DE4001086A1 - Medical treatment catheter widening constricted vessels - has two expandable balloons spaced in axial direction with heat conductive piece between them - Google Patents
Medical treatment catheter widening constricted vessels - has two expandable balloons spaced in axial direction with heat conductive piece between themInfo
- Publication number
- DE4001086A1 DE4001086A1 DE19904001086 DE4001086A DE4001086A1 DE 4001086 A1 DE4001086 A1 DE 4001086A1 DE 19904001086 DE19904001086 DE 19904001086 DE 4001086 A DE4001086 A DE 4001086A DE 4001086 A1 DE4001086 A1 DE 4001086A1
- Authority
- DE
- Germany
- Prior art keywords
- catheter
- treatment
- heat
- conducting body
- balloons
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Withdrawn
Links
Classifications
-
- 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
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical 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
- A61B18/22—Surgical 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
- A61B18/28—Surgical 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 for heating a thermal probe or absorber
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F7/12—Devices for heating or cooling internal body cavities
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1011—Multiple balloon catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
- A61B2017/22054—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation with two balloons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22082—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F7/00—Heating or cooling appliances for medical or therapeutic treatment of the human body
- A61F7/12—Devices for heating or cooling internal body cavities
- A61F2007/126—Devices for heating or cooling internal body cavities for invasive application, e.g. for introducing into blood vessels
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Physics & Mathematics (AREA)
- Heart & Thoracic Surgery (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Veterinary Medicine (AREA)
- Biomedical Technology (AREA)
- General Health & Medical Sciences (AREA)
- Thermal Sciences (AREA)
- Surgery (AREA)
- Optics & Photonics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Child & Adolescent Psychology (AREA)
- Pulmonology (AREA)
- Vascular Medicine (AREA)
- Hematology (AREA)
- Electromagnetism (AREA)
- Anesthesiology (AREA)
- Otolaryngology (AREA)
- Biophysics (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Laser Surgery Devices (AREA)
Abstract
Description
Die vorliegende Erfindung bezieht sich auf einen Behandlungs katheter zur Entfernung bzw. Aufweitung von Engstellen in Körperflüssigkeit führenden Gefäßen gemäß dem Oberbegriff des Anspruches 1.The present invention relates to treatment Catheter to remove or widen constrictions in Vessels carrying body fluid according to the generic term of claim 1.
Ein Behandlungskatheter dieser Art ist aus der EP-PS 00 80 436 bekannt. Bei der Anwendung dieses bekannten Behandlungskatheters hat sich herausgestellt, daß die Engstellenbehandlung, vorzugs weise von kalk- bzw. fettreichen Stenosen in Arterien, mit geeigneten Behandlungsmedien in manchen Fällen unbefriedigend ist, da das Behandlungsmedium das Gewebe nicht ausreichend auflöst.A treatment catheter of this type is known from EP-PS 00 80 436 known. When using this known treatment catheter has been found that the bottleneck treatment, preferential of limestone or fat-rich stenoses in arteries, with suitable treatment media unsatisfactory in some cases is because the treatment medium the tissue is insufficient dissolves.
Es ist andererseits aus der Veröffentlichung "Laser Balloon Angioplasty: "An Optical and Thermal Analysis" von A.J. Welch und Wai-Fung Cheong aus dem Biomedical Engineerung Programm, The University of Texas at Austin, Austin, Texas 78 712, Seiten 68 bis 95, bekannt, eine Gefäßverengung mit einem Behandlungskatheter zu erweitern oder zu beseitigen. Hierzu ist ein Behandlungskatheter mit einem einzigen ausdehnbaren Ballon versehen. Im Ballonbereich ist eine diffus strahlende Laserquelle vorgesehen, die durch die Ballonwand hindurch die Engstelle erhitzt. Die Ausdehnung des Ballons erfolgt mit einem Laserlicht nicht absorbierenden und nicht streuen den Fluid. Bei der Behandlung wird zunächst die Oberfläche der Engstelle auf ca. 200° erhitzt und erst nach Abschalten der Laserlichtquelle erfolgt die weitere Erhitzung des Ge webes durch Wärmeleitung. Dabei erhitzt sich auch das Fluid und unterstützt die Wärmeabgabe an tiefere Gewebeschichten. Dadurch wird das Gewebe denaturiert und in der Dehnstellung fixiert.On the other hand, it is from the publication "Laser Balloon Angioplasty: "An Optical and Thermal Analysis" by A.J. What and Wai-Fung Cheong from the Biomedical Engineering Program, The University of Texas at Austin, Austin, Texas 78 712, Pages 68 to 95, known a vasoconstriction with a Extend or eliminate treatment catheters. For this is a treatment catheter with a single expandable Balloon provided. In the balloon area there is a diffuse radiation Laser source provided through the balloon wall the constriction heats up. The balloon is expanded with a laser light not absorbing and not scattering the fluid. The first step in the treatment is the surface the narrow point is heated to approx. 200 ° and only after switching off the laser light source further heats the Ge weave through heat conduction. The fluid also heats up and supports the transfer of heat to deeper tissue layers. This causes the tissue to be denatured and stretched fixed.
