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    • 1. 发明授权
    • Catheter with cryogenic and electrical heating ablation
    • 导管用低温和电加热消融
    • US07896870B2
    • 2011-03-01
    • US11768259
    • 2007-09-10
    • Steven G. ArlessFredric L. MilderMarwan AbboudDan WittenbergerSean Carroll
    • Steven G. ArlessFredric L. MilderMarwan AbboudDan WittenbergerSean Carroll
    • A61B18/02A61B18/12A61B18/18
    • A61B18/02A61B18/1492A61B18/18A61B2017/00243A61B2018/0212A61B2018/0268
    • 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.
    • 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。
    • 5. 发明授权
    • Catheter with cryogenic and electrical heating ablation
    • 导管用低温和电加热消融
    • US07465300B2
    • 2008-12-16
    • US11219061
    • 2005-09-02
    • Steven G. ArlessFredric L. MilderMarwan AbboudDan WittenbergerSean Carroll
    • Steven G. ArlessFredric L. MilderMarwan AbboudDan WittenbergerSean Carroll
    • A61B18/02A61B18/04
    • A61B18/02A61B18/1492A61B18/18A61B2017/00243A61B2018/0212A61B2018/0268
    • 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.
    • 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。
    • 6. 发明授权
    • Catheter system
    • US06730077B2
    • 2004-05-04
    • US10237376
    • 2002-09-09
    • Sean CarrollGeorge KleinMarwan AbboudSteven G. ArlessFredric L. MilderDan Wittenberger
    • Sean CarrollGeorge KleinMarwan AbboudSteven G. ArlessFredric L. MilderDan Wittenberger
    • A61B1802
    • A61B18/02A61B18/1492A61B2017/00026A61B2017/00084A61B2018/0212A61B2018/0262A61B2090/065
    • 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.
    • 9. 发明授权
    • Catheter with cryogenic and heating ablation
    • 导管用低温和加热消融
    • US07097641B1
    • 2006-08-29
    • US09457958
    • 1999-12-09
    • Steven G. ArlessFrederic L. MilderMarwan AbboudDan WittenbergerSean Carroll
    • Steven G. ArlessFrederic L. MilderMarwan AbboudDan WittenbergerSean Carroll
    • A61B18/18
    • A61B18/02A61B18/1492A61B18/18A61B2017/00243A61B2018/0212A61B2018/0268
    • 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.
    • 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。
    • 10. 发明申请
    • CATHETER WITH CRYOGENIC AND ELECTRICAL HEATING ABLATION
    • 具有低温和电加热的导管
    • US20070299432A1
    • 2007-12-27
    • US11768259
    • 2007-09-10
    • Steven ArlessFredric MilderMarwan AbboudDan WittenbergerSean Carroll
    • Steven ArlessFredric MilderMarwan AbboudDan WittenbergerSean Carroll
    • A61B18/18
    • A61B18/02A61B18/1492A61B18/18A61B2017/00243A61B2018/0212A61B2018/0268
    • 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.
    • 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。