JP2001505472A - 心筋の脈管再生のモニタリング - Google Patents
心筋の脈管再生のモニタリングInfo
- Publication number
- JP2001505472A JP2001505472A JP53069698A JP53069698A JP2001505472A JP 2001505472 A JP2001505472 A JP 2001505472A JP 53069698 A JP53069698 A JP 53069698A JP 53069698 A JP53069698 A JP 53069698A JP 2001505472 A JP2001505472 A JP 2001505472A
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- JP
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- Prior art keywords
- heart
- signal
- tissue
- energy
- sensor
- Prior art date
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N5/00—Radiation therapy
- A61N5/06—Radiation therapy using light
- A61N5/0601—Apparatus for use inside the body
-
- 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
-
- 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
- A61B18/24—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 with a catheter
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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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
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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
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
- A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00351—Heart
- A61B2018/00392—Transmyocardial revascularisation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—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
- A61B2018/2255—Optical elements at the distal end of probe tips
- A61B2018/2272—Optical elements at the distal end of probe tips with reflective or refractive surfaces for deflecting the beam
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0071—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by measuring fluorescence emission
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
- A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4483—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device characterised by features of the ultrasound transducer
- A61B8/4488—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device characterised by features of the ultrasound transducer the transducer being a phased array
Abstract
Description
Claims (1)
- 【特許請求の範囲】 1.PMR治療のための装置であって、 患者の心臓と係合する遠位端を有し、潅流を促進するチャンネルを心臓組織に 形成するためのエネルギーを心臓組織に与える脈管再生装置から成る細長いプロ ーブと、 治療に応じた指標を提供するセンサとからなる装置。 2.センサは治療に応じて患者の身体が発生する信号を受信する請求項1に記 載の装置。 3.センサが電極を備えている請求項2に記載の装置。 4.電極がプローブの遠位端に隣接した位置に設けられている請求項3に記載 の装置。 5.電極がプローブとは無関係に患者の身体に置かれている請求項3に記載の 装置。 6.センサは治療に応じた信号を生成するトランスデューサから成る請求項1 に記載の装置。 7.トランスデューサは超音波トランスデューサから成る請求項6に記載の装 置。 8.トランスデューサはプローブの遠位端に隣接した位置に設けられている請 求項6に記載の装置。 9.センサは微小循環に応じた信号を生成する血流センサから成る請求項1に 記載の装置。 10.センサは光学センサから成る請求項1に記載の装置。 11.心筋組織に蛍光誘発放射を行う導波管を備え、センサは組織が発する蛍 光を受け取ってそれに応じた信号を発生する請求項10に記載の装置。 12.センサに結合し、信号を分析して治療の効力を示す指標を提供する信号 処理回路を備える請求項1乃至請求項11のいずれか1項に記載の装置。 13.回路はST部の上昇を検出する請求項12に記載の装置。 14.回路は不整脈を検出する請求項12に記載の装置。 15.回路によって検出された不整脈が少なくとも1つのVPBから成る請求 項14に記載の装置。 16.回路はプローブの遠位端に隣接した組織の性質変化を検出する請求項1 2に記載の装置。 17.組織の性質変化は組織の密度変化である請求項16に記載の装置。 18.回路はプローブの遠位端に隣接した部分での血液潅流の上昇を検出する 請求項12に記載の装置。 19.脈管再生装置は心臓組織にレーザを照射する請求項1乃至請求項11の いずれか1項に記載の装置。 