EP1225837A2 - Dispositif a ultrasons de thrombolyse transcranienne et procede de traitement d'une attaque - Google Patents

Dispositif a ultrasons de thrombolyse transcranienne et procede de traitement d'une attaque

Info

Publication number
EP1225837A2
EP1225837A2 EP00978327A EP00978327A EP1225837A2 EP 1225837 A2 EP1225837 A2 EP 1225837A2 EP 00978327 A EP00978327 A EP 00978327A EP 00978327 A EP00978327 A EP 00978327A EP 1225837 A2 EP1225837 A2 EP 1225837A2
Authority
EP
European Patent Office
Prior art keywords
transducer
centimeters
ultrasonic
ultrasonic energy
energy
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Withdrawn
Application number
EP00978327A
Other languages
German (de)
English (en)
Inventor
Christy K. Holland
Daniel S. Kanter
Lawrence J. Busse
Kenneth R. Wagner
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
University of Cincinnati
Original Assignee
University of Cincinnati
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by University of Cincinnati filed Critical University of Cincinnati
Publication of EP1225837A2 publication Critical patent/EP1225837A2/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00084—Temperature
    • A61B2017/00092—Temperature using thermocouples
    • 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
    • A61B2017/22084—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 stone- or thrombus-dissolving
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids

Definitions

  • the present invention is directed generally to a transcranial ultrasound
  • Ischemic strokes are generally caused by an
  • occlusion or blockage (either partial or complete) resulting from a blood clot in
  • rt-PA rt-PA activator
  • treatment may not be administered because of a delay in recognizing
  • Another object of the present invention is to provide a system and method
  • Still another object of the present invention is to provide a system and
  • Still another object of the present invention is to provide a system and
  • bioeffects either cavitational, mechanical or thermal in nature.
  • one embodiment of the present invention comprises a method
  • transducer adapted to provide a predetermined level of ultrasonic
  • FIG. 1 is a schematic diagram of a transcranial ultrasonic thrombolysis
  • FIG. 2 is a vertical cross-sectional view of a transducer employed in a
  • FIG. 3 is a front elevational view of a transducer employed in a system in
  • FIG. 4 is a front elevational view of a transducer in the form of a 2-
  • FIG. 5 is an elevational view of an exemplary transducer employed in a
  • FIG. 6 is an axial beam profile of the normalized intensity versus distance
  • FIG. 1 exemplifies a system 10 for
  • the system 10 comprises a transducer 20 which
  • the system 10 may further include an ultrasound system 11 and may be used in combination with
  • inventions can include an ultrasonic driver 14 for generating electrical energy that
  • Driver 14 can be converted to ultrasound waves or energy at transducer 20.
  • Driver 14 can be converted to ultrasound waves or energy at transducer 20.
  • the driver 14 should be such that the
  • ultrasound waves or energy are suitable and can be selected to penetrate the
  • frequency generator 16 used with the present invention should have an
  • adjustable frequency range preferably from about 100 kHz to about 1 MHZ.
  • adjustable range up to about 150 W, and/or provide up to about 60 dB of gain.
  • the driver 14 should have an adjustable duty cycle from about 10% to
  • Transducer 20 is preferably electrically connected to the ultrasonic driver
  • Transducer 20 may be configured for converting
  • transducer e.g., thrombolytic agent
  • the transducer 20 should be configured such that
  • transducer 20 can be from about 100 kHz to about 1 MHZ. In one example, the
  • transducer 20 can emit frequencies from about 100 kHz to about 250 kHz.
  • the frequency range of the transducer is about 120
  • the selected frequency should be any frequency of tissue including the temporal bone.
  • the selected frequency should be any frequency of tissue including the temporal bone.
  • the transducer 20 should be sized and configured so that it can deliver an
  • the transducer 20 can deliver an intensity range up to about
