US20060069385A1 - Methods and apparatus for tissue cryotherapy - Google Patents
Methods and apparatus for tissue cryotherapy Download PDFInfo
- Publication number
- US20060069385A1 US20060069385A1 US10/954,136 US95413604A US2006069385A1 US 20060069385 A1 US20060069385 A1 US 20060069385A1 US 95413604 A US95413604 A US 95413604A US 2006069385 A1 US2006069385 A1 US 2006069385A1
- Authority
- US
- United States
- Prior art keywords
- cooling
- cooling element
- target tissue
- tissue region
- location
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00084—Temperature
- A61B2017/00101—Temperature using an array of thermosensors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
- A61B2018/0022—Balloons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
- A61B2018/0212—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument inserted into a body lumen, e.g. catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3954—Markers, e.g. radio-opaque or breast lesions markers magnetic, e.g. NMR or MRI
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
Definitions
- the present invention relates generally to therapeutic cooling of body tissue, and more particularly, to methods and apparatus for deploying a plurality of cooling elements to at least partially surround and cool, e.g., to ablate by cryoplasty, a selected tissue region.
- Atrial fibrillation is a serious medical condition that is the result of abnormal electrical activity within the heart. This abnormal activity may occur at regions of the heart including the sino-atrial (SA) node, the atriovenricular (AV) node, or within other areas of cardiac tissue. Moreover, atrial fibrillation may be caused by abnormal activity within one or more isolated focal centers within the heart. It is believed that these foci can originate from within the pulmonary vein, particularly the superior pulmonary veins.
- SA sino-atrial
- AV atriovenricular
- Ablation catheters have been used in minimally invasive techniques to ablate target tissue, e.g., foci having abnormal electrical activity.
- the techniques typically are characterized by application of energy to create lesions at the foci or other areas possessing abnormal electrical activity.
- Ablation catheters can also be used to create lesions at the heart to block electrical signals or to alter a travel path of electrical signals at the heart.
- Some ablation devices utilize radio frequency (RF) energy for ablation, including the device disclosed in U.S. Pat. No. 6,024,740 to Lesh et al.
- RF energy devices may be used to ablate an area of interest with heat.
- the use of RF energy for ablation may, however, lead to untoward healing responses such as collagen build up at the area of interest after treatment.
- RF ablation may create lesions that cause occlusion of the coronary sinus in post procedure healing.
- blood delivered to and from the heart constantly provides heat to a target site at the heart, thereby counteracting against the cooling being delivered by the cryotherapy, and limiting the amount of cooling that can be delivered to the target site. This in turn, further prevents a transmural lesion, or lesion of a desired size or characteristic, from being created at the target tissue.
- a method for performing cryotherapy on a target tissue region in a body includes positioning a first cooling element in a first location in a body adjacent a target tissue region, positioning a second cooling element in a second location in the body adjacent the target tissue region, and cooling the respective first and second cooling elements so as to cool the target tissue region.
- a method for treating atrial fibrillation includes positioning a first cooling element in a patient's coronary sinus adjacent a target tissue region at least partially connecting the patient's left atrium and left ventricle, positioning a second cooling element in the patient's left atrium adjacent the target tissue region, and cooling the respective first and second cooling elements so as to ablate the target tissue region.
- an apparatus for performing cryotherapy on a target tissue region in a body includes a first cooling element configured for positioning in a first location in a body adjacent a target tissue region, the first cooling element comprising a locatable portion, a second cooling element configured for positioning in a second location in a body adjacent the target tissue region, the second cooling element comprising a locatable portion, each of the first and second cooling elements being in fluid communication with a coolant source, and one or more controllers for controlling cooling of the first and second cooling elements independent of each other.
- FIG. 1 is a perspective view of a tissue ablation system in accordance with some embodiments of the invention, showing the tissue ablation system having two ablation devices;
- FIG. 2 is a cross sectional view of one of the ablation devices of FIG. 1 ;
- FIG. 3 is a perspective view of an ablation device having an array of sensors in accordance with other embodiments of the invention.
- FIG. 4 is a perspective view of a variation of the ablation device of FIG. 3 ;
- FIG. 5 is a perspective view of a tissue ablation device in accordance with other embodiments of the invention, showing the tissue ablation device having three cryo balloons;
- FIGS. 6A and 6B are end views of the tissue ablation device of FIG. 5 , showing the tissue ablation device being used to create lesions;
- FIGS. 7A and 7B are cross-sectional views, showing a method for treating tissue, in accordance with some embodiments of the invention.
- FIG. 8 shows, in diagrammatic form, anatomic landmarks for lesion formation in left and right atriums
- FIG. 9A and 9B show representative lesion patterns in a left atrium that may be formed using the tissue ablation system of FIG. 1 ;
- FIG. 10A-10C show representative lesion patterns in a right atrium that may be formed using the tissue ablation system of FIG. 1 .
- FIG. 1 illustrates a tissue ablation system 10 in accordance with some embodiments of the invention.
- the tissue ablation system 10 includes a first and a second ablation devices 12 , 52 configured for introduction into the body of a patient for ablative treatment of target tissue.
- the tissue ablation system 10 also includes a coolant supply 80 configured for supplying cooling energy to the ablation devices 12 , 52 during use.
- the coolant supply 80 provides cooling media to both the first and the second ablation devices 12 , 52 .
- each of the first and the second ablation devices 12 , 52 can have its own coolant supply.
- the first ablation device 12 includes a shaft 16 having a proximal end 18 , a distal end 20 , and a lumen 21 extending between the proximal and the distal ends 18 , 20 , and terminating at a distal port 44 .
- the proximal end 18 of the shaft 16 has an extension 40 with a guidewire port 42 that is in fluid communication with the lumen 21 of the shaft 16 .
- a guidewire 120 can be inserted through the distal port 44 and exits through the guidewire port 42 at the proximal end 18 of the shaft 16 ( FIG. 2 ).
- the shaft 16 also includes a media delivery channel 130 and a suction channel 140 disposed within a wall 142 of the shaft 16 .
- the media delivery channel 130 and the suction channel 140 extend along the length of the shaft 16 and terminate at a delivery port 132 and a suction port 142 , respectively, located at the distal end 20 of the shaft 16 .
- the first ablation device 12 can include a fluid delivery tube and a drainage tube.
- the delivery tube and the drainage tube can be secured to an exterior surface of the shaft 16 , or alternatively, be disposed within the lumen 21 of the shaft 16 .
- a cooling tube having a coil configuration such as that described in U.S. patent application Ser. No. 10/231,738, can be provided.
- the entire disclosure of U.S. patent application Ser. No. 10/231,738 is expressly incorporated by reference herein.
- the first ablation device 12 also includes a cryo balloon 22 .
- the cryo balloon 22 has a proximal end 102 and a distal end 104 that are both secured to the distal end 20 of the shaft 16 , and a lumen 106 that is in fluid communication with the delivery port 132 and the suction port 142 .
- the cryo balloon 22 has a configuration that resembles an elliptical shape.
- the cryo balloon 22 can have other shapes, such as a spherical shape, an elongate shape, or other customized shapes.
- coolant is delivered from the coolant supply 80 via the media delivery channel 130 and exits through the delivery port 132 to inflate the cryo balloon 22 .
- the delivered coolant can be drained or vacuumed through the suction port 142 to circulate coolant through the cryo balloon 22 and/or to deflate the cryo balloon 22 .
- the first ablation device 12 further includes one or more steering wires disposed within the wall 142 of the shaft 16 , with the distal end(s) of the steering wire(s) secured to the distal end 20 of the shaft 16 . In such cases, tension can be applied to the steering wire(s) to bend the distal end 20 of the shaft 16 , thereby steering the cryo balloon 22 .
- the first ablation device 12 also includes an access cannula 30 having a distal end 32 , a proximal end 34 , and a lumen 36 extending between the distal and the proximal ends 32 , 34 .
- the shaft 16 is located coaxially within the lumen 36 of the cannula 30 , and is slidable relative to the cannula 30 .
- the cryo balloon 22 initially-in its deflated configuration is resided within the lumen 36 of the cannula 30 .
- the shaft 16 is then advanced distally relative to the cannula 30 (or the cannula 30 is retracted proximally relative to the shaft 16 ) to push the cryo balloon 22 out of the distal end 32 of the cannula 30 , and the cryo balloon 22 is then inflated to perform ablative therapy.
- the cannula 30 can further include one or more steering wires (not shown) having distal end(s) that is secured to the distal end 32 of the cannula 30 .
