JP2019527610A - 消化管の壁における神経アブレーションのための装置および方法 - Google Patents
消化管の壁における神経アブレーションのための装置および方法 Download PDFInfo
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Abstract
Description
Claims (23)
- 十二指腸アブレーションをリアルタイムで評価するための装置であって、カテーテルを備え、前記カテーテルは、
前記十二指腸壁を引き伸ばし、前記カテーテルの中心と前記十二指腸壁との間に固定された距離を生成するように構成された拡張可能な部材と、
前記カテーテル本体に結合され、第1のレーザビームおよび第2のレーザビームを伝送するように構成されたレーザ伝送素子であって、前記第1のレーザビームは、第1の波長および第1のスポット直径を有し、前記十二指腸壁の領域内に、前記領域に対する衝突の結果として切除損傷を引き起こすように構成され、前記第2のレーザビームは、第2の波長および第2のスポット直径を有し、前記十二指腸壁の前記領域内で、前記領域に対する前記第1のレーザビームの衝突の結果生じる変形を検出するように構成される、レーザ伝送素子と、
レーザ発光素子と機能的に結合され、前記十二指腸壁の上および/または下の領域に前記レーザビームを向けるように構成された偏向光学素子とを備える、装置。 - 前記レーザ発光素子が、前記第1のレーザビームを伝送するように構成された第1の光ファイバと、前記第2のレーザビームを伝送するように構成された第2の光ファイバとを備える、請求項1に記載の装置。
- 前記第1および第2のファイバが、空間的にずれている、請求項2に記載の装置。
- 前記レーザ伝送素子が、前記第1のレーザビームを偏向させるように構成されたレンズをさらに備え、それにより、前記第1および第2のレーザビームは、前記十二指腸壁の異なる標的領域に向かって伝送され、および/または前記偏向光学素子が回転されるとき、前記第2のレーザビームは所与の標的領域に、前記第1のレーザビームの衝突より遅れて衝突する、請求項2または3に記載の装置。
- 前記レーザ発光素子が、ダブルクラッドファイバを備える、請求項1に記載の装置。
- 前記第1のレーザビームが、前記ダブルクラッドファイバのコアを通って送られ、前記第2のビームが、前記ダブルクラッドファイバのクラッドを通って送られる、請求項5に記載の装置。
- 前記レーザ伝送素子が、前記第1および/または第2のレーザビームを選択的に屈折させるように構成された分散素子をさらに備え、それにより、前記第1および第2のレーザビームは、前記十二指腸壁の異なる標的領域に向けて伝送され、および/または前記偏向光学素子が回転されるとき、前記第2のレーザビームは所与の標的領域に、前記第1のレーザビームの衝突より遅れて衝突する、請求項5または6に記載の装置。
- 前記第1の波長が、1550nmまたは1567nmである、請求項1から7のいずれか一項に記載の装置。
- 前記第2の波長が、980nmである、請求項1から8のいずれか一項に記載の装置。
- 前記第2のスポット直径が、前記第1のスポット直径より大きく、それによって、前記第1のレーザビームによって直接的および間接的に影響を受ける組織に引き起こされた切除損傷の評価を可能にする、請求項1から9のいずれか一項に記載の装置。
- 前記十二指腸壁の前記領域に対する影響の程度を、前記領域内の検出された変形に基づいて評価するように構成された処理回路をさらに備える、請求項1から10のいずれか一項に記載の装置。
- 十二指腸アブレーションをリアルタイムで評価するための方法であって、
カテーテルを対象者の十二指腸に挿入することと、
前記カテーテルによって送られた拡張可能な部材を展開することであって、それによって前記十二指腸壁を引き伸ばし、前記カテーテルの中心と前記十二指腸壁との間に固定された距離を生成する、展開することと、
前記カテーテルの長手方向軸に対して本質的に垂直の方向に、前記十二指腸壁に向かって第1のレーザビームを伝送することであって、前記第1のレーザビームは、第1の波長および第1のスポット直径を有し、前記十二指腸壁の領域内に、前記領域に対する衝突の結果として切除損傷を引き起こすように構成される、第1のレーザビームを伝送することと、
前記カテーテルの前記長手方向軸に対して本質的に垂直に第2のレーザビームを伝送することであって、前記第2のレーザビームは、第2の波長および第2のスポット直径を有し、前記十二指腸壁の前記領域内で、前記領域に対する前記第1のレーザビームの衝突の結果生じる変形を検出するように構成される、第2のレーザビームを伝送することと、
前記十二指腸壁の前記領域に対する影響の程度を、前記領域内の検出された変形に基づいて評価することとを含む、方法。 - 前記第1の波長が、1450〜1600nmの範囲にある、請求項12に記載の方法。
- 前記第1の波長が、1550nmである、請求項13に記載の方法。
- 前記第2の波長が、980nmである、請求項12から14のいずれか一項に記載の方法。
- 前記第2のスポット直径が、前記第1のスポット直径より大きく、それによって、前記第1のレーザビームによって直接的および間接的に影響を受ける組織に引き起こされた切除損傷の評価を可能にする、請求項12から15のいずれか一項に記載の方法。
- 前記拡張可能な部材が、ノンコンプライアントバルーンを含む、請求項12から16のいずれか一項に記載の方法。
- 前記第2のレーザビームが、前記十二指腸壁の前記領域への前記第1のレーザビームの伝送より遅れて前記十二指腸壁の前記領域に伝送される、請求項12から17のいずれか一項に記載の方法。
- 前記遅延が、0.1〜10秒の範囲内である、請求項18に記載の方法。
- 前記第1および第2のレーザビームが、前記十二指腸壁の異なる標的領域に向かって同時に伝送される、請求項12から19のいずれかに一項に記載の方法。
- 前記第1および/または第2のレーザビームが、前記十二指腸壁に向かって本質的に円周パターンで偏向されるように、偏向光学素子を回転させることをさらに含む、請求項12から20のいずれか一項に記載の方法。
- 前記十二指腸壁の前記領域に対する影響の程度を評価することが、前記切除損傷の深さおよび/または幅を決定することを含む、請求項12から21のいずれか一項に記載の方法。
- 前記第2のレーザビームによって検出された前記十二指腸壁の前記領域に対する影響の前記評価された程度に基づいて、前記第1のレーザビームに関連するパラメータを調整することをさらに含む、請求項12から22のいずれか一項に記載の方法。
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EP3496800A1 (en) | 2019-06-19 |
US20190167349A1 (en) | 2019-06-06 |
CN114569245B (zh) | 2024-09-17 |
EP3811999A1 (en) | 2021-04-28 |
EP3811999B1 (en) | 2023-10-04 |
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