  • a tip including a quarter-wave matching layer and/or a lens 24 may
  • a predetermined level of ultrasonic energy is provided substantially throughout
  • a primary treatment zone 36 encompassing at least a substantial portion of the
  • the primary treatment zone 36 includes at least
  • Tip 24 should be sized and configured to optimize
  • the transducer 20 may have a diameter or aperture greaterthan
  • the transducer 20 may also have a diameter
  • the transducer In still another embodiment, the transducer
  • 20 may have a diameter or aperture of about 6 cm.
  • a beam width from about 3 cm to about 4 cm may be provided to allow
  • the system may provide a secondary treatment zone 34 that is effective
  • middle cerebral artery area is a transducer having a diameter of about 6 cm and a pillbox shaped configuration made of a piezoelectric ceramic.
  • the transducer 20 may be sized and configured to have a Rayleigh distance (R)
  • FIGS. 5 and 6 which is generally the distance between the front of
  • the transducer e.g., located adjacent the skin above the temporal bone
  • FIG. 5 shows one example of a transducer 20 emitting a beam 28 of
  • the beam 28 of ultrasonic energy or waves As illustrated in FIG. 5, the beam 28 of ultrasonic energy or waves. As illustrated in FIG. 5, the beam 28 of ultrasonic energy or waves.
  • the transducer to the distance at which the intensity of the beam reaches its
  • the Rayleigh distance (R) is determined by the operating frequency
  • an exemplary axial profile of the beam 28 is
  • treatment zone 34 is defined between the (X.,) and (X 2 ) positions.
  • FIG. 6 shows one embodiment where (X.,) and (X 2 ) are located at 50% of the
  • a therapeutic effect may be achieved by
  • a predetermined intensity level of ultrasonic energy may be
  • the predetermined level is at least 50% of the maximum intensity.
  • the predetermined level is at least 75% of the maximum
  • the predetermined level is at least
  • the ultrasound system may be designed such that the Rayleigh
  • distance (R) of the ultrasound beam is positioned at least substantially at the
  • the beam can be positioned so that the center of the primary
  • treatment zone 36 is located at the middle of the secondary treatment zone, i.e.,
  • the concepts of the present invention may treat both sides of the brain
  • the invention is also useful to treat one side of the brain. It is also useful to treat one side of the brain. It is also useful to treat one side of the brain. It is also useful to treat one side of the brain. It is also useful to treat one side of the brain. It is also useful to treat one side of the brain. It is also useful to treat one side of the brain. It is also useful to treat one side of the brain. It is also useful to treat one side of the brain. It is also useful to treat one side of the brain. It
  • treating one side of the brain may also result in incidental
  • the center line 30 (see FIG. 2) of an adult brain will typically be
  • C a distance of about 6 to 7/ 2 centimeters from the transducer 20.
  • the primary treatment zone begins at a distance T-* of about
  • width (W) throughout the primary treatment zone is from about 3 centimeters to
  • Rayleigh distance (R) is about 6.2 centimeters.
  • the beam width (W) of the beam between (X-) and (X-) is the beam width (W) of the beam between (X-) and
  • (X 2 ) is about 3 centimeters to about 4 centimeters.
  • the beam width can be
  • dB beam width of about 3 centimeters at the natural focus of the transducer.
  • one or more pre-focus high intensity spots 32 may be any pre-focus high intensity spots 32.
  • part of the head (H) may be arranged to eliminate or reduce the spot 32.
  • the transducer To enhance and optimize insonification into the head (H), the transducer
  • An integral gel pad 25 may be
  • the transducer 20 used with the present invention can be a transducer configured for transcranial use to minimize the invasiveness of the treatment as
  • a conventional cooling system may optionally be present in the transducer
  • thermocouple may be mounted on the edge of the transducer 20 to permit
  • a cooling medium may be directed to
  • the transducer 20 from a source away from the transducer 20, and the cooling