- the steering wire(s) can be tensioned to bend the distal end 32 , thereby steering the distal end 32 of the cannula 30 during use.
- the first ablation device 12 can further include an outer member (not shown) disposed over the cryo balloon 22 .
- the first ablation device 12 can further include an outer shaft (not shown ) disposed coaxially outside the shaft 16 .
- a vacuum can be created in the lumen that is between the shaft 16 and the outer shaft, thereby providing both thermal insulation and gas isolation between the coolant and the patient.
- the outer shaft can be made from a biocompatible material known to those skilled in the art of catheter construction, and should be sufficiently rigid to prevent the outer shaft from collapsing when a vacuum is created within the lumen of the outer shaft.
- the second ablation device 52 also includes a shaft 56 having a proximal end 58 , a distal end 60 , and a lumen 61 extending between the proximal and the distal ends 58 , 60 , and terminating at a port 84 .
- the proximal end 58 of the shaft 56 has an extension 80 with a guidewire port 82 that is in fluid communication with the lumen 61 of the shaft 56 .
- the second ablation device 52 also includes a cryo balloon 62 secured to the distal end 60 of the shaft 56 , and an access cannula 70 having a distal end 72 , a proximal end 74 , and a lumen 76 extending between the distal and the proximal ends 72 , 74 .
- the shaft 56 is located coaxially within the lumen 76 , and is slidable relative to the cannula 70 .
- the second ablation device 52 is similar to the first ablation device 12 , and therefore, will not be described in further details.
- the first and the second cryo balloons 22 , 62 are adapted to be placed relative to each other such that they at least partially surround a target tissue to be ablated.
- the first and the second ablation devices 12 , 52 further include a first element 110 and a second element 112 , respectively, for assisting placement of the cryo balloons 22 , 62 relative to each other.
- the first and the second elements 110 , 112 can be radio opaque markers that can be visualized under x-ray or fluoroscope.
- the first and the second elements 110 , 112 can be a signal transmitter, and a signal receiver, respectively, or vice versa.
- the first element 110 can be an ultrasound signal transmitter that transmits ultrasound signals
- the second element 112 can be an ultrasound signal sensor for sensing ultrasound signals.
- a distance between the first and the second elements 110 , 112 can then be determined.
- multiple receivers could be used to triangulate position(s) of the cryo balloons 22 , 62 .
- the first element 110 can be a magnet (e.g., a permanent magnet or an electromagnet), and the second element 112 can be a magnetic field sensor, or vice versa.
- a distance between the cryo balloons 22 , 62 can be determined (e.g., a stronger magnetic field indicates that the cryo balloons 22 , 62 are closer to each other, and vice versa).
- the first element 110 can be a radiofrequency energy transmitter
- the second element 112 can be a radiofrequency energy sensor, or vice versa.
- a relative distance between the first and the second elements 110 , 112 can be determined.
- both the first and the second elements 110 , 112 can be magnets (e.g., permanent magnets or electromagnets).
- the magnets mechanically attract the first and the second cryo balloons 22 , 62 towards each other, thereby positioning the cryo balloons 22 , 62 close to each other.
- the cryo balloons 22 , 62 are placed on opposite sides of target tissue. In such cases, the magnets will cause the cryo balloons 22 , 62 to move towards each other and make contact with opposite sides of the target tissue.
- the first and the second elements 110 , 112 are secured to the distal ends 20 , 60 of the respective shafts 16 , 56 .
- the first and the second elements 110 , 112 can be secured to the cryo balloons 22 , 62 , respectively.
- the first and the second ablation devices 12 , 52 can include other systems or devices known in the art for determining a relative position or distance between portions of the respective ablation devices 12 , 52 .
- the first and the second ablation devices 12 , 52 can each include one or more sensor(s) for sensing a characteristic of target tissue being ablated, a temperature of the cryo balloon, a temperature of the coolant within the lumen of the cryo balloon, and/or a characteristic of an environment in which the tissue is being ablated.
- FIG. 3 shows an ablation device 200 in accordance with other embodiments of the invention.
- the ablation device 200 can be used in substitute of either of the ablation devices 12 , 52 of FIG. 1 .
- the ablation device 200 includes an array 202 of sensors 204 secured to a cryo balloon 208 .
- the sensors 204 can be, for example, temperature sensors for sensing temperature of tissue being ablated, temperature of the cryo balloon 208 , and/or temperature of coolant within the cryo balloon 208 .
- the sensors 204 can be impedance sensors for sensing impedance of tissue being ablated.
- the sensors 204 can be other types of sensors for sensing electrical activity of cardiac tissue.
- the array 202 of sensors 204 are secured to an exterior surface of the cryo balloon 208 .
- the sensors 204 can be disposed within a wall of the cryo balloon 208 , or be secured to an interior surface of the cryo balloon 208 .
- the sensors 204 can be secured to the shaft 210 .
- the array 202 includes a plurality of splines 206 to each of which, three sensors 204 are secured. In other embodiments, each spline 206 can carry other number of sensors 204 . Also, in other embodiments, the array 202 of sensors 204 can be arranged in a staggered configuration ( FIG. 4 ), which allows the sensors 204 to be more uniformly spaced. Although a plurality of sensors 204 are shown, in alternative embodiments, the ablation device 200 can include a single sensor 204 . In some embodiments, the sensor 204 can be slidable relative to the shaft 210 . For example, the sensor 204 can be slidably coupled to the shaft 210 . Alternatively, the sensors 204 can be mounted on an entirely different member (not shown), such as another catheter, that is positionable relative to the shaft 210 .
- the sensors 204 are electrically coupled to a controller (not shown), which is configured to control a temperature of the coolant being delivered to the cryo balloon 208 in response to signals received from the sensors 204 .
- a controller (not shown), which is configured to control a temperature of the coolant being delivered to the cryo balloon 208 in response to signals received from the sensors 204 .
- the controller then lowers the temperature of the coolant at the source 80 until the temperature of the delivered coolant is within the prescribed threshold.
- the controller can be configured to control a flow rate of the coolant being delivered by the source 80 based on signals received from the sensors 204 .
- FIG. 5 shows an ablation device 300 in accordance with other embodiments of the invention.
- the ablation device 300 can be used in substitute of either of the ablation devices 12 , 52 of FIG. 1 .
- the ablation device 300 has three cryo balloons 302 , 304 , 306 secured to distal ends 310 , 312 , 314 of respective shafts 320 , 322 , 324 .
- the ablation device 300 further includes a cannula 330 having a distal end 332 , a proximal end 334 , and a lumen 336 extending between the distal and the proximal ends 332 , 334 .
- the cryo balloons 302 , 304 , 306 are pushed out of the distal end 332 of the cannula 330 and are inflated by coolant.
- the balloons 302 , 304 , 306 are then placed against target tissue to create a lesion 340 at the target tissue by cryolysis ( FIG. 6A ).
- the shafts 320 , 322 , 324 can be sequentially positioned to place the respective balloons 302 , 304 , 306 at different target tissue.
- the third balloon 306 is then placed adjacent the first balloon 302 to create another lesion 342 .
- the first and the second balloons 302 , 304 remain in their initial positions to further ablate the target tissue and to increase the size of the first lesion 340 .
- the second balloon 304 can next be placed adjacent the third balloon 306 to create another lesion 344 ( FIG. 6B ).
- the shafts 320 , 322 , 324 can be coupled to an inner tube (not shown) that is disposed within the lumen 336 of the cannula 330 .
- the inner tube can be rotated coaxially within the cannula 330 to sequentially place the balloons 302 , 304 , 306 against different target tissue.
- use of a plurality of balloons is advantageous because it allows target tissue be cooled synergistically.
- tissue ablation system 10 can also be used to treat tissue at other locations at the heart, such as an annulus of a mitral valve connecting a left atrium and a left ventricle, or an annulus of a tricuspid valve connecting the an atrium and a right ventricle of the heart.
- tissue ablation system 10 can also be used to treat tissue at other locations within a body.
- the first cannula 30 When using the system 10 to create a lesion at the left atrial isthmus, the first cannula 30 is inserted through the right atrium via jugular or femoral vein access to the vena cava, and is steered into the coronary sinus (CS).
- the second cannula 70 is also inserted through a main vein, and is steered into a right atrium (RA) of a heart.
- the cannulas 30 , 70 can be steered by using a guidewire in a conventional manner, or by applying tension to steering wire(s) (if the steering wire(s) is provided).
- a needle can be inserted into the lumen 76 of the cannula 70 and exits from the distal end 72 to puncture an atrial septum (AS) that separates the right atrium and left atrium (LA).
