JP6306211B2 - 圧受容器マッピングシステム - Google Patents
圧受容器マッピングシステム Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/02028—Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/024—Detecting, measuring or recording pulse rate or heart rate
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/053—Measuring electrical impedance or conductance of a portion of the body
- A61B5/0531—Measuring skin impedance
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B5/48—Other medical applications
- A61B5/4848—Monitoring or testing the effects of treatment, e.g. of medication
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- A—HUMAN NECESSITIES
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- 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
- A61B5/6867—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 specially adapted to be attached or implanted in a specific body part
- A61B5/6876—Blood vessel
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/0404—Electrodes for external use
- A61N1/0472—Structure-related aspects
- A61N1/0476—Array electrodes (including any electrode arrangement with more than one electrode for at least one of the polarities)
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/0551—Spinal or peripheral nerve electrodes
- A61N1/0556—Cuff electrodes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/0551—Spinal or peripheral nerve electrodes
- A61N1/0558—Anchoring or fixation means therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
- A61N1/36114—Cardiac control, e.g. by vagal stimulation
- A61N1/36117—Cardiac control, e.g. by vagal stimulation for treating hypertension
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/36128—Control systems
- A61N1/36146—Control systems specified by the stimulation parameters
- A61N1/36182—Direction of the electrical field, e.g. with sleeve around stimulating electrode
- A61N1/36185—Selection of the electrode configuration
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3904—Markers, e.g. radio-opaque or breast lesions markers specially adapted for marking specified tissue
- A61B2090/3908—Soft tissue, e.g. breast tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
- A61B5/053—Measuring electrical impedance or conductance of a portion of the body
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- 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
- Y10T156/00—Adhesive bonding and miscellaneous chemical manufacture
- Y10T156/10—Methods of surface bonding and/or assembly therefor
- Y10T156/1002—Methods of surface bonding and/or assembly therefor with permanent bending or reshaping or surface deformation of self sustaining lamina
- Y10T156/1028—Methods of surface bonding and/or assembly therefor with permanent bending or reshaping or surface deformation of self sustaining lamina by bending, drawing or stretch forming sheet to assume shape of configured lamina while in contact therewith
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- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Heart & Thoracic Surgery (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Radiology & Medical Imaging (AREA)
- Neurology (AREA)
- Neurosurgery (AREA)
- Physiology (AREA)
- Vascular Medicine (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Dermatology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Electrotherapy Devices (AREA)
- Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
Description
実施例3では、実施例1または2のシステムにおいて、マッピング装置はマッピング装置を通って延びる少なくとも一つのマーキング開口を備え、マーカーは少なくとも一つのマーキング開口を介して患者に取り付けられる。
実施例12では、実施例10または11のシステムにおいて、マーカーは、マッピング装置が患者の圧受容器領域から除去されるときに、患者に取り付けられた状態を維持する。
実施例14は、自己カーリングマッピング装置を製造する方法である。方法は、自己カーリングシートを平面に広げて留める工程と、自己カーリングシートの内側カーリング部分の少なくとも一部に接着剤の層を塗布する工程と、接着剤によってマッピング装置を自己カーリングシートに積層し、積層アセンブリを提供する工程と、接着剤をカーリングされた状態で硬化させるために、積層アセンブリをマンドレルの周りにカーリングさせる工程と、自己カーリングマッピング装置を伸ばす工程とを含む。
