WO1995013025A2 - Cryosurgical probe - Google Patents
Cryosurgical probe Download PDFInfo
- Publication number
- WO1995013025A2 WO1995013025A2 PCT/GB1994/002459 GB9402459W WO9513025A2 WO 1995013025 A2 WO1995013025 A2 WO 1995013025A2 GB 9402459 W GB9402459 W GB 9402459W WO 9513025 A2 WO9513025 A2 WO 9513025A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- probe
- probe head
- refrigerant fluid
- handle
- head
- Prior art date
Links
Classifications
-
- 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
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00084—Temperature
- A61B2017/00092—Temperature using thermocouples
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00115—Electrical control of surgical instruments with audible or visual output
- A61B2017/00119—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation
- A61B2017/00123—Electrical control of surgical instruments with audible or visual output alarm; indicating an abnormal situation and automatic shutdown
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
-
- 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
-
- 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
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
- A61B2018/0212—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument inserted into a body lumen, e.g. catheter
-
- 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
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
- A61B2018/0231—Characteristics of handpieces or probes
- A61B2018/0262—Characteristics of handpieces or probes using a circulating cryogenic fluid
- A61B2018/0268—Characteristics of handpieces or probes using a circulating cryogenic fluid with restriction of flow
- A61B2018/0281—Characteristics of handpieces or probes using a circulating cryogenic fluid with restriction of flow using a tortuous path, e.g. formed by fins or ribs
-
- 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
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
- A61B2018/0231—Characteristics of handpieces or probes
- A61B2018/0262—Characteristics of handpieces or probes using a circulating cryogenic fluid
- A61B2018/0268—Characteristics of handpieces or probes using a circulating cryogenic fluid with restriction of flow
- A61B2018/0281—Characteristics of handpieces or probes using a circulating cryogenic fluid with restriction of flow using a tortuous path, e.g. formed by fins or ribs
- A61B2018/0287—Characteristics of handpieces or probes using a circulating cryogenic fluid with restriction of flow using a tortuous path, e.g. formed by fins or ribs the fluid flowing through a long thin tube with spiral shape
Definitions
- This invention relates to cryosurgical probes.
- Cryosurgical probes employing a cooling element disposed at a distal end of a flexible catheter are used in the treatment of internal bodily organs such as the heart.
- cryosurgical probe An example of a cryosurgical probe is disclosed in the British published patent application number GB-A-2 226 497- This probe comprises a handle portion, a flexible catheter and a probe head.
- the probe head may be cooled by the expansion of a refrigerant fluid within a cavity of the probe head.
- the probe head and catheter are inserted into, for example, a patient's blood vessel such as the femoral vein, and are steered so that the probe head occupies a position within the heart.
- High pressure refrigerant gas is then supplied through the catheter to the probe head to cause cryosurgical necrosis of small areas of the cardiac tissue which are responsible for malfunctions such as cardiac arrhythmias.
- this arrangement provides inefficient cooling of the refrigerant gas.
- the arrangement also leads to an undesirably bulky probe head.
- the size of the probe head limits the minimum vein diameter in which the probe can be used. It is an aim of this invention to improve the cooling efficiency of a cryosurgical probe using a flexible catheter.
- This invention provides a cryosurgical probe comprising: a probe head operable to be cooled by the expansion of a refrigerant fluid within the probe head; a probe handle having means for precooling the refrigerant fluid; and a flexible catheter linking the probe handle and the probe head, the catheter defining a channel for carrying precooled refrigerant fluid from the probe handle to the probe head.
- the invention addresses the above problems by providing precooling of the refrigerant fluid (e.g. a gas) at the probe handle, rather than at the probe head.
- the refrigerant fluid e.g. a gas
- This allows a much more powerful precooling arrangement e.g. a dedicated refrigeration apparatus rather than merely a heat exchanger for heat transfer with the exhaust gases
- the probe head and the flexible catheter can be made smaller, because there is no need to employ a heat exchanger at the probe head and because the increased efficiency of the probe head (using the pre-cooled refrigerant fluid) means that a lower fluid flow is required to the probe head.
- a heat insulating and flexible material such as a plastics material
- this invention provides a cryosurgical catheter using a two-stage cooling process.