- AS atrial septum
- LA right atrium and left atrium
- the cannula 70 can be advanced through a guiding sheath placed transeptally into the LA.
- the distal end 72 of the cannula 70 is then advanced through the atrial septum, and into the left atrium.
- the distal end 72 of the cannula 70 is steered to adjacent a treatment site (TS) ( FIG. 7A ).
- TS treatment site
- cannula 30 , 70 are not steerable, separate cannulas that are steerable, or have a pre-bent configuration, can be used to access the coronary sinus and the left atrium. In such cases, after the separate cannulas have reached the coronary sinus and the left atrium, the cannulas 30 , 70 are then inserted into the separate cannulas and are advanced distally until the distal ends 32 , 72 exit from the separate cannulas at the coronary sinus and the left atrium, respectively.
- the first and the second cryo balloons 22 , 62 in their collapsed configuration, are inserted into the lumens 36 , 76 of the respective cannulas 30 , 70 , and are advanced distally within the respective lumens 36 , 76 until they reach the distal ends 32 , 72 of the cannulas 30 , 70 .
- the cryo balloons 22 , 62 can be housed within the lumens 36 , 76 of the respective cannulas 30 , 70 while the cannulas 30 , 70 are steered to the treatment site.
- the cannulas 30 , 70 are then retracted relative to the cryo balloons 22 , 62 (or the cryo balloons 22 , 62 are advanced distally relative to the cannulas 30 , 70 ), thereby exposing the cryo balloons 22 , 62 .
- cryo balloons 22 , 62 are positioned relative to each other such that they are substantially next to each other and are on opposite sides of target tissue.
- the cryo balloons 22 , 62 can be positioned by operating the proximal ends 18 , 58 of the respective shafts 16 , 56 .
- the cryo balloons 22 , 62 can also be steered by using guidewires that are disposed within the respective lumens 21 , 61 of the shafts 16 , 56 in a conventional manner. If the first and the second ablation devices, 12 , 52 include steering wires, tension can be applied to the steering wires to steer the cryo balloons 22 , 62 , and place the cryo balloons 22 , 62 at desired locations.
- the navigation assisting elements 110 , 112 can be used to assist placement of the cryo balloons 22 , 62 such that the cryo balloons 22 , 62 are substantially next to, or at least proximate, each other on opposite sides of the target tissue. Also, mapping catheter 200 or similar may be used to verify placement.
- inflation fluid is delivered under positive pressure by the coolant source 80 to urge the cryo balloons 22 , 62 to expand ( FIG. 7B ).
- the first cryo balloon 22 substantially occludes the coronary sinus, thereby preventing or substantially reducing flow of blood through the coronary sinus.
- Such technique is advantageous because it limits the amount of blood that carries heat from passing through target tissue, thereby allowing more cooling energy be delivered to the target tissue. As shown in FIG.
- the first cryo balloon 22 is in contact with a first surface 400 of target tissue at the left atrial isthmus, and the second cryo balloon 62 is in contact with a second surface 402 that is on an opposite side of the target tissue.
- the cryo balloons 22 , 62 each includes the sensor(s) 204
- the sensor(s) 204 can be used to sense a temperature or an electrical activity to determine whether the cryo balloons 22 , 62 are in contact with target tissue to be ablated.
- the cryo balloons 22 , 62 can be further positioned until they are in contact with target tissue to be ablated.
- the inflation fluid is a low freezing point liquid such as an ethanol mixture, or a liquified gas such as N 2 O or CO 2 .
- the coolant is one which will provide the appropriate heat transfer characteristics consistent with the goals of treatment.
- Liquid N 2 O can be used as a general purpose coolant, and is particularly useful when freezing of cells is desired. When liquid N 2 O is used, it can be transported to the cryo balloons 22 , 62 in the liquid phase where it evaporates at the port 132 and exits into the port 142 as a gas. Freon, and other types of gas can also be used as coolants.
- the cryo balloons 22 , 62 may then be used to cool target tissue to create a cold-induced lesion at the target site.
- the coolant cools the cryo balloons 22 , 62 , which in turn, cool the target tissue at the left atrial isthmus that is between the cryo balloons 22 , 62 .
- the target tissue is cooled to a temperature that is approximately between ⁇ 20° C. to ⁇ 100° C., and more preferably, between ⁇ 40° C. to ⁇ 80° C., such that at least part of the target tissue is ablated by cryolysis.
- the senor(s) 204 can be used to sense a temperature or an electrical characteristic of the tissue being ablated during the ablation procedure.
- the sensor(s) 204 then transmit a signal representative of the sensed temperature or electrical characteristic to a controller (not shown) that is coupled to the source 80 of coolant.
- the controller regulates the temperature and/or the flow rate of the coolant that is being delivered to the second cryo balloon 62 (or the first cryo balloon 22 ).
- the controller can independently control the temperatures and/or the flow rates of the coolants that are being delivered to the respective cryo balloons 22 , 62 .
- cryo balloons 22 , 62 may be placed at different target site(s), and the same steps discussed previously may be repeated.
- the cryo balloons 22 , 62 are deflated and retracted into the respective shaft lumens 36 , 76 , and the ablation devices 12 , 52 are removed from the treatment region.
- the system 10 and method described previously can be also used to create lesions at other locations of the heart.
- the system 10 and similar method can be used to create lesions inside the left atrium between the pulmonary veins and the mitral valve annulus. Tissue nearby these anatomic structures are recognized to develop arrhythmia substrates causing atrial fibrillation. Lesions in these tissue regions block reentry paths or destroy active pacemaker sites, and thereby prevent the arrhythmia from occurring.
- FIG. 8 shows (from outside the heart H) the location of major anatomic landmarks for lesion formation in the left atrium.
- the landmarks include the right inferior pulmonary vein (RIPV), the right superior pulmonary vein (RSPV), the left superior pulmonary vein (LSPV), the left inferior pulmonary vein (LIPV); and the mitral valve annulus (MVA).
- FIGS. 9A and 9B show examples of lesion patterns formed inside the left atrium based upon these landmarks.
- the lesion pattern comprises a first leg L 1 between the right inferior pulmonary vein (RIPV) and the right superior pulmonary vein (RSPV); a second leg L 2 between the RSPV and the left superior pulmonary vein (LSPV); a third leg L 3 between the left superior pulmonary vein (LSPV) and the left inferior pulmonary vein (LIPV); and a fourth leg L 4 leading between the LIPV and the mitral valve annulus (MVA).
- the first, second, and third legs L 1 -L 3 can be created by placing the first cryo balloon 22 at the left atrium (LA), and the second cryo balloon 62 inside the left ventrical (LV), the right ventrical (RV), or the coronary sinus (CS).
- the fourth leg L 4 can be created by placing the first cryo balloon 22 at the LA, and the second cryo balloon 62 inside the CS.
- the positions of the first and the second cryo balloons 22 , 62 described previously may be exchanged.
- FIG. 8 shows (from outside the heart H) the location of the major anatomic landmarks for lesion formation in the right atrium. These landmarks include the superior vena cava (SVC), the tricuspid valve annulus (TVA), the inferior vena cava (IVC), and the coronary sinus (CS). Tissue nearby these anatomic structures have been identified as developing arrhythmia substrates causing atrial fibrillation. Lesions in these tissue regions block reentry paths or destroy active pacemaker sites and thereby prevent the arrhythmia from occurring.
- SVC superior vena cava
- TVA tricuspid valve annulus
- IVC inferior vena cava
- CS coronary sinus
- FIGS. 10A to 10 C show representative lesion patterns formed inside the right atrium based upon these landmarks.
- FIG. 10A shows a representative lesion pattern L that extends between the superior vena cava (SVC) and the tricuspid valve annulus (TVA).
- the lesion L can be created by placing the first cryo balloon 22 at the LA, and the second cryo balloon 62 inside the LV or the RV. In an alternative embodiment, the positions of the first and the second cryo balloons 22 , 62 may be exchanged.
- FIG. 10B shows a representative lesion pattern that extends between the interior vena cava (IVC) and the TVA.
- the lesion L can be created by placing the first cryo balloon 22 at the LA, and the second cryo balloon 62 inside the LV or the RV.
- the positions of the first and the second cryo balloons 22 , 62 may be exchanged.
- FIG. 10C shows a representative lesion pattern L that extends between the coronary sinus (CS) and the tricuspid valve annulus (TVA).
- the lesion L can be created by placing the first cryo balloon 22 at the right atrium (RA), and the second cryo balloon 62 inside the LV, the RV, or the CS.
- the positions of the first and the second cryo balloons 22 , 62 may be exchanged.
