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1. 发明授权

US06730077B2 Catheter system 失效
公开(公告)号：US06730077B2
公开(公告)日：2004-05-04
申请号：US10237376
申请日：2002-09-09
申请人： Sean Carroll , George Klein , Marwan Abboud , Steven G. Arless , Fredric L. Milder , Dan Wittenberger
发明人： Sean Carroll , George Klein , Marwan Abboud , Steven G. Arless , Fredric L. Milder , Dan Wittenberger
IPC分类号： A61B1802
CPC分类号： A61B18/02 , A61B18/1492 , A61B2017/00026 , A61B2017/00084 , A61B2018/0212 , A61B2018/0262 , A61B2090/065
摘要： A cryocatheter for treatment of tissue has a tip adapted to provide a signal indicative of the quality and/or orientation of the tip contact with surrounding tissue. In one embodiment, a signal conductor extends through the catheter to the tip and connects to a thermally and electrically conductive shell or cap that applies an RF current to the region of tissue contacted by the tip. The tissue impedance path between the signal lead and a surface electrode mounted on the patient's skin is monitored to develop a quantitative measure of tissue contact at the distal tip, which is preferably displayed on the screen of a catheter monitoring console. In yet a further embodiment, the catheter is provided with a split tip having temperature monitoring sensors, such as thermistors, mounted on opposed halves of the tip so as to sense temperature on two sides of the catheter axis. The thermistor signals are processed to determine and display differential temperature between the two sides of the tip, thus revealing which side lies in contact. In yet a further aspect of the first embodiment, two separate and distinct high frequency electrical signals are applied to the two halves of a split metal shell or cap at the tip. Signals received at the surface electrode are filtered into first and second frequency components, and these are processed to determine the relative magnitude of the signal or the impedance of the path for each of the injected signals to determine and display the tissue contact orientation of the catheter. The catheter preferably has two separate cooling chambers within the cooling tip, positioned with one chamber on each side of the axis, and a separate cooling inlet to each chamber is switched on by a valve which directs the flow of coolant to the contact side during active cryotreatment. In another embodiment, the cap provides an RF electrode that may be opposed to the cooling side so that either the cryogenic or the RF ablation side may be rotated into contact to selectively heat or cool, or in representative protocol treat, then thaw, the same tissue site.

2. 发明授权

US07896870B2 Catheter with cryogenic and electrical heating ablation 有权
标题翻译：导管用低温和电加热消融
公开(公告)号：US07896870B2
公开(公告)日：2011-03-01
申请号：US11768259
申请日：2007-09-10
申请人： Steven G. Arless , Fredric L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
发明人： Steven G. Arless , Fredric L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
IPC分类号： A61B18/02 , A61B18/12 , A61B18/18
CPC分类号： A61B18/02 , A61B18/1492 , A61B18/18 , A61B2017/00243 , A61B2018/0212 , A61B2018/0268
摘要： A catheter includes a cryoablation tip with an ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber and have an RF electrode at its distal end. The electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled in combination with an RF treatment regimen to enhance the lesion size, speed or placement of multi-lesion or single lesion cycles. In one embodiment a microwave energy source operates to extend beyond the thermal conduction depth, or penetrate the ice ball and be absorbed in tissue beyond an ice boundary, thus extending a dimension of treatment. Also, the cooling and application of RF energy can be controlled to position the ablation region away from the surface contacted by the electrode thereby leaving surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth.
摘要翻译：导管包括具有用于加热组织的消融组件的冷冻消融尖端。冷冻消融尖端可以用冷却室实现，并且在其远端具有RF电极。可以操作电极以温热低温冷却的组织，或者可以与RF治疗方案结合控制冷却剂，以增强病变大小，速度或多损伤或单个病变周期的放置。在一个实施例中，微波能量源的作用是延伸超过热传导深度，或者穿透冰球并被吸收在超过冰界的组织中，从而延伸处理的尺寸。此外，可以控制RF能量的冷却和施加，以使消融区域远离与电极接触的表面，从而在深度消融时使表面组织不受伤害，或者提供具有更高均匀度的消融带，并且随着深度增加。

