JP5065052B2 - 可撓性シースカテーテル - Google Patents
可撓性シースカテーテル Download PDFInfo
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- JP5065052B2 JP5065052B2 JP2007556403A JP2007556403A JP5065052B2 JP 5065052 B2 JP5065052 B2 JP 5065052B2 JP 2007556403 A JP2007556403 A JP 2007556403A JP 2007556403 A JP2007556403 A JP 2007556403A JP 5065052 B2 JP5065052 B2 JP 5065052B2
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- JP
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- Prior art keywords
- catheter
- ablation
- heart
- flexible
- balloon member
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1002—Balloon catheters characterised by balloon shape
-
- 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
- A61B18/04—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
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
- A61M29/02—Dilators made of swellable material
-
- 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
- A61B2018/00375—Ostium, e.g. ostium of pulmonary vein or artery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M2025/0004—Catheters; Hollow probes having two or more concentrically arranged tubes for forming a concentric catheter system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
- A61M25/0026—Multi-lumen catheters with stationary elements
- A61M2025/0037—Multi-lumen catheters with stationary elements characterized by lumina being arranged side-by-side
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/06—Body-piercing guide needles or the like
- A61M25/0662—Guide tubes
- A61M2025/0681—Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1011—Multiple balloon catheters
- A61M2025/1015—Multiple balloon catheters having two or more independently movable balloons where the distance between the balloons can be adjusted, e.g. two balloon catheters concentric to each other forming an adjustable multiple balloon catheter system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0043—Catheters; Hollow probes characterised by structural features
- A61M25/0054—Catheters; Hollow probes characterised by structural features with regions for increasing flexibility
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0141—Tip steering devices having flexible regions as a result of using materials with different mechanical properties
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0147—Tip steering devices with movable mechanical means, e.g. pull wires
Description
12 遠端部
20 細長いカテーテル本体
21 中心管腔
24 壁部
25 プルワイヤ
30 先端
31 曲げ
33 テーパ
40 ハンドル部分
42 光ファイバ
43 滑車機構
45 中心管腔
47 終端ポート
49 側面ポート
50 アクチュエータ
60 編組部分
70 マーカーバンド
130 心臓
131 右心房
131 照準光源
132 アセンブリ本体
134 検出器
135,136 肺静脈
136 ディスプレイ
139 エネルギー源
140 エネルギー放射体
142 光ファイバ
144 導波路
145 凹形内部境界
147 光散乱粒子
149 近端部
150 拡張器
151 遠端部
152 中心管腔
157 遠端部
160 超音波トランスデューサ
166 シース
172A,172B 放射反射鏡
173 マイクロ波アンテナ
174 同軸伝達線
176 反射率センサ
194,196 傷
236,240 レンズ
