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1. 发明授权

US6152918A Laser device with auto-piercing tip for myocardial revascularization procedures 失效
标题翻译：具有自动穿刺尖端的激光装置用于心肌血运重建手术
公开(公告)号：US6152918A
公开(公告)日：2000-11-28
申请号：US58387
申请日：1998-04-09
申请人： Henry N. Padilla , Richard L. Mueller , Stuart D. Harman
发明人： Henry N. Padilla , Richard L. Mueller , Stuart D. Harman
IPC分类号： A61B1/018 , A61B1/267 , A61B1/313 , A61B17/00 , A61B17/22 , A61B17/34 , A61B18/20 , A61B18/22 , A61B18/24 , A61B19/00 , A61B18/18
CPC分类号： A61B17/3403 , A61B18/22 , A61B18/24 , A61B2017/00172 , A61B2017/00247 , A61B2017/22074 , A61B2017/22075 , A61B2017/22077 , A61B2018/00291 , A61B2018/00392 , A61B2018/208 , A61B90/37
摘要： The apparatus for combined mechanical/laser myocardial revascularization of a human heart includes: inserting a mechanical piercing device and an elongated flexible lasing apparatus into the chest cavity of a patient; mechanically auto-piercing, micro-tearing or spreading the epicardium of the heart; and then lasing from beneath the epicardium through the myocardium. The apparatus is guided to an area exterior to a ventricle of the patient's heart, and the distal end of the energy delivery device such as an optical fiber apparatus is placed internal to the exterior wall of the heart through an opening which has been created by mechanically piercing, micro-tearing or spreading the epicardium, so that the myocardium and not the epicardium is irradiated with laser energy to allow passage of said energy delivery device such as an optical fiber distal end or said laser energy into the left ventricular cavity without causing a laser irradiation of the epicardium which might be a cause of operative bleeding and for better allowing the sealing of the epicardium after the apparatus is removed. The apparatus includes a hand-held device controllable by the physician having a removable distal head portion with an auto-piercing mechanism and can use a vacuum source to provide a suction force at the head portion. The auto-piercing mechanism is implemented by various ways such as a spring-biased actuating member in the TMR hand-held device and an electro-mechanical operated piercing mechanism. The hand-held TMR device with handle assembly can also be controlled by a computer to provide auto- sequencing of the auto-piercing needle mechanism and the laser firing with auto-fiber advancement.
摘要翻译：用于人体心脏联合机械/激光心肌血运重建的装置包括：将机械刺穿装置和细长的柔性激光装置插入患者的胸腔中; 机械自动穿刺，微撕裂或散布心脏的心外膜; 然后通过心肌从心外膜下射出。该装置被引导到患者心脏的心室的外部区域，并且诸如光纤装置的能量输送装置的远端通过已经通过机械产生的开口放置在心脏的外壁内部穿透，微裂或扩散心外膜，使得心肌而不是心外膜被激光能量照射，以允许所述能量输送装置如光纤远端或所述激光能量通过到左心室，而不引起心外膜的激光照射可能是手术出血的原因，并且在移除装置之后更好地允许密封心包膜。该装置包括由医师控制的手持式装置，其具有带有自动穿孔机构的可拆卸远端头部，并且可以使用真空源在头部提供吸力。自动穿孔机构通过各种方式实现，例如TMR手持装置中的弹簧偏压致动构件和机电操作的穿孔机构。具有手柄组件的手持式TMR装置还可以由计算机控制，以提供自动穿刺针机构的自动排序和使用自动纤维前进的激光烧制。

2. 外观设计

USD389574S Finger grip device for a laser fiber optic delivery system 失效
公开(公告)号：USD389574S
公开(公告)日：1998-01-20
申请号：US63126
申请日：1996-11-27
申请人： Rick Emerson , Douglas R. Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steven A. Daniel
设计人： Rick Emerson , Douglas R. Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steven A. Daniel