Durch die unmittelbare Einwirkung des Laserlichts auf das Gewebe erhält man eine sehr hohe, zumeist unerwünschte Ober flächentemperatur, die zur Schorfbildung oder gar zur Ver kohlung des behandelten Gewebes führen kann. Außerdem ist nicht gewährleistet, daß die gesamte Oberfläche auch nur einigermaßen gleichmäßig erhitzt wird. Dies hängt damit zusammen, daß das Gewebe das Laserlicht nicht an allen Stellen gleich stark absorbiert, vor allem wenn krankhafte Veränderungen am Gewebe vorhanden sind.Due to the direct influence of the laser light on the Tissue gives a very high, mostly undesirable upper surface temperature, which can lead to scab formation or even ver carbonization of the treated tissue. Besides, is does not guarantee that the entire surface even is reasonably evenly heated. This depends on it together that the tissue does not have the laser light at all Places absorbed equally strongly, especially if pathological Changes to the tissue are present.
Mit der vorliegenden Erfindung soll die Aufgabe gelöst wer den, einen Behandlungskatheter der eingangs genannten Art derart auszugestalten, daß eine wirkungsvolle Vorbehandlung des Gewebes der Engstelle, bevorzugt eine ausreichende Denaturierung, erfolgt, die bei der anschließenden lokalen chemischen, enzymatischen, angiotropischen oder sonstigen Behandlung des Engstellenmaterials dessen wirksame Auflösung und Beseitigung gewährleistet.With the present invention, the task should be solved den, a treatment catheter of the type mentioned to be designed in such a way that an effective pre-treatment the tissue of the constriction, preferably an adequate one Denaturation takes place at the subsequent local chemical, enzymatic, angiotropic or other Treatment of the bottleneck material and its effective dissolution and disposal guaranteed.
Erfindungsgemäß wird diese Aufgabe durch die im Kennzeichen des Anspruches 1 angegebenen Merkmale gelöst.According to the invention, this object is achieved by the in the mark of the specified features solved.
Bei Anwendung des erfindungsgemäßen Behandlungskatheters wird das Gewebe durch das Laserlicht nicht direkt, sondern nur indirekt über den Wärmeleitkörper und das Behandlungs medium oder Vorbehandlungsmedium gleichmäßig erhitzt. Dabei ist der Anwender frei in der Wahl des Fluids, da dieses nicht vom Laserlicht bestrahlt wird. Die Laserenergie wird vielmehr in dem Wärmeleitkörper am oder auf dem Katheter absorbiert.When using the treatment catheter according to the invention the tissue is not directly through the laser light, but only indirectly via the heat sink and the treatment medium or pretreatment medium evenly heated. Here the user is free to choose the fluid as this is not irradiated by laser light. The laser energy is rather in the heat-conducting body on or on the catheter absorbed.
Mit dem erfindungsgemäßen Behandlungskatheter wird das zu behandelnde Verengungsmaterial, insbesondere Stenose, zu nächst durch die Wärmebehandlung, beispielsweise unter Ver wendung einer Kochsalzlösung, üblicherweise denaturiert. Da durch reißen die Zellen des behandelten Gewebes bzw. der Stenose auf und können durch die nachfolgende chemische, enzymatische oder angiotropische Behandlung schneller und intensiver vollständig aufgelöst werden. Alternativ kann auch gleich das Behandlungsmedium zur Vorbehandlung, bevor zugt zur Denaturierung durch Erwärmung, verwendet werden. In diesem Falle entfällt eine gesonderte Vorbehandlung der Engstelle bzw. des Engstellenmaterials.With the treatment catheter according to the invention that becomes treating constriction material, especially stenosis next through the heat treatment, for example under Ver use a saline solution, usually denatured. There by tearing the cells of the treated tissue or the Stenosis and can be caused by the subsequent chemical, enzymatic or angiotropic treatment faster and more fully resolved. Alternatively, you can also the treatment medium for pretreatment before used for denaturing by heating. In this case, there is no separate pretreatment of the Constriction or the constriction material.
