JPH10502290A - 音波切除 - Google Patents
音波切除Info
- Publication number
- JPH10502290A JPH10502290A JP8529742A JP52974296A JPH10502290A JP H10502290 A JPH10502290 A JP H10502290A JP 8529742 A JP8529742 A JP 8529742A JP 52974296 A JP52974296 A JP 52974296A JP H10502290 A JPH10502290 A JP H10502290A
- Authority
- JP
- Japan
- Prior art keywords
- catheter
- sonic
- power
- tissue
- ablation
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
- 238000002679 ablation Methods 0.000 title claims abstract description 164
- 238000000034 method Methods 0.000 claims abstract description 99
- 230000005855 radiation Effects 0.000 claims abstract description 30
- 238000001727 in vivo Methods 0.000 claims abstract description 11
- 210000001519 tissue Anatomy 0.000 claims description 122
- 239000007788 liquid Substances 0.000 claims description 34
- 238000002271 resection Methods 0.000 claims description 29
- 239000012809 cooling fluid Substances 0.000 claims description 14
- 238000004891 communication Methods 0.000 claims description 11
- 238000011282 treatment Methods 0.000 claims description 9
- 239000012530 fluid Substances 0.000 claims description 8
- 238000013507 mapping Methods 0.000 claims description 8
- 210000005003 heart tissue Anatomy 0.000 claims description 5
- 239000000110 cooling liquid Substances 0.000 claims description 4
- 210000002837 heart atrium Anatomy 0.000 claims description 4
- 230000005540 biological transmission Effects 0.000 claims description 3
- 238000003384 imaging method Methods 0.000 claims description 3
- 241000255925 Diptera Species 0.000 claims description 2
- 206010061592 cardiac fibrillation Diseases 0.000 claims description 2
- 230000002600 fibrillogenic effect Effects 0.000 claims description 2
- 239000012212 insulator Substances 0.000 claims description 2
- 238000002955 isolation Methods 0.000 claims description 2
- 230000001568 sexual effect Effects 0.000 claims description 2
- 230000009466 transformation Effects 0.000 claims description 2
- 238000000844 transformation Methods 0.000 claims description 2
- 230000007831 electrophysiology Effects 0.000 description 18
- 238000002001 electrophysiology Methods 0.000 description 18
- 239000002826 coolant Substances 0.000 description 6
- 239000004593 Epoxy Substances 0.000 description 4
- 238000010586 diagram Methods 0.000 description 3
- 239000000463 material Substances 0.000 description 3
- 206010003658 Atrial Fibrillation Diseases 0.000 description 2
- 239000004698 Polyethylene Substances 0.000 description 2
- 239000011358 absorbing material Substances 0.000 description 2
- 206010003119 arrhythmia Diseases 0.000 description 2
- 230000006793 arrhythmia Effects 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 239000008280 blood Substances 0.000 description 2
- 238000001816 cooling Methods 0.000 description 2
- 230000006378 damage Effects 0.000 description 2
