US20070299392A1 - Material Delivery System - Google Patents

Material Delivery System Download PDF

Info

Publication number
US20070299392A1
US20070299392A1 US11/632,476 US63247605A US2007299392A1 US 20070299392 A1 US20070299392 A1 US 20070299392A1 US 63247605 A US63247605 A US 63247605A US 2007299392 A1 US2007299392 A1 US 2007299392A1
Authority
US
United States
Prior art keywords
balloon
optionally
pressure
exemplary embodiment
ejection
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
US11/632,476
Other languages
English (en)
Inventor
Mordechay Beyar
Oren Globerman
Rami Keller
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.)
By Pass Inc
Original Assignee
By Pass 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
Application filed by By Pass Inc filed Critical By Pass Inc
Priority to US11/632,476 priority Critical patent/US20070299392A1/en
Assigned to BYPASS, INC. reassignment BYPASS, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: BEYAR, MORDECHAY, GLOBERMAN, OREN, KELLER, RAMI
Assigned to BYPASS, INC. reassignment BYPASS, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: BEYAR, MORDECHAY, GLOBERMAN, OREN, KELLER, RAMI
Publication of US20070299392A1 publication Critical patent/US20070299392A1/en
Priority to US13/304,756 priority patent/US8439890B2/en
Abandoned legal-status Critical Current

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/958—Inflatable balloons for placing stents or stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A61M25/1027—Making of balloon catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00023—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids closed, i.e. without wound contact by the fluid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/0022—Balloons
    • A61B2018/00238—Balloons porous
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00642—Sensing and controlling the application of energy with feedback, i.e. closed loop control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/0066—Sensing and controlling the application of energy without feedback, i.e. open loop control
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00666—Sensing and controlling the application of energy using a threshold value
    • A61B2018/00672—Sensing and controlling the application of energy using a threshold value lower
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00666—Sensing and controlling the application of energy using a threshold value
    • A61B2018/00678—Sensing and controlling the application of energy using a threshold value upper
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00702—Power or energy
    • A61B2018/00708—Power or energy switching the power on or off
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00696—Controlled or regulated parameters
    • A61B2018/00744—Fluid flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00863—Fluid flow
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B2018/2205—Characteristics of fibres
    • A61B2018/2211—Plurality of fibres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/26—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor for producing a shock wave, e.g. laser lithotripsy
    • A61B2018/266—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor for producing a shock wave, e.g. laser lithotripsy the conversion of laser energy into mechanical shockwaves taking place in a part of the probe
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A61M2025/1043—Balloon catheters with special features or adapted for special applications
    • A61M2025/105—Balloon catheters with special features or adapted for special applications having a balloon suitable for drug delivery, e.g. by using holes for delivery, drug coating or membranes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A61M2025/1043—Balloon catheters with special features or adapted for special applications
    • A61M2025/1088—Balloon catheters with special features or adapted for special applications having special surface characteristics depending on material properties or added substances, e.g. for reducing friction

