RU97119603A - RADIATION THERAPY OF THE CARDIOVASCULAR SYSTEM - Google Patents

RADIATION THERAPY OF THE CARDIOVASCULAR SYSTEM

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Publication number
RU97119603A
RU97119603A RU97119603/14A RU97119603A RU97119603A RU 97119603 A RU97119603 A RU 97119603A RU 97119603/14 A RU97119603/14 A RU 97119603/14A RU 97119603 A RU97119603 A RU 97119603A RU 97119603 A RU97119603 A RU 97119603A
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RU
Russia
Prior art keywords
aforementioned
catheter
lumen
channel
elements
Prior art date
Application number
RU97119603/14A
Other languages
Russian (ru)
Other versions
RU2177350C2 (en
Inventor
Рон Уаксман
Томас Д. Уелдон
Рафейел Ф. Мелоул
Ричард А. Хилстед
Джонатан Дж. Розен
Джордж К. Бонноит
Дейвид С. Холперн
Чарлз Э. Ларсен
Иан Р. Кроккер
Original Assignee
Новосте Корпорейшн (US), Эмори Университи
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Priority claimed from US08/628,231 external-priority patent/US5899882A/en
Application filed by Новосте Корпорейшн (US), Эмори Университи filed Critical Новосте Корпорейшн (US), Эмори Университи
Publication of RU97119603A publication Critical patent/RU97119603A/en
Application granted granted Critical
Publication of RU2177350C2 publication Critical patent/RU2177350C2/en

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Claims (35)

1. Устройство для лечения пораженного участка во внутрипросветном проходе тела больного, при этом лечебные элементы транспортируются к месту лечения и обратно жидкостью, включающее: катетер, имеющий удлиненный трубчатый элемент, включающий первый, второй и третий просветы в нем, проксимальный конец и дистальный конец; передаточное устройство, имеющее проксимальный конец и дистальный конец, при этом дистальный конец передаточного устройства сообщен с вышеупомянутыми первым и вторым просветами через проксимальный конец вышеупомянутого катетера, при этом передаточное устройство содержит наружный корпус, имеющий первый и второй каналы жидкости, сообщенные с вышеупомянутыми первым и вторым просветами вышеупомянутого катетера; переключатель подачи жидкости, избирательно допускающий или не допускающий подачу жидкости в вышеупомянутые первый и второй каналы жидкости и механизм затвора, избирательно допускающий или не допускающий проход лечебного элемента к вышеупомянутому катетеру или от него, при этом вышеупомянутый механизм затвора работает только тогда, когда вышеупомянутый катетер подсоединен к вышеупомянутому передаточному устройству.1. A device for treating the affected area in the intraluminal passage of the patient’s body, while the treatment elements are transported to the treatment site and back with fluid, including: a catheter having an elongated tubular element, including the first, second and third lumens in it, the proximal end and distal end; a transmission device having a proximal end and a distal end, wherein the distal end of the transmission device is in communication with the aforementioned first and second lumens through the proximal end of the aforementioned catheter, the transmission device comprising an outer casing having a first and second fluid channels in communication with the aforementioned first and second lumens of the aforementioned catheter; a fluid supply switch that selectively allows or prevents the flow of fluid into the aforementioned first and second fluid channels and a shutter mechanism that selectively allows or prevents the passage of the treatment element to or from the aforementioned catheter, while the aforementioned shutter mechanism only works when the aforementioned catheter is connected to the aforementioned transmission device. 2. Устройство по п.1, отличающееся тем, что содержит внутренний корпус для хранения лечебных элементов, имеющий канал, который включает часть вышеупомянутого первого канала жидкости, при этом во внутреннем корпусе размещена гильза, непроницаемая для излучения, для хранения лечебных элементов. 2. The device according to claim 1, characterized in that it contains an inner case for storing medical elements, having a channel that includes part of the aforementioned first channel of liquid, while in the inner case there is a sleeve impervious to radiation for storing medical elements. 3. Устройство по п.2, отличающееся тем, что вышеупомянутое передаточное устройство содержит, по меньшей мере, одну пару волоконно-оптических передающего и принимающего элементов для подтверждения того, находятся ли лечебные элементы в вышеупомянутом внутреннем корпусе. 3. The device according to claim 2, characterized in that the aforementioned transmission device contains at least one pair of fiber optic transmitting and receiving elements to confirm whether the treatment elements are in the aforementioned inner case. 4. Устройство по п.2, отличающееся тем, что гильза изготовлена из кварца. 