20.脈管再生装置は心臓組織にRFエネルギーを照射する請求項1乃至請求 項11のいずれか1項に記載の装置。 21.脈管再生装置は心臓組織に高強度の超音波照射を行う請求項1乃至請求 項11いずれか1項に記載の装置。 22.脈管再生装置は機械的エネルギーを心臓組織に加える請求項1乃至請求 項11いずれか1項に記載の装置。 23.患者の心臓に対するモニター付きPMR治療法であって、 心臓に対してエネルギーを加える脈管再生装置を含むプローブを患者の心臓組 織に係合させる段階と、 装置を用いてエネルギーを心臓組織に与え潅流を促進するチャンネルを心臓組 織に形成する段階と、 治療に応じて患者の身体から信号を受信する段階を含む方法。 24.信号の受信は治療の成功を示す信号の受信を含む請求項23に記載の方 法。 25.信号の受信は患者の身体が発生する信号の検知を含む請求項23に記載 の方法。 26.信号の検知は患者の心臓内部における電気信号の感知を含む請求項25 に記載の方法。 27.信号の検知は患者の身体表面での電気信号の検知を含む請求項25に記 載の方法。 28.信号の検知は心臓組織から反射されるエネルギーの受け取りを含む請求 項23に記載の方法。 29.エネルギーの受信は心臓内部の指定されたチャンネル位置からの超音波 エネルギーの受け取りを含む請求項28に記載の方法。 30.エネルギーの受信は心臓組織からの蛍光放射の受け取りを含む請求項2 8に記載の方法。 31.蛍光放射の受け取りは自己蛍光放射の受け取りを含む請求項30に記載 の方法。 32.蛍光放射の受け取りは患者の血流に投与された薬品からの蛍光放射の受 け取りを含む請求項30に記載の方法。 33.信号の受信は心臓内部の指定されたチャンネル位置近傍の微小循環血流 量に応じた信号の受信を含む請求項23に記載の方法。 34.信号を処理して治療の効力を示す指標を提供する段階を含む請求項23 乃至請求項33のいずれか1項に記載の方法。 35.信号の処理はST部の上昇の検出を含む請求項34に記載の方法。 36.信号の処理は不整脈の検出を含む請求項34に記載の方法。 37.不整脈の検出はVPBの検出を含む請求項36に記載の方法。 38.信号の処理はチャンネル領域での組織特性における変化の検出を含む請 求項34に記載の方法。 39.変化の検出は組織の密度の変化検出を含む請求項38に記載の方法。 40.変化の検出は組織の血液潅流における変化の検出を含む請求項38に記 載の方法。 41.組織の血液潅流における変化の検出は潅流が促進されたことの検出を含 む請求項40に記載の方法。 42.心臓へのエネルギー印可はレーザ照射を含む請求項23乃至請求項33 のいずれか1項に記載の方法。 43.心臓へのエネルギー印可はRFエネルギーの照射を含む請求項23乃至 請求項33に記載のいずれか1項に記載の方法。 44.心臓へのエネルギー印可は高強度の超音波の照射を含む請求項23乃至 請求項33に記載のいずれか1項に記載の方法。 45.心臓へのエネルギー印可は機械的エネルギーの印可を含む請求項23乃 至請求項33に記載のいずれか1項に記載の方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
WO97/00011 | 1997-01-08 | ||
PCT/IL1997/000011 WO1997025101A2 (en) | 1996-01-08 | 1997-01-08 | Methods and apparatus for myocardial revascularization |
PCT/IL1997/000307 WO1998030144A1 (en) | 1997-01-08 | 1997-09-15 | Monitoring of myocardial revascularization |
Publications (3)
Publication Number | Publication Date |
---|---|
JP2001505472A true JP2001505472A (ja) | 2001-04-24 |
JP2001505472A5 JP2001505472A5 (ja) | 2005-06-16 |
JP4236014B2 JP4236014B2 (ja) | 2009-03-11 |
Family
ID=11061976
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP53069698A Expired - Lifetime JP4236014B2 (ja) | 1997-01-08 | 1997-09-15 | 心筋の脈管再生のモニタリング |
Country Status (8)
Country | Link |
---|---|
US (2) | US6200310B1 (ja) |
EP (1) | EP0893965B1 (ja) |
JP (1) | JP4236014B2 (ja) |
AU (1) | AU741217B2 (ja) |
CA (1) | CA2248223C (ja) |
DE (1) | DE69732696T2 (ja) |
ES (1) | ES2237802T3 (ja) |
WO (1) | WO1998030144A1 (ja) |
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JP2010512176A (ja) * | 2006-12-06 | 2010-04-22 | ザ・ホスピタル・フォー・シック・チルドレン | リモートプレコンディショニングを行うシステム |
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Also Published As
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JP4236014B2 (ja) | 2009-03-11 |
EP0893965A1 (en) | 1999-02-03 |
AU741217B2 (en) | 2001-11-29 |
US6436095B1 (en) | 2002-08-20 |
AU4218297A (en) | 1998-08-03 |
US6200310B1 (en) | 2001-03-13 |
CA2248223A1 (en) | 1998-07-16 |
WO1998030144A1 (en) | 1998-07-16 |
EP0893965B1 (en) | 2005-03-09 |
DE69732696D1 (de) | 2005-04-14 |
DE69732696T2 (de) | 2006-04-13 |
ES2237802T3 (es) | 2005-08-01 |
CA2248223C (en) | 2007-01-16 |
EP0893965A4 (en) | 1999-04-07 |
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