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71. 发明申请

US20080114345A1 CATHETER WITH CRYOGENIC AND ELECTRICAL HEATING ABLATION 有权
标题翻译：具有低温和电加热的导管
公开(公告)号：US20080114345A1
公开(公告)日：2008-05-15
申请号：US11971582
申请日：2008-01-09
申请人： Steven Arless , Fredric Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
发明人： Steven Arless , Fredric Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
IPC分类号： A61B18/18
CPC分类号： A61B18/02 , A61B18/1492 , A61B18/18 , A61B2017/00243 , A61B2018/0212 , A61B2018/0268
摘要： A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen, allowing greater versatility of operation and enhancing the lesion size, speed or placement of multi-lesion treatment or single lesion retreatment cycles. In one embodiment a microwave energy source operates at a frequency to extend beyond the thermal conduction depth, or to penetrate the cryogenic ice ball and be absorbed in tissue beyond an ice boundary, thus extending the depth and/or width of a single treatment locus. In another embodiment, the cooling and the application of RF energy are both controlled to position the ablation region away from the surface contacted by the electrode, for example to leave surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth. The driver or RF energy source may supply microwave energy at a frequency effective to penetrate the ice ball which develops on a cryocatheter, and different frequencies may be selected for preferential absorption in a layer of defined thickness at depth in the nearby tissue. The catheter may operate between 70 and minus 70 degrees Celsius for different tissue applications, such as angioplasty, cardiac ablation and tissue remodeling, and may preset the temperature of the tip or adjacent tissue, and otherwise overlay or delay the two different profiles to tailor the shape or position where ablation occurs or to speed up a treatment cycle.
摘要翻译：导管包括具有用于加热组织的电驱动消融组件的冷冻消融尖端。冷冻消融尖端可以用冷却室来实现，通过该冷却室可控制地注入的冷却剂循环以降低尖端温度，并且在其远端具有RF电极。 RF电极可以被操作以加热低温冷却的组织，或者可以控制冷却剂以与RF治疗方案协调地导电地冷却组织，从而允许操作的更大的通用性和增强病变大小，速度或放置多病变治疗或单次病变治疗周期。在一个实施例中，微波能量源的频率以超出热传导深度的频率运行，或者穿透低温冰球并被吸收在超过冰界的组织中，从而延长单个处理轨迹的深度和/或宽度。在另一个实施例中，RF能量的冷却和应用都被控制以将消融区域远离与电极接触的表面，例如在深度消融时留下表面组织而不受伤害，或者提供具有更大均匀性的消融带，增加深度。驱动器或RF能源可以以有效穿透在低温导管上形成的冰球的频率提供微波能量，并且可以选择不同的频率用于在附近组织的深度处的限定厚度的层中的优先吸收。对于不同的组织应用（例如血管成形术，心脏消融和组织重建），导管可以在70摄氏度和零下70度之间运行，并且可以预设尖端或相邻组织的温度，否则叠加或延迟两个不同的轮廓以定制消融发生的形状或位置或加速治疗周期。

72. 发明申请

US20080009851A1 Variable geometry cooling chamber 有权
标题翻译：可变几何冷却室
公开(公告)号：US20080009851A1
公开(公告)日：2008-01-10
申请号：US11476928
申请日：2006-06-28
申请人： Dan Wittenberger , Marwan Abboud , Ioana Deac
发明人： Dan Wittenberger , Marwan Abboud , Ioana Deac
IPC分类号： A61B18/18
CPC分类号： A61B18/02 , A61B2017/00256 , A61B2017/00867 , A61B2017/22051 , A61B2018/0022 , A61B2018/0212 , A61B2018/0262 , A61M29/02 , A61M2025/1093 , A61M2029/025
摘要： The present invention provides a medical device that may include a catheter body having proximal and distal portions, a fluid injection lumen disposed within elongate body, and a guidewire lumen disposed within the elongate body. A tip portion defining a cavity in fluid communication with the fluid injection lumen may be coupled to the distal end of the guidewire lumen, and an expandable element may be coupled to the distal portion of the catheter body and to the tip portion, such that the expandable element is in fluid communication with the fluid injection lumen. A shaping element may at least partially surround the expandable element, where the shaping element is configurable in a first geometric configuration and a second geometric configuration.
摘要翻译：本发明提供一种医疗装置，其可以包括具有近端部分和远端部分的导管主体，设置在细长主体内的流体注射内腔和设置在细长主体内的导丝管腔。限定与流体注射腔流体连通的空腔的尖端部分可以联接到导丝管腔的远端，并且可扩张元件可以联接到导管主体的远端部分和尖端部分，使得可膨胀元件与流体注射内腔流体连通。成形元件可以至少部分地围绕可膨胀元件，其中成形元件可配置为第一几何配置和第二几何配置。

