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    • 75. 发明授权
    • Surgical instruments for making precise incisions in a cardiac vessel
    • 用于在心脏血管中进行精确切口的手术器械
    • US5776154A
    • 1998-07-07
    • US603329
    • 1996-02-20
    • Charles S. TaylorJohn J. FrantzenIvan Sepetka
    • Charles S. TaylorJohn J. FrantzenIvan Sepetka
    • A61B17/00A61B17/28A61B17/32
    • A61B17/32A61B17/320016A61B2017/00243A61B2017/00703A61B2017/00778A61B2017/2925A61B2017/320052
    • Surgical instruments and methods for making substantially linear incisions, especially through the wall of vessels, such as arteries, specifically designed for coronary artery bypass graft procedures (CABG) on the beating heart. The invention is particularly useful to create the incision in the artery to which a bypass graft is sewn, typically the left anterior descending artery (LAD). The instruments allow incisions to be rapidly made, precisely measured, and cleanly formed so that a bypass graft can be rapidly sewn in place, without undue trauma to surrounding tissue and excessive loss of blood. In one embodiment, a hand-held instrument has a cutting edge formed on the interior edge of a curved blade fixed near the end of the instrument. The tip of the blade has a point for penetrating the vessel wall which may have several alternate shapes to facilitate penetration of the vessel wall while minimizing trauma to the surrounding tissue. In another embodiment the hand-held instrument includes a moveable member which creates an incision by engaging a cutting blade against a stop, cutting tissue therebetween, the stop including a pointed tip similar to the previous embodiment. In another embodiment, the instrument features a motion-canceling member which compensates for the movement of the target surface to be incised. This embodiment has a cutting blade which is manipulated from a handle which is isolated from the movement of the tissue containing or proximate to the target of the incision.
    • 用于进行基本上线性切口的手术器械和方法,特别是通过专门设计用于搏动心脏上的冠状动脉旁路移植手术(CABG)的诸如动脉的血管壁。 本发明特别有用于在缝合旁路移植物的动脉中产生切口,通常为左前降支动脉(LAD)。 这些仪器允许快速地进行切割,精确测量和清洁地形成,使得旁路移植物可以快速缝合就位,而不会对周围组织造成过度的创伤和过度的血液损失。 在一个实施例中,手持式仪器具有形成在靠近仪器端部的弯曲刀片的内边缘上的切割刃。 叶片的尖端具有穿透血管壁的点,该点可以具有若干替代形状,以促进血管壁的穿透,同时最小化对周围组织的创伤。 在另一个实施例中,手持式仪器包括可移动构件,其通过将切割刀片接合止挡件而形成切口,在其间切割组织,止动件包括类似于先前实施例的尖端。 在另一个实施例中,仪器具有补偿待切割的目标表面的移动的运动消除构件。 该实施例具有从手柄操纵的切割刀片,该手柄与包含或接近切口目标的组织的运动隔离。
    • 77. 发明授权
    • Microballoon catheter
    • 微血管导管
    • US5429605A
    • 1995-07-04
    • US188382
    • 1994-01-26
    • Richling: BerndIvan SepetkaUriel H. CheeLiem HoPhong Pham
    • Richling: BerndIvan SepetkaUriel H. CheeLiem HoPhong Pham
    • A61M25/00A61F2/958A61M29/00
    • A61M25/1006A61M25/0054A61M25/1025
    • This invention is a microballoon tipped catheter. The catheter has a shaft which is of varying flexibility with the most flexible portion towards the distal tip. The balloon, located near the distal tip of the catheter, is typically of an elastic material, is quite flexible in its own right when deflated, and is quite small. The catheter shaft has a main lumen extending from the proximal end to the distal end so to allow the use of a guidewire in placing the catheter's distal tip in remote regions of the vasculature and for delivery of drugs, diagnostics, and other biologics to those regions. The catheter shaft has a wall that desirably is of a multilayer construction. The wall preferably includes an independent lumen, which may be formed from a small diameter tubing that is placed between layers of the wall, for the inflation and deflation of the microballoon. The inflation lumen proceeds from the proximal end of the catheter and terminates near the distal end of the catheter but within the microballoon. This catheter is especially useful in treating disease within the high pressure vessels of the brain with drugs or other therapeutic agents and permits temporary blockage of blood flow and thereby allow better absorption of those active agents.
    • 本发明是一种微气囊导管。 该导管具有一个具有不同柔性的轴,朝向远侧末端具有最柔韧的部分。 位于导管远侧末端附近的气囊通常是弹性材料,当放气时本身是相当灵活的,并且相当小。 导管轴具有从近端延伸到远端的主腔,以便允许使用导丝将导管的远侧末端放置在脉管系统的偏远区域中并用于将药物,诊断和其它生物制剂递送至那些区域 。 导管轴具有期望地具有多层结构的壁。 壁优选地包括独立的内腔,其可以由放置在壁的层之间的小直径管形成,用于微气泡的充气和放气。 膨胀腔从导管的近端延伸,并在导管的远端附近终止,但在微球内。 该导管特别适用于用药物或其它治疗剂治疗脑高压血管内的疾病,并允许临时阻塞血流,从而允许更好地吸收那些活性剂。
    • 78. 发明授权
    • Catheter with low-friction distal segment
    • 导管与低摩擦远端段
    • US5312356A
    • 1994-05-17
    • US527200
    • 1990-05-22
    • Erik T. EngelsonIvan Sepetka
    • Erik T. EngelsonIvan Sepetka
    • A61M25/00A61M25/01A61M25/09A61M5/178A61M5/32
    • A61M25/01A61M25/0052A61M25/0054A61M2025/0046A61M2025/0047A61M2025/09091A61M25/0012A61M25/0053A61M25/09
    • A catheter for accessing a target site along a tortuous, small-vessel pathway. The catheter includes a flexible distal segment which is composed of a flexible polymer tube and a low-friction internal tubular surface. The surface allows the catheter to be advanced over sharp bends and small-diameter loops in a guidewire, in advancing the catheter along a small-vessel pathway. Various embodiments of the catheter are disclosed wherein the internal tubular surface of a distal portion of the catheter include a variety of different constructions and are comprised of a variety of different materials so as to best avoid the jamming, sticking or locking of the distal end or any part of the guidewire against the surface. Braided sleeve-like constructions, surfaces embedded with a plurality of small particles and surfaces comprised of various anti-friction materials are used in order to obtain the object of the invention.
    • 用于沿着曲折的小血管途径进入目标部位的导管。 导管包括柔性远端段,其由柔性聚合物管和低摩擦内部管状表面组成。 表面允许导管在导丝中的尖锐弯曲和小直径环上前进,沿着小血管通路推进导管。 公开了导管的各种实施例,其中导管的远端部分的内部管状表面包括各种不同的结构,并且由各种不同的材料组成,以便最好地避免远端的卡住,粘附或锁定 导丝的任何部分抵靠表面。 为了获得本发明的目的,使用编织的套筒状结构,嵌入多个小颗粒的表面和由各种抗摩擦材料组成的表面。