4. The device according to claim 2, characterized in that the sleeve is made of quartz. 5. Устройство по п.1, отличающееся тем, что по меньшей мере, один баллончик на дистальном конце вышеупомянутого катетера для центровки дистального конца вышеупомянутого катетера на месте лечения, при этом баллончик по выбору раздувается через один из вышеупомянутых просветов. 5. The device according to claim 1, characterized in that at least one balloon at the distal end of the aforementioned catheter for centering the distal end of the aforementioned catheter at the treatment site, wherein the balloon is optionally inflated through one of the aforementioned gaps. 6. Устройство по п. 5, отличающееся тем, что баллончик имеет асимметричную форму. 6. The device according to p. 5, characterized in that the can has an asymmetric shape. 7. Устройство по п. 5, отличающееся тем, что вышеупомянутый баллончик имеет форму спирали. 7. The device according to p. 5, characterized in that the aforementioned spray can has a spiral shape. 8. Устройство по п.1 или 5, отличающееся тем, что вышеупомянутый третий просвет является сквозным просветом и дистальный конец вышеупомянутого сквозного просвета имеет отверстия между внешней частью катетера в вышеупомянутым сквозным просветом, чтобы обеспечить отток крови через катетер. 8. The device according to claim 1 or 5, characterized in that the aforementioned third lumen is a through lumen and the distal end of the aforementioned through lumen has openings between the outer part of the catheter in the aforementioned through lumen to allow blood to flow through the catheter. 9. Устройство по п.1, отличающееся тем, что вышеупомянутый катетер имеет поперечное сечение наподобие листа клевера. 9. The device according to claim 1, characterized in that the aforementioned catheter has a cross-section like a clover leaf. 10. Устройство по п.1, отличающееся тем, что вышеупомянутый третий просвет проходит вдоль вышеупомянутого катетера на заранее определенную длину к дистальному концу вышеупомянутого катетера для размещения проволочной направляющей. 10. The device according to claim 1, characterized in that the aforementioned third lumen extends along the aforementioned catheter to a predetermined length to the distal end of the aforementioned catheter to accommodate the guide wire. 11. Устройство по п.1, отличающееся тем, что дистальный конец вышеупомянутого катетера имеет покрытие, непроницаемое для излучения, при этом вышеупомянутое покрытие используется для того, чтобы по выбору пропустить или заблокировать излучение, испускаемое лечебными элементами, через катетер на месте лечения. 11. The device according to claim 1, characterized in that the distal end of the aforementioned catheter has a radiation impermeable coating, the aforementioned coating being used to optionally pass or block radiation emitted by the treatment elements through the catheter at the treatment site. 12. Устройство по п. 11, отличающееся тем, что вышеупомянутый третий просвет приспособлен для размещения проволочной направляющей, при этом дистальный конец вышеупомянутого катетера имеет отверстия между внешней частью катетера и вышеупомянутым третьим просветом в нем, чтобы обеспечить отток жидкости из организма через катетер. 12. The device according to p. 11, characterized in that the aforementioned third lumen is adapted to accommodate a guide wire, while the distal end of the aforementioned catheter has openings between the outer part of the catheter and the aforementioned third lumen in it to allow fluid to escape from the body through the catheter. 13. Устройство по п.11, отличающееся тем, что катетер имеет поперечное сечение наподобие листа клевера. 13. The device according to claim 11, characterized in that the catheter has a cross-section like a clover leaf. 14. Устройство по п.12, отличающееся тем, что вышеупомянутый третий просвет проходит вдоль вышеупомянутого катетера на заранее определенную длину к дистальному концу вышеупомянутого катетера. 14. The device according to p. 12, characterized in that the aforementioned third lumen extends along the aforementioned catheter to a predetermined length to the distal end of the aforementioned catheter. 15. Дозиметрическое устройство для расположения в ряд лечебных элементов, включающее блок хранения лечебных элементов, имеющий несколько камер для хранения вышеупомянутых лечебных элементов, передаточную гильзу, оперативно подсоединенную к вышеупомянутому блоку хранения, при этом передаточная гильза имеет канал для лечебных элементов и средства для выравнивания каналов блока хранения с каналом передаточной гильзы по выбору и для перемещения отдельных лечебных элементов из блока хранения в передаточную гильзу. 