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41. 发明授权

US08600495B2 Techniques for positioning therapy delivery elements within a spinal cord or brain 有权
标题翻译：用于在脊髓或脑内定位治疗递送元件的技术
公开(公告)号：US08600495B2
公开(公告)日：2013-12-03
申请号：US12794363
申请日：2010-06-04
申请人： Frans Gielen , Gary W. King , Daryle Petersen , Mark T. Rise , Michael Schendel , Warren Starkebaum
发明人： Frans Gielen , Gary W. King , Daryle Petersen , Mark T. Rise , Michael Schendel , Warren Starkebaum
IPC分类号： A61N1/00
CPC分类号： A61M5/14276 , A61M5/1723 , A61M2209/045 , A61M2210/0693 , A61M2210/1003 , A61N1/05 , A61N1/0531 , A61N1/0534 , A61N1/0539 , A61N1/0551 , A61N1/0553 , A61N1/0558 , A61N1/056 , A61N1/36071
摘要： Apparatus and techniques to address problems associated with lead migration, patient movement or position, histological changes, neural plasticity or disease progression. Disclosed are techniques for implanting a lead having therapy delivery elements, such as electrodes or drug delivery ports, within a vertebral or cranial bone so as to maintain these elements in a fixed position relative to a desired treatment site. The therapy delivery elements may thereafter be adjusted in situ with a position control mechanism and/or a position controller to improve the desired treatment, such as electrical stimulation and/or drug infusion to a precise target. The therapy delivery elements may be positioned laterally in any direction relative to the targeted treatment site or toward or away from the targeted treatment site. A control system maybe provided for open- or closed-loop feedback control of the position of the therapy delivery elements as well as other aspects of the treatment therapy.
摘要翻译：用于解决与铅迁移，患者运动或位置，组织学变化，神经可塑性或疾病进展相关的问题的装置和技术。公开了用于在椎骨或颅骨内植入具有治疗递送元件（例如电极或药物递送端口）的引线以将这些元件相对于期望的治疗部位保持在固定位置的技术。此后可以用位置控制机构和/或位置控制器原位调整治疗递送元件，以改善期望的治疗，例如电刺激和/或药物输注到精确靶。治疗递送元件可以相对于目标治疗部位或朝向或远离目标治疗部位的任何方向横向定位。可以提供控制系统用于开放或闭环反馈控制治疗递送元件的位置以及治疗疗法的其它方面。

42. 发明授权

US08588914B2 Implantable medical device with electrodes on multiple housing surfaces 有权
标题翻译：可植入医疗设备，电极在多个外壳表面
公开(公告)号：US08588914B2
公开(公告)日：2013-11-19
申请号：US11450127
申请日：2006-06-09
申请人： Ethan A. Rooney , Carl D. Wahlstrand , Gary W. King , Thomas E. Cross, Jr. , Richard T. Stone
发明人： Ethan A. Rooney , Carl D. Wahlstrand , Gary W. King , Thomas E. Cross, Jr. , Richard T. Stone
IPC分类号： A61N1/375
CPC分类号： A61N1/375 , A61N1/0504 , A61N1/0531 , A61N1/0534 , A61N1/0553 , A61N1/36071 , A61N1/3756
摘要： An implantable medical device (IMD) with a housing and electrodes on at least two surfaces of the housing is described. The surfaces may be, for example, opposed, substantially parallel surfaces, e.g., top and bottom surfaces. Location of electrodes on multiple surfaces of the housing may allow the IMD to deliver stimulation to a variety of tissues and with a variety of current field configurations. For example, the IMD may deliver peripheral nerve field stimulation (PNFS) to one or more tissue areas via electrodes selected from one or both of the surfaces to, for example, reduce the sensation of pain in a tissue area proximate to an implantation site of the IMD without targeting a specific nerve. The IMD may be implanted between or within intra-dermal, deep dermal, or subcutaneous layers of the tissue of the patient to deliver PNFS to any one or more of these layers.
摘要翻译：描述了在壳体的至少两个表面上具有壳体和电极的可植入医疗装置（IMD）。表面可以是例如相对的基本上平行的表面，例如顶部和底部表面。电极在壳体的多个表面上的位置可以允许IMD将刺激递送到各种组织以及各种当前的现场配置。例如，IMD可以通过选自一个或两个表面的电极将外周神经区域刺激（PNFS）递送到一个或多个组织区域，以例如减少接近植入部位的组织区域中的疼痛感觉 IMD没有针对特定的神经。 IMD可以植入在患者组织的真皮内，深层皮肤或皮下层之间或内，以将PNFS递送到这些层中的任何一个或多个层。

