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11. 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。

12. 发明授权

US08679104B2 Wide area ablation of myocardial tissue 有权
标题翻译：广泛消融心肌组织
公开(公告)号：US08679104B2
公开(公告)日：2014-03-25
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： A61B18/18
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本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。球囊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。

13. 发明授权

US07794455B2 Wide area ablation of myocardial tissue 有权
标题翻译：广泛消融心肌组织
公开(公告)号：US07794455B2
公开(公告)日：2010-09-14
申请号：US11119399
申请日：2005-04-29
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。球囊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。

14. 发明授权

US07648497B2 Endovascular cryotreatment catheter 有权
标题翻译：血管内冷冻治疗导管
公开(公告)号：US07648497B2
公开(公告)日：2010-01-19
申请号：US11244710
申请日：2005-10-06
申请人： Miriam Lane , Leonilda Capuano , David Holtan , Jean-Pierre Lalonde , Claudia Lückge , Jean-Luc Pageard , Marwan Abboud , Johnny Al Asmar , Abderrahim Benrabah , Ken Chen , John W. Lehmann , Philippe Marchand , Robert Martin , Fredric L. Milder , Daniel Nahon
发明人： Miriam Lane , Leonilda Capuano , David Holtan , Jean-Pierre Lalonde , Claudia Lückge , Jean-Luc Pageard , Marwan Abboud , Johnny Al Asmar , Abderrahim Benrabah , Ken Chen , John W. Lehmann , Philippe Marchand , Robert Martin , Fredric L. Milder , Daniel Nahon
IPC分类号： A61B18/18
CPC分类号： A61B18/02 , A61B2017/22001 , A61B2017/22051 , A61B2017/22054 , A61B2017/22069 , A61B2018/0022 , A61B2018/0212 , A61B2018/0262 , A61B2018/0268
摘要： An elongated catheter device with a distal balloon assembly is adapted for endovascular insertion. Coolant injected through the device may, in different embodiments, directly cool tissue contacting the balloon, or may cool a separate internal chamber. In the first case, the coolant also inflates the balloon, and spent coolant is returned to the handle via a return passage extending through the body of the catheter. Plural balloons may be provided, wherein a secondary outer balloon surrounds a primary inner balloon, the primary balloon being filled with coolant and acting as the cooling chamber, the secondary balloon being coupled to a vacuum return lumen to serve as a robust leak containment device and thermal insulator around the cooling chamber. Various configurations, such as surface modification of the balloon interface, or placement of particles, coatings, or expandable meshes or coils in the balloon interface, may be employed to achieve this function.
摘要翻译：具有远端球囊组件的细长导管装置适于血管内插入。在不同的实施例中，通过装置注入的冷却剂可以直接冷却接触气囊的组织，或者可以冷却单独的内部腔室。在第一种情况下，冷却剂还使气囊膨胀，并且废弃的冷却剂经由延伸穿过导管主体的返回通道返回到手柄。可以提供多个气球，其中次级外球囊围绕主内球囊，主气球填充有冷却剂并用作冷却室，次级球囊联接到真空返回腔以用作鲁棒的泄漏容纳装置，冷却室周围的绝热体。可以采用各种构造，例如球囊界面的表面改性，或者在气球界面中放置颗粒，涂层或可膨胀的网孔或线圈，以实现该功能。

15. 发明授权

US06575966B2 Endovascular cryotreatment catheter 有权
公开(公告)号：US06575966B2
公开(公告)日：2003-06-10
申请号：US09945319
申请日：2001-08-31
申请人： Miriam Lane , Leonilda Capuano , David Holtan , Jean-Pierre Lalonde , Claudia Lückge , Jean-Luc Pageard , Marwan Abboud , Johnny Al Asmar , Abderrahim Benrabah , Ken Chen , John W. Lehmann , Philippe Marchand , Robert Martin , Fredric L. Milder , Daniel Nahon
发明人： Miriam Lane , Leonilda Capuano , David Holtan , Jean-Pierre Lalonde , Claudia Lückge , Jean-Luc Pageard , Marwan Abboud , Johnny Al Asmar , Abderrahim Benrabah , Ken Chen , John W. Lehmann , Philippe Marchand , Robert Martin , Fredric L. Milder , Daniel Nahon
IPC分类号： A61B1818
CPC分类号： A61B18/02 , A61B2017/22001 , A61B2017/22051 , A61B2017/22054 , A61B2017/22069 , A61B2018/0022 , A61B2018/0212 , A61B2018/0262 , A61B2018/0268
摘要： An elongated catheter device with a distal balloon assembly is adapted for endovascular insertion. Coolant injected through the device may, in different embodiments, directly cool tissue contacting the balloon, or may cool a separate internal chamber. In the first case, the coolant also inflates the balloon, and spent coolant is returned to the handle via a return passage extending through the body of the catheter. Plural balloons may be provided, wherein a secondary outer balloon surrounds a primary inner balloon, the primary balloon being filled with coolant and acting as the cooling chamber, the secondary balloon being coupled to a vacuum return lumen to serve as a robust leak containment device and thermal insulator around the cooling chamber. Various configurations, such as surface modification of the balloon interface, or placement of particles, coatings, or expandable meshes or coils in the balloon interface, may be employed to achieve this function.