Auch wenn eine wirkungsvolle Vorbehandlung des Gewebes der Engstelle erwünscht ist, muß diese Vorbehandlung nicht un bedingt zu einer Denaturierung des Engstellenmaterials im Sinne einer Umstrukturierung von dessen Eiweißmolekülen führen. Auch Gewebevorbehandlungen, die lediglich zu einer oberflächenmäßigen "Aufweichung", insbesondere im Sinne einer Lockerung des Zellengefüges des Materials der Behandlungs stelle führen, können je nach der Konsistenz des Engstellen materials ausreichend sein. Weitere vorteilhafte Einzelheiten der Erfindung sind in den Unteransprüchen definiert und werden nachfolgend anhand der in der Zeichnung veranschaulichten Aus führungsbeispiele näher beschrieben. Es zeigen:Even if the fabric is effectively pretreated This pretreatment does not have to be narrow leads to a denaturation of the bottleneck material in the Meaning a restructuring of its protein molecules to lead. Even tissue pretreatments that only lead to one surface "softening", especially in the sense of a Loosening of the cell structure of the treatment material depending on the consistency of the bottlenecks materials should be sufficient. Further advantageous details the invention are defined in the dependent claims and are below based on the Aus illustrated in the drawing management examples described in more detail. Show it:
Fig. 1 das Endstück eines erfindungsgemäßen Behandlungs katheters von der Seite im Schnitt, Fig. 1, the end portion of a treatment catheter according to the invention from the side in section;
Fig. 2 einen Querschnitt gemäß dem Schnitt I-I der Fig. 1, Fig. 2 a cross section according to the section II of FIG. 1,
Fig. 3 die Ansicht eines abgewandelten Behandlungskathe ters von vorn, Fig. 3 is a view of a modified treatment Kathe ters from the front,
Fig. 4 und 5 je einen Behandlungskather mit axialer Einstrahlung des Laserlichts, FIGS. 4 and 5 each have a treatment with an axial Katherine irradiation of the laser light,
Fig. 6 eine Ansicht gemäß dem Schnitt I-I der Fig. 5 und Fig. 6 is a view according to section II of FIGS. 5 and
Fig. 7 einen Längsschnitt durch einen erfindungsgemäßen Behandlungskatheter mit einer außen angeordneten Lichtleitfaser und mit axialer Einstrahlung des Laserlichts. Fig. 7 is a longitudinal section through a treatment catheter with an externally arranged optical fiber and having an axial irradiation of the laser light.
In den Fig. 1 und 2 ist mit 1 ein Behandlungskatheter be zeichnet, der beispielsweise einen vorzugsweise zentralen als Versorgungskanal 2 dienenden Kanal aufweist, der am vorde ren Ende 3 in eine Öffnung 4 mündet. Der Versorgungskanal 2 ist mit der Wand 5 durch mehrere rippenförmige Längstrenn wände 6, 7, 8 und 9 verbunden, die im Behandlungskatheter 1 beim vorliegenden Ausführungsbeispiel vier voneinander unab hängige Kanäle 10, 11, 12 und 13 bilden.In Figs. 1 and 2 at 1 is a treatment catheter draws be, for example, having a preferably central serving as a supply channel 2 channel which opens in an opening 4 in the end 3 prede ren. The supply channel 2 is connected to the wall 5 by a plurality of rib-shaped longitudinal dividing walls 6 , 7 , 8 and 9 , which form four independent channels 10 , 11 , 12 and 13 in the treatment catheter 1 in the present exemplary embodiment.
Auf dem Behandlungskatheter 1 sind zwei ausdehnbare Ballons 14 und 15 aufgebracht, die voneinander die im Abstand eines Bereiches 16 zur Behandlung einer Verengung, insbesondere einer Stenose 17, eines Gefäßes 18, beispielsweise einer Arterie, angeordnet sind. Der vor dem Bereich 16 vorhandene Ballon 14 ist über eine Öffnung 19 in der Wand 5 des Kathe ters 1 mit dem Kanal 11 und der hinter dem Bereich 16 vor handene Ballon 15 ist über eine Öffnung 20 der Wand 5 des Katheters 1 mit dem Kanal 13 verbunden. Durch den Druck eines in den Kanälen 11 und 13 vorhandenen Mediums, bei spielsweise Gas, Wasser oder eine Kochsalzlösung, werden die Ballons 14, 15 so weit aufgedehnt, daß sie von innen dichtend an der Gefäßinnenwand 21 beiderseits der Verengung 17 anliegen. On the treatment catheter 1 two expandable balloons 14 and 15 are applied, which are arranged at a distance from one another 16 for the treatment of a narrowing, in particular a stenosis 17 , of a vessel 18 , for example an artery. The existing in front of the area 16 balloon 14 is via an opening 19 in the wall 5 of the catheter 1 with the channel 11 and behind the area 16 before the existing balloon 15 is via an opening 20 of the wall 5 of the catheter 1 with the channel 13 connected. Due to the pressure of a medium present in the channels 11 and 13 , for example gas, water or a saline solution, the balloons 14 , 15 are expanded to such an extent that they abut against the inside of the vessel wall 21 on both sides of the constriction 17 .
