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    • 81. 发明授权
    • System and method for determining tissue contact of an implantable medical device within a body
    • 用于确定体内可植入医疗装置的组织接触的系统和方法
    • US06714806B2
    • 2004-03-30
    • US09952869
    • 2001-09-14
    • Paul A. IaizzoTimothy G. LaskeWoohyek Choi
    • Paul A. IaizzoTimothy G. LaskeWoohyek Choi
    • A61B504
    • A61B5/053A61B5/05A61N1/056A61N1/0573
    • An improved system for monitoring the status of an IMD such as a medical electrical lead during an implant procedure is provided. The system includes a signal generator for supplying a first signal such as a constant current or voltage to the IMD. A resulting voltage or current signal is generated, respectively, and may be sensed as an indication of the impedance of a portion of the body that is proximal to one or more electrodes carried by the lead. This impedance indication is converted to an audible signal having a frequency that is proportional to the amplitude of the impedance indication. The pitch of the audible signal therefore rises when measured impedance increases, and drops as the impedance decreases. These pitch changes allow a user to determine positional information associated with the IMD, including the degree of lead tissue contact and extent of fixation of a device to tissue.
    • 提供了一种改进的系统,用于在植入过程期间监视诸如医疗电线之类的IMD的状态。 该系统包括用于向IMD提供诸如恒定电流或电压的第一信号的信号发生器。 分别产生所得到的电压或电流信号,并且可以将其感测为身体接近于由引线承载的一个或多个电极的部分的阻抗的指示。 该阻抗指示被转换成具有与阻抗指示的幅度成比例的频率的可听信号。 因此,当测量的阻抗增加时,听觉信号的音调会上升,并随着阻抗的降低而下降。 这些间距变化允许用户确定与IMD相关联的位置信息,包括铅组织接触的程度和装置固定到组织的程度。
    • 82. 发明授权
    • Method and apparatus for providing intra-pericardial access
    • 用于提供心包内通路的方法和装置
    • US06613062B1
    • 2003-09-02
    • US09430096
    • 1999-10-29
    • Michael E. LeckroneTimothy G. LaskeMichael Ujhelyi
    • Michael E. LeckroneTimothy G. LaskeMichael Ujhelyi
    • A61B1732
    • A61B17/3478A61B17/3417A61B18/1492A61B2017/00247A61B2017/22077A61B2017/3443A61B2017/3484A61B2017/3488A61B2017/349A61B2018/00291A61B2018/00357A61B2018/00392
    • A method and apparatus for accessing the pericardial space which provides for stable short term or long term placement of a delivery catheter or cannula having its distal most end located in the pericardial space. The catheter or cannula may be introduced into the pericardial space either transvenously through the wall of a heart chamber or transthoracically by penetrating the chest wall and the pericardium. Some embodiments are provided with a mechanism for stabilizing the distal end of the catheter or cannula, which mechanism may employ an extensible elastic, generally tubular member located at the distal end of the catheter or cannula. The device may be provided with a mechanism for extending the tubular member longitudinally, causing its diameter to diminish substantially. The tubular member may be passed through the wall of the heart or the pericardium in its extended configuration and thereafter, the distal-most portion of the tubular member may be moved proximally, causing its diameter enlarge, anchoring the distal end of the catheter or cannula to the pericardium or to the wall of a heart chamber. In these embodiments, the device is preferably provided with a shoulder or flange located proximal to the extendible tubular member, for location on the opposite side of the heart wall or pericardium from the distal end of the catheter or cannula.