15. A dosimetric device for arranging a number of medical elements, including a storage unit for medical elements, having several chambers for storing the aforementioned medical elements, a transfer sleeve operatively connected to the aforementioned storage unit, while the transfer sleeve has a channel for therapeutic elements and means for aligning the channels a storage unit with a transfer sleeve channel optionally and for moving individual treatment elements from the storage unit to the transfer sleeve. 16. Устройство для облучения места лечения во внутрипросветном проходе тела больного с использованием радиоактивных лечебных элементов, при этом радиоактивные лечебные элементы транспортируются к месту лечения и обратно жидкостью, а устройство содержит катетер, включающий удлиненный трубчатый элемент, имеющий проксимальный конец и дистальный конец, первый и второй просветы, имеющие проксимальные и дистальные концы, при этом дистальные концы вышеупомянутых первого и второго просветов замкнуты и соединены друг с другом, и просвет для размещения проволочной направляющей; унитарное передаточное устройство, подсоединенное к проксимальному концу катетера для передачи радиоактивных лечебных элементов в первый просвет катетера для доставки на место лечения и отвода обратно, включающее наружный корпус, имеющий первый канал, приспособленный для соединения с источником подачи жидкости на одном конце, второй канал, сообщающийся с резервуаром для приема жидкости, третий канал, соединенный с вышеупомянутым первым просветом катетера, и четвертый канал, соединенный с вышеупомянутым вторым просветом катетера, переключатель подачи жидкости, сообщающийся с вышеупомянутыми первым, вторым, третьим и четвертым каналами и имеющий возможность перемещения в первой позиции, в которой вышеупомянутый первый канал сообщается с вышеупомянутым третьим каналом, а вышеупомянутый второй канал сообщается с вышеупомянутым четвертым каналом для направления потока жидкости из вышеупомянутого проксимального конца в вышеупомянутый дистальный конец первого просвета и из дистального конца к проксимальному концу вышеупомянутого второго просвета для транспортировки лечебных элементов из передаточного устройства в дистальный конец вышеупомянутого первого просвета катетера, и во второй позиции, в которой вышеупомянутый первый канал сообщается с вышеупомянутым четвертым каналом и вышеупомянутый второй канал сообщается с вышеупомянутым третьим каналом для направления потока жидкости от проксимального к дистальному концу вышеупомянутого второго просвета и от дистального к проксимальному концу вышеупомянутого первого просвета для отвода лечебных элементов из первого просвета катетера в передаточное устройство, разъемный внутренний корпус для хранения радиоактивных лечебных элементов, который имеет канал, сообщающийся с вышеупомянутым третьим каналом жидкости и с вышеупомянутым первым просветом катетера, при этом разъемный корпус имеет материал, блокирующий облучение, группу радиоактивных лечебных элементов, испускающих излучение, находится в вышеупомянутом внутреннем корпусе, механизм затвора, сообщающийся с вышеупомянутым третьим каналом между вышеупомянутым разъемным внутренним корпусом и вышеупомянутым третьим просветом катетера и имеющий возможность передвигаться между первой позицией для допуска прохода радиоактивных лечебных элементов между внутренним корпусом и вышеупомянутым первым просветом катетера, и второй позицией для блокировки прохода радиоактивных лечебных элементов между вышеупомянутым внутренним корпусом и вышеупомянутым первым просветом катетера. 16. A device for irradiating the treatment site in the intraluminal passage of the patient’s body using radioactive treatment elements, while the radioactive treatment elements are transported to the treatment site and back with liquid, and the device contains a catheter comprising an elongated tubular element having a proximal end and a distal end, the first and second lumens having proximal and distal ends, while the distal ends of the aforementioned first and second lumens are closed and connected to each other, and the lumen for ra displacement of the wire guide; a unitary transmission device connected to the proximal end of the catheter for transferring the radioactive therapeutic elements into the first lumen of the catheter for delivery to the treatment site and withdrawal back, including an outer casing having a first channel adapted to be connected to a fluid supply source at one end, a second channel communicating with a reservoir for receiving fluid, a third channel connected to