- the incoming refrigerant fluid is first pre-cooled by a relatively bulky but high-capacity refrigeration apparatus in the probe handle. This in turn makes the second stage of cooling, namely the expansion of the fluid in the probe head, more efficient.
- the probe handle comprises a conduit for carrying the refrigerant fluid to the flexible catheter, the conduit having an aperture such that a portion of the refrigerant fluid is allowed to expand within the probe handle.
- the portion of the refrigerant fluid expands into an expansion chamber within the probe handle, the expansion chamber having an exhaust outlet communicating with an atmospheric air vent.
- the fluid which passes to the probe tip is that portion which has not expanded within the handle.
- the probe handle comprises means for directing refrigerant fluid, which has expanded through the aperture, along the outside of at least a part of the conduit, thereby allowing heat exchange between the expanded gas and the refrigerant fluid within the conduit.
- the means for directing comprises a helical vaned structure for directing the expanded fluid in a helical path along at least a part of the conduit.
- the means for directing are operable to direct the expanded fluid in an opposite direction to the flow of refrigerant fluid through the conduit. This provides for convenient exhaust of the expanded fluid (away from the catheter) and also ensures that the temperature gradients of both the incoming refrigerant and the fluid expanded within the handle are in the same direction (cooler towards the catheter end of the handle).
- the conduit is a metal tube.
- the flexible catheter comprises an outer channel for carrying exhaust gas from the probe head to the probe handle and an inner channel, within the outer channel, for carrying refrigerant fluid from the probe handle to the probe head.
- the inner channel comprises a plastics tube.
- Plastics tubes are cheaper to manufacture and less likely to block by kinking than the previously used steel tubes.
- the plastics tube is a polyamide tube having a thermal conductivity of less than 1 Watt per metre - Kelvin (W/mK) .
- the plastics tube has a rigidity modulus (El) of less than 20 Newtons per square metre (N/m 2 ) .
- the probe head comprises a temperature sensor for detecting the probe head temperature. It is preferred that the probe comprises control means for controlling the flow of refrigerant fluid to the probe head in response to the probe head temperature. In this way a negative feedback arrangement can be used to control the probe head temperature to be substantially a desired value.
- control means is selectively operable, under user control:
- This arrangement allows a surgeon to cool a particular part of the patient's tissue to 0° Celsius, to cause the probe head to freeze to that tissue and to disable electrical activity within that tissue. If a malfunction such as a cardiac arrythmia ceases, the surgeon can then cause that tissue to be necrosed.
- control means comprises: means for detecting a sudden increase in the probe head temperature (warming); and means, responsive to a detection of a sudden increase in the probe head temperature, for preventing and venting the flow of refrigerant fluid to the probe head.
- a sudden increase in temperature e.g. an increase to at least a predetermined temperature
- the fluid back pressure e.g. caused by a blockage
- the probe head comprises one or more electrodes for detecting electrical impulses generated by a patient's bodily tissue.
- the probe head comprises one or more electrodes for detecting electrical impulses generated by a patient's bodily tissue.
- the flexible catheter comprises a strengthening electrically conductive braid for connecting one of the one or more electrodes to the probe handle.
- the probe head is disposed at an angle with respect to the flexible catheter.
- the flexible catheter comprises one or more control wires for linking the probe head to the probe handle, the one or more control wires being connected to the probe head such that longitudinal movement of the one or more control wires causes the orientation of the probe head to change with respect to the flexible catheter; and the probe handle comprises orientation control means, connected to the one or more control wires, for allowing a user to move longitudinally the one or more control wires.
- the orientation control means could comprise, for example, slide controls connected to the control wires and mounted on the probe handle.
- the orientation control means comprises at least one rotatable crank connected to the one or more control wires.
- this invention provides a cryosurgical probe comprising: a probe head operable to be cooled by the expansion of a refrigerant fluid within the probe head; a flexible catheter linking the probe handle and the probe head, the catheter defining a channel for carrying the refrigerant fluid from the probe handle to the probe head; means for detecting a sudden increase in the probe head temperature; and means, responsive to a detection of a sudden increase in the probe head temperature, for preventing and venting the flow of refrigerant fluid to the probe head.