3. 发明授权

US07951140B2 Catheter with cryogenic and electrical heating ablation 有权
标题翻译：导管用低温和电加热消融
公开(公告)号：US07951140B2
公开(公告)日：2011-05-31
申请号：US11971582
申请日：2008-01-09
申请人： Steven G. Arless , Fredric L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
发明人： Steven G. Arless , Fredric L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
IPC分类号： A61B18/02
CPC分类号： A61B18/02 , A61B18/1492 , A61B18/18 , A61B2017/00243 , A61B2018/0212 , A61B2018/0268
摘要： A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen, allowing greater versatility of operation and enhancing the lesion size, speed or placement of multi-lesion treatment or single lesion re-treatment cycles.
摘要翻译：导管包括具有用于加热组织的电驱动消融组件的冷冻消融尖端。冷冻消融尖端可以用冷却室来实现，通过该冷却室可控制地注入的冷却剂循环以降低尖端温度，并且在其远端具有RF电极。 RF电极可以被操作以加热低温冷却的组织，或者可以控制冷却剂以与RF治疗方案协调地导电地冷却组织，从而允许操作的更大的通用性和增强病变大小，速度或放置多病变治疗或单次病变再治疗周期。

4. 发明授权

US08287526B2 Method of simultaneously freezing and heating tissue for ablation 有权
标题翻译：同时冷冻和加热组织消融的方法
公开(公告)号：US08287526B2
公开(公告)日：2012-10-16
申请号：US13301978
申请日：2011-11-22
申请人： Steven G. Arless , Fredric L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
发明人： Steven G. Arless , Fredric L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
IPC分类号： A61B18/02
CPC分类号： A61B18/02 , A61B18/1492 , A61B18/18 , A61B2017/00243 , A61B2018/0212 , A61B2018/0268
摘要： A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen.
摘要翻译：导管包括具有用于加热组织的电驱动消融组件的冷冻消融尖端。冷冻消融尖端可以用冷却室来实现，通过该冷却室可控制地注入的冷却剂循环以降低尖端温度，并且在其远端具有RF电极。可以操作RF电极以温热低温冷却的组织，或者可以控制冷却剂以与RF治疗方案协调地导电地冷却组织。

5. 发明授权

US08083732B2 Catheter with cryogenic and electrical heating ablation 有权
标题翻译：导管用低温和电加热消融
公开(公告)号：US08083732B2
公开(公告)日：2011-12-27
申请号：US13088709
申请日：2011-04-18
申请人： Steven G. Arless , Fredric L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
发明人： Steven G. Arless , Fredric L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
IPC分类号： A61B18/02 , A61B18/04
CPC分类号： A61B18/02 , A61B18/1492 , A61B18/18 , A61B2017/00243 , A61B2018/0212 , A61B2018/0268
摘要： A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen.
摘要翻译：导管包括具有用于加热组织的电驱动消融组件的冷冻消融尖端。冷冻消融尖端可以用冷却室来实现，通过该冷却室可控制地注入的冷却剂循环以降低尖端温度，并且在其远端具有RF电极。可以操作RF电极以温热低温冷却的组织，或者可以控制冷却剂以与RF治疗方案协调地导电地冷却组织。

