JP6114190B2 - 磁気誘導カテーテル - Google Patents
磁気誘導カテーテル Download PDFInfo
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- JP6114190B2 JP6114190B2 JP2013523165A JP2013523165A JP6114190B2 JP 6114190 B2 JP6114190 B2 JP 6114190B2 JP 2013523165 A JP2013523165 A JP 2013523165A JP 2013523165 A JP2013523165 A JP 2013523165A JP 6114190 B2 JP6114190 B2 JP 6114190B2
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- 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
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
- A61B34/73—Manipulators for magnetic surgery
-
- 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
- A61M25/0127—Magnetic means; Magnetic markers
-
- 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
- A61M25/0158—Tip steering devices with magnetic or electrical means, e.g. by using piezo materials, electroactive polymers, magnetic materials or by heating of shape memory materials
-
- 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
- A61B2018/00005—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
-
- 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
- A61B2018/00005—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
- A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
-
- 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
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00577—Ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
- A61B2034/2046—Tracking techniques
- A61B2034/2051—Electromagnetic tracking systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/002—Irrigation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
- A61B34/70—Manipulators specially adapted for use in surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/061—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body
- A61B5/062—Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body using magnetic field
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
- A61B5/287—Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
-
- 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
- A61M2025/0166—Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
- Y10T29/00—Metal working
- Y10T29/49—Method of mechanical manufacture
- Y10T29/49002—Electrical device making
- Y10T29/49117—Conductor or circuit manufacturing
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- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Surgery (AREA)
- Hematology (AREA)
- Anesthesiology (AREA)
- Biophysics (AREA)
