Connect public, paid and private patent data with Google Patents Public Datasets

Medical instrument positioning tool and method

Download PDF

Info

Publication number
US20030109868A1
US20030109868A1 US10301975 US30197502A US2003109868A1 US 20030109868 A1 US20030109868 A1 US 20030109868A1 US 10301975 US10301975 US 10301975 US 30197502 A US30197502 A US 30197502A US 2003109868 A1 US2003109868 A1 US 2003109868A1
Authority
US
Grant status
Application
Patent type
Prior art keywords
ablation
sheath
energy
tissue
device
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.)
Abandoned
Application number
US10301975
Inventor
Sing Chin
Dany Berube
Dinesh Mody
Nancy Norris
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Maquet Cardiovascular LLC
AFx Inc
Original Assignee
AFx Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date

Links

Images

Classifications

    • 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
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • 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
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/1815Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238Type of minimally invasive operation
    • A61B2017/00243Type of minimally invasive operation cardiac
    • 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
    • A61B2018/00315Surgical 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
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00839Bioelectrical parameters, e.g. ECG, EEG
    • 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
    • A61B2018/1407Loop

Abstract

A system and method for positioning a medical instrument at a desired biological target tissue site is provided. The system includes an elongated sheath having a deflectable distal end configured to deflect or otherwise position at least a portion of a medical instrument during a surgical procedure allowing for the placement of the deflected portion adjacent or proximate to a predetermined target tissue surface. The positioning system may be incorporated into the medical instrument. The medical instrument may be an ablation system.

