JP5574448B2 - 低温切除システム及び方法 - Google Patents
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Description
いくつかの例では、バルーンは、少なくとも冷媒搬送開口部を有する冷媒搬送装置の部分を外囲している。また、医療装置が、バルーンの漏出を検出する手段を備えている例もある。
感圧密閉部材は膨張可能な浮袋である。
また、安全バルブアセンブリが、弁体と排出流路との間に設けられた流量制限装置を有しており、加圧装置が、感圧密閉部材および排出流路の両方に流体連結されると、膨張可能な浮袋がバルーンよりも早い速度で膨張する。
最小の圧力径(hydraulic diameter)は、バルーン16の基端部42の領域にあるのが一般的である。図17Eに示すように、この径は、単に冷媒搬送チューブ22をこの領域を通すだけで最大にすることができる。内視鏡を通るために必要な長手方向の剛性を得るために、冷媒搬送チューブ22は、一般的に、ステンレス製ハイポチューブで構成されている。あるいは、搬送チューブはポリイミドなどの樹脂であってもよいし、金属支持ワイヤはカテーテルの全長を通るものであってもよい。硬質の冷媒搬送チューブ22もまた、バルーン16の長手方向の剛性を与えるものである。
Claims (27)
- 基端部、末端部および冷媒搬送内腔を備え、長手方向に延びるカテーテル軸芯を有するカテーテルと、
前記末端部に設けられるとともにバルーン内部を形成する内面を有するバルーンと、
前記末端部に連結されるとともに前記冷媒搬送内腔が開口する隔室、前記バルーン内部に流体連結される冷媒搬送開口部、および、前記隔室と前記冷媒搬送開口部に流体連結される流通路を有する冷媒搬送装置と、を備えた食道の対象組織を治療する医療装置であって、
冷媒が、前記冷媒搬送内腔から前記隔室内へ入り、前記流通路、前記冷媒搬送開口部を介して前記バルーン内部に搬送可能であり、前記バルーンを拡張した冷却状態にして、このバルーンが食道の対象組織に押し付けられて、これを冷却するようになっており、
前記流通路が前記カテーテル軸芯にほぼ平行でこれを外囲する長さを有する環状流路を備え、
前記冷媒搬送装置が、搬送アダプターチューブと当該搬送アダプターチューブを外囲するスリーブとを有し、
前記隔室の一部が前記搬送アダプターチューブによって形成され、
前記環状流路が前記スリーブおよび前記搬送アダプターチューブによって形成されている医療装置。 - 前記カテーテルが、カテーテル内部および前記バルーン内部と前記カテーテル内部に流体連結した排出ポートを有し、
排出気体流が、前記バルーンから前記排出ポート及び前記カテーテル内部を介して、前記カテーテルの基端部の方へ流れる請求項1に記載の医療装置。 - 前記バルーンが、少なくとも前記冷媒搬送開口部を有する前記冷媒搬送装置の部分を外囲する請求項1または2に記載の医療装置。
- 前記冷媒搬送開口部が、冷媒をほぼ360°放射分布パターンで前記バルーン内部に送る請求項3に記載の医療装置。
- 前記冷媒搬送開口部が、冷媒を選択された放射分布パターンで前記バルーン内部に送る請求項3に記載の医療装置。
- 前記冷媒搬送開口部が、180°以下の放射分布パターンで冷媒を前記バルーン内部に送る請求項3に記載の医療装置。
- 前記バルーンにおける漏出を検出する手段を備えた請求項1〜6の何れか一項に記載の医療装置。
- 前記バルーンと前記カテーテルの基端部との間に延びる圧力検出内腔を備え、前記バルーンの外圧における漏出を指示する変化が、前記圧力検出内腔における対応する圧力変化によって検出される請求項1〜6の何れか一項に記載の医療装置。
- 前記圧力検出内腔が前記バルーンの外側領域に開口している請求項8に記載の医療装置。
- 前記バルーンが、間に接合部を形成する前記カテーテルと前記冷媒搬送装置のいずれか一方に固定される取付け部を有し、前記圧力検出内腔が前記接合部に延出しており、前記接合部の欠陥が感知されるようになっている請求項8に記載の医療装置。
- 前記カテーテル内部で前記排出気体流と接触する流量検出器を備え、前記排出気体流における漏出を指示する流量の変化を検出することができる請求項2に記載の医療装置。
- 前記冷媒搬送開口部が前記隔室の末端に位置することにより、冷媒が、末端方向で前記環状流路に沿って流れる請求項1に記載の医療装置。
- 前記流通路が前記搬送アダプターチューブを貫通して形成される孔を有する請求項1に記載の医療装置。
- 前記冷媒搬送開口部が前記スリーブの基端部と末端部に位置する開口部を有する請求項13に記載の医療装置。
- 冷媒が、基端方向および末端方向の両方において、前記環状流路を介して流れるように前記孔が位置している請求項14に記載の医療装置。
- 前記冷媒搬送装置が、前記搬送アダプターチューブに設けられた偏流器を有しており、前記冷媒搬送開口部が前記スリーブと前記偏流器との間に形成されるとともに、前記偏流器が、前記環状流路に沿って流れる冷媒を、前記冷媒搬送開口部から径方向外側に向けるように位置するとともに構成されている請求項13に記載の医療装置。
- 前記搬送アダプターチューブが軸芯を形成し、前記冷媒搬送開口部が、前記軸芯の全周にわたって延びている請求項16に記載の医療装置。
- 前記冷媒搬送開口部が、前記軸芯に鋭角で前記軸芯に沿って延びる楕円経路を形成する請求項17に記載の医療装置。
- 前記冷媒搬送開口部が、前記軸芯に対して異なる鋭角で前記軸芯に沿って延びる一連のほぼ直線のセグメントを持つ経路を形成しており、隣接する前記セグメントが反対の軸芯方向に延びている請求項17に記載の医療装置。