実施例16は、マッピング装置と、刺激装置と、マーカーとを備えたシステムである。マッピング装置は、患者の圧受容器領域上に位置付けられる複数の電極を備える。刺激装置は、複数の電極のうちの選択された電極を刺激して、選択された電極の刺激に応答して患者から生理的反応を得るものである。マーカーは、患者からの生理的反応の分析に基づいて、選択された電極のうちの少なくとも一つの位置をマーキングするために、患者に取り付けられるものである。
実施例24では、実施例16〜23のいずれかのシステムにおいて、生理的反応を感知し、患者からの生理的反応を示す信号を提供するためのセンサを備え、刺激装置は、信号を受信し、信号を分析して、マーカーによってマーキングされる選択された電極のうちの少なくとも一つの位置を判定する。
実施例35では、実施例33または34の方法において、接着剤の層はシリコーン接着剤の層を含む。
420において、該方法は、自己カーリングシリコーンシート402を平面に広げて留める工程を含む。自己カーリングシリコーンシート402は、鋲410によって平面に留めることができる。422において、マッピング装置400を取り付けるために、自己カーリングシリコーンシート402の内側カーリング部分の少なくとも一部に、シリコーン接着剤の層412が塗布される。
Claims (13)
- 圧受容器領域において圧受容器をマッピングするために、患者の前記圧受容器領域上に位置付けられる複数の電極を備えるマッピング装置と、
複数の前記電極のうちの選択された電極を刺激して、選択された前記電極の刺激に応答して前記患者から生理的反応を得る刺激装置と、
前記患者からの前記生理的反応の分析に基づいて、選択された前記電極のうちの少なくとも一つの位置をマーキングするために、前記患者に取り付けられるマーカーとを備え、前記マーカーは、前記マッピング装置が前記患者から除去されるときに、前記患者上におけるその位置を維持するシステム。 - 前記マーカーを用いて前記圧受容器領域上に整合される少なくとも一つの植込み型電極を含む植込み型装置を備える、請求項1に記載のシステム。
- 前記マッピング装置は前記マッピング装置を通って延びる少なくとも一つのマーキング開口を備え、前記マーカーは少なくとも一つの前記マーキング開口を介して前記患者に取り付けられる、請求項1または2に記載のシステム。
- 複数の前記電極のうちの少なくとも一つはマッピング電極形状を有し、前記マッピング電極形状は前記マッピング電極形状の内部領域を通って延びるマーキング開口を備える、請求項1〜3のいずれか一項に記載のシステム。
- 植込み型装置は、前記植込み型装置を通って延びる少なくとも一つの整合開口を備え、かつ前記マーカーおよび少なくとも一つの前記整合開口によって前記圧受容器領域上に整合される、請求項1〜4のいずれか一項に記載のシステム。
- 植込み型装置は、植込み型電極形状と、前記植込み型電極形状の内部領域を通って延びる整合開口とを有する植込み型電極を備えることによって、前記マーカーおよび前記整合開口によって前記圧受容器領域上に整合される、請求項1〜5のいずれか一項に記載のシステム。
- 前記マーカーは、前記マーカーを前記患者に取り付けるためのピン形状、フックおよび縫合糸のうちの少なくとも一つと、前記患者における前記マーカーの挿入距離を調節するための停止具とを備える、請求項1〜6のいずれか一項に記載のシステム。
- 前記マッピング装置は、前記患者に前記マッピング装置を固定する自己カーリングシートを備える、請求項1〜7のいずれか一項に記載のシステム。
- 前記生理的反応を感知し、かつ前記患者からの前記生理的反応を示す信号を提供するセンサを備え、前記刺激装置は、前記信号を受信し、前記信号を分析し、刺激された前記電極下の前記圧受容器領域における前記圧受容器の刺激による前記患者の前記生理的反応を得て、刺激された前記電極および前記生理的反応の情報を前記圧受容器領域のマップに格納し、前記圧受容器領域のマップを分析して、前記マーカーによってマーキングされる選択された前記電極のうちの少なくとも一つの位置を判定する、請求項1〜8のいずれか一項に記載のシステム。
- 患者の圧受容器領域において圧受容器をマッピングおよびマーキングするためのシステムにおいて、前記システムは、
前記患者の前記圧受容器領域上に位置付けられる複数の電極を備えるマッピング装置と、
生理的パラメータを感知し、前記生理的パラメータを示す信号を提供するセンサと、
前記センサから前記信号を受信し、前記信号を分析して、複数の前記電極のうちの電極の刺激に対する生理的反応を得る制御装置とを備え、前記制御装置は、刺激された前記電極および対応する前記生理的反応に関するデータを前記圧受容器領域のマップに格納し、
前記圧受容器領域のマップの分析に基づいて、刺激されたときに有効な前記生理的反応を提供する前記電極のうちの少なくとも一つの位置をマーキングするために、前記患者に取り付けられるマーカーを備えるシステム。 - 前記制御装置は、前記圧受容器領域のマップを分析して、前記電極のうちの少なくとも一つの位置を特定する、請求項10に記載のシステム。
- 前記マーカーは、前記マッピング装置が前記患者の前記圧受容器領域から除去されるときに、前記患者に取り付けられた状態を維持する、請求項10または11に記載のシステム。
- 前記マーカーを用いて前記圧受容器領域上に整合される少なくとも一つの植込み型電極を含む植込み型装置を備える、請求項10〜12のいずれか一項に記載のシステム。
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US201462014390P | 2014-06-19 | 2014-06-19 | |
US201462014496P | 2014-06-19 | 2014-06-19 | |
US62/014,496 | 2014-06-19 | ||
US62/014,390 | 2014-06-19 | ||
PCT/US2015/036528 WO2015195982A2 (en) | 2014-06-19 | 2015-06-18 | Baroreceptor mapping system |
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JP2017521108A JP2017521108A (ja) | 2017-08-03 |
JP6306211B2 true JP6306211B2 (ja) | 2018-04-04 |
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US (2) | US20150366467A1 (ja) |
EP (2) | EP3157617B1 (ja) |
JP (2) | JP6306211B2 (ja) |
CN (2) | CN106659386B (ja) |
AU (2) | AU2015277004B2 (ja) |
WO (2) | WO2015195982A2 (ja) |
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WO2019095020A1 (en) | 2017-11-20 | 2019-05-23 | The Bionics Institute Of Australia | Peripheral nerve electrode array |
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EP3157617A2 (en) | 2017-04-26 |
CN106456010B (zh) | 2020-03-13 |
CN106659386A (zh) | 2017-05-10 |
CN106659386B (zh) | 2020-03-13 |
EP3157618B1 (en) | 2018-10-03 |
US20150366467A1 (en) | 2015-12-24 |
WO2015195982A3 (en) | 2016-03-03 |
JP2017521108A (ja) | 2017-08-03 |
EP3157617B1 (en) | 2018-04-11 |
WO2015195980A1 (en) | 2015-12-23 |
AU2015277004A1 (en) | 2016-10-06 |
AU2015277002B2 (en) | 2017-07-06 |
US20150366465A1 (en) | 2015-12-24 |
WO2015195982A2 (en) | 2015-12-23 |
JP2017518096A (ja) | 2017-07-06 |
US9763582B2 (en) | 2017-09-19 |
CN106456010A (zh) | 2017-02-22 |
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