254 接触加熱装置
256 伸長可能素子
258 接触加熱素子
259 透明バンド
312 カテーテル本体
314 内部コンジット
376 内視鏡
420 超音波アブレーション器具
422 バルーン
424 トランスデューサ
426 反射鏡
432 アセンブリ
440 放射体
476 センサ
476 内視鏡
480 並進機構
484 ハンドル
486 サムホイール
490 窓
498 位置決め装置
500 アブレーション器具
504 肺静脈
514 管腔
516 肺静脈
521,522 シール
524 カテーテル
525,527 シール
526 アンカーバルーン
529 放射透過流体
529 流体
536 出口ポート
540 アブレーション素子
542 光ファイバ
552 ターゲット組織領域
586 サムホイール
588 マッピング電極
589 細長い本体
Claims (5)
- 心臓アブレーション器具アセンブリであって、
心臓内に配置される可撓性の第1カテーテルであって、近端部から遠端部へと延在する少なくとも1つの管腔を当該第1カーテル内に備え、当該第1カテーテルが、可撓性遠端部分を有し、当該可撓性遠端部分が、心臓内のターゲット部位にアブレーション器具を配向するべく、複合曲線に沿って曲がり、又は曲げ面から外れた方向へ向けられた曲がった先端を有する、第1カテーテルと、
心臓内に配置される長尺な第2カテーテルであって、当該第2カテーテルが、少なくとも部分的に前記第1カテーテル内に包含される、第2カテーテルと、
前記長尺な第2カテーテルに結合し、肺静脈の近傍に配置されるべくサイズされた膨張可能なバルーン部材と、
前記バルーン部材を介してエネルギーを伝送することにより肺静脈の近傍に少なくとも1つの傷を形成するための前記バルーン部材内のアブレーション素子であって、当該アブレーション素子が、前記バルーン部材の内部において軸方向に移動可能であり、前記バルーン部材を介して前記エネルギーが伝送される位置の変更によりターゲット部位に前記エネルギーが向けられ、また、前記アブレーション素子が、前記第2カテーテル内の長尺な本体内に収容されている、アブレーション素子と、
前記長尺な本体内に収容されると共に、ターゲット部位の観察を可能とし、かつ前記アブレーション素子の位置付けを補助する内視鏡と、を備え、
前記管腔が、前記長尺な第2カテーテル、前記バルーン部材及び当該バルーン部材内に収容されるエネルギー放射体の通過を許容するべくサイズ及び構成され、
前記アブレーション素子が、前記バルーン部材内の選択位置への当該アブレーション素子の位置づけのための第1並進機構に対して動作可能に結合し、
前記内視鏡が、前記バルーン部材内に当該内視鏡を位置づけるための第2並進機構に対して動作可能に結合し、かつ当該内視鏡が、前記アブレーション素子に対して独立して位置付け可能である、心臓アブレーション器具アセンブリ。 - 前記アブレーション素子の位置決めを補助する位置決め指標を更に備える、請求項1に記載の心臓アブレーション器具アセンブリ。
- 前記位置決め指標の観察を可能とする窓を更に備える、請求項2に記載の心臓アブレーション器具アセンブリ。
- 前記第1並進機構が、前記アブレーション素子の移動用の第1ホイールを具備し、
前記第2並進機構が、前記内視鏡の移動用の第2ホイールを具備する請求項1乃至3のいずれか一項に記載の心臓アブレーション器具アセンブリ。 - 前記バルーン部材が、テーパー付けされた基部とテーパー付けされた先端部とを有し、前記基部と前記先端部との間の当該バルーン部材の幅が最大である、請求項1乃至4のいずれか一項に記載の心臓アブレーション器具アセンブリ。
Applications Claiming Priority (9)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/062,906 US20050222558A1 (en) | 1999-07-14 | 2005-02-22 | Methods of cardiac ablation employing a deflectable sheath catheter |
US11/062,905 | 2005-02-22 | ||
US11/062,774 US20050234436A1 (en) | 1999-07-14 | 2005-02-22 | Methods of cardiac ablation in the vicinity of the right inferior pulmonary vein |
US11/062,905 US7935108B2 (en) | 1999-07-14 | 2005-02-22 | Deflectable sheath catheters |
US11/062,774 | 2005-02-22 | ||
US11/062,903 | 2005-02-22 | ||
US11/062,903 US20050234437A1 (en) | 1999-07-14 | 2005-02-22 | Deflectable sheath catheters with out-of-plane bent tip |
US11/062,906 | 2005-02-22 | ||
PCT/US2006/006115 WO2006091597A1 (en) | 2005-02-22 | 2006-02-21 | Deflectable sheath catheters |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2008531086A JP2008531086A (ja) | 2008-08-14 |
JP5065052B2 true JP5065052B2 (ja) | 2012-10-31 |
Family
ID=36572384
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2007556403A Active JP5065052B2 (ja) | 2005-02-22 | 2006-02-21 | 可撓性シースカテーテル |
Country Status (3)
Country | Link |
---|---|
EP (1) | EP1866019B1 (ja) |
JP (1) | JP5065052B2 (ja) |
WO (1) | WO2006091597A1 (ja) |
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