WO2009021535A1 - Dispositifs, systèmes et procédés médicaux de régulation de la pression sanguine - Google Patents
Dispositifs, systèmes et procédés médicaux de régulation de la pression sanguine Download PDFInfo
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- WO2009021535A1 WO2009021535A1 PCT/EP2007/007180 EP2007007180W WO2009021535A1 WO 2009021535 A1 WO2009021535 A1 WO 2009021535A1 EP 2007007180 W EP2007007180 W EP 2007007180W WO 2009021535 A1 WO2009021535 A1 WO 2009021535A1
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- Prior art keywords
- transducer
- medical device
- wave signal
- target receptor
- stimulation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
- A61N2007/0004—Applications of ultrasound therapy
- A61N2007/0021—Neural system treatment
- A61N2007/0026—Stimulation of nerve tissue
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N7/00—Ultrasound therapy
- A61N2007/0078—Ultrasound therapy with multiple treatment transducers
Definitions
- the present invention generally relates to medical devices, systems and methods for the treatment and/or management of cardiovascular and renal disorders. Specifically, the present invention relates to devices and methods for stimulating target receptors, for example baroreceptors for blood pressure regulation.
- Hypertension or high blood pressure
- hypertension is a major cardiovascular disorder, often resulting in heart failure or heart stroke. Hypertension may occur when blood vessels constrict which results in an increased blood pressure due to the reduced cross-section of the vessel. This may lead to a heart attack, and sustained high blood pressure may eventually result in an enlarged and damaged heart, and finally to heart failure.
- the wall of the carotid sinus contains so-called baroreceptors which are stretch receptors that are sensitive to the blood pressure. These receptors send signals via the carotid sinus nerve to the brain, which in turn regulates the cardiovascular system to maintain normal blood pressure.
- US-A-2007/0038262 describes systems and methods for treating a patient by inducing a baroreceptor signal to effect a change in the baroreflex system.
- the baroreceptor signal is activated or otherwise modified by selectively activating baroreceptors.
- a baroreceptor activation device positioned near a baroreceptor in the carotid sinus, aortic arch, heart, common carotid arteries, subclavian arteries, and/or brachiocephalic artery.
- the baroreceptor activation device is located in the right and/or left carotid sinus or the aortic arch.
- US-A-2007/0038262 describes an implantable medical device comprising a pulse generator to generate a baroreflex stimulation signal as part of a baroreflex therapy; a lead to be electrically connected to the pulse generator and to be intravascularly fed into a heart, the lead including an electrode to be positioned in or proximate to the heart to deliver the baroreflex signal to a baroreceptor region in or proximate to the heart; a sensor to sense a physiological parameter regarding an efficacy of the baroreflex therapy and to provide a signal indicative of the efficacy of the baroreflex therapy; and a controller connected to the pulse generator to control the baroreflex stimulation signal and to the sensor to receive the signal indicative of the efficacy of the baroreflex therapy.
- the local baroreflex stimulation using an electrode as suggested in US-A-2007/0038262 is, however, disadvantageous due to high invasiveness which is necessary in order to place the electrodes in close contact or neighborhood to the baroreceptors. This additionally causes a higher risk of complications in case of infections because of the direct neighborhood of the electrodes to central vessels. Moreover, implanting the electrodes around the baroreceptors causes substantial risks and costs.
- the invention provides a medical device.
- a preferred medical device comprises (a) a first wave signal transducer to generate a target receptor localization wave signal, and to receive the reflected localization wave signal; and (b) a second wave signal transducer to generate a target receptor stimulation wave signal for stimulating a localized target receptor.
- At least one of the first wave transducer and second wave transducer generates a mechanical wave signal.
- at least one of the first wave transducer and second wave transducer is an ultrasound transducer.
- at least one of the transducer is a surface acoustic wave (SAW) transducer.
- a first wave signal is generated and emitted that is used for target receptor localization.
- the ultrasound transducer emits ultrasounds waves in a specific frequency range suitable for target receptor localization.
- Such frequency range is preferably a "diagnostic" frequency range.
- a “diagnostic” frequency range typically comprises frequencies that are larger than ultrasound frequencies used for therapeutic purposes, i.e. "therapeutic” frequencies. Such lower therapeutic frequencies are used according to the invention for target receptor stimulation with the second wave signal transducer. Preferred frequency ranges are described further below.
- the first wave transducer and the second wave transducer are integrally formed by a single wave transducer, for example integrated on a single chip.