- 230000003111 delayed effect Effects 0.000 description 2
- -1 polyethylene Polymers 0.000 description 2
- 229920000573 polyethylene Polymers 0.000 description 2
- 238000001356 surgical procedure Methods 0.000 description 2
- 206010047302 ventricular tachycardia Diseases 0.000 description 2
- 239000004677 Nylon Substances 0.000 description 1
- BQCADISMDOOEFD-UHFFFAOYSA-N Silver Chemical compound [Ag] BQCADISMDOOEFD-UHFFFAOYSA-N 0.000 description 1
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 1
- 238000013153 catheter ablation Methods 0.000 description 1
- 239000012141 concentrate Substances 0.000 description 1
- 210000003748 coronary sinus Anatomy 0.000 description 1
- 238000012937 correction Methods 0.000 description 1
- 238000005553 drilling Methods 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000000608 laser ablation Methods 0.000 description 1
- 210000004165 myocardium Anatomy 0.000 description 1
- 229920001778 nylon Polymers 0.000 description 1
- 229920000642 polymer Polymers 0.000 description 1
- 238000012545 processing Methods 0.000 description 1
- 230000002441 reversible effect Effects 0.000 description 1
- 210000005241 right ventricle Anatomy 0.000 description 1
- 230000008054 signal transmission Effects 0.000 description 1
- 229910052709 silver Inorganic materials 0.000 description 1
- 239000004332 silver Substances 0.000 description 1
- 239000011780 sodium chloride Substances 0.000 description 1
- 229910001220 stainless steel Inorganic materials 0.000 description 1
- 239000010935 stainless steel Substances 0.000 description 1
- 238000010408 sweeping Methods 0.000 description 1
- 230000003685 thermal hair damage Effects 0.000 description 1
- 230000001052 transient effect Effects 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
- 239000002699 waste material Substances 0.000 description 1
Classifications
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- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
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- A61B17/22—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
- 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
- A61B17/22012—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 in direct contact with, or very close to, the obstruction or concrement
- A61B17/2202—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 in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter
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- 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
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- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
- A61B8/445—Details of catheter construction
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- A61B8/4483—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device characterised by features of the ultrasound transducer