- one of the first and the second cryo balloons 22 , 62 can be placed at the atrium at the base of a heart, while the other of the first and the second cryo balloons 22 , 62 is placed at the LV.
- Such placement of the first and the second cryo balloons 22 , 62 allows a lesion to be created at the intersection of the atria and the ventricle.
- one of the cryo balloons 22 , 62 can be placed at the RV next to the septum, while the other of the cryo balloons 22 , 62 is placed at the LV. Such placement of the cryo balloons 22 , 62 allows a lesion to be created at the ventricular septum.
- arrhythmias such as ventricular tachycardia (VT), post-myocardial infraction, atrial fibrillation, supra-VT, flutter, and other heart conditions
- the system 10 may also be used in many different environments and/or applications.
- the system 10 may also be used to create lesions, such as transmural lesions, at different locations within the body.
Abstract
Description
- The present invention relates generally to therapeutic cooling of body tissue, and more particularly, to methods and apparatus for deploying a plurality of cooling elements to at least partially surround and cool, e.g., to ablate by cryoplasty, a selected tissue region.
- A number of medical conditions may be treated using ablative techniques or devices. Ablative therapy generally involves the killing of abnormal tissue at an area of interest, thereby resulting in an efficacious treatment for a medical condition. For example, atrial fibrillation may be treatable by ablation of the abnormal tissue within the left atrium and/or the pulmonary vein.
- Atrial fibrillation is a serious medical condition that is the result of abnormal electrical activity within the heart. This abnormal activity may occur at regions of the heart including the sino-atrial (SA) node, the atriovenricular (AV) node, or within other areas of cardiac tissue. Moreover, atrial fibrillation may be caused by abnormal activity within one or more isolated focal centers within the heart. It is believed that these foci can originate from within the pulmonary vein, particularly the superior pulmonary veins.
- Ablation catheters have been used in minimally invasive techniques to ablate target tissue, e.g., foci having abnormal electrical activity. The techniques typically are characterized by application of energy to create lesions at the foci or other areas possessing abnormal electrical activity. Ablation catheters can also be used to create lesions at the heart to block electrical signals or to alter a travel path of electrical signals at the heart.
- Some ablation devices utilize radio frequency (RF) energy for ablation, including the device disclosed in U.S. Pat. No. 6,024,740 to Lesh et al. The RF energy devices may be used to ablate an area of interest with heat. The use of RF energy for ablation may, however, lead to untoward healing responses such as collagen build up at the area of interest after treatment. In some cases, RF ablation may create lesions that cause occlusion of the coronary sinus in post procedure healing. A need, therefore, exists for ablative devices and methods that include improved healing responses.
- An alternative treatment strategy has been developed that uses cooling energy for ablation. This method, termed cryoplasty or cryotherapy, may be used to cool or otherwise freeze a portion of target tissue to ablate the target tissue. For example, cryoplasty may be used to cool or freeze and simultaneously dilate a lesion within a blood vessel that might otherwise lead to restenosis or recoil. Cryotherapy may also be used to create lesions at a heart to treat atrial fibrillation. However, creating lesions in a heart using cryotherapy poses a challenge in that it may be difficult to deliver sufficient cooling to create a transmural (i.e., a through thickness) lesion. In addition, blood delivered to and from the heart constantly provides heat to a target site at the heart, thereby counteracting against the cooling being delivered by the cryotherapy, and limiting the amount of cooling that can be delivered to the target site. This in turn, further prevents a transmural lesion, or lesion of a desired size or characteristic, from being created at the target tissue.
- Thus, there is currently a need for an improved device and method to perform ablation therapy.
- In accordance with some embodiments, a method for performing cryotherapy on a target tissue region in a body includes positioning a first cooling element in a first location in a body adjacent a target tissue region, positioning a second cooling element in a second location in the body adjacent the target tissue region, and cooling the respective first and second cooling elements so as to cool the target tissue region.
- In accordance with other embodiments, a method for treating atrial fibrillation includes positioning a first cooling element in a patient's coronary sinus adjacent a target tissue region at least partially connecting the patient's left atrium and left ventricle, positioning a second cooling element in the patient's left atrium adjacent the target tissue region, and cooling the respective first and second cooling elements so as to ablate the target tissue region.
- In accordance with other embodiments, an apparatus for performing cryotherapy on a target tissue region in a body includes a first cooling element configured for positioning in a first location in a body adjacent a target tissue region, the first cooling element comprising a locatable portion, a second cooling element configured for positioning in a second location in a body adjacent the target tissue region, the second cooling element comprising a locatable portion, each of the first and second cooling elements being in fluid communication with a coolant source, and one or more controllers for controlling cooling of the first and second cooling elements independent of each other.
- Other and further aspects and features of the invention will be evident from reading the following detailed description of the preferred embodiments, which are intended to illustrate, not limit, the invention.
- The drawings illustrate the design and utility of preferred embodiments of the present invention. It should be noted that the figures are not drawn to scale and that elements of similar structures or functions are represented by like reference numerals throughout the figures. In order to better appreciate how the above-recited and other advantages and objects of the present inventions are obtained, a more particular description of the present inventions briefly described above will be rendered by reference to specific embodiments thereof, which are illustrated in the accompanying drawings. Understanding that these drawings depict only typical embodiments of the invention and are not therefore to be considered limiting of its scope, the invention will be described and explained with additional specificity and detail through the use of the accompanying drawings in which:
-
FIG. 1 is a perspective view of a tissue ablation system in accordance with some embodiments of the invention, showing the tissue ablation system having two ablation devices; -
FIG. 2 is a cross sectional view of one of the ablation devices ofFIG. 1 ; -
FIG. 3 is a perspective view of an ablation device having an array of sensors in accordance with other embodiments of the invention; -
FIG. 4 is a perspective view of a variation of the ablation device ofFIG. 3 ; -
FIG. 5 is a perspective view of a tissue ablation device in accordance with other embodiments of the invention, showing the tissue ablation device having three cryo balloons; -
FIGS. 6A and 6B are end views of the tissue ablation device ofFIG. 5 , showing the tissue ablation device being used to create lesions; -
FIGS. 7A and 7B are cross-sectional views, showing a method for treating tissue, in accordance with some embodiments of the invention; -
FIG. 8 shows, in diagrammatic form, anatomic landmarks for lesion formation in left and right atriums; -
FIG. 9A and 9B show representative lesion patterns in a left atrium that may be formed using the tissue ablation system ofFIG. 1 ; and -
FIG. 10A-10C show representative lesion patterns in a right atrium that may be formed using the tissue ablation system ofFIG. 1 . - Various embodiments of the present invention are described hereinafter with reference to the figures. It should be noted that the figures are not drawn to scale and elements of similar structures or functions are represented by like reference numerals throughout the figures. It should also be noted that the figures are only intended to facilitate the description of specific embodiments of the invention. They are not intended as an exhaustive description of the invention or as a limitation on the scope of the invention. In addition, an aspect described in conjunction with a particular embodiment of the present invention is not necessarily limited to that embodiment and can be practiced in any other embodiments of the present invention.