- the single wave transducer is an ultrasound transducer array comprising a plurality of ultrasound transducer elements.
- the ultrasound transducer array may be a one-dimensional array or a two-dimensional array. Such array is shown, for example, in DE-A-101 22 765, which is incorporated herein by reference.
- the above-mentioned "diagnostic" transducer for target receptor localization and the "therapeutic" transducer for target receptor stimulation are preferably provided in an integrated manner, for example on the same chip or wafer.
- the different transducer can then be intermittently operated, first the first transducer for localization and then, once the target receptor is localized, the second transducer for stimulation.
- intermittently means in this context that after the target receptor has been stimulated for a particular, preferably predefined, period of time, the localization transducer may be activated again, for re-localization. This is particularly advantageous in case the patient moves or in some other way changes its position during receptor stimulation so that the stimulation wave beam becomes offset from or misaligned with the target receptor.
- the individual transducer elements are operable as "diagnostic” transducers or "therapeutic” transducers, i.e., for target receptor localization or stimulation. This depends on the circuitry and way of controlling or driving the individual elements.
- the invention also encompasses arrays of transducer elements comprising two distinct kinds of transducer elements which are operable as "diagnostic” or “therapeutic” transducer elements, respectively, only.
- the individual transducer elements can be operated in different patterns or subsets of elements, a first subset for target localization, and a second, preferably different subset for stimulation.
- the patterns may change or may be adapted depending on the position of the target receptor to be stimulated. For example, a receptor being positioned more closely to the skin of the patient may require a different localization and/or stimulation pattern than a receptor lying farther away from the medical device. For example, it may be desired to have a higher reception power, or a higher transmission power; depending to the individual needs the number of transmitting or receiving transducer elements can be increased (or reduced).
- the array of transducer elements may further be used for beam focusing, beam forming, beam steering, and beam sweeping in the process of receptor localization, and also for beam focusing for receptor stimulation. For example, the individual elements can be operated with a certain phase delay. Details thereof are explained below with reference to the accompanying figures. The selection of specific subsets is also helpful for intensity variations.
- the medical device of the invention encompasses that a first sub-set of ultrasound transducer elements of the array is operable in a first frequency range for target receptor localization, and a second-subset of ultrasound transducer elements is operable in a second frequency range for target receptor stimulation.
- the first frequency range and the second frequency range are, for example, in the range of 40 kHz to 40 MHz.
- the first frequency range for target receptor localization is in the range of 1 MHz to 10 MHz.
- the second frequency range for target receptor stimulation is in the range of 100 kHz to 1 MHz.
- a first sub-set of ultrasound transducer elements is operable in a first energy density for target receptor localization
- a second-subset of ultrasound transducer elements is operable in a second energy density range for target receptor stimulation.
- the first energy density and the second energy density are in the range of 0.1 mW/cm 2 to 10 W/cm 2 , and more preferably 0.1 W/cm 2 to 3.0 W/cm 2 .
- the frequency range for target localization is higher than the range used for stimulation, but the energy density for target localization is lower compared to the energy density for target stimulation.
- the individual transducer elements are preferably operated with a phase shift for beam shaping, beam focusing, and beam sweeping.
- the medical device according to the invention can be located remotely from the target receptor to be stimulated.
- the medical device is a non-invasive medical device.
- a noninvasive medical device is highly advantageous as it does not require the surgical procedure for implantation of the medical device into the patient, for example in close contact to the receptor as it is suggested in the prior art. There is further no risk for the patient of suffering from any infections occurring in this process.
- the non-invasive medical device according to the invention provides improved receptor stimulation in combination with a distant effect or remote effect.
- the medical device may also be an implantable medical device.
- the implantable medical device is subcutaneously placeable.
- a subcutaneously placed medical device enjoys the advantages of the distant effect or remote effect, respectively, provided by the medical device of the invention and does still not require a severe surgical procedure for placing the device at the receptor site. Placing the medical device subcutaneous is minimally invasive. Moreover, a subcutaneously placed medical device is advantageous in that the coupling of the wave signals into the tissue is more efficient.
- the medical device generates ultrasound imaging when connected to a computer interface.
- it may generate ultrasound imaging when telemetrically connected to a computer interface.
- imaging may support diagnostic evaluations.
- the stimulation signal comprises a series of pulses having a pulse frequency and an amplitude.
- the stimulation signal may have a pulse width.
- the stimulation signal may also comprise a series of pulses delivered in bursts having a burst frequency.
