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51. 发明授权

US07824399B2 Ablation system and method of use 有权
标题翻译：消融系统和使用方法
公开(公告)号：US07824399B2
公开(公告)日：2010-11-02
申请号：US11355465
申请日：2006-02-16
申请人： David E. Francischelli , Eduardo N. Warman , Rahul Mehra , Mark T. Stewart , James R. Skarda , Harry Puryear , David Schwartzman
发明人： David E. Francischelli , Eduardo N. Warman , Rahul Mehra , Mark T. Stewart , James R. Skarda , Harry Puryear , David Schwartzman
IPC分类号： A61B18/18
CPC分类号： A61B18/1445 , A61B5/04 , A61B18/12 , A61B2018/00065 , A61B2018/00363 , A61B2018/00577 , A61B2018/00654 , A61B2018/00702 , A61B2018/00755 , A61B2018/00779 , A61B2018/00791 , A61B2018/00839 , A61B2018/00875 , A61B2018/1226 , A61B2018/1253 , A61B2018/126 , A61B2018/1467 , A61B2018/1472 , A61B2218/002 , A61N1/403
摘要： A system and method for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the depolarization signal in a local electrogram taken using electrodes located adjacent the tissue to be ablated. Following onset of application of ablation energy to heart tissue, the local electrogram is measured with electrodes located adjacent tissue to be ablated so that the ablation energy to ablation elements can be selectively reduced or terminated when transmurality is detected.
摘要翻译：用于创建病变并评估其完整性或透视性的系统和方法。病变透壁度的评估是通过使用邻近待消融组织的电极拍摄的局部电描记图来监测去极化信号来实现的。在开始将消融能量施加到心脏组织之后，用邻近待组织的组织的电极测量局部电描记图，以便当检测到透视时，消融元件的消融能量可被选择性地减少或终止。

52. 发明申请

US20100168740A1 Heart Wall Ablation/Mapping Catheter and Method 审中-公开
标题翻译：心墙消融/绘图导管和方法
公开(公告)号：US20100168740A1
公开(公告)日：2010-07-01
申请号：US12721895
申请日：2010-03-11
申请人： Mark T. Stewart , Johnson E. Goode , James M. Speckien , Mark A. Taube , Eduardo N. Warman
发明人： Mark T. Stewart , Johnson E. Goode , James M. Speckien , Mark A. Taube , Eduardo N. Warman
IPC分类号： A61B18/14
CPC分类号： A61M25/0147 , A61B18/1492 , A61B2017/00243 , A61B2018/00916 , A61M25/0152 , A61M2025/015 , A61M2025/0161
摘要： Steerable electrophysiology catheters for use in mapping and/or ablation of accessory pathways in myocardial tissue of the heart wall and methods of use thereof are disclosed. The catheter comprises a catheter body and handle, the catheter body having a proximal section and a distal section and manipulators that enable the deflection of a distal segment of the distal tip section with respect to the independently formed curvature of a proximal segment of the distal tip section through a bending or knuckle motion of an intermediate segment between the proximal and distal segments. A wide angular range of deflection within a very small curve or bend radius in the intermediate segment is obtained. At least one distal tip electrode is preferably confined to the distal segment which can have a straight axis extending distally from the intermediate segment. The curvature of the proximal segment and the bending angle of the intermediate segment are independently selectable. The axial alignment of the distal segment with respect to the nominal axis of the proximal shaft section of the catheter body can be varied between substantially axially aligned (0° curvature) in an abrupt knuckle bend through a range of about −90° to about +180° within a bending radius of between about 2.0 mm and 7.0 mm and preferably less than 5.0 mm. The proximal segment curve can be independently formed in a range of about −180° through about +270° with respect to the axis of the proximal shaft section to provide an optimum angular orientation of the distal electrode(s). The distal segment can comprise a highly flexible elongated distal segment body and electrode(s) that conform with the shape and curvature of the heart wall.
摘要翻译：公开了用于在心壁的心肌组织中辅助通路的测绘和/或消融的可操纵的电生理学导管及其使用方法。导管包括导管主体和手柄，导管主体具有近端部分和远端部分以及操纵器，其能够相对于远端尖端的近端段的独立形成的曲率偏转远侧末端部分的远端部分通过近端段和远端段之间的中间段的弯曲或转向关节运动。获得在中间段内的非常小的曲线或弯曲半径内的宽的角度范围的偏转。至少一个远端末端电极优选地限制在远端段，该远段可以具有从中间段向远侧延伸的直轴。近端段的曲率和中间段的弯曲角度是可独立选择的。远侧段相对于导管主体的近端轴部分的标称轴线的轴向对准可以在突变关节弯曲部中的大致轴向对准（0°曲率）之间变化约-90°至约+ 弯曲半径为约2.0mm至7.0mm，优选小于5.0mm的180°。近端段曲线可相对于近轴部分的轴线独立地形成在约-180°至约+ 270°的范围内，以提供远端电极的最佳角度取向。远端段可以包括高度柔性的细长远端段体和符合心壁的形状和曲率的电极。