- this invention provides a cryosurgical probe control unit for controlling a cryosurgical probe having a probe head operable to be cooled by the expansion of a refrigerant fluid within the probe head, the unit comprising: means for supplying a refrigerant fluid to the probe head; means for detecting a sudden increase in the probe head temperature; and means, responsive to a detection of a sudden increase in the probe head temperature, for preventing and venting the flow of refrigerant fluid to the probe head.
- this invention provides a cryosurgical probe handle connectable via a flexible catheter to a probe head operable to be cooled by the expansion of a refrigerant fluid within the probe head, the handle comprising means for precooling the refrigerant fluid.
- FIG. 1 is a schematic diagram of a cryosurgical probe
- Figure 2 is a schematic diagram illustrating the cooling operation of a probe head
- Figure 3 is a schematic diagram illustrating the precooling operation of a probe handle
- Figure 4 is a schematic diagram illustrating a probe handle connected to a control apparatus
- Figure 5 is a schematic diagram illustrating steering of the probe head by torque control.
- FIG 6 is a schematic diagram of a two-axis steering mechanism.
- a cryosurgical probe comprises a probe handle 10, a probe head 20, and a flexible catheter 30 linking the probe handle and the probe head.
- the cryosurgical probe shown in Figure 1 may be used in surgical procedures in which a patient's bodily tissue is locally cooled to such a degree that the tissue is locally destroyed.
- the cryosurgical probe has particular application to treatment of internal organs such as the human heart.
- the probe head 20 is inserted into the femoral vein from a position in the patient's groin, and are passed through the patient's vein structure to reach the heart. Once the probe head 20 is in position in the patient's heart, the probe head can be cooled to destroy small portions of the heart tissue responsible for malfunctions of the heart such as arrhythmias.
- the cooling of the probe head is performed using expansion of a refrigerant gas in accordance with the Joule-Thomson effect, described in the book 'Equilibrium Thermodynamics' (C J Adkins, Cambridge
- the refrigerant gas at a high pressure (e.g. -4 x 10 Pascals) is supplied to the probe handle 10 via an inlet tube -40, and exhaust (expanded) gas at a lower pressure is returned from the probe handle 10 by an exhaust tube 50.
- the probe handle 10 comprises means for precooling the high pressure refrigerant gas to be used for cooling at the probe head. This precooling can improve the cooling performance of the probe head.
- the means for precooling will be described in detail below.
- the flexible catheter 30 has a diameter of nominally 3 nTM (conventionally referred to as a '9 French catheter').
- the outer wall of the catheter 30 is strengthened with a metal braid, which is also used as an electrical conductor (see below) .
- FIG. 2 is a schematic diagram illustrating the cooling operation of the probe head 20.
- high pressure refrigerant fluid is delivered through a narrow bore tube 60, and expands from the end 70 of the tube 60 into a larger exhaust cavity 80. This causes local cooling of a rounded metal tip 90 of the probe head by the Joule-Thomson effect.
- the rounded metal tip 90 of the probe head 20 provides a smooth leading surface for the probe head 20 as it is directed along a patient's blood vessels, and also allows effective heat conduction from the patient's tissue in contact with the tip 90 to the expanded refrigerant gas in the probe head 20.
- Figure 3 is a schematic diagram illustrating the precooling operation of the probe handle 10.
- High pressure refrigerant gas received through the inlet tube -40 is passed through an axial conduit 100 in the probe handle 10 before entering an axial refrigerant supply tube 110 in the catheter 30 (connected to the tube 60 in the probe head 20) .
- the refrigerant supply is a polyamide tube having a thermal conductivity of less than 1 Watt per metre - Kelvin (W/mK) and a rigidity modulus (El) of less than 20 Newtons per square metre (N/m 2 ) .
- An aperture 120 in the conduit 100 allows a portion (about two thirds) of the refrigerant gas to expand into an expansion area 130 of the probe handle 10. As mentioned above, this causes the expanded refrigerant gas to cool by the Joule-Thomson effect. The cooled gas is then directed by a helically-vaned heat exchanging structure 1-40 in a helical path around the conduit 100. This allows heat transfer from the high pressure refrigerant gas in the conduit 100 to the expanded gas in the expansion region 130, thereby precooling the high pressure refrigerant gas in the conduit 100.