Description

  • [0001]
    This application is a Continuation of U.S. patent application Ser. No.: 09/872,652, which is a Continuation-in-Part of U.S. patent application Ser. No.: 09/751,472, filed Dec. 29, 2000, each of which is incorporated herein by reference, in their entirety.
  • BACKGROUND OF THE INVENTION
  • [0002]
    1. Field of Invention
  • [0003]
    The present invention relates, generally, to ablation instrument systems that use ablative energy to ablate internal bodily tissues. More particularly, to preformed guide apparatus which cooperate with energy delivery arrangements to direct the ablative energy in selected directions along the guide apparatus.
  • [0004]
    2. Description of the Prior Art
  • [0005]
    It is well documented that atrial fibrillation, either alone or as a consequence of other cardiac disease, continues to persist as the most common cardiac arrhythmia.
  • [0006]
    According to recent estimates, more than two million people in the U.S. suffer from this common arrhythmia, roughly 0.15% to 1.0% of the population. Moreover, the prevalence of this cardiac disease increases with age, affecting nearly 8% to 17% of those over 60 years of age.
  • [0007]
    Atrial arrhythmia may be treated using several methods. Pharmacological treatment of atrial fibrillation, for example, is initially the preferred approach, first to maintain normal sinus rhythm, or secondly to decrease the ventricular response rate. Other forms of treatment include drug therapies, electrical cardioversion, and RF catheter ablation of selected areas determined by mapping. In the more recent past, other surgical procedures have been developed for atrial fibrillation, including left atrial isolation, transvenous catheter or cryosurgical ablation of His bundle, and the Corridor procedure, which have effectively eliminated irregular ventricular rhythm. However, these procedures have for the most part failed to restore normal cardiac hemodynamics, or alleviate the patient's vulnerability to thromboembolism because the atria are allowed to continue to fibrillate. Accordingly, a more effective surgical treatment was required to cure medically refractory atrial fibrillation of the Heart.
  • [0008]
    On the basis of electrophysiologic mapping of the atria and identification of macroreentrant circuits, a surgical approach was developed which effectively creates an electrical maze in the atrium (i.e., the MAZE procedure) and precludes the ability of the atria to fibrillate. Briefly, in the procedure commonly referred to as the MAZE III procedure, strategic atrial incisions are performed to prevent atrial reentry circuits and allow sinus impulses to activate the entire atrial myocardium, thereby preserving atrial transport function postoperatively. Since atrial fibrillation is characterized by the presence of multiple macroreentrant circuits that are fleeting in nature and can occur anywhere in the atria, it is prudent to interrupt all of the potential pathways for atrial macroreentrant circuits. These circuits, incidentally, have been identified by intraoperative mapping both experimentally and clinically in patients.
  • [0009]
    Generally, this procedure includes the excision of both atrial appendages, and the electrical isolation of the pulmonary veins. Further, strategically placed atrial incisions not only interrupt the conduction routes of the common reentrant circuits, but they also direct the sinus impulse from the sinoatrial node to the atrioventricular node along a specified route. In essence, the entire atrial myocardium, with the exception of the atrial appendages and the pulmonary veins, is electrically activated by providing for multiple blind alleys off the main conduction route between the sinoatrial node to the atrioventricular node. Atrial transport function is thus preserved postoperatively as generally set forth in the series of articles: Cox, Schuessler, Boineau, Canavan, Cain, Lindsay, Stone, Smith, Corr, Change, and D'Agostino, Jr., The Surgical Treatment Atrial Fibrillation (pts. 1-4), 101 THORAC CARDIOVASC SURG., 402-426, 569-592 (1991).
  • [0010]
    While this MAZE III procedure has proven effective in ablating medically refractory atrial fibrillation and associated detrimental sequelae, this operational procedure is traumatic to the patient since this is an open-heart procedure and substantial incisions are introduced into the interior chambers of the Heart. Consequently, other techniques have been developed to interrupt atrial fibrillation restore sinus rhythm. One such technique is strategic ablation of the atrial tissues through ablation catheters.
  • [0011]
    Most approved ablation catheter systems now utilize radio frequency (RF) energy as the ablating energy source. Accordingly, a variety of RF based catheters and power supplies are currently available to electrophysiologists. However, radio frequency energy has several limitations including the rapid dissipation of energy in surface tissues resulting in shallow “burns” and failure to access deeper arrhythmic tissues. Another limitation of RF ablation catheters is the risk of clot formation on the energy emitting electrodes. Such clots have an associated danger of causing potentially lethal strokes in the event that a clot is dislodged from the catheter. It is also very difficult to create continuous long lesions with RF ablation instruments.
  • [0012]
    As such, catheters which utilize other energy sources as the ablation energy source, for example in the microwave frequency range, are currently being developed. Microwave frequency energy, for example, has long been recognized as an effective energy source for heating biological tissues and has seen use in such hyperthermia applications as cancer treatment and preheating of blood prior to infusions. Accordingly, in view of the drawbacks of the traditional catheter ablation techniques, there has recently been a great deal of interest in using microwave energy as an ablation energy source. The advantage of microwave energy is that it is much easier to control and safer than direct current applications and it is capable of generating substantially larger and longer lesions than RF catheters, which greatly simplifies the actual ablation procedures. Such microwave ablation systems are described in the U.S. Pat. Nos. 4,641,649 to Walinsky; 5,246,438 to Langberg; 5,405,346 to Grundy, et al.; and 5,314,466 to Stern, et al, each of which is incorporated herein by reference.
  • [0013]
    Most of the existing microwave ablation catheters contemplate the use of longitudinally extending helical antenna coils that direct the electromagnetic energy in all radial directions that are generally perpendicular to the longitudinal axis of the catheter. Although such catheter designs work well for a number of applications, such radial output is inappropriate when the energy needs to be directed toward the tissue to ablate only.
  • [0014]
    Consequently, microwave ablation instruments have recently been developed which incorporate microwave antennas having directional reflectors. Typically, a tapered directional reflector is positioned peripherally around the microwave antenna to direct the waves toward and out of a window portion of the antenna assembly. These ablation instruments, thus, are capable of effectively transmitting electromagnetic energy in a more specific direction. For example, the electromagnetic energy may be transmitted generally perpendicular to the longitudinal axis of the catheter but constrained to a selected radial region of the antenna, or directly out the distal end of the instrument. Typical of these designs are described in the U.S. patent application Ser. Nos.: 09/178,066, filed Oct. 23, 1998; and 09/333,747, filed Jun. 14, 1999, each of which is incorporated herein by reference.
  • [0015]
    In these designs, the resonance frequency of the microwave antenna is preferably tuned assuming contact between the targeted tissue or blood and a contact region of the antenna assembly extending longitudinally adjacent to the antenna longitudinal axis. Hence, should a portion of, or substantially all of, the exposed contact region of the antenna not be in contact with the targeted tissue or blood during ablation, the resonance frequency will be adversely changed and the antenna will be untuned. As a result, the portion of the antenna not in contact with the targeted tissue or blood will radiate the electromagnetic radiation into the surrounding air. The efficiency of the energy delivery into the tissue will consequently decrease which in turn causes the penetration depth of the lesion to decrease.
  • [0016]
    This is particularly problematic when the microwave antenna is not in the blood pool, or when the tissue surfaces are substantially curvilinear, or when the targeted tissue for ablation is difficult to access, such as in the interior chambers of the Heart. Since these antenna designs are generally relatively rigid, it is often difficult to maneuver substantially all of the exposed contact region of the antenna into abutting contact against the targeted tissue. In these instances, several ablation instruments, having antennas of varying length and shape, may be necessary to complete just one series of ablations.
  • SUMMARY OF THE INVENTION
  • [0017]
    Accordingly, a system for ablating a selected portion of a contact surface of biological tissue is provided. The system is particularly suitable to ablate cardiac tissue, and includes an elongated ablation sheath having a preformed shape adapted to substantially conform a predetermined surface thereof with the contact surface of the tissue. The ablation sheath defines an ablation lumen extending therethrough along an ablation path proximate to the predetermined surface. An elongated ablative device includes a flexible ablation element which cooperate with an ablative energy source which is sufficiently strong for tissue ablation. The ablative device is formed and dimensioned for longitudinal sliding receipt through the ablation lumen of the ablation sheath for selective placement of the ablative device along the ablation path created by the ablation sheath. The ablation lumen and the ablative device cooperate to position the ablative device proximate to the ablation sheath predetermined surface for selective ablation of the selected portion.
  • [0018]
    Accordingly, the ablation sheath in its preshaped form functions as a guide device to guide the ablative device along the ablation path when the predetermined surface of the ablation sheath properly contacts the biological tissue. Further, the cooperation between the ablative device and the ablation lumen, as the ablative device is advanced through the lumen, positions the ablative device in a proper orientation to facilitate ablation of the targeted tissue during the advancement. Thus, once the ablation sheath is stationed relative the targeted contact surface, the ablative device can be easily advanced along the ablation path to generate the desired tissue ablations.
  • [0019]
    In one embodiment, the ablative device is a microwave antenna assembly which includes a flexible shield device coupled to the antenna substantially shield a surrounding area of the antenna from the electromagnetic field radially generated therefrom while permitting a majority of the field to be directed generally in a predetermined direction toward the ablation sheath predetermined surface. The microwave antenna assembly further includes a flexible insulator disposed between the shield device and the antenna. A window portion of the insulator is defined which enables transmission of the directed electromagnetic field in the predetermined direction toward the ablation sheath predetermined surface. The antenna, the shield device and the insulator are formed for manipulative bending thereof, as a unit, to one of a plurality of contact positions to generally conform the window portion to the ablation sheath predetermined surface as the insulator and antenna are advanced through the ablation lumen.
  • [0020]
    In another embodiment, to facilitate alignment of the ablative device assembly in the ablation lumen, the ablative device provides a key device which is slidably received in a mating slot portion of the ablation lumen. In still another embodiment, the system includes a guide sheath defining a guide lumen formed and dimensioned for sliding receipt of the ablation sheath therethrough. The guide sheath is pre-shaped to facilitate positioning of the ablation sheath toward the selected portion of the contact surface when the ablation sheath is advanced through guide lumen.
  • [0021]
    The ablation sheath includes a bendable shape retaining member extending longitudinally therethrough which is adapted to retain the preformed shape of the ablation sheath once positioned out of the guide lumen of the guide sheath.
  • [0022]
    The ablative energy is preferably provided by a microwave ablative device. Other suitable tissue ablation devices, however, include cryogenic, ultrasonic, laser and radiofrequency, to name a few.
  • [0023]
    In another aspect of the present invention, a method for treatment of a Heart includes forming a penetration through a muscular wall of the Heart into an interior chamber thereof; and positioning a distal end of an elongated ablation sheath through the penetration. The ablation sheath defines an ablation lumen extending along an ablation path therethrough. The method further includes contacting, or bringing close enough, a predetermined surface of the elongated ablation sheath with a first selected portion of an interior surface of the muscular wall; and passing a flexible ablative device through the ablation lumen of the ablation sheath for selective placement of the ablative device along the ablation path. Once these events have been performed, the method includes applying the ablative energy, using the ablative device and the ablation energy source, which is sufficiently strong to cause tissue ablation.
  • [0024]
    In one embodiment, the passing is performed by incrementally advancing the ablative device along a plurality of positions of the ablation path to produce a substantially continuous lesion. Before the positioning event, the method includes placing a distal end of a guide sheath through the penetration, and then positioning the distal end of the ablation sheath through the guide lumen of the guide sheath.
  • [0025]
    In still another embodiment, before the placing event, piercing the muscular wall with a piercing sheath. The piercing sheath defines a positioning passage extending therethrough. The placing the distal end of a guide sheath is performed by placing the guide sheath distal end through the positioning passage of the piercing sheath.
  • [0026]
    In yet another configuration, the positioning the distal end event includes advancing the ablation sheath toward the first selected portion of the interior surface of the muscular wall through a manipulation device extending through a second penetration into the Heart interior chamber independent from the first named penetration.
  • [0027]
    In another embodiment, a system for ablating tissue within a body of a patient is provided including an elongated rail device and an ablative device. The radial device is adapted to be positioned proximate and adjacent to a selected tissue region to be ablated within the body of the patient. The ablative device includes a receiving passage configured to slideably receive the rail device longitudinally therethrough. This enables the ablative device to be slideably positioned along the rail substantially adjacent to or in contact with the selected tissue region. The ablative device, having an energy delivery portion which is adapted to be coupled to an ablative energy source, can then be operated to ablate the selected tissue region.
  • [0028]
    In this configuration, the ablative device is adapted to directionally emit the ablative energy from the energy delivery portion. A key assembly cooperates between the ablative device and the rail member, thus, to properly align the directionally emitted ablative energy toward the tissue region to be ablated. This primarily performed by providing a rail device with a non-circular transverse cross-sectional sectional dimension. The receiving passage of the ablative device further includes a substantially similarly shaped non-circular transverse cross-section dimension to enable sliding of the ablative device in a manner continuously aligning the directionally emitted ablative energy toward the tissue region to be ablated as the ablative device advances along the rail device.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0029]
    The assembly of the present invention has other objects and features of advantage which will be more readily apparent from the following description of the best mode of carrying out the invention and the appended claims, when taken in conjunction with the accompanying drawing, in which:
  • [0030]
    [0030]FIGS. 1A and 1B are fragmentary, top perspective views, partially broken-away, of the ablation system constructed in accordance with the present invention, and illustrating advancement of a bendable directional reflective microwave antenna assembly through an ablation lumen of a ablation sheath.
  • [0031]
    FIGS. 2A-2D is series of fragmentary, side elevation views, in partial cross-section, of the Heart, and illustrating advancement of the ablation system of present invention into the left atrium for ablation of the targeted tissue.
  • [0032]
    [0032]FIG. 3 is a fragmentary, side elevation view, in partial cross-section, of the Heart showing a pattern of ablation lesions to treat atrial fibrillation.
  • [0033]
    [0033]FIGS. 4A and 4B are a series of enlarged, fragmentary, top perspective view of a pigtail ablation sheath of the ablation system of FIGS. 2C and 2D, and exemplifying the ablation sheath being advanced into one of the pulmonary vein orifices.
  • [0034]
    [0034]FIG. 5 is a front schematic view of a patient's cardiovascular system illustrating the positioning of a trans-septal piercing sheath through the septum wall of the patient's Heart.
  • [0035]
    [0035]FIG. 6 is a fragmentary, side elevation view, in partial cross-section, of another embodiment of the ablation sheath of the present invention employed for lesion formation.
  • [0036]
    [0036]FIG. 7 is a fragmentary, side elevation view, in partial cross-section, of yet another embodiment of the ablation sheath of the present invention employed for another lesion formation.
  • [0037]
    [0037]FIG. 8 is an enlarged, front elevation view, in cross-section, of the ablation system of FIG. 1 positioned through the trans-septal piercing sheath.
  • [0038]
    [0038]FIG. 9 is an enlarged, front elevation view, in cross-section, of the ablation sheath and the antenna assembly of the ablation system in FIG. 8 contacting the targeted tissue.
  • [0039]
    [0039]FIG. 10 is an enlarged, front elevation view, in cross-section, of the antenna assembly taken substantially along the plane of the line 10-10 in FIG. 9.
  • [0040]
    [0040]FIG. 11 is a diagrammatic top plan view of an alternative embodiment microwave ablation instrument system constructed in accordance with one embodiment of the present invention.
  • [0041]
    [0041]FIG. 12 is an enlarged, fragmentary, top perspective view of the ablation instrument system of FIG. 11 illustrated in a bent position to conform to a surface of the tissue to be ablated.
  • [0042]
    FIGS. 13A-13D is a series of side elevation views, in cross-section, of the ablation sheath of the present invention illustrating advancement of the ablation device incrementally through the ablation sheath to form plurality of overlapping lesions.
  • [0043]
    [0043]FIG. 14A is a fragmentary, side elevation view of a laser-type ablation device of the present invention.
  • [0044]
    [0044]FIG. 14B is a front elevation view of the laser-type energy delivery portion taken along the plane of the line 14B-14B in FIG. 14A.
  • [0045]
    [0045]FIG. 15A is a fragmentary, side elevation view of a cryogenic-type ablation device of the present invention.
  • [0046]
    [0046]FIG. 15B is a front elevation view of the cryogenic-type energy delivery portion taken along the plane of the line 15B-15B in FIG. 15A.
  • [0047]
    [0047]FIG. 16 is a fragmentary, side elevation view, in cross-section, of an ultrasonic-type ablation device of the present invention.
  • [0048]
    [0048]FIG. 17 is an enlarged, fragmentary, top perspective view of an alternative embodiment ablation sheath having an opened window portion.
  • [0049]
    [0049]FIG. 18 is a fragmentary, side elevation view of an alternative embodiment ablation assembly employing a rail system.
  • [0050]
    [0050]FIG. 19 is a front elevation view of the energy delivery portion of the ablation rail system taken along the plane of the line 19-19 in FIG. 18.
  • [0051]
    FIGS. 20A-20C are cross-sectional views of alternative key systems in accordance with the present invention.
  • [0052]
    [0052]FIG. 21 is a fragmentary, diagrammatic, front elevation view of a torso applying one embodiment of the present invention through a minimally invasive technique.
  • [0053]
    [0053]FIG. 22 is a top plan view, in cross-section of the fragmentary, diagrammatic, top plan view of the torso of FIG. 21 applying the minimally invasive technique.
  • [0054]
    FIGS. 23A-B are side elevation views of a positioning tool used in accordance with the present invention.
  • [0055]
    [0055]FIG. 23C is an end elevation view of a positioning tool used in accordance with the present invention.
  • [0056]
    [0056]FIG. 23D is an end elevation view of an alternative embodiment of a positioning tool used in accordance with the present invention.
  • [0057]
    [0057]FIG. 23E is a side elevation view of an alternative embodiment of a positioning tool used in accordance with the present invention.
  • [0058]
    [0058]FIG. 24 is a side view of another alternative embodiment of a positioning tool used in accordance with the present invention.
  • DETAILED DESCRIPTION OF THE INVENTION
  • [0059]
    While the present invention will be described with reference to a few specific embodiments, the description is illustrative of the invention and is not to be construed as limiting the invention. Various modifications to the present invention can be made to the preferred embodiments by those skilled in the art without departing from the true spirit and scope of the invention as defined by the appended claims. It will be noted here that for a better understanding, like components are designated by like reference numerals throughout the various Figures.
  • [0060]
    Turning generally now to FIGS. 1A-2D, an ablation system, generally designated 20, is provided for transmurally ablating a targeted tissue 21 of biological tissue. The system 20 is particularly suitable to ablate the epicardial or endocardial tissue 40 of the heart, and more particularly, to treat medically refractory atrial fibrillation of the Heart. The ablation system 20 for ablating tissue within a body of a patient includes an elongated flexible tubular member 22 having at least one lumen 25 (FIGS. 1A, 1B, 8 and 9) and including a pre-shaped distal end portion (E.g., FIGS. 2C, 6 and 7) which is shaped to be positioned adjacent to or in contact with a selected tissue region 21 within the body of the patient. An ablative device, generally designated 26, is configured to be slidably received longitudinally within the at least one lumen 25, and includes an energy delivery portion 27 located near a distal end portion of the ablative device 26 which is adapted to be coupled to an ablative energy source (not shown).
  • [0061]
    The ablative device is preferably provided by a microwave ablation device 26 formed to emit microwave energy sufficient to cause tissue ablation. As will be described in greater detail below, however, the ablative device energy may be provided by a laser ablation device, a Radio Frequency (RF) ablation device, an ultrasound ablation device or a cryoablation device.
  • [0062]
    The tubular member 22 is in the form of an elongated ablation sheath having, in a preferred embodiment, a resiliently preformed shape adapted to substantially conform a predetermined contact surface 23 of the sheath with the targeted tissue region 21. In another embodiment, the ablation sheath is malleable. Yet, in another embodiment, the ablation sheath is flexible. The lumen 25 of the tubular member extends therethrough along an ablation path proximate to the predetermined contact surface. Preferably, as will be described in more detail below, the ablative device 26 includes a flexible energy delivery portion 27 selectively generating an electromagnetic field which is sufficiently strong for tissue ablation. The energy delivery portion 27 is formed and dimensioned for longitudinal sliding receipt through the ablation lumen 25 of the ablation sheath 22 for selective placement of the energy delivery portion along the ablation path. The ablation lumen 25 and the ablative device 26 cooperate to position the energy delivery portion 27 proximate to the ablation sheath 22 predetermined contact surface 23 of the sheath for selective transmural ablation of the targeted tissue 21 within the electromagnetic field when the contact surface 23 strategically contacts or is positioned close enough to the targeted tissue 21.
  • [0063]
    Accordingly, in one preferred embodiment, the pre-shaped ablation sheath 22 functions to unidirectionally guide or position the energy delivery portion 27 of the ablative device 26 properly along the predetermined ablation path 28 proximate to the targeted tissue region 21 as the energy delivery portion 27 is advanced through the ablation lumen 25. By positioning the energy delivery portion 27, which is preferably adapted to emit a directional ablation field, at one of a plurality of positions incrementally along the ablation path (FIGS. 1A and 1B) in the lumen 25, a single continuous or plurality of spaced-apart lesions can be formed. In other instances, the antenna length may be sufficient to extend along the entire ablation path 28 so that only a single ablation sequence is necessary.
  • [0064]
    While the method and apparatus of the present invention are applicable to ablate any biological tissue which requires the formation of controlled lesions (as will be described in greater detail below), this ablation system is particularly suitable for ablating endocardial or epicardial tissue of the Heart. For example, the present invention may be applied in an intra-coronary configuration where the ablation procedure is performed on the endocardium of any cardiac chamber. Specifically, such ablations may be performed on the isthmus to address atrial flutter, or around the pulmonary vein ostium, electrically isolating the pulmonary veins, to treat medically refractory atrial fibrillation (FIG. 3). This procedure requires the precise formation of strategically placed endocardial lesions 30-36 which collectively isolate the targeted regions. By way of example, any of the pulmonary veins may be collectively isolated to treat chronic atrial fibrillation. The annular lesion isolating one or more than one pulmonary vein can be linked with another linear lesion joining the mitral valve annulus. In another example, the annular lesion isolating one or more than one pulmonary vein can be linked with another linear lesion joining the left atrium appendage.
  • [0065]
    In a preferred embodiment, the pre-shaped ablation sheath 22 and the sliding ablative device 26 may applied to ablate the epicardial tissue 39 of the Heart 40 as well (FIG. 12). An annular ablation, for instance, may be formed around the pulmonary vein for electrical isolation from the left atrium. As another example, the lesions may be created along the transverse sinus and oblique sinus as part of the collective ablation pattern to treat atrial fibrillation for example.
  • [0066]
    The application of the present invention, moreover, is preferably performed through minimally invasive techniques. It will be appreciated, however, that the present invention may be applied through open chest techniques as well.
  • [0067]
    Briefly, to illustrate the operation of the present invention, a flexible pre-shaped tubular member (i.e., ablation sheath 22) in the form of a pigtail is shown in FIGS. 2C and 2d which is specifically configured to electrically isolate a pulmonary vein of the Heart 40. The isolating lesions are preferably made on the posterior wall of the left atrium, around the ostium of one, or more than one of a pulmonary vein.
  • [0068]
    In this example and as illustrated in FIGS. 4A and 4B, a distal end of the pigtail-shaped ablation sheath or tubular member 22 is positioned into the left superior pulmonary vein orifice 37 from the left atrium 41. As the ablation sheath 22 is further advanced, a predetermined contact surface 23 of the ablation sheath is urged adjacent to or into contact with the endocardial surface of the targeted tissue region 21 (FIGS. 2D and 4B). Once the ablation sheath 22 is properly positioned and oriented, the ablative device 26 is advanced through the ablation lumen 25 of the ablation sheath 22 (FIGS. 1A and 1B) which moves the energy delivery portion 27 of the ablative device along the ablation path. When the energy delivery portion 27 is properly oriented and positioned in the ablation lumen 25, the directional ablation field may be generated to incrementally ablate (FIGS. 13A-13D) the epicardial surface of the targeted tissue 21 along the ablation path to isolate the Left Superior Pulmonary Vein (LIPV)
  • [0069]
    Accordingly, as shown in FIGS. 13A-13D, as the energy delivery portion 27 is incrementally advanced through the lumen 25, overlapping lesion sections 44-44′″ are formed by the ablation field which is directional in one preferred embodiment. Collectively, a continuous lesion or series of lesions can be formed which essentially three-dimensionally “mirror” the shape of the contact surface 23 of the ablation sheath 22 which is positioned adjacent to or in contact with the targeted tissue region. These transmural lesions may thus be formed in any shape on the targeted tissue region such as rectilinear, curvilinear or circular in shape. Further, depending upon the desired ablation lines pattern, both opened and closed path formation can be constructed.
  • [0070]
    Referring now to FIGS. 2A, 2D and 5, a minimal invasive application of the present invention is illustrated for use in ablating Heart tissue. By way of example, a conventional trans-septal piercing sheath 42 is introduced into the femoral vein 43 through a venous cannula 45 (FIG. 5). The piercing sheath is then intravenously advanced into the right atrium 46 of the Heart 40 through the inferior vena cava orifice 47. These piercing sheaths are generally resiliently pre-shaped to direct a conventional piercing device 48 toward the septum wall 50. The piercing device 48 and the piercing sheath 42 are manipulatively oriented and further advanced to pierce through the septum wall 50, as a unit, of access into the left atrium 41 of the Heart 40 (FIG. 2A).
  • [0071]
    These conventional devices are commonly employed in the industry for accessing the left atrium or ventricle, and have an outer diameter in the range of about 0.16 inch to about 0.175 inch, while having an inner diameter in the range of about 0.09 inch to about 0.135 inch.
  • [0072]
    Once the piercing device 48 is withdrawn from a positioning passage 51 (FIG. 8) of the piercing sheath 42, a guide sheath 52 of the ablation system 20 is slidably advanced through the positioning passage and into a cardiac chamber such as the left atrium 41 thereof (FIG. 2B). The guide sheath 52 is essentially a pre-shaped, open-ended tubular member which is inserted into the coronary circulation to direct and guide the advancing ablation sheath 22 into a selected cardiac chamber (i.e., the left atrium, right atrium, left ventricle or right ventricle) and toward the general direction of the targeted tissue. Thus, the guide sheath 52 and the ablation sheath 22 telescopically cooperate to position the predetermined contact surface 23 thereof substantially adjacent to or in contact with the targeted tissue region.
  • [0073]
    Moreover, the guide sheath and the ablation sheath cooperate to increase the structural stability of the system as the ablation sheath is rotated and manipulated from its proximal end into ablative contact with the targeted tissue 21 (FIG. 2A). As the distal curved portions of the ablation sheath 22, which is inherently longer than the guide sheath, is advanced past the distal lumen opening of the guide sheath, these resilient curved portions will retain their original unrestrained shape.
  • [0074]
    The telescopic effect of these two sheaths is used to position the contact surface 23 of the ablation sheath 22 substantially adjacent to or in contact with the targeted tissue. Thus, depending upon the desired lesion formation, the same guide sheath 52 may be employed for several different procedures. For example, the lesion 30 encircling the left superior pulmonary vein ostium and the Left Inferior Pulmonary Vein Ostium (RIPVO) lesion 31 (FIG. 3) may be formed through the cooperation of the pigtail ablation sheath 22 and the same guide sheath 52 of FIG. 2B and 2D, while the same guide sheath may also be utilized with a different ablation sheath 22 (FIG. 4) to create the long linear lesion 34 as shown in FIG. 3.
  • [0075]
    In contrast, as illustrated in FIG. 7, another guide sheath 52 having a different pre-shaped distal end section may be applied to direct the advancing ablation sheath 22 back toward the in the left and right superior pulmonary vein orifices 53, 55. Thus, several pre-shaped guide sheaths, and the corresponding ablation sheaths, as will be described, cooperate to create a predetermined pattern of lesions (E.g., a MAZE procedure) on the tissue.
  • [0076]
    In the preferred embodiment, the guide sheath 52 is composed of a flexible material which resiliently retains its designated shape once external forces urged upon the sheath are removed. These external forces, for instance, are the restraining forces caused by the interior walls 56 of the trans-septal piercing sheath 42 as the guide sheath 52 is advanced or retracted therethrough. While the guide sheath 52 is flexible, it must be sufficiently rigid so as to substantially retain its original unrestrained shape, and not to be adversely influenced by the ablation sheath 22, as the ablation sheath is advanced through the lumen of the guide sheath. Such flexible, biocompatible materials may be composed of braided Pebax or the like having an outer diameter formed and dimensioned for sliding receipt longitudinally through the positioning passage 51 of the trans-septal piercing sheath 42. The outer dimension is therefore preferably cylindrical having an outer diameter in the range of about 0.09 inch to about 0.145 inch, and more preferably about 0.135″, while having an inner diameter in the range of about 0.05 inch to about 0.125 inch, and more preferably about 0.115″. This cylindrical dimension enables longitudinal sliding receipt, as well as axial rotation, in the positioning passage 51 to properly place and advance the guide sheath 52. Thus, the dimensional tolerance between the cylindrical-shaped, outer peripheral wall of the guide sheath 52 and the interior walls 56 of the trans-septal piercing sheath 42 should be sufficiently large to enable reciprocal movement and relative axial rotation therebetween, while being sufficiently small to substantially prevent lateral displacement therebetween as the ablation sheath 22 is urged into contact with the targeted tissue 21. For example, the dimensional tolerance between the transverse cross-sectional periphery of the interior walls 56 of the positioning passage 51 and that of the substantially conforming guide sheath 52 should be in the range of about 0.005 inches to about 0.020 inches.
  • [0077]
    To increase the structural integrity of the guide sheath 52, metallic braids 57 are preferably incorporated throughout the sheath when the guide sheath is molded to its preformed shape. These braids 57 are preferably provided by 0.002″ wires composed of 304 stainless steel evenly spaced about the sheath.
  • [0078]
    Once the guide sheath 52 is properly positioned and oriented relative the trans-septal sheath 42, the ablation sheath 22 is advanced through a guide lumen 54 (FIG. 8) of the guide sheath 52 toward the targeted tissue. Similar to the pre-shaped guide sheath 52, the ablation sheath 22 is pre-shaped in the form of the desired lesions to be formed in the endocardial surface of the targeted tissue 21. As best viewed in FIGS. 2D, 6 and 7, each ablation sheath 52 is adapted facilitate an ablation in the targeted tissue 21 generally in the shape thereof. Thus, several pre-shaped ablation sheaths cooperate to form a type of steering system to position the ablation device about the targeted tissue. Collectively, a predetermined pattern of linear and curvilinear lesions (E.g., a MAZE procedure) can be ablated on the targeted tissue region.
  • [0079]
    Again, similar to the guide sheath 52, the ablation sheath 22 is composed of a flexible material which resiliently retains its designated shape once external forces urged upon the sheath are removed. These external forces, for instance, are the restraining forces caused by the interior walls 59 defining the guide lumen 54 of the guide sheath 52 as the ablation sheath 22 is advanced or retracted therethrough. Such flexible, biocompatible materials may be composed of Pebax or the like having an outer diameter formed and dimensioned for sliding receipt longitudinally through the guide lumen 54 of the ablation sheath 22. As mentioned, the inner diameter of the guide lumen 54 is preferably in the range of about 0.050 inch to about 0.125 inch, and more preferably about 0.115″, while the ablation sheath 26 has an outer diameter in the range of about 0.40 inch to about 0.115 inch, and more preferably about 0.105″.
  • [0080]
    The concentric cylindrical dimensions enable longitudinal sliding receipt, as well as axial rotation, of the ablation sheath 22 in the guide lumen 54 to properly place and advance the it toward the targeted tissue 21. Thus, the dimensional tolerance between the cylindrical-shaped, outer peripheral wall of the ablation sheath 22 and the interior walls 59 of the guide lumen 54 of the guide sheath 52 should be sufficiently large to enable reciprocal movement and relative axial rotation therebetween, while being sufficiently small to substantially prevent lateral displacement therebetween as the ablation sheath 22 is urged into contact with the targeted tissue 21. For example, the dimensional tolerance between the transverse cross-sectional periphery of the guide lumen 54 and that of the substantially conforming energy delivery portion 27 should be in the range of about 0.001 inches to about 0.005 inches.
  • [0081]
    As above-indicated, the pre-shaped ablation sheath 22 facilitates guidance of the ablative device 26 along the predetermined ablation path 28. This is primarily performed by advancing the energy delivery portion 27 of the ablative device 26 through the ablation lumen 25 of the ablation sheath 22 which is preferably off-set from the longitudinal axis 78 thereof. As best viewed in FIGS. 8 and 9, this off-set positions the energy delivery portion 27 relatively closer to the predetermined contact surface 23 of the ablation sheath 22, and hence the targeted tissue 21. Moreover, when using directional fields such as those emitted from their energy delivery portion 27, it is important to provide a mechanism for continuously aligning the directional field of the energy delivery portion 27 with the tissue 21 targeted for ablation. Thus, in this design, the directional field must be continuously aligned with the predetermined contact surface 23 of the ablation sheath 22 as the energy delivery portion 27 is advanced through the ablation lumen 25 since the ablation sheath contact surface 23 is designated to contact or be close enough to the targeted tissue.
  • [0082]
    If the directional field is not aligned correctly, for example, the energy may be transmitted into surrounding fluids and tissues designated for preservation rather than into the targeted tissue region. Therefore, in accordance with another aspect of the present invention, a key structure 48 (FIGS. 1, 8 and 9) cooperates between the ablative device 26 and the ablation lumen 25 to orient the directive energy delivery portion 27 of the ablative device continuously toward the targeted tissue region 21 as it is advanced through the lumen. This key structure 48, thus, only allows receipt of the energy delivery portion 27 in the lumen in one orientation. More particularly, the key structure 48 continuously aligns a window portion 58 of the energy delivery portion 27 substantially adjacent the predetermined contact surface 23 of the ablation sheath 22 during advancement. This window portion 58, as will be described below, enables the transmission of the directed ablative energy from the energy delivery portion 27, through the contact surface 23 of the ablation sheath 22 and into the targeted tissue region. Consequently, the directional ablative energy emitted from the energy delivery portion will always be aligned with the contact surface 23 of the ablation sheath 22, which is positioned adjacent to or in contact with the targeted tissue region 21, to maximize ablation efficiency. By comparison, the ablation sheath 22 is capable of relatively free rotational movement axially in the guide lumen 54 of the guide sheath 52 for maneuverability and positioning of the ablation sheath therein.
  • [0083]
    As mentioned, the transverse cross-sectional dimension of the energy delivery portion 27 is configured for sliding receipt in the ablation lumen 25 of the ablation sheath 22 in a manner positioning the directional ablative energy, emitted by the energy delivery portion, continuously toward the predetermined contact surface 23 of the ablation sheath 22. In one example, as shown in FIGS. 8 and 9, the transverse peripheral dimensions of the energy delivery portion 27 and the ablation lumen 25 are generally D-shaped, and substantially similar in dimension. Thus, the window portion 58 of the insulator 61, as will be discussed, is preferably semi-cylindrical and concentric with the interior wall 62 defining the ablation lumen 25 of the ablation sheath 22. It will be appreciated, however, that any geometric configuration may be applied to ensure unitary or aligned insertion. As another example, one of the energy delivery portion and the interior wall of the ablation lumen may include a key member and corresponding receiving groove, or the like. Such key and receiving groove designs, nonetheless, should avoid relatively sharp edges to enable smooth advancement and retraction of the energy delivery portion in the ablation lumen 25.
  • [0084]
    This dimension alignment relationship can be maintain along the length of the predetermined contact surface of the ablation sheath 22 as the energy delivery portion 27 is advanced through the ablation lumen whether in the configuration of FIGS. 2, 6, 7 or 12. In this manner, a physician may determine that once the predetermined contact surface 23 of the ablation sheath 22 is properly oriented and positioned adjacent or in contact against the targeted tissue 21, the directional component (as will be discussed) of the energy delivery portion 27 will then be automatically aligned with the targeted tissue as it is advanced through the ablation lumen 25. Upon selected ablation by the ablative energy, a series of overlapping lesions 44-44′″ (FIGS. 13A-13D) or a single continuous lesion can then be generated.
  • [0085]
    It will further be appreciated that the dimensional tolerances therebetween should be sufficiently large to enable smooth relative advancement and retraction of the energy delivery portion 27 around curvilinear geometries, and further enable the passage of gas therebetween. Since the ablation lumen 25 of the ablation sheath 22 is closed ended, gases must be permitted to flow between the energy delivery portion 27 and the interior wall 62 defining the ablation lumen 25 to avoid the compression of gas during advancement of the energy delivery portion therethrough. Moreover, the tolerance must be sufficiently small to substantially prevent axial rotation of the energy delivery portion in the ablation lumen 25 for alignment purposes. The dimensional tolerance between the transverse cross-sectional periphery of the ablation lumen and that of the substantially conforming energy delivery portion 27, for instance, should be in the range of about 0.001 inches to about 0.005 inches.
  • [0086]
    To further facilitate preservation of the fluids and tissues along the backside of the ablation sheath 22 (i.e., the side opposite the contact surface 23 of the sheath), a thermal isolation component (not shown) is disposed longitudinally along, and substantially adjacent to, the ablation lumen 25. Thus, during activation of the ablative device, the isolation component and the directive component 73 of the energy ablation portion 27 cooperate to form a thermal barrier along the backside of the ablation sheath.
  • [0087]
    For instance, the isolation component may be provided by an air filled isolation lumen extending longitudinally along, and substantially adjacent to, the ablation lumen 25. The cross-sectional dimension of the isolation lumen may be C-shaped or crescent shaped to partially surround the ablation lumen 25. In another embodiment, the isolation lumen may be filled with a thermally refractory material.
  • [0088]
    In still another embodiment, a circulating fluid, which is preferably biocompatible, may be disposed in the isolation lumen to provide to increase the thermal isolation. Two or more lumens may be provided to increase fluid flow. One such biocompatible fluid providing suitable thermal properties is saline solution.
  • [0089]
    Similar to the composition of the guide sheath 52, the ablation sheath 22 is composed of a flexible bio-compatible material, such as PU Pellethane, Teflon or polyethylent, which is capable of shape retention once external forces acting on the sheath are removed. By way of example, when the distal portions of the ablation sheath 22 are advanced past the interior walls of the guide lumen 54 of the guide sheath 52, the ablation sheath 22 will return to its preformed shape in the interior of the Heart.
  • [0090]
    To facilitate shape retention, the ablation sheath 22 preferably includes a shape retaining member 63 extending longitudinally through the distal portions of the ablation sheath where shape retention is necessary. As illustrated in FIGS. 1, 8 and 9, this retaining member 63 is generally extends substantially parallel and adjacent to the ablation lumen 25 to reshape the predetermined contact surface 23 to its desired pre-shaped form once the restraining forces are removed from the sheath. While this shape-memory material must be sufficiently resilient for shape retention, it must also be sufficiently bendable to enable insertion through the guide lumen 54 of the guide sheath 52. In the preferred form, the shape retaining member is composed of a superelastic metal, such as Nitinol (NiTi). Moreover, the preferred diameter of this material should be in the range of 0.020 inches to about 0.050 inches, and more preferably about 0.035 inches.
  • [0091]
    When used during a surgical procedure, the ablation sheath 22 is preferably transparent which enables a surgeon to visualize the position of the energy delivery portion 27 of the ablative device 26 through an endoscope or the like. Moreover, the material of ablation sheath 22 must be substantially unaffected by the ablative energy emitted by the energy delivery portion 27. Thus, as will be apparent, depending upon the type of energy delivery portion and the ablative source applied, the material of the tubular sheath must exhibit selected properties, such as a low loss tangent, low water absorption or low scattering coefficient to name a few, to be unaffected by the ablative energy.
  • [0092]
    As previously indicated, the ablation sheath 22 is advanced and oriented, relative to the guide sheath 52, adjacent to or into contact with the targeted tissue region 21 to form a series of over-lapping lesions 44-44′″, such as those illustrated in FIGS. 3 and 13A-13D. Preferably, the contact surface 23 of the pre-shaped ablation sheath 22 is negotiated into physical contact with the targeted tissue 21. Such contact increases the precision of the tissue ablation while further facilitating energy transfer between the ablation element and the tissue to be ablated, as will be discussed.
  • [0093]
    To assess proper contact and positioning of the contact surface 23 of the ablation sheath 22 against the targeted tissue 21, at least one positioning electrode, generally designated 64, is disposed on the exterior surface of the ablation sheath for contact with the tissue. Preferably a plurality of electrodes are positioned along and adjacent the contact surface 23 to assess contact of the elongated and three dimensionally shaped contact surface. These electrodes 64 essentially measure whether there is any electrical activity (or electrophysiological signals) to one or the other side of the ablation sheath 22. When a strong electrical activation signal is detected, or inter-electrode impedance is measured when two or more electrodes are applied, contact with the tissue can be assessed. Once the physician has properly situated and oriented the sheath, they may commence advancement of the energy delivery portion 27 through the ablation lumen 25. Additionally, these positioning electrodes may be applied to map the biological tissue prior to or after an ablation procedure, as well as be used to monitor the patient's condition during the ablation process.
  • [0094]
    To facilitate discussion of the above aspects of the present invention, FIG. 10 illustrates two side-by-side electrodes 64, 65 configured for sensing electrical activity in substantially one direction, in accordance with one aspect of the present invention. This electrode arrangement generally includes a pair of longitudinally extending electrode elements 66, 67 that are disposed on the outer periphery of the ablation sheath 22. The pair of electrode elements 66, 67 are positioned side by side and arranged to be substantially parallel to one another. In general, splitting the electrode arrangement into a pair of distinct elements permits substantial improvements in the resolution of the detected electrophysiological signals.
  • [0095]
    Therefore, the pair of electrode elements 66, 67 are preferably spaced apart and electrically isolated from one another. It will be appreciated, however, that only one electrode may be employed to sense proper tissue contact. It will also be appreciated that ring or coiled electrodes can also be used.
  • [0096]
    The pair of electrode elements 66, 67 are further arranged to be substantially parallel to the longitudinal axis of the ablation sheath 22. In order to ensure that the electrode elements are sensing electrical activity in substantially the same direction, the space between electrodes should be sufficiently small. It is generally believed that too large space may create problems in determining the directional position of the catheter and too small a space may degrade the resolution of the detected electrophysiological signals. By way of example, the distance between the two pair of electrode elements may be between about 0.5 and 2.0 mm.
  • [0097]
    The electrode elements 66, 67 are preferably positioned substantially proximate to the predetermined contact surface 23 of the ablation sheath 22. More preferably, the electrode elements 66, 67 are positioned just distal to the distal end of the predetermined contact surface 23 since it is believed to be particularly useful to facilitate mapping and monitoring as well as to position the ablation sheath 22 in the area designated for tissue ablation. For example, during some procedures, a surgeon may need to ascertain where the distal end of the ablation sheath 22 is located in order to ablate the appropriate tissues. In another embodiment, the electrode elements 66, 67 may be positioned substantially proximate the proximal end of the predetermined contact surface 23, at a central portion of the contact surface 23 or a combination thereof. For instance, when attempting to contact the loop-shaped ablation sheath 22 employed to isolate each of left and inferior pulmonary vein orifices 37, 38, a central location of the electrodes along the looped-shape contact surface 23 may best sense contact with the targeted tissue. Moreover, while not specifically illustrated, a plurality of electrode arrangements may be disposed along the ablation sheath as well. By way of example, a first set of electrode elements may be disposed distally from the predetermined contact surface, a second set of electrode elements may be disposed proximally to the contact surface, while a third set of electrode elements may be disposed centrally thereof. These electrodes may also be used with other types of mapping electrodes, for example, a variety of suitable mapping electrode arrangements are described in detail in U.S. Pat. No. 5,788,692 to Campbell, et al., which is incorporated herein by reference in its entirety. Although only a few positions have been described, it should be understood that the electrode elements may be positioned in any suitable position along the length of the ablation sheath.
  • [0098]
    The electrode elements 66, 67 may be formed from any suitable material, such as stainless steel and iridium platinum. The width (or diameter) and the length of the electrode may vary to some extent based on the particular application of the catheter and the type of material chosen. Furthermore, in the preferred embodiment where microwave is used as the ablative energy, the electrodes are preferably dimensioned to minimize electromagnetic field interference, for example, the capturing of the microwave field produced by the antenna. In most embodiments, the electrodes are arranged to have a length that is substantially larger than the width, and are preferably between about 0.010 inches to about 0.025 inches and a length between about 0.50 inch to about 1.0 inch.
  • [0099]
    Although the electrode arrangement has been shown and described as being parallel plates that are substantially parallel to the longitudinal axis of the ablation sheath 22 and aligned longitudinally (e.g., distal and proximal ends match up), it should be noted that this is not a limitation and that the electrodes can be configured to be angled relative to the longitudinal axis of the ablation sheath 22 (or one another) or offset longitudinally. Furthermore, although the electrodes have been shown and described as a plate, it should be noted that the electrodes may be configured to be a wire or a point such as a solder blob.
  • [0100]
    Each of the electrode elements 66, 67 is electrically coupled to an associated electrode wire 68, 70 and which extend through ablation sheath 22 to at least the proximal portion of the flexible outer tubing. In most embodiments, the electrode wires 68, 70 are electrically isolated from one another to prevent degradation of the electrical signal, and are positioned on opposite sides of the retaining member 63. The connection between the electrodes 64, 65 and the electrode wires 68, 70 may be made in any suitable manner such as soldering, brazing, ultrasonic welding or adhesive bonding. In other embodiments, the longitudinal electrodes can be formed from the electrode wire itself. Forming the longitudinal electrodes from the electrode wire, or out of wire in general, is particularly advantageous because the size of wire is generally small and therefore the longitudinal electrodes elements may be positioned closer together thereby forming a smaller arrangement that takes up less space. As a result, the electrodes may be positioned almost anywhere on a catheter or surgical tool. These associated electrodes are described in greater detail in U.S. patent application Ser. No.: 09/548,331, filed Apr. 12, 2000, and entitled “ELECTRODE ARRANGE-MENT FOR USE IN A MEDICAL INSTRUMENT”, and incorporated by reference.
  • [0101]
    Referring now to FIGS. 1, 8, 9 and 11, the ablative device 26 is preferably in the form of an elongated member, which is designed for insertion into the ablation lumen 25 of the ablation sheath 22, and which in turn is designed for insertion into a vessel (such as a blood vessel) in the body of a patient. It will be understood, however, that the present invention may be in the form of a handheld instrument for use in open surgical or minimally invasive procedures (FIG. 12).
  • [0102]
    The ablative device 26 typically includes a flexible outer tubing 71 (having one or several lumens therein), a transmission line 72 that extends through the flexible tubing 71 and an energy delivery portion 27 coupled to the distal end of the transmission line 72. The flexible outer tubing 71 may be made of any suitable material such as medical grade polyolefins, fluoropolymers, or polyvinylidene fluoride. By way of example, PEBAX resins from Autochem of Germany have been used with success for the outer tubing of the body of the catheter.
  • [0103]
    In accordance with another aspect of the present invention, the ablative energy emitted by the energy delivery portion 27 of the ablative device 26 may be one of several types. Preferably, the energy delivery portion 27 includes a microwave component which generates a electromagnetic field sufficient to cause tissue ablation. As mentioned, as will be discussed in greater detail below, the ablative energy may also be derived from a laser source, a cryogenic source, an ultrasonic source or a radiofrequency source, to name a few.
  • [0104]
    Regardless of the source of the energy, a directive component cooperates with the energy source to control the direction and emission of the ablative energy. This assures that the surrounding tissues of the targeted tissue regions will be preserved. Further, the use of a directional field has several potential advantages over conventional energy delivery structure that generate uniform fields about the longitudinal axis of the energy delivery portion. For example, in the microwave application, by forming a more concentrated and directional electromagnetic field, deeper penetration of biological tissues is enabled, and the targeted tissue region may be ablated without heating as much of the surrounding tissues and/or blood. Additionally, since substantial portions the radiated ablative energy is not emitted in the air or absorbed in the blood or the surrounding tissues, less power is generally required from the power source, and less power is generally lost in the microwave transmission line.
  • [0105]
    In the preferred form, the energy delivery portion 27 of the ablative device 26 is an antenna assembly configured to directionally emit a majority of an electromagnetic field from one side thereof. The antenna assembly 27, as shown in FIGS. 9 and 11, preferably includes a flexible antenna 60, for generating the electromagnetic field, and a flexible reflector 73 as a directive component, for redirecting a portion of the electromagnetic field to one side of the antenna opposite the reflector.
  • [0106]
    Correspondingly, the resultant electromagnetic field includes components of the originally generated field, and components of the redirected electromagnetic field.
  • [0107]
    During aligned insertion of the antenna assembly 27 into the ablation lumen 25, via the key structure 48, the directional field will thus be continuously aligned toward the contact surface 23 of the ablation sheath 22 as the antenna assembly is incrementally advanced through the ablation lumen 25.