Definitions

  • the present invention relates to the delivery of materials, for example, high speed intrabody needle-less injection.
  • a common treatment for a blocked artery, especially a coronary artery is PTCA, in which a balloon is inflated inside the lumen of the artery, causing the lumen to increase, while compressing the blockage and/or forcefully expanding the artery.
  • PTCA vascular endothelial artery
  • One problem with this method is restenosis, in which the artery responds to the PTCA procedure by inflammation and inward growth.
  • Another problem is collapse of the wall of the artery back into its lumen.
  • Injection of materials inside the body is also generally known.
  • the ejected material is used to penetrate the walls of tubular organs, for example, a blood vessel or a prostate, optionally for preventing restenosis.
  • the walls in the balloon comprise pressure sensitive holes which open only at a threshold internal pressure level, for example, a level above regular (e.g., PTCA) balloon inflation pressures.
  • a threshold internal pressure level for example, a level above regular (e.g., PTCA) balloon inflation pressures.
  • the spatial density and/or diameter of the holes varies along the length of the balloon, for example, to enhance uniformity of material provision and/or for other reasons, such as spatially-non-uniform treatment.
  • the drop of pressure caused by the opening of the holes is not sufficient to deflate the balloon in a period of less than, for example, 1 minute, 10 seconds, 5 seconds, 1 second, 0.5 seconds or intermediate or lesser values.
  • a same balloon is used both for PTCA and/or stenting and for material provision.
  • the balloon can be used for PTCA at regular balloon pressures and then, when the stenosis is compressed, the pressure can be increased to eject re-stenosis inhibiting material.
  • the balloon, at or about the holes is in full contact with the surrounding tissue.
  • a minimum contact pressure is ensured.
  • the high pressure source comprises an explosion, for example, sudden evaporation of water caused by electricity and/or energy absorption.
  • a laser light source provides the energy.
  • the balloon includes a mirror or target for energy distribution control, so that some or all of the energy is distributed by the target, rather than by absorption in the balloon filling.
  • a mechanical means provides the impulse.
  • a thin metallic or plastic plate that releases kinetic energy (e.g., due to its expansion) when irradiated by the laser light, may be used.
  • the laser light releases stored energy, for example, changing the shape of a shape-memory element or freeing a spring from a constraint.
  • multiple pressure sources for example multiple laser fibers to provide multiple sources of heat for expansion
  • multiple pressure sources are provided in the balloon.
  • means are provide to direct the advancing of a resulting high pressure wave and/or shock wave.
  • An aspect of some embodiments of the invention relates a balloon with pressure sensitive holes that open to allow material passage only above a certain threshold pressure.
  • the holes are arranged radially on the balloon.
  • one or more axial holes are provided.
  • the holes include a layer of material, for example, part of a layer used on the balloon, which layer is torn when the pressure rises and/or by a shockwave.
  • the holes are formed using multiple balloon layers, at least one of which is aperture.
  • the holes are formed during manufacture by drilling in the balloon (e.g., using a water jet, a laser, a hot needle and/or chemical means).
  • one or more apertures (or exit ports) in the balloon are created by a laser source used for injecting the material.
  • the apertures may be, for example through or partial (blind).
  • a multi-fiber laser source is used and the laser light is used both for creating passages through the balloon and for increasing the pressure inside the balloon.
  • a single pulse or a series of pulses may be used for this task.
  • the balloon wall itself serves as a target that absorbs laser energy, and parts of which heats explosively.
  • the threshold pressure is above a regular PTCA inflation pressure, for example, above 5, 10, 15 or 20 atmospheres.
  • the balloon is strengthened surrounding the holes and/or at other locations thereon, to prevent tearing.
  • the strengthening is by providing a braid of material surrounding the aperture.
  • An aspect of some embodiments of the invention relates to a strengthened apertured balloon, which includes a plurality of holes therein and which is strengthened near the holes, to prevent tearing of the balloon at the holes.
  • the strengthening is by elongate elements, such as fibers, having a length comparable or greater than the balloon diameter and optionally disposed axially, radially and/or otherwise along the balloon surface.
  • An aspect of some embodiments of the invention relates to injection of a structural material into the walls of tubular organs.
  • the injection is using a balloon that contacts the walls, optionally using needle-less injection.
  • one or more needles is used to inject the structural material.
  • the structural material is a hardening material.
  • the injected material does not harden.
  • the structural material is sufficient to enhance the structure of the wall and prevent collapse thereof.
  • the structural material is used to strengthen one or more of a stented vessel, a PTCAed vessel, an aneurysm, a prostate and/or an anastomosis region.
  • the injected material is adapted to dissipate with time, be bio-absorbed and/or migrate out of the walls, for example, due to dilution in inter-cellular fluids.
  • an expandable balloon body having a surface and having an axis
  • At least one predefined ejection port on said body adapted for ejection of fluid therefrom, in a transaxial direction;
  • an impulse source configured for and adapted to eject material out of said point at a velocity and shape suitable for mechanically penetrating tissue adjacent said port.
  • the balloon is adapted for a blood vessel.
  • the balloon is compliant.
  • the balloon is non-compliant.
  • said body is adapted to be pressurized during said ejection.
  • said impulse source comprises a laser source located remote from said body and a light guide adapted to guide said source into said body to generate a mechanical impulse thereat when said laser source is activated.
  • said impulse source comprises a target to which energy is provided from outside to generate said impulse.
  • said target releases energy stored in the balloon in response to said energy.
  • said target converts said outside energy into said impulse.
  • said impulse source comprises a source of electricity.
  • said impulse source comprises a mechanical pressure generator adapted to be located outside a human body containing the wall and a fluid column connecting said generator with said balloon body.
  • said impulse source is inside said balloon body.
  • said impulse source comprises a mechanical impulse source.
  • the balloon comprises at least one axial port predefined and adapted for axial ejection of fluid therefrom.
  • said port comprises a weakening in said body.
  • said body is strengthened adjacent said weakening.
  • the balloon has a stent mounted thereon and adapted to deliver said stent.
  • said at least one port comprises a plurality of ports arranged on said body.
  • said at least one port comprises a plurality of ports arranged and configured with said impulse source to generate a non-uniform fluid ejection pattern.
  • said at least one port comprises a plurality of ports arranged and configured with said impulse source to generate a uniform fluid ejection pattern over at least a predetermined axial length of the body.
  • said fluid comprises a structural material adapted to affect at least one mechanical property of human tissue when ejected into the tissue.
  • said fluid comprises an anti-proliferation bio-active component.
  • said fluid is stored within said body.
  • said fluid expands said body.
  • said body comprises at least one tube on an outside of said body and wherein said at least one port is defined on said tube.
  • a method of treating a hollow organ comprising:
  • a treatment balloon comprising:
  • a plurality of ports formed in said body and adapted to eject fluid responsive to pressure conditions in said balloon, said conditions being met only after said balloon is expanded to said ranges.
  • said balloon is adapted to apply PTCA prior to said ports opening.
  • said plurality of ports comprises weakened portions of said body.
  • said weakenings have an outside surface that is not flush with an outside surface of said balloon.
  • said weakenings have an inside surface that is not flush with an inside surface of said balloon.
  • said body comprises at least one strengthening element adjacent said weakenings.
  • said plurality of ports are adapted to close once a pressure on them is below a threshold value.
  • said plurality of ports are arranged to eject material radially to an axis of said balloon.
  • the balloon comprises an impulse source in or near said balloon and adapted to generate an impulse sufficient to open said ports.
  • said ports are adapted to remain closed at a pressure below 15 atmospheres.
  • a treatment balloon comprising:
  • kit comprising:
  • an ejector adapted to inject material into an organ wall, in-vivo
  • said structural material is mixed with a bioactive material.
  • said ejector is a needle-less ejector.
  • said structural material is a setting material.
  • FIGS. 2A-2E are a series illustrating an exemplary process of treating a blood vessel or another tubular organ, following the flowchart of FIG. 1 ;
  • FIG. 3 is a trans-axial cross-sectional view of a treated blood vessel, in accordance with an exemplary embodiment of the invention.
  • FIG. 4 is a schematic diagram of a vessel wall treatment system, in accordance with an exemplary embodiment of the invention.
  • FIG. 7 is a graph summarizing experimental results showing penetration depth as a function of pressure and amount of delivery material.
  • FIG. 1 shows a flowchart of a method and FIGS. 2A-2E illustrate the acts of the method, of applying material(s) to and/or driving material(s) into the walls of a blood vessel, in accordance with an exemplary embodiment of the invention.
  • FIGS. 2A-2E are discussed in parallel with the description of FIG. 1 . Variations on the devices and/or methods are described following.
  • FIG. 1 is a flowchart 100 of a method of treating blood vessels, in accordance with an exemplary embodiment of the invention.
  • a narrowing or other problem in a wall 204 of a blood vessel 200 is identified.
  • the narrowing is a plaque deposit 206 , for example, a deposit with a calcified filling 202 .
  • a catheter treatment system 210 ( FIG. 2B ) is inserted into the body and guided to the narrowing.
  • system 210 is used also to identify the problem, for example, including a contrast material port (not shown) or an imager (not shown).
  • a treatment balloon 212 ( FIG. 2B ) is shown, including a plurality of apertures (optionally initially sealed) 214 , for providing treatment to walls 204 .
  • Balloon 212 is optionally inflated with pressure sufficient to perform PTCA on deposits 206 ( FIG. 2C ).
  • the deposits are shown as schematically cracking.
  • apertures 214 leak only a small amount or are configured to remain sealed at pressures used for PTCA (e.g., 15-20 atmospheres inside the balloon).
  • the stenting and/or PTCA are performed using a different balloon from balloon 212 and/or performed after provision of material to the vessel.
  • the material delivery method e.g., high pressure pulse, described below
  • the material delivery method is also used to deliver the stent and/or fix it in place.
  • the delivery is at a delay after stenting and/or PTCA, for example, to allow the vessel tissue to adapt and/or to ensure the stenting and/or PTCA completed successfully.
  • exemplary delays are 30-90 seconds, for example, 60 seconds.
  • an optical fiber 230 delivers a pulse of light which is absorbed in a filling 238 (e.g., saline) or a target ( 406 in FIG. 4 ), causing an explosion 232 .
  • a filling 238 e.g., saline
  • a target 406 in FIG. 4
  • Shock and/or pressure waves 234 from explosion 232 travel to the walls of balloon 212 and cause the ejection of plumes 236 .
  • the plumes comprise the filling which may be, for example, saline mixed with a drug or a cement material.
  • the total volume of the balloon is not increased very much by the explosion, for example, the balloon diameter increasing no more than 1%, 5%, 10% or smaller, intermediate or larger values.
  • increase is avoided (e.g., by using a non-compliant balloon) to prevent and/or reduce pain and/or damage which may be caused by over expansion, for example, by overstenting and/or expansion of the urethra.
  • a significant increase in balloon volume occurs, for example, 10%, 20%, 30% or a smaller, intermediate or larger value. This increase may or may not decrease after plumes 236 flow.
  • varying or cycling of the balloon diameter and/or pressure are used to assist in material penetration and/or maintenance in the tissue.
  • increased pressure after or during injection prevents leakage from the penetration points.
  • decreased pressure before injection relaxes the vessel wall.
  • increased pressure (or waves) after penetration is used to cause sideways (e.g., circumferential) dispersion of the injected material.
  • the degree of pressure during injection controls the tissue thickness and thus the effective penetration depth.
  • the inflation of balloon 212 guarantees that the balloon portions surrounding apertures 214 are in good contact with walls 204 of the blood vessel, possibly ensuring less leakage and/or better penetration.
  • a minimal contact pressure is provided, for example, 0.5, 1, 3 or intermediate values or more of atmospheres.
  • apertures 214 may be covered by the stent. However, most of the apertures will not be.
  • the apertures are arranged to fit between stent struts, however this is not essential in some embodiments, for example, due to the presence of many apertures.
  • balloon 212 may be repositioned (e.g., axially or by rotation), optionally assisted by a slight deflation to reduce contact pressure, and then additional injections carried out. Second injections may also be used if a different material is to be injected. Optionally, the same balloon is used for both injections. Alternatively, the balloon may be replaced. Optionally, two balloons are provided in tandem, for example on a same balloon catheter and/or on a same guidewire.
  • balloon 212 is deflated for removal.
  • some leakage occurs through the apertures during removal.
  • the apertures are designed to seal again when the pressure goes below a threshold, possibly a threshold lower than the injection pressure, for example, 10 atmospheres (e.g., 25% or 50% lower).
  • the apertures are formed of a rubber-like material that self seals when the pressure goes down. A puncture in the rubber material expands when pressure is increased.
  • one or more flaps are provided on the apertures.
  • the flaps serve as a one way valve, allowing the flap to open outwards, but not inwards.
  • FIG. 3 is a trans-axial cross-section of vessel 200 showing plumes 236 in walls 204 and deposits 206 . If, for example, a structural material such as a glue is injected, it can be seen that the plumes can serve to hold the vessel open. In some embodiments of the invention, at least some of the material is provided outside of the wall. In one example, the balloon has ridges, for example in an axial or helical pattern and holes are provided at the bases of the ridges for material injection. Some or all of this injected material may remain trapped between the balloon and the vessel walls.
  • a structural material such as a glue
  • FIG. 4 illustrates an exemplary system 400 , such as may be used to carry out the method illustrated with the aid of FIGS. 1-3 , in accordance with an exemplary embodiment of the invention.
  • temperature control of the balloon is provided.
  • a closed loop control for example using a temperature sensor in the balloon coupled with fluid circulation through the balloon is used.
  • a heat exchanger is provided in the balloon, so the actual contents of the balloon need not be changed.
  • the heat exchanger is in the form of one or more coils in a lumen or a heat conducting web, such as gold.
  • open loop cooling is used, for example, pre-cooling of the fluid and/or the balloon.
  • a safety is used to warn a user and/or prevent additional energy provision.
  • the lumen used to provide cooling fluid is used to cool an energy providing conduit (e.g., fiber, wire).
  • a saline source 412 is optionally used to inflate balloon 212 .
  • an impulse source 418 is used to generate a pressure wave in balloon 212 instead of or in addition to laser source 410 .
  • source 418 is used to generate pressure waves in the balloon, for example, to provide a massaging effect.
  • vibrations are provided to the balloon, for example, to prevent adherence of the injected material to the apertures.
  • an external pressure impulse source and a laser impulse source may provide different types of effects.
  • a laser source can provide a very sharp impulse, albeit possibly reduced volume of expulsion and/or reduced power.
  • a pressure source for example, a source that is outside the body, is typically capable only of less sharp impulses, however, such impulses can include considerable power and/or volume.
  • both types of sources are used simultaneously, optionally in synchronization. Alternatively or additionally, with a delay between them.
  • Each source may be used to provide one or more pulses, only some of which are synchronized.
  • the type of source used depends on the length of the catheter.
  • a pressure source such as a syringe, pump or gas powered system, may be used.
  • a laser based solution may be most appropriate.
  • a source of drug or other material 420 to be provided as plume 236 is optionally used as well and may feed, for example into saline source 412 or downstream therefrom. Alternatively or additionally, material 420 is used instead of saline to inflate the balloon.
  • the material to be delivered and/or contrast material are provided directly into balloon 212 , for example by needle injection while the balloon is outside the body instead of or in addition to providing using saline (or other fluid).
  • balloon 212 is formed of two or more layers, with one or more blind apertures 414 formed thereon.
  • the apertures are formed only in an inner layer and/or only in an outer layer. More details are provided below.
  • a strengthening element 404 is optionally provided, for example, a fiber or cord.
  • element 404 is non-elastic and prevents over-expansion of balloon 212 above that needed for PTCA.
  • element 404 is placed near apertures 404 , to prevent tears from propagating from the apertures and rupturing balloon 212 .
  • element 404 comprises a grid and the apertures are formed in cells of the grid.
  • the grid is non-uniform.
  • a non-grid arrangement is used, for example a random felt-like arrangement or a spiral arrangement.
  • a metal stent-like frame is used to prevent over inflation of the balloon.
  • the stent-like cage is designed to stop expanding radially once a certain radius is reached.
  • the balloon is inflated, and the cage prevents inflation of the balloon past that point, but still allows ejection of fluids therefrom.
  • the cage remains and serves as a stent.
  • the cage is of a spring-back type, for example formed of Nitinol.
  • two tubes lead into balloon 212 , an inflation lumen 402 and optical fiber 230 .
  • a fluid removal lumen is provided as well (not shown) and used for replacing the contents of balloon 212 (e.g., saline by a glue material), optionally without deflating balloon 212 .
  • FIG. 6A shows a system 600 , in which a fiber 602 branches to multiple branches 604 , each of which may serve as a local energy source. This arrangement may be used to control the distribution of shock/pressure waves in the balloon.
  • fiber 602 has a diameter of 220 microns and fibers 604 have a diameter of 100-120 microns each.
  • the diameter of fiber 602 is set by a need to transmit a sufficient amount of power.
  • the diameter is determined by a need to allow bending of the fiber in blood vessels leading to the therapy area.
  • FIG. 6A Also visible in FIG. 6A are other parts which may be provided in a treatment system, namely a guide-wire 608 which optionally travels in its own channel 610 , a balloon 606 optionally including pressure-responsive apertures 612 and a guide sheath 614 .
  • an interior framework for example, of fibers, or a rigid attachment to the base of the balloon are provided to prevent the fiber from pointing in random directions.
  • the fiber is made stiff so that it stays axial.
  • the fiber is attached to an inner lumen used for the guide wire and which remains generally axial.
  • the fiber is aimed away from any surfaces of the balloon to prevent inadvertent penetration.
  • nearby areas are covered with a reflective coating.
  • a target or mirror 406 is provided for fiber 230 , to distribute and/or otherwise control the location and/or spatial extent of explosion 232 .
  • a target is optionally used to absorb the energy at the target location and a mirror is optionally used to assist in redistributing the energy in the fluid filling the balloon.
  • the target is formed of carbon or aluminum oxide.
  • the target heats and boils fluid near it. Alternatively or additionally, the target itself explodes or evaporates at least in part.
  • the wavelength used by laser 410 is absorbed by the fluid used and/or by one or more impurities (e.g., dye or suspended particles) mixed therein.
  • the impurity is selected to selectively absorb the laser energy.
  • the concentration is selected so that the depth of penetration of the laser energy is a known amount and has a known effect (e.g., impulse sharpness and spatial distribution of foci).
  • the impurity used is the one used in eye photo-treatment, for example Indocyanine green.
  • Target 406 is optionally a metal element. Alternatively or additionally, target 406 is a decomposing element, such as silver azide.
  • the target is made of a material that absorbs the laser energy and forms a known volume of gas when hit by the laser light.
  • the target itself explodes.
  • the target comprises multiple target layers and/or a significant thickness, so that additional laser pulses will also cause evaporation of parts of the target.
  • the target comprises a capsule whose shell is transparent to the wavelength used and whose contents are not.
  • the target is formed on the fiber tip that delivers the laser energy, for example, as a layer of dye or metal coating.
  • the laser source is a Nd:YAG laser and a dopant capable of absorbing at the wavelength of 1.064 microns is used.
  • Example dopants are carbon and metal particles.
  • Other materials that absorb between 0.800 and 1.100 microns may be used, for various laser wavelengths, for example diode lasers.
  • the laser source provides wavelengths that are absorbed in water, for example Holmium pulsed laser 2.1 microns, from an Erbium pulsed laser at 2.9 microns, or other wavelengths above 1.9 microns (for example the 1940 nm).
  • the absorption spectra of water is well known and wavelengths for which the absorption coefficient is high (and transmission means available) may be used.
  • the shock/pressure waves may be shaped by selecting a lower or higher absorption coefficient and/or different shapes for the beam.
  • a protective barrier is provided to prevent material affected by the laser from being injected outside of the balloon.
  • a balloon or membrane is provided around the fiber tip.
  • a membrane is provided inside the balloon.
  • the fiber tip is distanced from the apertures, for example, being outside the balloon.
  • a pre-defined capsule for absorbing energy and remaining sealed is provided.
  • one or more internal baffles 408 are used to guide the effects of explosion 232 , for example, setting paths lengths for the shock/pressure waves, aiming the shock/pressure waves, to impinge on the balloon wall at desired angles and/or for absorbing energy and/or slowing down an impulse attack rate, in some directions.
  • the guiding comprises distributing the waves more evenly spatially and/or temporally.
  • explosion 232 has been shown inside balloon 212 , it may be provided outside the balloon, for example, within 30, 20, 15, 10, 5 or fewer mm from the inflatable part of balloon 212 , for example, distally or proximally.
  • the area of the explosion is surrounded by a strengthening layer, for example, a layer of plastic or metal, optionally rigid, which may serve to prevent rupturing of catheter 210 and/or assist in guiding explosion waves 234 towards the balloon.
  • the balloon is formed of standard materials, such as Nylon 12 or PET.
  • the balloon is sized for its application, for example, 1, 2, 2.5, 3 or 4 mm for relatively small vessels such as the coronaries or brain vessels. Larger diameters may be used, for example, in veins and in the prostate (e.g., 7-10 mm).
  • a balloon may also be sized for treating the aorta or the abdominal aorta, for example, to treat calcifications or an aortic stenosis.
  • the injected material is a structural material which changes the structural (e.g., mechanical) properties of the tissue it is injected into.
  • a structural material is a glue or cement which hardens, for example, Bioglue Surgical Adhesive, Dermabond cyanoacrylate or collagen (in certain forms).
  • a non-hardening material is used, for example, silicon gel, carbon nano tubes, collagen (in certain forms), carbon fibers, plastic fibers and/or glass fibers. It is noted that the purposes of stiffening and/or strengthening blood vessels to prevent collapse and/or dissection thereof may be served even if the entire wall 204 is not made rigid.
  • Various amounts of material may be injected based on the material used and/or effect desired.
  • the volume of the injected material is used the volume of the injected material.
  • the injection is not spatially dense, for example, there being non-injected areas, for example of dimensions of 0.3 mm, 0.5 mm, 1 mm, 2 mm in minimum or maximum extent.
  • the injection fills only part of a thickness of the tissue, for example, not reaching substantially to within 10% of the edge of the tissue.
  • the injected material collects in certain spatial forms, for example elongate needle, where the length (radial) to width ratio is less than 1:1 or 1:2.
  • Another exemplary arrangement is a flat arrangement, where a plume has a height to width ratio of 2:1, 3:1 or more. Generally, a smaller amount of injected material is desired provided the desired mechanical and/or biological changes are achieved.
  • wall 204 changes elasticity, for example, increasing if an elastic material was injected or decreasing if a malleable material was injected.
  • the structural material is mixed in with a bioactive or other material, for example of a type described below.
  • the structural material is of a type not normally present in the tissue into which it is injected, at least not in significant amounts.
  • the structural material is provided instead of or in addition to a stent.
  • a less stiff stent is used due to the provision of structural material.
  • the stent, accompanied by the glue injection is at least 50%, 70%, 80% or more flexible that a standard suitable stent and/or there is reduction in metal content of 50%, 70%, 80% or more.
  • reduction in metal thickness allows stenting in small ducts, for example, smaller than 2 mm, 1 mm, 0.7 mm, 0.5 mm or smaller intra body ducts.
  • the amount of material in the stent is reduced as compared to an indication assumed to be correct by a physician.
  • a softer material is used for the stent, for example thin (as opposed to thick) plastic.
  • the stent is made biodegradable/absorbable, for example, biodegradable plastic or sugar.
  • a biodegradable stent is made more safe by the stent adhering to structural material (e.g., glue) injected by the balloon into or near the vessel walls, so that as the stent decomposes, the vessel wall prevents larger pieces of the stent from going with the blood flow.
  • the reduction in stent material amount may reduce complications.