-
FIG. 1 illustrates atissue ablation system 10 in accordance with some embodiments of the invention. Thetissue ablation system 10 includes a first and asecond ablation devices tissue ablation system 10 also includes acoolant supply 80 configured for supplying cooling energy to theablation devices coolant supply 80 provides cooling media to both the first and thesecond ablation devices second ablation devices - The
first ablation device 12 includes ashaft 16 having aproximal end 18, adistal end 20, and alumen 21 extending between the proximal and thedistal ends distal port 44. Theproximal end 18 of theshaft 16 has anextension 40 with aguidewire port 42 that is in fluid communication with thelumen 21 of theshaft 16. During use, aguidewire 120 can be inserted through thedistal port 44 and exits through theguidewire port 42 at theproximal end 18 of the shaft 16 (FIG. 2 ). As shown inFIG. 2 , theshaft 16 also includes amedia delivery channel 130 and asuction channel 140 disposed within awall 142 of theshaft 16. Themedia delivery channel 130 and thesuction channel 140 extend along the length of theshaft 16 and terminate at adelivery port 132 and asuction port 142, respectively, located at thedistal end 20 of theshaft 16. In other embodiments, instead of having thechannels wall 142 of theshaft 16, thefirst ablation device 12 can include a fluid delivery tube and a drainage tube. The delivery tube and the drainage tube can be secured to an exterior surface of theshaft 16, or alternatively, be disposed within thelumen 21 of theshaft 16. Also, in other embodiments, a cooling tube having a coil configuration, such as that described in U.S. patent application Ser. No. 10/231,738, can be provided. The entire disclosure of U.S. patent application Ser. No. 10/231,738 is expressly incorporated by reference herein. - The
first ablation device 12 also includes acryo balloon 22. Thecryo balloon 22 has aproximal end 102 and adistal end 104 that are both secured to thedistal end 20 of theshaft 16, and alumen 106 that is in fluid communication with thedelivery port 132 and thesuction port 142. In the illustrated embodiments, thecryo balloon 22 has a configuration that resembles an elliptical shape. Alternatively, thecryo balloon 22 can have other shapes, such as a spherical shape, an elongate shape, or other customized shapes. During use, coolant is delivered from thecoolant supply 80 via themedia delivery channel 130 and exits through thedelivery port 132 to inflate thecryo balloon 22. The delivered coolant can be drained or vacuumed through thesuction port 142 to circulate coolant through thecryo balloon 22 and/or to deflate thecryo balloon 22. - In some embodiments, the
first ablation device 12 further includes one or more steering wires disposed within thewall 142 of theshaft 16, with the distal end(s) of the steering wire(s) secured to thedistal end 20 of theshaft 16. In such cases, tension can be applied to the steering wire(s) to bend thedistal end 20 of theshaft 16, thereby steering thecryo balloon 22. - The
first ablation device 12 also includes anaccess cannula 30 having adistal end 32, aproximal end 34, and alumen 36 extending between the distal and the proximal ends 32, 34. Theshaft 16 is located coaxially within thelumen 36 of thecannula 30, and is slidable relative to thecannula 30. During use, thecryo balloon 22 initially-in its deflated configuration, is resided within thelumen 36 of thecannula 30. After thedistal end 32 of the-cannula 30 has been desirably positioned, theshaft 16 is then advanced distally relative to the cannula 30 (or thecannula 30 is retracted proximally relative to the shaft 16) to push thecryo balloon 22 out of thedistal end 32 of thecannula 30, and thecryo balloon 22 is then inflated to perform ablative therapy. In some embodiments, thecannula 30 can further include one or more steering wires (not shown) having distal end(s) that is secured to thedistal end 32 of thecannula 30. The steering wire(s) can be tensioned to bend thedistal end 32, thereby steering thedistal end 32 of thecannula 30 during use. - In other embodiments, the
first ablation device 12 can further include an outer member (not shown) disposed over thecryo balloon 22. Also, in other embodiments, thefirst ablation device 12 can further include an outer shaft (not shown ) disposed coaxially outside theshaft 16. During use, a vacuum can be created in the lumen that is between theshaft 16 and the outer shaft, thereby providing both thermal insulation and gas isolation between the coolant and the patient. The outer shaft can be made from a biocompatible material known to those skilled in the art of catheter construction, and should be sufficiently rigid to prevent the outer shaft from collapsing when a vacuum is created within the lumen of the outer shaft. - The above and similar devices have been disclosed in U.S. Pat. No. 6,666,858, and U.S. patent application Ser. No. 10/126,027, the entire disclosures of which are expressly incorporated by reference herein.
- Returning to
FIG. 1 , thesecond ablation device 52 also includes a shaft 56 having aproximal end 58, adistal end 60, and alumen 61 extending between the proximal and the distal ends 58, 60, and terminating at aport 84. Theproximal end 58 of the shaft 56 has anextension 80 with aguidewire port 82 that is in fluid communication with thelumen 61 of the shaft 56. Thesecond ablation device 52 also includes acryo balloon 62 secured to thedistal end 60 of the shaft 56, and anaccess cannula 70 having adistal end 72, aproximal end 74, and alumen 76 extending between the distal and the proximal ends 72, 74. The shaft 56 is located coaxially within thelumen 76, and is slidable relative to thecannula 70. Thesecond ablation device 52 is similar to thefirst ablation device 12, and therefore, will not be described in further details. - The first and the second cryo balloons 22, 62 are adapted to be placed relative to each other such that they at least partially surround a target tissue to be ablated. In the illustrated embodiments, the first and the
second ablation devices first element 110 and asecond element 112, respectively, for assisting placement of the cryo balloons 22, 62 relative to each other. The first and thesecond elements second elements first element 110 can be an ultrasound signal transmitter that transmits ultrasound signals, and thesecond element 112 can be an ultrasound signal sensor for sensing ultrasound signals. In such cases, based on a time difference between thefirst element 110 transmitting an ultrasound signal and thesecond element 112 receiving the ultrasound signal, a distance between the first and thesecond elements 110, 112 (and therefore, between the cryo balloons 22, 62) can then be determined. Also in other embodiments, multiple receivers could be used to triangulate position(s) of the cryo balloons 22, 62. - In other embodiments, the
first element 110 can be a magnet (e.g., a permanent magnet or an electromagnet), and thesecond element 112 can be a magnetic field sensor, or vice versa. In such cases, based on a sensed magnetic field by the magnetic field sensor, a distance between the cryo balloons 22, 62 can be determined (e.g., a stronger magnetic field indicates that the cryo balloons 22, 62 are closer to each other, and vice versa). - In other embodiments, the
first element 110 can be a radiofrequency energy transmitter, and thesecond element 112 can be a radiofrequency energy sensor, or vice versa. In such cases, based on a strength of the radiofrequency energy sensed by the sensor, a relative distance between the first and thesecond elements 110, 112 (and therefore, a relative position between the cryo balloons 22, 62) can be determined. - Also, in other embodiments, both the first and the
second elements - In the above described embodiments, the first and the
second elements respective shafts 16, 56. Alternatively, the first and thesecond elements second elements second ablation devices respective ablation devices - In other embodiments, instead of, or in addition to, having the
navigation assisting elements second ablation devices FIG. 3 shows anablation device 200 in accordance with other embodiments of the invention. Theablation device 200 can be used in substitute of either of theablation devices FIG. 1 . Theablation device 200 includes anarray 202 ofsensors 204 secured to acryo balloon 208. Thesensors 204 can be, for example, temperature sensors for sensing temperature of tissue being ablated, temperature of thecryo balloon 208, and/or temperature of coolant within thecryo balloon 208. Alternatively, thesensors 204 can be impedance sensors for sensing impedance of tissue being ablated. In other embodiments, thesensors 204 can be other types of sensors for sensing electrical activity of cardiac tissue. In the illustrated embodiments, thearray 202 ofsensors 204 are secured to an exterior surface of thecryo balloon 208. Alternatively, thesensors 204 can be disposed within a wall of thecryo balloon 208, or be secured to an interior surface of thecryo balloon 208. Also, in other embodiments, thesensors 204 can be secured to theshaft 210. In the illustrated embodiments, thearray 202 includes a plurality ofsplines 206 to each of which, threesensors 204 are secured. In other embodiments, eachspline 206 can carry other number ofsensors 204. Also, in other embodiments, thearray 202 ofsensors 204 can be arranged in a staggered configuration (FIG. 4 ), which allows thesensors 204 to be more uniformly spaced. Although a plurality ofsensors 204 are shown, in alternative embodiments, theablation device 200 can include asingle sensor 204. In some embodiments, thesensor 204 can be slidable relative to theshaft 210. For example, thesensor 204 can be slidably coupled to theshaft 210. Alternatively, thesensors 204 can be mounted on an entirely different member (not shown), such as another catheter, that is positionable relative to theshaft 210. - In the illustrated embodiments, the