43. 发明申请

US20120136409A1 RULE-BASED STIMULATION PROGRAM SEARCH 有权
标题翻译：基于规则的刺激程序搜索
公开(公告)号：US20120136409A1
公开(公告)日：2012-05-31
申请号：US13330016
申请日：2011-12-19
申请人： Steven M. Goetz , Donald R. Johnson , Andrew H. Houchins , Jeffrey T. Keacher , Theodore J. Stone , Kenneth T. Heruth , Gary W. King , Roy L. Testerman
发明人： Steven M. Goetz , Donald R. Johnson , Andrew H. Houchins , Jeffrey T. Keacher , Theodore J. Stone , Kenneth T. Heruth , Gary W. King , Roy L. Testerman
IPC分类号： A61N1/372
CPC分类号： A61N1/37264 , A61N1/36071 , A61N1/36132 , A61N1/36185 , A61N1/37247 , G06F19/00 , G16H40/63 , G16H50/20
摘要： Techniques that involve application of one or more rules to a “parent” program to generate a plurality of different “child” programs are described. Each of the rules may define a respective electrode configuration modification, and each child program may be a variation of the parent based on a modification of the electrode configuration of the parent according to one of the rules. The systems or devices may generate further generations of child programs from a previous generation child program using the same one or more rules. The child programs may be provided to a user, so that the user may test the efficacy of the new programs, assisting the user in identifying desirable programs. The child programs may be relatively minor variations of the parent program, and the user may “fine tune” a generally desirable parent program by testing the child programs.
摘要翻译：描述涉及将一个或多个规则应用于“父”程序以生成多个不同的“子”程序的技术。每个规则可以限定相应的电极配置修改，并且每个子程序可以是基于根据规则之一的父母的电极配置的修改的父母的变体。系统或设备可以使用相同的一个或多个规则从上一代子程序生成更多代的子程序。子程序可以被提供给用户，使得用户可以测试新程序的功效，帮助用户识别期望的程序。子程序可能是父程序的相对小的变化，并且用户可以通过测试子程序来“微调”通常期望的父程序。

44. 发明授权

US08090449B2 Apparatus and method for expanding a stimulation lead body in situ 失效
标题翻译：用于在原位扩张刺激引线体的装置和方法
公开(公告)号：US08090449B2
公开(公告)日：2012-01-03
申请号：US11970008
申请日：2008-01-07
申请人： Gary W. King , Mark T. Rise , Michael J. Schendel , Richard Schallhorn
发明人： Gary W. King , Mark T. Rise , Michael J. Schendel , Richard Schallhorn
IPC分类号： A61N1/05
CPC分类号： A61M5/14276 , A61M5/1723 , A61M2209/045 , A61M2210/0693 , A61M2210/1003 , A61N1/05 , A61N1/0551 , A61N1/0558 , A61N1/056
摘要： An implantable lead is provided with at least one extendable member to position therapy delivery elements, which may be electrodes or drug delivery ports, after the lead has been inserted into the body. The lead may formed as a resilient element which is contained in a retainer tube that may be removed to permit the lead to deploy. Alternatively, a non-resilient lead may be provided with a slotted retainer tube. A series of mechanical linkages for expanding and retracting the lead within the human body may be actuated with various mechanisms. A control system may be provided for closed-loop feedback control of the position of the extendable members. The invention also includes a method for expanding an implantable lead in situ.
摘要翻译：可植入引线设置有至少一个可延伸构件以在引线已经插入体内之后定位治疗递送元件，其可以是电极或药物递送端口。引线可以形成为弹性元件，该弹性元件容纳在可以被移除以允许引导部署的保持器管中。或者，非弹性引线可以设置有开槽的保持管。用于在人体内扩张和缩回引线的一系列机械连接可用各种机构来致动。可以提供控制系统用于可延伸构件的位置的闭环反馈控制。本发明还包括一种原位扩展可植入铅的方法。

45. 发明申请

US20100016919A1 METHOD AND APPARATUS FOR ELECTRICALLY STIMULATING THE NERVOUS SYSTEM TO IMPROVE VENTRICULAR DYSFUNCTION, HEART FAILURE, AND OTHER CARDIAC CONDITIONS 有权
标题翻译：用于电刺激神经系统以改善心脏功能障碍，心脏衰竭和其他心脏病症的方法和装置
公开(公告)号：US20100016919A1
公开(公告)日：2010-01-21
申请号：US12565910
申请日：2009-09-24
申请人： Michael R.S. Hill , Gary W. King , Thomas J. Mullen , Xiaohong Zhou
发明人： Michael R.S. Hill , Gary W. King , Thomas J. Mullen , Xiaohong Zhou
IPC分类号： A61N1/365
CPC分类号： A61N1/36114 , A61N1/3627
摘要： A method and apparatus are used to provide therapy to a patient experiencing ventricular dysfunction or heart failure. At least one electrode is located in a region associated with nervous tissue, such as nerve bundles T1-T4, in a patient's body. Electrical stimulation is applied to the at least one electrode to improve the cardiac efficiency of the patient's heart. One or more predetermined physiologic parameters of the patient are monitored, and the electrical stimulation is adjusted based on the one or more predetermined physiologic parameters.
摘要翻译：使用方法和装置为患有心室功能障碍或心力衰竭的患者提供治疗。至少一个电极位于与患者体内的神经组织如神经束T1-T4相关联的区域中。电刺激被施加到至少一个电极以改善患者心脏的心脏效率。监测患者的一个或多个预定生理参数，并且基于一个或多个预定生理参数来调整电刺激。