  • the structural material comprises fibers, optionally fibers that are curled shut and coated with a material, such as sugar or certain plastics, which will dissolve and release the fibers after time.
  • a material such as sugar or certain plastics
  • the material is dissipated when not in solid tissue (e.g., when in a blood flow) and/or dissolves.
  • the material is biodegradable.
  • these properties are used to reduce danger if the glue penetrates tissue past the blood vessel wall.
  • the material hardens in contact with tissue and/or blood.
  • the injected material comprises a suspension of particles.
  • the suspended particles will conglomerate and have a structural effect when inside the tissue, where fluid may be squeezed out and/or migration is in narrow channels. In the blood, such particles will disperse.
  • the particles are selected to be of a size comparable to endothelial pores (or larger) and/or comparable in size to inter cellular spaces.
  • a two part material for example PMMA
  • a first component material is injected into the walls and then a second component material (e.g., a catalyst or hardener) is injected.
  • a second component material e.g., a catalyst or hardener
  • the heat provided during such a reaction is used to further prevent restenosis.
  • balloon 212 is moved after injection of the material, to prevent sticking of the material thereto.
  • the balloon is rotated during a setting time of the material.
  • a clean saline (or other physiologically acceptable) solution is “sweated” out of balloon 212 , at a low pressure, which sweating cleans out apertures 414 and/or removes any surface residue of the injected material.
  • the sweated material includes a catalyst or solvent that prevents hardening of the injected material.
  • the balloon is coated with a material to which the structural material does adhere, for example Teflon or a silicon oil coating.
  • the balloon is removed before the material complete a setting process, for example, using a material with a 30 minute setting process and removing the balloon after 5 minutes.
  • a timer is provided with kit for using the system, which timer indicates when it is time to remove the balloon and prevent setting.
  • the balloon is kept inflated while the glue hardens or semi-hardens.
  • a blood flow bypass pathway is provided in the balloon, for example, a conduit, as known in the art.
  • the balloon includes a pressure sensor, used to measure the response of the wall of the vessel to applied pressure and thus assess the effect of the treatment.
  • a dye/marker is injected.
  • the dye is used to identify regions in a later treatment (e.g., an extent of cancer, for surgery).
  • the dye/marker is a radio-opaque material, which serves as an indication of stent position or treatment location.
  • the injection is patterned, for example so that a particular treatment and/or parameters thereof can be read from an image of the treated vessel.
  • a dye component is used to estimate the amount of material injected into the vessel walls and/or lumen.
  • a material that softens plaque and/or other tissue is injected.
  • this injection is made prior to a PTCA procedure, so that the PTCA procedure will not only flatten the plaque but also drain it.
  • a structural material is injected after PTCA and/or softening.
  • a drainage hole is formed in the plaque for draining the softened plaque, for example, using an advancable sharp tip in the catheter, for example, provided along the guidewire or extending out of the balloon.
  • a suction lumen is provided to suck out the plaque.
  • the sharp tip is provided along the suction lumen.
  • the injected material is a bioactive material, for example, a material which prevents inflammation and/or tissue proliferation, such as Rapamycin taxol, immune-sensitizing or desensitizing drugs and/or gene therapy substances.
  • the material is encapsulated, for example, in nanoparticles, so that a slow release over a period of time such as 1-3 month is provided.
  • Other exemplary periods are less than a week, between a week and a month and between three and six months or more.
  • the methods and/or apparatus in accordance with some embodiments of the invention allow a reduction in volume of drug and/or other material used.
  • insertion directly into the tissue, and optionally with a small penetration hole which may self-seal reduces leakage into the blood and possible side effects thereof.
  • the balloon remains inflated after ejection of the material, to prevent further leakage.
  • the surface to volume ratio of the material is better than for surface application, due to the high pressure which can, for example, ensure multiple narrow and deep insertions of the material into the vessel.
  • the use of needleless injection using short impulses may cause less pain to the patient and/or shorten treatment time.
  • the bio-active material is DNA or other genomic material, such as RNA (of various types), viruses, and plasmids.
  • the amount of injected material is less than 10 cc, for example, less than 1 cc, for example, 0.01-0.03 cc for a coronary blood vessel.
  • the injected material is prepared and/or provided near or at the treatment time, for example, for pharmaceuticals with a short life time.
  • FIGS. 5A-5D illustrate various aperture designs in which the aperture remain closed in a PTCA procedure and open when material injection is provided.
  • the apertures are 20 microns, 30 microns, 50 microns, 100 microns or other smaller intermediate or greater, dimension, in size.
  • the center-to center distance is 0.3 mm, 0.5 mm 0.7 mm or a smaller, intermediate or greater distance.
  • FIG. 5B shows an alternative design 510 in which a solid layer 516 is provided between to aperture layers 512 and 518 .
  • the outer apertures are provided with a material that prevents clotting.
  • the strength of the solid layer and/or depth of the apertures are configured to have desired properties of tearing only above a certain threshold pressure.
  • FIG. 5C shows a design 520 , in which a plurality of apertures 524 are formed in a single layer 522 of a balloon.
  • the thickness of the layer at the hole is 20-70% of the wall thickness of the balloons.
  • the layer at the hole is pre-weakened, for example, being punctured.
  • an Eximer or other laser type is used to ablate material from the balloon, thereby forming the apertures.
  • a light reflecting layer is provided between two balloon layers, to control laser penetration.
  • the absorption properties of the two layers may be different.
  • different layers are formed of different materials.
  • a water jet is used to drill the apertures.
  • a mask is used during aperture formation to prevent damaging the balloon except at areas where an aperture is desired.
  • a mold used to manufacture the balloons, contains micro protrusions that make the through or blind holes, for example, when forming the balloon by blowing a plastic tube in the mold.
  • the mold and/or the blown tube are covered with grains of salt or another water-soluble and/or biocompatible material, which is later washed off, leaving pores.
  • FIG. 5D shows a balloon design 530 , in which a plurality of apertures 534 are at least with a temporary filling 536 .
  • filling 536 is a material the dissolves in body fluids.
  • the dissolution takes time, so that a PTCA procedure can be carried out before dissolution and weakening of balloon 530 .
  • filling 536 weakens at body temperatures.
  • it is not filling 536 that weakens, but an adhesive that attaches it to the rest of balloon 530 .
  • a non-weakening section is provided so the filling will remain attached to the balloon.
  • filling 536 is dissolved using a solution inside balloon 530 , for example, a gelatin filling or a polyspridine filling.
  • clot dissolving material is used to dissolve a filling made of clot-like device. Any leaking material may be useful to prevent clotting caused by the procedure (if any).
  • filling 536 is weakened by the inflation of balloon 530 to a maximum diameter.
  • the apertures may have various shapes.
  • the radial profile can be straight as shown.
  • the radial profile is cone like, which may assist in aiming the ejected material.
  • an hourglass or an inverted cone profile are provided.
  • the balloon is filled using lumen 402
  • at least the injected material is not provided through the lumen, for example, to prevent clogging thereof and/or to reduce waste.
  • injection is into the balloon via a one way valve in the balloon, for example, injection through a rubber plug at a tip thereof.
  • material is provided as a layer on the inside of the balloon.
  • a two layer balloon is provided, with the material to be ejected provided between the layers and the apertures provided only in the outer layer.
  • the outer layer is provided as a cap which can be mounted on an existing balloon design, for example, being adhered to the base of the balloon and/or catheter.
  • the actual pattern of the injected material may vary.
  • the system is manufactured to have a desired pattern.
  • the pattern may be controlled, for example, using controller 427 or other means, for example, by varying the balloon pressure during the procedure or by varying the pulses of the laser thereby modifying the shape of the pressure/shock waves.
  • the direction of penetration is modified by changing the angle of the apertures relative to the balloon (e.g., to not be perpendicular as shown).
  • uniformity of material injection is controlled by one or more of non-uniform distribution of apertures and/or non-uniform size of apertures, so that the total amount of plume material per unit area is the same, for example, taking into account a non-uniform pressure profile inside the balloon.
  • the sizes of the apertures are calculated by experimenting with different apertures sizes to determine the effect of explosion on the transport through different apertures.
  • instructions are provided with a kit explaining what hole sizes and/or pressure profiles to use for what materials and/or lesions.
  • different materials and/or amount of materials are injected for plaque and vessel wall and/or for different plaque types.
  • the balloon includes a radio-opaque marker that indicates a rotation of the balloon on an x-ray image.
  • different balloons are used for providing lobes of material in different direction.
  • the filling of the balloon may be replaced.
  • a same balloon is used for multiple axial and/or rotational positions relative to the treated area, with some positions the balloon being activated in a manner that increases material injection relative to other positions.
  • a layer of setting material is provided at the plaque.
  • a material is squeezed between the balloon wall and the vessel wall (e.g., using a low pressure and optionally reduced balloon inflation pressure), so that the material can seep into cracks and/or other damage made to the vessel wall and/or plaque thereat.
  • this procedure is applied at known plaque positions.
  • pre-procedure or during procedure a diagnosis of the lesion to be treated is made.
  • a desired pattern of material distribution is selected and is optionally implemented by selecting a suitably apertured balloon and/or balloon cap.
  • the apertures are arranged in a regular grid pattern or any pattern suitable for manufacturing.
  • a helical pattern is used.
  • the holes sizes and/or distribution and/or source of pressure impulse are arranged to correspond to a known or expected plaque configuration. For example, as many vessels have a plaque lesion in a form that is thicker at the middle than near the ends, a balloon that ejects material more forcefully and/or in greater amounts near the middle may be manufactured. In special cases, other balloons, for example, which eject more at one end, are used, based on a diagnosis of the lesion to be treated.
  • ejection (optionally sector-limited) of a structural material is used to attach a graft or a patch to a blood vessel.
  • the graft or patch to be attached is provided on the balloon and inflation of the balloon positions the patch/graft in place.
  • Ejection of structural or bioactive material for example, plumes that skewer the patch and the vessel or material that passes the patch and collects between the patch and the vessel, serve to fix the patch to the vessel.
  • one or more apertures are pre-formed in the patch or graft and aligned with the apertures of the balloon, to help material provision past the patch.
  • the balloon includes one or more needles thereon, on which needles the graft may be engaged and through which needs the material is optionally provided.
  • an overtube (not shown) with an opening formed in a side thereof, is optionally provided over the balloon, so that injection can only be through apertures aligned with the opening.
  • the overtube is flexible and/or pleated, and is strong enough to resist the ejection pressure.
  • this overtube is provided once the narrowing in the vessel is expanded by the balloon.
  • pulse duration e.g., pulse of laser or of pressure source
  • pulse shape e.g., square, triangle or sinus
  • the energy may need to be changed in an appropriate manner.
  • a greater energy may be used, for example, 4 Joule, 5 Joule, 7 Joule, 10 Joule or more.
  • one or both of two transport mechanisms may be optionally and/or selectively used, a pressure impulse wave mechanism, where a sharp increase in internal balloon pressure causes part of the balloon filling to leave through the apertures, and a fluid induced laser shockwave transport method, where a high speed heating of fluid at a point generate a bubble gas which causes material to be ejected with force.
  • a stroke and pressure applied by an external piston is controlled, the stroke length controlling the amount of material ejected and the force and envelope of the stroke controlling the penetration depth.
  • the stroke length is manually or automatically settable, for example, by moving a stop.
  • the volume and depth penetration are controlled by modifying one or more of energy per pulse, pulse duration, and number of pulses.
  • both patterns are used, for example, utilizing a larger volume effect of the pressure mechanism and a lower volume but higher speed injection of the shock effect.
  • a sudden increase in pressure and/or generation of shock waves inside the balloon is generated by a different mechanism than described above.
  • Such pressure/shock waves may also be used for other purposes, such as surface sweating of a material.
  • an electrical spark method is used which generates a spark between two conductors under high voltage, causing an explosion and associated shock/pressure waves. While the energy may be provided by wire along the catheter, optionally it is provided using eddy currents induced by an outside-the-body magnetic field.
  • a capsule with a compressed spring (or other mechanical element) is used as the impulse source.
  • the potential energy stored in the spring changes to kinetic energy which results in fast tearing or expanding of the capsule and associated waves.
  • the energy is stored in the spring ahead of time, for example, at manufacture.
  • the capsule is in two parts and the heating only allows them relative motion, but no fluid enters the capsule.
  • such a capsule includes an explosive or gas forming element, such as a lump of silver azide, that when triggered, generates gas that expands the capsule and increases intra-balloon pressure.
  • an explosive or gas forming element such as a lump of silver azide, that when triggered, generates gas that expands the capsule and increases intra-balloon pressure.
  • FIG. 6B shows a catheter head 620 , in which a balloon 622 includes a target 624 , for example, a leaf spring 624 bent to a curved shape by a strong cord (not shown in the picture, made for example of an electro-resistive material, a heat sensitive material and/or a laser light absorbing material).
  • a strong cord not shown in the picture, made for example of an electro-resistive material, a heat sensitive material and/or a laser light absorbing material.
  • target 624 is a circular disc (or square) with a diameter of 400 microns, a thickness of 590 microns and a curve radius of 200 microns.
  • Application of energy to the disc will cause distortion, culminating in a sudden catastrophic shape change in the disc, which change will release some of the energy provided by the laser (or other source) and cause the shock/pressure effects.
  • the energy is supplied at a rate higher than loss via mechanisms such as heat.
  • the balloon and/or catheter are used as an elastic energy storage element.
  • pressure to the catheter is increased until the apertures tear and fluid from the balloon rushes out.
  • the parts of the catheter near the balloon and/or the balloon and/or a gas filled bladder in the balloon serve as storage areas that are near the fluid injection, so that there is a reduced loss of pressure
  • a small balloon or bag encapsulate the tip of the fiber (in a laser embodiment) and heating of a material in this small balloon will generate the desired impulse.
  • FIG. 6C shows a system design 640 , in which a balloon 642 may itself have no apertures, but one or more tubes 644 and 646 are provided outside of balloon 642 and include apertures 648 for material injection, therein. Tubes 644 and 646 may be attached to each other and/or be arranged differently than shown, for example, as a spiral around balloon 642 .
  • balloon 642 is used to ensure contact between apertures 648 and the surrounding blood vessel.
  • a pressure pulse is provided via tubes 644 and 648 , to inject material.
  • an optical fiber is provided in each arm, to generate a local impulse for the arm.
  • tubes 644 and 648 are compressible and the pressure pulse is provided by balloon 642 , for example using methods described above, whereby the pressure wave travels through the wall of balloon 642 and into tubes 644 and 648 .
  • balloon 642 is used for rhythmically squeezing the tubes and thus pumping material out of apertures 648 .
  • a one way valve (not shown) is optionally provided in side tubes 644 and 646 to prevent backflow in the tubes.
  • such external tubes are used for treating a prostate, where, in general, a larger diameter catheter may be used.
  • FIG. 6D is a schematic showing of a gas-powered two stage system 650 for creating a pressure impulse in a balloon 652 .
  • a gas pressure source for example a compressed gas cylinder 670 with an optional pressure regulator 668 that is used to charge a cartridge 666 , is selectively released by a valve 664 .
  • a first piston 662 is advanced, which moves a plunger 660 .
  • Plunger 660 advances a hydraulic fluid 658 , optionally with a low resistance, through some or the entire catheter to balloon 652 .
  • a filling 654 of balloon 652 (which may be high viscosity) is optionally separated from the hydraulic fluid by a second plunger 656 .
  • slow advancing of fluid 658 inflates the balloon and fast advancing causes an impulse that ejects material.
  • the hydraulic fluid may be a closed system filled during manufacture.
  • FIG. 6E is a schematic showing of a variant system 672 in which a filling 674 of the balloon is used instead of hydraulic fluid 658 .
  • Filling 674 may be provided ahead of time, for example, at manufacture.
  • any added drug is provided by injection into the balloon.
  • FIG. 6F is a schematic showing of a system 676 , in which a two capsule 678 tears apart and thereby causes a pressure wave.
  • pressure is provided to the capsule via a lumen 680 .
  • Capsule 678 is provided in two parts, 682 and 684 , which are coupled by a sliding seal and maintained together by one or more tension elements 686 , for example, wires. As the pressure is increased, the tension on the wires increases until they fail, releasing the capsule parts.
  • the pressure applied by the capsule can be determined by calculating the failing point of the wire and the cross-section of the capsule.
  • FIG. 6G shows a system 688 , in which a wire 690 is pulled back to deliver a pressure impulse in a balloon 692 .
  • a plunger is attached to the distal end of wire 690 and fits inside balloon 692 , such that pulling back will force fluid movement before the plunger.
  • the catheter has a rigid body 696 (e.g., for use in a prostate).
  • a braided body or other design that resists kinking upon axial compression is used.
  • the inflation of the balloon serves to reduce or prevent movement of the balloon during pullback of the wire (or other forces such as applied in other embodiments).
  • FIG. 6H shows a system 700 , in which a capsule 704 is provided inside a balloon 702 and a spring 706 is positioned to selectively expand capsule 704 .
  • a tension element 708 such as a wire, prevents such extension.
  • wire 708 is released or cut, the spring can expand the capsule and create a pressure pulse.
  • wire 708 is attached to capsule 704 at a point 710 , which is selectively releasable.
  • point 710 burns or melts upon application of an electric field to wire 708 (or a light pulse to an optical fiber tension element).
  • wire 708 is attached as well at a point 712 to capsule 704 , such that tension in wire 708 is mainly between points 710 and 712 and inside the balloon element and not along the entire catheter.
  • the balloon can be pre-filled with the material to be injected.
  • FIG. 7 is a graph showing penetration depth of a dye into a bovine aorta under various conditions.
  • the injection system was a gas powered system that applied up to 68 atmospheres to piston attached to a tube 4 mm in diameter and 250 mm in length.
  • the tube is attached to a hollow tube section with a diameter of 9.6 mm and 120 radial holes with a diameter of 50 microns and inter-hole spacing of about 2 mm.
  • the system provides an amplification of pressure of a factor of 8.
  • the solid line indicates the penetration depth in mm as a function of the applied pressure, for a 0.3 cc bolus.
  • the large dashes are for a case of 0.184 cc and the small dashes for 0.2446 cc. as can be seen, increasing pressure increases penetration depth. Size of bolus also appears to increase the penetration depth.
  • Each point on the graph is an average of several (e.g., 4) experiments. The aorta was firmly attached to the ejection holes, probably with a contact pressure below 2 atmospheres.
  • FIG. 8 is a graph showing the peak pressure as measured in the hollow tube section as a function of time for a 68 atmosphere pulse (e.g., amplified by a factor of 8 during delivery).
  • the pulse ended when all the material was ejected from the hollow tube.
  • the mean velocity of the jet is estimated to be 60 m/s. It is believed that penetration depth is affected by one or both of mean velocity and peak velocity.
  • other mean and/or peak velocities can be achieved, for example, 10 m/s, 40 m/s, 100 m/s, 200 m/s, 300 m/s or smaller, intermediate or larger speeds. If a sufficiently large pressure is applied, very high peak velocities can be achieved, for example, 1000 m/s, 1500 m/s or faster, such as above the speed of sound in tissue (e.g., using shock waves).
  • the above-described system and method may be used, for example, for coronary vessels and cerebral vessels.
  • the system and/or method optionally with some variations (e.g., balloon diameter and/or flexibility, volume of injected material) may be adapted for other tubular organs in the body, for example, the gall bladder duct, the urethra, the ureters, the esophagus, air passage ways in the lungs, such as the bronchi and various peripheral blood vessels.
  • the above apparatus and/or methods are used to apply treatment without making a structural change and/or implanting a stent in the vessel being treated.
  • the system and method are used to deliver a material to only one side of the balloon.
  • Exemplary applications include the larynx, pharynx, vocal cords, voice box and/or base of tongue.
  • the system and/or method are used for cosmetic applications, for example for stiffening tissue by injecting structural material into the tissue, for example, using a catheter (optionally without a balloon) inserted under the skin.
  • injection of structural material is used for strengthening an anastomosis region, for example, to help support vessels damaged by the manipulation and/or tensions associated with anastomosis.
  • injection of a structural material does not prevent further growing in diameter of the treated vessel. This may be useful, for example, when the treated vessel is a small vessel which may grow (e.g., to respond to additional demand), or when treating children.
  • changes in diameter allow the vessel to respond to pulse waves and/or changes in blood pressure.
  • injection of glue or other structural material is used to aid attachment to a wall of a blood vessel.
  • glue is injected into a wall to strengthen it so that it may be used for attaching an anastomosis connector thereto.
  • a calcified aorta is treated, to prevent breakaway of material during anastomosis or bypass procedures.
  • the injection is used to attach small hooks or stubs (e.g., of the glue material) to the wall, on which stubs a patch or a connector or other vessel may be attached.
  • the stubs are created by the apertures including an offset, for example 0.5-1 mm.
  • the stubs are created by injection using a needle and pulling back the needle slowly.
  • needle based methods may be used, especially for structural materials such as glue.
  • a plurality of needles are provided on the outside of the balloon.
  • the needles are provided on tubes 644 and 646 .
  • the needles are provided on a balloon or other expandable structure inside of balloon 642 and then, when deployed, the needles extend through the wall of balloon 642 (or other balloon design) and penetrate the nearby vessel walls.
  • the needles are 1 mm or less in length and/or diameter, for example, less than 0.5 mm.
  • 5, 10, 20 or an intermediate or larger number of needles are provided.
  • the balloon (e.g., 642 ) is optionally made more or completely rigid, for example, being a metallic balloon. This may be useful for prostate treatments.
  • the rigid balloon does not expand, and is more properly termed a hollow element.
  • the balloon expands but is non-compliant.
  • axial ejection is provided.
  • the use of a balloon when forward injecting of material holds the ejection port in a stable orientation and may help prevent misses of the target and/or motion of the ejection port due to the third law of motion.
  • forward ejection is used to help dissolve thrombosis, for example, by assisting in the distribution of material into the thrombosis.
  • the balloon used will have a different geometry, for example the geometry of a flat bag.
  • aorta is thicker, while a coronary vessel is thinner, thus suggesting different ejection parameters, powers and/or balloon pressures and sizes.
  • an aorta may be 3 mm thick, while a coronary vessel may be less than 1 mm thick.
  • Measurements are provided to serve only as exemplary measurements for particular cases.
  • the exact measurements stated in the text may vary depending on the application, the type of vessel (e.g., artery, vein, xenograft, synthetic graft), shape of plaque (e.g., local, elongate, thin, thick, outer remolding, vulnerable) and/or sizes of vessels involved (e.g., 1 mm, 2 mm, 3 mm, 5 mm, aorta sized).
  • vessel e.g., artery, vein, xenograft, synthetic graft
  • shape of plaque e.g., local, elongate, thin, thick, outer remolding, vulnerable
  • sizes of vessels involved e.g., 1 mm, 2 mm, 3 mm, 5 mm, aorta sized.
  • tube and other geometrical shapes have been described and used for generality, it should be appreciated that this tube need not have a full body nor have a circular cross-section, in some embodiments.
  • one or more of the devices are packaged and/or sold with an instruction leaflet and/or portions of treatment materials, describing the device dimensions and/or situations for which the device should be applied and/or what materials should be used.
  • various implementations are considered within the scope of the invention, including hardware, firmware software, computers loaded with suitable software and/or computer readable media having software thereon suitable for supporting the methods described herein. Section headings where they are provided are intended for aiding navigation and should not be construed to limiting the description to the headings.

