es sich dabei insbesondere um das Ende ei nes Laserfibers oder aber um einen mit hochfrequenter Energie beaufschlagten Draht handeln. For example, in the illustrated execution it may be, in particular, the end ei nes Laser Fibers or one loaded with high-frequency energy act wire.

Die Fixationskatheter 12 sind am proximalen Ende des Katheters über jeweils einen Steuerdraht 18 in ihrer Ausrichtung steuerbar, der Steuerdraht 18 dient weiter dazu, den Bohrkopf 16 in die Wandung des Myokards einzu schrauben und die Tochterkatheter so zu fixieren. The fixation catheter 12 can be controlled at the proximal end of the catheter via a respective control wire 18 is in its alignment, the control wire 18 further serves einzu screw the drill head 16 in the wall of the myocardium and fix the daughter catheter so on. Das Lochungskatheter 14 ist mit einem Steuerdraht 20 verse hen, der zur Ausrichtung seines distalen Endes dient, sowie mit einer die Energie - im dargestellten Ausfüh rungsbeispiel Laserlicht - zu dem distalen Ende zu füh ren. The Lochungskatheter 14 is 20 verse hen with a control wire, which serves for alignment of its distal end, as well as with a power - in the illustrated example exporting approximately laser light - to the distal end feels younger ren.

Die Tochterkatheter sind über jeweils ein haemostati sches Ventil 24 bzw. 26 aus dem Mutterkatheter 10 her ausgeführt. The daughter catheters are executed via a respective haemostati ULTRASONIC valve 24 or 26 from the mother catheter 10 forth. Das Mutterkatheter 10 ist über einen Lenkka nal 26 steuerbar. The mother catheter 10 is controlled via a Lenkka nal 26th

Die Fixationskatheter 14 tragen im Bereich ihrer dista len Austrittsenden eine ringförmige Piezofolie 28 , das distale Austrittsende des Lochungskatheters 14 eine ringförmig ausgebildete Piezofolie 30 . The fixation catheter 14 carry at their exit ends dista len an annular piezo sheet 28, the distal exit end of the Lochungskatheters 14 is a ring-shaped piezo film 30th Die Piezofolien 28 , 30 werden über - nicht dargestellte - sehr feine elektrische Leitungen angesteuert und zum Aussenden von Ultraschallwellen erregt. The piezoelectric films 28, 30 are - not shown - driven very fine electric wires and excited for emitting ultrasonic waves. Entsprechend werden empfangene Ultraschallwellen über diese Leitungen zu einer Auswert eausrichtung geführt. According to received ultrasonic waves are guided by these lines to an evaluation system eausrichtung.

Bei Verwendung des Katheters werden zunächst die Fixati onskatheter 14 am Myokard angeheftet. When using the catheter, the first Fixati be attached onskatheter 14 on the myocardium. Wenn nun die Pie zofolie 30 auf dem Lochungskatheter 16 erregt wird, sen det dieses Ultraschallwellen aus, die von den Piezofo lien 28 an den Enden der Katheter 14 empfangen werden. If now the zofolie Pie energized on the Lochungskatheter 16 30, det sen from this ultrasonic waves are received by the Piezofo lien 28 at the ends of the catheters fourteenth Durch eine Messung der Laufzeit, die der Ultraschall be nötigt, um von dem Lochungskatheter 16 zu den Fixations kathetern 14 zu wandern, kann in als Peiltechnik bekann ten Verfahren der Ort der Lochungseinrichtung 18 relativ zu den Fixationseinrichtungen 16 ermittelt werden. By measuring the propagation time of the ultrasonic be compels to the fixation of the catheters Lochungskatheter 16 14 to wander in a direction finding process of the well-th place of the punching means 18 can be determined relative to the fixation means sixteenth Auf entsprechende Weise kann auch der Ort der Fixationsein richtungen 16 relativ zueinander und zu der Lochungsein richtung 18 ermittelt werden. In a corresponding way also the location of the Fixationsein may directions 16 relative to each other and are determined to be the direction Lochungsein 18th Auf diese Weise können der Ort der freien Enden der wenigstens drei Katheter ein deutig bestimmt und auf einer Auswerteeinrichtung in Fig. 4 durch den PC 34 angedeutet, auf einem Bildschirm dargestellt werden. In this manner, the location of the free ends of the at least three catheter can have a clearly determined and indicated to an evaluation device in Fig. 4 by the PC 34 are shown on a screen.