Zwischen den Ballons 14, 15 ist auf der Wand 5 des Be handlungskatheters 1 ein Wärmeleitkörper 22 in Form eines Blockes, eines Ringes oder - wie dargestellt - eines Zylin ders angeordnet. Im Kanal 10 ist eine Lichtleitfaser 23 vor gesehen, in die am nicht dargestellten äußeren Ende dieser Lichtleitfaser 23 Laserlicht eingestrahlt werden kann. Die Lichtleitfaser 23 endet im Katheter 1 im Bereich 16. Ihr Endbereich 23.1 ist so geführt, daß außerhalb eingestrahltes Laserlicht von innen gegen den Wärmeleitkörper 22 gestrahlt werden kann. Damit der Wärmeleitkörper 22 vom Laserlicht mit hohem Wirkungsgrad erhitzt werden kann, besteht der Wärme leitkörper 22 oder zumindest die innere Oberfläche 24 des selben aus einem Material, das die Wellenlänge des ver wendeten Laserlichts, beispielsweise eines CO2-Lasers oder eines Neodym-Yttrium-Aluminium-Granat-Lasers (Nd:YAG-Laser) gut absorbiert. Gleichzeitig ist das Material des Wärmeleit körpers 22 so ausgewählt, daß es oder zumindest ein auf der äußeren Oberfläche 25 gesondert aufgebrachtes Material gegen das zu verwendende Erhitzungsmedium oder/und Behandlungs medium resistent ist bzw. zumindest über die vorgesehene Behandlungszeit von beispielsweise bis zu einigen Minuten resistent ist. Als geeignetes Material dient vorzugsweise Edelstahl, Nickel, Kupfer, Tantal oder auch eine geeignete, gut wärmeleitfähige Keramik, wie Siliziumcarbid oder dgl.Between the balloons 14 , 15 on the wall 5 of the loading treatment catheter 1, a heat-conducting body 22 in the form of a block, a ring or - as shown - a cylinder is arranged. In the channel 10 , an optical fiber 23 is seen before, in which 23 laser light can be radiated at the outer end of this optical fiber, not shown. The optical fiber 23 ends in the catheter 1 in the area 16 . Its end region 23.1 is guided in such a way that laser light radiated in from outside can be radiated from the inside against the heat-conducting body 22 . So that the heat-conducting body 22 can be heated with high efficiency by the laser light, the heat-conducting body 22 or at least the inner surface 24 of the same consists of a material that corresponds to the wavelength of the laser light used, for example a CO 2 laser or a neodymium yttrium Aluminum garnet laser (Nd: YAG laser) well absorbed. At the same time, the material of the heat-conducting body 22 is selected such that it or at least one material applied separately on the outer surface 25 is resistant to the heating medium and / or treatment medium to be used or at least resistant to the intended treatment time of, for example, up to a few minutes is. Stainless steel, nickel, copper, tantalum or a suitable, highly heat-conductive ceramic, such as silicon carbide or the like, is preferably used as a suitable material.
Bevorzugt wird als Material für den Behandlungskatheter 1 ein solches verwendet, das das verwendete Laserlicht mög lichst nicht oder wenig absorbiert und zweckmäßig auch nicht gestreut wird.Preferably, the material used for the treatment catheter 1 is one that absorbs the laser light as little or as little as possible and is expediently not scattered.
Die Wand 5 des Katheters 1 besitzt im Kanal 10 zwischen den Ballons 14 und 15 eine Öffnung 26 und im Kanal 12 eine Öffnung 27. Hierdurch kann der Behandlungsbereich mit dem ge wünschten Behandlungsmedium, insbesondere Behandlungsflüssig keit gefüllt, behandelt und das Behandlungsgut anschließend abgesaugt werden.The wall 5 of the catheter 1 has an opening 26 in the channel 10 between the balloons 14 and 15 and an opening 27 in the channel 12 . As a result, the treatment area can be filled with the desired treatment medium, in particular treatment liquid, treated and the material to be treated can then be suctioned off.
Falls erforderlich, können zwei oder mehr Lichtleitfasern in einem oder mehreren Kanälen vorgesehen sein. Gegebenen falls kann es zweckmäßig sein, einen oder mehrere Licht leitfasern, eventuell zusätzlich, außen am Behandlungs katheter 1, vorzugsweise in wenigstens einer Längsnut 28 anzuordnen (Fig. 3).If necessary, two or more optical fibers can be provided in one or more channels. If necessary, it may be appropriate to arrange one or more optical fibers, possibly additionally, on the outside of the treatment catheter 1 , preferably in at least one longitudinal groove 28 ( FIG. 3).
Gemäß einer vorteilhaften Ausgestaltung der Erfindung kann der Wärmeleitkörper 22 in der Mitte oder annähernd in der Mitte zwischen den beiden Ballons 14, 15 angeordnet sein. Weiterhin können auch beide Öffnungen 26, 27 in der Wand 5 des Katheters 1 zwischen dem Wärmeleitkörper 22 und dem vor dem Behandlungsbereich 16 vorgesehenen Ballon 15 vorgesehen sein.According to an advantageous embodiment of the invention, the heat-conducting body 22 can be arranged in the middle or approximately in the middle between the two balloons 14 , 15 . Furthermore, both openings 26 , 27 can also be provided in the wall 5 of the catheter 1 between the heat-conducting body 22 and the balloon 15 provided in front of the treatment area 16 .