Landscapes

  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • General Health & Medical Sciences (AREA)
  • Pulmonology (AREA)
  • Hematology (AREA)
  • Anesthesiology (AREA)
  • Biophysics (AREA)
  • Child & Adolescent Psychology (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Coating Apparatus (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
  • Surgical Instruments (AREA)
  • Medicinal Preparation (AREA)
US11/632,476 2004-07-14 2005-07-14 Material Delivery System Abandoned US20070299392A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US11/632,476 US20070299392A1 (en) 2004-07-14 2005-07-14 Material Delivery System
US13/304,756 US8439890B2 (en) 2004-07-14 2011-11-28 Material delivery system

Applications Claiming Priority (6)

Application Number Priority Date Filing Date Title
US58733504P 2004-07-14 2004-07-14
US59988404P 2004-08-10 2004-08-10
US60326204P 2004-08-23 2004-08-23
US67547705P 2005-04-28 2005-04-28
PCT/IL2005/000749 WO2006006169A2 (en) 2004-07-14 2005-07-14 Material delivery system
US11/632,476 US20070299392A1 (en) 2004-07-14 2005-07-14 Material Delivery System

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
PCT/IL2005/000749 A-371-Of-International WO2006006169A2 (en) 2004-07-14 2005-07-14 Material delivery system

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US13/304,756 Division US8439890B2 (en) 2004-07-14 2011-11-28 Material delivery system

Publications (1)

Publication Number Publication Date
US20070299392A1 true US20070299392A1 (en) 2007-12-27

Family

ID=35784260

Family Applications (3)

Application Number Title Priority Date Filing Date
US11/335,317 Abandoned US20060190022A1 (en) 2004-07-14 2005-07-14 Material delivery system
US11/632,476 Abandoned US20070299392A1 (en) 2004-07-14 2005-07-14 Material Delivery System
US13/304,756 Expired - Fee Related US8439890B2 (en) 2004-07-14 2011-11-28 Material delivery system

Family Applications Before (1)

Application Number Title Priority Date Filing Date
US11/335,317 Abandoned US20060190022A1 (en) 2004-07-14 2005-07-14 Material delivery system

Family Applications After (1)

Application Number Title Priority Date Filing Date
US13/304,756 Expired - Fee Related US8439890B2 (en) 2004-07-14 2011-11-28 Material delivery system

Country Status (5)

Country Link
US (3) US20060190022A1 (de)
EP (1) EP1773439A4 (de)
JP (1) JP2008506447A (de)
CA (1) CA2574013A1 (de)
WO (1) WO2006006169A2 (de)