- A61B8/4488—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device characterised by features of the ultrasound transducer the transducer being a phased array
-
- B—PERFORMING OPERATIONS; TRANSPORTING
- B06—GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS IN GENERAL
- B06B—METHODS OR APPARATUS FOR GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS OF INFRASONIC, SONIC, OR ULTRASONIC FREQUENCY, e.g. FOR PERFORMING MECHANICAL WORK IN GENERAL
- B06B1/00—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency
- B06B1/02—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy
- B06B1/06—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy operating with piezoelectric effect or with electrostriction
- B06B1/0607—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy operating with piezoelectric effect or with electrostriction using multiple elements
- B06B1/0622—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy operating with piezoelectric effect or with electrostriction using multiple elements on one surface
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- A61B2017/00243—Type of minimally invasive operation cardiac
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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
- A61B17/22012—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 in direct contact with, or very close to, the obstruction or concrement
- A61B17/2202—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 in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter
- A61B2017/22021—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 in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter electric leads passing through the catheter
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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
- A61B17/22012—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 in direct contact with, or very close to, the obstruction or concrement
- A61B2017/22024—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 in direct contact with, or very close to, the obstruction or concrement with a part reflecting mechanical vibrations, e.g. for focusing
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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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Abstract
Description
Claims (1)
- 【特許請求の範囲】 1.組織切除用のカテーテルシステムであって、 生体内の位置に送達するために構成された細長いカテーテル胴体であって、電 源への連結に適応したカテーテル胴体; 前記電源から電力を受け取るため、および、その受け取った電力に応じて、組 織を切除するのに充分な音波エネルギーを発生させるために構成された音波変換 器の配列;および 前記カテーテルから離れた選択位置において組織を切除するために所望の音波 エネルギーパターンを発生させるために、1つまたはそれ以上の前記変換器を他 の変換器から独立して制御する機構; を有して成り、 前記音波変換器が、前記カテーテル胴体の円周を取り囲む放射パターンに放射 する音波エネルギーを発生するようにデザインされた環状形態を有する、 カテーテルシステム。 2.前記各音波変換器が、前記環状形態を有する完全円筒である請求項1に記 載のカテーテルシステム。 3.前記各音波変換器が、半円筒であり、前記変換器が前記環状形態を有する 対になって配列される請求項1に記載のカテーテルシステム。 4.前記環状形態が、完全円筒を有して成る請求項1に記載のカテーテルシス テム。 5.前記制御機構が、前記変換器を個々に制御する請求項1に記載のカテーテ ルシステム。 