Gemäß einer vorteilhaften Ausgestaltung der Erfindung können die Lichtleitfasern 23 oder wengistens eine der Lichtleit fasern 23 und der Wärmeleitkörper 22 derart ausgebildet und angeordnet sein, daß die Lichtleitfaser(n) 23 axial, d. h. in Richtung der Längsachse 29 (siehe Fig. 5) des Behandlungs katheters 1 in den Wärmeleitkörper 22 einstrahlt. Hierzu ist gemäß den Fig. 4 bis 6 der Wärmeleitkörper 22 mit einem in das Lumen oder in einen der Kanäle 10 bis 13 hineinragenden Abschnitt 30 versehen. Dieser Abschnitt 30 besitzt auf der der Lichtleitfaser 23 zugewandten Stirnseite 31 eine Aus sparung 32 in Form eines axial, d. h. in Richtung der Längs achse 29 des Behandlungskatheters 1 verlaufenden Sackloches. In dieses Sackloch ragt der abstrahlende Endbereich 23.1 der Lichtleitfaser 23 hinein. Der Endbereich 23.1 kann in der Aussparung 32 beispielsweise durch Klebung befestigt sein. Je Aussparung 32 können mehrere Lichtleitfasern 23 vorge sehen sein. Auch können mehrere Aussparungen 32 vorhanden sein, in die jeweils wenigstens eine Lichtleitfaser 23 hin einragt. According to an advantageous embodiment of the invention, the optical fibers 23 or, if necessary, one of the optical fibers 23 and the heat-conducting body 22 can be designed and arranged in such a way that the optical fiber (s) 23 axially, ie in the direction of the longitudinal axis 29 (see FIG. 5) of the treatment irradiates catheter 1 in the heat-conducting body 22 . For this purpose, the heat-conducting body is shown in FIGS. 4 to 6 provided with a 22 in the lumen or in one of the channels 10 to 13 protruding portion 30. This section 30 has on the optical fiber 23 facing end face 31 from a cutout 32 in the form of an axial, ie in the direction of the longitudinal axis 29 of the treatment catheter 1 blind hole. The radiating end region 23.1 of the optical fiber 23 projects into this blind hole. The end region 23.1 can be fastened in the recess 32, for example by gluing. A plurality of optical fibers 23 can be seen per recess 32 . There may also be a plurality of cutouts 32 , into each of which at least one optical fiber 23 projects.
Die Fig. 7 zeigt ein weiteres Ausführungsbeispiel der Er findung, bei dem der Wärmeleitkörper 22 mit einem Abschnitt 33 über den Außendurchmesser des Katheters 1 so weit über steht, daß die dem Lichtleiter 23 zugewandte Stirnseite 31 mit einer sacklochartigen, axialen Aussparung 32 versehen werden kann, in die der Endbereich 23.1 des bzw. der Licht leitfaser(n) 23 hineinragt bzw. hineinragen. Hierbei kann die Lichtleitfaser 23 in einer äußeren Längsnut 28 liegen, wie dies in Fig. 3 dargestellt ist. Auch diese Ausführungs form des erfindungsgemäßen Katheters kann einen Versorgungs kanal 2 besitzen. Fig. 7 shows a further embodiment of the invention, in which the heat-conducting body 22 with a portion 33 on the outer diameter of the catheter 1 is so far beyond that the face 31 facing the light guide 23 can be provided with a blind hole-like, axial recess 32 , into which the end region 23.1 of the optical fiber (s) 23 protrude. Here, the optical fiber 23 can lie in an outer longitudinal groove 28 , as shown in Fig. 3. This embodiment form of the catheter according to the invention can have a supply channel 2 .
Bei allen Ausführungsbeispielen der Fig. 1 bis 7 kann der Wärmeleitkörper 22 an seiner Oberfläche mit Rippen oder mit anderen dessen Oberfläche vergrößernden Mitteln versehen sein.In all of the exemplary embodiments in FIGS. 1 to 7, the heat-conducting body 22 can be provided on its surface with ribs or with other means that enlarge its surface.