Cited By (39)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060190022A1 (en) * 2004-07-14 2006-08-24 By-Pass, Inc. Material delivery system
US20070250149A1 (en) * 2006-04-21 2007-10-25 Abbott Laboratories Stiffening Support Catheters and Methods for Using the Same
US20070270779A1 (en) * 2006-04-21 2007-11-22 Abbott Laboratories Support Catheter
US20070288036A1 (en) * 2006-06-09 2007-12-13 Niranjan Seshadri Assembly for crossing a chronic total occlusion and method therefor
US20070293821A1 (en) * 2006-04-21 2007-12-20 Abbott Laboratories Systems, Methods, and Devices for Injecting Media Contrast
US20070293846A1 (en) * 2006-04-21 2007-12-20 Abbott Laboratories Dual Lumen Guidewire Support Catheter
US20080058722A1 (en) * 2006-04-21 2008-03-06 Abbott Laboratories Stiffening Support Catheter and Methods for Using the Same
US20080140001A1 (en) * 2006-12-12 2008-06-12 By-Pass Inc. Fluid Delivery Apparatus And Methods
US20090299450A1 (en) * 2008-05-29 2009-12-03 Boston Scientific Scimed, Inc. Multi-layer balloon design for use in combination with catheter assemblies, and methods of making the same
US20120046599A1 (en) * 2010-02-18 2012-02-23 Cardiovascular Systems, Inc. Therapeutic agent delivery system, device and method for localized application of therapeutic substances to a biological conduit
US20120053567A1 (en) * 2010-08-30 2012-03-01 SinuSys Corporation Devices and Methods for Dilating a Paranasal Sinus Opening and for Treating Sinusitis
US8415318B2 (en) 2001-10-19 2013-04-09 Vascular Biogenics Ltd. Polynucleotide constructs, pharmaceutical compositions and methods for targeted downregulation of angiogenesis and anticancer therapy
US20130261540A1 (en) * 2010-12-16 2013-10-03 Justin M. Crank High-pressure pneumatic injection system and method
US8568354B2 (en) 2010-02-16 2013-10-29 Cardiovascular Systems, Inc. Devices and methods for low shearing local delivery of therapeutic agents to the wall of a bodily lumen
US9050414B2 (en) 2010-02-19 2015-06-09 Cardiovascular Systems, Inc. Systems and methods for mixing therapeutic agents before and/or during administration
US20160101275A1 (en) * 2014-10-08 2016-04-14 Alfred E. Mann Foundation For Scientific Research Percutaneous Ports with Wire Coils
JP2016515435A (ja) * 2013-04-13 2016-05-30 アイピーピラミッズ ゲーエムベーハー マイクロ穿孔および金属メッシュを備えるカテーテルバルーン
US9504812B2 (en) 2012-02-29 2016-11-29 SinuSys Corporation Devices and methods for dilating a paranasal sinus opening and for treating sinusitis
US9687263B2 (en) 2013-05-30 2017-06-27 SinuSys Corporation Devices and methods for inserting a sinus dilator
US10086184B2 (en) 2014-10-08 2018-10-02 Alfred E. Mann Foundation For Scientific Research Method of manufacturing percutaneous ports with wire coils
US10413240B2 (en) 2014-12-10 2019-09-17 Staton Techiya, Llc Membrane and balloon systems and designs for conduits
WO2021101766A1 (en) * 2019-11-22 2021-05-27 Bolt Medical, Inc. Energy manifold for directing and concentrating energy within a lithoplasty device
US20210186508A1 (en) * 2008-10-10 2021-06-24 Peter Forsell Apparatus for treating obesity
US11167116B2 (en) * 2012-05-07 2021-11-09 The Regents Of The University Of California Upper esophageal sphincter dilator
WO2022039783A1 (en) * 2020-08-19 2022-02-24 Bolt Medical, Inc. Faster rise time pulse shaping of plasma generated pressure waves for disruption of vascular calcium
US11517713B2 (en) 2019-06-26 2022-12-06 Boston Scientific Scimed, Inc. Light guide protection structures for plasma system to disrupt vascular lesions
US11583339B2 (en) 2019-10-31 2023-02-21 Bolt Medical, Inc. Asymmetrical balloon for intravascular lithotripsy device and method
US11648057B2 (en) 2021-05-10 2023-05-16 Bolt Medical, Inc. Optical analyzer assembly with safety shutdown system for intravascular lithotripsy device
US11660427B2 (en) 2019-06-24 2023-05-30 Boston Scientific Scimed, Inc. Superheating system for inertial impulse generation to disrupt vascular lesions
US11672585B2 (en) 2021-01-12 2023-06-13 Bolt Medical, Inc. Balloon assembly for valvuloplasty catheter system
US11672599B2 (en) 2020-03-09 2023-06-13 Bolt Medical, Inc. Acoustic performance monitoring system and method within intravascular lithotripsy device
US11707323B2 (en) 2020-04-03 2023-07-25 Bolt Medical, Inc. Electrical analyzer assembly for intravascular lithotripsy device
US11717139B2 (en) 2019-06-19 2023-08-08 Bolt Medical, Inc. Plasma creation via nonaqueous optical breakdown of laser pulse energy for breakup of vascular calcium
US11806075B2 (en) 2021-06-07 2023-11-07 Bolt Medical, Inc. Active alignment system and method for laser optical coupling
US11819229B2 (en) 2019-06-19 2023-11-21 Boston Scientific Scimed, Inc. Balloon surface photoacoustic pressure wave generation to disrupt vascular lesions
US11839391B2 (en) 2021-12-14 2023-12-12 Bolt Medical, Inc. Optical emitter housing assembly for intravascular lithotripsy device
US11903642B2 (en) 2020-03-18 2024-02-20 Bolt Medical, Inc. Optical analyzer assembly and method for intravascular lithotripsy device
US12016610B2 (en) 2020-12-11 2024-06-25 Bolt Medical, Inc. Catheter system for valvuloplasty procedure
US12102384B2 (en) 2019-11-13 2024-10-01 Bolt Medical, Inc. Dynamic intravascular lithotripsy device with movable energy guide