6.前記配列が、複数の環状音波変換器から成る請求項1に記載のカテーテル システム。 7.前記機構が、制御器を有して成る請求項1に記載のカテーテルシステム。 8.前記機構が、前記切除変換器の1つまたはそれ以上を電源につなぐスイッ チを含む一連のスイッチを有して成る請求項1に記載のカテーテルシステム。 9.前記機構が、前記変換器を駆動する前記電力の位相を選択的に変化させる ための位相制御器を有して成る請求項1に記載のカテーテルシステム。 10.前記機構が、切除変換器を前記電源に接続する遅延線をさらに有して成 る請求項9に記載のカテーテルシステム。 11.前記機構が、前記変換器を駆動する電力の周波数を変化させる周波数制 御手段を有して成る請求項1に記載のカテーテルシステム。 12.電気的および音波的に隣接する変換器を互いに絶縁するために、音波切 除変換器の配列の隣接する変換器の間に配置される絶縁体をさらに有して成る請 求項1に記載のカテーテルシステム。 13.前記切除変換器が、前記カテーテル胴体の壁にはめ込まれている請求項 1に記載のカテーテルシステム。 14.前記変換器を冷却する冷却液の流れのための通路を与えるために、前記 変換器配列と熱連絡している内腔を有して成る請求項1に記載のカテーテルシス テム。 15.隣接する切除変換器が、約0.001〜0.12インチの距離で間隔をあ けている請求項1に記載のカテーテルシステム。 16.前記変換器が、約22°〜約122°のビーム角度を有する請求項1に 記載のカテーテルシステム。 17.前記変換器が、約1〜102dbの範囲の電力レベルにおいて音波エネ ルギーを発生するように構成された請求項1に記載のカテーテルシステム。 18.環状音波変換器の配列に対応および連結している整合層の配列をさらに 有して成る請求項1に記載のカテーテルシステム。 19.前記音波切除変換器配列に近接して配置され、前記音波切除変換器配列 によって発生される音波エネルギーを切除される組織に向けて方向付けするため に形成された音波エネルギー再方向付けデバイスをさらに有して成る請求項1に 記載のカテーテルシステム。 20.前記再方向付けデバイスが、前記配列の一部のまわりに配置される反射 シールドである請求項19に記載のカテーテルシステム。 21.カテーテル胴体をその軸のまわりに回転させるためにカテーテル胴体に 連結された回転機構をさらに有して成る請求項20に記載のカテーテルシステム 。 22.カテーテル胴体を取り囲むシースをさらに有して成り、このシースの一 部が音波透過性である請求項1に記載のカテーテルシステム。 23.カテーテル胴体が、前記変換器と熱連絡しているカテーテル内腔、およ びこのカテーテル内腔と通じている液体口を有して成り、このカテーテル胴体が 前記シース内に配置され、前記シースが、前記変換器を冷却するために、シース 内腔、液体口、およびカテーテル内腔を通過する冷却液を循環するためのシース 内腔をさらに有して成る請求項22に記載のカテーテルシステム。 24.前記カテーテル胴体が前記シース内に配置され、前記シースが、切除変 換器を冷却するために冷却液をシースおよび流出口を通過して循環させるための 、前記変換器と熱連絡している内腔、およびこの内腔と通じている流出口をさら に有して成る請求項22に記載のカテーテルシステム。 25.前記カテーテル胴体が前記シース内に配置され、前記シースが、前記カ テーテル胴体を通すことのできる末端開口部を有して成る請求項22に記載のカ テーテルシステム。 26.シースが音波透過性スタンドオフバルーンをさらに有して成る請求項2 2に記載のカテーテルシステム。 27.音波画像変換器をさらに有して成る請求項1に記載のカテーテルシステ ム。 28.高周波切除電極をさらに有して成る請求項1に記載のカテーテルシステ ム。 29.マッピング電極をさらに有して成る請求項1に記載のカテーテルシステ ム。 30.組織切除用のカテーテルシステムであって、 生体内の位置に送達するために構成された細長いカテーテル胴体であって、電 源への連結に適応したカテーテル胴体; 前記電源から電力を受け取るため、および、その受け取った電力に応じて、組 織を切除するのに充分な音波エネルギーを発生させるために構成された音波切除 デバイス; 前記カテーテル胴体内の内腔;および 前記内腔と通じている液体口; を有して成り、 前記液体口が、前記内腔と前記カテーテル胴体の外部空間との間を液体が通過 するように構成され、 前記内腔が、前記音波切除デバイスを冷却するために、前記カテーテル胴体に 対して縦方向に、および前記音波切除デバイスに近接して、液体が通過するよう に構成されている、 カテーテルシステム。 31.前記音波切除デバイスが、放射外部表面、および内部表面を有して成る 請求項30に記載のカテーテルシステム。 32.前記内腔が、前記内部表面に近接して液体を通過させる請求項31に記 載のカテーテルシステム。 33.前記音波切除デバイスが、環状音波変換器の配列を有して成る請求項3 1に記載のカテーテルシステム。 34.組織切除用のカテーテルシステムであって、 生体内の位置に送達するために構成された細長いカテーテル胴体であって、電 源への連結に適応したカテーテル胴体; 前記電源から電力を受け取るため、および、その受け取った電力に応じて、組 織を切除するのに充分な音波エネルギーを発生させるために構成された音波切除 デバイス;および 前記音波切除デバイスを切除される組織に近接して配置させるための音波透過 性スタンドオフバルーン; を有して成り、 前記バルーンを通過する音波エネルギーによって組織を切除するように前記音 波切除デバイスが配置される、 カテーテルシステム。 35.組織切除用のカテーテルシステムであって、 生体内の位置に送達するために構成された細長いカテーテル胴体であって、電 源への連結に適応したカテーテル胴体; 前記電源から電力を受け取るため、および、その受け取った電力に応じて、組 織を切除するのに充分な音波エネルギーを発生させるために構成された音波切除 デバイス;および 前記音波切除デバイスに近接して配置され、前記音波切除デバイスによって発 生する音波エネルギーを切除される組織へ向けて再方向付けするように構成され た音波エネルギー再方向付けデバイス; を有して成るカテーテルシステム。 36.前記再方向付けデバイスが、前記音波切除デバイスの一部のまわりに配 置される反射シールドである請求項35に記載のカテーテルシステム。 37.カテーテル胴体をその軸のまわりに回転させるために、カテーテル胴体 に連結された回転機構をさらに有して成る請求項35に記載のカテーテルシステ ム。 