73. 发明申请

US20070021741A1 Method and device for epicardial ablation 失效
标题翻译：心外膜消融的方法和装置
公开(公告)号：US20070021741A1
公开(公告)日：2007-01-25
申请号：US11526494
申请日：2006-09-25
申请人： Marwan Abboud , Dan Wittenberger , Daniel Nahon , Steven Arless
发明人： Marwan Abboud , Dan Wittenberger , Daniel Nahon , Steven Arless
IPC分类号： A61B18/02
CPC分类号： A61B18/02
摘要： A method is disclosed for treating heart and vascular tissue with cryotreatment. A medical instrument, such as a catheter is positioned to contact a target region of cardiac tissue such as the epicardial tissue. The instrument or catheter provided includes a cryotreatment element that has thermally-transmissive properties. The cryotreatment element may be a cryochamber for enclosing the flow of a fluid refrigerant therein. The cryotreatment element is disposed at the situs of heart or vascular tissue to be treated, usually by piercing the epicardium sac via an opening in the patient's body. A refrigerant flow within the cryochamber creates endothermic cooling with respect to the targeted heart or vascular tissue, inducing hypothermia and forming iceballs proximate the tissue. The cooling may be reversible and non-permanent, or may be permanent leading to cell death, necrosis, apoptosis and/or surgical excision or ablation of tissue.
摘要翻译：公开了一种用冷冻治疗来治疗心脏和血管组织的方法。诸如导管的医疗器械定位成接触诸如心外膜组织的心脏组织的靶区域。提供的仪器或导管包括具有热传递特性的冷冻处理元件。冷冻处理元件可以是用于封闭其中的流体制冷剂的流动的冷冻箱。冷冻治疗元件设置在待治疗的心脏或血管组织的位置，通常通过穿过患者体内的开口刺穿心外膜。冷冻箱内的制冷剂流动相对于目标心脏或血管组织产生吸热冷却，诱导低体温并在组织附近形成冰球。冷却可以是可逆的和非永久性的，或者可能是永久性的导致细胞死亡，坏死，凋亡和/或手术切除或消融组织。

74. 发明授权

US07097641B1 Catheter with cryogenic and heating ablation 有权
标题翻译：导管用低温和加热消融
公开(公告)号：US07097641B1
公开(公告)日：2006-08-29
申请号：US09457958
申请日：1999-12-09
申请人： Steven G. Arless , Frederic L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
发明人： Steven G. Arless , Frederic L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
IPC分类号： A61B18/18
CPC分类号： A61B18/02 , A61B18/1492 , A61B18/18 , A61B2017/00243 , A61B2018/0212 , A61B2018/0268
摘要： A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen, allowing greater versatility of operation and enhancing the lesion size, speed or placement of multi-lesion treatment or single lesion re-treatment cycles. In one embodiment a microwave energy source operates at a frequency to extend beyond the thermal conduction depth, or to penetrate the cryogenic ice ball and be absorbed in tissue beyond an ice boundary, thus extending the depth and/or width of a single treatment locus. In another embodiment, the cooling and the application of RF energy are both controlled to position the ablation region away from the surface contacted by the electrode, for example to leave surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth. The driver or RF energy source may supply microwave energy at a frequency effective to penetrate the ice ball which develops on a cryocatheter, and different frequencies may be selected for preferential absorption in a layer of defined thickness at depth in the nearby tissue. The catheter may operate between 70 and minus 70 degrees Celsius for different tissue applications, such as angioplasty, cardiac ablation and tissue remodeling, and may preset the temperature of the tip or adjacent tissue, and otherwise overlay or delay the two different profiles to tailor the shape or position where ablation occurs or to speed up a treatment cycle.
摘要翻译：导管包括具有用于加热组织的电驱动消融组件的冷冻消融尖端。冷冻消融尖端可以用冷却室来实现，通过该冷却室可控制地注入的冷却剂循环以降低尖端温度，并且在其远端具有RF电极。 RF电极可以被操作以加热低温冷却的组织，或者可以控制冷却剂以与RF治疗方案协调地导电地冷却组织，从而允许操作的更大的通用性和增强病变大小，速度或放置多病变治疗或单次病变再治疗周期。在一个实施例中，微波能量源的频率以超出热传导深度的频率运行，或者穿透低温冰球并被吸收在超过冰界的组织中，从而延长单个处理轨迹的深度和/或宽度。在另一个实施例中，RF能量的冷却和应用都被控制以将消融区域远离与电极接触的表面，例如在深度消融时留下表面组织而不受伤害，或者提供具有更大均匀性的消融带，增加深度。驱动器或RF能源可以以有效穿透在低温导管上形成的冰球的频率提供微波能量，并且可以选择不同的频率用于在附近组织的深度处的限定厚度的层中的优先吸收。对于不同的组织应用（例如血管成形术，心脏消融和组织重建），导管可以在70摄氏度和零下70度之间运行，并且可以预设尖端或相邻组织的温度，否则叠加或延迟两个不同的轮廓以定制消融发生的形状或位置或加速治疗周期。