  • [0108]
    [0108]FIG. 11 illustrates that the proximal end of the antenna 60 is preferably coupled directly or indirectly to the inner conductor 75 of a coaxial transmission line 72. A direct connection between the antenna 60 and the inner conductor 75 may be made in any suitable manner such as soldering, brazing, ultrasonic welding or adhesive bonding. In other embodiments, antenna 60 can be formed from the inner conductor 75 of the transmission line 72 itself. This is typically more difficult from a manufacturing standpoint but has the advantage of forming a more rugged connection between the antenna and the inner conductor. As will be described in more detail below, in some implementations, it may be desirable to indirectly couple the antenna to the inner conductor through a passive component, such a capacitor, an inductor or a stub tuner for example, in order to provide better impedance matching between the antenna assembly and the transmission line, which is a coaxial cable in the preferred embodiment.
  • [0109]
    Briefly, the transmission line 72 is arranged for actuating and/or powering the antenna 60. Typically, in microwave devices, a coaxial transmission line is used, and therefore, the transmission line 72 includes an inner conductor 75, an outer conductor 76, and a dielectric material 77 disposed between the inner and outer conductors. In most instances, the inner conductor 75 is coupled to the antenna 60. Further, the antenna 60 and the reflector 73 are enclosed (e.g., encapsulated) in a flexible insulative material thereby forming the insulator 61, to be described in greater detail below, of the antenna assembly 27.
  • [0110]
    The power supply (not shown) includes a microwave generator which may take any conventional form. When using microwave energy for tissue ablation, the optimal frequencies are generally in the neighborhood of the optimal frequency for heating water. By way of example, frequencies in the range of approximately 800 MHz to 6 GHz work well. Currently, the frequencies that are approved by the Federal Communication Commission (FCC) for experimental clinical work includes 915 MHz and 2.45 GHz. Therefore, a power supply having the capacity to generate microwave energy at frequencies in the neighborhood of 2.45 GHz may be chosen. A conventional magnetron of the type commonly used in microwave ovens is utilized as the generator. It should be appreciated, however, that any other suitable microwave power source could be substituted in its place, and that the explained concepts may be applied at other frequencies like about 434 MHz or 5.8 GHz (ISM band).
  • [0111]
    In the preferred embodiment, the antenna assembly 27 includes a longitudinally extending antenna wire 60 that is laterally offset from the transmission line inner conductor 75 to position the antenna closer to the window portion 58 of the insulator 61 upon which the directed electric field is transmitted. The antenna 60 illustrated is preferably a longitudinally extending exposed wire that extends distally (albeit laterally offset) from the inner conductor. However it should be appreciated that a wide variety of other antenna geometries may be used as well. By way of example, helical coils, flat printed circuit antennas and other antenna geometries will work as well.
  • [0112]
    Briefly, the insulator 61 is preferably provided by a good, low-loss dielectric material which is relatively unaffected by microwave exposure, and thus capable of transmission of the electromagnetic field therethrough. Moreover, the insulator material preferably has a low water absorption so that it is not itself heated by the microwaves. Incidentally, when the emitted ablative energy is microwave in origin, the ablation sheath must also include these material properties. Finally, the insulation material must be capable of substantial flexibility without fracturing or breaking. Such materials include moldable TEFLON®, silicone, or polyethylene, polyimide, etc.
  • [0113]
    As will be appreciated by those familiar with antenna design, the field generated by the illustrated antenna will be generally consistent with the length of the antenna. That is, the length of the electromagnetic field is generally constrained to the longitudinal length of the antenna. Therefore, the length of the field may be adjusted by adjusting the length of the antenna. Accordingly, microwave ablation elements having specified ablation characteristics can be fabricated by building them with different length antennas. Additionally, it should be understood that longitudinally extending antennas are not a requirement and that other shapes and configurations may be used.
  • [0114]
    The antenna 60 is preferably formed from a conductive material. By way of example, copper or silver-plated metal work well. Further, the diameter of the antenna 60 may vary to some extent based on the particular application of the catheter and the type of material chosen. In microwave systems using a simple exposed wire type antenna, for instance, wire diameters between about 0.010 to about 0.020 inches work well. In the illustrated embodiment, the diameter of the antenna is about 0.013 inches.
  • [0115]
    In a preferred embodiment, the antenna 60 is positioned closer to the area designated for tissue ablation in order to achieve effective energy transmission between the antenna 60 and the targeted tissue 21 through the predetermined contact surface 23 of the ablation sheath 22. This is best achieved by placing the antenna 60 proximate to the outer peripheral surface of the antenna insulator 61. More specifically, a longitudinal axis of the antenna 60 is preferably off-set from, but parallel to, a longitudinal axis 78 of the inner conductor 75 in a direction away from the reflector 73 and therefore towards the concentrated electromagnetic field (FIGS. 8 and 9). By way of example, placing the antenna between about 0.010 to about 0.020 inches away from the outer peripheral surface of the antenna insulator works well. In the illustrated embodiment, the antenna is about 0.013 inches away from the outer peripheral surface of the antenna insulator 61. However, it should be noted that this is not a requirement and that the antenna position may vary according to the specific design of each catheter.
  • [0116]
    Referring now to the directive component or reflector 73, it is positioned adjacent and generally parallel to a first side of the antenna, and is configured to redirect those components of the electromagnetic field contacting the reflector back towards and out of a second side of the antenna assembly 27 opposite the reflector. A majority of the electromagnetic field, consequently, is directed out of the window portion 58 of the insulator 61 in a controlled manner during ablation.
  • [0117]
    To reduce undesirable electromagnetic coupling between the antenna and the reflector 73, the antenna 60 is preferably off-set from the reflector 73 (FIGS. 8 and 9). This off-set from the longitudinal axis 78 further positions the antenna 60 closer to the window portion 58 to facilitate ablation by positioning the antenna 60 closer to the targeted tissue region. It has been found that the minimum distance between the reflector and the antenna may be between about 0.020 to about 0.030 inches, in the described embodiment, in order to reduce the coupling. However, the distance may vary according to the specific design of each ablative device.
  • [0118]
    The proximal end of the reflector 73 is preferably coupled to the outer conductor 76 of the coaxial transmission line 72. Connecting the reflector to the outer conductor serves to better define the electromagnetic field generated during use. That is, the radiated field is better confined along the antenna, to one side, when the reflector is electrically connected to the outer conductor of,the coaxial transmission line. The connection between the reflector 73 and the outer conductor 76 may be made in any suitable manner such as soldering, brazing, ultrasonic welding or adhesive bonding. In other embodiments, the reflector can be formed from the outer conductor of the transmission line itself. This is typically more difficult from a manufacturing standpoint but has the advantage of forming a more rugged connection between the reflector and the outer conductor.
  • [0119]
    In one embodiment, to improve flexibility at the electrical connection with the outer conductor 76 and entirely along the energy delivery device, the proximal end of the reflector 73 is directly contacted against the outer conductor without applying solder or such conductive adhesive bonding. In this design, the insulator material of the insulator 61 functions as the adhesive to maintain electrical continuity. This is performed by initially molding the antenna wire in the silicone insulator. The reflector 73 is subsequently disposed on the molded silicone tube, and is extended over the outer conductor 76 of coaxial cable transmission line 72. A heat shrink tube is then applied over the assembly to firmly maintain the electrical contact between the reflector 73 and the coaxial cable outer conductor 76. In other embodiments, the reflector may be directly coupled to a ground source or be electrically floating.
  • [0120]
    As previously noted, the antenna 60 typically emits an electromagnetic field that is fairly well constrained to the length of the antenna. Therefore, in some embodiments, the distal end of the reflector 73 extends longitudinally to at about the distal end of the antenna 60 so that the reflector can effectively cooperate with the antenna. This arrangement serves to provide better control of the electromagnetic field during ablation. However, it should be noted that the actual length of the reflector may vary according to the specific design of each catheter. For example, catheters having specified ablation characteristics can be fabricated by building catheters with different length reflectors.
  • [0121]
    Furthermore, the reflector 73 is typically composed of a conductive, metallic material or foil. However, since the antenna assembly 27 must be relatively flexible in order to negotiate the curvilinear ablation lumen 25 of the ablation sheath 22 as the ablative device it is advanced therethrough, the insulator 61, the antenna wire and the reflector must collectively be relatively flexible. Thus, one particularly material suitable for such a reflector is a braided conductive mesh having a proximal end conductively mounted to the distal portion of the outer conductor of the coaxial cable. This conductive mesh is preferably thin walled to the shield assembly yet provide the appropriate microwave shielding properties, as well as enable substantial flexibility of the shield device during bending movement. For example, a suitable copper mesh wire should have a diameter in the range of about 0.005 inches to about 0.010 inches, and more preferably about 0.007 inches. A good electrical conductor is generally used for the shield assembly in order to reduce the self-heating caused by resistive losses. Such conductors includes, but are not restricted to copper, silver and gold.
  • [0122]
    Another suitable arrangement may be thin metallic foil reflector 73 which is inherently flexible. However, to further increase flexibility, the foil material can be pleated or folded which resists tearing during bending of the antenna assembly 27. These foils can be composed of copper that has a layer of silver plating formed on its inner peripheral surface. Such silver plating, which can also be applied to the metallic mesh material, is used to increase the conductivity of the reflector. It should be understood, however, that these materials are not a limitation. Furthermore, the actual thickness of the reflector may vary according to the specific material chosen.
  • [0123]
    Referring back to FIG. 11, the reflector 73 is preferably configured to have an arcuate or meniscus shape (e.g., crescent), with an arc angle that opens towards the antenna 60. Flaring the reflector towards the antenna serves to better define the electromagnetic field generated during use. Additionally, the reflector functions to isolate the antenna 60 from the restraining member 63 of the ablation sheath 22 during ablation. Since the restraining member 63 is preferably metallic in composition (most preferably Nitinol), it is desirable minimize electromagnetic coupling with the antenna. Thus, the reflector 73 is preferably configured to permit at most a 180° circumferential radiation pattern from the antenna. In fact, it has been discovered that arc angles greater than about 180° are considerably less efficient. More preferably, the arc angle of the radiation pattern is in the range of about 90° to about 120°.
  • [0124]
    While the reflector is shown and described as having an arcuate shape, it will be appreciated that a plurality of forms may be provided to accommodate different antenna shapes or to conform to other external factors necessary to complete a surgical procedure. For example, any flared shape that opens towards the antenna may work well, regardless of whether it is curvilinear or rectilinear.
  • [0125]
    Further still, it should be noted that the shape of the reflector need not be uniform.
  • [0126]
    For example, a first portion of the reflector (e.g., distal) may be configured with a first shape (e.g., 90° arc angle) and a second portion (e.g., proximal) of the reflector may be configured with a second shape (e.g., 120° arc angle). Varying the shape of the reflector in this manner may be desirable to obtain a more uniform radiated field. It is believed that the energy transfer between the antenna and the tissue to be ablated tends to increase by decreasing the coverage angle of the reflector, and conversely, the energy transfer between the antenna and the tissue to be ablated tends to decrease by increasing the coverage angle of the reflector. Accordingly, the shape of the reflector may be altered to balance out non-uniformities found in the radiated field of the antenna arrangement.
  • [0127]
    In another configuration, the directive component 73 for the microwave antenna assembly 27 can be provided by another dielectric material having a dielectric constant different than that of the insulator material 67. Indeed, a strong reflection of electromagnetic wave is observed when the wave reaches an interface created by two materials with a different dielectric constant. For example, a ceramic loaded polymer can have a dielectric constant comprised between 15 and 55, while the dielectric of a fluoropolymer like Teflon or is comprised between 2 and 3. Such an interface would create a strong reflection of the wave and act as a semi-reflector.
  • [0128]
    It should also be noted that the longitudinal length of the reflector need not be uniform. That is, a portion of the reflector may be stepped towards the antenna or a portion of the reflector may be stepped away from the antenna. Stepping the reflector in this manner may be desirable to obtain a more uniform radiated field. While not wishing to be bound by theory, it is believed that by placing the reflector closer to the antenna, a weaker radiated field may be obtained, and that by placing the reflector further away from the antenna, a stronger radiated field may be obtained. Accordingly, the longitudinal length of the reflector may be altered to balance out non uniformities found in the radiated field of the antenna arrangement. These associated reflectors are described in greater detail in U.S. patent application Ser. No.: 09/178,066, entitled “DIRECTIONAL REFLECTOR SHIELD ASSEMBLY FOR A MICROWAVE ABLATION INSTRUMENT, and Ser. No. 09/484,548 entitled “A MICROWAVE ABLATION INSTRUMENT WITH FLEXIBLE ANTENNA ASSEMBLY AND METHOD”, each of which is incorporated by reference.
  • [0129]
    In a typical microwave ablation system, it is important to match the impedance of the antenna with the impedance of the transmission line. As is well known to those skilled in the art, if the impedance is not matched, the catheter's performance tends to be well below the optimal performance. The decline in performance is most easily seen in an increase in the reflected power from the antenna toward the generator. Therefore, the components of a microwave transmission system are typically designed to provide a matched impedance. By way of example, a typical set impedance of the microwave ablation system may be on the order of fifty (50) ohms.
  • [0130]
    Referring back to FIGS. 10 and 11, and in accordance with one embodiment of the present invention, an impedance matching device 80 may be provided to facilitate impedance matching between the antenna 60 and the transmission line 72. The impedance matching device 80 is generally disposed proximate the junction between the antenna 60 and the inner conductor 75. For the most part, the impedance match is designed and calculated assuming that the antenna assembly 27, in combination with the predetermined contact surface 23 of the ablation sheath 22, is in resonance to minimize the reflected power, and thus increase the radiation efficiency of the antenna structure.
  • [0131]
    In one embodiment, the impedance matching device is determined by using a Smith Abacus Model. In the Smith Abacus Model, the impedance matching device may be ascertained by measuring the impedance of the antenna with a network analyzer, analyzing the measured value with a Smith Abacus Chart, and selecting the appropriate device. By way of example, the impedance matching device may be any combination of a capacitor, resistor, inductor, stub tuner or stub transmission line, whether in series or in parallel with the antenna. An example of the Smith Abacus Model is described in Reference: David K. Cheng, “Field and Wave Electromagnetics,” second edition, Addison-Wesley Publishing, 1989, which is incorporated herein by reference. In one preferred implementation, the impedance matching device is a serial capacitor having a capacitance in the range of about 0.6 to about 1.0 Pico Farads. In the illustration shown, the serial capacitor has a capacitance of about 0.8 Pico Farads.
  • [0132]
    As above-mentioned, the impedance will be matched assuming flush contact between the antenna assembly 27 and the ablation sheath (FIG. 9). In accordance with the present invention, as the antenna assembly 27 is advanced through the ablation lumen 25, before selective ablation, it is desirable to position the window portion 58 of the flexible antenna insulator 61 in flush contact against the interior wall 62 of the ablation lumen 25, opposite the predetermined contact surface 23. This arrangement may substantially reduce the impedance variance caused by the interface between insulator 61 and the ablation sheath 22 as the directional field is transmitted therethrough. In comparison, if the window portion 58 were not required to be positioned in flush contact against the interior wall 62 of the ablation lumen, pockets of air or fluid, or the like, may be disposed intermittently therebetween which would result in a greater degree of impedance variations at this interface. Consequently, the above-indicated impedance matching techniques would be less effective.
  • [0133]
    To assure such flush contact during selective directional ablation and advancement along the sheath ablation lumen, the ablation system 20 preferably incorporates a forcing mechanism 81 (FIGS. 8 and 9) adapted to urge the window portion 58 of the antenna assembly 27 into flush contact against the interior wall 62 of the ablation sheath. Preferably, the forcing mechanism cooperates between a support portion 82 of the interior wall 62 of the ablation lumen 25 and the forcing wall portion 83 of the antenna assembly.
  • [0134]
    When not operational, the forcing mechanism permits relative axial displacement between the ablative device 26 and the ablation sheath for repositioning of the antenna assembly 27 along the ablation path 28 (FIG. 8). Upon selective operation, the forcing mechanism 81 contacts the forcing wall portion 83 to urge window portion 58 flush against the interior wall 62 opposite the predetermined contact surface 23. Consequently, the impedance match between the antenna and the transmission line is properly achieved and stable even when the antenna is moving in the ablation sheath.
  • [0135]
    In one embodiment, the forcing mechanism may be provided by an inflatable structure acting between the support portion 82 of the interior wall 62 of the ablation lumen 25 and the forcing wall portion 83 of the antenna assembly device. Upon selective inflation of forcing mechanism 81 (FIG. 9), the window portion 58 will be urged into flush contact with the interior wall 62 of the ablation lumen.
  • [0136]
    Upon selective deflation of the forcing mechanism 81 (FIG. 8), relative axial displacement between the antenna assembly 27 and the ablation sheath may commence. The forcing mechanism can be provided by other techniques such as spring devices or the like.
  • [0137]
    In accordance with another aspect of the present invention, the ablative energy may be in the form of laser energy sufficient to ablate tissue. Example of such laser components include CO2—or Nd: YAG lasers. To transmit the beams, the transmission line 72 is preferably in the form of a fiber optic cable or the like.
  • [0138]
    In this design, as shown in FIGS. 14A and 14B, the directive component 73 may be provided by a reflector having a well polished smooth reflective or semi-reflective surface. This preferably metallic reflective surface is configured to reflect the emitted laser energy toward the targeted tissue region. By way of example, functional metallic materials include silver or platinum. In another configuration, similar to the difference in dielectric constants of the microwave ablation device 26, the directive component of the laser ablative device may be provided between two layers of dielectric materials with a sufficient difference between the refractory indexes. Here, at least one dielectric directive component layer functions like the outer dielectric layer of the fiber optic transmission line 72 to obtain “total internal reflection”. Consequently, the laser energy can be emitted away from the dielectric layer. By providing more than one dielectric layer, “total internal reflection” may be attained at several angles of incidence. Again, the reflection of the electromagnetic wave is caused by the interface between two media having different dielectric constants. Generally speaking, the higher is the difference between the dielectric constants, the more significant is the internal reflection. In addition, when more than one dielectric layer are involved, interference can be used to direct the laser energy in a preferred direction.
  • [0139]
    Moreover, when the ablative energy is laser based, it will be appreciated that it is desirable that both the ablation sheath 22 and the ablation device be composed of materials which have a low scattering coefficient and a low factor of absorption. In addition, it is also preferable to use material with low water absorption.
  • [0140]
    It will be appreciated that a plurality of designs can be used for the laser energy delivery portion. For example, the laser energy delivery portion can consist of multiple reflective particles embedded in a laser transparent material. The laser wave is propagating from the laser generator to the optic fiber transmission line and enter in the laser energy delivery portion. The embedded reflective particles diffracts the light, which is reflected toward the tissue to be ablated by the directive component 73.
  • [0141]
    In yet another alternative embodiment, cryogenic energy may be employed as an ablative energy. Briefly, as shown in FIGS. 15A and 15B, in these cryogenic ablation device designs, a cryogenic fluid, such as a pressurized gas (like Freon for example) is passed through an inflow lumen 90 in the ablation device transmission line 72. The distal ablative device 26 is preferably provided by a decompression chamber which decompresses the pressurized gas from the inflow lumen 90 therein. Upon decompression or expansion of the pressurized gas in the decompression chamber 91, the temperature of the exterior surface 92 of the decompression chamber is sufficiently reduced to cause tissue ablation upon contact thereof The decompressed gas is then exhausted through the outflow lumen 93 of the transmission line 72.
  • [0142]
    [0142]FIG. 15B illustrates that the directive component 73 is in the form of a thermal insulation layer extending longitudinally along one side of the energy delivery portion 27. By forming a good thermal insulator with a low thermal conductivity, the C-shaped insulation layer 73 will substantially minimize undesirable cryogenic ablation of the immediate tissue surrounding of the targeted tissue region. In one configuration, the isolation layer may define a thin, elongated gap 95 which partially surrounds the decompression chamber 91. This gap 95 may then be filled with air, or an inert gas, such as CO2, to facilitate thermal isolation. The isolation gap 95 may also be filled with a powder material having relatively small solid particulates or by air expended polymer. These materials would allow small air gaps between the insulative particles or polymeric matrix for additional insulation thereof. The isolation layer may also be provided by a refractory material. Such materials forming an insulative barrier include ceramics, oxides, etc.
  • [0143]
    Referring now to FIG. 16, an ultrasound ablation device may also be applied as another viable source of ablation energy. For example, a piezoelectric transducer 96 may be supplied as the ablative element which delivers acoustic waves sufficient to ablate tissue. These devices emit ablative energy which can be directed and shaped by applying a directive echogenic component to reflect the acoustic energy. Moreover, a series or array of piezoelectric transducers 96, 96′ and 96″ can be applied to collectively form a desired radiation pattern for tissue ablation. For example, by adjusting the delay between the electrical exciting signal of one transducer and its neighbor, the direction of transmission can be modified. Typical of these transducers include piezoelectric materials like quartz, barium oxides, etc.
  • [0144]
    In this configuration, the directive component 73 of the ultrasonic ablation device may be provided by an echogenic material (73-73″) positioned proximate the piezoelectric transducers. This material reflects the acoustic wave and which cooperates with the transducers to direct the ablative energy toward the targeted tissue region. By way of example, such echogenic materials are habitually hard. They include, but are not restricted to metals and ceramics for example.
  • [0145]
    Moreover, when the ablative energy is ultrasonic based, it will be appreciated that it is desirable that both the ablation sheath 22 and the ablation device be composed of materials which have low absorption of the acoustic waves, and that provide a good acoustic impedance matching between the tissue and the transducer. In that way, the thickness and the material chosen for the ablation sheath play in important role to match the acoustic properties of the tissue to be ablated and the transducer. An impedance matching jelly can also be used in the ablation sheath to improve the acoustic impedance matching.
  • [0146]
    Lastly, the ablation device may be provided by a radiofrequency (RF) ablation source which apply RF conduction current sufficient to ablate tissue. These conventional ablation instruments generally apply conduction current in the range of about 450 kHz to about 550 kHz. Typical of these RF ablation devices include ring electrodes, coiled electrodes or saline electrodes.
  • [0147]
    To selectively direct the RF energy, the directive component is preferably composed of an electrically insulative and flexible material, such as plastic or silicone. These biocompatible materials perform the function of directing the conduction current toward a predetermined direction.
  • [0148]
    In an alternative embodiment, as best viewed in FIG. 17, the window portion 58 of the ablation sheath 22 is provided by an opening in the sheath along the ablation path, as opposed to being merely transparent to the energy ablation devices. In this manner, when the ablation sheath 22 is properly positioned with the window portion placed proximate and adjacent the targeted tissue, the energy delivery portion 27 of the ablation device 26 may be slidably positioned into direct contact with the tissue for ablation thereof. Such direct contact is especially beneficial when it is technically difficult to find a sheath that is merely transparent to the used ablative energy. For example, it would be easier to use a window portion when RF energy is used. The ablative RF element could directly touch the tissue to be ablated while the directive element would be the part of the ablation sheath 22 facing away the window portion 58. Furthermore, during surgical ablation, the window portion could be used by the surgeon to indicate the area where an ablation can potentially be done with the energy ablation device.
  • [0149]
    In yet another embodiment, the ablation system 20 may be in the form of a rail system including a rail device 96 upon which the ablation device 26 slides therealong as compared to therethrough. FIGS. 18 and 19 illustrate the rail device 96 which is preferably pre-shaped or bendable to proximately conform to the surface of the targeted tissue. Once the rail device 96 is positioned, the ablation device can be advanced or retracted along the path defined by the rail device for ablation of the targeted tissue 21.
  • [0150]
    The ablation device 26 in this arrangement includes a body portion 98 housing the energy delivery portion 27 therein. The window portion 58 is preferably extend longitudinally along the outer surface of one side of the housing. An opposite side of the housing, and longitudinally oriented substantially parallel to the window portion 58 is a rail receiving passage 97 formed and dimensioned to slidably receive and slide over the rail device 96 longitudinally therethrough. In one configuration, the energy delivery portion 27 may be advanced by pushing the body portion 98 through the transmission line 72. Alternatively, the energy delivery portion 27 may be advanced by pulling the body portion 98 along the path of the rail system 20.
  • [0151]
    As best viewed in FIG. 19, the directive component 73 of the ablation device 26 is integrally formed with the body portion 98 of the ablation device. This preferably C-shaped component extends partially peripherally around the energy delivery portion 27 to shield the rail device 96 from exposure to the ablative energy. Depending upon the type of ablative energy employed, the material or structure of the directive component 73 can be constructed as set forth above.
  • [0152]
    To assure the directional position and orientation of the window portion 58 of the ablative device toward the targeted tissue, a key structure 48 is employed. Generally, the transverse cross-sectional dimension of the rail device 96 and matching rail receiving passage 97 is shaped to assure proper directional orientation of the ablative energy. Examples of such key forms are shown in FIGS. 20A-20B.
  • [0153]
    As with the previous embodiments, the open window embodiment and the rail system embodiment may employ multiple ablative element technology. These include microwave, radiofrequency, laser, ultrasound and cryogenic energy sources.
  • [0154]
    In accordance with another aspect of the present invention, the tissue ablation system further includes a temperature sensor which is applied to measure the temperature of the ablated tissue during the ablation. In one embodiment, the temperature sensor is mounted to the ablation device proximate the energy delivery portion 27 so that the sensor moves together with the energy delivery portion as it is advanced through the ablation sheath. In another embodiment, the temperature sensor is attached on the ablation sheath.
  • [0155]
    To determine the temperature of the ablated tissue, a mathematical relationship is used to calculate the tissue temperature from the measured temperature. Typical of such temperature sensors include a metallic temperature sensor, a thermocouple, a thermistor, or a non-metallic temperature sensor such as fiber optic temperature sensor.
  • [0156]
    In accordance with the present invention, the guide sheath 52 and the ablation sheath 22 can be designed and configured to steer the ablative device along any three dimensional path. Thus, the tissue ablation system of present invention may be adapted for an abundance of uses. For instance, the distal end portion of the ablation sheath can be configured to form a closed ablation path for the ablation device. This design may be employed to ablate around an ostium of an organ, or to electrically isolate one or several pulmonary veins to treat atrial fibrillation. A closed ablation path may also utilized to ablate around an aneurysm, such as a cardiac aneurysm or tumor, or any kink of tumor. In other example, the ablation sheath can be inserted in an organ in order to ablate a deep tumor or to perform any surgical treatment where a tissue ablation is required.
  • [0157]
    In other instances, the distal end portion of the ablation sheath 22 may define a rectilinear or curvilinear open ablation path for the ablation device. Such open ablation paths may be applied to ablate on the isthmus between the inferior vena cava vein (IVC) and the tricuspid valve (TV), to treat regular flutter, or to generate a lesion between the IVC and the SVC, to avoid macro-reentry circuits in the right atrium. Other similar ablation lesions can be formed between: any of the pulmonary vein ostium to treat atrial fibrillation; the mitral valve and one of the pulmonary veins to avoid macro-reentry circuit around the pulmonary veins in the left atrium; and the left appendage and one of the pulmonary veins to avoid macro-reentry circuit around the pulmonary veins in the left atrium.
  • [0158]
    The ablation apparatus may be applied through several techniques. By way of example, the ablation apparatus may be inserted into the coronary circulation to produce strategic lesions along the endocardium of the cardiac chambers (i.e., the left atrium, the right atrium, the left ventricle or the right ventricle). Alternatively, the ablation apparatus may be inserted through the chest to produce epicardial lesions on the heart. This insertion may be performed through open surgery techniques, such as by a sternotomy or a thoracotomy, or through minimally invasive techniques, applying a cannula and an endoscope to visualize the location of the ablation apparatus during a surgery.
  • [0159]
    The ablation apparatus is also suitable for open surgery applications such as ablating the exterior surfaces of an organ as well, such as the heart, brain, stomach, esophagus, intestine, uterus, liver, pancreas, spleen, kidney or prostate. The present invention may also be applied to ablate the inside wall of hollow organs, such as heart, stomach, esophagus, intestine, uterus, bladder or vagina. When the hollow organ contains bodily fluid, the penetration port formed in the organ by the ablation device must be sealed to avoid a substantial loss of this fluid. By way of example, the seal may be formed by a purse string, a biocompatible glue or by other conventional sealing devices.
  • [0160]
    As mentioned, the present invention may be applied in an intra-coronary configuration where the ablation device is used to isolate the pulmonary vein from the left atrium. FIG. 2C illustrates that a distal end of the ablation sheath 22 is adapted for insertion into the pulmonary vein. In this embodiment, the distal end of the ablation device may include at least one electrode used to assess the electrical isolation of the vein. This is performed by pacing the distal electrode to “capture” the heart. If pacing captures the heart, the vein is not yet electrically isolated, while, if the heart cannot be captured, the pulmonary vein is electrically isolated from the left atrium. As an example, a closed annular ablation on the posterior wall of the left atrium around the ostium of the pulmonary vein by applying the pigtail ablation sheath 22 of FIGS. 2 and 4.
  • [0161]
    In yet another configuration, the ablation device may include a lumen to inject a contrasting agent into the organ. For instance, the contrasting agent facilitates visualization of the pulmonary vein anatomy with a regular angiogram technique. This is important for an intra-coronary procedure since fluoroscopy is used in this technique. The premise, of course, is to visualize the shape and the distal extremity of the sheaths, as well as the proximal and distal part of the sliding energy delivery portion during an ablative procedure under fluoroscopy. It is essential for the electrophysiologist to be able to identify not only the ablative element but also the path that the ablation sheath will provide to guide the energy delivery portion 27 therealong.
  • [0162]
    Another visualization technique may be to employ a plurality of radio-opaque markers spaced-apart along the guide sheath to facilitate location and the shape thereof. By applying the radio-opaque element that will show the shape of the sheath. This element can be a metallic ring or soldering such as platinum which is biocompatible and very radio-opaque. Another example of a radio-opaque element would be the application of a radio-opaque polymer such as a beryllium loaded material. Similarly, radio-opaque markers may be disposed along the proximal, middle and distal ends of the energy delivery portion 27 to facilitate the visualization and the location of the energy delivery portion when the procedure is performed under fluoroscopy.
  • [0163]
    To facilitate identification of the distal end portion of the ablation sheath, a fluoro-opaque element may be placed at the distal extremity. Another implementation of this concept would be to have different opacities for the ablation sheath and the energy delivery portion 27. For example, the energy delivery portion may be more opaque than that of the ablation sheath, and the ablation sheath may be more opaque than the trans-septal sheath, when the later is used.
  • [0164]
    The surgical ablation device of the present invention may also be applied minimally invasively to ablate the epicardium of a beating heart through an endoscopic procedure. As viewed in FIGS. 21 and 22, at least one intercostal port 85 or access port is formed in the thorax. A dissection tool (not shown) or the like may be utilized to facilitate access to the pericardial cavity. For instance, the pericardium may be dissected to enable access to the epicardium of a beating heart. The pericardial reflections may be dissected in order to allow the positioning of the ablation device 26 around the pulmonary veins. Another dissection and positioning tool 100, described in more detail below, may also be utilized to puncture the pericardial reflection located in proximity to a pulmonary vein and assist in positioning the ablation device housed therein. After the puncture of the pericardial reflection, the ablation sheath can be positioned around one, or more than one pulmonary vein in order to produce the ablation pattern used to treat the arrhythmia, atrial fibrillation in particular.
  • [0165]
    For example, a guide sheath 52 may be inserted through the access port 85 while visualizing the insertion process with an endoscopic device 86 positioned in another access port 87. Once the guide sheath 52 is properly positioned by handle 88, the ablation sheath 22 may be inserted through the guide sheath, while again visualizing the insertion process with the endoscopic system to position the ablation sheath on the targeted tissue to ablate. The ablation device may then be slid through the ablation lumen of the ablation sheath and adjacent the targeted tissue. Similar to the previous ablation techniques, the ablative element of the ablation device may be operated and negotiated in an overlapping manner to form a gap free lesion or a plurality of independent lesions. The ablation sheath may also be malleable or flexible. The surgeon can use a surgical instrument, like a forceps, to manipulate, bend and position the ablation sheath.
  • [0166]
    With reference also made to FIGS. 23A-C, a dissection and positioning tool 100 will now be described, in accordance with the present invention. As stated above, the dissection and positioning tool 100 allows a surgeon to gain access to, and further position medical instruments, such as the ablation system described herein, at various surgical sites throughout the body, especially during minimally invasive surgical procedures on the beating heart. More specifically, tool 100 further enables a surgeon to place the ablation device of an ablation instrument, or other medical instrument, adjacent to the outer surfaces of bodily structures along a predetermined lesion path, surrounding the structure for example. For illustration purposes only, the positioning tool 100 provides better access to the pulmonary truck and, more specifically, the individual pulmonary veins, during minimally invasive procedures facilitating placement of an ablation device adjacent to one or more pulmonary veins.
  • [0167]
    As shown in FIGS. 23A and 23B, positioning tool 100 comprises a handle 102 and a guide sheath 104 having a deflectable tip 106 operably attached to the distal end of sheath 104. Guide sheath 104 and tip 106 may be made from any suitable biocompatible material, such as those materials described herein with respect to sheath 52.
  • [0168]
    As will become readily apparent, an attachment point 108 may be utilized to permit the deflection of tip 106 along at least one plane allowing the distal end of tip 106 to more readily engage specific tissue at predetermined locations throughout the patients body. Attachment point 108 may be comprised of any suitable system allowing deflection of tip 106. For illustration purposes only, attachment point 108 may be formed by a matching node/recess pair. In this example, with reference also made to FIG. 23C, the distal end of sheath 104 comprises one or more nodes 114, preferably two, protruding from the external surface of the distal end of sheath 104. In turn, tip 106 comprises on or more matching recesses 116 which accept nodes 114 providing retention and holding tip 106 in a rotatably fixed position relative to sheath 104.
  • [0169]
    Alternatively, with reference to FIG. 23D, attachment point 108 could be achieved by one or more pins or rods passing through the distal portion of sheath 104 and the proximal portion of tip 106 at attachment point 108, defining a fulcrum about which tip 106 rotates. For example, attachment point 108 may comprise two rods 120, each passing through only the sheath 104 and tip 106 material, allowing for medical instruments to pass through sheath 104 and tip 106.
  • [0170]
    The tip portion 106 is deflectable with respect to sheath 104 through activation of a deflection means (not shown) as part of tool 100. FIGS. 23A & 23B depict tip 106 in an un-deflected and a deflected position, respectively, along one plane, with the distal end of tip 106 rotating about the attachment point 108 as indicated by arrow R. The deflection means may be any suitable means including, but not limited to, systems comprising one or more pull wires, springs of various shapes and configurations, sliders, switches, or motors, alone or in combination, allowing for the deflection of tip 106 in at least one plane. For example, tip 106 can be held in an un-deflected position relative to sheath 104 by a spring as part of a deflection means located at attachment point 108. Tension force applied to the distal end of tip 106, via one or more pull cables, overcomes the spring force and results in the deflection of tip 106. As the tension force is removed, the spring force acts to return tip 106 to its un-deflected position.
  • [0171]
    With reference also to FIG. 23C, tip 106 may be U-shaped along its longitudinal axis and may further comprise a retractable sharp distal tip 112 which further aides in dissection of bodily membranes, the pericardial reflection for example. While the distal tip 106 may be used to dissect or otherwise advance through tissue, sharp tip 112 encourages and assists with such advancement. For example, sharp tip 112 may assist in the dissection of the pericardial reflection allowing a medical instrument, ablation instrument 20 for example, to be positioned around the pulmonary veins for creation of a continuous transmural lesion, as described in more detail above. As should be readily understood, the recess defined by the U-shaped tip 106 acts to deflect medical instruments to facilitate proper placement with respect to a target tissue site. It should be apparent that if tool 100 is incorporated into and part of a medical instrument, as discussed in more detail below, tip 106 may comprise at least one lumen, accepting a slidably disposed medical instrument which passes from within sheath 104 and tip 106.
  • [0172]
    Deflectable tip 206 may also comprise an illumination means (not shown) operably attached to tip 206 such that light energy emitting therefrom aides in positioning of tip 206, especially during minimally invasive procedures. For example, when the tip 206 is advanced behind and around a bodily structure, the light energy provides an indication of where tip 206 is located. The illumination means may be any suitable source of light energy including, but not limited to, light emitting diodes, incandescent light sources, or any other sources which fluoresce and are compatible with corresponding light sensing systems utilized. The illumination means may provide light energy in the visible or non-visible range.
  • [0173]
    Sharp tip 112 is slidably disposed within tip 106 such that it can be retracted to a safe position when not in use. The tip 112 may be slidably affixed within the tip 106 itself or may be slidably attached to handle 102, passing through sheath 104 in an inner lumen (not shown) protecting the sheath 104 from sharp tip 112 translating therein. The tip 112 is controlled through any suitable activation means including, but not limited to, spring activated or pull wire systems. For example, tip 112 may be operably attached to a spring which, when triggered, allows for the instantaneous advancement of sharp tip 112 out from tip 106, the sharp tip 112 engaging adjacent tissue.
  • [0174]
    Alternatively, tip 112 activation means may be incorporated within or otherwise part of the deflection means of tip 106 described above. For illustration purposes only, the deflection means may comprise a slider in the handle portion operably attached to a pull wire and the tip 112. With the slider in a first position, the tip 106 is un-deflected and the sharp tip 112 is retracted to a point at least just within the distal end of tip 106. When the slider is advanced to a second position, the tip 106 is deflected such that the longitudinal axis of tip 106 defines a predetermined angle, indicated as arrow A in FIG. 23B, with the longitudinal axis of sheath 104. Finally, with the slider advanced to a third position, while the tip 106 remains rotatably fixed relative to the sheath 104, the sharp tip 112 may protrude from the distal end of the tip 106 a predetermined distance. In this way, the tip 106 of the tool 100 can be positioned at a predetermined location prior to activation of the sharp tip 112. The predetermined angle may be selected by a second slider, for example, such that operation of the tip 106, as discussed immediately above, may be performed in one controlled movement of the first slider.
  • [0175]
    The predetermined angle about which tip 106 is rotated with respect to sheath 104 can be any value between 0° and approximately 180°, 0° being defined as the angle A formed by the longitudinal axes of tip 106 and sheath 104 when tip 106 is in an un-deflected position, as shown in FIG. 23A. Further, it should be readily understood that tip 106 and sheath 104 can be of any suitable length with respect to each other allowing for differing configurations of tool 100 enabling tip 106 to engage tissue at any predetermined tissue site within a patient's body. Additionally, as should be readily apparent, sheath 104 may be slidably attached to handle 102 allowing for the extension and retraction of sheath 104 within handle 102 resulting in greater control over the placement of tip 106.
  • [0176]
    As is shown in FIGS. 23A and 23C, tip 106 may be formed having suitable dimensions allowing for passage of various medical instruments therethrough. Tip 106 may also include different geometric surfaces, such as lobe 110, which aide to move bodily structures away from sharp tip 112 as tip 106 is advanced and further provide clearance around the bodily structures for passage of the medical instrument. For example, after piercing of the pericardial reflection between a pulmonary vein and the superior vena cava, the tip 106 may be advanced, the lobe 110 slightly displacing the pulmonary vein allowing for passage of a medical instrument, such as ablation system 20.
  • [0177]
    Turning back to FIG. 21, in operation, tool 100 can be passed through access port 87A (not shown) and advanced into the body. As discussed above, the tool 100 is manipulated to position the distal tip 106 at a predetermined location and orientation within the body to facilitate positioning of a medical instrument system, such as an ablation system, at a target tissue site. The target tissue site may comprise, for example, a circumferential portion of the external surface of a biological structure, the heart for example.
  • [0178]
    Additionally, if applicable, tool 100 is manipulated until the distal tip 106 nears or engages tissue to be dissected. At this point tip 106 is positioned at a predetermined angle with respect to sheath 104 and is proximate to the tissue. Sharp tip 112 is then advanced passed the distal end of tip 106 engaging the tissue and creating an opening therethrough. Once the opening is created, tool 100 can be retracted and the medical instrument system advanced therethrough allowing access to target tissue sites beyond the dissected tissue. The medical instrument system, for example, may be an ablation system as described herein which can be passed therethrough and further advanced along an ablation path.
  • [0179]
    As should be readily apparent, the functionality of tool 100 can be incorporated into the ablation system 20 itself For example, tip 106 may be attached to the distal end of guide sheath 52, in a manner described above. In this configuration, tip 106 would act to further deflect or otherwise direct the ablation sheath which passes therethrough such that at least a portion of the ablation element of the ablation system is deflected and positioned at a desired target tissue site. Alternatively, with reference to FIG. 24, the deflectable tip can be integral to the guide sheath itself.
  • [0180]
    [0180]FIG. 24 depicts tool 200 comprising a guide sheath 204 having at least one lumen and a deflectable tip 206, and an inner sheath 220 slidably disposed within the at least one lumen of sheath 204. Sheath 204 has at least one lumen passing therethrough and an angled needle tip 212 at its distal end. The medical instrument, ablation system 20 for example, is slidably disposed within the at least one lumen of inner sheath 220. In operation, as with tool 100, tool 200 is first advanced within a patient's body, the deflectable tip 206 being positioned adjacent a target tissue site. In this way the medical instrument can be slidably advanced through the inner sheath 220, at least a portion of the medical instrument being deflected and positioned adjacent to the target tissue site.
  • [0181]
    As with the sharp tip 112 of tool 100, inner sheath 220 can be translated within inner sheath 220 such that the distal end of needle tip 212 passes through the distal opening of deflectable tip 206, engaging and penetrating tissue to be dissected and creating an opening therethrough for at least a portion of the medical instrument to pass. The needle tip 212 of the inner sheath 220 is angled in such a way as to encourage the creation of an opening in the tissue, rather than removal of the tissue itself. As with the tool 100 embodiments above, the deflectable tip 206 may act to deflect and position the medical instrument such that at least a portion of the medical instrument is adjacent to a target tissue site.
  • [0182]
    Furthermore, it should be understood that tool 100, 200 may be utilized with any ablation system, as a separate tool or as part of the ablation system itself. For example, tool 100, 200 could be used along with or as part of the ablation instrument as described in U.S. patent application Ser. No. 09/484,548, which is incorporated herein by reference, in its entirety.
  • [0183]
    Now with reference to FIG. 23D, another embodiment of the dissection and positioning tool 100 is depicted having an alternate tip 106A. Tip 106A comprises a grasping means 118 at its distal end. Grasping means 118 allows a surgeon to grasp a surgical instrument during operative procedures enabling the surgeon to place the surgical instrument adjacent to the outer surfaces of bodily structures, surrounding the structure for example.
  • [0184]
    For illustration purposes only, the positioning tool 100 as depicted in FIG. 23D may be passed through the pericardial reflection from an inferior vena cava access point, as discussed above. Once the tip 106A passes through the pericardial reflection, the grasping means 118 would then grasp the distal tip of a medical instrument, such as the ablation system 20, and retract the instrument, further guiding and positioning the instrument adjacent to the pulmonary trunk, from the transverse sinus to the inferior pulmonary vein sinus and finally back out to the inferior vena cava access point.
  • [0185]
    More specifically, the distal end of ablation system 20, such as the ablation guide 22 for example, incorporates a grasping surface (not shown) suitable for grasping by grasping means 118. The distal tip of tool 100 is passed through the pericardial reflection as described above, and the grasping means 118 as part of the tip 106A grasps or otherwise engages and holds onto the grasping surface. The tool 100 is then retracted along with the ablation guide 22, back out the inferior vena cava access point resulting in the proper positioning of the ablation guide 22 and, ultimately, the ablation device 26 slidably disposed therein. Once positioned, tissue ablation occurs as described in greater detail above.
  • [0186]
    The grasping means can be any suitable means compatible with the medical instrument. For example, the distal end of the instrument may comprise an opening allowing for placement of a suture thereon. The grasping means 118 of tool 100 as part of tip 106A may be in the form of a pair of pivoted jaws 120, at least one of the jaws being movable with respect to the other enabling the jaws 120 to close upon the suture, grasping or otherwise holding onto the suture for retraction by tool 100 as described above. The pivot point of the pivoted jaws 120 may form part of attachment point 108 as described above.
  • [0187]
    Alternatively, the grasping means 118 may be in the form of a hook and loop system (not shown), the hook disposed on the distal end of tip 106A and the loop formed as a structural part of the distal end of the ablation device or formed with a suture as described immediately above. Additionally, tip 106 may further comprise a blunt barb (not shown) for grasping a suture or other loop as part of the distal end of an ablation device allowing for retraction of the ablation device as discussed above.
  • [0188]
    In accordance with yet another aspect of the present invention, the guide sheath, or ablation sheath, or ablation element could be controlled by a robot during a robotic minimally invasive surgical procedure. The robot could indeed telescopically translate or rotate the guide sheath, or the ablation sheath, or the ablation element in order to position the ablation sheath and the ablation element correctly to produce the ablation of tissue. The robot could also perform other tasks to facilitate the access of the ablation sheath to the tissue to be ablated. These tasks include, but are not limited to: performing the pericardial reflection in the area of a pulmonary vein; performing an incision on the pericardial sac; manipulating, bending or shaping the ablation sheath; or performing an incision on an organ to penetrate the ablation sheath through the penetration hole.
  • [0189]
    In accordance with yet another aspect of the present invention, the concept of using a sliding ablation element in an ablation sheath to ablate from the epicardium of a beating heart can also be applied in open chest surgery. In this procedure, a malleable ablation sheath may be beneficial, as compared to a pre-shaped ablation sheath. For example, a malleable metallic wire (e.g., copper, stainless steel, etc . . . ) could be integrated into the ablation sheath. The cardiac surgeon will then shape the ablation sheath to create the ablation path that he wants and will finally produce the ablation line by overlapping several ablations
  • [0190]
    In this technique, it is important to note that the ablation sheath must be stabilized against the epicardium since the ablation sheath will define the ablation path of the energy delivery portion. Should the ablation sheath be inadvertently moved during the process, the final ablation line may be undesirably discontinuous. Thus, a securing device may be applied to secure the ablation sheath against the epicardium. Such a securing device may include stitches or the like which may be strung through receiving holes or cracks placed in the ablation sheath. Another device to anchor the ablation sheath to the epicardium may be in the form of a biocompatible adhesive, or a suction device.
  • [0191]
    In accordance with yet another aspect of the present invention, a way to visually locate the ablation element within the ablation sheath is provided to the surgeon. In one embodiment of the invention, the ablation sheath is transparent and the ablation element can be directly visualized, or indirectly visualized via an endoscope. In yet another embodiment of the application, a marking element that can be directly visually identify along the ablation sheath, or indirectly visualized via an endoscope, is used to identify the location of the ablation element within the sheath. The marking element is sliding with the ablation element to show the location of the ablation element.
  • [0192]
    In accordance with yet another aspect of the present invention, a way to indirectly locate the ablation element within the ablation sheath is provided to the surgeon. A position finding system is incorporated in the handle of the device to indicate the position of the ablation element within the ablation sheath. At least one marker can be directly visually, or indirectly visually identified. These markers can be used in collaboration with the position finding system as reference points to identify the location of the ablation element.
  • [0193]
    While the present invention has been primarily described and applied for epicardial tissue ablations, it will be appreciated that the ablation system 20 may just as easily apply to endocardial tissue ablations as well. The tissue ablations may be performed through either open surgery techniques or through minimal invasive techniques.
  • [0194]
    Although the foregoing invention has been described in some detail for purposes of clarity of understanding, it will be apparent that certain changes and modifications may be practiced within the scope of the appended claims.