- the stimulation signal is preferably at least one of amplitude modulated and phase modulated.
- At least one of the first and second transducer is preferably a piezoelectric transducer or a capacitive membrane transducer, or in case of a transducer array comprises respective piezoelectric transducer elements or capacitive membrane transducer elements.
- the medical device of the invention is preferably for localization and stimulation of a target receptor.
- a target receptor is, for example, a baroreceptor.
- a baroreceptor to be stimulated is, for example, selected from the group comprising carotid sinus receptors, aortic arch receptors, subclavia receptors, or combinations thereof.
- the use of the medical device for baroreceptor stimulation is particularly advantageous.
- the remote effect provided by the medical device of the invention makes the medical device of the invention particularly useful for baroreceptor stimulation as a risky surgical procedure for stimulator location in closest contact to the receptor is no longer required.
- At least one of the first wave signal transducer and the second wave signal transducer are useable to generate an image of the volume of stimulation and/or localisation.
- image can either be a ID, 2D cross section of the volume or a full 3D image of the volume.
- the image or at least part of the image can be used by an electronic signal processing circuitry for localisation for the purpose of beam steering, beam shaping, and/or beam focusing.
- the image can be a physical image representing a certain property of the tissue and blood vessels (e.g. density, water content) but it can also be a representation of any other physical parameter (e.g. velocity distribution).
- the image provided by the medical device may be used in the closed feedback control of the medical device or used as a diagnostic instrument or method by itself.
- the invention provides a system comprising at least one medical device according to the first aspect, and further comprising signal processing circuitry for controlling the medical device.
- the system may comprise more than just a single medical device so that a particular receptor can be localized and stimulated from different positions/directions. This may improve localization speed (reduced localization time) and stimulation efficiency.
- the individual medical devices may also be used to stimulate different receptors at the same time.
- the system is preferably a closed-loop system using feedback from the first wave signal transducer for target receptor localization for controlling target receptor stimulation by the medical device.
- the system further comprises at least one sensor for sensing a physiological parameter.
- the additional sensor or sensors is/are helpful in two ways. First of all, additional input data may be provided so that, for example, a synchronized stimulation may be performed, for example synchronized with respect to a pulsating blood pressure. On the other hand, the additional sensor(s) provide(s) additional feedback on the effect of the stimulation.
- At least one of the first wave signal transducer and the second wave signal transducer of the medical device can be used according to the invention to simultaneously measure a physiological parameter.
- Potential parameters for this type of measurement are e.g. related to blood flow (for example in the case of Doppler measurements) and blood pressure (for example if surface acoustic waves are used). Surface acoustic waves could also be used for stimulation if the transducer is in reasonably close contact with the receptor.
- the first wave signal transducer, the second wave signal transducer and the sensor are integrally formed by a wave single transducer.
- the sensor is a piezoresistive or capacitive sensor and is integrated on a single chip as part of the array of transducers, sufficient mechanical decoupling from the wave generators provided.
- the sensed physiological parameter is, for example, systolic blood pressure, diastolic blood pressure, heart rate, blood flow rate, blood flow velocity, blood vessel cross-sectional changes.
- the sensor is preferably a heart rate sensor, blood pressure sensor, electrocardiography sensor, ultrasonic flow rate transducer.
- the signal processing circuitry simulates a complex physiological model.
- the signal processing circuitry provides synchronization between the baroreceptor stimulation and the sensed blood pressure pulses.
- system of the second aspect of the invention may further comprise telemetry circuitry for providing telemetry signals for signal transmission between the signal processing circuitry and the medical device. This is particularly advantageous if the medical device is a subcutaneous medical device.
- the first wave signal transducer, the second wave signal transducer, the sensor and signal processing circuitry and/or telemetry circuitry as well as preferably electrical interconnects and passive components are monolithically integrated in a single component.
- Such integration is, however, only possible if the respective technology is compatible.
- conventional piezo-ultrasound transducer cut from crystals or formed from polymers are not compatible for such monolithic integration on a wafer.
- the medical device when the medical device is connected to a computer interface, it generates ultrasound imaging. Similarly, when the medical device is telemetrically connected to a computer interface, it may generate ultrasound imaging, as also mentioned above.
- the signal processing circuitry may further coupled with a cardiac pacemaker.
- the baroreceptor stimulation can be synchronized with the pacemaker signal. It is furthermore preferred that in the system of the invention, once the reflected wave signal is stored within an external computer interface, it may be altered to suit the user's needs through manipulation of the image processing controls.