6. 发明授权

US07465300B2 Catheter with cryogenic and electrical heating ablation 有权
标题翻译：导管用低温和电加热消融
公开(公告)号：US07465300B2
公开(公告)日：2008-12-16
申请号：US11219061
申请日：2005-09-02
申请人： Steven G. Arless , Fredric L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
发明人： Steven G. Arless , Fredric L. Milder , Marwan Abboud , Dan Wittenberger , Sean Carroll
IPC分类号： A61B18/02 , A61B18/04
CPC分类号： A61B18/02 , A61B18/1492 , A61B18/18 , A61B2017/00243 , A61B2018/0212 , A61B2018/0268
摘要： A catheter includes a cryoablation tip with an electrically-driven ablation assembly for heating tissue. The cryoablation tip may be implemented with a cooling chamber through which a controllably injected coolant circulates to lower the tip temperature, and having an RF electrode at its distal end. The RF electrode may be operated to warm cryogenically-cooled tissue, or the coolant may be controlled to conductively cool the tissue in coordination with an RF treatment regimen, allowing greater versatility of operation and enhancing the lesion size, speed or placement of multi-lesion treatment or single lesion re-treatment cycles. In one embodiment a microwave energy source operates at a frequency to extend beyond the thermal conduction depth, or to penetrate the cryogenic ice ball and be absorbed in tissue beyond an ice boundary, thus extending the depth and/or width of a single treatment locus. In another embodiment, the cooling and the application of RF energy are both controlled to position the ablation region away from the surface contacted by the electrode, for example to leave surface tissue unharmed while ablating at depth or to provide an ablation band of greater uniformity with increasing depth. The driver or RF energy source may supply microwave energy at a frequency effective to penetrate the ice ball which develops on a cryocatheter, and different frequencies may be selected for preferential absorption in a layer of defined thickness at depth in the nearby tissue. The catheter may operate between 70 and minus 70 degrees Celsius for different tissue applications, such as angioplasty, cardiac ablation and tissue remodeling, and may preset the temperature of the tip or adjacent tissue, and otherwise overlay or delay the two different profiles to tailor the shape or position where ablation occurs or to speed up a treatment cycle.
摘要翻译：导管包括具有用于加热组织的电驱动消融组件的冷冻消融尖端。冷冻消融尖端可以用冷却室来实现，通过该冷却室可控制地注入的冷却剂循环以降低尖端温度，并且在其远端具有RF电极。 RF电极可以被操作以加热低温冷却的组织，或者可以控制冷却剂以与RF治疗方案协调地导电地冷却组织，从而允许操作的更大的通用性和增强病变大小，速度或放置多病变治疗或单次病变再治疗周期。在一个实施例中，微波能量源的频率以超出热传导深度的频率运行，或者穿透低温冰球并被吸收在超过冰界的组织中，从而延长单个处理轨迹的深度和/或宽度。在另一个实施例中，RF能量的冷却和应用都被控制以将消融区域远离与电极接触的表面，例如在深度消融时留下表面组织而不受伤害，或者提供具有更大均匀性的消融带，增加深度。驱动器或RF能源可以以有效穿透在低温导管上形成的冰球的频率提供微波能量，并且可以选择不同的频率用于在附近组织的深度处的限定厚度的层中的优先吸收。对于不同的组织应用（例如血管成形术，心脏消融和组织重建），导管可以在70摄氏度和零下70度之间运行，并且可以预设尖端或相邻组织的温度，否则叠加或延迟两个不同的轮廓以定制消融发生的形状或位置或加速治疗周期。

7. 发明授权

US06913604B2 Cryosurgical catheter 有权
标题翻译：冷冻导管
公开(公告)号：US06913604B2
公开(公告)日：2005-07-05
申请号：US10346032
申请日：2003-01-16
申请人： Teresa Mihalik , Cristian Petre , Daniel Nahon , Steven G. Arless , Fredric L. Milder , Dan Wittenberger , Domenic N. Santoianni , Claudia Lückge , John W. Lehmann , Jean-Pierre Lalonde , Kenneth A. Spector
发明人： Teresa Mihalik , Cristian Petre , Daniel Nahon , Steven G. Arless , Fredric L. Milder , Dan Wittenberger , Domenic N. Santoianni , Claudia Lückge , John W. Lehmann , Jean-Pierre Lalonde , Kenneth A. Spector
IPC分类号： A61B17/00 , A61B18/00 , A61B18/02 , A61B19/00 , A61F7/02 , A61M25/00 , A61B18/18
CPC分类号： A61M25/0029 , A61B18/02 , A61B2017/00053 , A61B2017/00243 , A61B2017/00292 , A61B2017/00973 , A61B2018/00095 , A61B2018/00196 , A61B2018/0212 , A61B2018/0262 , A61B2090/0463 , A61F2007/0298 , A61M2025/0037 , A61M2025/0039
摘要： A cryosurgical system including a housing having a front portion and a rear portion. The front portion and rear portion are connectable to support a fluid supply. A control unit attached to the front portion, and has a regulator assembly connecting the fluid supply to the control unit. A medical device is connected to the control unit, the medical device including a handle, a shaft, and a thermally-transmissive region. The handle, the shaft, and the thermally-transmissive region defining a fluid pathway through the handle, shaft, and thermally-transmissive region. The shaft is malleable to retain a first shape until manipulated to a second shape.
摘要翻译：一种冷冻手术系统，包括具有前部和后部的壳体。前部和后部可连接以支撑流体供应。控制单元，其附接到前部，并且具有将流体供应连接到控制单元的调节器组件。医疗设备连接到控制单元，医疗设备包括手柄，轴和热传导区域。手柄，轴和透热区域限定通过手柄，轴和热透射区域的流体路径。轴可延展以保持第一形状，直到操纵到第二形状。