53. 发明授权

US07682358B2 Steerable catheter 有权
标题翻译：导向导管
公开(公告)号：US07682358B2
公开(公告)日：2010-03-23
申请号：US10697486
申请日：2003-10-30
申请人： George Gullickson , Mark T. Stewart , Joseph E. Cardinal , Harry A. Puryear , Scott G. Klimek , James R. Skarda , Richard A. Thompson, II , Alan L. Carlson
发明人： George Gullickson , Mark T. Stewart , Joseph E. Cardinal , Harry A. Puryear , Scott G. Klimek , James R. Skarda , Richard A. Thompson, II , Alan L. Carlson
IPC分类号： A61M25/092
CPC分类号： A61M25/0136
摘要： A deflection mechanism for selectively inducing a bend in a catheter body includes an elongated deflection wire extending within a deflection lumen of the catheter body and into a handle. A guide track is formed within the handle and a thumb wheel is mounted proximal to the elongated guide track within the handle and supports a pinion gear; the thumb wheel and the pinion gear are adapted to be rotated about a common thumb wheel axis, which extends substantially perpendicular to the longitudinal axis. A rack arm extends obliquely to the longitudinal axis of the handle and includes runners received by the guide track, an attachment point coupling the deflection wire to the rack arm and a linear rack engaging the pinion gear. Rotation of the thumb wheel in a first direction draws the deflection wire proximally through the deflection lumen.
摘要翻译：用于选择性地诱导导管主体中的弯曲的偏转机构包括在导管主体的偏转腔内延伸并延伸到手柄中的细长偏转线。引导轨道形成在手柄内，拇指轮安装在手柄内的细长导轨附近，并支撑小齿轮; 拇指轮和小齿轮适于围绕基本上垂直于纵向轴线延伸的公共拇指轮轴旋转。齿条臂相对于手柄的纵向轴线倾斜地延伸，并且包括由导轨接收的跑道，将偏转线连接到齿条臂的连接点和与小齿轮啮合的直线齿条。拇指轮在第一方向的旋转将偏转线向近侧拉出通过偏转内腔。

54. 发明授权

US07367972B2 Ablation system 有权
标题翻译：消融系统
公开(公告)号：US07367972B2
公开(公告)日：2008-05-06
申请号：US10657987
申请日：2003-09-09
申请人： David E. Francischelli , Mark T. Stewart , James R. Skarda , Rahul Mehra
发明人： David E. Francischelli , Mark T. Stewart , James R. Skarda , Rahul Mehra
IPC分类号： A61B18/18
CPC分类号： A61B18/1206 , A61B18/1445 , A61B2018/0016 , A61B2018/00351 , A61B2018/00363 , A61B2018/00577 , A61B2018/00702 , A61B2018/00761 , A61B2018/00791 , A61B2018/00875 , A61B2018/00886 , A61B2018/1467 , A61B2218/002
摘要： A system for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the impedance of the tissue to be ablated. Rather than attempting to detect a desired drop or a desired increase impedance, completeness of a lesion is detected in response to the measured impedance remaining at a stable level for a desired period of time, referred to as an impedance plateau. The mechanism for determining transmurality of lesions adjacent individual electrodes or pairs may be used to deactivate individual electrodes or electrode pairs, when the lesions in tissue adjacent these individual electrodes or electrode pairs are complete, to create an essentially uniform lesion along the line of electrodes or electrode pairs, regardless of differences in tissue thickness adjacent the individual electrodes or electrode pairs.
摘要翻译：创建病变并评估其完整性或透明度的系统。通过监测要消融的组织的阻抗来评估病变的透壁性。不是试图检测到期望的下降或期望的增加阻抗，而是响应于被测量的阻抗保持在稳定的电平，在期望的时间段（被称为阻抗平台）来检测损伤的完整性。当邻近这些单独的电极或电极对的组织中的损伤完成时，用于确定邻近各个电极或对的损伤的透壁性的机制可用于使单个电极或电极对失活，以产生沿电极线或基本均匀的病变电极对，而不管邻近各个电极或电极对的组织厚度的差异。

