JP7091410B2 - 肺静脈の周囲のアブレーションのためのバルーン - Google Patents
肺静脈の周囲のアブレーションのためのバルーン Download PDFInfo
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- 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
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- A61B2018/00053—Mechanical features of the instrument of device
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- A61B2018/00267—Expandable means emitting energy, e.g. by elements carried thereon having a basket shaped structure
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- 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
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- A—HUMAN NECESSITIES
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- 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
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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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00839—Bioelectrical parameters, e.g. ECG, EEG
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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
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1407—Loop
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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
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1435—Spiral
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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
- A61B2018/1467—Probes or electrodes therefor using more than two electrodes on a single probe
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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
- A61B2018/1475—Electrodes retractable in or deployable from a housing
-
- 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]
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Description
(1) アブレーションの方法であって、
心臓の左心房の中にカテーテルを導入する工程であって、前記カテーテルがルーメン及び遠位端を有する、工程と、
前記カテーテルの前記ルーメンを通して輪縄式ガイド(lasso guide)を延長して肺静脈の内壁と係合させる工程と、
バルーンを前記輪縄式ガイドの一部の上に展開させる工程であって、前記バルーンが長手方向軸及びその外壁に配置された電極アセンブリを有し、前記電極アセンブリが前記長手方向軸の周囲に円周方向に配置された複数のアブレーション電極を含む、工程と、
前記バルーンを膨張させる工程と、
前記バルーンを前記肺静脈に接してその口のところに位置決めする工程であって、前記アブレーション電極が前記肺静脈にガルバニック接触する、工程と、
前記アブレーション電極を介して電気エネルギーを伝達して、前記肺静脈を取り囲む円周方向の損傷を生じる工程と、を含む、方法。
(2) 前記バルーンの位置決め後に、前記肺静脈の中に前記カテーテルを通して造影剤を注入する工程を更に含む、実施態様1に記載の方法。
(3) 前記バルーンの位置決め後に、前記バルーンの中に前記カテーテルを通して造影剤を注入する工程を更に含む、実施態様1に記載の方法。
(4) 前記輪縄式ガイドが、その上に配置されたマッピング電極を有し、前記アブレーション電極を介して電気エネルギーを伝達する工程を実行する前に、前記マッピング電極を用いてアブレーション前の電位図を得る工程を更に含む、実施態様1に記載の方法。
(5) 前記輪縄式ガイドが、その上に配置されたマッピング電極を有し、前記アブレーション電極を介して電気エネルギーを伝達する工程を実行した後に、前記マッピング電極を用いてアブレーション後の電位図を得る工程を更に含む、実施態様1に記載の方法。
前記プローブの前記ルーメンを通って送達されるための折り畳んだ状態、及び拡張状態をとる輪縄式ガイドであって、前記輪縄式ガイドがその上に複数のマッピング電極を有し、前記マッピング電極が心電計回路に接続可能である、輪縄式ガイドと、
前記ルーメンを通って前記輪縄式ガイドの上に展開可能な膨張式のバルーンであって、前記バルーンが長手方向軸及び外壁を有する、バルーンと、