Claims (5)

What is claimed is:
1. A device to position a medical instrument during a surgical procedure, comprising:
a handle;
a guide sheath operably attached to the handle and having a deflectable distal end comprising a grasping means for grasping a distal end of the medical instrument; and
a deflection means for deflecting the distal end of the guide sheath.
2. The device of claim 1, wherein the grasping means is a hook configured to grasp the medical device.
3. The device of claim 1, wherein the grasping means is a pair of pivoted jaws operably attached to the deflectable distal end and configured to grasp the medical device.
4. The device of claim 1, wherein the medical instrument is an ablation system.
5. A method of positioning a medical instrument within a patient's body during a surgical procedure, comprising the steps of:
providing a positioning tool comprising a guide sheath having a deflectable distal end, the deflectable distal end comprising a grasping means for grasping the medical instrument;
introducing the guide sheath into the patient's body along a first path;
deflecting the deflectable distal end of the sheath;
introducing the medical instrument into the patient's body along a second path;
grasping the medical instrument with the grasping means;
retracting the guide sheath along the first path,
wherein at least a portion of the medical instrument is operably placed adjacent a target tissue site.
US10301975 2000-12-29 2002-11-21 Medical instrument positioning tool and method Abandoned US20030109868A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
US09751472 US20020087151A1 (en) 2000-12-29 2000-12-29 Tissue ablation apparatus with a sliding ablation instrument and method
US09872652 US6802840B2 (en) 2000-12-29 2001-06-01 Medical instrument positioning tool and method
US10301975 US20030109868A1 (en) 2000-12-29 2002-11-21 Medical instrument positioning tool and method

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US10301975 US20030109868A1 (en) 2000-12-29 2002-11-21 Medical instrument positioning tool and method

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US09872652 Continuation US6802840B2 (en) 2000-12-29 2001-06-01 Medical instrument positioning tool and method

Publications (1)

Publication Number Publication Date
US20030109868A1 true true US20030109868A1 (en) 2003-06-12

Family

ID=25022126

Family Applications (7)

Application Number Title Priority Date Filing Date
US09751472 Abandoned US20020087151A1 (en) 2000-12-29 2000-12-29 Tissue ablation apparatus with a sliding ablation instrument and method
US09872652 Expired - Fee Related US6802840B2 (en) 2000-12-29 2001-06-01 Medical instrument positioning tool and method
US10177840 Abandoned US20030069575A1 (en) 2000-12-29 2002-06-21 Tissue ablation system with a sliding ablating device and method
US10211621 Abandoned US20030050630A1 (en) 2000-12-29 2002-08-02 Tissue ablation apparatus with a sliding ablation instrument and method
US10211685 Abandoned US20030050631A1 (en) 2000-12-29 2002-08-02 Tissue ablation apparatus with a sliding ablation instrument and method
US10301975 Abandoned US20030109868A1 (en) 2000-12-29 2002-11-21 Medical instrument positioning tool and method
US10949014 Expired - Fee Related US7303560B2 (en) 2000-12-29 2004-09-24 Method of positioning a medical instrument