16. 发明授权

US07300433B2 Endovascular cryotreatment catheter 有权
标题翻译：血管内冷冻治疗导管
公开(公告)号：US07300433B2
公开(公告)日：2007-11-27
申请号：US10397619
申请日：2003-03-26
申请人： Miriam Lane , Leonilda Capuano , David Holtan , Jean-Pierre Lalonde , Claudia Lückge , Jean-Luc Pageard , Marwan Abboud , Johnny Al Asmar , Abderrahim Benrabah , Ken Chen , John W. Lehmann , Philippe Marchand , Robert Martin , Fredric L. Milder , Daniel Nahon
发明人： Miriam Lane , Leonilda Capuano , David Holtan , Jean-Pierre Lalonde , Claudia Lückge , Jean-Luc Pageard , Marwan Abboud , Johnny Al Asmar , Abderrahim Benrabah , Ken Chen , John W. Lehmann , Philippe Marchand , Robert Martin , Fredric L. Milder , Daniel Nahon
IPC分类号： A61B18/18
CPC分类号： A61B18/02 , A61B2017/22001 , A61B2017/22051 , A61B2017/22054 , A61B2017/22069 , A61B2018/0022 , A61B2018/0212 , A61B2018/0262 , A61B2018/0268
摘要： An elongated catheter device with a distal balloon assembly is adapted for endovascular insertion. Coolant injected through the device may, in different embodiments, directly cool tissue contacting the balloon, or may cool a separate internal chamber. In the first case, the coolant also inflates the balloon, and spent coolant is returned to the handle via a return passage extending through the body of the catheter. Plural balloons may be provided, wherein a secondary outer balloon surrounds a primary inner balloon, the primary balloon being filled with coolant and acting as the cooling chamber, the secondary balloon being coupled to a vacuum return lumen to serve as a robust leak containment device and thermal insulator around the cooling chamber. Various configurations, such as surface modification of the balloon interface, or placement of particles, coatings, or expandable meshes or coils in the balloon interface, may be employed to achieve this function.
摘要翻译：具有远端球囊组件的细长导管装置适于血管内插入。在不同的实施例中，通过装置注入的冷却剂可以直接冷却接触气囊的组织，或者可以冷却单独的内部腔室。在第一种情况下，冷却剂还使气囊膨胀，并且废弃的冷却剂经由延伸穿过导管主体的返回通道返回到手柄。可以提供多个气球，其中次级外球囊围绕主内球囊，主气球填充有冷却剂并用作冷却室，次级球囊联接到真空返回腔以用作鲁棒的泄漏容纳装置，冷却室周围的绝热体。可以采用各种构造，例如球囊界面的表面改性，或者在气球界面中放置颗粒，涂层或可膨胀的网孔或线圈，以实现该功能。