75. 发明申请

US20050010201A1 Method and device for epicardial ablation 有权
标题翻译：心外膜消融的方法和装置
公开(公告)号：US20050010201A1
公开(公告)日：2005-01-13
申请号：US10839979
申请日：2004-05-04
申请人： Marwan Abboud , Dan Wittenberger , Daniel Nahon , Steven Arless
发明人： Marwan Abboud , Dan Wittenberger , Daniel Nahon , Steven Arless
IPC分类号： A61B18/02
CPC分类号： A61B18/02
摘要： A method is disclosed for treating heart and vascular tissue with cryotreatment. A medical instrument, such as a catheter is positioned to contact a target region of cardiac tissue such as the epicardial tissue. The instrument or catheter provided includes a cryotreatment element that has thermally-transmissive properties. The cryotreatment element may be a cryochamber for enclosing the flow of a fluid refrigerant therein. The cryotreatment element is disposed at the situs of heart or vascular tissue to be treated, usually by piercing the epicardium sac via an opening in the patient's body. A refrigerant flow within the cryochamber creates endothermic cooling with respect to the targeted heart or vascular tissue, inducing hypothermia and forming iceballs proximate the tissue. The cooling may be reversible and non-permanent, or may be permanent leading to cell death, necrosis, apoptosis and/or surgical excision or ablation of tissue.
摘要翻译：公开了一种用冷冻治疗来治疗心脏和血管组织的方法。诸如导管的医疗器械定位成接触诸如心外膜组织的心脏组织的靶区域。提供的仪器或导管包括具有热传递特性的冷冻处理元件。冷冻处理元件可以是用于封闭其中的流体制冷剂的流动的冷冻箱。冷冻治疗元件设置在待治疗的心脏或血管组织的位置，通常通过穿过患者体内的开口刺穿心外膜。冷冻箱内的制冷剂流动相对于目标心脏或血管组织产生吸热冷却，诱导低体温并在组织附近形成冰球。冷却可以是可逆的和非永久性的，或者可能是永久性的导致细胞死亡，坏死，凋亡和/或手术切除或消融组织。