8. 发明授权

US5899899A Cryosurgical linear ablation structure 失效
标题翻译：冷冻线性消融结构
公开(公告)号：US5899899A
公开(公告)日：1999-05-04
申请号：US893825
申请日：1997-07-11
申请人： Steven G. Arless , Fredric L. Milder , Kenneth A. Spector , Dan Wittenberger , Domenic N. Santoianni , Claudia Lueckge
发明人： Steven G. Arless , Fredric L. Milder , Kenneth A. Spector , Dan Wittenberger , Domenic N. Santoianni , Claudia Lueckge
IPC分类号： A61B17/00 , A61B18/00 , A61B18/02 , A61F7/02 , A61M25/00 , A61B17/36
CPC分类号： A61B18/02 , A61B2017/00243 , A61B2017/00292 , A61B2017/00973 , A61B2018/00095 , A61B2018/0212 , A61F2007/0298 , A61M2025/0039 , A61M25/0029
摘要： A cryogenic catheter includes a flexible member having an elongate, thermally-transmissive region and a cryogenic fluid path through the flexible member to the thermally-transmissive region. The thermally-transmissive region can be deformable from a linear configuration to an arcuate configuration and can include multiple thermally-transmissive elements having a first side exposed to the cryogenic fluid path and a second side exposed to points exterior to the flexible member. The thermally-transmissive elements can be rigid or flexible longitudinal strips. Alternatively, annular, cylindrical, or wedge-shaped metallic structures disposed in a spaced-apart relationship can define the thermally-transmissive region. In other embodiments the thermally-transmissive region is defined by a helical coil that is at least partially embedded in the flexible member. The helical coil can also define at least a portion of the cryogenic fluid path through the flexible member and include a gas expansion or boiling chamber.
摘要翻译：低温导管包括具有细长的热透射区域的柔性构件和通过柔性构件到达热传导区域的低温流体路径。热传导区域可以从线性构造变形到弓形构造，并且可以包括具有暴露于低温流体路径的第一侧的多个热传递元件和暴露于柔性构件外部的点的第二侧。透光元件可以是刚性或柔性的纵向条。或者，以间隔开的关系设置的环形，圆柱形或楔形金属结构可以限定热传导区域。在其它实施例中，热传导区域由至少部分地嵌入在柔性构件中的螺旋线圈限定。螺旋线圈还可以限定通过柔性构件的低温流体路径的至少一部分，并且包括气体膨胀或沸腾室。