38.組織切除用のカテーテルシステムであって、 生体内の位置に送達するために構成された細長いカテーテル胴体であって、電 源への連結に適応したカテーテル胴体; 前記電源から電力を受け取るため、および、その受け取った電力に応じて、組 織を切除するのに充分な音波エネルギーを発生するために構成された音波変換器 の配列;および 前記カテーテル胴体から離れた選択位置において組織を切除するのに所望の音 波エネルギーパターンを発生させるために、1つまたはそれ以上の前記切除変換 器を選択的に制御する機構; を有して成り、前記機構が、 1つまたはそれ以上の前記変換器に、他の前記変換器から独立して電力を供給 するために形成された電力アプリケーター;および 1つまたはそれ以上の前記変換器に、他の前記変換器から独立して供給される 前記電力の位相をシフトするために形成された位相シフター; を有して成る機構であるカテーテルシステム。 39.前記変換器が環状音波変換器である請求項38に記載のカテーテルシス テム。 40.前記機構が、前記電力アプリケーターおよび前記位相シフターを制御す るために構成された制御器をさらに有して成る請求項38に記載のカテーテルシ ステム。 41.前記電力アプリケーターが、1つまたはそれ以上の前記切除変換器を電 源につなぐスイッチを含む一連のスイッチを有して成る請求項38に記載のカテ ーテルシステム。 42.前記位相シフターが、前記電力アプリケーターによって1つまたはそれ 以上の前記変換器に供給される前記電力の位相を選択的に変化させる位相制御器 を有して成る請求項38に記載のカテーテルシステム。 43.前記位相シフターが、1つまたはそれ以上の前記変換器を前記電源に接 続する遅延線をさらに有して成る請求項42に記載のカテーテルシステム。 44.前記機構が、前記電力アプリケーターによって1つまたはそれ以上の前 記変換器に供給される前記電力の周波数を変化させる周波数制御デバイスをさら に有して成る請求項38に記載のカテーテルシステム。 45.生体内の組織の選択的音波切除方法であって、 組織の音波切除のためのカテーテルシステムを準備し、このカテーテルシステ ムが、 生体内の位置に送達するために構成された細長いカテーテル胴体であって、 電源への連結に適応したカテーテル胴体、 前記電源から電力を受け取るため、および、その受け取った電力に応じて、 組織を切除するのに充分な音波エネルギーを発生させるために構成された音波変 換器の配列、および、 前記カテーテルから離れた選択位置において組織を切除するために所望の音 波エネルギーパターンを発生させるために、1つまたはそれ以上の前記変換器を 他の変換器から独立して制御する機構、を有して成り、 前記音波変換器が、前記カテーテル胴体の円周を取り囲む放射パターンに放 射する音波エネルギーを発生するようにデザインされた環状形態を有する、 カテーテルシステムであり; 変換器配列が切除される組織に近接して配置されるようにして前記カテーテル 胴体を前記生体内に挿入し; 前記カテーテル胴体から離れた選択位置において組織を切除するための所望の エネルギーパターンを得るために、前記切除変換器の少なくとも1つを制御する ; ことを含んで成る方法。 46.前記変換器の制御が種々の形状の切除を可能にする請求項45に記載の 方法。 47.種々の形状の切除が線状切除を包含する請求項46に記載の方法。 48.前記変換器の制御によって、カテーテル胴体を移動させずに組織の異な る個々の部分を切除する請求項45に記載の方法。 49.制御が、切除変換器に選択的に電力を供給することを含んで成る請求項 45に記載の方法。 50.制御が、切除変換器に供給される電力の位相を制御することをさらに含 んで成る請求項45に記載の方法。 51.制御が、切除変換器に供給される電力の周波数を制御することを含んで 成る請求項45に記載の方法。 52.制御が、個々の選択組織位置に極大部を位置するように選択変換器にの み電力を供給し、周波数を選択することによって、前記配列中の選択変換器に放 射状に隣接する個々の選択組織位置を切除するように前記配列中の前記変換器を 制御することを含んで成る請求項45に記載の方法。 53.制御が、複数の変換器からの音波エネルギーが個々の選択組織領域にお ける切除を生じるような方法で、前記変換器の位相を制御することによって、前 記領域を切除するように、前記配列中の前記変換器を制御することを含んで成る 請求項45に記載の方法。 54.前記領域が、前記配列よりも短い、デバイス軸に沿った幅を有する請求 項53に記載の方法。 55.前記領域が、前記変換器配列よりも軸方向に広い請求項53に記載の方 法。 56.制御が、前記カテーテル胴体のまわりのリング状パターンにおいて組織 を切除するように、前記変換器を制御することを含んで成る請求項45に記載の 方法。 57.細動治療のために、前記生体の心房に前記カテーテル胴体を送達するこ とをさらに含んで成る請求項56に記載の方法。 58.前記カテーテルシステムが、マッピング電極を有して成り、前記方法が 、前記切除の位置を決定するために前記生体の心臓をマッピングすることをさら に含んで成る請求項45に記載の方法。 59.変換器配列を冷却するために、変換器配列と熱連絡しているカテーテル 内腔に、冷却液を流動させることをさらに含んで成る請求項45に記載の方法。 60.装着段階の前に、音波透過性部分を有するシースの中にカテーテル胴体 を挿入することをさらに含んで成る請求項45に記載の方法。 61.変換器を冷却するために、変換器と熱連絡している前記シース中のシー ス内腔に冷却液を流動させることをさらに含んで成る請求項60に記載の方法。 62.流動段階が、前記シース内腔と連絡する流出口に、冷却液を流動させる ことを含んで成る請求項61に記載の方法。 63.流動段階が、カテーテル内腔および前記シース内腔と連絡する液体口に 、冷却液を流動させることを含んで成る請求項61に記載の方法。 64.組織切除方法であって、 請求項1に記載の音波切除のためのカテーテルシステムを準備する; 変換器配列が、切除される心臓組織に近接して位置するように、画像デバイス を有するカテーテルシステムを生体の心臓内に配置する; 選択位置における組織切除のための治療エネルギーパターンを得るために前記 切除変換器の1つまたはそれ以上を制御する;および 生体からカテーテルシステムを取り除く; ことを含んで成る方法。 65.