3. 发明授权

US06551302B1 Steerable catheter with tip alignment and surface contact detector 失效
标题翻译：具有尖端对准和表面接触检测器的导向导管
公开(公告)号：US06551302B1
公开(公告)日：2003-04-22
申请号：US09697672
申请日：2000-10-26
申请人： Michael J. Rosinko , Alexander Khairkhahan , Michael Horzewski , Stuart D. Harman , Richard L. Mueller , Douglas R. Murphy-Chutorian
发明人： Michael J. Rosinko , Alexander Khairkhahan , Michael Horzewski , Stuart D. Harman , Richard L. Mueller , Douglas R. Murphy-Chutorian
IPC分类号： A61M3100
CPC分类号： A61M25/0147 , A61B8/06 , A61B8/12 , A61M25/0084 , A61M25/0136 , A61M2025/0089
摘要： A steerable percutaneous catheter for guiding at least one functional device to selected surfaces of a body for treatment thereon, particularly adapted for laser-assisted Percutaneous Transmyocardial Revascularization (PTMR). The steerable catheter has a handle portion at its proximal end and a controllably deflectable end portion at its distal end. The distal end of the catheter and the distal end of the functional device maintain alignment automatically during deflection. The invention also includes a surface contact detection system to detect contact with an interior body surface, such as the heart wall.
摘要翻译：一种可导向的经皮导管，用于将至少一个功能装置引导到身体的选定表面上用于在其上进行治疗，特别适用于激光辅助经皮心肌血运重建术（PTMR）。可操纵的导管在其近端处具有手柄部分，在其远端具有可控制地偏转的端部。导管的远端和功能装置的远端在偏转期间自动保持对准。本发明还包括一个表面接触检测系统，用于检测与诸如心脏壁的内部身体表面的接触。

4. 发明授权

US5925012A Laser assisted drug delivery 失效
标题翻译：激光辅助药物输送
公开(公告)号：US5925012A
公开(公告)日：1999-07-20
申请号：US773872
申请日：1996-12-27
申请人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Robert Lincoln Lathrop, III , Bruce Richardson
发明人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Robert Lincoln Lathrop, III , Bruce Richardson
IPC分类号： A61B17/00 , A61B18/24 , A61M1/00
CPC分类号： A61B18/24 , A61B2017/00247 , A61B2018/00392
摘要： A drug delivery apparatus for dispensing predetermined volumes of drug, drug solution or other substances into an opening, such as a TMR channel in the human heart, or other laser treated area within the human body, the apparatus consisting of a bifurcated needle with a laser inlet for guiding a laser delivery means, such as an optical fiber or fiber bundle, to adjacent a surface of the human heart or other body structure for creating an opening, such as a TMR channel, or other laser treated area thereon. A drug inlet is for receiving the drug and transmitting the drug to the TMR channel or other laser treated area. Optionally, a piercing tip and/or suction device assists in positioning the apparatus adjacent the tissue to be treated. Drug is dispensed by manually or automatically actuating a piston or syringe element. A method of use is also disclosed.
摘要翻译：用于将预定体积的药物，药物溶液或其它物质分配到诸如人心脏中的TMR通道或人体内的其它激光处理区域的开口中的药物递送装置，该装置由具有激光的分叉针用于将诸如光纤或纤维束的激光传送装置引导到靠近人心或其他身体结构的表面以在其上形成诸如TMR通道或其他激光处理区域的开口。药物入口用于接收药物并将药物传输到TMR通道或其他激光治疗区域。可选地，刺穿尖端和/或抽吸装置有助于将装置定位在待处理组织附近。通过手动或自动启动活塞或注射器元件来分配药物。还公开了一种使用方法。

5. 外观设计

USD389578S In-line device for a laser fiber optic delivery system 失效
公开(公告)号：USD389578S
公开(公告)日：1998-01-20
申请号：US63101
申请日：1996-11-27
申请人： Rick Emerson , Douglas R. Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steven A. Daniel
设计人： Rick Emerson , Douglas R. Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steven A. Daniel