  • medium may be either air or liquid.
  • One or more transducers 20 may be used with the present invention, and
  • each may be selectively adjusted to account for variations in head geometry.
  • the transducer 120 may comprise an array of transducers, such as
  • the beam can be characterized, with a focus for example, by the
  • the system of the present invention may also include a holding device to
  • the holding device should be configured for maintaining the transducer's 20 desired position during use and treatment to
  • examples of such devices may include a head harness, straps, frames, helmets,
  • the transducer 20 may be releasably detached, or permanently
  • the medicine delivery system 40 can include any conventional
  • intravascular IV delivery system for the delivery of fluids into the circulatory
  • the thrombolytic agent or solution 48 is generally housed
  • a container 42 such as an IV bag or bottle, and is in fluid communication to
  • Solution 48 is preferably injected and delivered
  • the solution or thrombolytic agent 48 used with the present invention can
  • thrombolytic agent 48 used with the present invention may include an
  • Any thrombolytic agent or anti-platelet drug can be used with the present invention.
  • present invention include recombinanttissue plasminogen activator, forexample
  • rt-PA In another example, abciximab or other antiplatelet agents are used.
  • a suitable dosage or concentration of rt-PA may be about 0.9 mg per kg of body
  • present invention may be less than 0.9 mg per kg of body weight.
  • the thrombolytic agent e.g., t-PA
  • t-PA thrombolytic agent
  • thrombolytic agent can be delivered to the body (B) and transmitted
  • protective medium is capable of being ruptured or otherwise exposing the
  • encapsulating materials include microballoons made of a cross-linked albumin,
  • lipid vehicle and a targeting moiety, or other protein compatible with blood
  • the size of the encapsulation should be optimized to allow circulation
  • the present invention may use targeted gas-filled echocontrast
  • agents to act as cavitation nuclei at the site of the clot are agents to act as cavitation nuclei at the site of the clot.
  • the present invention can be used to treat acute stroke patients.
  • the medicine delivery system 40 is intravenously connected to the body (B) of a patient. More
  • the needle 46 can be inserted through the skin and is inserted into
  • Exemplary vessels include the radial vein (e.g., see FIG. 1 ),
  • a valve 50 may be
  • the transducer 20 may be placed near or
  • the transducer 20 is selected, positioned, and activated
  • R Rayleigh distance
  • the driver 14 can be connected to an electrical source, activated, or
  • the electrical energy is converted or transformed to ultrasound
  • temporal bone and toward the blockage or occlusion e.g., blood clot
  • the transducer 20 can radiate, direct, emit or provide ultrasound waves or energy (US) at a frequency range from about 100
  • the frequency of the transducer is about 120 kHz.
  • amplitude, or intensity, of the sound waves are from about 0.5 W/cm 2 to about
  • the amplitude or intensity might be up to 2
  • the duty cycle of the ultrasound waves or energy may be
  • adjustable as desired, and can be set at a range from about 10% to 100% (or
  • the ultrasound waves or energy are radiated, directed,
  • the ultrasound waves or energy may be radiated, directed,
  • a transducer 20 may also be fixed in the
  • ultrasonic zone that targets the primary zone. Accordingly, therapy may be initiated sooner since there is no need for radiologic or imaging guidance to
  • the portability and ease of use of the device may even allow treatment
  • emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be used to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital. For instance, emergency technicians may be required to begin before arrival at the hospital.
  • thrombolytics may be used with the present invention.
  • certain aspects of the present invention may be used with the present invention.
  • polygons e.g., triangle, square, or other polygon with four or more sides
  • secondary treatment zone can involve focusing the beam with a spherical