Family Applications Before (5)

Application Number Title Priority Date Filing Date
US09751472 Abandoned US20020087151A1 (en) 2000-12-29 2000-12-29 Tissue ablation apparatus with a sliding ablation instrument and method
US09872652 Expired - Fee Related US6802840B2 (en) 2000-12-29 2001-06-01 Medical instrument positioning tool and method
US10177840 Abandoned US20030069575A1 (en) 2000-12-29 2002-06-21 Tissue ablation system with a sliding ablating device and method
US10211621 Abandoned US20030050630A1 (en) 2000-12-29 2002-08-02 Tissue ablation apparatus with a sliding ablation instrument and method
US10211685 Abandoned US20030050631A1 (en) 2000-12-29 2002-08-02 Tissue ablation apparatus with a sliding ablation instrument and method

Family Applications After (1)

Application Number Title Priority Date Filing Date
US10949014 Expired - Fee Related US7303560B2 (en) 2000-12-29 2004-09-24 Method of positioning a medical instrument

Country Status (5)

Country Link
US (7) US20020087151A1 (en)
JP (2) JP2005512668A (en)
CA (1) CA2433416A1 (en)
EP (1) EP1395190A2 (en)
WO (1) WO2003053259A3 (en)

Cited By (22)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20050096643A1 (en) * 2003-10-30 2005-05-05 Medical Cv, Inc. Apparatus and method for laser treatment
US20050182392A1 (en) * 2003-10-30 2005-08-18 Medical Cv, Inc. Apparatus and method for guided ablation treatment
US20050209589A1 (en) * 2003-10-30 2005-09-22 Medical Cv, Inc. Assessment of lesion transmurality
US20060084960A1 (en) * 2003-10-30 2006-04-20 Medicalcv Inc. Guided ablation with end-fire fiber
US20070073281A1 (en) * 2005-09-16 2007-03-29 Medicalcv, Inc. Guided ablation with motion control
US20070073280A1 (en) * 2005-09-16 2007-03-29 Medicalcv, Inc. End-fire guided ablation
US20090203991A1 (en) * 2006-04-21 2009-08-13 Cedars-Sinai Medical Center Multiple imaging and/or spectroscopic modality probe
US20090326620A1 (en) * 2008-06-26 2009-12-31 Francesca Rossetto Deployable Microwave Antenna for Treating Tissue
US20100049185A1 (en) * 2008-08-25 2010-02-25 Vivant Medical, Inc. Microwave Antenna Assembly Having a Dielectric Body Portion With Radial Partitions of Dielectric Material
US20100121319A1 (en) * 2008-11-10 2010-05-13 Microcube, Llc Methods and devices for applying energy to bodily tissues
US20100137857A1 (en) * 2008-10-21 2010-06-03 Microcube, Limited Liability Corporation Methods and devices for applying energy to bodily tissues
US20110004205A1 (en) * 2009-07-01 2011-01-06 Chu Chun Yiu Methods and devices for delivering microwave energy
US20110238055A1 (en) * 2010-03-26 2011-09-29 Vivant Medical, Inc. Ablation Devices with Adjustable Radiating Section Lengths, Electrosurgical Systems Including Same, and Methods of Adjusting Ablation Fields Using Same
US8052605B2 (en) 2008-05-07 2011-11-08 Infraredx Multimodal catheter system and method for intravascular analysis
US8317703B2 (en) 2011-02-17 2012-11-27 Vivant Medical, Inc. Energy-delivery device including ultrasound transducer array and phased antenna array, and methods of adjusting an ablation field radiating into tissue using same
US8376948B2 (en) 2011-02-17 2013-02-19 Vivant Medical, Inc. Energy-delivery device including ultrasound transducer array and phased antenna array
US8568404B2 (en) 2010-02-19 2013-10-29 Covidien Lp Bipolar electrode probe for ablation monitoring
US8740893B2 (en) 2010-06-30 2014-06-03 Covidien Lp Adjustable tuning of a dielectrically loaded loop antenna
US8832927B2 (en) 2009-03-10 2014-09-16 Covidien Lp Method of manufacturing surgical antennas
US8882759B2 (en) 2009-12-18 2014-11-11 Covidien Lp Microwave ablation system with dielectric temperature probe
US8932208B2 (en) 2005-05-26 2015-01-13 Maquet Cardiovascular Llc Apparatus and methods for performing minimally-invasive surgical procedures
US9615882B2 (en) 2008-10-21 2017-04-11 Microcube, Llc Methods and devices for applying energy to bodily tissues