- a target receptor stimulation method is provided.
- the invention provides a method of stimulating target receptors with at least one target receptor stimulation wave signal being generated remote or distant, respectively, from the target receptor.
- the at least one target receptor stimulation wave signal preferably comprises a mechanical wave signal, for example an ultrasound wave signal.
- the ultrasound target receptor stimulation wave signal is generated extracorporeal or subcutaneous.
- the receptor stimulation for example baroreceptor stimulation, is remotely performed.
- the method may further comprise the preceding step of localizing with an ultrasound wave signal the target receptor to be stimulated.
- the steps of target receptor localization and target receptor stimulation are preferably intermittently performed, as already described above with reference to the medical device.
- Target localization is performed, for example, by comparing (a) received reflection pattern(s) with a reference reflection pattern for the target receptor to be stimulated.
- the reflection pattern is preferably a Doppler flow profile of the vessel the receptor is located at.
- the comparison result is then used for stimulation signal direction and focus adjustment.
- Target signal adjustment may also be performed with reference to at least one reference object.
- the individual transducer elements are operable as diagnostic transducers or therapeutic transducers, for target receptor localization or stimulation.
- the individual transducer elements are operated in different patterns or subsets of elements, a first subset for target localization, and a second, preferably different subset for stimulation.
- the patterns may vary depending on the position of the target receptor to be stimulated.
- the array of transducer elements is preferably operated to provide for beam focusing, beam forming, beam steering, and beam sweeping in the process of receptor localization, and also for beam focusing and beam forming for receptor stimulation.
- target receptor localization is performed in a first frequency range
- target receptor stimulation is performed in a second frequency range.
- the first frequency range and the second frequency range are preferably in the range of 40 kHz to 40 MHz. More preferably, the first frequency range for target receptor localization is in the range of 1 MHz to 10 MHz.
- the second frequency range for target receptor stimulation is preferably in the range of 100 kHz to 1 MHz.
- target receptor localization is performed with a first energy density range
- target receptor stimulation is performed with a second energy density range.
- the first energy density and the second energy density are preferably in the range of 0.1 mW/cm 2 to 10 W/cm 2 , and more preferably 0.1 W/cm 2 to 3.0 W/cm 2 .
- the stimulation signal comprises a series of pulses having a pulse frequency and an amplitude.
- the stimulation signal may also have a pulse width.
- the stimulation signal may comprise a series of pulses delivered in bursts having a burst frequency.
- the stimulation signal is preferably at least one of amplitude modulated and phase modulated.
- the method of the invention is preferably applicable to target receptors being baroreceptors.
- target receptors being baroreceptors.
- baroreceptor are preferably selected from the group comprising carotid sinus receptors, aortic arch receptors, subclavia receptors, or combinations thereof.
- the method of the invention may further comprise the step of sensing at least one physiological parameter.
- physiological parameter is, for example, systolic blood pressure, diastolic blood pressure, heart rate, blood flow rate, blood flow velocity, blood vessel cross-sectional changes.
- the method of the invention furthermore uses feedback from the sensed physiological parameter for controlling generation of the baroreceptor stimulation signal.
- the baroreceptor stimulation is synchronized with the sensed blood pressure pulses.
- the invention provides a method of blood pressure regulation.
- the method of blood pressure regulation preferably comprises the steps of (a) providing a first target receptor localization wave signal transducer to generate a target receptor localization wave signal, and to receive the reflected localization wave signal; (b) providing a second wave signal transducer to generate a target receptor stimulation wave signal for stimulating a localized target receptor; (c) positioning the first and second wave signal transducer so that a respective wave signal beam is directable onto the target receptors to be simulated; (d) emitting a signal beam from the first signal transducer onto the target receptors to be simulated; (e) determining localization of the target receptor to be stimulated on the basis of the reflected beam emitted from the first signal transducer; (f) adjusting direction and focus of the second signal transducer with respect to the determined localization of the target receptor; and (g) emitting a stimulation signal beam from the second signal transducer onto the target receptor.
- the first and second wave signal transducer are preferably positioned extracorporeal in contact or close to the patient's skin in an area in proximity to the target receptors to be simulated.
- target localization is performed by comparing (a) received reflection pattern(s) with a reference reflection pattern for the target receptor to be stimulated.
- the reflection pattern is for example a Doppler flow profile of the vessel the receptor is located at.
- the target receptor may be a barorecptor.
- At least one of the first wave signal transducer and second wave signal transducer generates a mechanical wave signal.