9. 发明授权

US5899898A Cryosurgical linear ablation 失效
标题翻译：冷冻外科线性消融
公开(公告)号：US5899898A
公开(公告)日：1999-05-04
申请号：US807382
申请日：1997-02-27
申请人： Steven G. Arless , Fredric L. Milder , Kenneth A. Spector , Dan Wittenberger , Domenic N. Santoianni , Claudia Lueckge
发明人： Steven G. Arless , Fredric L. Milder , Kenneth A. Spector , Dan Wittenberger , Domenic N. Santoianni , Claudia Lueckge
IPC分类号： A61B17/00 , A61B18/00 , A61B18/02 , A61F7/02 , A61M25/00 , A61B17/36
CPC分类号： A61B18/02 , A61B2017/00243 , A61B2017/00292 , A61B2017/00973 , A61B2018/00095 , A61B2018/0212 , A61F2007/0298 , A61M2025/0039 , A61M25/0029
摘要： A cryogenic catheter includes a flexible member having an elongate, thermally-transmissive region and a cryogenic fluid path through the flexible member to the thermally-transmissive region. The thermally-transmissive region can be deformable from a linear configuration to an arcuate configuration and can include multiple thermally-transmissive elements having a first side exposed to the cryogenic fluid path and a second side exposed to points exterior to the flexible member. The thermally-transmissive elements can be rigid or flexible longitudinal strips. Alternatively, annular, cylidrical, or wedge-shaped metallic structures disposed in a spaced-apart relationship can define the thermally-transmissive region. In other embodiments the thermally-transmissive region is defined by a helical coil that is at least partially embedded in the flexible member. The helical coil can also define at least a portion of the cryogenic fluid path through the flexible member and include a gas expansion or boiling chamber.
摘要翻译：低温导管包括具有细长的热透射区域的柔性构件和通过柔性构件到达热传导区域的低温流体路径。热传导区域可以从线性构造变形到弓形构造，并且可以包括具有暴露于低温流体路径的第一侧的多个热传递元件和暴露于柔性构件外部的点的第二侧。透光元件可以是刚性或柔性的纵向条。或者，以间隔开的关系设置的环形，圆形或楔形金属结构可以限定热传导区域。在其它实施例中，热传导区域由至少部分地嵌入在柔性构件中的螺旋线圈限定。螺旋线圈还可以限定通过柔性构件的低温流体路径的至少一部分，并且包括气体膨胀或沸腾室。

10. 发明授权

US08475440B2 Wide area ablation of myocardial tissue 有权
标题翻译：广泛消融心肌组织
公开(公告)号：US08475440B2
公开(公告)日：2013-07-02
申请号：US11953189
申请日：2007-12-10
申请人： Marwan Abboud , Fredric L. Milder , George Klein
发明人： Marwan Abboud , Fredric L. Milder , George Klein
IPC分类号： A61B18/02
CPC分类号： A61B18/02 , A61B2017/22051 , A61B2018/0022 , A61B2018/0212 , A61B2018/0262
摘要： The present invention advantageously provides a method and system for cryogenically ablating large areas of tissue within the left atrium. In an exemplary embodiment a cryotherapy device includes a catheter body having a substantially fixed diameter, a proximal end and a distal end; a first lumen for permitting passage of a cooling fluid from the proximal end to the distal end; a second lumen permitting return of the cooling fluid from the distal end to the proximal end; and an ablation element expandable from a first diameter that is substantially the same as the diameter of the catheter body to a second diameter that is at least twice the diameter of the catheter body, the ablation element having a surface portion that conforms to the uneven surface topography of the cardiac tissue. The ablation element can include one or more balloon and/or a flexible element that is deformed by moving the distal end of the catheter toward the proximal end of the catheter. The surface of the balloon can further be shaped by regulation of pressure within the one or more balloons. In an exemplary method a tissue ablation device is provided and tissue in the antrum of the left atrium is ablated with the device. In an exemplary method, only tissue in the antrum is ablated, and the ablation is created by freezing tissue.
摘要翻译：本发明有利地提供了用于低温切除左心房内的大面积组织的方法和系统。在示例性实施例中，冷冻治疗装置包括具有基本上固定的直径，近端和远端的导管主体; 用于允许冷却流体从近端通向远端的第一腔; 允许冷却流体从远端返回到近端的第二管腔; 以及可从第一直径扩张的消融元件，所述第一直径基本上与所述导管主体的直径相同至所述导管主体直径的至少两倍的第二直径，所述消融元件具有与所述不平坦表面一致的表面部分心脏组织的形貌。消融元件可以包括通过将导管的远端朝向导管的近端移动而变形的一个或多个气囊和/或柔性元件。球囊的表面可以通过调节一个或多个气囊内的压力而进一步成形。在一种示例性方法中，提供组织消融装置，并且使用装置消融左心房窦内的组织。在示例性方法中，只有窦中的组织被消融，并且通过冷冻组织产生消融。

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