JP2010540099A - 高周波エネルギを用いた閉塞血管再疎通術 - Google Patents
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- 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
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- A—HUMAN NECESSITIES
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- A61B17/32—Surgical cutting instruments
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- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
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- A—HUMAN NECESSITIES
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
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- A—HUMAN NECESSITIES
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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
- 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
- A61B18/245—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 for removing obstructions in blood vessels or calculi
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
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Abstract
Description
20 ピグテール
30 コネクタ
100a,100b 縦材
105a,105b 電極
Claims (28)
- 第一縦材を閉塞の近位端へ順行性方式で進める工程と、
第二縦材を前記閉塞の遠位端へ逆行性方式で進める工程と、
前記第一および第二縦材との間にエネルギを適用する工程と、
前記閉塞を再疎通する工程と、
を備えている閉塞血管再疎通方法。 - 前記エネルギは、高周波エネルギである請求項1に記載の方法。
- 前記エネルギは、レーザエネルギである請求項1に記載の方法。
- 前記エネルギは、マイクロ波エネルギである請求項1に記載の方法。
- 前記エネルギは、超音波エネルギである請求項1に記載の方法。
- さらに、血流が最大となるときに前記適用を起こすタイミングをはかる工程を備えており、それによって血流の冷却効果を最大にするとともに前記血管への熱の暴露を最小にする請求項1に記載の方法。
- さらに、心電図(EKG)信号を用いて前記適用のタイミングをはかる工程を備えている請求項1に記載の方法。
- 前記タイミングをはかる工程は、前記心電図(EKG)信号のR波を検出する工程を備えている請求項7に記載の方法。
- さらに、破片を捕獲および回収する工程を備えている請求項1に記載の方法。
- 高周波発生器を備えており、
近位端および遠位端を有する順行性縦材を備えており、前記順行性縦材の遠位端が第一導電性電極を備え且つ前記順行性縦材の近位端が前記高周波発生器と結合されるように構成されており、かつ、
近位端および遠位端を有する逆行性縦材を備えており、前記逆行性縦材の遠位端が第二の導電性電極を備え且つ前記逆行性縦材の近位端が前記高周波発生器と結合されるように構成されている再疎通システム。 - 前記縦材は、ガイドワイヤまたはカテーテルまたはマイクロカテーテルまたは拡張カテーテルである請求項10に記載のシステム。
- 前記縦材は、内側ガイドワイヤ内腔を備えている請求項10に記載のシステム。
- 前記縦材は、十分なねじれ剛性および縦方向柔軟性を有して、閉塞を通して進むと共に、前記電極を前記血管壁から離隔および互いに対向するように配置する請求項10に記載のシステム。
- 前記電極は、前記縦材の片側に取り付けられている請求項10に記載のシステム。
- 前記電極は、アレイ状に配列されている請求項10に記載のシステム。
- 前記縦材は、放射線不透過性マーカを備えている請求項10に記載のシステム。
- 少なくとも一つの前記縦材は、破片を捕獲および回収する塞栓保護機構を備えている請求項10に記載のシステム。
- 前記塞栓保護機構は、フィルタである請求項17に記載のシステム。
- 前記塞栓保護機構は、バルーンを備えている請求項17に記載のシステム。
- 前記塞栓保護機構は、前記縦材の一方を通して吸引ができる管腔を備えている請求項17に記載のシステム。
- 前記縦材は、カテーテルまたはガイドシース内に配置されるように構成されている請求項10に記載のシステム。
- さらに、高周波エネルギを制御および発生する回路を備えている請求項10に記載のシステム。
- さらに、EKGに接続して、エネルギ放出のタイミングをはかるように構成された接続ポートを備えている請求項10に記載のシステム。
- 遠位端、近位端、及びガイドワイヤ管腔を構成しているガイドワイヤシャフトを有している縦材を備えており、前記縦材をねじることにより、狭い内径の血管を通して進めることができるように、前記縦材が少なくともその長さ部分に沿って構成されており、
前記縦材の遠位端に電極を備え、
エネルギを前記電極から外部エネルギ源に伝える一つ以上の導線を備え、かつ
絶縁シースを備えている焼灼カテーテル。 - 前記縦材は、らせん状の外部を有するように構成されている請求項24に記載のカテーテル。
- 前記縦材は、ライナに巻かれた複数のワイヤを備えている請求項24に記載のカテーテル。
- 前記複数のワイヤは、少なくとも二つの異なる直径を有している請求項26に記載のカテーテル。
- 前記複数のワイヤは、電極または導線であるように構成されている請求項26に記載のカテーテル。
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US97547307P | 2007-09-26 | 2007-09-26 | |
US60/975,473 | 2007-09-26 | ||
PCT/US2008/077403 WO2009042614A1 (en) | 2007-09-26 | 2008-09-23 | Recanalizing occluded vessels using radiofrequency energy |
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JP2014124232A Division JP6050283B2 (ja) | 2007-09-26 | 2014-06-17 | 高周波エネルギを用いた閉塞血管再疎通術 |
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JP2010540099A5 JP2010540099A5 (ja) | 2011-11-10 |
JP5618332B2 JP5618332B2 (ja) | 2014-11-05 |
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JP2014124232A Active JP6050283B2 (ja) | 2007-09-26 | 2014-06-17 | 高周波エネルギを用いた閉塞血管再疎通術 |
JP2016227657A Active JP6461891B2 (ja) | 2007-09-26 | 2016-11-24 | 高周波エネルギを用いた閉塞血管再疎通術 |
JP2018240919A Active JP6785832B2 (ja) | 2007-09-26 | 2018-12-25 | 高周波エネルギを用いた閉塞血管再疎通術 |
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JP2016227657A Active JP6461891B2 (ja) | 2007-09-26 | 2016-11-24 | 高周波エネルギを用いた閉塞血管再疎通術 |
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US (1) | US8911435B2 (ja) |
EP (2) | EP2197383B1 (ja) |
JP (4) | JP5618332B2 (ja) |
KR (1) | KR101228879B1 (ja) |
AU (1) | AU2008304599B2 (ja) |
CA (2) | CA2700968C (ja) |
WO (1) | WO2009042614A1 (ja) |
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WO2009042614A1 (en) | 2009-04-02 |
US8911435B2 (en) | 2014-12-16 |
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JP6785832B2 (ja) | 2020-11-18 |
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CA3024053C (en) | 2021-12-07 |
JP5618332B2 (ja) | 2014-11-05 |
JP2019076741A (ja) | 2019-05-23 |
JP6050283B2 (ja) | 2016-12-21 |
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EP2197383B1 (en) | 2018-01-31 |
AU2008304599A1 (en) | 2009-04-02 |
EP2197383A4 (en) | 2012-08-22 |
KR101228879B1 (ko) | 2013-02-05 |
EP3348221A1 (en) | 2018-07-18 |
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JP2017094092A (ja) | 2017-06-01 |
AU2008304599B2 (en) | 2012-11-22 |
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