JP5307900B2 - 組織トポグラフィの知識によらないエネルギーの選択的な蓄積 - Google Patents
組織トポグラフィの知識によらないエネルギーの選択的な蓄積 Download PDFInfo
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- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
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- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
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- A61B2018/00345—Vascular system
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Description
本出願は、米国特許法119条第(e)項の下で、全開示内容の参照により本明細書に完全に組み込まれる、2008年11月17日に出願された米国仮特許出願第61/115,344号の利益を主張するものである。
該当なし
(技術分野)
・比較的不十分な(低い)熱伝導率、
・低い比熱容量、
・弱い生得の血液灌流、および/または
・十分に灌流された領域からの距離が比較的大きい。
t=RC=(l/n・k)(mcp)、
ここで、健全な組織 t≒7s、そして、疾患組織 t≒14s
中膜 Cp≒3.9
外膜 Cp≒3.1
脂肪 Cp≒2.4
中膜 k≒.59
外膜 k≒.49
脂肪 k≒.20
14 カテーテル・ボディ; 15 カテーテル軸; 16 近位端;
18 遠位端; 20 膨張可能バルーン; 22 ガイドワイヤ管;
24 膨張管; 26、28 コネクタ; 29 ハウジング; 34 電極;
36 導体; 38 電気コネクタ; 40 コントローラ; 42 エネルギー源。
Claims (21)
- 第1の組織タイプおよび第2の組織タイプの両方を含み、かつ身体の管腔に隣接する身体組織領域を加熱するためのカテーテル・システムであって、前記システムは、
間に軸を有する近位端および遠位端を有し、前記遠位端に隣接し且つ径方向に拡張可能な構造を備えた、細長い可撓性のカテーテル・ボディと、
前記遠位端に近位するエネルギー供給部分と、
前記エネルギー供給部分に結合されるエネルギー源と、
前記エネルギー源に結合されるプロセッサと、
から構成され、
前記第1の組織タイプは健全な組織であり、前記第2の組織タイプは疾患組織であり、
前記エネルギー供給部分は、前記身体の管腔内で前記拡張可能な構造が拡張されたときに前記複数の電極面が前記管腔に径方向に係合するように、前記径方向に拡張可能な構造の周りに配置された複数の電極面を備え、前記管腔に係合された前記複数の電極面により複数の回路が完成され、その回路のうち少なくともいくつかの回路は第1の組織タイプおよび第2の組織タイプを通る一方、その他の回路は前記第2の組織タイプを通らず、第1の組織タイプのみを通り、
前記プロセッサは、前記エネルギー源から前記複数の回路のそれぞれに伝達されるパルス・エネルギーのパルス特性を制御するように構成され、第1の組織タイプの熱損傷を回避することができるパルス率のパルス・エネルギーを前記その他の回路に伝達しながら、前記第2の組織タイプを加熱によって治療するために、前記少なくともいくつかの回路に前記パルス率の同じパルス・エネルギーを伝達する、
ことを特徴とするカテーテル・システム。 - 前記パルス・エネルギーは、前記第1の組織タイプではなく前記第2の組織タイプを優先的に加熱し、前記優先的な加熱は前記第1の組織タイプの熱伝導より弱い熱伝導、前記第1の組織タイプの比熱容量より低い比熱容量、前記第1の組織タイプの生得の血液灌流より弱い生得の血液灌流、および/または、十分に灌流された領域と前記第1の組織タイプとの間の距離より大きい、十分に灌流された領域からの距離、という前記第2の組織タイプの特性の群のうちの1つまたは複数によって少なくとも部分的に誘発されることを特徴とする請求項1に記載のシステム。
- 前記特性の群の大部分により、前記第2の組織タイプ内に熱を構築しながら、前記第1の組織タイプを有意に熱損傷するのを回避するような率で前記第1の組織タイプから熱が引き出されることを特徴とする請求項2に記載のシステム。
- 前記パルス・エネルギーは、0.25ワットから5ワットの平均率で前記身体組織領域に供給されることを特徴とする請求項1に記載のシステム。
- 前記パルス・エネルギーの各パルスは、4ジュールと45ジュールの間で前記身体組織領域に提供されることを特徴とする請求項1に記載のシステム。
- 前記身体組織領域に供給されるパルス・エネルギーの平均率は、前記第1の組織タイプによるエネルギー消失率の0.1倍と10.0倍の間であることを特徴とする請求項1に記載のシステム。
- パルスとパルスの間の時間に、前記第1の組織タイプが、前記パルス・エネルギーにより前記第1の組織タイプが熱損傷されるのを回避するように、十分な熱を消失することが可能であることを特徴とする請求項1に記載のシステム。
- パルス・エネルギーのパルスとパルスの間の前記時間は、0.1秒と180秒の間であることを特徴とする請求項1に記載のシステム。
- 前記第1の組織タイプの熱時定数が、個別の体積の所与の組織が指数関数的減衰を受けながらその熱の63%を失うくらいの長さであることを特徴とする請求項1に記載のシステム。
- 前記パルス・エネルギーは、第1の組織タイプの少なくとも異なる複数の時定数の持続時間にわたって前記身体組織領域へと供給され、前記第1の組織の前記熱時定数が前記第1の組織タイプの熱伝導率に比例することを特徴とする請求項1に記載のシステム。