6. 发明授权

US06620153B2 Intraoperative myocardial device and stimulation procedure 失效
标题翻译：术中心肌装置及刺激程序
公开(公告)号：US06620153B2
公开(公告)日：2003-09-16
申请号：US09854072
申请日：2001-05-11
申请人： Richard L. Mueller , Douglas Murphy-Chutorian , Stuart D. Harman
发明人： Richard L. Mueller , Douglas Murphy-Chutorian , Stuart D. Harman
IPC分类号： A61G1820
CPC分类号： A61B18/24 , A61B2017/00172 , A61B2017/00247 , A61B2017/22074 , A61B2017/22077 , A61B2018/00392 , A61B2018/208
摘要： An apparatus for stimulating revascularization of myocardium tissue in the ventricular wall of a human heart is disclosed. The apparatus includes means for moving the distal end of an optical fiber element forwardly through the epicardium of the heart and into the myocardium and emitting relatively low power bursts of laser energy from the distal end to form stimulus injury zones that promote capillary growth and tissue revascularization. Each penetration of the optical fiber element may produce multiple stimulus zones spaced radially from or in line with the axis of the optical fiber element. Apparatus for moving the optical fiber element and controlling the laser emissions in a predetermined manner is also disclosed.
摘要翻译：公开了一种用于刺激人心脏心室壁心肌组织血运重建的装置。该装置包括用于将光纤元件的远端向前移动通过心脏心外膜并进入心肌的装置，并且从远端发射相对低功率的激光能量脉冲以形成促进毛细血管生长和组织血运重建的刺激性损伤区域。光纤元件的每次穿透可以产生与光纤元件的轴线径向间隔开或与光纤元件的轴线成间隔的多个刺激区域。还公开了用于移动光纤元件并以预定方式控制激光发射的装置。

7. 发明授权

US5999678A Laser delivery means adapted for drug delivery 失效
标题翻译：用于药物输送的激光输送装置
公开(公告)号：US5999678A
公开(公告)日：1999-12-07
申请号：US773430
申请日：1996-12-27
申请人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Bruce Richardson
发明人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Bruce Richardson
IPC分类号： A61B17/00 , A61B18/24 , G02B6/06 , A61B17/36 , A61M31/00
CPC分类号： A61B18/24 , A61B2017/00247 , A61B2018/00392
摘要： A drug delivery apparatus for dispensing a predetermined amount of one or more drugs into a laser created opening in the human body, the apparatus consisting of a laser delivery means such as an optical fiber or fiber bundle, a drug conduit which transfers the one or more drugs, drug solutions or other substances to the distal end of the laser delivery means, and the laser delivery means disposed essentially coaxially with the drug conduit. Laser delivery means is used to create a TMR channel or other opening in the body. Dispensed drug or other substance travels through the drug conduit and emanates from the drug conduit to be delivered into the TMR channel or other laser created opening. Drug is dispensed by manually or automatically activating an electric motor which actuates a piston element. A method of use is also disclosed.
摘要翻译：一种用于将预定量的一种或多种药物分配到人体内的激光产生开口中的药物输送装置，该装置由诸如光纤或纤维束的激光输送装置组成，药物导管将一个或多个药物，药物溶液或其它物质，并且激光输送装置基本上与药物导管同轴地设置。激光输送装置用于在体内产生TMR通道或其他开口。分配的药物或其他物质通过药物导管，并从药物导管发出，以被输送到TMR通道或其他激光产生的开口中。药物通过手动或自动激活致动活塞元件的电动机来分配。还公开了一种使用方法。