Dabei ist es möglich, die Orte, an denen bereits eine Lasion in Form eines Loches in das Myokard eingebracht worden ist, markieren, der Ort, an dem sich die Lo chungseinrichtung 18 befindet (in Fig. 4 durch ein "x" angedeutet) kann dargestellt und so ein geeigneter Ort für das Setzen eines weiteren Lochs von dem Operateur bestimmt werden. It is possible, the places where a lesion has been introduced in the form of a hole in the myocardium already mark the place where the Lo monitoring device 18 is located (in FIG. 4 by an "x" indicated) may shown and so are determined by the operator, a suitable place for the setting of a further hole.

Die piezoelektrischen Elemente 20 , 22 an den Austritt senden der Katheter 14 , 16 können auch dazu genutzt wer den, die Dicke des Myokards zu ermitteln, um eine für den jeweiligen Fall geeignete Tiefe des in die Herzin nenwandung einzubringenden Lochs zu bestimmen. Send the piezoelectric elements 20, 22 at the outlet of the catheter 14, 16 may also be used to determine the, the thickness of the myocardium in order to determine a suitable for the respective case depth of the hole to be introduced Herzin nenwandung who. Eine ent sprechende Darstellung des Myokards in ihrer Dicke und der Ort der in das Loch einzudringenden Lochungseinrich tung 18 ist auf einfache Weise durch ein bildgebendes Verfahren unter Nutzung der von den Piezoelementen 20 , 22 ausgesandten und wieder empfangenen Signalen möglich, indem das Echo von der Grenzlinie zwischen der Außensei te des Myokards und des dieses umgebenden Gewebes erfaßt und ausgewertet wird. Take out a suitable representation of the myocardium in its thickness and the location of the einzudringenden in the hole Lochungseinrich tung 18 is possible in a simple manner by an image forming method making use of, 22 emitted by the piezoelectric elements 20, and back signals received by the echo from the boundary line between the geek of the myocardium and the surrounding tissue, this te is detected and evaluated.

Claims (5)

