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61. 发明授权

US06985771B2 Rapid response system for the detection and treatment of cardiac events 有权
公开(公告)号：US06985771B2
公开(公告)日：2006-01-10
申请号：US10051743
申请日：2002-01-22
申请人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
发明人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
IPC分类号： A61B5/04
CPC分类号： A61B5/6865 , A61B5/0006 , A61B5/0031 , A61B5/0452 , A61B5/076 , A61B5/1112 , A61B5/4839 , A61B2505/01 , A61B2560/0462 , A61B2562/0209 , A61M39/0208 , A61M2025/0076 , A61M2039/0226 , A61M2205/18 , A61M2205/3523 , A61M2205/3584 , A61M2230/04
摘要： Disclosed is a system for detecting an acute myocardial infarction (i.e., a heart attack) at the earliest possible time and promptly warning the patient that he should immediately seek medical care. The present invention includes an implantable electronic system that can sense a change in the patient's electrogram that is indicative of a heart attack. If a heart attack is sensed, the device would then cause an implantable and/or externally located alarm to be actuated to warn the patient of his condition and a medical practitioner at a remote diagnostic center would receive the patient's electrogram for analysis. The patient or a caretaker would then be informed to self-inject medication through a subcutaneous, pass-through drug port that can be a separate device or integrated into the implanted device that is designed for the early detection of a heart attack. Since an implantable heart pacemaker or defibrillator already has within its structure many of the elements required for the device to recognize a heart attack, it would be expeditious to add a capability to these existing devices to detect a heart attack, have a pass-through drug port and provide an implantable and/or external alarm means to inform the patient to take appropriate action.

62. 发明授权

US06540775B1 Ultraflexible open cell stent 有权
标题翻译：超柔性混合支架
公开(公告)号：US06540775B1
公开(公告)日：2003-04-01
申请号：US09607980
申请日：2000-06-30
申请人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
发明人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
IPC分类号： A61F206
CPC分类号： A61F2/915 , A61F2/91 , A61F2002/91508 , A61F2002/91516 , A61F2002/91525 , A61F2002/91533 , A61F2002/91541 , A61F2002/91558 , A61F2002/91575 , A61F2002/91583
摘要： Disclosed is an open cell stent that has adjacent sets of circumferential struts connected by means of highly flexible, undulating, connecting struts. To decrease outward flaring of the circumferential struts when the pre-deployed stent is advanced through highly curved vessels, each unconnected strut of the sets of circumferential struts has a decreased longitudinal length as compared to the longitudinal length of the circumferential struts that are connected by the flexible connecting struts. To decrease the propensity for outward flaring of the end set of circumferential struts, the longitudinal length of the end set of circumferential struts is shorter than the longitudinal length of the interior set of circumferential struts. Also, the attachment point of the flexible connecting struts is off the center of the curved sections of the circumferential struts, thus also decreasing the tendency for outward flaring of the end set of circumferential struts.
摘要翻译：公开了一种开放式细胞支架，其具有通过高度柔性，起伏的连接支柱连接的相邻的一组周向支柱。当预先展开的支架通过高度弯曲的容器前进时，为了减小周向支柱的向外的扩张，与通过所述外周支柱连接的周向支柱的纵向长度相比，该组周向支柱的每个未连接的支柱具有减小的纵向长度柔性连接支柱。为了减小圆周支柱的端部组件向外扩张的倾向，圆周支柱的端部组件的纵向长度短于内部组件的周向支柱的纵向长度。此外，柔性连接支柱的附接点离开圆周支柱的弯曲部分的中心，因此也降低了圆周支柱端部组件向外扩张的趋势。

63. 发明授权

US06534693B2 Surgically implanted devices having reduced scar tissue formation 有权
公开(公告)号：US06534693B2
公开(公告)日：2003-03-18
申请号：US09772693
申请日：2001-01-31
申请人： Robert E. Fischell , David R. Fischell , Tim A. Fischell , Scott J. S. Fischell
发明人： Robert E. Fischell , David R. Fischell , Tim A. Fischell , Scott J. S. Fischell
IPC分类号： A61F1300
CPC分类号： A61L27/54 , A61B17/06166 , A61B17/064 , A61B2017/00831 , A61F2/0063 , A61F2013/00451 , A61L15/44 , A61L31/16 , A61L2300/416 , A61L2300/424 , A61L2300/602 , A61L2300/604 , A61L2300/622 , A61L2300/626
摘要： This invention is an anti-proliferative drug placed onto or within a sterile sheet or mesh that is designed to be placed between internal body tissues to prevent the formation of post-operative adhesions, which adhesions are really scar tissue formation. This mesh or gauze onto or into which the drug is placed may be either a permanent implant or it may be biodegradable. By impregnating an existing product such as the Johnson & Johnson SURGICEL™ absorbable hemostat gauze-like sheet with an anti-proliferative drug such as Rapamycin or Taxol, the biodegradable, drug impregnated mesh would act as a barrier to cell proliferation and hence be a deterrent to the formation of adhesions. Another embodiment of this invention is an anti-proliferative drug attached to a bandage that is placed onto a cut in the skin to decrease scar tissue formation. Still another embodiment of the invention is an anti-proliferative drug that is attached to a surgical suture or coated onto a surgical staple both of which are used for connecting human tissues. The suture or staple then being more capable for decreasing cellular proliferation where the suture or staple material passes through the human tissue.