76. 发明授权

US06730077B2 Catheter system 失效
公开(公告)号：US06730077B2
公开(公告)日：2004-05-04
申请号：US10237376
申请日：2002-09-09
申请人： Sean Carroll , George Klein , Marwan Abboud , Steven G. Arless , Fredric L. Milder , Dan Wittenberger
发明人： Sean Carroll , George Klein , Marwan Abboud , Steven G. Arless , Fredric L. Milder , Dan Wittenberger
IPC分类号： A61B1802
CPC分类号： A61B18/02 , A61B18/1492 , A61B2017/00026 , A61B2017/00084 , A61B2018/0212 , A61B2018/0262 , A61B2090/065
摘要： A cryocatheter for treatment of tissue has a tip adapted to provide a signal indicative of the quality and/or orientation of the tip contact with surrounding tissue. In one embodiment, a signal conductor extends through the catheter to the tip and connects to a thermally and electrically conductive shell or cap that applies an RF current to the region of tissue contacted by the tip. The tissue impedance path between the signal lead and a surface electrode mounted on the patient's skin is monitored to develop a quantitative measure of tissue contact at the distal tip, which is preferably displayed on the screen of a catheter monitoring console. In yet a further embodiment, the catheter is provided with a split tip having temperature monitoring sensors, such as thermistors, mounted on opposed halves of the tip so as to sense temperature on two sides of the catheter axis. The thermistor signals are processed to determine and display differential temperature between the two sides of the tip, thus revealing which side lies in contact. In yet a further aspect of the first embodiment, two separate and distinct high frequency electrical signals are applied to the two halves of a split metal shell or cap at the tip. Signals received at the surface electrode are filtered into first and second frequency components, and these are processed to determine the relative magnitude of the signal or the impedance of the path for each of the injected signals to determine and display the tissue contact orientation of the catheter. The catheter preferably has two separate cooling chambers within the cooling tip, positioned with one chamber on each side of the axis, and a separate cooling inlet to each chamber is switched on by a valve which directs the flow of coolant to the contact side during active cryotreatment. In another embodiment, the cap provides an RF electrode that may be opposed to the cooling side so that either the cryogenic or the RF ablation side may be rotated into contact to selectively heat or cool, or in representative protocol treat, then thaw, the same tissue site.

77. 发明申请

US20080215043A1 WIDE AREA ABLATION OF MYOCARDIAL TISSUE 有权
标题翻译：心肌组织的大面积消融
公开(公告)号：US20080215043A1
公开(公告)日：2008-09-04
申请号：US12120439
申请日：2008-05-14
申请人： Marwan Abboud , Fredric L. Milder , George Klein
发明人： Marwan Abboud , Fredric L. Milder , George Klein
IPC分类号： A61B18/02
CPC分类号： A61B18/02 , A61B2017/22051 , A61B2018/0022 , A61B2018/0212 , A61B2018/0262
摘要： The present invention advantageously provides a method and system for cryogenically ablating large areas of tissue within the left atrium. In an exemplary embodiment a cryotherapy device includes a catheter body having a substantially fixed diameter, a proximal end and a distal end; a first lumen for permitting passage of a cooling fluid from the proximal end to the distal end; a second lumen permitting return of the cooling fluid from the distal end to the proximal end; and an ablation element expandable from a first diameter that is substantially the same as the diameter of the catheter body to a second diameter that is at least twice the diameter of the catheter body, the ablation element having a surface portion that conforms to the uneven surface topography of the cardiac tissue. The ablation element can include one or more balloon and/or a flexible element that is deformed by moving the distal end of the catheter toward the proximal end of the catheter. The surface of the balloon can further be shaped by regulation of pressure within the one or more balloons. In an exemplary method a tissue ablation device is provided and tissue in the antrum of the left atrium is ablated with the device. In an exemplary method, only tissue in the antrum is ablated, and the ablation is created by freezing tissue.
摘要翻译：本发明有利地提供了用于低温切除左心房内的大面积组织的方法和系统。在示例性实施例中，冷冻治疗装置包括具有基本上固定的直径，近端和远端的导管主体; 用于允许冷却流体从近端通向远端的第一腔; 允许冷却流体从远端返回到近端的第二管腔; 以及可从第一直径扩张的消融元件，所述第一直径基本上与所述导管主体的直径相同至所述导管主体直径的至少两倍的第二直径，所述消融元件具有与所述不平坦表面一致的表面部分心脏组织的形貌。消融元件可以包括通过将导管的远端朝向导管的近端移动而变形的一个或多个气囊和/或柔性元件。气球的表面可以通过调节一个或多个气囊内的压力而进一步成形。在一种示例性方法中，提供组织消融装置，并且使用装置消融左心房窦内的组织。在示例性方法中，只有窦中的组织被消融，并且通过冷冻组织产生消融。

