DK3117784T3 - Anvendelse af intrakorporale trykchokbølger i medicin - Google Patents

Anvendelse af intrakorporale trykchokbølger i medicin Download PDF

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Publication number
DK3117784T3
DK3117784T3 DK16186021.8T DK16186021T DK3117784T3 DK 3117784 T3 DK3117784 T3 DK 3117784T3 DK 16186021 T DK16186021 T DK 16186021T DK 3117784 T3 DK3117784 T3 DK 3117784T3
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DK
Denmark
Prior art keywords
shock waves
pressure shock
shock wave
treatment
reflector
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Application number
DK16186021.8T
Other languages
English (en)
Inventor
Christopher Cashman
Dr Iulian Cioanta
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Sanuwave Inc
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Publication of DK3117784T3 publication Critical patent/DK3117784T3/da

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    • 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
    • A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A—HUMAN NECESSITIES
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    • 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
    • A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
    • A—HUMAN NECESSITIES
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    • 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
    • A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B17/2202—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter
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    • A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B17/22022—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement using electric discharge
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    • A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22029—Means for measuring shock waves
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    • A61B17/225—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 for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
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    • 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
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H23/00—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms
    • A61H23/008—Percussion or vibration massage, e.g. using supersonic vibration; Suction-vibration massage; Massage with moving diaphragms using shock waves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H9/00—Pneumatic or hydraulic massage
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    • G—PHYSICS
    • G10—MUSICAL INSTRUMENTS; ACOUSTICS
    • G10K—SOUND-PRODUCING DEVICES; METHODS OR DEVICES FOR PROTECTING AGAINST, OR FOR DAMPING, NOISE OR OTHER ACOUSTIC WAVES IN GENERAL; ACOUSTICS NOT OTHERWISE PROVIDED FOR
    • G10K11/00—Methods or devices for transmitting, conducting or directing sound in general; Methods or devices for protecting against, or for damping, noise or other acoustic waves in general
    • G10K11/18—Methods or devices for transmitting, conducting or directing sound
    • G10K11/26—Sound-focusing or directing, e.g. scanning
    • G10K11/28—Sound-focusing or directing, e.g. scanning using reflection, e.g. parabolic reflectors
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    • A—HUMAN NECESSITIES
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    • A61B17/225—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 for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
    • A61B17/2255—Means for positioning patient, shock wave apparatus or locating means, e.g. mechanical aspects, patient beds, support arms, aiming means
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    • A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B2017/22014—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire
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    • A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
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    • A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B2017/22025—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement applying a shock wave
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    • 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
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    • 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
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    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2212—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having a closed distal end, e.g. a loop
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    • 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
    • A61B17/225—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 for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
    • A61B17/2251—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 for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves characterised by coupling elements between the apparatus, e.g. shock wave apparatus or locating means, and the patient, e.g. details of bags, pressure control of bag on patient
    • A61B2017/2253—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 for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves characterised by coupling elements between the apparatus, e.g. shock wave apparatus or locating means, and the patient, e.g. details of bags, pressure control of bag on patient using a coupling gel or liquid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/14—Special force transmission means, i.e. between the driving means and the interface with the user
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61H—PHYSICAL THERAPY APPARATUS, e.g. DEVICES FOR LOCATING OR STIMULATING REFLEX POINTS IN THE BODY; ARTIFICIAL RESPIRATION; MASSAGE; BATHING DEVICES FOR SPECIAL THERAPEUTIC OR HYGIENIC PURPOSES OR SPECIFIC PARTS OF THE BODY
    • A61H2201/00—Characteristics of apparatus not provided for in the preceding codes
    • A61H2201/16—Physical interface with patient
    • A61H2201/1657—Movement of interface, i.e. force application means
    • A61H2201/1664—Movement of interface, i.e. force application means linear
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N2007/0004—Applications of ultrasound therapy
    • A61N2007/0008—Destruction of fat cells

Claims (15)