- Pulmonology (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Physics & Mathematics (AREA)
- Cardiology (AREA)
- Plasma & Fusion (AREA)
- Otolaryngology (AREA)
- Robotics (AREA)
- Surgical Instruments (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Description
本出願は、2010年8月4日に出願された米国特許出願第12/850,485号明細書に対する優先権を主張し、その出願は、本明細書に完全に示されているかのように参照により本明細書に援用される。
以下の項目は、本願出願時の要素である。
(項目1)
アブレーションカテーテル用の電極アセンブリであって、
近位シャンク部および遠位部を有する位置決め磁石本体と、
灌注流体を受け取るように構成された分散キャビティと、前記流体を送達するための遠位出口ポートを有する前記キャビティに結合された灌注通路とを有するマニホルドであって、前記キャビティおよび前記通路が前記本体から隔離されている、マニホルドと、
前記本体を包囲する外側カプセルであって、遠位アブレーション面を含む導電材料を含む、カプセルと、
を備えるアセンブリ。
(項目2)
前記位置決め磁石が、永久磁石、希土類元素を含む永久磁石および電磁石のうちの1つを含む、項目1に記載のアセンブリ。
(項目3)
前記永久磁石が、ネオジム鉄ホウ素(NdFeB)材料を含む、項目2に記載のアセンブリ。
(項目4)
前記マニホルドが、前記分散キャビティを有しかつ軸に沿って延在する管状部を含み、前記管状部が、前記流体を受け取るように構成された近位端部を含み、前記灌注通路が、前記管状部の遠位部から延在し、前記通路が、前記管状部と流体連通し、前記マニホルドが、前記本体内の対応する凹部に配置されている、項目1に記載のアセンブリ。
(項目5)
前記本体内の前記対応する凹部が、前記マニホルドの前記管状部を受け取るように構成された中心に配置された長手方向に延在する孔を含む、項目4に記載のアセンブリ。
(項目6)
前記通路に関連する前記出口ポートが、遠位出口ポート、側部出口ポートおよび角度付き出口ポートのうちの1つを含む、項目4に記載のアセンブリ。
(項目7)
前記灌注通路が半径方向に延在する灌注通路である、項目4に記載のアセンブリ。
(項目8)
前記本体および前記マニホルドが、軸に沿って延在し、前記灌注通路が、軸方向に延在する灌注通路である、項目1に記載のアセンブリ。
(項目9)
前記カプセルが導電性コーティングを含む、項目4に記載のアセンブリ。
(項目10)
前記コーティングが、
(i)前記本体の外面のNi−Ni材料の第1層、前記第1層の上の金(Au)材料を含む第2層、および前記第2層の上にプラチナ(Pt)材料を含む第3層と、
(ii)前記本体の外面のNi−Ni材料の第1層、前記第1層の上のチタン(Ti)材料を含む第2層、および前記第2層の上のプラチナ(Pt)材料を含む第3層と、
のうちの一方を含む、項目9に記載のアセンブリ。
(項目11)
前記カプセルが、(i)前記本体の前記遠位部を覆うように構成されたカップ状先端キャップと、(ii)前記シャンク部を包囲するように構成された円柱状シャンクカバーとを含み、前記先端キャップが前記灌注出口ポートに対応する少なくとも1つの穴を含む、項目1に記載のアセンブリ。
(項目12)
電極カテーテル用の電極アセンブリであって、
近位シャンク部および遠位部を有する位置決め磁石本体と、
前記本体を包囲する外側ケーシングであって、前記本体の前記遠位部を覆うように構成されたカップ状先端キャップと、前記本体の前記シャンク部を包囲するように構成された円柱状シャンクカバーとを含むとともに、導電性材料を含み、前記シャンクカバーが、カテーテルシャフトの遠位端部を受け取るように構成されている、ケーシングと、
を具備するアセンブリ。
(項目13)
前記位置決め磁石が、永久磁石、希土類元素を含む永久磁石および電磁石のうちの1つを含む、項目12に記載のアセンブリ。
(項目14)
前記永久磁石が、ネオジム鉄ホウ素(NdFeB)材料を含む、項目13に記載のアセンブリ。
(項目15)
前記本体の内部孔に結合された遠位端部と近位端とを有する安全線をさらに含む、項目1に記載のアセンブリ。
(項目16)
前記安全線が、液晶ポリマー(LCP)材料およびパラアラミド合成繊維のうちの一方を含む、項目15に記載のアセンブリ。
(項目17)
灌注アブレーションカテーテル用の電極アセンブリを製造する方法であって、
電極基部および電極先端を含む位置決め磁石を提供するステップであって、前記基部が、近位シャンク部、軸方向に延在する貫通孔および遠位面の複数の半チャネルを含む、ステップと、
前記電極基部にマニホルドを、その管状部が前記孔内に配置されるように、かつ複数の通路を備えた半径方向分散部が前記複数の半チャネルに位置合せされかつその中に着座するように挿入するステップであって、前記マニホルドが、前記通路内を搬送される灌注流体が前記位置決め磁石と接触しないように隔離する、ステップと、
複数の対応する半チャネルを有する前記電極先端を、前記半径方向分散部が前記位置決め磁石内に取り込まれるように、前記電極基部の前記面に取り付けるステップと、
前記位置決め磁石を包囲する外側カプセルを提供するステップであって、前記カプセルが導電性材料を含む、ステップと、
を含む方法。
(項目18)
外側カプセルを提供する前記ステップが、導電性コーティングを前記電極基部および前記電極先端の外面に施すサブステップを含む項目17に記載の方法。