- the conduit 100 and the vaned heat exchanger 1-40 are fabricated from a good heat conducting material such as copper.
- a second aperture 150 allows the refrigerant gas which has expanded through the aperture 120 to escape along the exhaust tube 50.
- the portion of the high pressure refrigerant gas which does not expand through the aperture 120 passes into the refrigerant supply tube 110 in the flexible catheter 30, to be supplied to the probe head 20.
- Exhaust gas from the probe head 20 returns to the probe handle through an exhaust return tube 160 which communicates with the exhaust cavity 8 ⁇ in the probe head.
- This exhaust gas from the probe head 20 passes through apertures 170 into an outer region of the body of the probe handle 10, and from there into the exhaust tube 50.
- Figure 4 is a schematic diagram illustrating the probe handle 10 connected to control apparatus 200, 210.
- the control apparatus 200 attends to the control of the flow of high pressure refrigerant gas to the probe handle 10 and, ultimately, to the probe head 20.
- the apparatus 200 comprises a vessel 220 containing high pressure refrigerant gas and connected, via a flow valve 230, to the inlet tube 40.
- the exhaust tube 50 from the probe handle is connected to an atmospheric air vent 2-40 or scavenging system.
- thermocouple temperature sensor is provided in the probe head 20. -An electrical signal from the thermocouple sensor is passed, via signal wires (not shown) within the flexible catheter 30 and the exhaust tube 50 to a temperature detector 250 within the control apparatus 200. An output electrical signal from the temperature detector 250 is passed in parallel to a high pass electrical filter 260 and a feedback temperature controller 270.
- the high pass filter 260 detects a sudden increase in the temperature of the probe head 20 (e.g. an increase over a threshold tip temperature such as -65° Celsius) . Such a sudden increase indicates a corresponding increase in the back pressure (exhaust pressure) of the cooling operation in the probe head 20 and can therefore indicate a possible blockage in the exhaust return tube l6 ⁇ or the exhaust tube 50. In this case, for safety reasons the flow of refrigerant gas to the probe handle 10 is immediately terminated by the high pass filter 26 ⁇ applying a control signal to the flow valve 230.
- the refrigerant supply tube 110 is also vented by an atmospheric air vent (not shown) .
- the feedback temperature controller 270 responds to either a variable temperature control (to be set by a surgeon or other operator using the cryosurgical probe) or, as shown in Figure -4, to three possible temperature selections, namely 'Off, '0 Degrees' and 'Freeze'. In Figure -4, these selections are made by control buttons mounted on the probe handle 10. However, in other embodiments, the temperature controls could be part of the control apparatus 200.
- the flow of refrigerant gas to the probe handle 10 is shut off completely by means of a control signal from the feedback temperature controller 270 to the flow valve 230.
- the refrigerant supply tube 110 is also vented to an atmospheric air vent (not shown) .
- the feedback temperature controller 270 varies the flow of refrigerant gas to the probe handle 10 using negative feedback in order to maintain a probe head temperature of substantially 0° Celsius.
- the feedback temperature controller 270 controls the flow valve 230 to open fully, thereby decreasing the probe head temperature to a temperature (for example, -30° Celsius to -70° Celsius) suitable for cryosurgical necrosis of the patient's bodily tissue. '
- the reason for the three stage temperature control in this embodiment is as follows.
- the surgeon positions the probe head 20 at an approximately correct position within the heart, and then controls the probe head temperature to be reduced to substantially 0° Celsius. This has two effects: the metal tip 90 of the probe head 20 is frozen to a particular portion of the tissue, and electrical activity in that tissue is rendered inactive (although the tissue is not killed) by being cooled to the freezing point of water.
- the tissue to which the tip 90 is currently frozen is responsible for the cardiac arrythmia, then cooling that tissue to 0° Celsius will cause the arrythmia to be temporarily stopped.
- the surgeon can then operate the control to cause the probe head temperature to be reduced to a suitable temperature for cryosurgical necrosis of that area of tissue.
- the necrosis of the tissue is then performed without the probe head temperature rising above 0° Celsius, so that the tip 90 of the probe head 20 remains in contact with the same portion of tissue throughout the necrosis process.