- at least one of the first wave signal transducer and second wave signal transducer is an ultrasound transducer. It is preferred that the first wave signal transducer and the second wave signal transducer are integrally formed by a single wave signal transducer.
- the single wave signal transducer may be an ultrasound transducer array comprising a plurality of ultrasound transducer elements.
- the ultrasound transducer array is, for example, a one-dimensional array or a two-dimensional array.
- the invention provides a medical device, preferably according to the first aspect of the invention, the medical device comprising a first wave transducer, second wave transducer, and sensor, wherein first wave transducer, second wave transducer and sensor are integrally formed by a wave single transducer; e.g. realised as one single chip on a silicon wafer.
- the wave single transducer array is preferably a one-dimensional array or a two-dimensional array.
- the invention encompasses a medical device, wherein the first wave signal transducer, second wave signal transducer and the sensor are identical in terms of the technology used for their fabrication (e.g.
- the invention is advantageous and provides substantial improvements with respect to blood pressure regulation in that it realizes treatment of the generally difficult blood pressure regulation by providing baroreceptor stimulation with controllable focused waves, such as mechanical waves, for example ultrasound waves, applied onto the physiological receptors. This is in contrast to prior art approaches that provide local electrical stimulation that only simulates nerve pulses.
- the concept of the invention is further advantageous in that it is applicable transcutaneous but can also implanted subcutaneous which is minimally invasive.
- Fig. 1 is a schematic illustration of the location of arterial baroreceptors
- Fig. 2 shows as an example the result of the application of a conventional ultrasound probe for the purpose of the invention
- Fig. 3 shows as another example the result of the application of a conventional ultrasound probe for the purpose of the invention
- Fig. 4 shows details of a preferred system of the invention
- Fig. 5 shows three different Doppler profiles in the area of the carotid sinus
- Fig. 6 shows an exemplary ultrasound transducer array of a preferred embodiment of the invention
- Fig. 7 shows four different patterns of ultrasound transducer elements used according to a preferred embodiment for target receptor localization and stimulation
- Fig. 8 shows a first alternative of ultrasound beam focusing according to a preferred embodiment of the invention
- Fig. 9 shows another alternative of ultrasound beam focusing according to a preferred embodiment of the invention.
- FIG. 1 is a schematic illustration of the location of arterial baroreceptors.
- baroreceptors sense stretch and rate of stretch by generating action potentials, i.e. voltage spikes.
- the baroreceptors are located in highly distensible regions of the blood circulation to maximize sensitivity.
- Fig. 1 shows the baroreceptors located at the left and right carotid sinus and the aortic arch. Further baroreceptors are subclavia receptors.
- the invention is not limited to baroreceptor localization and stimulation.
- the stimulation of other receptors is also encompassed by the invention, such as veno-atrial mechanoreceptors, unmyelinated mechanoreceptors, heart chemosensors, arterial chemosensors, or lung stretch receptors.
- Fig. 2 shows as an example the result of the application of a ultrasound probe for the purpose of the invention.
- a medical device being an ultrasound probe (8 - 11 MHz) was used transcutaneous to stimulate carotid sinus baroreceptors. After a quiescent phase R the stimulation is initiated at D which results in an immediate drop of the blood pressure and frequency which continues even during a following recovery phase starting at E.
- the ultrasound stimulation is comparable to a manual stimulation M..
- Fig. 3 shows another example.
- a non-invasive ultrasound probe (8 - 11 MHz) was used to stimulate carotid sinus baroreceptors. After a quiescent phase R the stimulation is initiated at D which results in an immediate drop of the blood pressure and frequency. Whereas the frequency drop persists blood pressure rises again during the late stimulation phase and after stop of stimulation at E. The effect is early counter-regulation of blood pressure in a context of auto- regulation at rather low pressures.
- the vagal stimulation is effective as may be seen from frequency.
- FIG. 4 A schematic diagram showing details of a preferred system of the invention is shown in Fig. 4.
- a sensor unit provides input data, for example with respect to blood pressure, pulse pressure, pulse frequency, blood flow and/or velocity, or about the vascular diameter of the vessel of interest.
- Such sensor data is supplied to a control unit that provides for further processing of the sensed input data.
- a complex physiological model or a training algorithm is simulated by the control unit.
- processing in the control unit may take into account additional information such as medication of the patient.
- betablockers are known to curb frequency regulation so that the pulse frequency as input data is of limited use with respect to patients that are on betablockers.