(項目19)
コーティングを施す前記ステップが、
前記位置決め磁石の外面にNi−Ni材料の第1層を施すサブステップと、
前記第1層の上に金(Au)材料およびチタン(Ti)材料のうちの一方を含む第2層を施すサブステップと、
前記第2層の上にプラチナ(Pt)材料を含む第3層を施すサブステップと、
を含む、前記項目18に記載の方法。
(項目20)
外側カプセルを提供する前記ステップが、
前記電極基部の前記シャンク部の上にリングを配置するサブステップと、
前記近位シャンクの上に円柱状シャンクカバーの開放端を配置するサブステップと、
前記電極先端を先端キャップで覆うサブステップと、
前記先端キャップを前記シャンクカバーに取り付けるサブステップと、
を含む、項目17に記載の方法。
(項目21)
磁化可能材料を含む加工物から磁気ペレットを製造する方法であって、
(A)ペレット構成に従って工具経路を確定するステップと、
(B)前記加工物を回転させる間に前記工具経路に沿ってビットを移動させることにより前記加工物を機械加工するステップと、
(C)前記機械加工された加工物を磁化し、それにより前記磁気ペレットを製造するステップと、
を含む方法。
Claims (10)
- 灌注アブレーションカテーテルのための電極アセンブリであって、
近位シャンク部及び遠位部を有し、前記近位シャンク部は、細長く前記遠位部よりも小径であり、前記遠位部は半球状の遠位先端部を有する、位置決め磁石本体と、
前記近位シャンク部及び前記遠位部を通じて位置しており、これらの内部において灌注流体を受け取るように構成された分散キャビティと、前記流体を前記遠位部を通過して送達するための遠位出口ポートを有する前記分散キャビティに結合された灌注通路とを有するマニホルドであって、前記分散キャビティおよび前記潅注通路が前記磁石本体から隔離されている、マニホルドと、
前記磁石本体を被覆する外側カプセルであって、前記遠位部を被覆する導電性コーティングを有する外側カプセルと
を備え、
前記近位シャンク部が前記外側カプセルによって被覆されるとき、前記近位シャンク部のみが前記カテーテルのシャフトを受け取ることが可能なサイズ及び形状に構成され、前記遠位部は、前記電極アセンブリにおいて露出されて半球状の遠位アブレーション面を構成するようになっている、アセンブリ。 - 前記磁石本体が、永久磁石、希土類元素を含む永久磁石および電磁石のうちの1つを含む、請求項1に記載のアセンブリ。
- 前記永久磁石が、ネオジム鉄ホウ素(NdFeB)材料を含む、請求項2に記載のアセンブリ。
- 前記マニホルドが、前記分散キャビティを有しかつ軸に沿って延在する管状部を含み、前記管状部が、前記流体を受け取るように構成された近位端部を含み、前記灌注通路が、前記管状部の遠位部から延在し、前記潅注通路が、前記管状部と流体連通し、前記マニホルドが、前記磁石本体内の対応する凹部に配置されている、請求項1〜3のいずれかに記載のアセンブリ。
- 前記磁石本体内の前記対応する凹部が、前記マニホルドの前記管状部を受け取るように構成された中心に配置された長手方向に延在する孔を含む、請求項4に記載のアセンブリ。
- 前記潅注通路に関連する前記出口ポートが、遠位出口ポート、側部出口ポートおよび角度付き出口ポートのうちの1つを含む、請求項1〜5のいずれかに記載のアセンブリ。
- 前記灌注通路が半径方向に延在する灌注通路である、請求項1〜6のいずれかに記載のアセンブリ。
- 前記磁石本体および前記マニホルドが、軸に沿って延在し、前記灌注通路が、軸方向に延在する灌注通路である、請求項1〜7のいずれかに記載のアセンブリ。
- 前記導電性コーティングが、
(i)前記本体の外面のNi−Ni材料の第1層、前記第1層の上の金(Au)材料を含む第2層、および前記第2層の上にプラチナ(Pt)材料を含む第3層と、
(ii)前記本体の外面のNi−Ni材料の第1層、前記第1層の上のチタン(Ti)材料を含む第2層、および前記第2層の上のプラチナ(Pt)材料を含む第3層と、
のうちの一方を含む、請求項1〜8のいずれかに記載のアセンブリ。 - 前記磁石本体の内部孔に結合された遠位端部と近位端とを有する安全線をさらに含む、請求項1〜9のいずれかに記載のアセンブリ。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US12/850,485 | 2010-08-04 | ||
US12/850,485 US9023033B2 (en) | 2010-08-04 | 2010-08-04 | Magnetically guided catheters |
PCT/US2011/040425 WO2012018439A1 (en) | 2010-08-04 | 2011-06-15 | Magnetically guided catheters |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2016074253A Division JP2016152938A (ja) | 2010-08-04 | 2016-04-01 | 磁気誘導カテーテル |
Publications (3)
Publication Number | Publication Date |
---|---|
JP2013536011A JP2013536011A (ja) | 2013-09-19 |
JP2013536011A5 JP2013536011A5 (ja) | 2014-07-24 |
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