Families Citing this family (333)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6719755B2 (en) 1996-10-22 2004-04-13 Epicor Medical, Inc. Methods and devices for ablation
US7052493B2 (en) 1996-10-22 2006-05-30 Epicor Medical, Inc. Methods and devices for ablation
US6161543A (en) 1993-02-22 2000-12-19 Epicor, Inc. Methods of epicardial ablation for creating a lesion around the pulmonary veins
US6311692B1 (en) 1996-10-22 2001-11-06 Epicor, Inc. Apparatus and method for diagnosis and therapy of electrophysiological disease
US6805128B1 (en) 1996-10-22 2004-10-19 Epicor Medical, Inc. Apparatus and method for ablating tissue
US8709007B2 (en) 1997-10-15 2014-04-29 St. Jude Medical, Atrial Fibrillation Division, Inc. Devices and methods for ablating cardiac tissue
WO2001005306A1 (en) 1999-07-19 2001-01-25 Epicor, Inc. Apparatus and method for ablating tissue
US8308719B2 (en) 1998-09-21 2012-11-13 St. Jude Medical, Atrial Fibrillation Division, Inc. Apparatus and method for ablating tissue
US6634363B1 (en) 1997-04-07 2003-10-21 Broncus Technologies, Inc. Methods of treating lungs having reversible obstructive pulmonary disease
US7027869B2 (en) 1998-01-07 2006-04-11 Asthmatx, Inc. Method for treating an asthma attack
US7425212B1 (en) * 1998-06-10 2008-09-16 Asthmatx, Inc. Devices for modification of airways by transfer of energy
US8251070B2 (en) 2000-03-27 2012-08-28 Asthmatx, Inc. Methods for treating airways
US7992572B2 (en) 1998-06-10 2011-08-09 Asthmatx, Inc. Methods of evaluating individuals having reversible obstructive pulmonary disease
US7921855B2 (en) 1998-01-07 2011-04-12 Asthmatx, Inc. Method for treating an asthma attack
US8181656B2 (en) 1998-06-10 2012-05-22 Asthmatx, Inc. Methods for treating airways
US6104959A (en) 1997-07-31 2000-08-15 Microwave Medical Corp. Method and apparatus for treating subcutaneous histological features
US7090683B2 (en) * 1998-02-24 2006-08-15 Hansen Medical, Inc. Flexible instrument
US7713190B2 (en) 1998-02-24 2010-05-11 Hansen Medical, Inc. Flexible instrument
US8414598B2 (en) 1998-02-24 2013-04-09 Hansen Medical, Inc. Flexible instrument
US7766894B2 (en) 2001-02-15 2010-08-03 Hansen Medical, Inc. Coaxial catheter system
US20030135204A1 (en) 2001-02-15 2003-07-17 Endo Via Medical, Inc. Robotically controlled medical instrument with a flexible section
US7169141B2 (en) * 1998-02-24 2007-01-30 Hansen Medical, Inc. Surgical instrument
US8414505B1 (en) 2001-02-15 2013-04-09 Hansen Medical, Inc. Catheter driver system
US7775972B2 (en) * 1998-02-24 2010-08-17 Hansen Medical, Inc. Flexible instrument
US7699835B2 (en) * 2001-02-15 2010-04-20 Hansen Medical, Inc. Robotically controlled surgical instruments
US7214230B2 (en) * 1998-02-24 2007-05-08 Hansen Medical, Inc. Flexible instrument
US6245062B1 (en) * 1998-10-23 2001-06-12 Afx, Inc. Directional reflector shield assembly for a microwave ablation instrument
US6702811B2 (en) 1999-04-05 2004-03-09 Medtronic, Inc. Ablation catheter assembly with radially decreasing helix and method of use
US7226446B1 (en) * 1999-05-04 2007-06-05 Dinesh Mody Surgical microwave ablation assembly
US6306132B1 (en) 1999-06-17 2001-10-23 Vivant Medical Modular biopsy and microwave ablation needle delivery apparatus adapted to in situ assembly and method of use
US9314298B2 (en) 2007-04-17 2016-04-19 St. Jude Medical, Atrial Fibrillation Divisions, Inc. Vacuum-stabilized ablation system
US20060095032A1 (en) 1999-11-16 2006-05-04 Jerome Jackson Methods and systems for determining physiologic characteristics for treatment of the esophagus
US20040215235A1 (en) 1999-11-16 2004-10-28 Barrx, Inc. Methods and systems for determining physiologic characteristics for treatment of the esophagus
US7104987B2 (en) * 2000-10-17 2006-09-12 Asthmatx, Inc. Control system and process for application of energy to airway walls and other mediums
US7198635B2 (en) 2000-10-17 2007-04-03 Asthmatx, Inc. Modification of airways by application of energy
US20030163128A1 (en) * 2000-12-29 2003-08-28 Afx, Inc. Tissue ablation system with a sliding ablating device and method
US20030083654A1 (en) * 2000-12-29 2003-05-01 Afx, Inc. Tissue ablation system with a sliding ablating device and method
US20080114394A1 (en) 2001-04-24 2008-05-15 Houser Russell A Arteriotomy Closure Devices and Techniques
US8992567B1 (en) 2001-04-24 2015-03-31 Cardiovascular Technologies Inc. Compressible, deformable, or deflectable tissue closure devices and method of manufacture
US7054939B2 (en) * 2001-06-28 2006-05-30 Bellsouth Intellectual Property Corportion Simultaneous visual and telephonic access to interactive information delivery
US6776784B2 (en) 2001-09-06 2004-08-17 Core Medical, Inc. Clip apparatus for closing septal defects and methods of use
US8579936B2 (en) 2005-07-05 2013-11-12 ProMed, Inc. Centering of delivery devices with respect to a septal defect
US20060052821A1 (en) 2001-09-06 2006-03-09 Ovalis, Inc. Systems and methods for treating septal defects
US6702835B2 (en) 2001-09-07 2004-03-09 Core Medical, Inc. Needle apparatus for closing septal defects and methods for using such apparatus
WO2003024309A3 (en) * 2001-09-19 2003-09-04 Urologix Inc Microwave ablation device
US20030065318A1 (en) * 2001-09-28 2003-04-03 Rajesh Pendekanti Method and tool for epicardial ablation around pulmonary vein
US7128739B2 (en) * 2001-11-02 2006-10-31 Vivant Medical, Inc. High-strength microwave antenna assemblies and methods of use
US6878147B2 (en) 2001-11-02 2005-04-12 Vivant Medical, Inc. High-strength microwave antenna assemblies
US20070066972A1 (en) * 2001-11-29 2007-03-22 Medwaves, Inc. Ablation catheter apparatus with one or more electrodes
JP2005511135A (en) * 2001-11-29 2005-04-28 メッドウェイブズ、インコーポレイテッドMedwaves, Inc. Deflection mechanism and an improved steering mechanism RF based catheter system
US7399300B2 (en) * 2001-12-04 2008-07-15 Endoscopic Technologies, Inc. Cardiac ablation devices and methods
US7099717B2 (en) 2002-01-03 2006-08-29 Afx Inc. Catheter having improved steering
US7967816B2 (en) 2002-01-25 2011-06-28 Medtronic, Inc. Fluid-assisted electrosurgical instrument with shapeable electrode
EP1788936A4 (en) * 2004-08-12 2010-10-06 Medtronic Inc Catheter apparatus for treatment of heart arrhythmia
US7192427B2 (en) * 2002-02-19 2007-03-20 Afx, Inc. Apparatus and method for assessing transmurality of a tissue ablation
WO2003070547A1 (en) * 2002-02-22 2003-08-28 Bombardier Inc. A three-wheeled vehicle having a split radiator and an interior storage compartment
US8774913B2 (en) 2002-04-08 2014-07-08 Medtronic Ardian Luxembourg S.A.R.L. Methods and apparatus for intravasculary-induced neuromodulation
US8347891B2 (en) * 2002-04-08 2013-01-08 Medtronic Ardian Luxembourg S.A.R.L. Methods and apparatus for performing a non-continuous circumferential treatment of a body lumen
US7653438B2 (en) 2002-04-08 2010-01-26 Ardian, Inc. Methods and apparatus for renal neuromodulation
US20140018880A1 (en) 2002-04-08 2014-01-16 Medtronic Ardian Luxembourg S.A.R.L. Methods for monopolar renal neuromodulation
US7197363B2 (en) 2002-04-16 2007-03-27 Vivant Medical, Inc. Microwave antenna having a curved configuration
US6752767B2 (en) 2002-04-16 2004-06-22 Vivant Medical, Inc. Localization element with energized tip
US6932813B2 (en) * 2002-05-03 2005-08-23 Scimed Life Systems, Inc. Ablation systems including insulated energy transmitting elements
EP1534113A4 (en) * 2002-06-12 2010-06-09 Mann Medical Res Organization Injection devices and methods for testing implants and for unimpeded target location testing
US7572257B2 (en) 2002-06-14 2009-08-11 Ncontact Surgical, Inc. Vacuum coagulation and dissection probes
US6893442B2 (en) 2002-06-14 2005-05-17 Ablatrics, Inc. Vacuum coagulation probe for atrial fibrillation treatment
US8235990B2 (en) 2002-06-14 2012-08-07 Ncontact Surgical, Inc. Vacuum coagulation probes
US7063698B2 (en) 2002-06-14 2006-06-20 Ncontact Surgical, Inc. Vacuum coagulation probes
US9439714B2 (en) 2003-04-29 2016-09-13 Atricure, Inc. Vacuum coagulation probes
US20040106937A1 (en) * 2002-06-21 2004-06-03 Afx, Inc. Clamp accessory and method for an ablation instrument
US8768485B2 (en) * 2002-11-27 2014-07-01 Medical Device Innovations Limited Tissue ablation apparatus and method of ablating tissue
US7387629B2 (en) 2003-01-21 2008-06-17 St. Jude Medical, Atrial Fibrillation Division, Inc. Catheter design that facilitates positioning at tissue to be diagnosed or treated
CN100377696C (en) * 2003-03-26 2008-04-02 悉尼科技大学 A microwave antenna for medical ablation
US20040199154A1 (en) * 2003-04-02 2004-10-07 Cryocath Technologies Inc. Device for tissue ablation
US20040226556A1 (en) 2003-05-13 2004-11-18 Deem Mark E. Apparatus for treating asthma using neurotoxin
US8021387B2 (en) * 2003-07-11 2011-09-20 Biosense Webster, Inc. Trans-septal sheath with splitting dilating needle and method for its use
US7311703B2 (en) 2003-07-18 2007-12-25 Vivant Medical, Inc. Devices and methods for cooling microwave antennas
US9713730B2 (en) 2004-09-10 2017-07-25 Boston Scientific Scimed, Inc. Apparatus and method for treatment of in-stent restenosis
DE202004021944U1 (en) 2003-09-12 2013-07-16 Vessix Vascular, Inc. Selectable eccentric remodeling and / or ablation of atherosclerotic material
CA2586022A1 (en) * 2004-10-28 2006-05-11 Medicalcv, Inc. Apparatus and method for guided ablation treatment
US20070073277A1 (en) 2005-09-16 2007-03-29 Medicalcv, Inc. Controlled guided ablation treatment
US20070073278A1 (en) * 2005-09-16 2007-03-29 Johnson Kevin C Cardiac Ablation Dosing
US7282050B2 (en) * 2003-10-31 2007-10-16 Medtronic, Inc. Ablation of exterior of stomach to treat obesity
US7252665B2 (en) * 2003-10-31 2007-08-07 Medtronic, Inc Ablation of stomach lining to reduce stomach acid secretion
US7056286B2 (en) 2003-11-12 2006-06-06 Adrian Ravenscroft Medical device anchor and delivery system
KR100624161B1 (en) * 2003-12-15 2006-09-18 김영선 Apparatus for pressing a blood vessel
US7150745B2 (en) * 2004-01-09 2006-12-19 Barrx Medical, Inc. Devices and methods for treatment of luminal tissue
US20050165312A1 (en) * 2004-01-26 2005-07-28 Knowles Heather B. Acoustic window for ultrasound probes
US8046049B2 (en) * 2004-02-23 2011-10-25 Biosense Webster, Inc. Robotically guided catheter
US20070055224A1 (en) * 2004-04-29 2007-03-08 Lee Fred T Jr Intralumenal microwave device
WO2006127847A3 (en) * 2005-05-24 2009-04-16 Micrablate Llc Microwave surgical device
WO2005115235A1 (en) * 2004-05-26 2005-12-08 Medical Device Innovations Limited Tissue detection and ablation apparatus and apparatus and method for actuating a tuner
EP2024259A4 (en) 2006-06-08 2013-01-09 Surgical Solutions Llc Medical device with articulating shaft
WO2006052940A3 (en) * 2004-11-05 2006-09-28 Asthmatx Inc Medical device with procedure improvement features
US7156570B2 (en) * 2004-12-30 2007-01-02 Cotapaxi Custom Design And Manufacturing, Llc Implement grip
US7481225B2 (en) * 2005-01-26 2009-01-27 Ethicon Endo-Surgery, Inc. Medical instrument including an end effector having a medical-treatment electrode
US7278992B2 (en) * 2005-02-01 2007-10-09 Ethicon Endo-Surgery, Inc. Medical instrument having medical-treatment electrode
US20060241476A1 (en) * 2005-02-10 2006-10-26 Loubser Paul G Apparatus and method for holding a transesophageal echocardiography probe
US20060235372A1 (en) * 2005-04-06 2006-10-19 Ward Jim L Facilitating tools for cardiac tissue ablation
CA2605360C (en) 2005-04-21 2017-03-28 Asthmatx, Inc. Control methods and devices for energy delivery
US7740627B2 (en) * 2005-04-29 2010-06-22 Medtronic Cryocath Lp Surgical method and apparatus for treating atrial fibrillation
US7794455B2 (en) * 2005-04-29 2010-09-14 Medtronic Cryocath Lp Wide area ablation of myocardial tissue
US8092464B2 (en) * 2005-04-30 2012-01-10 Warsaw Orthopedic, Inc. Syringe devices and methods useful for delivering osteogenic material
US7799019B2 (en) 2005-05-10 2010-09-21 Vivant Medical, Inc. Reinforced high strength microwave antenna
US7727191B2 (en) * 2005-05-13 2010-06-01 Medtronic Cryocath Lp Compliant balloon catheter
US7615012B2 (en) * 2005-08-26 2009-11-10 Cardiac Pacemakers, Inc. Broadband acoustic sensor for an implantable medical device
US7846179B2 (en) 2005-09-01 2010-12-07 Ovalis, Inc. Suture-based systems and methods for treating septal defects
US9259267B2 (en) * 2005-09-06 2016-02-16 W.L. Gore & Associates, Inc. Devices and methods for treating cardiac tissue
US7410410B2 (en) * 2005-10-13 2008-08-12 Sae Magnetics (H.K.) Ltd. Method and apparatus to produce a GRM lapping plate with fixed diamond using electro-deposition techniques
US20070093802A1 (en) * 2005-10-21 2007-04-26 Danek Christopher J Energy delivery devices and methods
US7997278B2 (en) 2005-11-23 2011-08-16 Barrx Medical, Inc. Precision ablating method
US8702694B2 (en) 2005-11-23 2014-04-22 Covidien Lp Auto-aligning ablating device and method of use
US20070135686A1 (en) * 2005-12-14 2007-06-14 Pruitt John C Jr Tools and methods for epicardial access
JP4744284B2 (en) * 2005-12-19 2011-08-10 株式会社デージーエス・コンピュータ Chiryoko
US20070179340A1 (en) * 2005-12-20 2007-08-02 Medicept, Inc. Method and devices for minimally invasive arthroscopic procedures
US8679097B2 (en) * 2005-12-20 2014-03-25 Orthodynamix Llc Method and devices for minimally invasive arthroscopic procedures
US20070198046A1 (en) * 2006-02-17 2007-08-23 Medicalcv, Inc. Surgical visualization tool
JP2009529930A (en) * 2006-03-13 2009-08-27 ノボ・ノルデイスク・エー/エス Medical system comprising a dual-purpose communication means
US9173992B2 (en) 2006-03-13 2015-11-03 Novo Nordisk A/S Secure pairing of electronic devices using dual means of communication
EP1998698A1 (en) * 2006-03-24 2008-12-10 Micrablate Transmission line with heat transfer ability
WO2007112102A1 (en) * 2006-03-24 2007-10-04 Micrablate Center fed dipole for use with tissue ablation systems, devices, and methods
JP5094132B2 (en) * 2006-04-07 2012-12-12 株式会社デージーエス・コンピュータ Subject foci for rf wave irradiation device
US8019435B2 (en) 2006-05-02 2011-09-13 Boston Scientific Scimed, Inc. Control of arterial smooth muscle tone
JP5410962B2 (en) 2006-05-12 2014-02-05 ビトロンユーエス, インコーポレイテッド Device for ablating body tissue
US20080147056A1 (en) * 2006-07-14 2008-06-19 Micrablate Energy delivery systems and uses thereof
US20080045938A1 (en) * 2006-07-14 2008-02-21 Micrablate Energy delivery systems and uses thereof
EP2046227A2 (en) * 2006-08-03 2009-04-15 Hansen Medical, Inc. Systems for performing minimally invasive procedures
EP2068739A4 (en) * 2006-09-14 2013-01-23 Lazure Technologies Llc Device and method for destruction of cancer cells
US8068921B2 (en) 2006-09-29 2011-11-29 Vivant Medical, Inc. Microwave antenna assembly and method of using the same
GB0620061D0 (en) * 2006-10-10 2006-11-22 Medical Device Innovations Ltd Oesophageal treatment apparatus and method
ES2444645T3 (en) * 2006-10-10 2014-02-26 Creo Medical Limited surgical antenna
JP5559539B2 (en) 2006-10-18 2014-07-23 べシックス・バスキュラー・インコーポレイテッド System to induce the temperature desired effect on the body tissue
WO2008049084A3 (en) 2006-10-18 2008-08-07 Minnow Medical Inc Tuned rf energy and electrical tissue characterization for selective treatment of target tissues
US7931647B2 (en) * 2006-10-20 2011-04-26 Asthmatx, Inc. Method of delivering energy to a lung airway using markers
US7766909B2 (en) * 2006-11-08 2010-08-03 Boston Scientific Scimed, Inc. Sphincterotome with stiffening member
JP4598197B2 (en) * 2006-11-09 2010-12-15 Hoya株式会社 Endoscopic treatment tool
US7912270B2 (en) * 2006-11-21 2011-03-22 General Electric Company Method and system for creating and using an impact atlas
US20080255550A1 (en) * 2006-11-30 2008-10-16 Minos Medical Systems and methods for less invasive neutralization by ablation of tissue including the appendix and gall bladder
US8961551B2 (en) 2006-12-22 2015-02-24 The Spectranetics Corporation Retractable separating systems and methods
US9028520B2 (en) 2006-12-22 2015-05-12 The Spectranetics Corporation Tissue separating systems and methods
US20080161705A1 (en) * 2006-12-29 2008-07-03 Podmore Jonathan L Devices and methods for ablating near AV groove
WO2008098074A3 (en) 2007-02-06 2008-11-06 Microcube Llc A delivery system for delivering a medical device to a location within a patient's body
US20140187895A1 (en) * 2007-02-06 2014-07-03 Microcube, Llc Delivery system for delivering a medical device to a location within a patient's body
DE102007014739A1 (en) * 2007-03-20 2008-09-25 Karl Storz Gmbh & Co. Kg Deflectable autoclavable endoscope
US8308725B2 (en) * 2007-03-20 2012-11-13 Minos Medical Reverse sealing and dissection instrument
EP2271276A4 (en) 2008-04-17 2013-01-23 Miramar Labs Inc Systems, apparatus, methods and procedures for the noninvasive treatment of tissue using microwave energy
WO2008131306A1 (en) * 2007-04-19 2008-10-30 The Foundry, Inc. Systems and methods for creating an effect using microwave energy to specified tissue
CN101711134B (en) 2007-04-19 2016-08-17 米勒玛尔实验室公司 System for applying microwave energy to the tissue and produce a tissue layer effect in a tissue system
EP2142129A4 (en) 2007-04-19 2011-04-20 Miramar Labs Inc Methods and apparatus for reducing sweat production
US7998139B2 (en) 2007-04-25 2011-08-16 Vivant Medical, Inc. Cooled helical antenna for microwave ablation
WO2008137757A1 (en) * 2007-05-04 2008-11-13 Barrx Medical, Inc. Method and apparatus for gastrointestinal tract ablation for treatment of obesity
US8353901B2 (en) 2007-05-22 2013-01-15 Vivant Medical, Inc. Energy delivery conduits for use with electrosurgical devices
US9023024B2 (en) 2007-06-20 2015-05-05 Covidien Lp Reflective power monitoring for microwave applications
US8784338B2 (en) 2007-06-22 2014-07-22 Covidien Lp Electrical means to normalize ablational energy transmission to a luminal tissue surface of varying size
US8251992B2 (en) 2007-07-06 2012-08-28 Tyco Healthcare Group Lp Method and apparatus for gastrointestinal tract ablation to achieve loss of persistent and/or recurrent excess body weight following a weight-loss operation
US8439908B2 (en) 2007-07-06 2013-05-14 Covidien Lp Ablation in the gastrointestinal tract to achieve hemostasis and eradicate lesions with a propensity for bleeding
US8235983B2 (en) * 2007-07-12 2012-08-07 Asthmatx, Inc. Systems and methods for delivering energy to passageways in a patient
US9108052B2 (en) 2007-07-24 2015-08-18 Asthmatx, Inc. System and method for controlling power based on impedance detection, such as controlling power to tissue treatment devices
US8646460B2 (en) * 2007-07-30 2014-02-11 Covidien Lp Cleaning device and methods
US8273012B2 (en) 2007-07-30 2012-09-25 Tyco Healthcare Group, Lp Cleaning device and methods
US20090043301A1 (en) * 2007-08-09 2009-02-12 Asthmatx, Inc. Monopolar energy delivery devices and methods for controlling current density in tissue
US20090076496A1 (en) * 2007-09-14 2009-03-19 Lazure Technologies Llc. Prostate cancer ablation
US8562602B2 (en) 2007-09-14 2013-10-22 Lazure Technologies, Llc Multi-layer electrode ablation probe and related methods
US20090076500A1 (en) * 2007-09-14 2009-03-19 Lazure Technologies, Llc Multi-tine probe and treatment by activation of opposing tines
US8651146B2 (en) 2007-09-28 2014-02-18 Covidien Lp Cable stand-off
US8280525B2 (en) 2007-11-16 2012-10-02 Vivant Medical, Inc. Dynamically matched microwave antenna for tissue ablation
US8292880B2 (en) 2007-11-27 2012-10-23 Vivant Medical, Inc. Targeted cooling of deployable microwave antenna
US8961541B2 (en) 2007-12-03 2015-02-24 Cardio Vascular Technologies Inc. Vascular closure devices, systems, and methods of use
KR20110086831A (en) * 2008-10-22 2011-08-01 미라마 랩스 인코포레이티드 Systems, apparatus, methods, and procedures for the non-invasive treatment of tissue using microwave energy
US8353907B2 (en) * 2007-12-21 2013-01-15 Atricure, Inc. Ablation device with internally cooled electrodes
US8998892B2 (en) 2007-12-21 2015-04-07 Atricure, Inc. Ablation device with cooled electrodes and methods of use
US9043018B2 (en) * 2007-12-27 2015-05-26 Intuitive Surgical Operations, Inc. Medical device with orientable tip for robotically directed laser cutting and biomaterial application
US9198726B2 (en) * 2007-12-31 2015-12-01 St. Jude Medical, Atrial Fibrillation Division, Inc. Photodynamic-based cardiac ablation device and method via the esophagus
US20090192485A1 (en) * 2008-01-28 2009-07-30 Heuser Richard R Snare device
US8483831B1 (en) 2008-02-15 2013-07-09 Holaira, Inc. System and method for bronchial dilation
FR2928532B1 (en) * 2008-03-13 2011-12-02 Optomed Electronic Endoscope improves
JP5181791B2 (en) * 2008-04-03 2013-04-10 ソニー株式会社 Voltage-controlled variable frequency oscillator and a signal processing circuit
US8272383B2 (en) 2008-05-06 2012-09-25 Nxthera, Inc. Systems and methods for male sterilization
ES2398052T3 (en) 2008-05-09 2013-03-13 Innovative Pulmonary Solutions, Inc. Systems for treating bronchial tree
US8425500B2 (en) * 2008-05-19 2013-04-23 Boston Scientific Scimed, Inc. Method and apparatus for protecting capillary of laser fiber during insertion and reducing metal cap degradation
US9277961B2 (en) 2009-06-12 2016-03-08 Advanced Cardiac Therapeutics, Inc. Systems and methods of radiometrically determining a hot-spot temperature of tissue being treated
US8206380B2 (en) * 2008-06-13 2012-06-26 Advanced Caridiac Therapeutics Inc. Method and apparatus for measuring catheter contact force during a medical procedure
US9155588B2 (en) 2008-06-13 2015-10-13 Vytronus, Inc. System and method for positioning an elongate member with respect to an anatomical structure
US20100152582A1 (en) * 2008-06-13 2010-06-17 Vytronus, Inc. Handheld system and method for delivering energy to tissue
US20090312673A1 (en) * 2008-06-14 2009-12-17 Vytronus, Inc. System and method for delivering energy to tissue
US20100049099A1 (en) * 2008-07-18 2010-02-25 Vytronus, Inc. Method and system for positioning an energy source
US20100016762A1 (en) * 2008-07-18 2010-01-21 Vytronus, Inc. System and method for delivering energy to tissue
US8608739B2 (en) 2008-07-22 2013-12-17 Covidien Lp Electrosurgical devices, systems and methods of using the same
WO2010019481A1 (en) 2008-08-11 2010-02-18 Conceptx Medical, Inc. Systems and methods for treating dyspnea, including via electrical afferent signal blocking
US8403924B2 (en) * 2008-09-03 2013-03-26 Vivant Medical, Inc. Shielding for an isolation apparatus used in a microwave generator
US20100100093A1 (en) * 2008-09-16 2010-04-22 Lazure Technologies, Llc. System and method for controlled tissue heating for destruction of cancerous cells
US20100082083A1 (en) * 2008-09-30 2010-04-01 Brannan Joseph D Microwave system tuner
US8180433B2 (en) * 2008-09-30 2012-05-15 Vivant Medical, Inc. Microwave system calibration apparatus, system and method of use
US8346370B2 (en) * 2008-09-30 2013-01-01 Vivant Medical, Inc. Delivered energy generator for microwave ablation
US8174267B2 (en) * 2008-09-30 2012-05-08 Vivant Medical, Inc. Intermittent microwave energy delivery system
US8248075B2 (en) * 2008-09-30 2012-08-21 Vivant Medical, Inc. System, apparatus and method for dissipating standing wave in a microwave delivery system
US8287527B2 (en) * 2008-09-30 2012-10-16 Vivant Medical, Inc. Microwave system calibration apparatus and method of use
US8242782B2 (en) 2008-09-30 2012-08-14 Vivant Medical, Inc. Microwave ablation generator control system
US8597288B2 (en) * 2008-10-01 2013-12-03 St. Jude Medical, Artial Fibrillation Division, Inc. Vacuum-stabilized ablation system
US9700365B2 (en) 2008-10-06 2017-07-11 Santa Anna Tech Llc Method and apparatus for the ablation of gastrointestinal tissue
US9561068B2 (en) 2008-10-06 2017-02-07 Virender K. Sharma Method and apparatus for tissue ablation
US9561066B2 (en) 2008-10-06 2017-02-07 Virender K. Sharma Method and apparatus for tissue ablation
US9192789B2 (en) * 2008-10-30 2015-11-24 Vytronus, Inc. System and method for anatomical mapping of tissue and planning ablation paths therein
US9033885B2 (en) * 2008-10-30 2015-05-19 Vytronus, Inc. System and method for energy delivery to tissue while monitoring position, lesion depth, and wall motion
US8414508B2 (en) * 2008-10-30 2013-04-09 Vytronus, Inc. System and method for delivery of energy to tissue while compensating for collateral tissue
US9220924B2 (en) 2008-10-30 2015-12-29 Vytronus, Inc. System and method for energy delivery to tissue while monitoring position, lesion depth, and wall motion
CA2742566A1 (en) 2008-11-06 2010-05-14 Nxthera, Inc. Systems and methods for treatment of bph
CN105434039A (en) * 2008-11-06 2016-03-30 恩克斯特拉公司 Systems and methods for treatment of prostatic tissue
CA2742560A1 (en) 2008-11-06 2010-05-14 Nxthera, Inc. Systems and methods for treatment of prostatic tissue
US8396548B2 (en) 2008-11-14 2013-03-12 Vessix Vascular, Inc. Selective drug delivery in a lumen
US8475379B2 (en) * 2008-11-17 2013-07-02 Vytronus, Inc. Systems and methods for ablating body tissue
EP2355737A4 (en) 2008-11-17 2013-01-16 Vessix Vascular Inc Selective accumulation of energy with or without knowledge of tissue topography
EP2352559B1 (en) 2008-11-17 2013-12-25 Vytronus, Inc. System for ablating body tissue
US8372033B2 (en) * 2008-12-31 2013-02-12 St. Jude Medical, Atrial Fibrillation Division, Inc. Catheter having proximal heat sensitive deflection mechanism and related methods of use and manufacturing
US8388611B2 (en) * 2009-01-14 2013-03-05 Nxthera, Inc. Systems and methods for treatment of prostatic tissue
US20100179416A1 (en) * 2009-01-14 2010-07-15 Michael Hoey Medical Systems and Methods
US20100191232A1 (en) * 2009-01-27 2010-07-29 Boveda Marco Medical Llc Catheters and methods for performing electrophysiological interventions
US20100198065A1 (en) * 2009-01-30 2010-08-05 VyntronUS, Inc. System and method for ultrasonically sensing and ablating tissue
WO2010118312A3 (en) 2009-04-09 2011-04-28 Cardiovascular Technologies, Inc. Tissue closure devices, device and systems for delivery, kits and methods therefor
US8728139B2 (en) 2009-04-16 2014-05-20 Lazure Technologies, Llc System and method for energy delivery to a tissue using an electrode array
US9833277B2 (en) * 2009-04-27 2017-12-05 Nxthera, Inc. Systems and methods for prostate treatment
US8235981B2 (en) 2009-06-02 2012-08-07 Vivant Medical, Inc. Electrosurgical devices with directional radiation pattern
WO2011008903A3 (en) 2009-07-15 2011-04-28 Uab Research Foundation Catheter having temperature controlled anchor and related methods
CN106214246A (en) 2009-07-28 2016-12-14 纽韦弗医疗设备公司 Energy delivery systems and uses thereof
US9005217B2 (en) * 2009-08-12 2015-04-14 Biosense Webster, Inc. Robotic drive for catheter
US8906007B2 (en) 2009-09-28 2014-12-09 Covidien Lp Electrosurgical devices, directional reflector assemblies coupleable thereto, and electrosurgical systems including same
CA2779135A1 (en) 2009-10-27 2011-05-12 Innovative Pulmonary Solutions, Inc. Delivery devices with coolable energy emitting assemblies
US9649211B2 (en) 2009-11-04 2017-05-16 Confluent Medical Technologies, Inc. Alternating circumferential bridge stent design and methods for use thereof
CN106618731A (en) 2009-11-11 2017-05-10 赫莱拉公司 Systems, apparatuses, and methods for treating tissue and controlling stenosis
US8911439B2 (en) 2009-11-11 2014-12-16 Holaira, Inc. Non-invasive and minimally invasive denervation methods and systems for performing the same
CN102711648B (en) * 2009-11-30 2015-07-29 麦迪威公司 Radiofrequency ablation system having a tracking sensor
US8926602B2 (en) * 2010-01-28 2015-01-06 Medtronic Cryocath Lp Triple balloon catheter
US20110213353A1 (en) 2010-02-26 2011-09-01 Lee Anthony C Tissue Ablation System With Internal And External Radiation Sources
US9033996B1 (en) 2010-03-01 2015-05-19 Michael B. West System, method and apparatus for placing therapeutic devices in a heart
WO2011119957A3 (en) 2010-03-25 2011-12-29 Nxthera, Inc. Systems and methods for prostate treatment
EP2372208B1 (en) * 2010-03-25 2013-05-29 Tenaris Connections Limited Threaded joint with elastomeric seal flange
US8409188B2 (en) * 2010-03-26 2013-04-02 Covidien Lp Ablation devices with adjustable radiating section lengths, electrosurgical systems including same, and methods of adjusting ablation fields using same
KR20130108067A (en) 2010-04-09 2013-10-02 베식스 바스큘라 인코포레이티드 Power generating and control apparatus for the treatment of tissue
US9192790B2 (en) 2010-04-14 2015-11-24 Boston Scientific Scimed, Inc. Focused ultrasonic renal denervation
US9526911B1 (en) 2010-04-27 2016-12-27 Lazure Scientific, Inc. Immune mediated cancer cell destruction, systems and methods
US8568397B2 (en) * 2010-04-28 2013-10-29 Covidien Lp Induction sealing
EP2566410A4 (en) 2010-05-03 2013-10-30 Neuwave Medical Inc Energy delivery systems and uses thereof
US8473067B2 (en) 2010-06-11 2013-06-25 Boston Scientific Scimed, Inc. Renal denervation and stimulation employing wireless vascular energy transfer arrangement
US8647336B2 (en) * 2010-06-16 2014-02-11 Medtronic Ablation Frontiers Llc Cryogenic medical device with thermal guard and method
US9408661B2 (en) 2010-07-30 2016-08-09 Patrick A. Haverkost RF electrodes on multiple flexible wires for renal nerve ablation
US9084609B2 (en) 2010-07-30 2015-07-21 Boston Scientific Scime, Inc. Spiral balloon catheter for renal nerve ablation
US9463062B2 (en) 2010-07-30 2016-10-11 Boston Scientific Scimed, Inc. Cooled conductive balloon RF catheter for renal nerve ablation
US9155589B2 (en) 2010-07-30 2015-10-13 Boston Scientific Scimed, Inc. Sequential activation RF electrode set for renal nerve ablation
US9358365B2 (en) 2010-07-30 2016-06-07 Boston Scientific Scimed, Inc. Precision electrode movement control for renal nerve ablation
EP2593028B1 (en) * 2010-09-15 2017-08-16 Icecure Medical Ltd. Cryosurgical instrument for treating large volume of tissue
JP2012075800A (en) * 2010-10-05 2012-04-19 Inter Noba Kk Catheter
WO2012061161A1 (en) 2010-10-25 2012-05-10 Medtronic Ardian Luxembourg S.A.R.L. Catheter apparatuses having multi-electrode arrays for renal neuromodulation and associated systems and methods
US8974451B2 (en) 2010-10-25 2015-03-10 Boston Scientific Scimed, Inc. Renal nerve ablation using conductive fluid jet and RF energy
US9220558B2 (en) 2010-10-27 2015-12-29 Boston Scientific Scimed, Inc. RF renal denervation catheter with multiple independent electrodes
US9119647B2 (en) 2010-11-12 2015-09-01 Covidien Lp Apparatus, system and method for performing an electrosurgical procedure
US9028485B2 (en) 2010-11-15 2015-05-12 Boston Scientific Scimed, Inc. Self-expanding cooling electrode for renal nerve ablation
US9668811B2 (en) 2010-11-16 2017-06-06 Boston Scientific Scimed, Inc. Minimally invasive access for renal nerve ablation
US9089350B2 (en) 2010-11-16 2015-07-28 Boston Scientific Scimed, Inc. Renal denervation catheter with RF electrode and integral contrast dye injection arrangement
US9326751B2 (en) 2010-11-17 2016-05-03 Boston Scientific Scimed, Inc. Catheter guidance of external energy for renal denervation
US9060761B2 (en) 2010-11-18 2015-06-23 Boston Scientific Scime, Inc. Catheter-focused magnetic field induced renal nerve ablation
US9023034B2 (en) 2010-11-22 2015-05-05 Boston Scientific Scimed, Inc. Renal ablation electrode with force-activatable conduction apparatus
US9192435B2 (en) 2010-11-22 2015-11-24 Boston Scientific Scimed, Inc. Renal denervation catheter with cooled RF electrode
US20120157993A1 (en) 2010-12-15 2012-06-21 Jenson Mark L Bipolar Off-Wall Electrode Device for Renal Nerve Ablation
US9308041B2 (en) * 2010-12-22 2016-04-12 Biosense Webster (Israel) Ltd. Lasso catheter with rotating ultrasound transducer
WO2012100095A1 (en) 2011-01-19 2012-07-26 Boston Scientific Scimed, Inc. Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury
EP2734259B1 (en) 2011-07-20 2016-11-23 Boston Scientific Scimed, Inc. Percutaneous device to visualize, target and ablate nerves
US9186209B2 (en) 2011-07-22 2015-11-17 Boston Scientific Scimed, Inc. Nerve modulation system having helical guide
US9387031B2 (en) 2011-07-29 2016-07-12 Medtronic Ablation Frontiers Llc Mesh-overlayed ablation and mapping device
US9314301B2 (en) 2011-08-01 2016-04-19 Miramar Labs, Inc. Applicator and tissue interface module for dermatological device
US9439720B2 (en) 2011-09-01 2016-09-13 Iogyn, Inc. Tissue extraction devices and methods
EP2765942B1 (en) 2011-10-10 2016-02-24 Boston Scientific Scimed, Inc. Medical devices including ablation electrodes
US9420955B2 (en) 2011-10-11 2016-08-23 Boston Scientific Scimed, Inc. Intravascular temperature monitoring system and method
US9364284B2 (en) 2011-10-12 2016-06-14 Boston Scientific Scimed, Inc. Method of making an off-wall spacer cage
WO2013059202A1 (en) 2011-10-18 2013-04-25 Boston Scientific Scimed, Inc. Integrated crossing balloon catheter
EP2768563B1 (en) 2011-10-18 2016-11-09 Boston Scientific Scimed, Inc. Deflectable medical devices
WO2013070724A1 (en) 2011-11-08 2013-05-16 Boston Scientific Scimed, Inc. Ostial renal nerve ablation
US9119600B2 (en) 2011-11-15 2015-09-01 Boston Scientific Scimed, Inc. Device and methods for renal nerve modulation monitoring
US9119632B2 (en) 2011-11-21 2015-09-01 Boston Scientific Scimed, Inc. Deflectable renal nerve ablation catheter
US20130158545A1 (en) * 2011-12-15 2013-06-20 Assaf Govari Monitoring and tracking bipolar ablation
WO2013096803A3 (en) 2011-12-21 2014-09-25 Neuwave Medical, Inc. Energy delivery systems and uses thereof
US9265969B2 (en) 2011-12-21 2016-02-23 Cardiac Pacemakers, Inc. Methods for modulating cell function
WO2013096919A1 (en) 2011-12-23 2013-06-27 Vessix Vascular, Inc. Expandable balloon or an electrode pad with a heat sensing device
CN104135958B (en) 2011-12-28 2017-05-03 波士顿科学西美德公司 There are new methods and apparatus with an ablation catheter ablation element becomes transferred polymer nerve
US9050106B2 (en) 2011-12-29 2015-06-09 Boston Scientific Scimed, Inc. Off-wall electrode device and methods for nerve modulation
WO2013112920A1 (en) 2012-01-25 2013-08-01 Nevro Corporation Lead anchors and associated systems and methods
US8926605B2 (en) 2012-02-07 2015-01-06 Advanced Cardiac Therapeutics, Inc. Systems and methods for radiometrically measuring temperature during tissue ablation
WO2013123089A1 (en) * 2012-02-17 2013-08-22 Cohen Nathaniel L Apparatus for using microwave energy for insect and pest control and methods thereof
US9226791B2 (en) 2012-03-12 2016-01-05 Advanced Cardiac Therapeutics, Inc. Systems for temperature-controlled ablation using radiometric feedback
US8968290B2 (en) 2012-03-14 2015-03-03 Covidien Lp Microwave ablation generator control system
EP2840993A4 (en) 2012-04-24 2016-03-30 Cibiem Inc Endovascular catheters and methods for carotid body ablation
EP3181081A1 (en) 2012-05-11 2017-06-21 Medtronic Ardian Luxembourg S.à.r.l. Multi-electrode catheter assemblies for renal neuromodulation and associated systems
US8954161B2 (en) 2012-06-01 2015-02-10 Advanced Cardiac Therapeutics, Inc. Systems and methods for radiometrically measuring temperature and detecting tissue contact prior to and during tissue ablation
WO2013181667A1 (en) * 2012-06-01 2013-12-05 Cibiem, Inc. Percutaneous methods and devices for carotid body ablation
WO2013181660A1 (en) 2012-06-01 2013-12-05 Cibiem, Inc. Methods and devices for cryogenic carotid body ablation
WO2013184319A1 (en) 2012-06-04 2013-12-12 Boston Scientific Scimed, Inc. Systems and methods for treating tissue of a passageway within a body
US9283033B2 (en) 2012-06-30 2016-03-15 Cibiem, Inc. Carotid body ablation via directed energy
US9592086B2 (en) 2012-07-24 2017-03-14 Boston Scientific Scimed, Inc. Electrodes for tissue treatment
US9113911B2 (en) 2012-09-06 2015-08-25 Medtronic Ablation Frontiers Llc Ablation device and method for electroporating tissue cells
US20140081303A1 (en) 2012-09-14 2014-03-20 The Spectranetics Corporation Tissue slitting methods and systems
US9173696B2 (en) 2012-09-17 2015-11-03 Boston Scientific Scimed, Inc. Self-positioning electrode system and method for renal nerve modulation
US9662165B2 (en) 2012-10-02 2017-05-30 Covidien Lp Device and method for heat-sensitive agent application
US9370392B2 (en) 2012-10-02 2016-06-21 Covidien Lp Heat-sensitive optical probes
US9272132B2 (en) 2012-11-02 2016-03-01 Boston Scientific Scimed, Inc. Medical device for treating airways and related methods of use
WO2014071372A1 (en) 2012-11-05 2014-05-08 Boston Scientific Scimed, Inc. Devices for delivering energy to body lumens
US9095321B2 (en) 2012-11-21 2015-08-04 Medtronic Ardian Luxembourg S.A.R.L. Cryotherapeutic devices having integral multi-helical balloons and methods of making the same
US9398933B2 (en) 2012-12-27 2016-07-26 Holaira, Inc. Methods for improving drug efficacy including a combination of drug administration and nerve modulation
EP2945556A4 (en) 2013-01-17 2016-08-31 Virender K Sharma Method and apparatus for tissue ablation
US20160066789A1 (en) * 2013-02-13 2016-03-10 John Rogers Injectable and implantable cellular-scale electronic devices
US9693821B2 (en) 2013-03-11 2017-07-04 Boston Scientific Scimed, Inc. Medical devices for modulating nerves
US9283040B2 (en) 2013-03-13 2016-03-15 The Spectranetics Corporation Device and method of ablative cutting with helical tip
US9291663B2 (en) 2013-03-13 2016-03-22 The Spectranetics Corporation Alarm for lead insulation abnormality
US9808311B2 (en) 2013-03-13 2017-11-07 Boston Scientific Scimed, Inc. Deflectable medical devices
US9456872B2 (en) 2013-03-13 2016-10-04 The Spectranetics Corporation Laser ablation catheter
USD765243S1 (en) 2015-02-20 2016-08-30 The Spectranetics Corporation Medical device handle
US9297845B2 (en) 2013-03-15 2016-03-29 Boston Scientific Scimed, Inc. Medical devices and methods for treatment of hypertension that utilize impedance compensation
US9179974B2 (en) 2013-03-15 2015-11-10 Medtronic Ardian Luxembourg S.A.R.L. Helical push wire electrode
US20150258334A1 (en) 2013-03-15 2015-09-17 The Spectranetics Corporation Medical device for removing an implanted object
EP2967734A1 (en) 2013-03-15 2016-01-20 Boston Scientific Scimed, Inc. Methods and apparatuses for remodeling tissue of or adjacent to a body passage
US9668765B2 (en) 2013-03-15 2017-06-06 The Spectranetics Corporation Retractable blade for lead removal device
USD770616S1 (en) 2015-02-20 2016-11-01 The Spectranetics Corporation Medical device handle
US9814618B2 (en) 2013-06-06 2017-11-14 Boston Scientific Scimed, Inc. Devices for delivering energy and related methods of use
WO2014200807A1 (en) * 2013-06-14 2014-12-18 Lc Therapeutics, Inc. Methods of performing cardiac surgical procedures and kits for practicing the same
US9707036B2 (en) 2013-06-25 2017-07-18 Boston Scientific Scimed, Inc. Devices and methods for nerve modulation using localized indifferent electrodes
US9265935B2 (en) 2013-06-28 2016-02-23 Nevro Corporation Neurological stimulation lead anchors and associated systems and methods
CN105358084A (en) 2013-07-01 2016-02-24 波士顿科学国际有限公司 Medical devices for renal nerve ablation
CN105592778A (en) 2013-10-14 2016-05-18 波士顿科学医学有限公司 High resolution cardiac mapping electrode array catheter
US9770606B2 (en) 2013-10-15 2017-09-26 Boston Scientific Scimed, Inc. Ultrasound ablation catheter with cooling infusion and centering basket
US20160287894A1 (en) * 2013-11-07 2016-10-06 Arai Medphoton Research Laboratories, Corporation Medical instrument and light-ray treatment device
US20150250537A1 (en) * 2014-01-24 2015-09-10 Ncontact Surgical, Inc. Methods to prevent stress remodeling of atrial tissue
JP2018501837A (en) 2014-11-19 2018-01-25 アドバンスド カーディアク セラピューティクス,インコーポレイテッド System and method for high resolution mapping of the tissue
EP3220843A1 (en) 2014-11-19 2017-09-27 Advanced Cardiac Therapeutics, Inc. Ablation devices, systems and methods of using a high-resolution electrode assembly
US9636164B2 (en) 2015-03-25 2017-05-02 Advanced Cardiac Therapeutics, Inc. Contact sensing systems and methods
US20170296268A1 (en) 2016-04-15 2017-10-19 Neuwave Medical, Inc. Systems and methods for energy delivery