- the control apparatus 210 in Figure -4 comprises a signal amplifier 280 and a signal display 290.
- the signal amplifier 280 receives electrical impulses from electrodes disposed at the probe head 20 and amplifies those impulses for identification on the signal display 290. This provides a further aid to the surgeon to assist in correctly positioning the probe head 20 on the area of cardiac tissue to be destroyed.
- Figure 5 is a schematic diagram illustrating steering of the probe head within the patient's blood vessels by torque control.
- the probe head 20 is disposed at an angle to the flexible catheter 30. This means that axial rotation 300 of the flexible catheter 30 (for example by rotating the entire probe handle 10) causes a corresponding change 310 in the orientation of the probe head 20.
- Figure 6 is a schematic diagram illustrating a two-axis steering mechanism for steering the probe head 20.
- two control wires 320, 330 are connected to a rotatable crank 3 ⁇ 0 forming part of the probe handle 10.
- the control wires 320, 330 pass along the flexible catheter 30 into the probe head 20 and are linked to opposite sides 350, 36O of the probe head 20.
- This arrangement means that rotation of the crank 340 in, for example, a clockwise direction causes the control wire 320 to be pushed towards the probe head 20 and the control wire 330 to be pulled from the probe head 20. This in turn causes a downward movement 370 of the probe head 20.
- This type of steering mechanism can be applied in two orthogonal directions, to provide a four-axis steering mechanism.
- FIG. 6 also illustrates the thermocouple -400 connected via signal wires 410 to the temperature detector 250 in the control apparatus 200.
- Sensing of electrical impulses at the probe head is provided by two electrodes, one of which is the probe head tip 90 and the other which -420 is an annular metal ring around the probe head 20.
- the probe head tip 90 is connected to the probe handle 10 by a metal braid which is also used for strengthening the flexible catheter 30.
- the electrode -420 is connected to the probe handle 10 by a signal wire •430. This arrangement is similar to a coaxial cable and provides screening of the signal wire 430.
- four or more electrodes could be used.
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
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Abstract
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/637,819 US5759182A (en) | 1993-11-09 | 1994-11-09 | Cryosurgical probe with pre-cooling feature |
DE69416685T DE69416685T2 (en) | 1993-11-09 | 1994-11-09 | CRYO-SURGICAL PROBE |
EP95900226A EP0726734B1 (en) | 1993-11-09 | 1994-11-09 | Cryosurgical probe |
JP7513679A JPH09506272A (en) | 1993-11-09 | 1994-11-09 | Cryosurgery probe |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
GB9323111A GB2283678B (en) | 1993-11-09 | 1993-11-09 | Cryosurgical catheter probe |
GB9323111.6 | 1993-11-09 |
Publications (2)
Publication Number | Publication Date |
---|---|
WO1995013025A2 true WO1995013025A2 (en) | 1995-05-18 |
WO1995013025A3 WO1995013025A3 (en) | 1995-07-13 |
Family
ID=10744903
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/GB1994/002459 WO1995013025A2 (en) | 1993-11-09 | 1994-11-09 | Cryosurgical probe |
Country Status (6)
Country | Link |
---|---|
US (1) | US5759182A (en) |
EP (2) | EP0726734B1 (en) |
JP (1) | JPH09506272A (en) |
DE (2) | DE69432366D1 (en) |
GB (1) | GB2283678B (en) |
WO (1) | WO1995013025A2 (en) |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
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US5758505A (en) * | 1995-10-12 | 1998-06-02 | Cryogen, Inc. | Precooling system for joule-thomson probe |
WO2001001049A1 (en) * | 1999-06-25 | 2001-01-04 | Cryogen, Inc. | Precooled cryogenic ablation system |