46. 发明授权

US07650190B2 Methods and apparatus for the regulation of hormone release 有权
标题翻译：用于调节激素释放的方法和装置
公开(公告)号：US07650190B2
公开(公告)日：2010-01-19
申请号：US11751813
申请日：2007-05-22
申请人： Xiaohong Zhou , Thomas J. Mullen , Gary W. King , Michael R. S. Hill
发明人： Xiaohong Zhou , Thomas J. Mullen , Gary W. King , Michael R. S. Hill
IPC分类号： A61N1/00
CPC分类号： A61N1/36071 , A61N1/205 , A61N1/36021
摘要： A method and apparatus for delivering corrective therapy through hormone regulation is provided. Inhibition of sympathetic fibers by spinal cord stimulation is used to regulate the levels of hormones such as catecholamines, renin, and calcitonin gene-related peptide. The invention utilizes a closed or open loop feedback system in which physiological parameters such as the concentrations of hormones and sympathetic indicators such as heart rate and urine production are monitored and used to determine the appropriate level of neurostimulation. The site of electrical stimulation includes, but is not limited to, the spinal cord at levels T7-L2 and the associated neural fibers within a region of the T7-L2 dermatomes.
摘要翻译：提供了一种通过激素调节进行矫正治疗的方法和装置。通过脊髓刺激抑制交感神经纤维用于调节激素水平，如儿茶酚胺，肾素和降钙素基因相关肽。本发明利用封闭或开环反馈系统，其中监测诸如心率和尿液产生之间的激素和交感神经指标的生理参数，并用于确定适当的神经刺激水平。电刺激部位包括但不限于在T7-L2皮层区域内的T7-L2级和相关神经纤维的脊髓。

47. 发明授权

US07376468B2 Apparatus and method for expanding a stimulation lead body in situ 失效
标题翻译：用于在原位扩张刺激引线体的装置和方法
公开(公告)号：US07376468B2
公开(公告)日：2008-05-20
申请号：US10767244
申请日：2004-01-27
申请人： Gary W. King , Mark T. Rise , Michael J. Schendel , Richard Schallhorn
发明人： Gary W. King , Mark T. Rise , Michael J. Schendel , Richard Schallhorn
IPC分类号： A61N1/05
CPC分类号： A61M5/14276 , A61M5/1723 , A61M2209/045 , A61M2210/0693 , A61M2210/1003 , A61N1/05 , A61N1/0551 , A61N1/0558 , A61N1/056
摘要： An implantable lead is provided with at least one extendable member to position therapy delivery elements, which may be electrodes or drug delivery ports, after the lead has been inserted into the body. The lead may formed as a resilient element which is contained in a retainer tube that may be removed to permit the lead to deploy. Alternatively, a non-resilient lead may be provided with a slotted retainer tube. A series of mechanical linkages for expanding and retracting the lead within the human body may be actuated with various mechanisms. A control system may be provided for closed-loop feedback control of the position of the extendable members. The invention also includes a method for expanding an implantable lead in situ.
摘要翻译：可植入引线设置有至少一个可延伸构件以在引线已经插入体内之后定位治疗递送元件，其可以是电极或药物递送端口。引线可以形成为弹性元件，该弹性元件容纳在可以被移除以允许引导部署的保持器管中。或者，非弹性引线可以设置有开槽的保持管。用于在人体内扩张和缩回引线的一系列机械连接可用各种机构来致动。可以提供控制系统用于可延伸构件的位置的闭环反馈控制。本发明还包括一种原位扩展可植入铅的方法。