Families Citing this family (165)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8177743B2 (en) 1998-05-18 2012-05-15 Boston Scientific Scimed, Inc. Localized delivery of drug agents
AU7720100A (en) 1999-09-27 2001-04-30 Essex Technology, Inc. Rotate-to-advance catheterization system
US8071740B2 (en) * 2000-11-17 2011-12-06 Vascular Biogenics Ltd. Promoters exhibiting endothelial cell specificity and methods of using same for regulation of angiogenesis
AU2003222427B8 (en) * 2000-11-17 2010-04-29 Vascular Biogenics Ltd. Promoters exhibiting endothelial cell specificity and methods of using same
DE10105592A1 (de) 2001-02-06 2002-08-08 Achim Goepferich Platzhalter zur Arzneistofffreigabe in der Stirnhöhle
US8317816B2 (en) 2002-09-30 2012-11-27 Acclarent, Inc. Balloon catheters and methods for treating paranasal sinuses
US7419497B2 (en) 2004-04-21 2008-09-02 Acclarent, Inc. Methods for treating ethmoid disease
US9399121B2 (en) 2004-04-21 2016-07-26 Acclarent, Inc. Systems and methods for transnasal dilation of passageways in the ear, nose or throat
US20060063973A1 (en) 2004-04-21 2006-03-23 Acclarent, Inc. Methods and apparatus for treating disorders of the ear, nose and throat
US9089258B2 (en) 2004-04-21 2015-07-28 Acclarent, Inc. Endoscopic methods and devices for transnasal procedures
US7803150B2 (en) 2004-04-21 2010-09-28 Acclarent, Inc. Devices, systems and methods useable for treating sinusitis
US20190314620A1 (en) 2004-04-21 2019-10-17 Acclarent, Inc. Apparatus and methods for dilating and modifying ostia of paranasal sinuses and other intranasal or paranasal structures
US20060004323A1 (en) 2004-04-21 2006-01-05 Exploramed Nc1, Inc. Apparatus and methods for dilating and modifying ostia of paranasal sinuses and other intranasal or paranasal structures
US7559925B2 (en) 2006-09-15 2009-07-14 Acclarent Inc. Methods and devices for facilitating visualization in a surgical environment
US9351750B2 (en) 2004-04-21 2016-05-31 Acclarent, Inc. Devices and methods for treating maxillary sinus disease
US20070167682A1 (en) 2004-04-21 2007-07-19 Acclarent, Inc. Endoscopic methods and devices for transnasal procedures
US9554691B2 (en) 2004-04-21 2017-01-31 Acclarent, Inc. Endoscopic methods and devices for transnasal procedures
US8747389B2 (en) 2004-04-21 2014-06-10 Acclarent, Inc. Systems for treating disorders of the ear, nose and throat
US7654997B2 (en) 2004-04-21 2010-02-02 Acclarent, Inc. Devices, systems and methods for diagnosing and treating sinusitus and other disorders of the ears, nose and/or throat
US8764729B2 (en) 2004-04-21 2014-07-01 Acclarent, Inc. Frontal sinus spacer
US8932276B1 (en) 2004-04-21 2015-01-13 Acclarent, Inc. Shapeable guide catheters and related methods
US9101384B2 (en) 2004-04-21 2015-08-11 Acclarent, Inc. Devices, systems and methods for diagnosing and treating sinusitis and other disorders of the ears, Nose and/or throat
US8146400B2 (en) 2004-04-21 2012-04-03 Acclarent, Inc. Endoscopic methods and devices for transnasal procedures
US7462175B2 (en) 2004-04-21 2008-12-09 Acclarent, Inc. Devices, systems and methods for treating disorders of the ear, nose and throat
US7410480B2 (en) 2004-04-21 2008-08-12 Acclarent, Inc. Devices and methods for delivering therapeutic substances for the treatment of sinusitis and other disorders
US8894614B2 (en) 2004-04-21 2014-11-25 Acclarent, Inc. Devices, systems and methods useable for treating frontal sinusitis
US8702626B1 (en) 2004-04-21 2014-04-22 Acclarent, Inc. Guidewires for performing image guided procedures
US7720521B2 (en) * 2004-04-21 2010-05-18 Acclarent, Inc. Methods and devices for performing procedures within the ear, nose, throat and paranasal sinuses
US7361168B2 (en) 2004-04-21 2008-04-22 Acclarent, Inc. Implantable device and methods for delivering drugs and other substances to treat sinusitis and other disorders
US20070208252A1 (en) 2004-04-21 2007-09-06 Acclarent, Inc. Systems and methods for performing image guided procedures within the ear, nose, throat and paranasal sinuses
US10188413B1 (en) 2004-04-21 2019-01-29 Acclarent, Inc. Deflectable guide catheters and related methods
US8951225B2 (en) 2005-06-10 2015-02-10 Acclarent, Inc. Catheters with non-removable guide members useable for treatment of sinusitis
US8080057B2 (en) * 2005-08-09 2011-12-20 Steven J. Kronowitz Methods and devices for breast reconstruction
US8998923B2 (en) 2005-08-31 2015-04-07 Spinealign Medical, Inc. Threaded bone filling material plunger
US8114113B2 (en) 2005-09-23 2012-02-14 Acclarent, Inc. Multi-conduit balloon catheter
US8043258B2 (en) * 2006-01-24 2011-10-25 Boston Scientific Scimed, Inc. Flow-inflated diffusion therapeutic delivery
US8190389B2 (en) 2006-05-17 2012-05-29 Acclarent, Inc. Adapter for attaching electromagnetic image guidance components to a medical device
JP5276259B2 (ja) * 2006-06-16 2013-08-28 富士フイルム株式会社 医療装置
US7547323B2 (en) * 2006-08-29 2009-06-16 Sinexus, Inc. Stent for irrigation and delivery of medication
US9820688B2 (en) 2006-09-15 2017-11-21 Acclarent, Inc. Sinus illumination lightwire device
US8439687B1 (en) 2006-12-29 2013-05-14 Acclarent, Inc. Apparatus and method for simulated insertion and positioning of guidewares and other interventional devices
MX336844B (es) 2007-01-21 2016-02-03 Hemoteq Ag Dispositivo medico para el tratamiento de estenosis de pasajes corporales y para la prevencion de reestenosis inminente.
WO2008124787A2 (en) 2007-04-09 2008-10-16 Acclarent, Inc. Ethmoidotomy system and implantable spacer devices having therapeutic substance delivery capability for treatment of paranasal sinusitis
US8118757B2 (en) 2007-04-30 2012-02-21 Acclarent, Inc. Methods and devices for ostium measurement
US8485199B2 (en) 2007-05-08 2013-07-16 Acclarent, Inc. Methods and devices for protecting nasal turbinate during surgery
US20120149985A1 (en) * 2007-05-18 2012-06-14 Frassica James J Rotate-to-advance catheterization system
EP2201910B1 (de) * 2007-06-01 2013-04-03 Allergan, Inc. Gerät zur Erzeugung des zugspannungsinduzierten Wachstums von biologischem Gewebe
WO2008152639A2 (en) * 2007-06-12 2008-12-18 Bypass, Inc. Pressure pulse actuating device for delivery systems
US9192697B2 (en) 2007-07-03 2015-11-24 Hemoteq Ag Balloon catheter for treating stenosis of body passages and for preventing threatening restenosis
US8717412B2 (en) 2007-07-18 2014-05-06 Samsung Electronics Co., Ltd. Panoramic image production
US8068693B2 (en) * 2007-07-18 2011-11-29 Samsung Electronics Co., Ltd. Method for constructing a composite image
US8652084B2 (en) 2007-08-09 2014-02-18 Indiana University Research And Technology Corporation Arteriovenous shunt with integrated surveillance system
US8057421B2 (en) * 2007-08-09 2011-11-15 Indiana University Research And Technology Corporation Modular arterio-venous shunt device and methods for establishing hemodialytic angioaccess
US10206821B2 (en) 2007-12-20 2019-02-19 Acclarent, Inc. Eustachian tube dilation balloon with ventilation path
EP2262566A1 (de) * 2008-03-06 2010-12-22 Boston Scientific Scimed, Inc. Ballonkathetervorrichtungen mit gefalteten ballons
US8182432B2 (en) 2008-03-10 2012-05-22 Acclarent, Inc. Corewire design and construction for medical devices
US20100036294A1 (en) * 2008-05-07 2010-02-11 Robert Mantell Radially-Firing Electrohydraulic Lithotripsy Probe
CA2727429C (en) 2008-06-13 2016-01-26 Daniel Hawkins Shockwave balloon catheter system
US9072534B2 (en) 2008-06-13 2015-07-07 Shockwave Medical, Inc. Non-cavitation shockwave balloon catheter system
US10702293B2 (en) 2008-06-13 2020-07-07 Shockwave Medical, Inc. Two-stage method for treating calcified lesions within the wall of a blood vessel
CN102112040B (zh) 2008-07-30 2015-04-01 阿克拉伦特公司 鼻旁孔口探示器器件和方法
EP2331187A4 (de) * 2008-09-02 2011-09-28 By Pass Inc Mikroporöser ballonkatheter
CN103623498B (zh) 2008-09-18 2015-12-30 阿克拉伦特公司 用于治疗耳鼻喉科疾病的方法和设备
US9180280B2 (en) * 2008-11-04 2015-11-10 Shockwave Medical, Inc. Drug delivery shockwave balloon catheter system
US9044618B2 (en) 2008-11-05 2015-06-02 Shockwave Medical, Inc. Shockwave valvuloplasty catheter system
US20100241155A1 (en) 2009-03-20 2010-09-23 Acclarent, Inc. Guide system with suction
US8460238B2 (en) * 2009-03-25 2013-06-11 Medtronic Vascular, Inc. Drug delivery catheter with soluble balloon coating containing releasable microspheres and delivery method
US7978742B1 (en) 2010-03-24 2011-07-12 Corning Incorporated Methods for operating diode lasers
US8435290B2 (en) 2009-03-31 2013-05-07 Acclarent, Inc. System and method for treatment of non-ventilating middle ear by providing a gas pathway through the nasopharynx
AU2010241740B9 (en) * 2009-04-27 2015-10-01 Intersect Ent, Inc. Devices and methods for treating pain associated with tonsillectomies
ES2550634T3 (es) 2009-07-10 2015-11-11 Boston Scientific Scimed, Inc. Uso de nanocristales para un balón de suministro de fármaco
WO2011008393A2 (en) 2009-07-17 2011-01-20 Boston Scientific Scimed, Inc. Nucleation of drug delivery balloons to provide improved crystal size and density
US20110082452A1 (en) * 2009-10-02 2011-04-07 Cardiofocus, Inc. Cardiac ablation system with automatic safety shut-off feature
US8696653B2 (en) * 2009-10-02 2014-04-15 Cardiofocus, Inc. Cardiac ablation system with pulsed aiming light
US8684965B2 (en) * 2010-06-21 2014-04-01 Illuminoss Medical, Inc. Photodynamic bone stabilization and drug delivery systems
US9005163B2 (en) * 2010-08-03 2015-04-14 Bayer Pharma Aktiengesellschaft Balloon catheter with external delivery tube
EP2611476B1 (de) 2010-09-02 2016-08-10 Boston Scientific Scimed, Inc. Beschichtungsverfahren für wirkstofffreisetzungsballons mit wärmeinduziertem rewrap-gedächtnis
US9155492B2 (en) 2010-09-24 2015-10-13 Acclarent, Inc. Sinus illumination lightwire device
WO2012096787A1 (en) * 2010-12-30 2012-07-19 Surmodics, Inc. Double wall catheter for delivering therapeutic agent
WO2012156914A2 (en) 2011-05-15 2012-11-22 By-Pass, Inc. Microporous balloon catheter, delivery system, and methods of manufacture and use
US11033318B2 (en) 2011-06-14 2021-06-15 Aerin Medical, Inc. Methods and devices to treat nasal airways
US11241271B2 (en) 2011-06-14 2022-02-08 Aerin Medical Inc. Methods of treating nasal airways
US11304746B2 (en) 2011-06-14 2022-04-19 Aerin Medical Inc. Method of treating airway tissue to reduce mucus secretion
WO2012174161A1 (en) * 2011-06-14 2012-12-20 Aerin Medical, Inc. Devices for treating nasal airways
WO2013022458A1 (en) 2011-08-05 2013-02-14 Boston Scientific Scimed, Inc. Methods of converting amorphous drug substance into crystalline form
US9056152B2 (en) 2011-08-25 2015-06-16 Boston Scientific Scimed, Inc. Medical device with crystalline drug coating
US9808605B2 (en) 2011-10-06 2017-11-07 W. L. Gore & Associates, Inc. Controlled porosity devices for tissue treatments, methods of use, and methods of manufacture
US8574247B2 (en) 2011-11-08 2013-11-05 Shockwave Medical, Inc. Shock wave valvuloplasty device with moveable shock wave generator
EP2790569B1 (de) * 2011-12-16 2018-01-10 Chordate Medical AB Druckmesssystem und -verfahren
EP2790633B1 (de) 2011-12-16 2017-03-22 Chordate Medical AB Vorrichtung zur hypothalamusstimulation
EP2790632B1 (de) 2011-12-16 2017-07-19 Chordate Medical AB Vorrichtung zur behandlung von kopfschmerzen
US9486381B2 (en) 2011-12-16 2016-11-08 Chordate Medical Ab ALS treatment
CN104144668B (zh) 2011-12-16 2016-08-24 考地特医疗Ab公司 用于在受试者的至少一个鼻腔中振动刺激的设备和系统
EP2827827B1 (de) 2012-03-20 2017-05-03 Chordate Medical AB Vorrichtung zur vibrationsstimulation
EP2641580B1 (de) 2012-03-20 2020-06-03 Chordate Medical AB Elektroaktive Vibrationsvorrichtung
US9642673B2 (en) 2012-06-27 2017-05-09 Shockwave Medical, Inc. Shock wave balloon catheter with multiple shock wave sources
WO2014025620A1 (en) 2012-08-06 2014-02-13 Shockwave Medical, Inc. Shockwave catheter
EP2879607B1 (de) 2012-08-06 2019-02-27 Shockwave Medical, Inc. Niedrigprofilelektroden für einen angioplastie-stosswellenkatheter
CN104519809B (zh) * 2012-08-08 2018-01-02 冲击波医疗公司 具有多个球囊的冲击波瓣膜成形术
US9138249B2 (en) 2012-08-17 2015-09-22 Shockwave Medical, Inc. Shock wave catheter system with arc preconditioning
US10173038B2 (en) 2012-09-05 2019-01-08 W. L. Gore & Associates, Inc. Retractable sheath devices, systems, and methods
US9522012B2 (en) 2012-09-13 2016-12-20 Shockwave Medical, Inc. Shockwave catheter system with energy control
US9333000B2 (en) 2012-09-13 2016-05-10 Shockwave Medical, Inc. Shockwave catheter system with energy control
US20140180326A1 (en) * 2012-12-20 2014-06-26 Empire Technology Development Llc Inflatable balloon for protecting blood vessel
US9468443B2 (en) 2012-12-27 2016-10-18 Cook Medical Technologies Llc Occlusion balloon
US8827953B2 (en) 2013-01-15 2014-09-09 Krishna Rocha-Singh Apparatus and method for delivering intraluminal therapy
CA2905107C (en) 2013-03-11 2020-04-14 Northgate Technologies Inc. Unfocused electrohydraulic lithotripter
US9320530B2 (en) 2013-03-13 2016-04-26 The Spectranetics Corporation Assisted cutting balloon
US9204963B2 (en) 2013-03-13 2015-12-08 Gyrus Acmi, Inc. Stabilizing implant with expandable segments
US10201387B2 (en) * 2013-03-13 2019-02-12 The Spectranetics Corporation Laser-induced fluid filled balloon catheter
US10842567B2 (en) 2013-03-13 2020-11-24 The Spectranetics Corporation Laser-induced fluid filled balloon catheter
US9629684B2 (en) 2013-03-15 2017-04-25 Acclarent, Inc. Apparatus and method for treatment of ethmoid sinusitis
US10080676B2 (en) * 2013-03-15 2018-09-25 Boston Scientific Scimed, Inc. Delivery devices and related methods of use
US9433437B2 (en) 2013-03-15 2016-09-06 Acclarent, Inc. Apparatus and method for treatment of ethmoid sinusitis
US9555218B2 (en) 2013-03-15 2017-01-31 Boston Scientific Scimed, Inc. Methods and systems for treatment of a bladder
US10016580B2 (en) * 2013-12-17 2018-07-10 Biovision Technologies, Llc Methods for treating sinus diseases
US9694163B2 (en) 2013-12-17 2017-07-04 Biovision Technologies, Llc Surgical device for performing a sphenopalatine ganglion block procedure
US9516995B2 (en) * 2013-12-17 2016-12-13 Biovision Technologies, Llc Surgical device for performing a sphenopalatine ganglion block procedure
US9510743B2 (en) * 2013-12-17 2016-12-06 Biovision Technologies, Llc Stabilized surgical device for performing a sphenopalatine ganglion block procedure
US20150250489A1 (en) * 2014-03-10 2015-09-10 Terumo Kabushiki Kaisha Method for treating varicose veins and intraluminal device used in such method
US9730715B2 (en) 2014-05-08 2017-08-15 Shockwave Medical, Inc. Shock wave guide wire
US11246659B2 (en) 2014-08-25 2022-02-15 The Spectranetics Corporation Liquid laser-induced pressure wave emitting catheter sheath
WO2016061692A1 (en) * 2014-10-22 2016-04-28 Jmd Innovation Anti-adhesion intrauterine balloon
EP3240600B1 (de) 2014-12-30 2019-05-08 The Spectranetics Corporation Elektrisch induzierter druckwellenemittierender katheterschaft
EP3240603B1 (de) * 2014-12-30 2019-05-01 The Spectranetics Corporation Laserinduzierter flüssigkeitsgefüllter ballonkatheter
US11058492B2 (en) 2014-12-30 2021-07-13 The Spectranetics Corporation Laser-induced pressure wave emitting catheter sheath
US10179190B2 (en) 2015-05-29 2019-01-15 Boston Scientific Scimed, Inc. Compositions and methods for treatment of tissue
US20170049256A1 (en) * 2015-08-21 2017-02-23 Azizbek Razakov Devices for pressing food into liquid
US10327846B1 (en) 2015-08-25 2019-06-25 The Spectranetics Corporation Methods for treating vascular stenoses including laser atherectomy and drug delivery via drug-coated balloons
US10682498B2 (en) * 2015-09-24 2020-06-16 Silicon Microstructures, Inc. Light shields for catheter sensors
US10641672B2 (en) 2015-09-24 2020-05-05 Silicon Microstructures, Inc. Manufacturing catheter sensors
WO2017079459A2 (en) 2015-11-04 2017-05-11 Boston Scientific Scimed, Inc. Medical device and related methods
WO2017087195A1 (en) 2015-11-18 2017-05-26 Shockwave Medical, Inc. Shock wave electrodes
US10226265B2 (en) 2016-04-25 2019-03-12 Shockwave Medical, Inc. Shock wave device with polarity switching
CA3038330A1 (en) 2016-10-06 2018-04-12 Shockwave Medical, Inc. Aortic leaflet repair using shock wave applicators
US10357264B2 (en) 2016-12-06 2019-07-23 Shockwave Medical, Inc. Shock wave balloon catheter with insertable electrodes
US10441300B2 (en) 2017-04-19 2019-10-15 Shockwave Medical, Inc. Drug delivery shock wave balloon catheter system
US11020135B1 (en) 2017-04-25 2021-06-01 Shockwave Medical, Inc. Shock wave device for treating vascular plaques
US10966737B2 (en) 2017-06-19 2021-04-06 Shockwave Medical, Inc. Device and method for generating forward directed shock waves
US10709462B2 (en) 2017-11-17 2020-07-14 Shockwave Medical, Inc. Low profile electrodes for a shock wave catheter
US11103262B2 (en) 2018-03-14 2021-08-31 Boston Scientific Scimed, Inc. Balloon-based intravascular ultrasound system for treatment of vascular lesions
EP3809988B1 (de) 2018-06-21 2023-06-07 Shockwave Medical, Inc. System zur behandlung von okklusionen in körperlumen
WO2020005910A1 (en) 2018-06-28 2020-01-02 Sandler Scientific, Llc Sino-nasal rinse delivery device with agitation, flow-control and integrated medication management system
US11622779B2 (en) 2018-10-24 2023-04-11 Boston Scientific Scimed, Inc. Photoacoustic pressure wave generation for intravascular calcification disruption
CN113660972A (zh) * 2019-04-08 2021-11-16 尤迪安·帕特尔 在具有旁路通路的导管上的可充胀球囊
JP7515576B2 (ja) 2019-09-24 2024-07-12 ショックウェーブ メディカル， インコーポレイテッド 身体管腔内の血栓を治療するためのシステム
US20210186613A1 (en) * 2019-12-18 2021-06-24 Bolt Medical, Inc. Multiplexer for laser-driven intravascular lithotripsy device
US11141191B2 (en) 2020-01-15 2021-10-12 Covidien Lp Surgical access assembly
US20210267685A1 (en) * 2020-02-27 2021-09-02 Bolt Medical, Inc. Fluid recirculation system for intravascular lithotripsy device
US20220008130A1 (en) * 2020-07-09 2022-01-13 Boston Scientific Scimed, Inc. Acoustic tissue identification for balloon intravascular lithotripsy guidance
US11992232B2 (en) 2020-10-27 2024-05-28 Shockwave Medical, Inc. System for treating thrombus in body lumens
AU2021397309A1 (en) * 2020-12-11 2023-06-22 Research Development Foundation Systems and methods for laser-induced calcium fractures
US11944331B2 (en) 2021-02-26 2024-04-02 Fastwave Medical Inc. Intravascular lithotripsy
US11911056B2 (en) 2021-02-26 2024-02-27 Fastwave Medical Inc. Intravascular lithotripsy
US11957369B2 (en) 2021-08-05 2024-04-16 Nextern Innovation, Llc Intravascular lithotripsy systems and methods
US11877761B2 (en) 2021-08-05 2024-01-23 Nextern Innovation, Llc Systems, devices and methods for monitoring voltage and current and controlling voltage of voltage pulse generators
US11896248B2 (en) 2021-08-05 2024-02-13 Nextern Innovation, Llc Systems, devices and methods for generating subsonic pressure waves in intravascular lithotripsy
US11801066B2 (en) 2021-08-05 2023-10-31 Nextern Innovation, Llc Systems, devices and methods for selection of arc location within a lithoplasty balloon spark gap
US12089861B2 (en) 2021-08-05 2024-09-17 Nextern Innovation, Llc Intravascular lithotripsy system and device
US12023098B2 (en) 2021-10-05 2024-07-02 Shockwave Medical, Inc. Lesion crossing shock wave catheter
WO2023069902A1 (en) 2021-10-19 2023-04-27 Shockwave Medical, Inc. Intravascular lithotripsy catheter with interfering shock waves
US11918285B2 (en) * 2022-06-01 2024-03-05 Fast Wave Medical Inc. Intravascular lithotripsy
KR102451172B1 (ko) * 2022-06-22 2022-10-06 서석배 약물 주입 장치
US20240325032A1 (en) * 2023-03-31 2024-10-03 Shockwave Medical, Inc. Shockwave catheters for treating rhinosinusitis
US12035932B1 (en) 2023-04-21 2024-07-16 Shockwave Medical, Inc. Intravascular lithotripsy catheter with slotted emitter bands