sensors 204 are electrically coupled to a controller (not shown), which is configured to control a temperature of the coolant being delivered to thecryo balloon 208 in response to signals received from thesensors 204. For example, if asensor 204 senses a temperature indicating that the temperature of the delivered coolant is above a prescribed threshold, the controller then lowers the temperature of the coolant at thesource 80 until the temperature of the delivered coolant is within the prescribed threshold. In other embodiments, the controller can be configured to control a flow rate of the coolant being delivered by thesource 80 based on signals received from thesensors 204. - Although the first and the
second ablation devices ablation devices FIG. 5 shows anablation device 300 in accordance with other embodiments of the invention. Theablation device 300 can be used in substitute of either of theablation devices FIG. 1 . Theablation device 300 has threecryo balloons distal ends respective shafts ablation device 300 further includes acannula 330 having adistal end 332, aproximal end 334, and alumen 336 extending between the distal and the proximal ends 332, 334. During use, the cryo balloons 302, 304, 306 are pushed out of thedistal end 332 of thecannula 330 and are inflated by coolant. Theballoons lesion 340 at the target tissue by cryolysis (FIG. 6A ). During the ablation procedure, theshafts respective balloons lesion 340 has been created by theballoons third balloon 306 is then placed adjacent thefirst balloon 302 to create anotherlesion 342. While thethird balloon 306 is used to create thelesion 342, the first and thesecond balloons first lesion 340. In a similar fashion, thesecond balloon 304 can next be placed adjacent thethird balloon 306 to create another lesion 344 (FIG. 6B ). In some embodiments, theshafts lumen 336 of thecannula 330. In such cases, the inner tube can be rotated coaxially within thecannula 330 to sequentially place theballoons - Referring now to
FIGS. 7A and 7B , the operation of thetissue ablation system 10 will now be described with reference to cardiac ablation therapy, and more specifically, to creating a lesion at a left atrial isthmus of a heart. However, it should be understood by those skilled in the art that thetissue ablation system 10 can also be used to treat tissue at other locations at the heart, such as an annulus of a mitral valve connecting a left atrium and a left ventricle, or an annulus of a tricuspid valve connecting the an atrium and a right ventricle of the heart. In other embodiments, thetissue ablation system 10 can also be used to treat tissue at other locations within a body. - When using the
system 10 to create a lesion at the left atrial isthmus, thefirst cannula 30 is inserted through the right atrium via jugular or femoral vein access to the vena cava, and is steered into the coronary sinus (CS). Thesecond cannula 70 is also inserted through a main vein, and is steered into a right atrium (RA) of a heart. Thecannulas distal end 72 of thecannula 70 has reached the right atrium, a needle can be inserted into thelumen 76 of thecannula 70 and exits from thedistal end 72 to puncture an atrial septum (AS) that separates the right atrium and left atrium (LA). Alternatively, thecannula 70 can be advanced through a guiding sheath placed transeptally into the LA. Thedistal end 72 of thecannula 70 is then advanced through the atrial septum, and into the left atrium. At the left atrium, thedistal end 72 of thecannula 70 is steered to adjacent a treatment site (TS) (FIG. 7A ). If thecannula cannulas - Next, the first and the second cryo balloons 22, 62, in their collapsed configuration, are inserted into the
lumens respective cannulas respective lumens cannulas lumens respective cannulas cannulas cannulas cannulas 30, 70), thereby exposing the cryo balloons 22, 62. - Next, the cryo balloons 22, 62 are positioned relative to each other such that they are substantially next to each other and are on opposite sides of target tissue. For example, the cryo balloons 22, 62 can be positioned by operating the proximal ends 18, 58 of the
respective shafts 16, 56. The cryo balloons 22, 62 can also be steered by using guidewires that are disposed within therespective lumens shafts 16, 56 in a conventional manner. If the first and the second ablation devices, 12, 52 include steering wires, tension can be applied to the steering wires to steer the cryo balloons 22, 62, and place the cryo balloons 22, 62 at desired locations. Thenavigation assisting elements mapping catheter 200 or similar may be used to verify placement. - Next, inflation fluid is delivered under positive pressure by the
coolant source 80 to urge the cryo balloons 22, 62 to expand (FIG. 7B ). After thefirst cryo balloon 22 has been expanded, thefirst cryo balloon 22 substantially occludes the coronary sinus, thereby preventing or substantially reducing flow of blood through the coronary sinus. Such technique is advantageous because it limits the amount of blood that carries heat from passing through target tissue, thereby allowing more cooling energy be delivered to the target tissue. As shown inFIG. 7B , after the cryo balloons 22, 62 have been expanded, thefirst cryo balloon 22 is in contact with afirst surface 400 of target tissue at the left atrial isthmus, and thesecond cryo balloon 62 is in contact with asecond surface 402 that is on an opposite side of the target tissue. If the cryo balloons 22, 62 each includes the sensor(s) 204, the sensor(s) 204 can be used to sense a temperature or an electrical activity to determine whether the cryo balloons 22, 62 are in contact with target tissue to be ablated. The cryo balloons 22, 62 can be further positioned until they are in contact with target tissue to be ablated. - In the illustrated embodiments, the inflation fluid is a low freezing point liquid such as an ethanol mixture, or a liquified gas such as N2O or CO2. The coolant is one which will provide the appropriate heat transfer characteristics consistent with the goals of treatment. Liquid N2O can be used as a general purpose coolant, and is particularly useful when freezing of cells is desired. When liquid N2O is used, it can be transported to the cryo balloons 22, 62 in the liquid phase where it evaporates at the
port 132 and exits into theport 142 as a gas. Freon, and other types of gas can also be used as coolants. Other coolants that could be used include cold alcohol/saline solution, Fluisol (a freon based blood substitute), or a mixture of saline solution and ethanol. One skilled in the art would appreciate that other coolants could be used in a similar manner to achieve one or more of the treatment goals. In some embodiments, regulated back pressure may be maintained along the path followed by the coolant in order to prevent freezing of coolant (i.e., dry ice formation) within therespective shafts 16, 56. - After the cryo balloons 22, 62 have been inflated and desirably positioned, the cryo balloons 22, 62 may then be used to cool target tissue to create a cold-induced lesion at the target site. Particularly, the coolant cools the cryo balloons 22, 62, which in turn, cool the target tissue at the left atrial isthmus that is between the cryo balloons 22, 62. In the illustrated embodiments, the target tissue is cooled to a temperature that is approximately between −20° C. to −100° C., and more preferably, between −40° C. to −80° C., such that at least part of the target tissue is ablated by cryolysis. As shown in the illustrated embodiments, by using two cryo balloons that are placed on opposite sides of target tissue to cool the target tissue, sufficient cooling can be delivered to create a transmural (i.e., a through thickness) lesion at the target tissue. It is believed that, by using two cryo balloons (instead of one), synergistic cooling can be delivered to the target tissue, thereby improving the lesion creation process.
- In some embodiments, if the second ablation device 52 (or the first ablation device 12) includes the sensor(s) 204, the sensor(s) 204 can be used to sense a temperature or an electrical characteristic of the tissue being ablated during the ablation procedure. The sensor(s) 204 then transmit a signal representative of the sensed temperature or electrical characteristic to a controller (not shown) that is coupled to the