US6241722B1 (en) | 1998-06-17 | 2001-06-05 | Cryogen, Inc. | Cryogenic device, system and method of using same |
US8298221B2 (en) | 2006-11-17 | 2012-10-30 | Coopersurgical, Inc. | Disposable sheath with replaceable console probes for cryosurgery |
EP2497436A3 (en) * | 2003-06-25 | 2013-06-05 | Endocare, Inc. | Detachable cryosurgical probe |
US8747396B2 (en) | 2003-06-25 | 2014-06-10 | Endocare, Inc. | Cryosurgical probe with adjustable sliding apparatus |
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US6161543A (en) | 1993-02-22 | 2000-12-19 | Epicor, Inc. | Methods of epicardial ablation for creating a lesion around the pulmonary veins |
US6530234B1 (en) | 1995-10-12 | 2003-03-11 | Cryogen, Inc. | Precooling system for Joule-Thomson probe |
US5901783A (en) * | 1995-10-12 | 1999-05-11 | Croyogen, Inc. | Cryogenic heat exchanger |
US5910104A (en) | 1996-12-26 | 1999-06-08 | Cryogen, Inc. | Cryosurgical probe with disposable sheath |
US6270494B1 (en) | 1996-12-26 | 2001-08-07 | Cryogen, Inc. | Stretchable cryoprobe sheath |
WO2000032126A1 (en) * | 1997-02-27 | 2000-06-08 | Cryocath Technologies Inc. | Cryosurgical catheter |
US7591814B2 (en) * | 1997-02-27 | 2009-09-22 | Cryocath Technologies Inc. | Extended treatment zone catheter |
US7220257B1 (en) | 2000-07-25 | 2007-05-22 | Scimed Life Systems, Inc. | Cryotreatment device and method |
US5885276A (en) * | 1997-12-02 | 1999-03-23 | Galil Medical Ltd. | Method and device for transmyocardial cryo revascularization |
US6051019A (en) * | 1998-01-23 | 2000-04-18 | Del Mar Medical Technologies, Inc. | Selective organ hypothermia method and apparatus |
US6368304B1 (en) | 1999-02-19 | 2002-04-09 | Alsius Corporation | Central venous catheter with heat exchange membrane |
US6589271B1 (en) | 1998-04-21 | 2003-07-08 | Alsius Corporations | Indwelling heat exchange catheter |
US8128595B2 (en) | 1998-04-21 | 2012-03-06 | Zoll Circulation, Inc. | Method for a central venous line catheter having a temperature control system |
US6682551B1 (en) | 1999-03-11 | 2004-01-27 | Alsius Corporation | Method and system for treating cardiac arrest using hypothermia |
US6126684A (en) | 1998-04-21 | 2000-10-03 | The Regents Of The University Of California | Indwelling heat exchange catheter and method of using same |
US6458150B1 (en) | 1999-02-19 | 2002-10-01 | Alsius Corporation | Method and apparatus for patient temperature control |
US6716236B1 (en) | 1998-04-21 | 2004-04-06 | Alsius Corporation | Intravascular catheter with heat exchange element having inner inflation element and methods of use |
US6419643B1 (en) | 1998-04-21 | 2002-07-16 | Alsius Corporation | Central venous catheter with heat exchange properties |
US6149670A (en) * | 1999-03-11 | 2000-11-21 | Alsius Corporation | Method and system for treating cardiac arrest using hypothermia |
GB2336781B (en) * | 1998-04-30 | 2001-03-07 | Spembly Medical Ltd | Cryosurgical apparatus |
GB2337000B (en) * | 1998-04-30 | 2000-08-09 | Spembly Medical Ltd | Improvements relating to cooled probes |
US6440121B1 (en) * | 1998-05-28 | 2002-08-27 | Pearl Technology Holdings, Llc. | Surgical device for performing face-lifting surgery using radiofrequency energy |
US7494488B2 (en) * | 1998-05-28 | 2009-02-24 | Pearl Technology Holdings, Llc | Facial tissue strengthening and tightening device and methods |
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DE69416685T2 (en) | 1999-09-02 |
EP0857464B1 (en) | 2003-03-26 |
EP0726734B1 (en) | 1999-02-24 |
EP0726734A1 (en) | 1996-08-21 |
GB2283678A (en) | 1995-05-17 |
DE69416685D1 (en) | 1999-04-01 |
GB2283678B (en) | 1998-06-03 |
EP0857464A1 (en) | 1998-08-12 |
DE69432366D1 (en) | 2003-04-30 |
GB9323111D0 (en) | 1994-01-05 |
US5759182A (en) | 1998-06-02 |
WO1995013025A3 (en) | 1995-07-13 |
JPH09506272A (en) | 1997-06-24 |
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