64. 发明授权

US5910145A Stent delivery catheter system 失效
公开(公告)号：US5910145A
公开(公告)日：1999-06-08
申请号：US66852
申请日：1998-04-28
申请人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
发明人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
IPC分类号： A61F2/82 , A61F2/06 , A61F2/84 , A61F11/00
CPC分类号： A61F2/958
摘要： The present invention is a stent delivery catheter system for placing a stent within a stenosis in a vessel of a human body. The stent delivery catheter system utilizes a slideable sheath with a thin-walled distal portion that is situated coaxially over a stent that is placed onto a balloon located at the distal portion of a balloon angioplasty catheter. The distal end of a central portion of the sheath has an interior shoulder which is capable of exerting a distally directed push force on the balloon angioplasty catheter at a point that is just proximal to the stent. This push force is then transferred through the non-deployed stent to a gradually tapered, highly flexible, lubricity coated distal tip of the balloon angioplasty catheter. The structure of a continuous outer surface extending backward from the distal tip and onto the distal section of the sheath, plus the lubricity coating of the outer surfaces of the distal tip and the sheath, plus the increased stent delivery catheter system pushability provided by the sheath and the stent itself makes it possible for the stent delivery catheter system to be pushed through even very tight stenoses.

65. 发明授权

US5879370A Stent having a multiplicity of undulating longitudinals 失效
标题翻译：支架有多个起伏的纵骨
公开(公告)号：US5879370A
公开(公告)日：1999-03-09
申请号：US864221
申请日：1997-05-28
申请人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
发明人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
IPC分类号： A61F2/00 , A61F2/82 , A61F2/90 , A61M29/00
CPC分类号： A61F2/844 , A61F2/90 , A61F2/91 , A61F2/915 , A61F2002/825 , A61F2002/91533 , A61F2002/9155 , A61F2210/0019
摘要： The present invention provides for an expandable stent (10 or 20) for use in an artery or other vessel of a human body. The stent structure (10 or 20) maintains the patency of the vessel within which the stent (10 or 20) is expanded radially outward. One embodiment of the present invention is a stent (10) having a multiplicity of frames (12) joined together by at least two undulating longitudinal structures (14L and 14R) which can readily change their length in the longitudinal direction so as to provide increased longitudinal flexibility for the stent (10) for easy passage through and placement within a curved vessel such as a coronary artery. The stent (20) is an embodiment of the present invention having frames (22) joined with longitudinal structures (24B, 24T and 24R) and formed from a single, thin-walled piece of metal by means of laser cutting or chemical etching. Because the stent (20) is fabricated from a single piece of metal, it provides a multiplicity of closed perimeter cells that are formed as a continuous metal structure.
摘要翻译：本发明提供一种用于人体动脉或其他血管的可扩张支架（10或20）。支架结构（10或20）保持支架（10或20）径向向外扩张的容器的通畅性。本发明的一个实施例是具有通过至少两个起伏的纵向结构（14L和14R）连接在一起的多个框架（12）的支架（10），其可以容易地改变其在纵向上的长度，从而提供增加的纵向支架（10）的灵活性容易通过并放置在诸如冠状动脉的弯曲容器内。支架（20）是本发明的实施例，其具有通过激光切割或化学蚀刻由单个薄壁金属片形成的具有纵向结构（24B，24T和24R）的框架（22）。因为支架（20）由单块金属制成，所以它提供了多个形成为连续金属结构的封闭周边细胞。

66. 发明授权

US5792144A Stent delivery catheter system 失效
公开(公告)号：US5792144A
公开(公告)日：1998-08-11
申请号：US828662
申请日：1997-03-31
申请人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
发明人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
IPC分类号： A61F2/82 , A61F2/06 , A61F2/84 , A61M29/00
CPC分类号： A61F2/958
摘要： The present invention is a stent delivery catheter system for placing a stent within a stenosis in a vessel of a human body. The stent delivery catheter system utilizes a slideable sheath with a thin-walled distal portion that is situated coaxially over a stent that is placed onto a balloon located at the distal portion of a balloon angioplasty catheter. The distal end of a central portion of the sheath has an interior shoulder which is capable of exerting a distally directed push force on the balloon angioplasty catheter at a point that is just proximal to the stent. This push force is then transferred through the non-deployed stent to a gradually tapered, highly flexible, lubricity coated distal tip of the balloon angioplasty catheter. The structure of a continuous outer surface extending backward from the distal tip and onto the distal section of the sheath, plus the lubricity coating of the outer surfaces of the distal tip and the sheath, plus the increased stent delivery catheter system pushability provided by the sheath and the stent itself makes it possible for the stent delivery catheter system to be pushed through even very tight stenoses.