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Thermotherapy And Cooling Therapy Devices (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)

Abstract

L'invention concerne un procédé de thrombolyse à ultrasons transcrânienne qui consiste à produire un niveau prédéterminé d'énergie ultrasonore sensiblement à travers toute une zone de traitement primaire englobant la branche M1 et les branches M2 de l'artère cérébrale moyenne d'un patient. Un agent thrombolytique est également administré au patient. L'invention concerne en outre un dispositif à ultrasons de thrombolyse transcrânienne qui comporte un transducteur, lequel est conçu pour produire un niveau prédéterminé d'énergie ultrasonore sensiblement à travers toute une zone de traitement comprenant au moins une partie importante de la branche M1 et des branches M2 de l'artère cérébrale moyenne dans un hémisphère du cerveau.
EP00978327A 1999-11-01 2000-11-01 Dispositif a ultrasons de thrombolyse transcranienne et procede de traitement d'une attaque Withdrawn EP1225837A2 (fr)

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US16297699P 1999-11-01 1999-11-01
US162976P 1999-11-01
US24198600P 2000-10-20 2000-10-20
US241986P 2000-10-20
PCT/US2000/030104 WO2001032258A2 (fr) 1999-11-01 2000-11-01 Dispositif a ultrasons de thrombolyse transcranienne et procede de traitement d'une attaque

Publications (1)

Publication Number Publication Date
EP1225837A2 true EP1225837A2 (fr) 2002-07-31

Family

ID=26859208

Family Applications (1)

Application Number Title Priority Date Filing Date
EP00978327A Withdrawn EP1225837A2 (fr) 1999-11-01 2000-11-01 Dispositif a ultrasons de thrombolyse transcranienne et procede de traitement d'une attaque

Country Status (5)

Country Link
EP (1) EP1225837A2 (fr)
JP (1) JP2003523794A (fr)
AU (1) AU1579901A (fr)
CA (1) CA2389669C (fr)
WO (1) WO2001032258A2 (fr)

Families Citing this family (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050124897A1 (en) * 2003-12-03 2005-06-09 Scimed Life Systems, Inc. Apparatus and methods for delivering acoustic energy to body tissue
JP4492818B2 (ja) * 2004-06-21 2010-06-30 博 古幡 超音波脳梗塞治療装置
AU2006246311B2 (en) * 2005-05-12 2008-08-21 Compumedics Medical Innovations Pty Ltd Ultrasound diagnosis and treatment apparatus
JP2008539908A (ja) * 2005-05-12 2008-11-20 コンピュメディクス メディカル イノベーション ピーティーワイ リミテッド 超音波診断および治療装置
EP2051777B1 (fr) * 2006-08-11 2019-01-16 Koninklijke Philips N.V. Système à ultrasons pour l'imagerie de la circulation sanguine cérébrale et la lyse de caillot sanguin au moyen de microbulles
KR101121379B1 (ko) 2009-09-03 2012-03-09 삼성메디슨 주식회사 복수의 뷰에 대한 복수의 단면 영상을 제공하는 초음파 시스템 및 방법
JP2012200454A (ja) * 2011-03-25 2012-10-22 Hitachi Medical Corp 薬剤導入装置及び薬剤導入システム
CN114886412A (zh) 2015-06-03 2022-08-12 蒙特非奥里医疗中心 用于治疗癌症和转移的低强度聚焦超声
CN111836666A (zh) * 2017-11-09 2020-10-27 蒙特非奥里医疗中心 用于治疗癌症和转移的低能量免疫致敏

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5217018A (en) * 1989-05-16 1993-06-08 Hewlett-Packard Company Acoustic transmission through cladded core waveguide
US5313944A (en) * 1992-09-21 1994-05-24 Biomagnetic Technologies, Inc. Measurement of internal body structure during biomagnetometry
US5944687A (en) * 1996-04-24 1999-08-31 The Regents Of The University Of California Opto-acoustic transducer for medical applications

Non-Patent Citations (1)

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Title
See references of WO0132258A2 *

Also Published As

Publication number Publication date
WO2001032258A2 (fr) 2001-05-10
WO2001032258A3 (fr) 2002-01-24
CA2389669C (fr) 2010-06-01
JP2003523794A (ja) 2003-08-12
CA2389669A1 (fr) 2001-05-10
AU1579901A (en) 2001-05-14

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