8. 发明授权

US5766164A Contiguous, branched transmyocardial revascularization (TMR) channel, method and device 失效
公开(公告)号：US5766164A
公开(公告)日：1998-06-16
申请号：US675698
申请日：1996-07-03
申请人： Richard L. Mueller , Stuart D. Harman , Robert L. Lathrop, Jr. , Bruce J. Richardson
发明人： Richard L. Mueller , Stuart D. Harman , Robert L. Lathrop, Jr. , Bruce J. Richardson
IPC分类号： A61B17/00 , A61B17/22 , A61B17/34 , A61B18/22 , A61B17/36
CPC分类号： A61B17/3403 , A61B18/22 , A61B2017/00247 , A61B2017/22075 , A61B2018/00392
摘要： Improved methods and devices related to laser-assisted transmyocardial revascularization (TMR), and more particularly, to improved methods and devices for creating branched TMR channels through myocardium in which a single opening is made in an epicardial surface with a plurality of channel branches, having predetermined geometries extending into and through myocardium, depending therefrom. A method of creating branched TMR channels comprises piercing an epicardial surface mechanically or with laser energy, directing laser energy through the opening in a first predetermined angular orientation with respect to the epicardial surface to create a first channel and delivering laser energy in a second predetermined angular orientation to create a second branch. A plurality of branches can thus be created in a single channel structure. A guide block device allows an opening to be made in an epicardial surface mechanically or with laser energy and provides a structure for directing laser energy into myocardium in a plurality of channels depending from the opening. Rotating guide devices and finger held devices with rotating head means include a hand held device with an elongated wand-like handle portion, a rotating head portion and a hollow guide needle means. Preferred embodiments further comprise a laser delivery means advancing mechanism and guide needle rotating means.

9. 发明授权

US06706011B1 Laser assisted drug delivery 失效
标题翻译：激光辅助药物输送
公开(公告)号：US06706011B1
公开(公告)日：2004-03-16
申请号：US09288251
申请日：1999-04-08
申请人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Bruce Richardson
发明人： Douglas Murphy-Chutorian , Richard L. Mueller , Stuart D. Harman , Steve A. Daniel , Larry Witham , Bruce Richardson
IPC分类号： A61M3100
CPC分类号： A61B18/24 , A61B2017/00247 , A61B2018/00392
摘要： A drug delivery apparatus for dispensing predetermined volumes of drug, drug solution or other substances into an opening, such as a TMR channel in the human heart, or other laser treated area within the human body, the apparatus consisting of a bifurcated needle with a laser inlet for guiding a laser delivery means, such as an optical fiber or fiber bundle, to adjacent a surface of the human heart or other body structure for creating an opening, such as a TMR channel, or other laser treated area thereon. A drug inlet is for receiving the drug and transmitting the drug to the TMR channel or other laser treated area. Optionally, a piercing tip and/or suction device assists in positioning the apparatus adjacent the tissue to be treated. Drug is dispensed by manually or automatically actuating a piston or syringe element. A method of use is also disclosed.
摘要翻译：用于将预定体积的药物，药物溶液或其它物质分配到诸如人心脏中的TMR通道或人体内的其它激光处理区域的开口中的药物递送装置，该装置由具有激光的分叉针用于将诸如光纤或纤维束的激光传送装置引导到靠近人心或其他身体结构的表面以在其上形成诸如TMR通道或其他激光处理区域的开口。药物入口用于接收药物并将药物传输到TMR通道或其他激光治疗区域。可选地，刺穿尖端和/或抽吸装置有助于将装置定位在待处理组织附近。通过手动或自动启动活塞或注射器元件来分配药物。还公开了一种使用方法。

10. 发明授权

US06179809B2 Drug delivery catheter with tip alignment 失效
标题翻译：药物输送导管与尖端对齐
公开(公告)号：US06179809B2
公开(公告)日：2001-01-30
申请号：US09156964
申请日：1998-09-18
申请人： Alexander Khairkhahan , Michael J. Horzewski , Stuart D. Harman , Richard L. Mueller , Douglas R. Murphy-Chutorian
发明人： Alexander Khairkhahan , Michael J. Horzewski , Stuart D. Harman , Richard L. Mueller , Douglas R. Murphy-Chutorian
IPC分类号： A61M3700
CPC分类号： A61M25/0147 , A61M25/0084 , A61M25/0136 , A61M2025/0089
摘要： A steerable drug delivery catheter and method of use, particularly adapted for percutaneous use. The distal end of the drug delivery catheter is deflectable. The catheter has a relative movement compensation mechanism for maintaining positioning between the distal end of the drug delivery catheter and the distal end of the drug delivery device therein.
摘要翻译：可导向的药物输送导管和使用方法，特别适用于经皮使用。药物输送导管的远端是可偏转的。导管具有相对运动补偿机构，用于保持药物输送导管的远端与药物输送装置的远端之间的定位。

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