the aforementioned first lumen of the catheter, and a fourth channel connected to the aforementioned second lumen of the catheter, per a fluid supply switch communicating with the aforementioned first, second, third and fourth channels and having the ability to move in a first position in which the aforementioned first channel communicates with the aforementioned third channel and the aforementioned second channel communicates with the aforementioned fourth channel to direct fluid flow from the aforementioned proximal end to the aforementioned distal end of the first lumen and from the distal end to the proximal end of the aforementioned second lumen for transport and therapeutic elements from the transfer device to the distal end of the aforementioned first catheter lumen, and in a second position in which the aforementioned first channel communicates with the aforementioned fourth channel and the aforementioned second channel communicates with the aforementioned third channel to direct fluid flow from the proximal to the distal end of the aforementioned second lumen and from the distal to the proximal end of the aforementioned first lumen for the removal of medical elements from the first lumen of the catheter into the anterior full-time device, a detachable inner case for storing radioactive therapeutic elements, which has a channel communicating with the aforementioned third fluid channel and with the aforementioned first lumen of the catheter, while the detachable case has a radiation blocking material, a group of radioactive therapeutic elements emitting radiation is in the aforementioned an inner case, a shutter mechanism in communication with the aforementioned third channel between the aforementioned detachable inner case and the aforementioned third by the light of a catheter and having the ability to move between the first position for allowing the passage of radioactive therapeutic elements between the inner casing and the aforementioned first lumen of the catheter, and the second position for blocking the passage of radioactive therapeutic elements between the aforementioned internal casing and the aforementioned first catheter lumen. 17. Устройство по п.16, отличающееся тем, что содержит соединитель для прикрепления вышеупомянутого катетера к вышеупомянутому передаточному устройству, при этом вышеупомянутое устройство имеет приемное отверстие для соединителя, элемент фиксатора, имеющий рычаг упора, и сопряженная поверхность для соединителя, при этом элемент фиксатора имеет возможность движения при вставлении соединителя в вышеупомянутое приемное отверстие для соединителя между первой позицией, в которое рычаг упора препятствует движению вышеупомянутого затвора в его первую позицию, если вышеупомянутый соединитель не вошел в вышеупомянутое отверстие, и второй позицией, в которой рычаг упора не препятствует такому движению вышеупомянутого механизма затвора, когда вышеупомянутый соединитель находится в вышеупомянутом отверстии. 17. The device according to clause 16, characterized in that it contains a connector for attaching the aforementioned catheter to the aforementioned transfer device, the aforementioned device has a receiving hole for the connector, a locking element having a stop lever, and a mating surface for the connector, while the locking element has the ability to move upon insertion of the connector into the aforementioned receiving hole for the connector between the first position, in which the stop lever prevents the movement of the aforementioned shutter in its first position, if the aforementioned connector has not entered the aforementioned hole, and a second position in which the stop lever does not interfere with such movement of the aforementioned shutter mechanism when the aforementioned connector is in the aforementioned hole. 18. Устройство по п.16, отличающееся тем, что вышеупомянутое передаточное устройство имеет по меньшей мере одну пару волоконно-оптических передающего и приемного элементов для подтверждения того, что вышеупомянутые лечебные элементы находятся в вышеупомянутом внутреннем корпусе. 18. The device according to clause 16, wherein the aforementioned transmission device has at least one pair of fiber optic transmitting and receiving elements to confirm that the aforementioned treatment elements are located in the aforementioned inner case. 19. Способ по п.16, отличающееся тем, что вышеупомянутый внутренний корпус имеет часть гильзы, изготовленной из кварца. 19. The method according to clause 16, wherein the aforementioned inner case has a portion of a sleeve made of quartz. 