48. 发明申请

US20080046036A1 Selecting electrode combinations for stimulation therapy 有权
标题翻译：选择电极组合进行刺激治疗
公开(公告)号：US20080046036A1
公开(公告)日：2008-02-21
申请号：US11810943
申请日：2007-06-07
申请人： Gary W. King , Gabriela C. Miyazawa , Jordan J. Greenberg , Steven M. Goetz
发明人： Gary W. King , Gabriela C. Miyazawa , Jordan J. Greenberg , Steven M. Goetz
IPC分类号： A61N1/32
CPC分类号： A61N1/37247 , A61N1/0529 , A61N1/0534 , A61N1/0553 , A61N1/36185 , G06F19/00 , G06F19/3481 , G16H40/63
摘要： Techniques for selecting electrode combinations for stimulation therapy include delivering stimulation via each of at least five combination groups. A first group of electrode combinations is characterized by the presence of a caudal anode. A second group of electrode combinations is characterized by the presence of a rostral anode. A third group of electrode combinations is characterized by the presence of a single anode above and a single anode below the cathode(s) of the combination. A fourth group of electrode combinations is characterized by the presence of multiple anodes above and below the cathode(s) of the combination. A fifth group of electrode combinations is characterized by the presence of transverse anodes. A sixth group of electrode combination is characterized by at least one off-center cathode. One or more preferred electrode combinations groups, and/or a number of leads to implant within the patient, may by selected based on patient feedback.
摘要翻译：用于选择用于刺激治疗的电极组合的技术包括通过至少五个组合组中的每一个递送刺激。第一组电极组合的特征在于尾部阳极的存在。第二组电极组合的特征在于存在罗氏阳极。第三组电极组合的特征在于在组合的阴极下方存在单个阳极和单个阳极。第四组电极组合的特征在于在组合的阴极上方和下方存在多个阳极。第五组电极组合的特征在于存在横向阳极。第六组电极组合的特征在于至少一个偏心阴极。可以通过基于患者反馈来选择一个或多个优选的电极组合组和/或在患者体内植入的多个引线。

49. 发明授权

US06988006B2 Technique for adjusting the locus of excitation of electrically excitable tissue 失效
公开(公告)号：US06988006B2
公开(公告)日：2006-01-17
申请号：US10247981
申请日：2002-09-20
申请人： Gary W. King , Rob Leinders , Greg Hrdlicka , Michael D. Baudino
发明人： Gary W. King , Rob Leinders , Greg Hrdlicka , Michael D. Baudino
IPC分类号： A61N1/36
CPC分类号： A61N1/36164 , A61N1/0531 , A61N1/0534 , A61N1/0551 , A61N1/36017 , A61N1/36071 , A61N1/36167
摘要： The locus of electrically excitable tissue where action potentials are induced can be controlled using the physiological principle of electrotonus. In one embodiment, first and second pulses are applied to first and second electrodes, respectively, to generate first and second subthreshold potential areas, respectively, within the tissue. The locus within the tissue where action potentials are induced is determined by a superposition of the first and second subthreshold areas according to the physiological principle of electrotonus. In another embodiment, a two-dimensional array of electrodes are formed. The cathode may be positioned near the center of the two-dimensional array or may be left out. The first and second subthreshold areas may thereby be steered. An array of anodal rings may be used to contain the field of excitation.

50. 发明授权

US06319241B1 Techniques for positioning therapy delivery elements within a spinal cord or a brain 失效
公开(公告)号：US06319241B1
公开(公告)日：2001-11-20
申请号：US09303145
申请日：1999-04-30
申请人： Gary W. King , Frans Gielen , Daryle Petersen , Mark T. Rise , Michael Schendel , Warren Starkebaum
发明人： Gary W. King , Frans Gielen , Daryle Petersen , Mark T. Rise , Michael Schendel , Warren Starkebaum
IPC分类号： A61M3100
CPC分类号： A61M5/14276 , A61M5/1723 , A61M2209/045 , A61M2210/0693 , A61M2210/1003 , A61N1/05 , A61N1/0531 , A61N1/0534 , A61N1/0539 , A61N1/0551 , A61N1/0553 , A61N1/0558 , A61N1/056 , A61N1/36071
摘要： The present invention addresses the problems associated with lead migration, patient movement or position, histological changes, neural plasticity or disease progression. The present invention discloses techniques for implanting a lead having therapy delivery elements, such as electrodes or drug delivery ports, within a vertebral or cranial bone so as to maintain these elements in a fixed position relative to a desired treatment site. The therapy delivery elements may thereafter be adjusted in situ with a position control mechanism and/or a position controller to improve the desired treatment therapy. The present invention also discloses techniques for non-invasively positioning and re-positioning therapy delivery elements after implant to provide electrical stimulation and/or drug infusion to a precise target. A position control mechanism and/or a position controller are provided for adjusting in situ the position of the therapy delivery elements relative to the targeted tissue of interest. The therapy delivery elements may be positioned laterally in any direction relative to the targeted treatment site or toward or away from the targeted treatment site. A control system may be provided for open- or closed-loop feedback control of the position of the therapy delivery elements as well as other aspects of the treatment therapy.

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