78. 发明申请

US20070255162A1 Bioimpedance measurement system and method 有权
标题翻译：生物阻抗测量系统和方法
公开(公告)号：US20070255162A1
公开(公告)日：2007-11-01
申请号：US11283057
申请日：2005-11-18
申请人： Marwan Abboud , Johnny Asmar , Chadi Harmouche
发明人： Marwan Abboud , Johnny Asmar , Chadi Harmouche
IPC分类号： A61B5/05
CPC分类号： A61B5/0537 , A61B18/02 , A61B2017/00026 , A61B2018/0022 , A61B2018/0212
摘要： Methods and systems for detecting fluid egress, assessing lesion quality, determining tissue composition or structure, determining ice coverage of catheter tip and providing tissue contact assessment, by providing a catheter having a shaft with a proximal end portion and a distal end portion, the proximal end portion and the distal end portion define at least one fluid pathway therebetween with the shaft having a plurality of electrodes, positioning the catheter at a tissue treatment site, applying an electrical current between at least two of the plurality of electrodes, measuring impedance voltage between the at least two of the plurality of electrodes and, processing the measured impedance voltage caused by the applied electrical current to determine if fluid egress is present, to assess lesion quality, to determine tissue composition, ice cover of catheter tip, and to provide contact assessment. The system may have a control unit, a microprocessor, an impedance measuring device or the like to perform processing of impedance data.
摘要翻译：用于检测流体出口的方法和系统，评估病变质量，确定组织组成或结构，通过提供具有近端部分和远端部分的轴的导管，确定导管尖端的冰覆盖和提供组织接触评估，末端部分和远端部分限定其间的至少一个流体通路，其中轴具有多个电极，将导管定位在组织治疗部位，在多个电极中的至少两个之间施加电流，测量多个电极之间的阻抗电压所述多个电极中的至少两个，并且处理由施加的电流引起的测量的阻抗电压以确定是否存在流体出口，以评估病变质量，确定组织组成，导管尖端的冰盖，并提供接触评定。系统可以具有控制单元，微处理器，阻抗测量装置等，以执行阻抗数据的处理。

79. 发明授权

US06761714B2 Leak detection system 有权
标题翻译：泄漏检测系统
公开(公告)号：US06761714B2
公开(公告)日：2004-07-13
申请号：US10124560
申请日：2002-04-17
申请人： Marwan Abboud , Johnny Al Asmar , John W. Lehmann
发明人： Marwan Abboud , Johnny Al Asmar , John W. Lehmann
IPC分类号： A61B1818
CPC分类号： A61B18/02 , A61B2017/00092 , A61B2017/00119 , A61B2018/0212 , A61B2018/0262 , A61F7/12
摘要： A surgical device includes a device body defining a sealed fluid path having a first end and a second end, a refrigerant supply in communication with the first end of the sealed fluid path; and a vacuum source in communication with the second end of the sealed fluid path. Leak detection apparatus can be provided in communication with the sealed fluid path.
摘要翻译：手术装置包括限定具有第一端和第二端的密封流体路径的装置主体，与密封流体路径的第一端连通的制冷剂供应; 以及与密封流体路径的第二端连通的真空源。泄漏检测装置可以与密封流体通道连通。

80. 发明授权

US06746445B2 Cryoblation catheter handle 失效
标题翻译：冷冻导管手柄
公开(公告)号：US06746445B2
公开(公告)日：2004-06-08
申请号：US10202991
申请日：2002-07-25
申请人： Marwan Abboud , Domenic Santoianni , Philippe Marchand
发明人： Marwan Abboud , Domenic Santoianni , Philippe Marchand
IPC分类号： A61B1818
CPC分类号： A61B18/02 , A61B2017/00292 , A61B2018/0212 , A61M39/1011
摘要： A cryocatheter system includes a first handle portion having a proximal end, a distal end, a first fluid flow path, and a second fluid flow path; a second handle portion having a proximal end, a distal end, a first fluid flow path, and a second fluid flow path; and a catheter having a proximal end, a distal end, a first fluid flow path, and a second fluid flow path. The distal end of the first handle portion is matable with the proximal end of the second handle portion to place the respective first and second fluid flow paths of each handle portion in fluid communication; and the distal end of the second handle portion is matable with the proximal end of the catheter to place the respective first and second fluid flow paths of the second handle portion and the catheter in fluid communication.
摘要翻译：一种低温切管系统包括具有近端，远端，第一流体流动路径和第二流体流路的第一手柄部分; 具有近端，远端，第一流体流动路径和第二流体流路的第二手柄部分; 以及具有近端，远端，第一流体流动路径和第二流体流动路径的导管。第一手柄部分的远端可与第二手柄部分的近端配合，以使每个手柄部分的相应的第一和第二流体流动路径流体连通; 并且第二手柄部分的远端可与导管的近端配合，以使第二手柄部分和导管的相应的第一和第二流体流动路径流体连通。

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