RU2012127341A - Катетер с регулируемой дугообразной дистальной секцией - Google Patents

Катетер с регулируемой дугообразной дистальной секцией Download PDF

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RU2012127341A
RU2012127341A RU2012127341/14A RU2012127341A RU2012127341A RU 2012127341 A RU2012127341 A RU 2012127341A RU 2012127341/14 A RU2012127341/14 A RU 2012127341/14A RU 2012127341 A RU2012127341 A RU 2012127341A RU 2012127341 A RU2012127341 A RU 2012127341A
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elongated body
shape
catheter
longitudinal axis
catheter according
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Том Аллен ДИТТЕР
Диана ГАЛАРДО
Шахрам МОАДДЕБ
Майкл Олен ЗЕРКЛ
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Байосенс Вебстер (Изрэйл), Лтд.
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/05Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
    • A61B5/053Measuring electrical impedance or conductance of a portion of the body
    • A61B5/0538Measuring electrical impedance or conductance of a portion of the body invasively, e.g. using a catheter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/24Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/25Bioelectric electrodes therefor
    • A61B5/279Bioelectric electrodes therefor specially adapted for particular uses
    • A61B5/28Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
    • A61B5/283Invasive
    • A61B5/287Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/68Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846Arrangements 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
    • A61B5/6847Arrangements 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
    • A61B5/6852Catheters
    • A61B5/6857Catheters with a distal pigtail shape
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B2017/00831Material properties
    • A61B2017/00867Material properties shape memory effect
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00029Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00214Expandable means emitting energy, e.g. by elements carried thereon
    • AHUMAN NECESSITIES
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    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
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    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
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    • A61B2018/00351Heart
    • A61B2018/00357Endocardium
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    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • A61B2018/00375Ostium, e.g. ostium of pulmonary vein or artery
    • AHUMAN NECESSITIES
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    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • AHUMAN NECESSITIES
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature
    • A61B2018/00821Temperature measured by a thermocouple
    • AHUMAN NECESSITIES
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    • A61B2018/00875Resistance or impedance
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1407Loop
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1425Needle
    • A61B2018/1432Needle curved
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1435Spiral
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1467Probes or electrodes therefor using more than two electrodes on a single probe
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2051Electromagnetic tracking systems
    • AHUMAN NECESSITIES
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
    • A61B2034/2046Tracking techniques
    • A61B2034/2063Acoustic tracking systems, e.g. using ultrasound
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, 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
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/064Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension
    • A61B2090/065Measuring instruments not otherwise provided for for measuring force, pressure or mechanical tension for measuring contact or contact pressure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2217/00General characteristics of surgical instruments
    • A61B2217/002Auxiliary appliance
    • A61B2217/007Auxiliary appliance with irrigation system
    • AHUMAN NECESSITIES
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Measuring for diagnostic purposes; Identification of persons
    • A61B5/06Devices, other than using radiation, for detecting or locating foreign bodies ; Determining position of diagnostic devices within or on the body of the patient
    • A61B5/061Determining 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
    • A61B5/062Determining 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

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Abstract

1. Катетер, содержащий:удлиненный корпус, имеющий продольную ось;дистальный узел, расположенный дистально по отношению к удлиненному корпусу, при этом дистальный узел имеет опорный элемент с эффектом запоминания формы и спиралевидную форму;по меньшей мере один орошаемый абляционный кольцевой электрод, установленный на спиралевидной форме; ирукоятку управления, расположенную проксимально по отношению к удлиненному корпусу;при этом спиралевидная форма имеет такую осевую конфигурацию, что центральная продольная ось спиралевидной формы выровнена в аксиальном направлении с продольной осью удлиненного корпуса.2. Катетер по п.1, дополнительно содержащий сжимающую проволоку, проходящую через удлиненный корпус, и дистальный узел, причем рукоятка управления включает в себя первый элемент управления, выполненный с возможностью приведения в действие сжимающей проволоки для сжатия спиралевидной формы.3. Катетер по п.1, дополнительно содержащий отклоняющую проволоку, проходящую через удлиненный корпус, причем рукоятка управления включает в себя второй элемент управления, выполненный с возможностью приведения в действие отклоняющей проволоки для отклонения части удлиненного корпуса.4. Катетер по п.1, в котором опорный элемент с эффектом запоминания формы является полым.5. Катетер по п.4, дополнительно содержащий мандрен, выполненный с возможностью введения через опорный элемент с эффектом запоминания формы, причем мандрен имеет форму, отличную от спиралевидной формы.6. Катетер по п.1, в котором орошаемый абляционный кольцевой электрод имеет по меньшей мере одно отверстие, выполненное с возможностью пропускания жи�

Claims (21)