Citations (94)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4011872A (en) * 1974-04-01 1977-03-15 Olympus Optical Co., Ltd. Electrical apparatus for treating affected part in a coeloma
US4073287A (en) * 1976-04-05 1978-02-14 American Medical Systems, Inc. Urethral profilometry catheter
US4244371A (en) * 1976-10-13 1981-01-13 Erbe Elektromedizin Gmbh & Co. Kg High-frequency surgical apparatus
US4312364A (en) * 1977-04-08 1982-01-26 C.G.R. Mev Apparatus for localized heating of a living tissue, using electromagnetic waves of ultra high frequency, for medical applications
US4494539A (en) * 1982-04-03 1985-01-22 Toshio Zenitani Method and apparatus for surgical operation using microwaves
US4564200A (en) * 1984-12-14 1986-01-14 Loring Wolson J Tethered ring game with hook configuration
US4565200A (en) * 1980-09-24 1986-01-21 Cosman Eric R Universal lesion and recording electrode system
US4573473A (en) * 1984-04-13 1986-03-04 Cordis Corporation Cardiac mapping probe
US4640983A (en) * 1984-04-09 1987-02-03 Institut Straumann Ag Conductor device, particularly for at least partial insertion in a human or animal body, comprising a spiral formed from at least one conductor
US4641646A (en) * 1985-04-05 1987-02-10 Kenneth E. Schultz Endotracheal tube/respirator tubing connecting lock mechanism and method of using same
US4641649A (en) * 1985-10-30 1987-02-10 Rca Corporation Method and apparatus for high frequency catheter ablation
US4643186A (en) * 1985-10-30 1987-02-17 Rca Corporation Percutaneous transluminal microwave catheter angioplasty
US4800899A (en) * 1984-10-22 1989-01-31 Microthermia Technology, Inc. Apparatus for destroying cells in tumors and the like
US4891483A (en) * 1985-06-29 1990-01-02 Tokyo Keiki Co. Ltd. Heating apparatus for hyperthermia
US5078713A (en) * 1988-12-01 1992-01-07 Spembly Medical Limited Cryosurgical probe
US5080102A (en) * 1983-12-14 1992-01-14 Edap International, S.A. Examining, localizing and treatment with ultrasound
US5085659A (en) * 1990-11-21 1992-02-04 Everest Medical Corporation Biopsy device with bipolar coagulation capability
US5097845A (en) * 1987-10-15 1992-03-24 Labthermics Technologies Microwave hyperthermia probe
US5100388A (en) * 1989-09-15 1992-03-31 Interventional Thermodynamics, Inc. Method and device for thermal ablation of hollow body organs
US5188122A (en) * 1989-06-20 1993-02-23 Rocket Of London Limited Electromagnetic energy generation method
US5192278A (en) * 1985-03-22 1993-03-09 Massachusetts Institute Of Technology Multi-fiber plug for a laser catheter
US5281213A (en) * 1992-04-16 1994-01-25 Implemed, Inc. Catheter for ice mapping and ablation
US5281215A (en) * 1992-04-16 1994-01-25 Implemed, Inc. Cryogenic catheter
US5281217A (en) * 1992-04-13 1994-01-25 Ep Technologies, Inc. Steerable antenna systems for cardiac ablation that minimize tissue damage and blood coagulation due to conductive heating patterns
US5293869A (en) * 1992-09-25 1994-03-15 Ep Technologies, Inc. Cardiac probe with dynamic support for maintaining constant surface contact during heart systole and diastole
US5295484A (en) * 1992-05-19 1994-03-22 Arizona Board Of Regents For And On Behalf Of The University Of Arizona Apparatus and method for intra-cardiac ablation of arrhythmias
US5295955A (en) * 1992-02-14 1994-03-22 Amt, Inc. Method and apparatus for microwave aided liposuction
US5383876A (en) * 1992-11-13 1995-01-24 American Cardiac Ablation Co., Inc. Fluid cooled electrosurgical probe for cutting and cauterizing tissue
US5383922A (en) * 1993-03-15 1995-01-24 Medtronic, Inc. RF lead fixation and implantable lead
US5391147A (en) * 1992-12-01 1995-02-21 Cardiac Pathways Corporation Steerable catheter with adjustable bend location and/or radius and method
US5397304A (en) * 1992-04-10 1995-03-14 Medtronic Cardiorhythm Shapable handle for steerable electrode catheter
US5398683A (en) * 1991-05-24 1995-03-21 Ep Technologies, Inc. Combination monophasic action potential/ablation catheter and high-performance filter system
US5482037A (en) * 1993-01-18 1996-01-09 X-Trode S.R.L. Electrode catheter for mapping and operating on cardiac cavities
US5484433A (en) * 1993-12-30 1996-01-16 The Spectranetics Corporation Tissue ablating device having a deflectable ablation area and method of using same
US5487757A (en) * 1993-07-20 1996-01-30 Medtronic Cardiorhythm Multicurve deflectable catheter
US5492126A (en) * 1994-05-02 1996-02-20 Focal Surgery Probe for medical imaging and therapy using ultrasound
US5494039A (en) * 1993-07-16 1996-02-27 Cryomedical Sciences, Inc. Biopsy needle insertion guide and method of use in prostate cryosurgery
US5496312A (en) * 1993-10-07 1996-03-05 Valleylab Inc. Impedance and temperature generator control
US5496271A (en) * 1990-09-14 1996-03-05 American Medical Systems, Inc. Combined hyperthermia and dilation catheter
US5500012A (en) * 1992-07-15 1996-03-19 Angeion Corporation Ablation catheter system
US5590657A (en) * 1995-11-06 1997-01-07 The Regents Of The University Of Michigan Phased array ultrasound system and method for cardiac ablation
US5593405A (en) * 1994-07-16 1997-01-14 Osypka; Peter Fiber optic endoscope
US5599295A (en) * 1992-08-12 1997-02-04 Vidamed, Inc. Medical probe apparatus with enhanced RF, resistance heating, and microwave ablation capabilities
US5599346A (en) * 1993-11-08 1997-02-04 Zomed International, Inc. RF treatment system
US5603697A (en) * 1995-02-14 1997-02-18 Fidus Medical Technology Corporation Steering mechanism for catheters and methods for making same
US5707369A (en) * 1995-04-24 1998-01-13 Ethicon Endo-Surgery, Inc. Temperature feedback monitor for hemostatic surgical instrument
US5718226A (en) * 1996-08-06 1998-02-17 University Of Central Florida Photonically controlled ultrasonic probes
US5718241A (en) * 1995-06-07 1998-02-17 Biosense, Inc. Apparatus and method for treating cardiac arrhythmias with no discrete target
US5720775A (en) * 1996-07-31 1998-02-24 Cordis Corporation Percutaneous atrial line ablation catheter
US5855614A (en) * 1993-02-22 1999-01-05 Heartport, Inc. Method and apparatus for thoracoscopic intracardiac procedures
US5861002A (en) * 1991-10-18 1999-01-19 Desai; Ashvin H. Endoscopic surgical instrument
US5861021A (en) * 1996-06-17 1999-01-19 Urologix Inc Microwave thermal therapy of cardiac tissue
US5860920A (en) * 1993-10-14 1999-01-19 Ep Technologies, Inc. Systems for locating and ablating accessory pathways in the heart
US5863290A (en) * 1995-08-15 1999-01-26 Rita Medical Systems Multiple antenna ablation apparatus and method
US5868737A (en) * 1995-06-09 1999-02-09 Engineering Research & Associates, Inc. Apparatus and method for determining ablation
US5871525A (en) * 1992-04-13 1999-02-16 Ep Technologies, Inc. Steerable ablation catheter system
US5871481A (en) * 1997-04-11 1999-02-16 Vidamed, Inc. Tissue ablation apparatus and method
US5873896A (en) * 1997-05-27 1999-02-23 Uab Research Foundation Cardiac device for reducing arrhythmia
US5873828A (en) * 1994-02-18 1999-02-23 Olympus Optical Co., Ltd. Ultrasonic diagnosis and treatment system
US6010516A (en) * 1998-03-20 2000-01-04 Hulka; Jaroslav F. Bipolar coaptation clamps
US6012457A (en) * 1997-07-08 2000-01-11 The Regents Of The University Of California Device and method for forming a circumferential conduction block in a pulmonary vein
US6016848A (en) * 1996-07-16 2000-01-25 W. L. Gore & Associates, Inc. Fluoropolymer tubes and methods of making same
US6016811A (en) * 1998-09-01 2000-01-25 Fidus Medical Technology Corporation Method of using a microwave ablation catheter with a loop configuration
US6024740A (en) * 1997-07-08 2000-02-15 The Regents Of The University Of California Circumferential ablation device assembly
US6027497A (en) * 1996-03-29 2000-02-22 Eclipse Surgical Technologies, Inc. TMR energy delivery system
US6027501A (en) * 1995-06-23 2000-02-22 Gyrus Medical Limited Electrosurgical instrument
US6032077A (en) * 1996-03-06 2000-02-29 Cardiac Pathways Corporation Ablation catheter with electrical coupling via foam drenched with a conductive fluid
US6030382A (en) * 1994-08-08 2000-02-29 Ep Technologies, Inc. Flexible tissue ablatin elements for making long lesions
US6171303B1 (en) * 1996-01-08 2001-01-09 Biosense, Inc. Methods and apparatus for myocardial revascularization
US6174309B1 (en) * 1999-02-11 2001-01-16 Medical Scientific, Inc. Seal & cut electrosurgical instrument
US6178354B1 (en) * 1998-12-02 2001-01-23 C. R. Bard, Inc. Internal mechanism for displacing a slidable electrode
US6182664B1 (en) * 1996-02-19 2001-02-06 Edwards Lifesciences Corporation Minimally invasive cardiac valve surgery procedure
US6190382B1 (en) * 1998-12-14 2001-02-20 Medwaves, Inc. Radio-frequency based catheter system for ablation of body tissues
US20020001655A1 (en) * 2000-03-10 2002-01-03 The Pillsbury Company Inc. Scoopable dough and products resulting therefrom
US6346104B2 (en) * 1996-04-30 2002-02-12 Western Sydney Area Health Service System for simultaneous unipolar multi-electrode ablation
US20020017306A1 (en) * 1996-10-22 2002-02-14 Epicor, Inc. Surgical system and procedure for treatment of medically refractory atrial fibrillation
US20030004507A1 (en) * 2001-04-26 2003-01-02 Medtronic, Inc. Ablation system and method of use
US6502575B1 (en) * 1996-05-03 2003-01-07 Clemens J. Jacobs Instrument for interrupting conduction paths within the heart
US6508774B1 (en) * 1999-03-09 2003-01-21 Transurgical, Inc. Hifu applications with feedback control
US6511478B1 (en) * 2000-06-30 2003-01-28 Scimed Life Systems, Inc. Medical probe with reduced number of temperature sensor wires
US6514246B1 (en) * 1993-10-14 2003-02-04 Ep Technologies, Inc. Systems and methods for forming large lesions in body tissue using curvilinear electrode elements
US6514249B1 (en) * 1997-07-08 2003-02-04 Atrionix, Inc. Positioning system and method for orienting an ablation element within a pulmonary vein ostium
US20030028187A1 (en) * 1996-10-22 2003-02-06 Epicor, Inc. Device and method for forming a lesion
US6517536B2 (en) * 2000-04-27 2003-02-11 Atricure, Inc. Transmural ablation device and method
US6517568B1 (en) * 1996-08-13 2003-02-11 Oratec Interventions, Inc. Method and apparatus for treating intervertebral discs
US20030032952A1 (en) * 2000-04-27 2003-02-13 Hooven Michael D. Sub-xyphoid method for ablating cardiac tissue
US6526320B2 (en) * 1998-11-16 2003-02-25 United States Surgical Corporation Apparatus for thermal treatment of tissue
US20040002045A1 (en) * 2002-06-26 2004-01-01 Wellman Parris S. Training model for endoscopic vessel harvesting
US6673068B1 (en) * 2000-04-12 2004-01-06 Afx, Inc. Electrode arrangement for use in a medical instrument
US6685715B2 (en) * 2001-05-02 2004-02-03 Novare Surgical Systems Clamp having bendable shaft
US6689062B1 (en) * 1999-11-23 2004-02-10 Microaccess Medical Systems, Inc. Method and apparatus for transesophageal cardiovascular procedures
US6689128B2 (en) * 1996-10-22 2004-02-10 Epicor Medical, Inc. Methods and devices for ablation
US6692491B1 (en) * 2000-03-24 2004-02-17 Scimed Life Systems, Inc. Surgical methods and apparatus for positioning a diagnostic or therapeutic element around one or more pulmonary veins or other body structures
US6696844B2 (en) * 1999-06-04 2004-02-24 Engineering & Research Associates, Inc. Apparatus and method for real time determination of materials' electrical properties

Family Cites Families (111)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US335590A (en) * 1886-02-09 Velocipede
US1586645A (en) 1925-07-06 1926-06-01 Bierman William Method of and means for treating animal tissue to coagulate the same
US3598108A (en) 1969-02-28 1971-08-10 Khosrow Jamshidi Biopsy technique and biopsy device
US3827436A (en) 1972-11-10 1974-08-06 Frigitronics Of Conn Inc Multipurpose cryosurgical probe
DE7305040U (en) 1973-02-10 1973-06-20 Lindemann H Elektrokoagulationsfasszange for the tubal sterilization by means of bipolar hochfrequenzwaermestrahlung
US3886944A (en) 1973-11-19 1975-06-03 Khosrow Jamshidi Microcautery device
NL7502008A (en) 1974-02-25 1975-08-27 German Schmitt Intrakardiale stimulation electrode.
US4033357A (en) 1975-02-07 1977-07-05 Medtronic, Inc. Non-fibrosing cardiac electrode
US4045056A (en) 1975-10-14 1977-08-30 Gennady Petrovich Kandakov Expansion compensator for pipelines
US4245624A (en) * 1977-01-20 1981-01-20 Olympus Optical Co., Ltd. Endoscope with flexible tip control
US4204549A (en) 1977-12-12 1980-05-27 Rca Corporation Coaxial applicator for microwave hyperthermia
GB2022640B (en) 1978-05-25 1982-08-11 English Card Clothing Interlocking card-clothing wire
US4448198A (en) 1979-06-19 1984-05-15 Bsd Medical Corporation Invasive hyperthermia apparatus and method
US4476872A (en) 1980-03-07 1984-10-16 The Kendall Company Esophageal probe with disposable cover
US4462412A (en) 1980-04-02 1984-07-31 Bsd Medical Corporation Annular electromagnetic radiation applicator for biological tissue, and method
JPS6233906B2 (en) 1980-07-23 1987-07-23 Olympus Optical Co
US4416276A (en) 1981-10-26 1983-11-22 Valleylab, Inc. Adaptive, return electrode monitoring system
US4445892A (en) 1982-05-06 1984-05-01 Laserscope, Inc. Dual balloon catheter device
US4465079A (en) 1982-10-13 1984-08-14 Medtronic, Inc. Biomedical lead with fibrosis-inducing anchoring strand
US4583556A (en) 1982-12-13 1986-04-22 M/A-Com, Inc. Microwave applicator/receiver apparatus
DE3300694A1 (en) 1983-01-11 1984-08-09 Siemens Ag Bipolar electrode for medical applications
DE3306402C2 (en) 1983-02-24 1985-03-07 Werner Prof. Dr.-Ing. 6301 Wettenberg De Irnich
US4655219A (en) 1983-07-22 1987-04-07 American Hospital Supply Corporation Multicomponent flexible grasping device
US4601296A (en) 1983-10-07 1986-07-22 Yeda Research And Development Co., Ltd. Hyperthermia apparatus
US4522212A (en) 1983-11-14 1985-06-11 Mansfield Scientific, Inc. Endocardial electrode
USRE33590E (en) 1983-12-14 1991-05-21 Edap International, S.A. Method for examining, localizing and treating with ultrasound
DE3511107C2 (en) 1985-03-27 1988-03-17 Fischer Met Gmbh, 7800 Freiburg, De
US4841990A (en) 1985-06-29 1989-06-27 Tokyo Keiki Co., Ltd. Applicator for use in hyperthermia
US4660571A (en) 1985-07-18 1987-04-28 Cordis Corporation Percutaneous lead having radially adjustable electrode
US4681122A (en) 1985-09-23 1987-07-21 Victory Engineering Corp. Stereotaxic catheter for microwave thermotherapy
US4699147A (en) 1985-09-25 1987-10-13 Cordis Corporation Intraventricular multielectrode cardial mapping probe and method for using same
US4785815A (en) 1985-10-23 1988-11-22 Cordis Corporation Apparatus for locating and ablating cardiac conduction pathways
US4763668A (en) 1985-10-28 1988-08-16 Mill Rose Laboratories Partible forceps instrument for endoscopy
US4924864A (en) 1985-11-15 1990-05-15 Danzig Fred G Apparatus and article for ligating blood vessels, nerves and other anatomical structures
US4700716A (en) 1986-02-27 1987-10-20 Kasevich Associates, Inc. Collinear antenna array applicator
US4823812A (en) 1986-05-12 1989-04-25 Biodan Medical Systems Ltd. Applicator for insertion into a body opening for medical purposes
EP0393021A1 (en) 1986-09-12 1990-10-24 Oral Roberts University Radio frequency surgical tool
US4825880A (en) 1987-06-19 1989-05-02 The Regents Of The University Of California Implantable helical coil microwave antenna
US4841988B1 (en) 1987-10-15 1990-08-14 Marquette Electronics Inc
FR2622098B1 (en) 1987-10-27 1990-03-16 Glace Christian Method and azimuthal probe to locate the point of emergence of ventricular tachycardias
US4832048A (en) 1987-10-29 1989-05-23 Cordis Corporation Suction ablation catheter
US4924863A (en) 1988-05-04 1990-05-15 Mmtc, Inc. Angioplastic method for removing plaque from a vas
EP0415997A4 (en) 1988-05-18 1992-04-08 Kasevich Associates, Inc. Microwave balloon angioplasty
US5178620A (en) * 1988-06-10 1993-01-12 Advanced Angioplasty Products, Inc. Thermal dilatation catheter and method
US4938217A (en) 1988-06-21 1990-07-03 Massachusetts Institute Of Technology Electronically-controlled variable focus ultrasound hyperthermia system
US4881543A (en) 1988-06-28 1989-11-21 Massachusetts Institute Of Technology Combined microwave heating and surface cooling of the cornea
US4920978A (en) 1988-08-31 1990-05-01 Triangle Research And Development Corporation Method and apparatus for the endoscopic treatment of deep tumors using RF hyperthermia
US5147355A (en) 1988-09-23 1992-09-15 Brigham And Womens Hospital Cryoablation catheter and method of performing cryoablation
US4932420A (en) 1988-10-07 1990-06-12 Clini-Therm Corporation Non-invasive quarter wavelength microwave applicator for hyperthermia treatment
US4966597A (en) 1988-11-04 1990-10-30 Cosman Eric R Thermometric cardiac tissue ablation electrode with ultra-sensitive temperature detection
US5129396A (en) 1988-11-10 1992-07-14 Arye Rosen Microwave aided balloon angioplasty with lumen measurement
US5108390A (en) 1988-11-14 1992-04-28 Frigitronics, Inc. Flexible cryoprobe
US4960134A (en) 1988-11-18 1990-10-02 Webster Wilton W Jr Steerable catheter
US4945912A (en) 1988-11-25 1990-08-07 Sensor Electronics, Inc. Catheter with radiofrequency heating applicator
US5230349A (en) 1988-11-25 1993-07-27 Sensor Electronics, Inc. Electrical heating catheter
US4976711A (en) 1989-04-13 1990-12-11 Everest Medical Corporation Ablation catheter with selectively deployable electrodes
DE69027678D1 (en) 1989-05-03 1996-08-08 Medical Technologies Inc Enter Instrument for intraluminal relief of stenoses
US5007437A (en) 1989-06-16 1991-04-16 Mmtc, Inc. Catheters for treating prostate disease
US5104393A (en) 1989-08-30 1992-04-14 Angelase, Inc. Catheter
US5114403A (en) 1989-09-15 1992-05-19 Eclipse Surgical Technologies, Inc. Catheter torque mechanism
US5044375A (en) 1989-12-08 1991-09-03 Cardiac Pacemakers, Inc. Unitary intravascular defibrillating catheter with separate bipolar sensing
US5172699A (en) 1990-10-19 1992-12-22 Angelase, Inc. Process of identification of a ventricular tachycardia (VT) active site and an ablation catheter system
US5171255A (en) 1990-11-21 1992-12-15 Everest Medical Corporation Biopsy device
US5139496A (en) 1990-12-20 1992-08-18 Hed Aharon Z Ultrasonic freeze ablation catheters and probes
US5156151A (en) 1991-02-15 1992-10-20 Cardiac Pathways Corporation Endocardial mapping and ablation system and catheter probe
US5147357A (en) 1991-03-18 1992-09-15 Rose Anthony T Medical instrument
CA2108012A1 (en) 1991-04-10 1992-11-26 Leo Rubin Defibrillator and demand pacer catheter and method
US5207674A (en) 1991-05-13 1993-05-04 Hamilton Archie C Electronic cryogenic surgical probe apparatus and method
DE4122050C2 (en) 1991-07-03 1996-05-30 Gore W L & Ass Gmbh Antenna arrangement with feed line to the medical application of heat in body cavities
US5230334A (en) 1992-01-22 1993-07-27 Summit Technology, Inc. Method and apparatus for generating localized hyperthermia
US5222501A (en) 1992-01-31 1993-06-29 Duke University Methods for the diagnosis and ablation treatment of ventricular tachycardia
US5263493A (en) 1992-02-24 1993-11-23 Boaz Avitall Deflectable loop electrode array mapping and ablation catheter for cardiac chambers
US5242441A (en) 1992-02-24 1993-09-07 Boaz Avitall Deflectable catheter with rotatable tip electrode
US5314466A (en) 1992-04-13 1994-05-24 Ep Technologies, Inc. Articulated unidirectional microwave antenna systems for cardiac ablation
US5248312A (en) 1992-06-01 1993-09-28 Sensor Electronics, Inc. Liquid metal-filled balloon
GB9215042D0 (en) 1992-07-15 1992-08-26 Microwave Engineering Designs Microwave treatment apparatus
US5322507A (en) * 1992-08-11 1994-06-21 Myriadlase, Inc. Endoscope for treatment of prostate
US5470308A (en) * 1992-08-12 1995-11-28 Vidamed, Inc. Medical probe with biopsy stylet
US5385146A (en) 1993-01-08 1995-01-31 Goldreyer; Bruce N. Orthogonal sensing for use in clinical electrophysiology
US6237605B1 (en) 1996-10-22 2001-05-29 Epicor, Inc. Methods of epicardial ablation
US5405346A (en) 1993-05-14 1995-04-11 Fidus Medical Technology Corporation Tunable microwave ablation catheter
US5454807A (en) * 1993-05-14 1995-10-03 Boston Scientific Corporation Medical treatment of deeply seated tissue using optical radiation
US5630837A (en) * 1993-07-01 1997-05-20 Boston Scientific Corporation Acoustic ablation
US5571088A (en) * 1993-07-01 1996-11-05 Boston Scientific Corporation Ablation catheters
US5417208A (en) 1993-10-12 1995-05-23 Arrow International Investment Corp. Electrode-carrying catheter and method of making same
US5545193A (en) 1993-10-15 1996-08-13 Ep Technologies, Inc. Helically wound radio-frequency emitting electrodes for creating lesions in body tissue
US5730127A (en) * 1993-12-03 1998-03-24 Avitall; Boaz Mapping and ablation catheter system
US5405375A (en) 1994-01-21 1995-04-11 Incontrol, Inc. Combined mapping, pacing, and defibrillating catheter
EP0738501B1 (en) * 1994-11-02 2000-05-24 Olympus Optical Co., Ltd. Endoscope operative instrument
US5785707A (en) * 1995-04-24 1998-07-28 Sdgi Holdings, Inc. Template for positioning interbody fusion devices
US5606974A (en) * 1995-05-02 1997-03-04 Heart Rhythm Technologies, Inc. Catheter having ultrasonic device
US5788692A (en) 1995-06-30 1998-08-04 Fidus Medical Technology Corporation Mapping ablation catheter
US5843050A (en) * 1995-11-13 1998-12-01 Micro Therapeutics, Inc. Microcatheter
US5733280A (en) * 1995-11-15 1998-03-31 Avitall; Boaz Cryogenic epicardial mapping and ablation
US5733281A (en) * 1996-03-19 1998-03-31 American Ablation Co., Inc. Ultrasound and impedance feedback system for use with electrosurgical instruments
US5725523A (en) * 1996-03-29 1998-03-10 Mueller; Richard L. Lateral-and posterior-aspect method and apparatus for laser-assisted transmyocardial revascularization and other surgical applications
US5800494A (en) 1996-08-20 1998-09-01 Fidus Medical Technology Corporation Microwave ablation catheters having antennas with distal fire capabilities
US5741249A (en) * 1996-10-16 1998-04-21 Fidus Medical Technology Corporation Anchoring tip assembly for microwave ablation catheter
US5785706A (en) * 1996-11-18 1998-07-28 Daig Corporation Nonsurgical mapping and treatment of cardiac arrhythmia using a catheter contained within a guiding introducer containing openings
US6056743A (en) * 1997-11-04 2000-05-02 Scimed Life Systems, Inc. Percutaneous myocardial revascularization device and method
US6245062B1 (en) 1998-10-23 2001-06-12 Afx, Inc. Directional reflector shield assembly for a microwave ablation instrument
US6179776B1 (en) * 1999-03-12 2001-01-30 Scimed Life Systems, Inc. Controllable endoscopic sheath apparatus and related method of use
US6325797B1 (en) * 1999-04-05 2001-12-04 Medtronic, Inc. Ablation catheter and method for isolating a pulmonary vein
US6287302B1 (en) 1999-06-14 2001-09-11 Fidus Medical Technology Corporation End-firing microwave ablation instrument with horn reflection device
US6602224B1 (en) * 1999-12-22 2003-08-05 Advanced Cardiovascular Systems, Inc. Medical device formed of ultrahigh molecular weight polyolefin
US6309388B1 (en) * 1999-12-23 2001-10-30 Mayo Foundation For Medical Education And Research Symmetric conization electrocautery device
US6663622B1 (en) * 2000-02-11 2003-12-16 Iotek, Inc. Surgical devices and methods for use in tissue ablation procedures
US6558375B1 (en) * 2000-07-14 2003-05-06 Cardiofocus, Inc. Cardiac ablation instrument
US6743225B2 (en) * 2001-03-27 2004-06-01 Uab Research Foundation Electrophysiologic measure of endpoints for ablation lesions created in fibrillating substrates
US6740080B2 (en) * 2001-08-31 2004-05-25 Cardiac Pacemakers, Inc. Ablation system with selectable current path means
US6761716B2 (en) * 2001-09-18 2004-07-13 Cardiac Pacemakers, Inc. System and method for assessing electrode-tissue contact and lesion quality during RF ablation by measurement of conduction time

