JP2016127993A - アブレーションされた組織を視覚化するシステムと方法 - Google Patents
アブレーションされた組織を視覚化するシステムと方法 Download PDFInfo
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Abstract
【解決手段】組織を撮影するシステムは末端部と基端部を有するカテーテル1601、カテーテル1601の末端部付近に配置された膨張可能なバルーン1603、カテーテル1601の末端部からバルーン1603に伸びる光学ハウジングを有する。光学ハウジングは、バルーン1603の内部に、バルーン1603の外側の組織を照明する光源と照明された組織を撮影するカメラを配置するように構成されている。
【選択図】図16
Description
Claims (33)
- 組織を撮影するシステムであって、
末端部と基端部を有するカテーテルと、
前記カテーテルの前記末端部の近くに配置された膨張可能なバルーンと、
前記カテーテルの前記末端部から前記バルーンの中に伸びる光学ハウジングとを有し、
前記光学ハウジングは、前記バルーンの中に、前記バルーンの外側の組織を照明する光源と前記照明された組織を撮影するカメラとを配置するように構成されている、システム。 - 前記システムはアブレーション部材を備えており、
前記アブレーション部材は、無線周波数エネルギー、マイクロ波エネルギー、電気エネルギー、電磁エネルギー、冷凍エネルギー、レーザエネルギー、超音波エネルギー、音響エネルギー、化学エネルギー、及び熱エネルギーからなる群から選択されたエネルギー源を備えている、請求項1のシステム。 - 前記光源が紫外線の発光ダイオード(LED)である、請求項1のシステム。
- 前記カメラが、光学画像を電子信号に変換する撮像センサを含む、請求項1のシステム。
- 前記システムがロボット制御される、請求項1のシステム。
- 前記光学ハウジングは、前記光学ハウジングの外面と前記カテーテルの内壁との間に隙間を形成する大きさとしてある、請求項1のシステム。
- 前記隙間は、前記バルーンを操作するために、前記カテーテルと前記バルーンに流体接続されている、請求項6のシステム。
- 前記バルーンに対して前記光学ハウジングが回転する、請求項1のシステム。
- 前記バルーンを支持するための構造を提供するために、前記カテーテルの前記末端部を越えて伸びる支持チューブを有する、請求項1のシステム。
- 前記支持チューブの末端部近傍に先端を備えており、前記先端はアブレーション部材として機能するように構成されている、請求項9のシステム。
- 前記アブレーション部材を前記バルーンの末端側に向けて移動させるために、前記支持チューブは前記カテーテルの内腔に連通する内側ルーメンを有する、請求項9のシステム。
- 前記カテーテルは、前記組織に血管を通じて近づくように構成されている、請求項1のシステム。
- 前記カテーテルは、前記組織に向けて、切開部から導入されるか、経皮的に導入されるように構成されている、請求項1のシステム。
- 前記光源は、組織中の天然還元型ニコチンアミド・アデニン・ヌクレオチド(ADH)を励起するように構成されている、請求項1のシステム。
- 第1の光源と、前記第1の光源とは異なる波長の光を発生することができる第2の光源を有する、請求項1のシステム。
- 検出されたNADH蛍光に基づいて、照明された組織の画像を作成するために、前記カメラに接続されたディスプレイ装置を有する、請求項1のシステム。
- 前記カメラと前記ディスプレイ装置は無線接続されている、請求項14のシステム。
- 前記システムは、難治性不整脈、上室性不整脈、心室性不整脈、心房細動、肺静脈マッピング及びアブレーションの診断及び治療中に心臓内で使用される、請求項1のシステム。
- 組織を撮影するシステムであって、
末端部と基端部とを有するカテーテルと、
前記カテーテルの前記末端部の近くに配置された膨張可能なバルーンと、
前記カテーテルの前記末端部から前記バルーンに伸びる光学ハウジングと、
前記バルーン内の光源であって、前記光学ハウジングに支持されており、組織内でNADHを励起するように構成されている光源と、
前記バルーン内のカメラであって、前記光学ハウジングに支持されており、前記光源によって照明された前記組織を撮影するように構成されている、システム。 - 前記光学ハウジングは、前記バルーンに対して、前記カメラと前記光源を回転するように構成されている、請求項19のシステム。
- 前記カメラは、前記光源で照明された前記組織のNADH蛍光を検出するように構成されている、請求項19のシステム。
- 白色光を提供するための第2の光源を備えている、請求項19のシステム。
- 組織を撮影するシステムであって、
末端部と基端部を有するカテーテルと、
前記カテーテルの末端近傍で血液を流体に置き換えるためのかん流ポートと、
前記カテーテルの前記末端部から伸びる光学ハウジングとを有し、
前記光学ハウジングは、組織を照明するための発光ダイオード光源と、前記照明された組織を撮影するために、光学画像を電子信号に変換する複数の撮像センサを含む視覚化装置とを支持するように構成されている、システム。 - 組織を撮影するシステムであって、
血液を移動させるために液体を注入するとともに光を送るためのシースと、
末端部と基端部とを有し、前記シース内に配置されるカテーテルと、
前記カテーテルの前記末端部から伸びる光学ハウジングとを有し、
前記光学ハウジングは、前記組織を照明するための発光ダイオード光源と、前記照明された組織を撮影するために、光学画像を電子信号に変換する複数の撮像センサを含む視覚化装置とを支持するように構成されている、システム。 - 組織を撮影する方法であって、
組織に向けてカテーテルを前進させる工程であって、前記カテーテルは、前記カテーテルの末端近傍に配置された膨張可能なバルーンと、前記カテーテルの前記末端部から前記バルーン内に伸びて光源とカメラを前記バルーン内に配置する光学ハウジングとを備えているものと、
前記組織をアブレーションする工程と、
アブレーションによって治療された組織と周辺組織を含む組織領域を前記光源で照明して前記組織領域でNADHを励起する工程と、
前記組織領域を撮影装置で撮影して前記組織領域のNADH蛍光を検出する工程と、
照明され撮影された組織の表示を作る工程であって、前記表示は、アブレーションされた組織をアブレーションされていない組織よりも弱い蛍光をもって表す、方法。 - 前記組織が心臓筋肉組織である、請求項25の方法。
- 前記暗い外観を有するアブレーションされた組織と明るい外観を有する損傷した組織との間を区別する工程を有する、請求項25の方法。
- 蛍光量に基づいて前記アブレーションされた組織と前記損傷した組織との間を区別することで識別された損傷組織をアブレーションする工程を有する、請求項25の方法。
- もはや電気的に導電性でない組織と電気的に導電性を留めている組織との間を区別する工程を有する、請求項25の方法。
- アブレーションされた組織、浮腫組織、アブレーションされていない組織を区別する工程を有する、請求項25の方法。
- MRI画像、CT(断層撮影)画像、超音波画像、及び三次元再生画像などの撮影画像を使って、前記システムによって作成された前記画像を患者の生体構造上に重ね合わる、請求項25の方法。
- 電子解剖学的マッピング、生体構造再生、及びナビゲーションシステムを使って、前記システムで作成された画像を、前記患者の生体構造に重ねる、請求項25の方法。
- 前記手術中に前記重ね合わせを行う、請求項31の方法。
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