20. Устройство по п.16, отличающееся тем, что вышеупомянутый катетер имеет по меньшей мере один баллончик на своем дистальном конце для центровки вышеупомянутого дистального конца на месте лечения, при этом вышеупомянутый баллончик раздувается через вышеупомянутый первый или второй просвет по выбору. 20. The device according to clause 16, wherein the aforementioned catheter has at least one balloon at its distal end to center the aforementioned distal end at the treatment site, while the aforementioned balloon is inflated through the aforementioned first or second lumen of choice. 21. Устройство по п.20, отличающееся тем, что содержит четвертый просвет для раздувания вышеупомянутого баллончика. 21. The device according to claim 20, characterized in that it contains a fourth lumen for inflating the aforementioned spray can. 22. Устройство по п. 16, отличающееся тем, что вышеупомянутый просвет проволочной направляющей проходит вдоль катетера на заранее определенную длину к его дистальному концу. 22. The device according to p. 16, characterized in that the aforementioned lumen of the guidewire extends along the catheter to a predetermined length to its distal end. 23. Устройство по п.16, отличающееся тем, что дистальный конец катетера имеет две разнесенные друг относительно друга маркерных полосы, непроницаемые для излучения, предназначенные для выравнивания дистального конца с местом лечения. 23. The device according to p. 16, characterized in that the distal end of the catheter has two spaced apart from each other marker strip, impervious to radiation, designed to align the distal end with the treatment site. 24. Устройство по п.19, отличающееся тем, что вышеупомянутый наружный корпус имеет прозрачный материал, который встраивается над вышеупомянутой кварцевой гильзой таким образом, чтобы вышеупомянутая кварцевая гильза была видна через наружный корпус. 24. The device according to claim 19, characterized in that the aforementioned outer case has a transparent material that is embedded above the aforementioned quartz sleeve so that the aforementioned quartz sleeve is visible through the outer case. 25. Устройство по п.23, отличающееся тем, что кварцевая гильза имеет на одной стороне белую пленку, создающую контрастирующий фон для вышеупомянутых лечебных элементов. 25. The device according to item 23, wherein the quartz sleeve has a white film on one side, creating a contrasting background for the aforementioned medical elements. 26. Устройство по п.23, отличающееся тем, что вышеупомянутый прозрачный материал включает увеличивающую линзу. 26. The device according to item 23, wherein the aforementioned transparent material includes a magnifying lens. 27. Устройство по п.16, отличающееся тем, что дистальные концы вышеупомянутых первого и второго просветов катетера соединены с помощью усиливающего соединителя с размерами, позволяющими заблокировать движение лечебных элементов. 27. The device according to clause 16, wherein the distal ends of the aforementioned first and second lumen of the catheter are connected using a reinforcing connector with dimensions that allow to block the movement of therapeutic elements. 28. Устройство по п.16, отличающееся тем, что дистальный конец катетера имеет суженый атравматический наконечник. 28. The device according to clause 16, wherein the distal end of the catheter has a narrowed atraumatic tip. 29. Устройство по п.16, отличающееся тем, что вышеупомянутый наружный корпус имеет оболочку, которая заключает в себе вышеупомянутые каналы, переключатель подачи жидкости, внутренний корпус и механизм затвора. 29. The device according to clause 16, wherein the aforementioned outer casing has a shell that encloses the aforementioned channels, a fluid supply switch, an inner casing and a shutter mechanism. 30. Устройство по п. 16, отличающееся тем, что механизм затвора прикреплен к вышеупомянутому наружному корпусу с возможностью движения и имеет первое отверстие, допускающее проход лечебных элементов, которое соединяется с вышеупомянутым третьим каналом, когда механизм затвора находится в вышеупомянутой первой позиции, и второе отверстие с размерами, допускающими проход жидкости, но блокирующими лечебные элементы, которое соединяется с вышеупомянутым третьим каналом, когда механизм затвора находится в вышеупомянутой второй позиции. 30. The device according to p. 16, characterized in that the shutter mechanism is attached to the aforementioned outer case with the possibility of movement and has a first opening that allows the passage of medical elements, which is connected to the aforementioned third channel when the shutter mechanism is in the aforementioned first position, and the second an opening with dimensions allowing fluid passage but blocking treatment elements, which is connected to the aforementioned third channel when the shutter mechanism is in the aforementioned second position. 