1. Intrakorporal chokbølgeindretning omfattende: et kateter (340) tilpasset i størrelse til at passe inden i mindst et af et blodkar, transplantat og kunstigt blodkar; mindst en ballon (154) koblet til kateteret; mindst en chokbølgeapplikator (350) koblet til kateteret; og en første vand-, saltholdig- eller saltopløsningsåbning (392) eller lumen (365) operativt koblet til kateteret for at levere saltopløsning til en placering tilstødende chokbølgeapplikatoren; og en anden vand-, saltholdig- eller saltopløsningsåbning (394) eller lumen (366) er koblet til kateteret for at ekstrahere vand-, saltholdig- eller saltopløsning væk fra placeringen tilstødende chokbølgeapplikatoren; kendetegnet ved at chokbølgeapplikatoren (350) er konfigureret til at producere chokbølger (372) tilstødende mindst en reflektor (402), der har en geometri, der fokuserer chokbølgerne (372) ind i et fokalt volumen (108) på et behandlingssted fri fra kontakt med den mindst ene ballon (154).
2. Indretning ifølge krav 1, hvor den mindst ene chokbølgeapplikator (350) er indesluttet i den mindst ene ballon (440).
3. Indretning ifølge krav 2, hvor flere chokbølgeapplikatorer (350) er indesluttede i den mindst ene ballon (440).
4. Indretning ifølge krav 3, hvor flere chokbølgeapplikatorer (350) inkluderer flere reflektorer (402 og 404) anbragt i forskellige vinkler.
5. Indretning ifølge krav 4, hvor en første gruppe af flere reflektorer (402) er anbragt for at fokusere chokbølger i en modsat retning fra en anden gruppe af flere reflektorer (404).
6. Indretning ifølge et hvilket som helst af kravene 1-5, hvor den mindst ene chokbølgeapplikator (350) inkluderer en chokbølge-frembringelseskilde valgt fra gruppen bestående af en elektrohydraulisk chokbølgegenerator, en laserchokbølgegenerator, en elektromagnetisk chokbølgegenerator og en piezoelektrisk chokbølgegenerator og geometrien af den mindst ene reflektor er valgt fra gruppen bestående af elliptisk geometri, parabolsk geometri og sfærisk geometri.
7. Indretning ifølge krav 1, hvor den mindst ene ballon inkluderer en første ballon (154) og en anden ballon (156) koblet til kateteret, hvor den mindst ene chokbølgeapplikator (350) er koblet til kateteret (340) mellem den første og anden ballon, og hvor de første og anden vand-, saltholdig- eller saltopløsningsåbninger eller lumener begge er positioneret mellem den første og anden ballon.
8. Indretning ifølge krav 7, hvor den mindst ene chokbølgereflektor er dækket af en membran (205), der omslutter en chokbølge-frembringelseskilde i væske inden i den mindst ene chokbølgeapplikator (350).
9. Indretning ifølge krav 7, hvor chokbølgeapplikatoren (350) er uomsluttet og inkluderer en chokbølge-frembringelseskilde positioneret i den mindst ene reflektor.
10. Indretning ifølge et hvilket som helst af kravene 7 og 9, hvor den mindst ene chokbølgeapplikator inkluderer flere chokbølge-frembringelseskilder.
11. Indretning ifølge et hvilket som helst af kravene 7-10, hvor den mindst ene chokbølgeapplikator (350) inkludereren chokbølge-frembringelseskilde valgt fra gruppen bestående afen elektrohydraulisk chokbølgegenerator, en laserchokbølgegenerator, en elektromagnetisk chokbølgegenerator og en piezoelektrisk chokbølgegenerator og geometrien af den mindst ene reflektor er valgt fra gruppen bestående af elliptisk geometri, parabolsk geometri og sfærisk geometri.
12. Indretning ifølge krav 1, hvor den mindst ene chokbølgereflektor er dækket af en membran (205), der omslutter en chokbølge-frembringelseskilde i væske inden i den mindst ene chokbølgeapplikator (350).
13. Indretning ifølge krav 12, hvor chokbølgeapplikatoren (350) er konfigureret til at membranen (205) bringes i kontakt med behandlingsstedet og chokbølgeapplikatoren (350) ikke er inden i den mindst ene ballon (154).
14. Indretning ifølge et hvilket som helst af kravene 8 og 12, hvor chokbølgeapplikatoren (350) er konfigureret til at membranen (205) er fri fra kontakt med behandlingsstedet og chokbølgeapplikatoren (350) ikke er inden i den mindst ene ballon (154).
15. Indretning ifølge et hvilket som helst af kravene 12-14, hvor den mindst ene chokbølgeapplikator (350) inkludereren chokbølge-frembringelseskilde valgt fra gruppen bestående afen elektrohydraulisk chokbølgegenerator, en laserchokbølgegenerator, en elektromagnetisk chokbølgegenerator og en piezoelektrisk chokbølgegenerator og geometrien af den mindst ene reflektor er valgt fra gruppen bestående af elliptisk geometri, parabolsk geometri og sfærisk geometri.
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US9522011B2 (en) 2016-12-20
US20210085349A1 (en) 2021-03-25
US20210085350A1 (en) 2021-03-25
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US20140243715A1 (en) 2014-08-28
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US9161768B2 (en) 2015-10-20
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US20160000645A1 (en) 2016-01-07
US11925366B2 (en) 2024-03-12
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US20210267615A1 (en) 2021-09-02
US10058340B2 (en) 2018-08-28
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US8556813B2 (en) 2013-10-15
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US11666348B2 (en) 2023-06-06
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