Citations (52)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4793349A (en) * 1984-09-10 1988-12-27 Weinrib Harry P Needle holder for surgery
US4990134A (en) * 1986-01-06 1991-02-05 Heart Technology, Inc. Transluminal microdissection device
US4994033A (en) * 1989-05-25 1991-02-19 Schneider (Usa) Inc. Intravascular drug delivery dilatation catheter
US5049132A (en) * 1990-01-08 1991-09-17 Cordis Corporation Balloon catheter for delivering therapeutic agents
US5053041A (en) * 1990-03-12 1991-10-01 Ansari Shapoor S Vessel holder
US5087244A (en) * 1989-01-31 1992-02-11 C. R. Bard, Inc. Catheter and method for locally applying medication to the wall of a blood vessel or other body lumen
US5098381A (en) * 1988-04-20 1992-03-24 Schneider Europe Catheter for recanalizing constricted vessels
US5180366A (en) * 1990-10-10 1993-01-19 Woods W T Apparatus and method for angioplasty and for preventing re-stenosis
US5213576A (en) * 1991-06-11 1993-05-25 Cordis Corporation Therapeutic porous balloon catheter
US5306250A (en) * 1992-04-02 1994-04-26 Indiana University Foundation Method and apparatus for intravascular drug delivery
US5314407A (en) * 1986-11-14 1994-05-24 Heart Technology, Inc. Clinically practical rotational angioplasty system
US5332444A (en) * 1992-11-25 1994-07-26 Air Products And Chemicals, Inc. Gas phase cleaning agents for removing metal containing contaminants from integrated circuit assemblies and a process for using the same
US5336178A (en) * 1992-11-02 1994-08-09 Localmed, Inc. Intravascular catheter with infusion array
US5358487A (en) * 1993-10-15 1994-10-25 Cordis Corporation Frangible balloon catheter
US5364356A (en) * 1993-07-19 1994-11-15 Bavaria Medizin Technologie Gmbh Sleeve catheter
US5364393A (en) * 1990-07-02 1994-11-15 Heart Technology, Inc. Tissue dissipative recanalization catheter
US5421826A (en) * 1992-04-29 1995-06-06 Cardiovascular Dynamics, Inc. Drug delivery and dilatation catheter having a reinforced perfusion lumen
US5447497A (en) * 1992-08-06 1995-09-05 Scimed Life Systems, Inc Balloon catheter having nonlinear compliance curve and method of using
US5611775A (en) * 1993-03-15 1997-03-18 Advanced Cardiovascular Systems, Inc. Method of delivery therapeutic or diagnostic liquid into tissue surrounding a body lumen
US5614502A (en) * 1993-01-15 1997-03-25 The General Hospital Corporation High-pressure impulse transient drug delivery for the treatment of proliferative diseases
US5704911A (en) * 1992-09-28 1998-01-06 Equidyne Systems, Inc. Needleless hypodermic jet injector
US5730723A (en) * 1995-10-10 1998-03-24 Visionary Medical Products Corporation, Inc. Gas pressured needle-less injection device and method
US5746716A (en) * 1995-07-10 1998-05-05 Interventional Technologies Inc. Catheter for injecting fluid medication into an arterial wall
US5814016A (en) * 1991-07-16 1998-09-29 Heartport, Inc. Endovascular system for arresting the heart
US5858400A (en) * 1995-10-11 1999-01-12 Talaria Therapeutics, Inc. Method of suppressing a rise in LDL concentrations after administration of an agent having small acceptors
US5891085A (en) * 1995-01-09 1999-04-06 Medi-Ject Corporation Nozzle assembly with lost motion connection for medical injector assembly
US6027514A (en) * 1997-12-17 2000-02-22 Fox Hollow Technologies, Inc. Apparatus and method for removing occluding material from body lumens
US6036700A (en) * 1998-07-14 2000-03-14 Ethicon Endo-Surgery, Inc. Surgical anastomosis instrument
US6280411B1 (en) * 1998-05-18 2001-08-28 Scimed Life Systems, Inc. Localized delivery of drug agents
US6280414B1 (en) * 1998-09-30 2001-08-28 Medtronic Ave, Inc. Method and apparatus for local delivery of therapeutic agent
US6299622B1 (en) * 1999-08-19 2001-10-09 Fox Hollow Technologies, Inc. Atherectomy catheter with aligned imager
US20010035456A1 (en) * 1998-05-18 2001-11-01 Lennox Charles D. Localized delivery of drug agents
US6344027B1 (en) * 1999-12-08 2002-02-05 Scimed Life Systems, Inc. Needle-less injection apparatus and method
US6364856B1 (en) * 1998-04-14 2002-04-02 Boston Scientific Corporation Medical device with sponge coating for controlled drug release
US20020107504A1 (en) * 2001-02-06 2002-08-08 Gordon Lucas S. Apparatus for local drug delivery in limb
US20020115982A1 (en) * 1999-03-01 2002-08-22 Coaxia, Inc. Partial aortic occlusion devices and methods for cerebral perfusion augmentation
US6447525B2 (en) * 1999-08-19 2002-09-10 Fox Hollow Technologies, Inc. Apparatus and methods for removing material from a body lumen
US6544223B1 (en) * 2001-01-05 2003-04-08 Advanced Cardiovascular Systems, Inc. Balloon catheter for delivering therapeutic agents
US6623452B2 (en) * 2000-12-19 2003-09-23 Scimed Life Systems, Inc. Drug delivery catheter having a highly compliant balloon with infusion holes
US6628233B2 (en) * 1997-08-19 2003-09-30 Siemens Vdo Automotive Corporation Vehicle information system
US6629853B2 (en) * 2001-05-17 2003-10-07 Tyco Electronics Corporation Self-aligning power connector system
US6699231B1 (en) * 1997-12-31 2004-03-02 Heartport, Inc. Methods and apparatus for perfusion of isolated tissue structure
US6716190B1 (en) * 2000-04-19 2004-04-06 Scimed Life Systems, Inc. Device and methods for the delivery and injection of therapeutic and diagnostic agents to a target site within a body
US20040073169A1 (en) * 2000-09-28 2004-04-15 Shai Amisar Constant pressure apparatus for the administration of fluids intravenously
US20040181252A1 (en) * 1999-11-19 2004-09-16 Boyle Christopher T. Balloon catheter having metal balloon and method of making same
US20040236308A1 (en) * 2003-05-22 2004-11-25 Atrium Medical Corp. Kinetic isolation pressurization
US20040260239A1 (en) * 1996-10-10 2004-12-23 Kusleika Richard S. Catheter for tissue dilation and drug delivery
US20050288632A1 (en) * 2004-06-23 2005-12-29 Willard Martin R Intravascular dilatation infusion catheter
US20060184118A1 (en) * 2000-05-22 2006-08-17 Birger Hjertman Medical device
US20060190022A1 (en) * 2004-07-14 2006-08-24 By-Pass, Inc. Material delivery system
US20080140001A1 (en) * 2006-12-12 2008-06-12 By-Pass Inc. Fluid Delivery Apparatus And Methods
US20100191215A1 (en) * 2007-06-12 2010-07-29 By-Pass ,Inc. Pressure pulse actuating device for delivery systems

Family Cites Families (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3821544C2 (de) * 1988-06-25 1994-04-28 H Prof Dr Med Just Dilatationskatheter
DE4225553C1 (de) 1992-08-03 1994-05-11 Michael Dr Rudolf Ballonkatheter
US5817144A (en) * 1994-10-25 1998-10-06 Latis, Inc. Method for contemporaneous application OF laser energy and localized pharmacologic therapy
US5836940A (en) * 1994-10-25 1998-11-17 Latis, Inc. Photoacoustic drug delivery
US5707385A (en) 1994-11-16 1998-01-13 Advanced Cardiovascular Systems, Inc. Drug loaded elastic membrane and method for delivery
US20030060876A1 (en) * 2000-09-28 2003-03-27 Amir Loshakove Graft delivery system
JP2000070367A (ja) * 1998-08-27 2000-03-07 Shimadzu Corp 針無注射器
US6638233B2 (en) * 1999-08-19 2003-10-28 Fox Hollow Technologies, Inc. Apparatus and methods for material capture and removal
US6629953B1 (en) * 2000-02-18 2003-10-07 Fox Hollow Technologies, Inc. Methods and devices for removing material from a vascular site
US6638246B1 (en) * 2000-11-28 2003-10-28 Scimed Life Systems, Inc. Medical device for delivery of a biologically active material to a lumen
AU2003264854A1 (en) 2003-09-25 2005-04-11 By-Pass, Inc. Snare for blood vessels used in anastomotic procedures
WO2006114783A2 (en) 2005-04-28 2006-11-02 Bypass, Inc. Material delivery system
GB2426457A (en) 2005-05-26 2006-11-29 Leonid Shturman Balloon angioplasty device with distal protection capability

Patent Citations (56)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4793349A (en) * 1984-09-10 1988-12-27 Weinrib Harry P Needle holder for surgery
US4990134A (en) * 1986-01-06 1991-02-05 Heart Technology, Inc. Transluminal microdissection device
US4990134B1 (en) * 1986-01-06 1996-11-05 Heart Techn Inc Transluminal microdissection device
US5314407A (en) * 1986-11-14 1994-05-24 Heart Technology, Inc. Clinically practical rotational angioplasty system
US5098381A (en) * 1988-04-20 1992-03-24 Schneider Europe Catheter for recanalizing constricted vessels
US5087244A (en) * 1989-01-31 1992-02-11 C. R. Bard, Inc. Catheter and method for locally applying medication to the wall of a blood vessel or other body lumen
US4994033A (en) * 1989-05-25 1991-02-19 Schneider (Usa) Inc. Intravascular drug delivery dilatation catheter
US5049132A (en) * 1990-01-08 1991-09-17 Cordis Corporation Balloon catheter for delivering therapeutic agents
US5053041A (en) * 1990-03-12 1991-10-01 Ansari Shapoor S Vessel holder
US5364393A (en) * 1990-07-02 1994-11-15 Heart Technology, Inc. Tissue dissipative recanalization catheter
US5180366A (en) * 1990-10-10 1993-01-19 Woods W T Apparatus and method for angioplasty and for preventing re-stenosis
US5213576A (en) * 1991-06-11 1993-05-25 Cordis Corporation Therapeutic porous balloon catheter
US5814016A (en) * 1991-07-16 1998-09-29 Heartport, Inc. Endovascular system for arresting the heart
US5306250A (en) * 1992-04-02 1994-04-26 Indiana University Foundation Method and apparatus for intravascular drug delivery
US5421826A (en) * 1992-04-29 1995-06-06 Cardiovascular Dynamics, Inc. Drug delivery and dilatation catheter having a reinforced perfusion lumen
US5447497A (en) * 1992-08-06 1995-09-05 Scimed Life Systems, Inc Balloon catheter having nonlinear compliance curve and method of using
US5704911A (en) * 1992-09-28 1998-01-06 Equidyne Systems, Inc. Needleless hypodermic jet injector
US5336178A (en) * 1992-11-02 1994-08-09 Localmed, Inc. Intravascular catheter with infusion array
US5332444A (en) * 1992-11-25 1994-07-26 Air Products And Chemicals, Inc. Gas phase cleaning agents for removing metal containing contaminants from integrated circuit assemblies and a process for using the same
US5614502A (en) * 1993-01-15 1997-03-25 The General Hospital Corporation High-pressure impulse transient drug delivery for the treatment of proliferative diseases
US5611775A (en) * 1993-03-15 1997-03-18 Advanced Cardiovascular Systems, Inc. Method of delivery therapeutic or diagnostic liquid into tissue surrounding a body lumen
US5364356A (en) * 1993-07-19 1994-11-15 Bavaria Medizin Technologie Gmbh Sleeve catheter
US5358487A (en) * 1993-10-15 1994-10-25 Cordis Corporation Frangible balloon catheter
US5891085A (en) * 1995-01-09 1999-04-06 Medi-Ject Corporation Nozzle assembly with lost motion connection for medical injector assembly
US5746716A (en) * 1995-07-10 1998-05-05 Interventional Technologies Inc. Catheter for injecting fluid medication into an arterial wall
US5730723A (en) * 1995-10-10 1998-03-24 Visionary Medical Products Corporation, Inc. Gas pressured needle-less injection device and method
US5858400A (en) * 1995-10-11 1999-01-12 Talaria Therapeutics, Inc. Method of suppressing a rise in LDL concentrations after administration of an agent having small acceptors
US20040260239A1 (en) * 1996-10-10 2004-12-23 Kusleika Richard S. Catheter for tissue dilation and drug delivery
US6628233B2 (en) * 1997-08-19 2003-09-30 Siemens Vdo Automotive Corporation Vehicle information system
US6027514A (en) * 1997-12-17 2000-02-22 Fox Hollow Technologies, Inc. Apparatus and method for removing occluding material from body lumens
US6699231B1 (en) * 1997-12-31 2004-03-02 Heartport, Inc. Methods and apparatus for perfusion of isolated tissue structure
US6364856B1 (en) * 1998-04-14 2002-04-02 Boston Scientific Corporation Medical device with sponge coating for controlled drug release
US20010035456A1 (en) * 1998-05-18 2001-11-01 Lennox Charles D. Localized delivery of drug agents
US6280411B1 (en) * 1998-05-18 2001-08-28 Scimed Life Systems, Inc. Localized delivery of drug agents
US6036700A (en) * 1998-07-14 2000-03-14 Ethicon Endo-Surgery, Inc. Surgical anastomosis instrument
US6280414B1 (en) * 1998-09-30 2001-08-28 Medtronic Ave, Inc. Method and apparatus for local delivery of therapeutic agent
US20020115982A1 (en) * 1999-03-01 2002-08-22 Coaxia, Inc. Partial aortic occlusion devices and methods for cerebral perfusion augmentation
US6447525B2 (en) * 1999-08-19 2002-09-10 Fox Hollow Technologies, Inc. Apparatus and methods for removing material from a body lumen
US6997934B2 (en) * 1999-08-19 2006-02-14 Fox Hollow Technologies, Inc. Atherectomy catheter with aligned imager
US6623496B2 (en) * 1999-08-19 2003-09-23 Fox Hollow Technologies, Inc. Atherectomy catheter with aligned imager
US6299622B1 (en) * 1999-08-19 2001-10-09 Fox Hollow Technologies, Inc. Atherectomy catheter with aligned imager
US20040181252A1 (en) * 1999-11-19 2004-09-16 Boyle Christopher T. Balloon catheter having metal balloon and method of making same
US6344027B1 (en) * 1999-12-08 2002-02-05 Scimed Life Systems, Inc. Needle-less injection apparatus and method
US6964649B2 (en) * 1999-12-08 2005-11-15 Boston Scientific Scimed., Inc. Needle-less injection apparatus and method
US6716190B1 (en) * 2000-04-19 2004-04-06 Scimed Life Systems, Inc. Device and methods for the delivery and injection of therapeutic and diagnostic agents to a target site within a body
US20060184118A1 (en) * 2000-05-22 2006-08-17 Birger Hjertman Medical device
US20040073169A1 (en) * 2000-09-28 2004-04-15 Shai Amisar Constant pressure apparatus for the administration of fluids intravenously
US6623452B2 (en) * 2000-12-19 2003-09-23 Scimed Life Systems, Inc. Drug delivery catheter having a highly compliant balloon with infusion holes
US6544223B1 (en) * 2001-01-05 2003-04-08 Advanced Cardiovascular Systems, Inc. Balloon catheter for delivering therapeutic agents
US20020107504A1 (en) * 2001-02-06 2002-08-08 Gordon Lucas S. Apparatus for local drug delivery in limb
US6629853B2 (en) * 2001-05-17 2003-10-07 Tyco Electronics Corporation Self-aligning power connector system
US20040236308A1 (en) * 2003-05-22 2004-11-25 Atrium Medical Corp. Kinetic isolation pressurization
US20050288632A1 (en) * 2004-06-23 2005-12-29 Willard Martin R Intravascular dilatation infusion catheter
US20060190022A1 (en) * 2004-07-14 2006-08-24 By-Pass, Inc. Material delivery system
US20080140001A1 (en) * 2006-12-12 2008-06-12 By-Pass Inc. Fluid Delivery Apparatus And Methods
US20100191215A1 (en) * 2007-06-12 2010-07-29 By-Pass ,Inc. Pressure pulse actuating device for delivery systems