組織切除方法であって、 細長いカテーテル胴体を有するカテーテルシステムを生体内に配置し、前記カ テーテル胴体が電源への連結に適応している; 電力を受け取るように構成された音波切除デバイスに、電源からの電力を供給 する; 前記の受け取った電力に応じて、前記音波切除デバイスによって音波エネルギ ーを発生させ、前記音波エネルギーが組織を除去するのに充分である;および 前記音波切除デバイスを冷却するために、前記カテーテル胴体内の内腔および この内腔と連絡する液体口に液体を通過させ、前記液体口が、前記内腔と前記カ テーテル胴体の外部の空間との間に液体を通過させるように構成され、前記内腔 が、前記カテーテル胴体に対して縦方向に、および前記音波切除デバイスに近接 して、液体を通過させるように構成されている; ことを含んで成る方法。 66.音波エネルギーの発生が、前記音波切除デバイスの外部表面から音波エ ネルギーを放射することを含んで成る請求項65に記載の方法。 67.音波エネルギーの放射が、前記カテーテル胴体の円周を取り囲む放射パ ターンに音波エネルギーを放射することを含んで成る請求項66に記載の方法。 68.前記内腔への液体の通過が、前記音波切除デバイスの内部表面に近接し て液体を通過させる請求項65に記載の方法。 69.組織切除方法であって、 細長いカテーテル胴体を生体内に配置し、前記カテーテル胴体が電源への連結 に適応している; 前記電源から電力を受け取るように構成された音波切除デバイスに電力を供給 する; 前記の受け取った電力に応じて、前記音波切除デバイスによって音波エネルギ ーを発生させ、前記音波エネルギーが組織を除去するのに充分である;および 音波透過性スタンドオフバルーンを生体内に配置する; 前記音波切除デバイスが切除される組織に近接して配置されるように、前記カ テーテル胴体を前記バルーン内に挿入する;および 前記バルーンを通過する音波エネルギーによって、前記組織を切除する; ことを含んで成る方法。 70.組織切除方法であって、 細長いカテーテル胴体を生体内に配置し、前記カテーテル胴体が電源への連結 に適応している; 前記電源から電力を受け取るように構成された音波切除デバイスに電力を供給 する; 前記の受け取った電力に応じて、前記音波切除デバイスによって音波エネルギ ーを発生させ、前記音波エネルギーが組織を切除するのに充分である;および 前記音波切除デバイスに近接して配置された音波エネルギー再方向付けデバイ スによって、前記音波エネルギーを切除される組織に向けて再方向付けする; ことを含んで成る方法。 71.前記音波エネルギー再方向付けが、前記音波エネルギーを反射すること を含んで成る請求項70に記載の方法。 72.再方向付けが、前記カテーテル胴体をその軸のまわりに回転させること を含んで成る請求項70に記載の方法。 73.組織切除方法であって、 細長いカテーテル胴体を生体内に配置し、前記カテーテル胴体が電源への連結 に適応している; 前記電源から電力を受け取るように構成された音波変換器の配列に電力を供給 する; 前記の受け取った電力に応じて、前記音波変換器の配列によって音波エネルギ ーを発生させ、前記音波エネルギーが組織を除去するのに充分である;および 所望の音波エネルギーパターンを発生させるために、1つまたはそれ以上の前 記切除変換器を他の前記変換器から独立して選択的に制御することによって、前 記カテーテル胴体から離れた選択位置において組織を切除することであって、こ の切除は、 前記変換器の1つまたはそれ以上に、他の前記変換器から独立して前記電力 を供給すること、および 前記変換器の1つまたはそれ以上に、他の前記変換器から独立して供給され た電力の位相をシフトすること、を含んで成る切除である; ことを含んで成る方法。 74.音波エネルギーを発生させることが、前記カテーテル胴体の円周を取り 囲む放射パターンに音波エネルギーを放射させることを含んで成る請求項73に 記載の方法。 75.前記電力を供給することが、前記切除変換器の1つまたはそれ以上に対 して、前記電力をオンおよびオフにスイッチングすることを含んで成る請求項7 3に記載の方法。 76.位相をシフトすることが、前記変換器の1つまたはそれ以上に供給され る電力の位相を変化させることを含んで成る請求項73に記載の方法。 77.位相を変化させることが、前記変換器の1つまたはそれ以上に前記電力 を供給するのを遅延させることをさらに含んで成る請求項75に記載の方法。 78.組織を切除することが、前記変換器の1つまたはそれ以上に供給される 前記電力の周波数を変化させることをさらに含んで成る請求項73に記載の方法 。
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PCT/US1996/004455 WO1996029935A1 (en) | 1995-03-31 | 1996-04-01 | Acoustic ablation |
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- 1996-04-01 JP JP52974296A patent/JP3853364B2/ja not_active Expired - Fee Related
- 1996-04-01 AU AU53822/96A patent/AU5382296A/en not_active Abandoned
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JP2005324029A (ja) * | 2004-05-15 | 2005-11-24 | Irvine Biomedical Inc | 非接触組織焼灼装置及びその使用方法 |
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JP2010522578A (ja) * | 2006-11-21 | 2010-07-08 | コーニンクレッカ フィリップス エレクトロニクス エヌ ヴィ | 超音波導波路 |
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US5630837A (en) | 1997-05-20 |
EP0764004A1 (en) | 1997-03-26 |
JP3853364B2 (ja) | 2006-12-06 |
AU5382296A (en) | 1996-10-16 |
EP0764004A4 (en) | 1998-09-02 |
WO1996029935A1 (en) | 1996-10-03 |
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