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    • 6. 发明申请
    • GUIDED CARDIAC ABLATION CATHETERS
    • 指导性戒毒导管
    • WO2004110258A3
    • 2005-08-25
    • PCT/US2004018471
    • 2004-06-10
    • CARDIOFOCUS INCMELSKY GERALDARNOLD JEFFREY MSINOFSKY EDWARD LFARR NORMAN E
    • MELSKY GERALDARNOLD JEFFREY MSINOFSKY EDWARD LFARR NORMAN E
    • A61B17/00A61B17/22A61B18/00A61B18/24A61B19/00A61N7/02
    • A61B18/24A61B2017/00057A61B2017/22051A61B2018/0022A61B2018/00982A61B2018/0212A61B2090/3937A61N7/02
    • Guided ablation instruments are disclosed for creating lesions in tissue, especially cardiac tissue for treatment of arrhythmias, including atrial fibrillation. In one aspect of the invention, a percutaneous catheter is disclosed with an endoscope positionable in the instrument's distal end region to obtain an image. The image allows the clinician to determine whether contact has been achieved (or blood has been cleared from an ablative energy transmission path) before ablation begins or while ablation is occurring. In one embodiment, percutaneous ablation catheters are disclosed having at least one central lumen and one or more balloon structures at the distal end region of the instrument. Also disposed in the distal end region are an illuminating light source and an endoscope capable of collecting sufficient light to relay an image to the user. The instruments can further include an ablation element. The ablation element can be a contact ablation element, or a radiant energy emitter, which is preferably independently positionable within the lumen of the instrument and adapted to project ablative energy through a transmissive region of the instrument body (and/or balloon) to a target tissue site proximate to the pulmonary veins. The energy can delivered without the need for contact between the energy emitter and the target tissue so long as a clear transmission pathway is established. The endoscope element of the instrument allows the clinician to determine the position of the instrument and, if radiant energy is to be employed, see if such a pathway is clear. Moreover, because the position of the radiant energy emitter can be varied, endoscopic guidance permits the clinician to select a desired location and dose for the lesion.
    • 公开了引导消融器械用于在组织中产生损伤,特别是用于治疗心律失常的心脏组织,包括房颤。 在本发明的一个方面,公开了一种经皮导管,其具有可置于仪器的远端区域中的内窥镜,以获得图像。 图像允许临床医生确定在消融开始之前还是在消融期间已经实现了接触(或者从消融能量传递路径中清除血液)。 在一个实施例中,公开了经皮消融导管,其在器械的远端区域具有至少一个中心腔和一个或多个气囊结构。 还设置在远端区域中的是能够收集足够的光以将图像中继给用户的照明光源和内窥镜。 仪器还可以包括消融元件。 消融元件可以是接触消融元件或辐射能发射器,其优选地可独立地定位在器械的内腔内并且适于将烧蚀能量穿过器械主体(和/或气囊)的透射区域投射到靶 靠近肺静脉的组织部位。 只要建立清晰的传输路径,能量可以传送而不需要能量发射器和目标组织之间的接触。 仪器的内窥镜元件允许临床医生确定仪器的位置,并且如果要使用辐射能量,看看这样的通路是否清晰。 此外,由于辐射能发射器的位置可以改变,所以内窥镜引导允许临床医生选择病变的期望位置和剂量。