17. 发明授权

US5281213A Catheter for ice mapping and ablation 失效
标题翻译：导管用于冰图和消融
公开(公告)号：US5281213A
公开(公告)日：1994-01-25
申请号：US870495
申请日：1992-04-16
申请人： Fredric L. Milder , A Ze'ev Hed
发明人： Fredric L. Milder , A Ze'ev Hed
IPC分类号： A61B17/00 , A61B18/00 , A61B18/02 , A61B18/14 , A61B18/24 , A61B18/28 , A61F7/00 , A61M25/01 , A61B17/36
CPC分类号： A61M25/0147 , A61B18/02 , A61B18/1492 , A61M25/0158 , A61B18/14 , A61B18/24 , A61B18/28 , A61B2017/00022 , A61B2017/00243 , A61B2017/00292 , A61B2017/003 , A61B2018/00011 , A61B2018/00023 , A61B2018/00077 , A61B2018/00095 , A61B2018/00357 , A61B2018/00577 , A61B2018/00815 , A61B2018/00821 , A61B2018/00839 , A61B2018/0212 , A61B2018/0275 , A61B2018/1253 , A61B2218/002 , A61B2218/003 , A61F2007/0056
摘要： The invention provides a catheter for ice mapping and ablation and a method of ablation using the catheter. The catheter includes at least two lumens for circulating a refrigerating fluid adjacent an ablation device located at the end of a catheter. The refrigerated ablation device is used to chill a localized region of myocardial tissue, thereby permitting the resulting change in electrical activity to be determined. In response to the test results, the ablation device may be used to make a lesion in the myocardial tissue to correct a cardiac arrhythmia. In one embodiment, the ablation device is an electrode which uses radio frequency energy to ablate the myocardial tissue. Alternatively, the ablation device is an electrode adapted for direct current ablation. In another embodiment, the electrode is replaced with an optical fiber in communication with a laser which uses the laser's light energy to ablate tissue. The embodiments may include provisions for steering the catheter and for stabilizing the ablation device at the proposed lesion site.
摘要翻译：本发明提供一种用于冰图和消融的导管以及使用该导管消融的方法。导管包括至少两个流体，用于循环位于导管端部处的消融装置附近的冷冻流体。冷冻消融装置用于冷冻心肌组织的局部区域，从而允许确定所导致的电活动变化。响应于测试结果，消融装置可用于在心肌组织中形成损伤以矫正心律失常。在一个实施例中，消融装置是使用射频能量来消融心肌组织的电极。或者，消融装置是适于直流消融的电极。在另一个实施例中，电极被替换为与使用激光的光能来消融组织的激光器连通的光纤。实施例可以包括用于转向导管并用于在所提出的病变部位处稳定消融装置的装置。

18. 发明授权

US5275608A Generic endoscopic instrument 失效
标题翻译：通用内窥镜仪器
公开(公告)号：US5275608A
公开(公告)日：1994-01-04
申请号：US777090
申请日：1991-10-16
申请人： Jeffrey L. Forman , Fredric L. Milder , Henri F. deGuillebon , Irving Kalikow , A. Ze'ev Hed
发明人： Jeffrey L. Forman , Fredric L. Milder , Henri F. deGuillebon , Irving Kalikow , A. Ze'ev Hed
IPC分类号： A61B17/28 , A61B17/32
CPC分类号： A61B17/29 , A61B17/2909 , A61B2017/291 , A61B2017/2927
摘要： A surgical tool for operating within a body cavity through a small diameter opening includes a substantially rigid member which is elongated along a first axis and which has a cross-sectional dimension to fit within the opening. A head is mounted on one end of the rigid member for movement in at least one plane through an angle with respect to the first axis. An operable control member is mounted on an opposite end of the rigid member for having at least one degree of manipulability. The control member is coupled to the head member through the rigid member such that manipulation of the control member through an angle with respect to the first axis causes movement of the head member through a corresponding angle. Accordingly, the head member can be steered within a body cavity by control external to the body cavity. In some embodiments, the control member is manipulable to a second degree for actuating an actuating member mounted on the head.
摘要翻译：用于通过小直径开口在体腔内操作的手术工具包括基本上刚性的构件，其沿着第一轴线是细长的，并且具有适合于开口内的横截面尺寸。头部安装在刚性构件的一端上，用于在至少一个平面中相对于第一轴线移动一个角度。可操作的控制构件安装在刚性构件的相对端上，用于具有至少一个操纵程度。控制构件通过刚性构件联接到头部构件，使得控制构件相对于第一轴线的角度的操纵引起头部构件相应角度的移动。因此，通过体腔外部的控制可以将头部构件转向体腔内。在一些实施例中，控制构件可操纵到第二程度，用于致动安装在头部上的致动构件。