- Another input to the control unit in this example is stored data and presettings, such as stimulation protocols, stimulation duration, stimulation frequency and intensity, pulse frequency, and time length during intermittent application of the transducer as stimulator and localization sensor.
- the control unit determines and decides on the individual stimulation of the patient, such as selection of an appropriate stimulation protocol, decision with respect to triggered stimulation, and stimulation settings.
- a stimulation unit then performs stimulation.
- the stimulation unit may also be used for target localization.
- Fig. 5 shows Doppler flow profiles in three different areas at the carotid sinus and nicely shows how these profiles differ with respect to their characteristics.
- Such distinguishing Doppler profile characteristics are according to the invention used for target receptor localization.
- the arteria carotid communis bifurcates at the carotid sinus into the arteria carotid interna and the arteria carotid externa.
- the Doppler flow profiles differ from each other in a characteristic way: There is diastolic flow in the arteria carotid communis, the is no diastolic flow in the arteria carotid externa, and there is an increased diastolic flow in the arteria carotid interna.
- Fig. 6 shows a schematic perspective view of an example of an ultrasound transducer array according to an embodiment of the invention.
- the array consists of nine transducer elements in a 3x3 arrangement.
- the individual transducer elements are individually operable and controllable.
- the transducer elements of the array can be operated in different patterns or subsets, for example as diagnostic transducer elements or therapeutic transducer elements, or for providing desired transmission or reception powers.
- Four different patterns are schematically shown in Fig. 7, for a transducer array having 5x5 transducer elements.
- Figs. 8 and 9 are schematic cross-sectional views of a transducer array.
- the transducer array may have a plurality of transducer elements arranged in rows and columns but for simplification purposes only three transducer elements are shown in these cross-sectional views.
- the individual transducer elements are driven with a certain phase shift, starting with element "3" (at the right hand side), followed by the centre element "2", and finally element "1".
- element "3" at the right hand side
- element "2" at the right hand side
- element "1" the centre element
- the beam focus sweeps form the right to the left.
- Such transducer operation is particularly useful for receptor localization.
- Fig. 9 Another example is shown in Fig. 9.
- the ultrasound waves are emitted such that the beam focus move along an axis perpendicular to the surface of the array.
- the beam focus can be targeted to different depths of the tissue, for example.
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Abstract
L'invention porte sur un dispositif médical comprenant un premier transducteur de signal d'onde pour générer un signal d'onde de localisation de récepteur cible et recevoir le signal d'onde de localisation réfléchi; et un second transducteur de signal d'onde pour générer un signal d'onde de stimulation de récepteur cible et stimuler un récepteur cible localisé.
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PCT/EP2007/007180 WO2009021535A1 (fr) | 2007-08-14 | 2007-08-14 | Dispositifs, systèmes et procédés médicaux de régulation de la pression sanguine |
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US11052247B2 (en) | 2016-03-15 | 2021-07-06 | Leonhardt Ventures Llc | Skin treatment system |
US11110274B2 (en) | 2016-03-15 | 2021-09-07 | Leonhardt Ventures Llc | System and method for treating inflammation |
US11167141B2 (en) | 2016-03-15 | 2021-11-09 | Leonhardt Ventures Llc | Bioelectric blood pressure management |
US11849910B2 (en) | 2016-03-15 | 2023-12-26 | Valvublator Inc. | Methods, systems, and devices for heart valve decalcification, regeneration, and repair |
US11691007B2 (en) | 2016-03-15 | 2023-07-04 | Leonhardt Ventures Llc | Bioelectric OPG treatment of cancer |
WO2020061538A1 (fr) * | 2018-09-20 | 2020-03-26 | Cal-X Stars Business Accelerator, Inc. | Gestion bioélectrique de la pression sanguine |
US11446488B2 (en) | 2019-03-13 | 2022-09-20 | Leonhardt Ventures Llc | Kidney treatment |
US11471686B2 (en) | 2019-03-13 | 2022-10-18 | Leonhardt Ventures Llc | Klotho modulation |
USD957646S1 (en) | 2019-08-29 | 2022-07-12 | OrthodontiCell, Inc. | Dental mouthpiece |
CN110584708A (zh) * | 2019-09-26 | 2019-12-20 | 重庆琨大医疗科技有限公司 | 一种基于耳迷走神经刺激的便携式智能超声血压监控系统 |
USD1025361S1 (en) | 2021-06-11 | 2024-04-30 | OrthodontiCell, Inc. | Dental mouthpiece |
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