Claims (14)
daß im Bereich (16) zwischen den Ballons (14, 15) ein Wärmeleitkörper (22) am oder auf dem Katheter (1) angebracht ist, daß im oder am Katheter (1) wenigstens eine Lichtleitfaser (23) vorgesehen ist, aus deren Endbereich (23.1) ein von außen einstrahlbares Laser licht gegen den Wärmeleitkörper (22) strahlen kann,
daß der Wärmeleitkörper (22) oder zumindest dessen innere Oberfläche (24) aus einem Laserlicht absor bierenden Material besteht und daß dieses Material oder zumindest die äußere Oberfläche (25) des Wärme leitkörpers (22) gegen das Behandlungsmedium resistent oder zumindest über einen vorgesehenen Behandlungs zeitraum resistent ist. 1. Treatment catheter for the removal or expansion of constrictions in vessels carrying body fluid, with two expandable balloons arranged in the axial direction at a distance from one another, of which the first balloon seals the area of the treatment on the back side in the expanded state and the second balloon in the expanded direction stood the area of treatment sealed on the front side, the degree of expansion of the two balloons being adjustable from the outside, as well as with at least one opening in the wall of the catheter between the two balloons and with longitudinal dividers provided in the interior of the catheter, through which the interior of the catheter in is divided into three or more channels, through which media for expanding the balloons on the one hand and, on the other hand, the area between the balloons can be filled and / or rinsed with treatment medium via one or more opening (s) in the outer catheter wall,
that in the area ( 16 ) between the balloons ( 14 , 15 ) a heat-conducting body ( 22 ) is attached to or on the catheter ( 1 ), that in or on the catheter ( 1 ) at least one optical fiber ( 23 ) is provided, from the end area thereof ( 23.1 ) an externally irradiated laser light can radiate against the heat-conducting body ( 22 ),
that the heat-conducting body ( 22 ) or at least its inner surface ( 24 ) consists of a laser light absorbing material and that this material or at least the outer surface ( 25 ) of the heat-conducting body ( 22 ) is resistant to the treatment medium or at least over an intended treatment period is resistant.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19904001086 DE4001086A1 (en) | 1990-01-17 | 1990-01-17 | Medical treatment catheter widening constricted vessels - has two expandable balloons spaced in axial direction with heat conductive piece between them |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19904001086 DE4001086A1 (en) | 1990-01-17 | 1990-01-17 | Medical treatment catheter widening constricted vessels - has two expandable balloons spaced in axial direction with heat conductive piece between them |
Publications (1)
Publication Number | Publication Date |
---|---|
DE4001086A1 true DE4001086A1 (en) | 1991-07-18 |
Family
ID=6398172
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19904001086 Withdrawn DE4001086A1 (en) | 1990-01-17 | 1990-01-17 | Medical treatment catheter widening constricted vessels - has two expandable balloons spaced in axial direction with heat conductive piece between them |
Country Status (1)
Country | Link |
---|---|
DE (1) | DE4001086A1 (en) |
Cited By (25)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE4233816A1 (en) * | 1991-10-07 | 1993-04-08 | Olympus Optical Co | Thermal therapeutic unit for complementing medication in treatment of e.g. cancer - has applicator with one section insertable into body cavity of patient and other section at rear end of insertion section outside body of patient with heating electrode |
DE4328249A1 (en) * | 1993-08-23 | 1994-01-05 | Mark Dr Med Schweizer | Device for medical and physical-chemical removal of masses from deteriorated blood circuit vessels - includes inflatable balloon pressure-controlled from outside patient and located before blood vessel section,thus producing treatment chamber |
US5320604A (en) * | 1991-04-24 | 1994-06-14 | Baxter International Inc. | Low-profile single-lumen dual-balloon catheter with integrated guide wire for embolectomy dilatation/occlusion and delivery of treatment fluid |
EP0680284A4 (en) * | 1992-04-16 | 1995-06-20 | Implemed Inc | Cryogenic catheter. |
US5454788A (en) * | 1991-04-24 | 1995-10-03 | Baxter International Inc. | Exchangeable integrated-wire balloon catheter |
DE4437834A1 (en) * | 1994-10-16 | 1996-04-18 | Lindeke Udo | Clinical appts. for rinsing or drainage of site of operation |
DE19702402A1 (en) * | 1997-01-24 | 1998-07-30 | Beyersdorf Friedhelm Univ Prof | Method and reperfusion device |
WO1999000064A1 (en) * | 1997-06-27 | 1999-01-07 | Daig Corporation | Medical device for ablation procedures within vessels |
DE19900698A1 (en) * | 1999-01-04 | 2000-07-06 | Gabor Keresztury | Balloon catheter with two inflatable balloons and middle part has connecting tube with several pipes and valve |
WO2002056772A2 (en) * | 2001-01-16 | 2002-07-25 | Novacept | Apparatus and method for treating venous reflux |