Cited By (53)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8415318B2 (en) 2001-10-19 2013-04-09 Vascular Biogenics Ltd. Polynucleotide constructs, pharmaceutical compositions and methods for targeted downregulation of angiogenesis and anticancer therapy
US20060190022A1 (en) * 2004-07-14 2006-08-24 By-Pass, Inc. Material delivery system
US8439890B2 (en) 2004-07-14 2013-05-14 By-Pass, Inc. Material delivery system
US7927305B2 (en) * 2006-04-21 2011-04-19 Abbott Laboratories Systems, methods, and devices for injecting media contrast
US20070293821A1 (en) * 2006-04-21 2007-12-20 Abbott Laboratories Systems, Methods, and Devices for Injecting Media Contrast
US20070293846A1 (en) * 2006-04-21 2007-12-20 Abbott Laboratories Dual Lumen Guidewire Support Catheter
US20080058722A1 (en) * 2006-04-21 2008-03-06 Abbott Laboratories Stiffening Support Catheter and Methods for Using the Same
US8246574B2 (en) 2006-04-21 2012-08-21 Abbott Laboratories Support catheter
US7993303B2 (en) 2006-04-21 2011-08-09 Abbott Laboratories Stiffening support catheter and methods for using the same
US20070270779A1 (en) * 2006-04-21 2007-11-22 Abbott Laboratories Support Catheter
US20070250149A1 (en) * 2006-04-21 2007-10-25 Abbott Laboratories Stiffening Support Catheters and Methods for Using the Same
US8206370B2 (en) 2006-04-21 2012-06-26 Abbott Laboratories Dual lumen guidewire support catheter
US20070288036A1 (en) * 2006-06-09 2007-12-13 Niranjan Seshadri Assembly for crossing a chronic total occlusion and method therefor
US20080140001A1 (en) * 2006-12-12 2008-06-12 By-Pass Inc. Fluid Delivery Apparatus And Methods
US20090299450A1 (en) * 2008-05-29 2009-12-03 Boston Scientific Scimed, Inc. Multi-layer balloon design for use in combination with catheter assemblies, and methods of making the same
US8771332B2 (en) * 2008-05-29 2014-07-08 Boston Scientific Scimed, Inc. Multi-layer balloon design for use in combination with catheter assemblies, and methods of making the same
US20210186508A1 (en) * 2008-10-10 2021-06-24 Peter Forsell Apparatus for treating obesity
US8568354B2 (en) 2010-02-16 2013-10-29 Cardiovascular Systems, Inc. Devices and methods for low shearing local delivery of therapeutic agents to the wall of a bodily lumen
US20120046599A1 (en) * 2010-02-18 2012-02-23 Cardiovascular Systems, Inc. Therapeutic agent delivery system, device and method for localized application of therapeutic substances to a biological conduit
US9050414B2 (en) 2010-02-19 2015-06-09 Cardiovascular Systems, Inc. Systems and methods for mixing therapeutic agents before and/or during administration
US20120053567A1 (en) * 2010-08-30 2012-03-01 SinuSys Corporation Devices and Methods for Dilating a Paranasal Sinus Opening and for Treating Sinusitis
US9629644B2 (en) * 2010-08-30 2017-04-25 SinuSys Corporation Devices and methods for dilating a paranasal sinus opening and for treating sinusitis
US9498239B2 (en) 2010-08-30 2016-11-22 SinuSys Corporation Devices and methods for inserting a sinus dilator
US20130261540A1 (en) * 2010-12-16 2013-10-03 Justin M. Crank High-pressure pneumatic injection system and method
US9597485B2 (en) 2012-02-29 2017-03-21 SinuSys Corporation Devices and methods for dilating a paranasal sinus opening and for treating sinusitis
US9504812B2 (en) 2012-02-29 2016-11-29 SinuSys Corporation Devices and methods for dilating a paranasal sinus opening and for treating sinusitis
US11167116B2 (en) * 2012-05-07 2021-11-09 The Regents Of The University Of California Upper esophageal sphincter dilator
JP2016515435A (ja) * 2013-04-13 2016-05-30 アイピーピラミッズ ゲーエムベーハー マイクロ穿孔および金属メッシュを備えるカテーテルバルーン
US9687263B2 (en) 2013-05-30 2017-06-27 SinuSys Corporation Devices and methods for inserting a sinus dilator
US10086184B2 (en) 2014-10-08 2018-10-02 Alfred E. Mann Foundation For Scientific Research Method of manufacturing percutaneous ports with wire coils
US10940303B2 (en) 2014-10-08 2021-03-09 Alfred E. Mann Foundation For Scientific Research Percutaneous ports with wire coils
US20160101275A1 (en) * 2014-10-08 2016-04-14 Alfred E. Mann Foundation For Scientific Research Percutaneous Ports with Wire Coils
US10226612B2 (en) * 2014-10-08 2019-03-12 Alfred E. Mann Foundation For Scientific Research Percutaneous ports with wire coils
US10413240B2 (en) 2014-12-10 2019-09-17 Staton Techiya, Llc Membrane and balloon systems and designs for conduits
US11759149B2 (en) 2014-12-10 2023-09-19 Staton Techiya Llc Membrane and balloon systems and designs for conduits
US11819229B2 (en) 2019-06-19 2023-11-21 Boston Scientific Scimed, Inc. Balloon surface photoacoustic pressure wave generation to disrupt vascular lesions
US11717139B2 (en) 2019-06-19 2023-08-08 Bolt Medical, Inc. Plasma creation via nonaqueous optical breakdown of laser pulse energy for breakup of vascular calcium
US11660427B2 (en) 2019-06-24 2023-05-30 Boston Scientific Scimed, Inc. Superheating system for inertial impulse generation to disrupt vascular lesions
US11517713B2 (en) 2019-06-26 2022-12-06 Boston Scientific Scimed, Inc. Light guide protection structures for plasma system to disrupt vascular lesions
US11911574B2 (en) 2019-06-26 2024-02-27 Boston Scientific Scimed, Inc. Fortified balloon inflation fluid for plasma system to disrupt vascular lesions
US11583339B2 (en) 2019-10-31 2023-02-21 Bolt Medical, Inc. Asymmetrical balloon for intravascular lithotripsy device and method
US12102384B2 (en) 2019-11-13 2024-10-01 Bolt Medical, Inc. Dynamic intravascular lithotripsy device with movable energy guide
WO2021101766A1 (en) * 2019-11-22 2021-05-27 Bolt Medical, Inc. Energy manifold for directing and concentrating energy within a lithoplasty device
US11672599B2 (en) 2020-03-09 2023-06-13 Bolt Medical, Inc. Acoustic performance monitoring system and method within intravascular lithotripsy device
US11903642B2 (en) 2020-03-18 2024-02-20 Bolt Medical, Inc. Optical analyzer assembly and method for intravascular lithotripsy device
US11707323B2 (en) 2020-04-03 2023-07-25 Bolt Medical, Inc. Electrical analyzer assembly for intravascular lithotripsy device
CN116113379A (zh) * 2020-08-19 2023-05-12 博尔特医疗有限公司 用于破坏血管钙的等离子体生成的压力波的更快上升时间脉冲成形
WO2022039783A1 (en) * 2020-08-19 2022-02-24 Bolt Medical, Inc. Faster rise time pulse shaping of plasma generated pressure waves for disruption of vascular calcium
US12016610B2 (en) 2020-12-11 2024-06-25 Bolt Medical, Inc. Catheter system for valvuloplasty procedure
US11672585B2 (en) 2021-01-12 2023-06-13 Bolt Medical, Inc. Balloon assembly for valvuloplasty catheter system
US11648057B2 (en) 2021-05-10 2023-05-16 Bolt Medical, Inc. Optical analyzer assembly with safety shutdown system for intravascular lithotripsy device
US11806075B2 (en) 2021-06-07 2023-11-07 Bolt Medical, Inc. Active alignment system and method for laser optical coupling
US11839391B2 (en) 2021-12-14 2023-12-12 Bolt Medical, Inc. Optical emitter housing assembly for intravascular lithotripsy device

Also Published As

Publication number Publication date
JP2008506447A (ja) 2008-03-06
EP1773439A4 (de) 2010-01-20
US20120071715A1 (en) 2012-03-22
EP1773439A2 (de) 2007-04-18
CA2574013A1 (en) 2006-01-19
WO2006006169A2 (en) 2006-01-19
WO2006006169A3 (en) 2006-08-31
US20060190022A1 (en) 2006-08-24
US8439890B2 (en) 2013-05-14

Similar Documents

Publication Publication Date Title
US20070299392A1 (en) Material Delivery System
EP1874384A2 (de) Materialablagesystem
US20240000478A1 (en) Temporary vascular scaffold and scoring device
US8740961B2 (en) Method for treating a target site in a vascular body channel
EP2089087B1 (de) Deflation eines medizinischen ballons
JP2016501075A5 (de)
EP1604704A1 (de) Wirkstoffabgabesystem mit Mikroprojektionen
JP2008541936A (ja) 生体内ステント形成
US20090270787A1 (en) Systems and methods for creating enlarged migration channels for therapeutic agents within the endothelium
US10098650B2 (en) Systems and methods for treating atherosclerotic plaque
US20160184526A1 (en) Material delivery system
US20230381468A1 (en) Inflatable balloon over catheter with bypass passageway
CN101208127A (zh) 材料输送系统
JP2005349202A (ja) 治療薬を組織内へ導入する器具および方法
US20240299051A1 (en) Intravascular lithotripsy balloon perfusion catheters
US20220331555A1 (en) Intravascular devices and methods for delivery of fluids and therapeutic agents into blood vessel walls and intravascular structures
US20210346034A1 (en) Device for closing a vein juncture in the treatment of varicose veins
WO2006074159A2 (en) Diffusion catheter
WO2024118049A1 (en) Medical apparatus for endorectal use and related methods
WO2023212373A2 (en) Intravascular devices and methods for delivery of fluids and therapeutic agents into blood vessel walls and intravascular structures

Legal Events

Date Code Title Description
AS Assignment

Owner name: BYPASS, INC., NEW YORK

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BEYAR, MORDECHAY;GLOBERMAN, OREN;KELLER, RAMI;REEL/FRAME:019780/0244

Effective date: 20070829

Owner name: BYPASS, INC., NEW YORK

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BEYAR, MORDECHAY;GLOBERMAN, OREN;KELLER, RAMI;REEL/FRAME:019780/0150

Effective date: 20070829

STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION