JP2012502772A - 代替エネルギー源を使用する身体組織に対する望ましい温度効果の誘発 - Google Patents
代替エネルギー源を使用する身体組織に対する望ましい温度効果の誘発 Download PDFInfo
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Abstract
Description
本出願は、2008年9月22日に出願された米国仮出願第61/099,155号の35 USC 119(e)の下での利益を主張し、その全開示は参照により本明細書に全体として組み込まれる。
該当なし
本発明は一般的に、医療装置、システム及び方法に関する。例示的な実施態様において、本発明は、管腔疾患のための、特に、アテローム硬化性プラーク、不安定又はホット(hot)プラーク等のための処置を提供する。本発明の構造は、切除なしに、穏やかな熱を使用して動脈組織をリモデリングすることを可能にする。
1. バルーン全体が、圧電プラスチックでできている。
2. バルーンの一部のみが、圧電プラスチックでできており、かつ従って膨張前、かつ収縮後に回転によって罹患組織を特異的に処置できる。
3. (送信及び受信)層が、薄層状に相互接続される、圧電物質又はいずれかの他の適切な材料を含む受信層を使用することによって、カテーテル、例えばIVUSカテーテルは、診断することもできる。このことにより、1つのカテーテルのみを使用して、処置中にプラーク深度及び組織タイプの検出が可能になる。
4. バルーン表面材料の離散サブセットが、超音波トランスデューサ要素により埋設される。次に離散要素が、所望であれば、独立して、かつ独立した電力、周波数等で要素を起動できる外部発電機に独立して接続される。この独立した起動は、管腔内の選択的投与、並びに処置エネルギーの離散化を可能にし、そのことは、他の利益を有する。例えば、エネルギーは、非選択的、非集束エネルギーが当てはまるように、組織組成及び性質が指示する場所に流れるよりもむしろ有向で、かつ均一に送達される。
Claims (39)
- 管腔の周囲に位置した身体組織に対して望ましい温度効果を誘発するシステムであって、
近位端と遠位端を有しそれらの間に軸を持つ細長いカテーテルであって、エネルギー伝送のためのエネルギー送達部を有するカテーテルと、
前記エネルギー送達部に近接した前記管腔内の前記身体組織を特徴付けるように構成された組織分析器と、
組織処置エネルギーを伝送する前記エネルギー送達部に結合されたエネルギー源であって、前記エネルギーが、非RFエネルギーであるエネルギー源と、
前記組織分析器及びエネルギー源に結合されたプロセッサであって、切除せずに前記エネルギー送達部により前記身体組織を軽度に加熱するように、前記特徴付けされた身体組織のために適した処置エネルギーを決定するように構成されたプロセッサと
を含むシステム。 - 前記エネルギー源が、レーザエネルギー源を含む請求項1に記載のシステム。
- 前記エネルギー送達部が、前記カテーテルの前記近位端と、前記レーザエネルギー源から前記身体組織にレーザエネルギーを伝送するための少なくとも1つの半径方向に配向した窓との間に伸長する少なくとも1つの光学導管に結合された少なくとも1つの半径方向に配向した窓を含む請求項2に記載のシステム。
- 前記エネルギー源が、超音波エネルギー源である請求項1に記載のシステム。
- 前記エネルギー送達部が、前記身体組織に超音波エネルギーを送達するように構成された少なくとも1つの超音波トランスデューサを含む請求項4に記載のシステム。
- 前記エネルギーの周波数が、1kHz〜20MHzである請求項4に記載のシステム。
- 前記エネルギー源が、マイクロ波エネルギー源である請求項1に記載のシステム。
- 前記エネルギー送達部が、前記身体組織にマイクロ波エネルギーを送達するように構成された少なくとも1つのマイクロ波アンテナを含む請求項7に記載のシステム。
- 前記プロセッサが、異なる特徴付けされた物質を軽度に加熱するために適した所定の処置エネルギー特性を有する請求項1に記載のシステム。
- 前記プロセッサが、前記身体組織の加熱中に前記組織分析器からのフィードバックに応答して前記処置エネルギーを調整するように構成される請求項1に記載のシステム。
- 前記組織分析器が、前記カテーテルの前記近位端と、少なくとも1つの半径方向に配向した窓との間に伸長する少なくとも1つの光学導管に結合された光コヒーレンストモグラファを含み、前記トモグラファは、前記身体組織を特徴付けるように前記身体組織からの撮像光から画像信号を発生させ、前記撮像光は、少なくとも1つの前記窓を通って伝送される請求項1に記載のシステム。
- 身体管腔内の身体組織に対して望ましい温度効果を誘発する方法であって、
カテーテルのエネルギー送達部を、加熱する前記組織に隣接した前記管腔内に位置決めすることと、
組織分析器を使用して、前記エネルギー送達部に近接した前記管腔内の組織を特徴付けることと、
前記組織分析器に結合されたプロセッサを使用して、前記特徴付けされた組織のために適した処置エネルギーを決定することと、
前記プロセッサに結合されたエネルギー源からの適切な処置エネルギーにより前記エネルギー送達部にエネルギーを与え、前記エネルギーが、非RFエネルギーであることと、
前記組織への過度の熱損傷によって引き起こされる長期閉塞性応答を誘発せずに、適切な処置エネルギーにより、切除せずに前記組織を穏やかに加熱することとを含む方法。 - 前記エネルギー源が、レーザエネルギー源を含む請求項12に記載の方法。
- 前記エネルギー送達部が、前記カテーテルの前記近位端と、前記レーザエネルギー源から前記組織にレーザエネルギーを伝送するための少なくとも1つの半径方向に配向した窓との間に伸長する少なくとも1つの光学導管に結合された少なくとも1つの半径方向に配向した窓を含む請求項13に記載の方法。
- 前記エネルギー源が、超音波エネルギー源を含む請求項12に記載の方法。
- エネルギー送達部が、前記身体組織に超音波エネルギーを送達するように構成された少なくとも1つの超音波トランスデューサを含む請求項15に記載の方法。
- 前記エネルギーの周波数が、1kHz〜20MHzである請求項15に記載の方法。
- 前記エネルギー源が、マイクロ波エネルギー源を含む請求項12に記載の方法。
- 前記エネルギー送達部が、前記身体組織にマイクロ波エネルギーを送達するように構成された少なくとも1つのマイクロ波アンテナを含む請求項18に記載の方法。
- 前記組織の加熱が、45〜約99℃である請求項12に記載の方法。
- 前記組織への平均エネルギー送達速度が、前記組織によるエネルギー散逸速度と同じ規模にある請求項12に記載の方法。
- 健常組織と、罹患組織との両方を有する身体組織に対して望ましい温度効果を誘発するシステムであって、前記身体組織が、管腔の周囲に配置され、
エネルギー伝送のためのエネルギー送達部を有する細長いカテーテルと、
組織処置エネルギーを伝送する前記エネルギー送達部に結合されたエネルギー源であって、前記エネルギーが、非RFエネルギーであるエネルギー源と、
前記組織分析器及びエネルギー源に結合されたプロセッサであって、長期閉塞性応答を誘発するような前記健常組織への過度の熱損傷を引き起こすことなく、罹患組織を有効に変えるために十分な温度に、切除せずに前記身体組織を軽度に加熱するように、適切な処置エネルギーを決定するように構成されたプロセッサと
を含むシステム。 - 前記エネルギー源が、レーザエネルギー源を含み、かつ前記エネルギー送達部が、前記カテーテルの近位端と、前記レーザエネルギー源から前記組織処置領域にレーザエネルギーを伝送するための少なくとも1つの半径方向に配向した窓との間に伸長する少なくとも1つの光学導管に結合された少なくとも1つの半径方向に配向した窓を含む
請求項22に記載のシステム。 - 前記エネルギー源が、超音波エネルギー源であり、かつ前記エネルギー送達部が、前記組織処置領域に超音波エネルギーを送達するように構成された少なくとも1つの超音波トランスデューサを含む請求項22に記載のシステム。
- 前記エネルギー源が、マイクロ波エネルギー源であり、かつ前記エネルギー送達部が、前記組織処置領域にマイクロ波エネルギーを送達するように構成された複数のマイクロ波アンテナを含む請求項22に記載のシステム。
- 身体管腔内の組織処置領域で組織に対して望ましい温度効果を非侵襲的に誘発するシステムであって、
集束超音波エネルギーを組織処置領域に送達するように構成された集束超音波エネルギー装置と、
前記組織処置領域の組織を特徴付けるように構成された組織分析器と、
前記組織分析器及び集束超音波エネルギー装置に結合されたプロセッサであって、前記組織への過度の熱損傷によって引き起こされる長期閉塞性応答を誘発せずに、切除せずに適切な集束超音波エネルギーにより組織を穏やかに加熱するように、前記特徴付けされた組織に適切な集束超音波パラメータを決定するように構成されたプロセッサと
を含むシステム。 - 前記組織処置領域への平均集束超音波エネルギー送達速度が、前記組織処置領域によるエネルギー散逸速度と同じ規模にある請求項26に記載のシステム。
- 前記組織処置領域が、健常組織と、罹患組織との両方を含み、かつ前記適切な集束超音波エネルギーが、前記健常組織への過度の熱損傷を引き起こすことなく、前記罹患組織を有効に変えるために十分な温度に罹患を加熱する請求項26に記載のシステム。
- 前記組織処置領域が、健常組織と、罹患組織との両方を含み、かつ前記適切な集束超音波エネルギーが、十分に低いので、熱が罹患組織に蓄積されることを可能にしながら、熱伝導、熱容量、生得的血液灌流、及び十分に灌流された組織からの距離を含む組織性質の相違によって、熱が、前記健常組織への重大な熱損傷を回避する速度で、前記健常組織から奪われることになる請求項26に記載のシステム。
- 前記組織分析器が、磁気共鳴撮像診断(MRI)装置である請求項26に記載のシステム。
- 前記プロセッサが、前記組織の加熱中に前記組織分析器からのフィードバックに応答して前記集束超音波エネルギーを調整するように構成される請求項26に記載のシステム。
- 前記プロセッサが、異なる特徴付けされた組織を穏やかに加熱するために適した所定の集束超音波エネルギー特性を有する請求項26に記載のシステム。
- 身体管腔内の組織処置領域で組織に対して望ましい温度効果を非侵襲的に誘発する方法であって、
集束超音波エネルギーを組織処置領域に送達するように構成された集束超音波エネルギー装置を位置決めすることと、
組織分析器を使用して、エネルギー送達部に近接した前記管腔内の前記組織を特徴付けることと、
前記組織分析器及び前記集束超音波エネルギー装置に結合されたプロセッサを使用して、前記特徴付けされた組織のために適した処置エネルギーを決定することと、
適切な処置エネルギーにより前記集束超音波エネルギー装置にエネルギーを与えることと、
前記組織への過度の熱損傷によって引き起こされる長期閉塞性応答を誘発せずに、切除せずに前記適切な処置エネルギーにより前記組織を穏やかに加熱することと
を含む方法。 - 前記組織処置領域への平均集束超音波エネルギー送達速度が、前記組織処置領域によるエネルギー散逸速度と同じ規模にある請求項33に記載の方法。
- 前記組織処置領域が、健常組織と、罹患組織との両方を含み、かつ前記適切な集束超音波エネルギーが、前記健常組織への過度の熱損傷を引き起こすことなく、前記罹患組織を有効に変えるために十分な温度に前記罹患組織を加熱する請求項33に記載の方法。
- 前記組織処置領域が、健常組織と、罹患組織との両方を含み、かつ前記適切な集束超音波エネルギーが十分に低いので、熱が、罹患組織に蓄積されることを可能にしながら、熱伝導、熱容量、生得的血液灌流、及び十分に灌流された組織からの距離を含む組織性質の相違によって、前記健常組織への重大な熱損傷を回避する速度で、前記健常組織から奪われることになる請求項33に記載の方法。
- 前記組織分析器が、磁気共鳴撮像診断(MRI)装置である請求項33に記載の方法。
- 前記プロセッサが、前記組織の加熱中に前記組織分析器からのフィードバックに応答して前記集束超音波エネルギーを調整するように構成される請求項33に記載の方法。
- 前記プロセッサが、異なる特徴付けされた組織を軽度に加熱するために適した所定の集束超音波エネルギー特性を有する請求項33に記載の方法。
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US20100076299A1 (en) | 2010-03-25 |
EP2341839A1 (en) | 2011-07-13 |
CN102209497A (zh) | 2011-10-05 |
JP5622729B2 (ja) | 2014-11-12 |
WO2010033940A1 (en) | 2010-03-25 |
CA2737785A1 (en) | 2010-03-25 |
EP2341839A4 (en) | 2012-11-14 |
EP2341839B1 (en) | 2015-10-21 |
AU2009292987A1 (en) | 2010-03-25 |
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