55. 发明授权

US06949097B2 Ablation catheter and method for isolating a pulmonary vein 失效
标题翻译：消融导管和隔离肺静脉的方法
公开(公告)号：US06949097B2
公开(公告)日：2005-09-27
申请号：US10414800
申请日：2003-04-16
申请人： Mark T. Stewart , William J. Flickinger , David E. Francischelli , Rahul Mehra , Xiaoyi Min
发明人： Mark T. Stewart , William J. Flickinger , David E. Francischelli , Rahul Mehra , Xiaoyi Min
IPC分类号： A61B17/00 , A61B18/14
CPC分类号： A61B18/1492 , A61B2017/00044 , A61B2017/00243 , A61B2017/00867 , A61B2018/00214 , A61B2018/1407 , A61B2018/1435
摘要： A catheter body of a catheter assembly includes a proximal portion, an intermediate portion extending from the proximal portion, a distal portion extending from the intermediate portion, and a locating device including a distal tip extending from the distal portion of the catheter body. The intermediate portion defines a longitudinal axis and the distal portion forms a loop including one or more loop segments formed around a central loop axis. The central loop axis is substantially parallel with the longitudinal axis and the one or more loop segments include at least one ablation electrode coupled thereto and adapted to create a lesion, the lesion electrically isolating a vessel from a chamber for treatment of a cardiac arrhythmia. The distal tip of the locating device is substantially parallel with the central loop axis.
摘要翻译：导管组件的导管主体包括近端部分，从近侧部分延伸的中间部分，从中间部分延伸的远侧部分和定位装置，该定位装置包括从导管主体的远端部分延伸的远侧末端。中间部分限定纵向轴线，并且远侧部分形成包括围绕中心环轴线形成的一个或多个环形部分的环。中心回路轴线基本上与纵向轴线平行，并且一个或多个环路段包括耦合到其上的适于产生病变的至少一个消融电极，所述损伤使血管与腔室电隔离以治疗心律失常。定位装置的远端基本上与中心环轴平行。

56. 发明授权

US06840091B1 Geophysical method for quantification of dense non-aqueous phase liquids in the subsurface 失效
标题翻译：用于定量地下致密非水相液体的地球物理方法
公开(公告)号：US06840091B1
公开(公告)日：2005-01-11
申请号：US10604240
申请日：2003-07-03
申请人： Mark T. Stewart
发明人： Mark T. Stewart
IPC分类号： E21B47/10 , G01N9/36 , G01N27/22 , G01N33/24 , E21B49/08
CPC分类号： G01N33/24 , E21B47/10 , G01N9/36 , G01N27/221
摘要： The present invention is a method of calculating non-aqueous phase liquid saturation in a soil sample including the steps of measuring the bulk dielectric constant of the sample, measuring the bulk density of the sample, estimating the bulk porosity of the sample from the measured bulk density and calculating the non-aqueous phase liquid saturation from the measured bulk dielectric constant and the estimated bulk porosity.
摘要翻译：本发明是一种在土壤样品中计算非水相液体饱和度的方法，包括以下步骤：测量样品的体积介电常数，测量样品的体积密度，从测量体积估计样品的体积孔隙度从测量的体介电常数和估计的体积孔隙度计算非水相液体饱和度。