    • 一种用于进入心包空间的方法和装置,其提供其最远端位于心包空间中的输送导管或插管的稳定的短期或长期放置。 导管或插管可以通过穿透胸壁和心包而经心脏穿过心室的壁或经胸腔引入心包空间。 一些实施例设置有用于稳定导管或插管的远端的机构,该机构可以使用位于导管或插管的远端处的可伸展的弹性大体管状构件。 该装置可以设置有用于纵向延伸管状构件的机构,从而使其直径基本上减小。 管状构件可以以其延伸构型穿过心脏壁或心包,此后,管状构件的最远端部分可向近侧移动,导致其直径增大,将导管或插管的远端固定 到心包室或心室的壁。 在这些实施例中,装置优选地设置有位于可伸缩管状构件的近侧的肩部或凸缘,用于位于与导管或插管远端的心脏壁或心包相反的一侧。
    • 83. 发明授权
    • Introducer system
    • 介绍系统
    • US06280433B1
    • 2001-08-28
    • US09392715
    • 1999-09-09
    • Michael E. McIvorKenneth C. GardeskiPedro A. MeregotteMathew D. BonnerTimothy G. LaskeLinda L. Lach
    • Michael E. McIvorKenneth C. GardeskiPedro A. MeregotteMathew D. BonnerTimothy G. LaskeLinda L. Lach
    • A61M2500
    • A61M25/0668A61M25/01A61M2025/0675
    • An introducer or guide catheter for directing an implantable medical device such as a lead or catheter to a desired location within a patient's body. In one embodiment of the invention, the introducer comprises a two-lumen tube. A first lumen is configured to receive the implantable medical device that is to be introduced. A second lumen is provided to receive an insertable, elongated guiding member such as a stylet, which may be shapable in various orientations, and which may be used to alter the configuration of the introducer. The second lumen may be provided with an internal coil or other tubular reinforcement member to prevent perforation of this lumen by the guiding member when the introducer is in the patient's body. In order to facilitate removal of the introducer over an implantable medical device having a connector or fitting that is larger than the internal diameter of the first lumen, the introducer may be adapted to be slit or split along its length. In some embodiments of the invention, the introducer may be rendered splittable by provision of a weakened zone along its length. According to yet another aspect of the invention, the introducer may be provided with a luer lock at its proximal end to facilitate connection of the introducer to a hemostasis valve, t-fitting, or the like.
    • 导引器或引导导管,用于将诸如引线或导管的可植入医疗装置引导到患者体内的期望位置。 在本发明的一个实施例中,导引器包括两腔管。 第一管腔被配置为接收待引入的可植入医疗装置。 提供第二内腔以接收可插入的细长引导构件,例如探针,其可以以各种取向成形,并且其可以用于改变导引器的构造。 第二内腔可以设置有内部线圈或其他管状加强构件,以在导引器位于患者体内时防止引导构件对该内腔穿孔。 为了便于在具有大于第一内腔的内径的连接器或配件的可植入医疗装置上移除导引器,导引器可以适于沿着其长度被切割或分开。 在本发明的一些实施例中,导引器可以通过沿着其长度提供弱化区域而被分解。 根据本发明的另一方面,导引器在其近端可以设置有鲁尔锁,以便于将导引器连接到止血阀,t形配件等。
    • 84. 发明授权
    • Introducer with external hemostasis clip
    • 介绍与外部止血夹
    • US06213988B1
    • 2001-04-10
    • US09021558
    • 1998-02-10
    • Michael E. McIvorMary M. MorrisJudith BetzTimothy G. Laske
    • Michael E. McIvorMary M. MorrisJudith BetzTimothy G. Laske
    • A61M500
    • A61M25/0662A61M25/01
    • An introducer of the type employing an elongated introducer sleeve for receiving a catheter or lead body and an associated hemostasis clamp including a clamping member configured to engage the outer circumference of the introducer sleeve. The clamp is provided with a mechanism for maintaining the clamping member in engagement with said outer circumference of the sleeve to compress the outer circumference of the sleeve around a catheter or lead body inserted therethrough. In some embodiments the clamp takes the form of a hinged clamp provided with two jaws each having a recess adapted to engage a portion of the other circumference of the introducer sleeve. In other embodiments the clamp takes the form of interacting ramped members. The clamp is maintained in engagement with the sleeve either resiliently or by means of a latch.
    • 一种引入器,其采用细长导引器套筒,用于接纳导管或引线体,以及相关联的止血钳,其包括构造成接合引导器套筒的外圆周的夹紧构件。 夹具设置有用于将夹紧构件保持与套筒的外周接合的机构,以将套筒的外周压缩成插入其中的导管或引线体。 在一些实施例中,夹具采取铰链夹具的形式,其设置有两个钳口,每个钳口具有适于接合导引套筒的另一个圆周的一部分的凹部。 在其他实施例中,夹具采取相互作用的倾斜构件的形式。 夹具可以弹性地或通过闩锁保持与套筒接合。