source 80 of coolant. In response to the signal, the controller regulates the temperature and/or the flow rate of the coolant that is being delivered to the second cryo balloon 62 (or the first cryo balloon 22). In other embodiments, if the cryo balloons 22, 62 each includes the sensor(s) 204, the controller can independently control the temperatures and/or the flow rates of the coolants that are being delivered to the respective cryo balloons 22, 62. - In many cases, a single ablation may be sufficient to create a desired lesion. However, if it is desired to perform further ablation to increase the lesion size or to create lesions at different site(s) within the treatment region or elsewhere, the cryo balloons 22, 62 may be placed at different target site(s), and the same steps discussed previously may be repeated. When a desired lesion at treatment region has been created, the cryo balloons 22, 62 are deflated and retracted into the
respective shaft lumens ablation devices - The
system 10 and method described previously can be also used to create lesions at other locations of the heart. For example, thesystem 10 and similar method can be used to create lesions inside the left atrium between the pulmonary veins and the mitral valve annulus. Tissue nearby these anatomic structures are recognized to develop arrhythmia substrates causing atrial fibrillation. Lesions in these tissue regions block reentry paths or destroy active pacemaker sites, and thereby prevent the arrhythmia from occurring.FIG. 8 shows (from outside the heart H) the location of major anatomic landmarks for lesion formation in the left atrium. The landmarks include the right inferior pulmonary vein (RIPV), the right superior pulmonary vein (RSPV), the left superior pulmonary vein (LSPV), the left inferior pulmonary vein (LIPV); and the mitral valve annulus (MVA).FIGS. 9A and 9B show examples of lesion patterns formed inside the left atrium based upon these landmarks. - In
FIG. 9 , the lesion pattern comprises a first leg L1 between the right inferior pulmonary vein (RIPV) and the right superior pulmonary vein (RSPV); a second leg L2 between the RSPV and the left superior pulmonary vein (LSPV); a third leg L3 between the left superior pulmonary vein (LSPV) and the left inferior pulmonary vein (LIPV); and a fourth leg L4 leading between the LIPV and the mitral valve annulus (MVA). The first, second, and third legs L1-L3 can be created by placing thefirst cryo balloon 22 at the left atrium (LA), and thesecond cryo balloon 62 inside the left ventrical (LV), the right ventrical (RV), or the coronary sinus (CS). The fourth leg L4 can be created by placing thefirst cryo balloon 22 at the LA, and thesecond cryo balloon 62 inside the CS. In alternative methods, the positions of the first and the second cryo balloons 22, 62 described previously may be exchanged. -
FIG. 9B shows a criss-crossing lesion pattern comprising a first leg L1 extending between the RSPV and LIPV; a second leg L2 extending between the LSPV and RIPV; and a third leg L3 extending from the LIPV to the MVA. The first and second legs L1, L2 can be created by placing thefirst cryo balloon 22 at the LA, and thesecond cryo balloon 62 inside the LV, RV, or the CS. The third leg L3 can be created by placing thefirst cryo balloon 22 at the LA, and thesecond cryo balloon 62 inside the CS. In alternative embodiments, the positions of the first and the second cryo balloons 22, 62 described previously may be exchanged. - The
system 10 described previously can also be used to create lesions inside the right atrium.FIG. 8 shows (from outside the heart H) the location of the major anatomic landmarks for lesion formation in the right atrium. These landmarks include the superior vena cava (SVC), the tricuspid valve annulus (TVA), the inferior vena cava (IVC), and the coronary sinus (CS). Tissue nearby these anatomic structures have been identified as developing arrhythmia substrates causing atrial fibrillation. Lesions in these tissue regions block reentry paths or destroy active pacemaker sites and thereby prevent the arrhythmia from occurring. -
FIGS. 10A to 10C show representative lesion patterns formed inside the right atrium based upon these landmarks.FIG. 10A shows a representative lesion pattern L that extends between the superior vena cava (SVC) and the tricuspid valve annulus (TVA). The lesion L can be created by placing thefirst cryo balloon 22 at the LA, and thesecond cryo balloon 62 inside the LV or the RV. In an alternative embodiment, the positions of the first and the second cryo balloons 22, 62 may be exchanged. -
FIG. 10B shows a representative lesion pattern that extends between the interior vena cava (IVC) and the TVA. The lesion L can be created by placing thefirst cryo balloon 22 at the LA, and thesecond cryo balloon 62 inside the LV or the RV. In an alternative embodiment, the positions of the first and the second cryo balloons 22, 62 may be exchanged. -
FIG. 10C shows a representative lesion pattern L that extends between the coronary sinus (CS) and the tricuspid valve annulus (TVA). The lesion L can be created by placing thefirst cryo balloon 22 at the right atrium (RA), and thesecond cryo balloon 62 inside the LV, the RV, or the CS. In an alternative embodiment, the positions of the first and the second cryo balloons 22, 62 may be exchanged. - Although several examples of lesions that can be created using the above-described system have been discussed, the above described system and method can also be used to create lesions at other locations of the heart. For example, in one embodiment, one of the first and the second cryo balloons 22, 62 can be placed at the atrium at the base of a heart, while the other of the first and the second cryo balloons 22, 62 is placed at the LV. Such placement of the first and the second cryo balloons 22, 62 allows a lesion to be created at the intersection of the atria and the ventricle. In another embodiment, one of the cryo balloons 22, 62 can be placed at the RV next to the septum, while the other of the cryo balloons 22, 62 is placed at the LV. Such placement of the cryo balloons 22, 62 allows a lesion to be created at the ventricular septum. In addition, although the above described system and method have been described in the context of cardiac ablation therapy, e.g., for treating arrhythmias, such as ventricular tachycardia (VT), post-myocardial infraction, atrial fibrillation, supra-VT, flutter, and other heart conditions, the
system 10 may also be used in many different environments and/or applications. For example, thesystem 10 may also be used to create lesions, such as transmural lesions, at different locations within the body. - Although particular embodiments of the present invention have been shown and described, it should be understood that the above discussion is not intended to limit the present invention to these embodiments. It will be obvious to those skilled in the art that various changes and modifications may be made without departing from the spirit and scope of the present invention. For example, in alternative embodiments, instead of using cryo balloons, other cooling elements, such as cooling tubes, can be used to deliver cooling energy to ablate target tissue. In addition, an illustrated embodiment needs not have all the aspects or advantages of the invention shown. An aspect or an advantage described in conjunction with a particular embodiment of the present invention is not necessarily limited to that embodiment and can be practiced in any other embodiments of the present invention even if not so illustrated. Thus, the present invention is intended to cover alternatives, modifications, and equivalents that may fall within the spirit and scope of the present invention as defined by the claims.
Claims (42)
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/954,136 US20060069385A1 (en) | 2004-09-28 | 2004-09-28 | Methods and apparatus for tissue cryotherapy |
US12/104,095 US8080006B2 (en) | 2004-09-28 | 2008-04-16 | Method for tissue cryotherapy |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/954,136 US20060069385A1 (en) | 2004-09-28 | 2004-09-28 | Methods and apparatus for tissue cryotherapy |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US12/104,095 Division US8080006B2 (en) | 2004-09-28 | 2008-04-16 | Method for tissue cryotherapy |
Publications (1)
Publication Number | Publication Date |
---|---|
US20060069385A1 true US20060069385A1 (en) | 2006-03-30 |
Family
ID=36100257
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US10/954,136 Abandoned US20060069385A1 (en) | 2004-09-28 | 2004-09-28 | Methods and apparatus for tissue cryotherapy |
US12/104,095 Active 2027-04-03 US8080006B2 (en) | 2004-09-28 | 2008-04-16 | Method for tissue cryotherapy |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US12/104,095 Active 2027-04-03 US8080006B2 (en) | 2004-09-28 | 2008-04-16 | Method for tissue cryotherapy |
Country Status (1)
Country | Link |
---|---|
US (2) | US20060069385A1 (en) |
Cited By (46)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2008010039A2 (en) * | 2006-07-12 | 2008-01-24 | Les Hôpitaux Universitaires De Geneve | Medical device for tissue ablation |
US20080140066A1 (en) * | 2006-11-02 | 2008-06-12 | Davison Paul O | Electric plasma-mediated cutting and coagulation of tissue and surgical apparatus |
US20080183164A1 (en) * | 2005-05-20 | 2008-07-31 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US20090248001A1 (en) * | 2007-11-14 | 2009-10-01 | Myoscience, Inc. | Pain management using cryogenic remodeling |