57. 发明授权

US06755790B2 Transseptal access tissue thickness sensing dilator devices and methods for fabricating and using same 失效
标题翻译：经血管通路组织厚度感应扩张装置及其制造和使用方法
公开(公告)号：US06755790B2
公开(公告)日：2004-06-29
申请号：US10269768
申请日：2002-10-14
申请人： Mark T. Stewart , Harry A. Puryear
发明人： Mark T. Stewart , Harry A. Puryear
IPC分类号： A61B814
CPC分类号： A61B8/0883 , A61B5/1076 , A61B8/12 , A61B8/445 , A61B8/4472 , A61B18/1492 , A61B2017/00106 , A61B2018/00375 , A61B2090/062
摘要： The present invention relates to medical devices; in particular, the present invention provides devices and methods for sensing thickness of cardiac tissue and the like so that medical procedures may be efficiently performed through and/or upon a discrete location having suitable tissue thickness. The invention includes an elongated resilient dilator apparatus having an ultrasound transceiver coupled thereto. When the ultrasound transceiver is disposed proximate a region of relatively thin tissue, such as a latent Fossa Ovalis valve, a clinician receives a signal. The clinician may then proceed with enhanced confidence to pierce the relatively thin tissue. Thus, in the case of a transseptal procedure, the clinician gains access to the left atrial chamber from the right atrial chamber.
摘要翻译：本发明涉及医疗器械; 特别地，本发明提供用于感测心脏组织等的厚度的装置和方法，使得可以通过和/或在具有适当组织厚度的离散位置上有效地执行医学程序。本发明包括具有耦合到其上的超声波收发器的细长弹性扩张器装置。当超声收发器设置在相对薄的组织的区域附近时，例如潜在的Fossa Ovalis瓣膜时，临床医生接收信号。然后，临床医生可以进一步增强信心以刺穿相对薄的组织。因此，在经心脏手术的情况下，临床医生从右心房获得进入左心房。

58. 发明授权

US06702811B2 Ablation catheter assembly with radially decreasing helix and method of use 有权
标题翻译：消融导管组件具有径向减小的螺旋和使用方法
公开(公告)号：US06702811B2
公开(公告)日：2004-03-09
申请号：US09848555
申请日：2001-05-03
申请人： Mark T. Stewart , James R. Skarda
发明人： Mark T. Stewart , James R. Skarda
IPC分类号： A61B1814
CPC分类号： A61B18/1492 , A61B2017/00044 , A61B2017/00243 , A61B2017/00867 , A61B2018/00065 , A61B2018/00214 , A61B2018/00267 , A61B2018/00351 , A61B2018/00375 , A61B2018/00404 , A61B2018/00898 , A61B2018/1407 , A61B2018/1435 , A61B2018/1472
摘要： A catheter assembly for treatment of cardiac arrhythmia. The catheter assembly includes a catheter body and an ablative energy source. The catheter body includes a proximal portion, an intermediate portion, and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and includes an ablation section and a tip. The ablation section forms a loop defining a diameter greater than an outer dimension of a pulmonary vein ostium. The tip extends distally from the ablation section and is configured to locate a pulmonary vein. Finally, the ablative energy source is associated with the ablation section. With this configuration, upon activation of the energy source, the ablation section ablates a desired lesion pattern. In one preferred embodiment, the ablation section forms a distally decreasing radius helix, whereas the tip includes a relatively linear leader section. With this one preferred configuration, the tip readily locates a pulmonary vein and guides the ablation section to a seated relationship about a pulmonary vein ostium (or extra-ostial).
摘要翻译：用于治疗心律失常的导管组件。导管组件包括导管主体和消融能源。导管主体包括近端部分，中间部分和远端部分。中间部分从近端部分延伸并且限定纵向轴线。远侧部分从中间部分延伸并且包括消融部分和尖端。消融部分形成限定直径大于肺静脉口的外部尺寸的环。尖端从消融部分向远端延伸并且被配置为定位肺静脉。最后，烧蚀能源与消融部分相关联。利用这种配置，在激活能量源时，消融部分消除所需的损伤模式。在一个优选实施例中，消融部分形成远端减小的半径螺旋，而尖端包括相对线性的引导部分。利用这一优选的构造，尖端容易地定位肺静脉，并将消融部分引导到关于肺静脉口（或口外）的就座关系。