67. 发明授权

US5639274A Integrated catheter system for balloon angioplasty and stent delivery 失效
标题翻译：用于球囊血管成形术和支架输送的集成导管系统
公开(公告)号：US5639274A
公开(公告)日：1997-06-17
申请号：US458471
申请日：1995-06-02
申请人： Robert E. Fischell , Tim A. Fischell , David R. Fischell
发明人： Robert E. Fischell , Tim A. Fischell , David R. Fischell
IPC分类号： A61F2/06 , A61F2/84 , A61M25/10 , A61M29/00
CPC分类号： A61F2/958 , A61M2025/0183 , A61M25/10
摘要： This invention is directed to an integrated catheter system (60) including a stent catheter (65) and a balloon angioplasty catheter (20). The balloon angioplasty catheter (20) has an inflatable balloon (23) mounted near the catheter's distal end which is initially used for dilation of a vessel at a low balloon pressure to partially inflate the balloon (23). The stent catheter (65) contains a stent (15) within a stent containment cavity (69) and the stent (15) is displaced over the balloon (23). The stent (15) is held in place over the partially inflated balloon (23) and an outer tube (62) of the stent catheter (65) is pulled back. The stent (15) is deployed and the balloon (23) is reinflated to a higher pressure to embed the stent (15) into the wall of the vessel.
摘要翻译：本发明涉及一种包括支架导管（65）和球囊血管成形术导管（20）的集成导管系统（60）。球囊血管成形术导管（20）具有安装在导管远端附近的可膨胀气球（23），其最初用于在低气囊压力下扩张容器以部分地使气囊（23）膨胀。支架导管（65）在支架容纳腔（69）内包含支架（15），支架（15）在气囊（23）上移位。将支架（15）保持在部分充气的球囊（23）上的适当位置，支架导管（65）的外管（62）被拉回。支架（15）展开，并且气球（23）被再次膨胀到更高的压力以将支架（15）嵌入容器的壁中。

68. 发明授权

US5492530A Method for accessing the coronary arteries from the radial or brachial artery in the arm 失效
标题翻译：从手臂的桡动脉或肱动脉进入冠状动脉的方法
公开(公告)号：US5492530A
公开(公告)日：1996-02-20
申请号：US384277
申请日：1995-02-02
申请人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
发明人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
IPC分类号： A61M25/06 , A61M25/088 , A61M31/00
CPC分类号： A61M25/0662
摘要： The present invention is a method for using an improved guiding catheter that eliminates the need for an introducer sheath or a separate Tuohy-Borst "Y" adaptor, thus reducing the time and expense for performing artery opening procedures. Furthermore, the guiding catheter with straightening dilator as described herein allows the hole in the wall of the femoral artery in the groin, or even more advantageously, the radial artery in the arm to be approximately 2 French sizes smaller in diameter as compared to the hole that would be created if an introducer sheath is also used. The advantages of the present invention are accomplished by utilizing a guiding catheter with a dilator that has a stiffened and/or curved distal section that can be used to straighten the distal section of the guiding catheter as it is advanced through the arterial system. The guiding catheter plus dilator can then be used in a manner similar to an introducer sheath to percutaneously enter the artery by being advanced over a previously placed guide wire. Once the distal ends of the dilator and the guiding catheter are placed near the ostium of the coronary artery, the dilator and guide wire are withdrawn which allows the guiding catheter to assume its normal bent shape (e.g., a Judkin's bend) near its distal end. The cardiologist can then, by well known techniques, place the guiding catheter's distal end in the ostium of a coronary artery. Any of several well known procedures can then be performed including angiography, balloon angioplasty, atherectomy or stent placement.
摘要翻译：本发明是一种使用改进的引导导管的方法，其不需要导引鞘或单独的Tuohy-Borst“Y”适配器，因此减少了执行动脉开放程序的时间和费用。此外，如本文所述的具有矫直扩张器的引导导管允许在腹股沟的股动脉壁中的孔，或甚至更有利地，臂中的桡动脉与孔相比为直径更小的约2个法国尺寸如果还使用导引鞘，将会产生这种情况。本发明的优点是通过利用具有扩张器的引导导管实现的，所述扩张器具有加强和/或弯曲的远端部分，该远端部分可用于在引导导管的远端部分通过动脉系统前进时拉直。引导导管加扩张器然后可以以类似于导引鞘的方式使用，以通过在先前放置的导丝上推进来经皮进入动脉。一旦扩张器和引导导管的远端放置在冠状动脉的口处附近，扩张器和引导线被拉出，允许引导导管在其远端附近呈现其正常的弯曲形状（例如，Judkin的弯曲）。然后，通过众所周知的技术，心脏病专家将引导导管的远端放置在冠状动脉的口中。然后可以执行几种众所周知的方法中的任何一种，包括血管造影，球囊血管成形术，粥样斑块切除术或支架放置。