前記外壁上で前記長手方向軸の周りに円周方向に配置された複数のアブレーション電極であって、前記バルーンが複数の洗浄孔により有窓であり、前記孔を通過するための流体の供給源と接続されている、アブレーション電極と、を備える、アブレーション装置。
(7) 前記バルーンの前記長手方向軸から外向きに放射される複数のストリップを含むサブアセンブリを更に含み、前記アブレーション電極が前記ストリップ上に配置される、実施態様6に記載の装置。
(8) 前記サブアセンブリが、内部に貫通形成された開口部を有し、前記開口部が前記バルーンの前記孔と流体連通する、実施態様7に記載の装置。
(9) 前記遠位部分において前記アブレーション電極につながるワイヤを更に含み、前記サブアセンブリの前記ストリップが、前記バルーンの表面上に延在し、それぞれ前記ワイヤを覆うピグテールを含む、実施態様7に記載の装置。
Claims (6)
- アブレーション装置であって、
遠位部分、近位部分、及びルーメンを有するカテーテルと、
前記カテーテルの前記ルーメンを通って送達されるための折り畳んだ状態、及び拡張状態をとる輪縄式ガイドであって、前記輪縄式ガイドがその上に複数のマッピング電極を有し、前記複数のマッピング電極が心電計回路に接続可能である、輪縄式ガイドと、
シャフトに取り付けられ、前記ルーメンを通って前記輪縄式ガイドの上に展開可能である、膨張式のバルーンであって、前記膨張式のバルーンが長手方向中心軸及び外壁を有する、膨張式のバルーンと、
中央開口部、及び複数のストリップを備えるサブアセンブリであって、前記複数のストリップは、前記中央開口部に接続され、前記中央開口部から離れるように放射状に延在し、前記複数のストリップは、前記膨張式のバルーンの前記外壁上に配置されており、前記シャフトの遠位部分が、前記中央開口部を通って配置されており、前記複数のストリップはまた、前記シャフトの近位部分に向かって延在している、サブアセンブリと、
前記複数のストリップ上に配置された複数のアブレーション電極と、
前記アブレーション電極につながるワイヤと、を備え、
前記複数のストリップが、前記膨張式のバルーンの表面上に延在し、それぞれ前記ワイヤを覆うピグテールを含み、
前記アブレーション電極は、前記中央開口部と前記ピグテールとの間の前記ストリップの幅広部分上に配置されており、前記複数のストリップはそれぞれ前記幅広部分から幅狭の前記ピグテールへとテーパーしており、前記ピグテールの近位端は前記膨張式のバルーンの近位端の遠位に配置されている、アブレーション装置。 - 前記膨張式のバルーンは、複数の洗浄孔を含む、請求項1に記載の装置。
- 前記サブアセンブリが、貫通孔を有し、前記貫通孔が前記膨張式のバルーンの前記複数の洗浄孔と流体連通する、請求項2に記載の装置。
- 前記シャフトは、少なくとも部分的に前記ルーメン内に配置されている、請求項1に記載の装置。
- 前記複数のストリップは、前記ピグテールで終端している、請求項1に記載の装置。
- 前記シャフトの前記遠位部分が、前記中央開口部を通って前記膨張式のバルーンの遠位端を越えて延在している、請求項1に記載の装置。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US14/578,807 US20160175041A1 (en) | 2014-12-22 | 2014-12-22 | Balloon for ablation around pulmonary veins |
US14/578,807 | 2014-12-22 |
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JP2015248267A Division JP6768293B2 (ja) | 2014-12-22 | 2015-12-21 | 肺静脈の周囲のアブレーションのためのバルーン |
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JP7091410B2 true JP7091410B2 (ja) | 2022-06-27 |
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JP2015248267A Active JP6768293B2 (ja) | 2014-12-22 | 2015-12-21 | 肺静脈の周囲のアブレーションのためのバルーン |
JP2020157166A Active JP7091410B2 (ja) | 2014-12-22 | 2020-09-18 | 肺静脈の周囲のアブレーションのためのバルーン |
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US (1) | US20160175041A1 (ja) |
EP (2) | EP3037034B1 (ja) |
JP (2) | JP6768293B2 (ja) |
CN (2) | CN105708544A (ja) |
AU (1) | AU2015268771A1 (ja) |
CA (1) | CA2915224A1 (ja) |
IL (1) | IL242663B (ja) |
RU (1) | RU2015153896A (ja) |
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AU2015268771A1 (en) | 2016-07-07 |
IL242663B (en) | 2021-05-31 |
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RU2015153896A (ru) | 2017-06-20 |
JP2021003571A (ja) | 2021-01-14 |
EP3932304A1 (en) | 2022-01-05 |
IL242663A0 (en) | 2016-02-29 |
JP2016116863A (ja) | 2016-06-30 |
JP6768293B2 (ja) | 2020-10-14 |
EP3037034B1 (en) | 2021-10-13 |
CN105708544A (zh) | 2016-06-29 |
CA2915224A1 (en) | 2016-06-22 |
US20160175041A1 (en) | 2016-06-23 |
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