59. 发明授权

US06663627B2 Ablation system and method of use 有权
公开(公告)号：US06663627B2
公开(公告)日：2003-12-16
申请号：US10132392
申请日：2002-04-24
申请人： David E. Francischelli , Eduardo N. Warman , Rahul Mehra , Mark T. Stewart , James R. Skarda , Harry Puryear , David Schwartzman
发明人： David E. Francischelli , Eduardo N. Warman , Rahul Mehra , Mark T. Stewart , James R. Skarda , Harry Puryear , David Schwartzman
IPC分类号： A61B1818
CPC分类号： A61B18/1445 , A61B5/04 , A61B18/12 , A61B2018/00065 , A61B2018/00363 , A61B2018/00577 , A61B2018/00654 , A61B2018/00702 , A61B2018/00755 , A61B2018/00779 , A61B2018/00791 , A61B2018/00839 , A61B2018/00875 , A61B2018/1226 , A61B2018/1253 , A61B2018/126 , A61B2018/1467 , A61B2018/1472 , A61B2218/002 , A61N1/403
摘要： A system and method for creating lesions and assessing their completeness or transmurality. Assessment of transmurality of a lesion is accomplished by monitoring the depolarization signal amplitude in a local electrogram taken using electrodes located adjacent the tissue to be ablated. Following onset of application of ablation energy to heart tissue, the amplitude of a local electrogram measured with electrodes located adjacent tissue to be ablated first gradually drops and then stabilizes, indicating that the tissue being monitored has ceased making any contribution to the sensed electrogram. The amplitude drop and/or the following amplitude plateau may be used alone or together as indicators of transmurality. Detection of a rapid drop in amplitude may be employed as an indicator that the ablation process is proceeding too quickly and may be employed to trigger a reduction in the power of applied ablation energy. Detection of an insufficiently rapid drop in amplitude may be employed as an indicator that the ablation process is proceeding too slowly and may be employed to trigger an increase in the power of applied ablation energy.

60. 发明授权

US06372283B1 Plasma process for surface modification of pyrolitic carbon 失效
标题翻译：用于表面改性热解碳的等离子体工艺
公开(公告)号：US06372283B1
公开(公告)日：2002-04-16
申请号：US09285953
申请日：1999-04-02
申请人： Hong S. Shim , Mark C. S. Shu , David L. Miller , Edward Di Domenico , Catherine E. Taylor , Kenneth Keeney , Mark T. Stewart , Eileen L. Halverson
发明人： Hong S. Shim , Mark C. S. Shu , David L. Miller , Edward Di Domenico , Catherine E. Taylor , Kenneth Keeney , Mark T. Stewart , Eileen L. Halverson
IPC分类号： B05D306
CPC分类号： A61L33/0088 , A61F2/24 , A61L27/34 , A61L33/0094 , B05D1/62
摘要： The present invention provides a method for modifying a pyrolytic carbon surface to improve adhesion between it and a subsequently added polymer and/or a bio-active compound. In particular, plasma depositing an oxygen-containing, silicon-containing film forming monomer on a pyrolytic carbon surface improves adhesion of a polymer thereto, wherein the modified pyrolytic carbon surface and silicone rubber has a wet adhesion peel force greater than the wet adhesion peel force between an unmodified pyrolytic carbon and silicone rubber as measured by ASTM D 903-49 after 28 days in an aqueous environment, typically, at least 10 times greater.
摘要翻译：本发明提供了一种改性热解碳表面以改善其与随后加入的聚合物和/或生物活性化合物之间的粘合性的方法。特别地，在热解碳表面上等离子体沉积含氧的含硅膜形成单体改善了聚合物对其的粘合性，其中改性热解碳表面和硅橡胶具有大于湿粘合剥离力的湿粘合剥离力在未经改性的热解碳和硅橡胶之间，在水性环境中28天后通过ASTM D 903-49测量，通常为至少10倍以上。

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