- 前記冷媒搬送開口部が軸芯に沿って延びる経路を形成しており、この経路が少なくとも1つのほぼS字形の曲線セグメントを有している請求項17に記載の医療装置。
- 前記冷媒搬送開口部が前記カテーテル軸芯の全周にわたって延びており、前記スリーブが前記搬送アダプターチューブを浮遊外囲するよう、前記搬送アダプターチューブに対して完全に固定されていない請求項13に記載の医療装置。
- 前記冷媒搬送開口部が、変化する回転方向及び軸方向位置を有する経路に沿って延びている請求項21に記載の医療装置。
- 前記冷媒搬送開口部が、前記カテーテル軸芯の少なくとも半分にわたって延びている請求項1〜22の何れか一項に記載の医療装置。
- 前記冷媒搬送装置が、前記冷媒搬送開口部が形成される偏流器スリーブと、当該偏流器スリーブを少なくとも部分的に外囲する軸方向に位置決め可能な導流スリーブとを有し、(1)前記冷媒搬送開口部と(2)前記導流スリーブの少なくとも一方が、前記カテーテル軸芯の周囲に少なくとも部分的に伸びて、変化する回転方向及び軸方向位置をもつ経路に沿う縁部を備えており、
前記偏流器スリーブが、冷媒の搬送を前記バルーン内部に振り分けるべく、前記冷媒搬送開口部の全部あるいは一部を覆うように位置している請求項1〜23の何れか一項に記載の医療装置。 - 前記縁部が変化する回転方向及び軸方向位置をもつ経路に沿うように、前記冷媒搬送開口部が変化する回転方向及び軸方向位置をもつ経路に沿って延びている請求項24に記載の医療装置。
- 前記縁部がほぼ一定の軸方向位置をもつ経路に沿うように、前記冷媒搬送開口部がほぼ一定の軸方向位置をもつ経路に沿って延びている請求項24に記載の医療装置。
- 開放した内部、末端部、排出内腔及び冷媒搬送内腔を有する本体シャフトを備え、前記末端部の外径が前記本体シャフトよりも小さいカテーテルと、
大径の本体部およびその基端部に小径の軸部を有するとともに、前記小径の軸部が前記カテーテルの末端部に設けられており、バルーン内部を形成する内面を有しているバルーンと、
前記末端部に連結されるとともに、前記冷媒搬送内腔が開口する隔室、および、当該隔室に流体連結されバルーン内部に開口する冷媒搬送開口部、および、前記隔室と前記冷媒搬送開口部に流体連結される流通路を備えた冷媒搬送装置と、を備えた食道の対象組織を治療する医療装置であって、
冷媒が、前記冷媒搬送内腔から前記隔室内へ入り、前記冷媒搬送開口部を介して前記バルーン内部に搬送可能であり、前記バルーンを拡張した冷却状態にして、このバルーンが食道の対象組織に押し付けられて、これを冷却するようになっており、
前記流通路が前記カテーテル軸芯にほぼ平行でこれを外囲する長さを有する環状流路を備え、
前記冷媒搬送装置が、搬送アダプターチューブと当該搬送アダプターチューブを外囲するスリーブとを有し、
前記隔室の一部が前記搬送アダプターチューブによって形成され、
前記環状流路が前記スリーブおよび前記搬送アダプターチューブによって形成されている医療装置。
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US12/611,057 US8382746B2 (en) | 2008-11-21 | 2009-11-02 | Cryogenic ablation system and method |
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US20040215235A1 (en) | 1999-11-16 | 2004-10-28 | Barrx, Inc. | Methods and systems for determining physiologic characteristics for treatment of the esophagus |
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JP2017060830A (ja) | 2017-03-30 |
US20160302841A1 (en) | 2016-10-20 |
CN102223848A (zh) | 2011-10-19 |
US9168081B2 (en) | 2015-10-27 |
EP2352451A1 (en) | 2011-08-10 |
JP2012509146A (ja) | 2012-04-19 |
US20100130970A1 (en) | 2010-05-27 |
US20130197500A1 (en) | 2013-08-01 |
JP2014140772A (ja) | 2014-08-07 |
EP2352451A4 (en) | 2012-05-23 |
US11298174B2 (en) | 2022-04-12 |
JP6051255B2 (ja) | 2016-12-27 |
US10383676B2 (en) | 2019-08-20 |
JP2015144871A (ja) | 2015-08-13 |
CN102223848B (zh) | 2014-05-21 |
US8382746B2 (en) | 2013-02-26 |
JP6231649B2 (ja) | 2017-11-15 |
EP2352451B1 (en) | 2014-01-08 |
WO2010059519A1 (en) | 2010-05-27 |
US20190328438A1 (en) | 2019-10-31 |
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