31. Устройство по п.16, отличающееся тем, что механизм затвора содержит эластичный элемент, имеющий просвет с размерами, не допускающими проход обычных лечебных элементов, когда он не деформирован, и полый плунжер с размерами, допускающими проход лечебных элементов, при этом плунжер вставлен через просвет в эластичном элементе, когда вышеупомянутый механизм затвора находится в вышеупомянутой первой позиции, но он вытянут из просвета эластичного элемента, когда механизм затвора находится в вышеупомянутой второй позиции. 31. The device according to clause 16, wherein the shutter mechanism comprises an elastic element having a clearance with dimensions that prevent the passage of conventional medical elements when it is not deformed, and a hollow plunger with dimensions that allow the passage of medical elements, while the plunger is inserted through the lumen in the elastic member when the aforementioned shutter mechanism is in the aforementioned first position, but it is elongated from the lumen of the elastic member when the shutter mechanism is in the aforementioned second position. 32. Устройство по п.16, отличающееся тем, что механизм затвора содержит штифт, имеющий диаметр, который меньше, чем диаметр третьего канала, при этом штифт пересекает поперек вышеупомянутый третий канал, когда вышеупомянутый подвижный механизм затвора находится в вышеупомянутой второй позиции, при этом штифт выводится из вышеупомянутого третьего канала, когда механизм затвора находится в вышеупомянутой первой позиции. 32. The device according to clause 16, wherein the shutter mechanism includes a pin having a diameter that is smaller than the diameter of the third channel, while the pin crosses across the aforementioned third channel when the aforementioned movable shutter mechanism is in the aforementioned second position, wherein the pin is withdrawn from the aforementioned third channel when the shutter mechanism is in the aforementioned first position. 33. Устройство по п. 16, отличающееся тем, что вышеупомянутое передаточное устройство содержит втулку для подсоединения катетера к вышеупомянутому передаточному устройству по выбору, кнопку разъединения для отсоединения втулки от катетера и переключатель управления для перемещения механизма затвора между вышеупомянутыми первой и второй позициями, при этом переключатель управления блокирует доступ к кнопке разъединения, когда механизм затвора находится в вышеупомянутой первой позиции. 33. The device according to p. 16, characterized in that the aforementioned transfer device comprises a sleeve for connecting a catheter to the aforementioned transfer device, an disconnect button for disconnecting the sleeve from the catheter and a control switch for moving the shutter mechanism between the aforementioned first and second positions, wherein the control switch blocks access to the disconnect button when the shutter mechanism is in the aforementioned first position. 34. Устройство по п.16, отличающееся тем, что передаточное устройство содержит втулку для избирательного подсоединения катетера к передаточному устройству, разъединитель для отсоединения вышеупомянутой втулки от катетера, и переключатель управления с возможностью движения между первой и второй позициями для вышеупомянутого механизма затвора между вышеупомянутыми первой и второй позициями, и с возможностью движения к третьей позиции для приведения в действие вышеупомянутого разъединителя для отсоединения катетера. 34. The device according to clause 16, wherein the transfer device comprises a sleeve for selectively connecting the catheter to the transfer device, a disconnector for disconnecting the aforementioned sleeve from the catheter, and a control switch for moving between the first and second positions for the aforementioned shutter mechanism between the aforementioned first and the second positions, and with the possibility of movement to the third position to actuate the aforementioned disconnector to disconnect the catheter. 35. Устройство по п.16, отличающееся тем, что лечебные элементы расположены в линию, имеющую проксимальный конец и дистальный конец, при этом нерадиоактивные маркерные капсулы, непроницаемые для извлечения, расположены в линию с лечебными элементами по краям. 35. The device according to clause 16, wherein the treatment elements are arranged in a line having a proximal end and a distal end, while non-radioactive marker capsules impervious to extraction are located in a line with treatment elements at the edges.
RU97119603/14A 1996-04-04 1997-04-04 Radiation therapy for treating cardiovascular system diseases RU2177350C2 (en)

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