19. 发明授权

US6060000A Iontophoretic material containing carbon and metal granules 失效
标题翻译：含有碳和金属颗粒的离子电渗材料
公开(公告)号：US6060000A
公开(公告)日：2000-05-09
申请号：US37156
申请日：1998-03-09
申请人： Fredric L. Milder , Robert Hausslein
发明人： Fredric L. Milder , Robert Hausslein
IPC分类号： A61F2/00 , A61F2/28 , A61F2/30 , A61F2/36 , A61L27/30 , A61L27/44 , A61L27/54 , A61L29/10 , A61L29/12 , A61L29/16 , A61L31/08 , A61L31/12 , A61L31/16 , A61N1/05 , A61N1/20 , A61N1/30 , H01B1/06
CPC分类号： A61N1/20 , A61F2/30767 , A61L27/303 , A61L27/306 , A61L27/443 , A61L27/446 , A61L27/54 , A61L29/103 , A61L29/106 , A61L29/126 , A61L29/16 , A61L31/084 , A61L31/086 , A61L31/126 , A61L31/128 , A61L31/16 , A61N1/056 , A61N1/303 , A61N1/306 , A61F2/36 , A61F2/3662 , A61F2002/2821 , A61F2002/30064 , A61F2310/0052 , A61F2310/00574 , A61L2300/102 , A61L2300/104 , A61L2300/108 , A61L2300/404 , A61L2300/62 , A61L2300/80
摘要： A material is provided that uses controlled electrical current derived from two dissimilar galvanic materials to drive oligodynamic metal ions into solution. Exemplary materials include carbon and silver.
摘要翻译：提供了一种材料，其使用由两种不同的电偶材料得到的受控电流以将低分子量金属离子驱动到溶液中。示例性材料包括碳和银。

20. 发明授权

US5423807A Cryogenic mapping and ablation catheter 失效
标题翻译：低温贴图和消融导管
公开(公告)号：US5423807A
公开(公告)日：1995-06-13
申请号：US186263
申请日：1994-01-24
申请人： Fredric L. Milder
发明人： Fredric L. Milder
IPC分类号： A61B18/12 , A61B5/0402 , A61B17/00 , A61B18/00 , A61B18/02 , A61B18/14 , A61B18/20 , A61B18/24 , A61B18/28 , A61F7/00 , A61M25/01 , A61B17/36
CPC分类号： A61M25/0158 , A61B18/02 , A61B18/1492 , A61B18/14 , A61B18/20 , A61B18/24 , A61B18/28 , A61B2017/00017 , A61B2017/00022 , A61B2017/00243 , A61B2017/00292 , A61B2017/003 , A61B2018/00011 , A61B2018/00023 , A61B2018/00077 , A61B2018/00095 , A61B2018/00273 , A61B2018/00357 , A61B2018/00577 , A61B2018/00815 , A61B2018/00821 , A61B2018/00839 , A61B2018/0212 , A61B2018/0275 , A61B2018/0281 , A61B2018/1253 , A61B2218/002 , A61B2218/003 , A61F2007/0056
摘要： The invention provides a catheter for ice mapping and ablation and a method of ablation using the catheter. The catheter includes at least two conduits for circulating a refrigerating fluid adjacent an ablation device located at the end of a catheter. The refrigerated ablation device is used to chill a localized region of myocardial tissue, thereby permitting the resulting change in electrical activity to be determined. In response to the test results, the ablation device may be used to make a lesion in the myocardial tissue to correct a cardiac arrhythmia. In one embodiment, the ablation device is an electrode which uses radio frequency energy to ablate the myocardial tissue. Alternatively, the ablation device is an electrode adapted for direct current ablation. In another embodiment, the electrode is replaced with an optical fiber in communication with a laser which uses the laser's light energy to ablate tissue. Yet another embodiment is a cryogenic catheter having combined or separate mapping and ablation devices. In another embodiment, a cryogenic catheter is provided having an inner conduit with a stepped down diameter. The embodiments may include provisions for steering the catheter and for stabilizing the ablation device at the proposed lesion site.
摘要翻译：本发明提供一种用于冰图和消融的导管以及使用该导管消融的方法。导管包括至少两个导管，用于使位于导管端部的消融装置附近的冷冻流体循环。冷冻消融装置用于冷冻心肌组织的局部区域，从而允许确定所导致的电活动变化。响应于测试结果，消融装置可用于在心肌组织中形成损伤以矫正心律失常。在一个实施例中，消融装置是使用射频能量来消融心肌组织的电极。或者，消融装置是适于直流消融的电极。在另一个实施例中，电极被替换为与使用激光的光能来消融组织的激光器连通的光纤。另一个实施例是具有组合或分离的映射和消融装置的低温导管。在另一个实施例中，提供了具有具有阶梯下降直径的内导管的低温导管。实施例可以包括用于转向导管并用于在所提出的病变部位处稳定消融装置的装置。

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