1. Катетер, содержащий:
удлиненный корпус, имеющий продольную ось;
дистальный узел, расположенный дистально по отношению к удлиненному корпусу, при этом дистальный узел имеет опорный элемент с эффектом запоминания формы и спиралевидную форму;
по меньшей мере один орошаемый абляционный кольцевой электрод, установленный на спиралевидной форме; и
рукоятку управления, расположенную проксимально по отношению к удлиненному корпусу;
при этом спиралевидная форма имеет такую осевую конфигурацию, что центральная продольная ось спиралевидной формы выровнена в аксиальном направлении с продольной осью удлиненного корпуса.
2. Катетер по п.1, дополнительно содержащий сжимающую проволоку, проходящую через удлиненный корпус, и дистальный узел, причем рукоятка управления включает в себя первый элемент управления, выполненный с возможностью приведения в действие сжимающей проволоки для сжатия спиралевидной формы.
3. Катетер по п.1, дополнительно содержащий отклоняющую проволоку, проходящую через удлиненный корпус, причем рукоятка управления включает в себя второй элемент управления, выполненный с возможностью приведения в действие отклоняющей проволоки для отклонения части удлиненного корпуса.
4. Катетер по п.1, в котором опорный элемент с эффектом запоминания формы является полым.
5. Катетер по п.4, дополнительно содержащий мандрен, выполненный с возможностью введения через опорный элемент с эффектом запоминания формы, причем мандрен имеет форму, отличную от спиралевидной формы.
6. Катетер по п.1, в котором орошаемый абляционный кольцевой электрод имеет по меньшей мере одно отверстие, выполненное с возможностью пропускания жидкой среды из внутренней части кольцевого электрода наружу от кольцевого электрода в радиальном направлении.
7. Катетер по п.1, в котором орошаемый абляционный кольцевой электрод имеет по меньшей мере одно отверстие, выполненное с возможностью пропускания жидкой среды из внутренней части кольцевого электрода наружу от кольцевого электрода в аксиальном направлении.
8. Катетер по п.1, дополнительно содержащий по меньшей мере один кольцевой электрод, выполненный с возможностью измерения импеданса.
9. Катетер по п.1, дополнительно содержащий по меньшей мере один кольцевой электрод, выполненный с возможностью измерения потенциалов ЛВ.
10. Катетер, содержащий:
удлиненный корпус, имеющий продольную ось;
дистальный узел, расположенный дистально по отношению к удлиненному корпусу, при этом дистальный элемент имеет полый опорный элемент, определяющий первую заданную форму;
по меньшей мере один электрод, установленный на дистальном узле;
рукоятку управления, расположенную проксимально по отношению к удлиненному корпусу; и
мандрен, определяющий вторую заданную форму, причем мандрен выполнен с возможностью введения в полый опорный элемент.
11. Катетер по п.10, в котором первая заданная форма дистального узла является по существу спиралевидной.
12. Катетер по п.10, в котором первая заданная форма дистального узла является по существу серповидной.
13. Катетер по п.10, в котором первая заданная форма дистального узла имеет большую кривизну, а вторая заданная форма мандрена имеет меньшую кривизну.
14. Катетер по п.10, в котором первая заданная форма имеет осевую конфигурацию, так что центральная продольная ось первой заданной формы выровнена в аксиальном направлении с продольной осью удлиненного корпуса.
15. Катетер по п.10, в котором первая заданная форма дистального узла имеет такую конфигурацию за кромкой, что заданная форма имеет центральную продольную ось, которая параллельна, но не выровнена в аксиальном направлении с продольной осью удлиненного корпуса.
16. Катетер по п.10, в котором полый опорный элемент включает в себя полую витую трубку.
17. Катетер по п.10, в котором полый опорный элемент включает в себя трубчатый элемент со спиральной насечкой по его длине.
18. Катетер по п.17, в котором спиральная насечка имеет переплетающийся рисунок.
19. Катетер, содержащий:
удлиненный корпус, имеющий продольную ось;
дистальный узел, расположенный дистально по отношению к удлиненному корпусу, при этом дистальный элемент имеет опорный элемент с эффектом запоминания формы и по существу круглую форму;
по меньшей мере один орошаемый абляционный кольцевой электрод, установленный на по существу круглой форме; и
рукоятку управления, расположенную проксимально по отношению к удлиненному корпусу;
в котором круглая форма имеет такую конфигурацию за кромкой, что круглая форма закручивается в спираль вокруг продольной оси удлиненного корпуса.
20. Катетер по п.19, в котором круглая форма имеет внеосевую конфигурацию, при этом центральная продольная ось круглой формы смещена в осевом направлении от продольной оси удлиненного корпуса.
21. Катетер по п.19, дополнительно содержащий мандрен, имеющий форму, отличающуюся от по существу круглой формы, причем опорный элемент с эффектом запоминания формы выполнен с возможностью приема мандрена.
RU2012127341/14A 2011-06-30 2012-06-29 Катетер с регулируемой дугообразной дистальной секцией RU2542088C2 (ru)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US13/174,742 2011-06-30
US13/174,742 US9220433B2 (en) 2011-06-30 2011-06-30 Catheter with variable arcuate distal section

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RU2012127341A true RU2012127341A (ru) 2014-01-20
RU2542088C2 RU2542088C2 (ru) 2015-02-20

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US20160128771A1 (en) 2016-05-12
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