Patent Citations (99)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4011872A (en) * 1974-04-01 1977-03-15 Olympus Optical Co., Ltd. Electrical apparatus for treating affected part in a coeloma
US4073287A (en) * 1976-04-05 1978-02-14 American Medical Systems, Inc. Urethral profilometry catheter
US4244371A (en) * 1976-10-13 1981-01-13 Erbe Elektromedizin Gmbh & Co. Kg High-frequency surgical apparatus
US4312364A (en) * 1977-04-08 1982-01-26 C.G.R. Mev Apparatus for localized heating of a living tissue, using electromagnetic waves of ultra high frequency, for medical applications
US4565200A (en) * 1980-09-24 1986-01-21 Cosman Eric R Universal lesion and recording electrode system
US4494539A (en) * 1982-04-03 1985-01-22 Toshio Zenitani Method and apparatus for surgical operation using microwaves
US5080101A (en) * 1983-12-14 1992-01-14 Edap International, S.A. Method for examining and aiming treatment with untrasound
US5080102A (en) * 1983-12-14 1992-01-14 Edap International, S.A. Examining, localizing and treatment with ultrasound
US4640983A (en) * 1984-04-09 1987-02-03 Institut Straumann Ag Conductor device, particularly for at least partial insertion in a human or animal body, comprising a spiral formed from at least one conductor
US4573473A (en) * 1984-04-13 1986-03-04 Cordis Corporation Cardiac mapping probe
US4800899A (en) * 1984-10-22 1989-01-31 Microthermia Technology, Inc. Apparatus for destroying cells in tumors and the like
US4564200A (en) * 1984-12-14 1986-01-14 Loring Wolson J Tethered ring game with hook configuration
US5192278A (en) * 1985-03-22 1993-03-09 Massachusetts Institute Of Technology Multi-fiber plug for a laser catheter
US4641646A (en) * 1985-04-05 1987-02-10 Kenneth E. Schultz Endotracheal tube/respirator tubing connecting lock mechanism and method of using same
US4891483A (en) * 1985-06-29 1990-01-02 Tokyo Keiki Co. Ltd. Heating apparatus for hyperthermia
US4643186A (en) * 1985-10-30 1987-02-17 Rca Corporation Percutaneous transluminal microwave catheter angioplasty
US4641649A (en) * 1985-10-30 1987-02-10 Rca Corporation Method and apparatus for high frequency catheter ablation
US5190054A (en) * 1987-10-15 1993-03-02 Labthermics Technologies, Inc. Microwave hyperthermia probe
US5097845A (en) * 1987-10-15 1992-03-24 Labthermics Technologies Microwave hyperthermia probe
US5078713A (en) * 1988-12-01 1992-01-07 Spembly Medical Limited Cryosurgical probe
US5188122A (en) * 1989-06-20 1993-02-23 Rocket Of London Limited Electromagnetic energy generation method
US5100388A (en) * 1989-09-15 1992-03-31 Interventional Thermodynamics, Inc. Method and device for thermal ablation of hollow body organs
US5496271A (en) * 1990-09-14 1996-03-05 American Medical Systems, Inc. Combined hyperthermia and dilation catheter
US5085659A (en) * 1990-11-21 1992-02-04 Everest Medical Corporation Biopsy device with bipolar coagulation capability
US5398683A (en) * 1991-05-24 1995-03-21 Ep Technologies, Inc. Combination monophasic action potential/ablation catheter and high-performance filter system
US5861002A (en) * 1991-10-18 1999-01-19 Desai; Ashvin H. Endoscopic surgical instrument
US5295955A (en) * 1992-02-14 1994-03-22 Amt, Inc. Method and apparatus for microwave aided liposuction
US5397304A (en) * 1992-04-10 1995-03-14 Medtronic Cardiorhythm Shapable handle for steerable electrode catheter
US5281217A (en) * 1992-04-13 1994-01-25 Ep Technologies, Inc. Steerable antenna systems for cardiac ablation that minimize tissue damage and blood coagulation due to conductive heating patterns
US5871525A (en) * 1992-04-13 1999-02-16 Ep Technologies, Inc. Steerable ablation catheter system
US5281215A (en) * 1992-04-16 1994-01-25 Implemed, Inc. Cryogenic catheter
US5281213A (en) * 1992-04-16 1994-01-25 Implemed, Inc. Catheter for ice mapping and ablation
US5295484A (en) * 1992-05-19 1994-03-22 Arizona Board Of Regents For And On Behalf Of The University Of Arizona Apparatus and method for intra-cardiac ablation of arrhythmias
US5500012A (en) * 1992-07-15 1996-03-19 Angeion Corporation Ablation catheter system
US5599295A (en) * 1992-08-12 1997-02-04 Vidamed, Inc. Medical probe apparatus with enhanced RF, resistance heating, and microwave ablation capabilities
US5720718A (en) * 1992-08-12 1998-02-24 Vidamed, Inc. Medical probe apparatus with enhanced RF, resistance heating, and microwave ablation capabilities
US5293869A (en) * 1992-09-25 1994-03-15 Ep Technologies, Inc. Cardiac probe with dynamic support for maintaining constant surface contact during heart systole and diastole
US5383876A (en) * 1992-11-13 1995-01-24 American Cardiac Ablation Co., Inc. Fluid cooled electrosurgical probe for cutting and cauterizing tissue
US5391147A (en) * 1992-12-01 1995-02-21 Cardiac Pathways Corporation Steerable catheter with adjustable bend location and/or radius and method
US5482037A (en) * 1993-01-18 1996-01-09 X-Trode S.R.L. Electrode catheter for mapping and operating on cardiac cavities
US5855614A (en) * 1993-02-22 1999-01-05 Heartport, Inc. Method and apparatus for thoracoscopic intracardiac procedures
US5383922A (en) * 1993-03-15 1995-01-24 Medtronic, Inc. RF lead fixation and implantable lead
US5494039A (en) * 1993-07-16 1996-02-27 Cryomedical Sciences, Inc. Biopsy needle insertion guide and method of use in prostate cryosurgery
US5487757A (en) * 1993-07-20 1996-01-30 Medtronic Cardiorhythm Multicurve deflectable catheter
US5496312A (en) * 1993-10-07 1996-03-05 Valleylab Inc. Impedance and temperature generator control
US5860920A (en) * 1993-10-14 1999-01-19 Ep Technologies, Inc. Systems for locating and ablating accessory pathways in the heart
US6514246B1 (en) * 1993-10-14 2003-02-04 Ep Technologies, Inc. Systems and methods for forming large lesions in body tissue using curvilinear electrode elements
US5599346A (en) * 1993-11-08 1997-02-04 Zomed International, Inc. RF treatment system
US5484433A (en) * 1993-12-30 1996-01-16 The Spectranetics Corporation Tissue ablating device having a deflectable ablation area and method of using same
US5873828A (en) * 1994-02-18 1999-02-23 Olympus Optical Co., Ltd. Ultrasonic diagnosis and treatment system
US5492126A (en) * 1994-05-02 1996-02-20 Focal Surgery Probe for medical imaging and therapy using ultrasound
US5593405A (en) * 1994-07-16 1997-01-14 Osypka; Peter Fiber optic endoscope
US6030382A (en) * 1994-08-08 2000-02-29 Ep Technologies, Inc. Flexible tissue ablatin elements for making long lesions
US5603697A (en) * 1995-02-14 1997-02-18 Fidus Medical Technology Corporation Steering mechanism for catheters and methods for making same
US5707369A (en) * 1995-04-24 1998-01-13 Ethicon Endo-Surgery, Inc. Temperature feedback monitor for hemostatic surgical instrument
US5718241A (en) * 1995-06-07 1998-02-17 Biosense, Inc. Apparatus and method for treating cardiac arrhythmias with no discrete target
US5868737A (en) * 1995-06-09 1999-02-09 Engineering Research & Associates, Inc. Apparatus and method for determining ablation
US6027501A (en) * 1995-06-23 2000-02-22 Gyrus Medical Limited Electrosurgical instrument
US5863290A (en) * 1995-08-15 1999-01-26 Rita Medical Systems Multiple antenna ablation apparatus and method
US5590657A (en) * 1995-11-06 1997-01-07 The Regents Of The University Of Michigan Phased array ultrasound system and method for cardiac ablation
US6171303B1 (en) * 1996-01-08 2001-01-09 Biosense, Inc. Methods and apparatus for myocardial revascularization
US6182664B1 (en) * 1996-02-19 2001-02-06 Edwards Lifesciences Corporation Minimally invasive cardiac valve surgery procedure
US6032077A (en) * 1996-03-06 2000-02-29 Cardiac Pathways Corporation Ablation catheter with electrical coupling via foam drenched with a conductive fluid
US6027497A (en) * 1996-03-29 2000-02-22 Eclipse Surgical Technologies, Inc. TMR energy delivery system
US6346104B2 (en) * 1996-04-30 2002-02-12 Western Sydney Area Health Service System for simultaneous unipolar multi-electrode ablation
US6502575B1 (en) * 1996-05-03 2003-01-07 Clemens J. Jacobs Instrument for interrupting conduction paths within the heart
US5861021A (en) * 1996-06-17 1999-01-19 Urologix Inc Microwave thermal therapy of cardiac tissue
US6016848A (en) * 1996-07-16 2000-01-25 W. L. Gore & Associates, Inc. Fluoropolymer tubes and methods of making same
US5720775A (en) * 1996-07-31 1998-02-24 Cordis Corporation Percutaneous atrial line ablation catheter
US5718226A (en) * 1996-08-06 1998-02-17 University Of Central Florida Photonically controlled ultrasonic probes
US6517568B1 (en) * 1996-08-13 2003-02-11 Oratec Interventions, Inc. Method and apparatus for treating intervertebral discs
US20030028187A1 (en) * 1996-10-22 2003-02-06 Epicor, Inc. Device and method for forming a lesion
US20030029462A1 (en) * 1996-10-22 2003-02-13 Epicor, Inc. Device and method for forming a lesion
US6689128B2 (en) * 1996-10-22 2004-02-10 Epicor Medical, Inc. Methods and devices for ablation
US20020017306A1 (en) * 1996-10-22 2002-02-14 Epicor, Inc. Surgical system and procedure for treatment of medically refractory atrial fibrillation
US20030024537A1 (en) * 1996-10-22 2003-02-06 Epicor, Inc. Device and method for forming a lesion
US5871481A (en) * 1997-04-11 1999-02-16 Vidamed, Inc. Tissue ablation apparatus and method
US5873896A (en) * 1997-05-27 1999-02-23 Uab Research Foundation Cardiac device for reducing arrhythmia
US6024740A (en) * 1997-07-08 2000-02-15 The Regents Of The University Of California Circumferential ablation device assembly
US6012457A (en) * 1997-07-08 2000-01-11 The Regents Of The University Of California Device and method for forming a circumferential conduction block in a pulmonary vein
US6514249B1 (en) * 1997-07-08 2003-02-04 Atrionix, Inc. Positioning system and method for orienting an ablation element within a pulmonary vein ostium
US6010516A (en) * 1998-03-20 2000-01-04 Hulka; Jaroslav F. Bipolar coaptation clamps
US6016811A (en) * 1998-09-01 2000-01-25 Fidus Medical Technology Corporation Method of using a microwave ablation catheter with a loop configuration
US6526320B2 (en) * 1998-11-16 2003-02-25 United States Surgical Corporation Apparatus for thermal treatment of tissue
US6178354B1 (en) * 1998-12-02 2001-01-23 C. R. Bard, Inc. Internal mechanism for displacing a slidable electrode
US6190382B1 (en) * 1998-12-14 2001-02-20 Medwaves, Inc. Radio-frequency based catheter system for ablation of body tissues
US6174309B1 (en) * 1999-02-11 2001-01-16 Medical Scientific, Inc. Seal & cut electrosurgical instrument
US6508774B1 (en) * 1999-03-09 2003-01-21 Transurgical, Inc. Hifu applications with feedback control
US6696844B2 (en) * 1999-06-04 2004-02-24 Engineering & Research Associates, Inc. Apparatus and method for real time determination of materials' electrical properties
US6689062B1 (en) * 1999-11-23 2004-02-10 Microaccess Medical Systems, Inc. Method and apparatus for transesophageal cardiovascular procedures
US20020001655A1 (en) * 2000-03-10 2002-01-03 The Pillsbury Company Inc. Scoopable dough and products resulting therefrom
US6692491B1 (en) * 2000-03-24 2004-02-17 Scimed Life Systems, Inc. Surgical methods and apparatus for positioning a diagnostic or therapeutic element around one or more pulmonary veins or other body structures
US6673068B1 (en) * 2000-04-12 2004-01-06 Afx, Inc. Electrode arrangement for use in a medical instrument
US6517536B2 (en) * 2000-04-27 2003-02-11 Atricure, Inc. Transmural ablation device and method
US20030032952A1 (en) * 2000-04-27 2003-02-13 Hooven Michael D. Sub-xyphoid method for ablating cardiac tissue
US6511478B1 (en) * 2000-06-30 2003-01-28 Scimed Life Systems, Inc. Medical probe with reduced number of temperature sensor wires
US20030004507A1 (en) * 2001-04-26 2003-01-02 Medtronic, Inc. Ablation system and method of use
US6685715B2 (en) * 2001-05-02 2004-02-03 Novare Surgical Systems Clamp having bendable shaft
US20040002045A1 (en) * 2002-06-26 2004-01-01 Wellman Parris S. Training model for endoscopic vessel harvesting

Cited By (46)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7238180B2 (en) 2003-10-30 2007-07-03 Medicalcv Inc. Guided ablation with end-fire fiber
US20050143722A1 (en) * 2003-10-30 2005-06-30 Medical Cv, Inc. Laser-based maze procedure for atrial fibrillation
US20050143721A1 (en) * 2003-10-30 2005-06-30 Medical Cv, Inc. Malleable energy wand for maze procedure
US20050159734A1 (en) * 2003-10-30 2005-07-21 Medical Cv, Inc. Atraumatic laser tip for atrial fibrillation treatment
US20050171521A1 (en) * 2003-10-30 2005-08-04 Medical Cv, Inc. Cardiac lesions with continuity testing
US20050182392A1 (en) * 2003-10-30 2005-08-18 Medical Cv, Inc. Apparatus and method for guided ablation treatment
US20050209589A1 (en) * 2003-10-30 2005-09-22 Medical Cv, Inc. Assessment of lesion transmurality
US20060084960A1 (en) * 2003-10-30 2006-04-20 Medicalcv Inc. Guided ablation with end-fire fiber
WO2006050011A1 (en) * 2003-10-30 2006-05-11 Medical Cv, Inc. Apparatus and method for guided ablation treatment
US7137977B2 (en) 2003-10-30 2006-11-21 Medical Cv, Inc. Atraumatic laser tip for atrial fibrillation treatment
US7163534B2 (en) 2003-10-30 2007-01-16 Medical Cv, Inc. Laser-based maze procedure for atrial fibrillation
US7169142B2 (en) 2003-10-30 2007-01-30 Medical Cv, Inc. Malleable energy wand for maze procedure
US7338485B2 (en) 2003-10-30 2008-03-04 Medical Cv, Inc. Cardiac lesions with continuity testing
US7267674B2 (en) 2003-10-30 2007-09-11 Medical Cv, Inc. Apparatus and method for laser treatment
US7238179B2 (en) 2003-10-30 2007-07-03 Medical Cv, Inc. Apparatus and method for guided ablation treatment
US20050096643A1 (en) * 2003-10-30 2005-05-05 Medical Cv, Inc. Apparatus and method for laser treatment
US8932208B2 (en) 2005-05-26 2015-01-13 Maquet Cardiovascular Llc Apparatus and methods for performing minimally-invasive surgical procedures
US20070073280A1 (en) * 2005-09-16 2007-03-29 Medicalcv, Inc. End-fire guided ablation
US20070073281A1 (en) * 2005-09-16 2007-03-29 Medicalcv, Inc. Guided ablation with motion control
US20090203991A1 (en) * 2006-04-21 2009-08-13 Cedars-Sinai Medical Center Multiple imaging and/or spectroscopic modality probe
US8052605B2 (en) 2008-05-07 2011-11-08 Infraredx Multimodal catheter system and method for intravascular analysis
US20090326620A1 (en) * 2008-06-26 2009-12-31 Francesca Rossetto Deployable Microwave Antenna for Treating Tissue
US8343149B2 (en) 2008-06-26 2013-01-01 Vivant Medical, Inc. Deployable microwave antenna for treating tissue
US8211098B2 (en) 2008-08-25 2012-07-03 Vivant Medical, Inc. Microwave antenna assembly having a dielectric body portion with radial partitions of dielectric material
EP2481370A1 (en) * 2008-08-25 2012-08-01 Vivant Medical, Inc. Microwave antenna assembly having a dielectric body portion with radial partitions of dielectric material
US8512329B2 (en) 2008-08-25 2013-08-20 Covidien Lp Microwave antenna assembly having a dielectric body portion with radial partitions of dielectric material
EP2158869A1 (en) * 2008-08-25 2010-03-03 Vivant Medical, Inc. Microwave antenna assembly having a dielectric body portion with radial partitions of dielectric material
US20100049185A1 (en) * 2008-08-25 2010-02-25 Vivant Medical, Inc. Microwave Antenna Assembly Having a Dielectric Body Portion With Radial Partitions of Dielectric Material
EP2349045A4 (en) * 2008-10-21 2012-04-11 Microcube Llc Methods and devices for applying energy to bodily tissues
US9615882B2 (en) 2008-10-21 2017-04-11 Microcube, Llc Methods and devices for applying energy to bodily tissues
US8968287B2 (en) 2008-10-21 2015-03-03 Microcube, Llc Methods and devices for applying energy to bodily tissues
EP2349045A1 (en) * 2008-10-21 2011-08-03 Microcube, LLC Methods and devices for applying energy to bodily tissues
US20100137857A1 (en) * 2008-10-21 2010-06-03 Microcube, Limited Liability Corporation Methods and devices for applying energy to bodily tissues
US20100121319A1 (en) * 2008-11-10 2010-05-13 Microcube, Llc Methods and devices for applying energy to bodily tissues
US8832927B2 (en) 2009-03-10 2014-09-16 Covidien Lp Method of manufacturing surgical antennas
US20110004205A1 (en) * 2009-07-01 2011-01-06 Chu Chun Yiu Methods and devices for delivering microwave energy
US8882759B2 (en) 2009-12-18 2014-11-11 Covidien Lp Microwave ablation system with dielectric temperature probe
US8568404B2 (en) 2010-02-19 2013-10-29 Covidien Lp Bipolar electrode probe for ablation monitoring
US9839477B2 (en) 2010-02-19 2017-12-12 Covidien Lp Bipolar electrode probe for ablation monitoring
US20110238055A1 (en) * 2010-03-26 2011-09-29 Vivant Medical, Inc. Ablation Devices with Adjustable Radiating Section Lengths, Electrosurgical Systems Including Same, and Methods of Adjusting Ablation Fields Using Same
US8740893B2 (en) 2010-06-30 2014-06-03 Covidien Lp Adjustable tuning of a dielectrically loaded loop antenna
US9549778B2 (en) 2010-06-30 2017-01-24 Covidien Lp Adjustable tuning of a dielectrically loaded loop antenna
US8636664B2 (en) 2011-02-17 2014-01-28 Covidien Lp Energy-delivery device including ultrasound transducer array and phased antenna array, and methods of adjusting an ablation field radiating into tissue using same
US9192441B2 (en) 2011-02-17 2015-11-24 Covidien Lp Energy-delivery device including ultrasound transducer array and phased antenna array, and methods of adjusting an ablation field radiating into tissue using same
US8317703B2 (en) 2011-02-17 2012-11-27 Vivant Medical, Inc. Energy-delivery device including ultrasound transducer array and phased antenna array, and methods of adjusting an ablation field radiating into tissue using same
US8376948B2 (en) 2011-02-17 2013-02-19 Vivant Medical, Inc. Energy-delivery device including ultrasound transducer array and phased antenna array

Also Published As

Publication number Publication date Type
WO2003053259A3 (en) 2003-12-24 application
US6802840B2 (en) 2004-10-12 grant
US20030050631A1 (en) 2003-03-13 application
US20030050630A1 (en) 2003-03-13 application
US20020128636A1 (en) 2002-09-12 application
CA2433416A1 (en) 2003-07-03 application
JP2005512668A (en) 2005-05-12 application
WO2003053259A2 (en) 2003-07-03 application
US20060217694A1 (en) 2006-09-28 application
US20030069575A1 (en) 2003-04-10 application
EP1395190A2 (en) 2004-03-10 application
US20020087151A1 (en) 2002-07-04 application
JP2005137916A (en) 2005-06-02 application
US7303560B2 (en) 2007-12-04 grant
JP4131414B2 (en) 2008-08-13 grant

Similar Documents

Publication Publication Date Title
US6314963B1 (en) Method of ablating tissue from an epicardial location
US7001415B2 (en) Transmural ablation device
US7052493B2 (en) Methods and devices for ablation
US6471697B1 (en) Tissue ablation device and method
US6287302B1 (en) End-firing microwave ablation instrument with horn reflection device
US5941845A (en) Catheter having multiple-needle electrode and methods thereof
US6120496A (en) Surgical method and apparatus for positioning a diagnostic or therapeutic element within the body and coupling device for use with same
US5938659A (en) Catheter system having cooled multiple-needle electrode and methods thereof
US7004938B2 (en) Radio-frequency-based catheter system with improved deflection and steering mechanisms
US6142994A (en) Surgical method and apparatus for positioning a diagnostic a therapeutic element within the body
US5849028A (en) Catheter and method for radiofrequency ablation of cardiac tissue
US8337492B2 (en) Ablation catheter
US6238390B1 (en) Ablation catheter system having linear lesion capabilities
US6071281A (en) Surgical method and apparatus for positioning a diagnostic or therapeutic element within the body and remote power control unit for use with same
US6267760B1 (en) Surgical method and apparatus for positioning a diagnostic or therapeutic element within the body and forming an incision in tissue with minimal blood loss
US5897554A (en) Steerable catheter having a loop electrode
US7435248B2 (en) Medical probes for creating and diagnosing circumferential lesions within or around the ostium of a vessel
US6752805B2 (en) Surgical ablation probe for forming a circumferential lesion
US6971394B2 (en) Methods and devices for ablation
US20020004644A1 (en) Methods of deploying helical diagnostic and therapeutic element supporting structures within the body
US6416505B1 (en) Surgical method and apparatus for positioning a diagnostic or therapeutic element within the body and pressure application probe for use with same
US6217576B1 (en) Catheter probe for treating focal atrial fibrillation in pulmonary veins
US20050027289A1 (en) Cryoablation systems and methods
US7846157B2 (en) Method and apparatus for control of ablation energy and electrogram acquisition through multiple common electrodes in an electrophysiology catheter
US6926669B1 (en) Heart wall ablation/mapping catheter and method

Legal Events

Date Code Title Description
AS Assignment

Owner name: MAQUET CARDIOVASCULAR LLC, CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BOSTON SCIENTIFIC LIMITED;BOSTON SCIENTIFIC SCIMED, INC.;CORVITA CORPORATION;AND OTHERS;REEL/FRAME:020462/0322

Effective date: 20080102

Owner name: MAQUET CARDIOVASCULAR LLC,CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BOSTON SCIENTIFIC LIMITED;BOSTON SCIENTIFIC SCIMED, INC.;CORVITA CORPORATION;AND OTHERS;REEL/FRAME:020462/0322

Effective date: 20080102