  1. 1. Katheter zur transmyokardialen Revaskularisation, mit einem lenkbaren, mehrlumigen Mutterkatheter ( 10 ) und einer Mehrzahl von von dem Mutterkatheter ( 10 ) geführten, einzeln lenkbaren Tochterkathetern ( 12 , 14 ), wobei wenigstens zwei der Tochterkatheter ( 12 ) an ihrem distalen Ende mit einer Einrichtung ( 16 ) zu dessen Fixation an der Innenwandung des Herzens versehen ist und ein weiteres der Tochterkatheter ( 14 ) mit einer Einrichtung ( 18 ) zum Einbringen eines feinen Lochs in die Innenwandung des Herzens versehen ist, dadurch gekennzeichnet, daß wenigstens einige der Toch terkatheter ( 12 , 14 ) im Bereich ihrer distalen Enden mit über das Katheter anzusteuernden piezoelektrischen Elementen ( 20 , 22 ) zum Aussenden und zum Empfangen von Ultraschallenergie versehen sind. 1. A catheter for transmyocardial revascularization, with a steerable multi-lumen mother catheter (10) and a plurality of of the mother catheter (10) guided individually steerable daughter catheters (12, 14), at least two of the daughter catheter (12) at its distal end with means (16) is provided for its fixation against the inner wall of the heart and another of the daughter catheter (14) having means (18) for introducing a fine hole is provided in the inner wall of the heart, characterized in that at least some of the Toch terkatheter (12, 14) in the area of their distal ends about the catheter to be controlled piezoelectric elements (20, 22) for emitting and receiving ultrasonic energy are provided.
  2. 2. Katheter nach Anspruch 1, dadurch gekennzeichnet, daß die piezoelektrischen Elemente der Fixationskathe ter ( 12 ) als die Fixationseinrichtung ( 16 ) ringförmig umgebende Piezofolie ( 20 ) ausgebildet ist. 2. A catheter according to claim 1, characterized in that the piezoelectric elements of the fixation Kathe ter (12) as the fixation means (16) annularly surrounding the piezoelectric film (20) is formed.
  3. 3. Katheter nach Anspruch 1 oder Anspruch 2, dadurch gekennzeichnet, daß die piezoelektrischen Elemente des Lochungskatheters ( 12 ) als die Lochungseinrichtung ( 16 ) ringförmig umgebende Piezofolie ( 20 ) ausgebildet ist. 3. The catheter of claim 1 or claim 2, characterized in that the piezoelectric elements of the Lochungskatheters (12) as the punching means (16) annularly surrounding the piezoelectric film (20) is formed.
  4. 4. Katheter nach einem der vorangehenden Ansprüche, dadurch gekennzeichnet, daß die Einrichtung zum Ein bringen eines feinen Lochs in die Innenwandung des Her zens eine Laserstrahl-Einrichtung ist. 4. Catheter according to one of the preceding claims, characterized in that the means for bringing an A pinhole in the inner wall of Her zen is a laser beam device.
  5. 5. Katheter nach einem der Ansprüche 1 bis 4, dadurch gekennzeichnet, daß die Einrichtung zum Einbringen eines feinen Lochs in die Innenwandung des Herzens ein mit hochfrequenter Energie beaufschlagter Draht ist. 5. Catheter according to one of claims 1 to 4, characterized in that the means for introducing a fine hole in the inner wall of the heart is acted upon by a high-frequency power wire.
DE1995137084 1995-10-05 1995-10-05 Catheter for transmyocardial revasculation with guidable multi=ID main catheter Withdrawn DE19537084A1 (en)

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US5873855A (en) * 1992-01-07 1999-02-23 Arthrocare Corporation Systems and methods for electrosurgical myocardial revascularization
DE19745488A1 (en) * 1997-10-15 1999-04-29 Wolf Gmbh Richard Endoscopic instrument for heart muscle therapy
EP0876796A3 (en) * 1997-05-07 1999-05-26 Eclipse Surgical Technologies, Inc. Device for use in the treatment of cardiovascular or other tissue
US5938632A (en) * 1997-03-06 1999-08-17 Scimed Life Systems, Inc. Radiofrequency transmyocardial revascularization apparatus and method
US5944716A (en) * 1996-12-09 1999-08-31 Scimed Life Systems, Inc. Radio frequency transmyocardial revascularization corer
US5968059A (en) * 1997-03-06 1999-10-19 Scimed Life Systems, Inc. Transmyocardial revascularization catheter and method
US6030380A (en) * 1996-12-09 2000-02-29 Bsc Northwest Technology Center, Inc. Radio frequency transmyocardial revascularization
US6045565A (en) * 1997-11-04 2000-04-04 Scimed Life Systems, Inc. Percutaneous myocardial revascularization growth factor mediums and method
EP0934728A3 (en) * 1997-11-25 2000-04-26 ECLIPSE SURGICAL TECHNOLOGIES, Inc. Selective treatment of endocardial/myocardial boundary
US6056743A (en) * 1997-11-04 2000-05-02 Scimed Life Systems, Inc. Percutaneous myocardial revascularization device and method
US6063082A (en) * 1997-11-04 2000-05-16 Scimed Life Systems, Inc. Percutaneous myocardial revascularization basket delivery system and radiofrequency therapeutic device
US6086534A (en) * 1997-03-07 2000-07-11 Cardiogenesis Corporation Apparatus and method of myocardial revascularization using ultrasonic pulse-echo distance ranging
US6093185A (en) * 1998-03-05 2000-07-25 Scimed Life Systems, Inc. Expandable PMR device and method
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US8012153B2 (en) 2003-07-16 2011-09-06 Arthrocare Corporation Rotary electrosurgical apparatus and methods thereof
US7416551B2 (en) 2003-07-28 2008-08-26 A.F.M. Medical Systems Ltd. Catheter for delivering a tissue ablation probe
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