US6450988B1 (en) | 1999-12-29 | 2002-09-17 | Advanced Cardiovascular Systems, Inc. | Centering catheter with improved perfusion |
US7669309B2 (en) | 2003-09-22 | 2010-03-02 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Method for manufacturing a medical device having integral traces and formed electrodes |
US7674260B2 (en) | 2005-04-28 | 2010-03-09 | Cytyc Corporation | Emergency hemostasis device utilizing energy |
EP2190381A1 (en) * | 2007-08-23 | 2010-06-02 | Harshal S. Broker | Apparatus and method for the intravascular control of trauma |
US7731712B2 (en) | 2004-12-20 | 2010-06-08 | Cytyc Corporation | Method and system for transcervical tubal occlusion |
US7789877B2 (en) | 2003-07-02 | 2010-09-07 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation catheter electrode arrangement |
US7846160B2 (en) | 2006-12-21 | 2010-12-07 | Cytyc Corporation | Method and apparatus for sterilization |
US8052680B2 (en) | 1997-06-27 | 2011-11-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Process and device for the treatment of atrial arrhythmia |
US8147486B2 (en) | 2003-09-22 | 2012-04-03 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Medical device with flexible printed circuit |
US8162879B2 (en) | 2008-09-22 | 2012-04-24 | Tyco Healthcare Group Lp | Double balloon catheter and methods for homogeneous drug delivery using the same |
US8221408B2 (en) | 2003-09-22 | 2012-07-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Medical device having integral traces and formed electrodes |
US8486060B2 (en) | 2006-09-18 | 2013-07-16 | Cytyc Corporation | Power ramping during RF ablation |
US8506563B2 (en) | 1996-04-12 | 2013-08-13 | Cytyc Surgical Products | Moisture transport system for contact electrocoagulation |
US8551082B2 (en) | 1998-05-08 | 2013-10-08 | Cytyc Surgical Products | Radio-frequency generator for powering an ablation device |
CN114010918A (en) * | 2021-11-05 | 2022-02-08 | 首都医科大学宣武医院 | Balloon catheter system for intravertebral astride eccentric plaque denudation operation |
-
1990
- 1990-01-17 DE DE19904001086 patent/DE4001086A1/en not_active Withdrawn
Cited By (41)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5454788A (en) * | 1991-04-24 | 1995-10-03 | Baxter International Inc. | Exchangeable integrated-wire balloon catheter |
US5320604A (en) * | 1991-04-24 | 1994-06-14 | Baxter International Inc. | Low-profile single-lumen dual-balloon catheter with integrated guide wire for embolectomy dilatation/occlusion and delivery of treatment fluid |
DE4233816A1 (en) * | 1991-10-07 | 1993-04-08 | Olympus Optical Co | Thermal therapeutic unit for complementing medication in treatment of e.g. cancer - has applicator with one section insertable into body cavity of patient and other section at rear end of insertion section outside body of patient with heating electrode |
US5380319A (en) * | 1991-10-07 | 1995-01-10 | Olympus Optical Co., Ltd. | Heat using therapeutic device |
EP0680284A1 (en) * | 1992-04-16 | 1995-11-08 | Implemed, Inc. | Cryogenic catheter |
EP0680284A4 (en) * | 1992-04-16 | 1995-06-20 | Implemed Inc | Cryogenic catheter. |
DE4328249A1 (en) * | 1993-08-23 | 1994-01-05 | Mark Dr Med Schweizer | Device for medical and physical-chemical removal of masses from deteriorated blood circuit vessels - includes inflatable balloon pressure-controlled from outside patient and located before blood vessel section,thus producing treatment chamber |
DE4437834A1 (en) * | 1994-10-16 | 1996-04-18 | Lindeke Udo | Clinical appts. for rinsing or drainage of site of operation |
US9247989B2 (en) | 1996-04-12 | 2016-02-02 | Cytyc Surgical Products | Moisture transport system for contact electrocoagulation |
US8506563B2 (en) | 1996-04-12 | 2013-08-13 | Cytyc Surgical Products | Moisture transport system for contact electrocoagulation |
US8998898B2 (en) | 1996-04-12 | 2015-04-07 | Cytyc Surgical Products | Moisture transport system for contact electrocoagulation |
US9095348B2 (en) | 1996-04-12 | 2015-08-04 | Cytyc Surgical Products | Moisture transport system for contact electrocoagulation |
DE19702402A1 (en) * | 1997-01-24 | 1998-07-30 | Beyersdorf Friedhelm Univ Prof | Method and reperfusion device |
US6306113B1 (en) | 1997-01-24 | 2001-10-23 | Friedhelm Beyersdorf | Reperfusion device |
US5938660A (en) * | 1997-06-27 | 1999-08-17 | Daig Corporation | Process and device for the treatment of atrial arrhythmia |
US6503247B2 (en) | 1997-06-27 | 2003-01-07 | Daig Corporation | Process and device for the treatment of atrial arrhythmia |
US6235025B1 (en) | 1997-06-27 | 2001-05-22 | Daig Corporation | Process and device for the treatment of atrial arrhythmia |
US8052680B2 (en) | 1997-06-27 | 2011-11-08 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Process and device for the treatment of atrial arrhythmia |
WO1999000064A1 (en) * | 1997-06-27 | 1999-01-07 | Daig Corporation | Medical device for ablation procedures within vessels |