69. 发明授权

US5295969A Vascular access device with air-tight blood containment capability 失效
标题翻译：具有气密血液容纳能力的血管通路装置
公开(公告)号：US5295969A
公开(公告)日：1994-03-22
申请号：US874366
申请日：1992-04-27
申请人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
发明人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
IPC分类号： A61M25/02 , A61M25/06 , A61M39/06 , A61M5/178
CPC分类号： A61M25/0693 , A61M39/0606 , A61M2039/062 , A61M2039/0633 , A61M2039/0666 , Y10S604/90
摘要： The present invention is a means for accessing blood vessels for the insertion of a guide wire while preventing the free release of blood. Specifically, a hollow, thin-walled metal tube typically having a sharp point at its distal end is joined at its proximal end to a transparent viewing section. The viewing section has a distal narrow lumen and a proximal chamber which has a cap at its proximal end. The cap encloses a pressure sealing means through which a guide wire can be passed. After the distal end of the metal tube is placed in an artery, blood will rush through the metal tube and into the viewing section. The air in the air-tight proximal chamber will alternatively be compressed between diastolic and systolic blood pressure. Feedback to the operator that the distal end of the metal tube is properly placed within an artery can be achieved by observing the reciprocating pulsatile motion of the blood column within the distal narrow lumen of the viewing section. When the proper pulsatile motion is observed, a guide wire can be passed through the sealing means in the cap, through the viewing section, through the metal tube and finally the guide wire will enter the lumen of the artery.
摘要翻译：本发明是一种用于在防止血液自由释放的同时插入导丝的血管。具体来说，通常在其远端具有尖锐点的中空薄壁金属管在其近端处连接到透明观察部分。观察部分具有远端狭窄的管腔和近端腔室，其近端具有帽盖。盖子包围压力密封装置，引导线可以通过该压力密封装置通过。在金属管的远端放置在动脉中之后，血液将通过金属管冲入观察部分。空气密封近端腔室中的空气可以在舒张压和收缩压之间被压缩。通过观察在观察部分的远端狭窄管腔内的血柱的往复式脉动运动，可以对操作者反馈金属管的远端适当地放置在动脉内。当观察到适当的脉动运动时，导丝可以穿过盖中的密封装置，通过观察部分穿过金属管，最后引导线将进入动脉的内腔。

70. 发明申请

US20190117936A9 INTRAVASCULAR FLUID CATHETER WITH MINIMAL INTERNAL FLUID VOLUME 审中-公开
公开(公告)号：US20190117936A9
公开(公告)日：2019-04-25
申请号：US13643065
申请日：2012-08-22
申请人： David R. Fischell , Tim A. Fischell
发明人： David R. Fischell , Tim A. Fischell
IPC分类号： A61M25/00 , A61M25/06 , A61M25/01
摘要： A catheter-based/intravascular ablation (denervation) system includes a multiplicity of needles which expand open around a central axis to engage the wall of a blood vessel, or the wall of the left atrium, allowing the injection of a cytotoxic or/or neurotoxic solution for ablating conducting tissue, or nerve fibers around the ostium of the pulmonary vein, or circumferentially in or just beyond the outer layer of the renal artery. The expandable needle delivery system is formed with self-expanding materials and include structures, near the end portion of the needles, or using separate guide tubes. The system also includes means to limit and/or adjust the depth of penetration of the ablative fluid into the tissue of the wall of the targeted blood vessel. The preferred embodiment of the catheter delivered through the vascular system of a patient includes a multiplicity of expandable guide tubes that engage the wall of a blood vessel. Injection needles having injection egress at or near their sharpened distal end are then advanced through the guide tubes to penetrate the wall of the blood vessel to a prescribed depth. The ability to provide PeriVascular injection so as to only affect the outer layer(s) of a blood vessel without affecting the media has particular application for PeriVascular Renal Denervation (PVRD) of the sympathetic nerves which lie in the adventitia or outside the adventitia of the renal artery.

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