- 前記第2の組織タイプの熱伝導率は、前記第1の組織タイプの熱伝導率の2倍であることを特徴とする請求項10に記載のシステム。
- 前記エネルギー源は無線周波(RF)エネルギー源を含むことを特徴とする請求項1に記載のシステム。
- 前記エネルギー供給部分は、前記身体の管腔に面する複数の電極面に係合する径方向に拡張可能な構造を有し、前記身体の管腔に面する前記複数の電極面により、前記第1の組織タイプおよび前記第2の組織タイプを通る複数の回路が完成され、パルス・エネルギーが前記複数の回路に供給されることを特徴とする請求項12に記載のシステム。
- 前記複数の電極面は、前記電極面が前記管腔の円周上で前記管腔と係合するように、前記径方向に拡張可能な構造の円周上に配置されることを特徴とする請求項1に記載のシステム。
- 前記複数の電極面は、選択された二極性の電極対の電極面の間にあるリモデリング・ゾーンにリモデリング・エネルギーを供給するための複数の前記二極性の電極対を備え、前記リモデリング・ゾーンは各前記電極対の前記電極面の間に管腔の組織を含むことを特徴とする請求項14に記載のシステム。
- 前記複数の二極性の電極対は、前記複数のリモデリング・ゾーンを画定し、前記複数のリモデリング・ゾーンは前記電極対の組合せにより前記管腔の円周に拡張することを特徴とする請求項15に記載のシステム。
- 異なる組合せの電極対にエネルギーを供給することで、前記複数の二極性の電極対は前記管腔の円周上の前記複数のリモデリング・ゾーン間のギャップを軽減または排除することができるように構成されることを特徴とする請求項16に記載のシステム。
- 異なる組合せの電極対にエネルギーを供給することで、前記管腔の円周上でオーバーラップする前記複数のリモデリング・ゾーンにエネルギーを供給するように、前記複数の二極性の電極対は配置されることを特徴とする請求項16に記載のシステム。
- 前記プロセッサは前記第1の組織タイプのの熱的性質に対応して、処置中に供給される前記パルス・エネルギーのパルス幅を変化するように構成されることを特徴とする請求項1に記載のシステム。
- 前記径方向に拡張可能な構造はバルーンで構成され、前記複数の電極は前記バルーンの表面上に取り付けられることを特徴とする請求項15に記載のシステム。
- 前記複数の電極は前記カテーテル本体の軸に沿って軸方向にオフセットされることを特徴とする請求項20に記載のシステム。
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Application Number | Priority Date | Filing Date | Title |
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US11534408P | 2008-11-17 | 2008-11-17 | |
US61/115,344 | 2008-11-17 | ||
PCT/US2009/064027 WO2010056745A1 (en) | 2008-11-17 | 2009-11-11 | Selective accumulation of energy with or without knowledge of tissue topography |
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JP2012509101A JP2012509101A (ja) | 2012-04-19 |
JP2012509101A5 JP2012509101A5 (ja) | 2012-12-27 |
JP5307900B2 true JP5307900B2 (ja) | 2013-10-02 |
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WO2007140331A2 (en) | 2006-05-25 | 2007-12-06 | Medtronic, Inc. | Methods of using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions |
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2009
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- 2009-11-11 JP JP2011536440A patent/JP5307900B2/ja not_active Expired - Fee Related
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AU2009314133A1 (en) | 2010-05-20 |
AU2016201555A1 (en) | 2016-03-31 |
KR20110104504A (ko) | 2011-09-22 |
AU2009314133B2 (en) | 2015-12-10 |
CN102271603A (zh) | 2011-12-07 |
WO2010056745A1 (en) | 2010-05-20 |
US20100125268A1 (en) | 2010-05-20 |
JP2012509101A (ja) | 2012-04-19 |
US9486355B2 (en) | 2016-11-08 |
US20130197614A1 (en) | 2013-08-01 |
EP2355737A1 (en) | 2011-08-17 |
EP2355737B1 (en) | 2021-08-11 |
EP2355737A4 (en) | 2013-01-16 |
CA2743992A1 (en) | 2010-05-20 |
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