US9554853B2 (en) | 1998-05-08 | 2017-01-31 | Hologic, Inc. | Radio-frequency generator for powering an ablation device |
US8551082B2 (en) | 1998-05-08 | 2013-10-08 | Cytyc Surgical Products | Radio-frequency generator for powering an ablation device |
DE19900698A1 (en) * | 1999-01-04 | 2000-07-06 | Gabor Keresztury | Balloon catheter with two inflatable balloons and middle part has connecting tube with several pipes and valve |
US6450988B1 (en) | 1999-12-29 | 2002-09-17 | Advanced Cardiovascular Systems, Inc. | Centering catheter with improved perfusion |
US7294126B2 (en) | 2001-01-16 | 2007-11-13 | Cytyc Corporation | Apparatus and method for treating venous reflux |
WO2002056772A2 (en) * | 2001-01-16 | 2002-07-25 | Novacept | Apparatus and method for treating venous reflux |
WO2002056772A3 (en) * | 2001-01-16 | 2002-10-24 | Novacept | Apparatus and method for treating venous reflux |
US6712815B2 (en) | 2001-01-16 | 2004-03-30 | Novacept, Inc. | Apparatus and method for treating venous reflux |
US7087052B2 (en) | 2001-01-16 | 2006-08-08 | Cytyc Surgical Products | Apparatus and method for treating venous reflux |
US7789877B2 (en) | 2003-07-02 | 2010-09-07 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Ablation catheter electrode arrangement |
US7669309B2 (en) | 2003-09-22 | 2010-03-02 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Method for manufacturing a medical device having integral traces and formed electrodes |
US8147486B2 (en) | 2003-09-22 | 2012-04-03 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Medical device with flexible printed circuit |
US8221408B2 (en) | 2003-09-22 | 2012-07-17 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Medical device having integral traces and formed electrodes |
US7731712B2 (en) | 2004-12-20 | 2010-06-08 | Cytyc Corporation | Method and system for transcervical tubal occlusion |
US7674260B2 (en) | 2005-04-28 | 2010-03-09 | Cytyc Corporation | Emergency hemostasis device utilizing energy |
US8486060B2 (en) | 2006-09-18 | 2013-07-16 | Cytyc Corporation | Power ramping during RF ablation |
US7846160B2 (en) | 2006-12-21 | 2010-12-07 | Cytyc Corporation | Method and apparatus for sterilization |
EP2190381A1 (en) * | 2007-08-23 | 2010-06-02 | Harshal S. Broker | Apparatus and method for the intravascular control of trauma |
EP2190381A4 (en) * | 2007-08-23 | 2011-02-23 | Cook Inc | Apparatus and method for the intravascular control of trauma |
US8603064B2 (en) | 2008-09-22 | 2013-12-10 | Covidien Lp | Double balloon catheter and methods for homogeneous drug delivery using the same |
US8162879B2 (en) | 2008-09-22 | 2012-04-24 | Tyco Healthcare Group Lp | Double balloon catheter and methods for homogeneous drug delivery using the same |
CN114010918A (en) * | 2021-11-05 | 2022-02-08 | 首都医科大学宣武医院 | Balloon catheter system for intravertebral astride eccentric plaque denudation operation |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
DE4001086A1 (en) | Medical treatment catheter widening constricted vessels - has two expandable balloons spaced in axial direction with heat conductive piece between them | |
EP0634909B1 (en) | Working shaft for photo-thermal therapy | |
DE102006016957B4 (en) | laser applicator | |
DE3516830C2 (en) | ||
EP0697840B1 (en) | Device for thermally obliterating biological tissues | |
DE4137983C2 (en) | Application device for the treatment of biological tissue with laser radiation | |
DE9102312U1 (en) | Device for the treatment of stenoses or growths | |
DE2950976A1 (en) | LASER DEVICE FOR OPENING PIPE-LIKE PRODUCTS | |
EP0344279A1 (en) | Inflatable catheter for dilating stenosis in body channels. | |
EP2187818A1 (en) | Medical implant | |
EP0387754A1 (en) | Catheter system to introduce laserbeams into bloodvessels of the human body | |
DE19901530A1 (en) | Surgical stents laser cut on a ceramic support which absorbs heat and minimizes distortion | |
EP0647152A1 (en) | Probe for heating body tissue. | |
DE3339076A1 (en) | COOLED MIRROR, ESPECIALLY FOR LASER | |
EP3808296B1 (en) | Device for local application of and / or for rinsing with fluids | |
EP0825880A1 (en) | Device for the irradiation of bodily fluids with uv light | |
DE9003184U1 (en) | Treatment catheter | |
DE4100290A1 (en) | Medical treatment catheter widening constricted vessels - has balloon inflated by fluid medium and heated by laser light | |
WO2010066221A1 (en) | Drilling method, drilling machine intended for surgical purposes having an attachment, and attachment for a drilling machine intended for surgical purposes | |
EP1894512A1 (en) | Flexible tube with 2-component lubricant | |
EP1646323B1 (en) | Surgical probe | |
EP1205209B1 (en) | Cardioplegia balloon catheter | |
DE19739456B4 (en) | Application device for the treatment of body tissue by means of light | |
EP0657141B1 (en) | Apparatus for institial thermotherapeutical treatment | |
DE9000452U1 (en) | Treatment catheter |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
8139 | Disposal/non-payment of the annual fee |