US20090299355A1 (en) * | 2008-05-27 | 2009-12-03 | Boston Scientific Scimed, Inc. | Electrical mapping and cryo ablating with a balloon catheter |
US20090326526A1 (en) * | 2008-06-27 | 2009-12-31 | Boston Scientific Scimed, Inc. | Methods and devices for monitoring tissue ablation |
WO2010007600A1 (en) * | 2008-07-17 | 2010-01-21 | Maestroheart Sa | Medical device for tissue ablation |
US7713266B2 (en) | 2005-05-20 | 2010-05-11 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US20100292687A1 (en) * | 2007-11-21 | 2010-11-18 | Kauphusman James V | Methods and Systems for Occluding Vessels During Cardiac Ablation |
US8100899B2 (en) | 2007-11-12 | 2012-01-24 | Ihc Intellectual Asset Management, Llc | Combined endocardial and epicardial magnetically coupled ablation device |
WO2012078612A3 (en) * | 2010-12-07 | 2012-09-13 | Boaz Avitall | Catheter systems for cardiac arrhythmia ablation |
US20130046198A1 (en) * | 2007-09-19 | 2013-02-21 | Edmund J. Roschak | Methods for maintaining the patency of collateral channels in the lungs using cryo-energy |
US8409185B2 (en) | 2007-02-16 | 2013-04-02 | Myoscience, Inc. | Replaceable and/or easily removable needle systems for dermal and transdermal cryogenic remodeling |
US8641710B2 (en) | 2007-11-12 | 2014-02-04 | Intermountain Invention Management, Llc | Magnetically coupling devices for mapping and/or ablating |
US20140046353A1 (en) * | 2012-08-08 | 2014-02-13 | Shockwave Medical, Inc. | Shockwave valvuloplasty with multiple balloons |
US9017318B2 (en) | 2012-01-20 | 2015-04-28 | Myoscience, Inc. | Cryogenic probe system and method |
US9066712B2 (en) | 2008-12-22 | 2015-06-30 | Myoscience, Inc. | Integrated cryosurgical system with refrigerant and electrical power source |
US9155584B2 (en) | 2012-01-13 | 2015-10-13 | Myoscience, Inc. | Cryogenic probe filtration system |
US20160015444A1 (en) * | 2014-07-18 | 2016-01-21 | Medtronic Cryocath Lp | Cardiac cryolipolysis for the treatment of cardiac arrhythmia |
US9241753B2 (en) | 2012-01-13 | 2016-01-26 | Myoscience, Inc. | Skin protection for subdermal cryogenic remodeling for cosmetic and other treatments |
US9254162B2 (en) | 2006-12-21 | 2016-02-09 | Myoscience, Inc. | Dermal and transdermal cryogenic microprobe systems |
US9295512B2 (en) | 2013-03-15 | 2016-03-29 | Myoscience, Inc. | Methods and devices for pain management |
US20160095656A1 (en) * | 2012-02-24 | 2016-04-07 | Omer Peled | Ablation techniques for the treatment of atrial fibrillation |
US9314290B2 (en) | 2012-01-13 | 2016-04-19 | Myoscience, Inc. | Cryogenic needle with freeze zone regulation |
EP2854680A4 (en) * | 2012-06-01 | 2016-07-20 | Cibiem Inc | Methods and devices for cryogenic carotid body ablation |
US9486229B2 (en) | 2011-05-13 | 2016-11-08 | Broncus Medical Inc. | Methods and devices for excision of tissue |
US20170086919A1 (en) * | 2015-09-30 | 2017-03-30 | Fiab S.P.A. | Esophageal probe with the temperature change speed detection system |
US9610112B2 (en) | 2013-03-15 | 2017-04-04 | Myoscience, Inc. | Cryogenic enhancement of joint function, alleviation of joint stiffness and/or alleviation of pain associated with osteoarthritis |
US9668800B2 (en) | 2013-03-15 | 2017-06-06 | Myoscience, Inc. | Methods and systems for treatment of spasticity |
US9757180B2 (en) | 2012-04-24 | 2017-09-12 | Cibiem, Inc. | Endovascular catheters and methods for carotid body ablation |
US9795784B2 (en) | 2008-08-11 | 2017-10-24 | Cibiem, Inc. | Systems and methods for treating dyspnea, including via electrical afferent signal blocking |
US9913969B2 (en) | 2006-10-05 | 2018-03-13 | Broncus Medical Inc. | Devices for delivering substances through an extra-anatomic opening created in an airway |
US9955946B2 (en) | 2014-03-12 | 2018-05-01 | Cibiem, Inc. | Carotid body ablation with a transvenous ultrasound imaging and ablation catheter |
US9993306B2 (en) | 2011-05-13 | 2018-06-12 | Broncus Medical Inc. | Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall |
US10130409B2 (en) | 2013-11-05 | 2018-11-20 | Myoscience, Inc. | Secure cryosurgical treatment system |
US10272260B2 (en) | 2011-11-23 | 2019-04-30 | Broncus Medical Inc. | Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall |
US10646240B2 (en) | 2016-10-06 | 2020-05-12 | Shockwave Medical, Inc. | Aortic leaflet repair using shock wave applicators |
US10888366B2 (en) | 2013-03-15 | 2021-01-12 | Pacira Cryotech, Inc. | Cryogenic blunt dissection methods and devices |
EP3658053A4 (en) * | 2017-07-26 | 2021-04-14 | Innoblative Designs, Inc. | Minimally invasive articulating assembly having ablation capabilities |
US11083519B2 (en) | 2016-10-17 | 2021-08-10 | Innoblative Designs, Inc. | Treatment devices and methods |
US11134998B2 (en) | 2017-11-15 | 2021-10-05 | Pacira Cryotech, Inc. | Integrated cold therapy and electrical stimulation systems for locating and treating nerves and associated methods |
US11311327B2 (en) | 2016-05-13 | 2022-04-26 | Pacira Cryotech, Inc. | Methods and systems for locating and treating nerves with cold therapy |
US20220409255A1 (en) * | 2019-12-27 | 2022-12-29 | Lifetech Scientific (Shenzhen) Co., Ltd. | Left atrial appendage occluder and occlusion system |
US11737820B2 (en) * | 2017-01-06 | 2023-08-29 | St. Jude Medical, Cardiology Division, Inc. | Pulmonary vein isolation balloon catheter |
US11786295B2 (en) | 2016-11-08 | 2023-10-17 | Innoblative Designs, Inc. | Electrosurgical tissue and vessel sealing device |
US11832829B2 (en) | 2017-04-20 | 2023-12-05 | Medtronic, Inc. | Stabilization of a transseptal delivery device |
Families Citing this family (109)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6306166B1 (en) * | 1997-08-13 | 2001-10-23 | Scimed Life Systems, Inc. | Loading and release of water-insoluble drugs |
US8241274B2 (en) | 2000-01-19 | 2012-08-14 | Medtronic, Inc. | Method for guiding a medical device |
US8150519B2 (en) | 2002-04-08 | 2012-04-03 | Ardian, Inc. | Methods and apparatus for bilateral renal neuromodulation |
US7756583B2 (en) | 2002-04-08 | 2010-07-13 | Ardian, Inc. | Methods and apparatus for intravascularly-induced neuromodulation |
US8347891B2 (en) | 2002-04-08 | 2013-01-08 | Medtronic Ardian Luxembourg S.A.R.L. | Methods and apparatus for performing a non-continuous circumferential treatment of a body lumen |
US7617005B2 (en) | 2002-04-08 | 2009-11-10 | Ardian, Inc. | Methods and apparatus for thermally-induced renal neuromodulation |
DE202004021942U1 (en) | 2003-09-12 | 2013-05-13 | Vessix Vascular, Inc. | Selectable eccentric remodeling and / or ablation of atherosclerotic material |
US9713730B2 (en) | 2004-09-10 | 2017-07-25 | Boston Scientific Scimed, Inc. | Apparatus and method for treatment of in-stent restenosis |
US8396548B2 (en) | 2008-11-14 | 2013-03-12 | Vessix Vascular, Inc. | Selective drug delivery in a lumen |
US9125667B2 (en) | 2004-09-10 | 2015-09-08 | Vessix Vascular, Inc. | System for inducing desirable temperature effects on body tissue |
US8019435B2 (en) | 2006-05-02 | 2011-09-13 | Boston Scientific Scimed, Inc. | Control of arterial smooth muscle tone |
US20080039746A1 (en) | 2006-05-25 | 2008-02-14 | Medtronic, Inc. | Methods of using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions |
AU2007310988B2 (en) | 2006-10-18 | 2013-08-15 | Vessix Vascular, Inc. | Tuned RF energy and electrical tissue characterization for selective treatment of target tissues |
AU2007310986B2 (en) | 2006-10-18 | 2013-07-04 | Boston Scientific Scimed, Inc. | Inducing desirable temperature effects on body tissue |
KR101144984B1 (en) | 2007-01-21 | 2012-05-21 | 헤모텍 아게 | Medical product for treating stenosis of body passages and for preventing threatening restenosis |
US9192697B2 (en) | 2007-07-03 | 2015-11-24 | Hemoteq Ag | Balloon catheter for treating stenosis of body passages and for preventing threatening restenosis |
US10695126B2 (en) | 2008-10-06 | 2020-06-30 | Santa Anna Tech Llc | Catheter with a double balloon structure to generate and apply a heated ablative zone to tissue |
AU2009314133B2 (en) | 2008-11-17 | 2015-12-10 | Vessix Vascular, Inc. | Selective accumulation of energy with or without knowledge of tissue topography |
EP2451496B1 (en) | 2009-07-10 | 2015-07-22 | Boston Scientific Scimed, Inc. | Use of nanocrystals for a drug delivery balloon |
WO2011008393A2 (en) | 2009-07-17 | 2011-01-20 | Boston Scientific Scimed, Inc. | Nucleation of drug delivery balloons to provide improved crystal size and density |
US20110270238A1 (en) | 2009-12-31 | 2011-11-03 | Raed Rizq | Compliant Cryoballoon Apparatus for Denervating Ostia of the Renal Arteries |
US20110263921A1 (en) | 2009-12-31 | 2011-10-27 | Anthony Vrba | Patterned Denervation Therapy for Innervated Renal Vasculature |
KR20130108067A (en) | 2010-04-09 | 2013-10-02 | 베식스 바스큘라 인코포레이티드 | Power generating and control apparatus for the treatment of tissue |
US9192790B2 (en) | 2010-04-14 | 2015-11-24 | Boston Scientific Scimed, Inc. | Focused ultrasonic renal denervation |
US8473067B2 (en) | 2010-06-11 | 2013-06-25 | Boston Scientific Scimed, Inc. | Renal denervation and stimulation employing wireless vascular energy transfer arrangement |
US9084609B2 (en) | 2010-07-30 | 2015-07-21 | Boston Scientific Scime, Inc. | Spiral balloon catheter for renal nerve ablation |
US9358365B2 (en) | 2010-07-30 | 2016-06-07 | Boston Scientific Scimed, Inc. | Precision electrode movement control for renal nerve ablation |
US9408661B2 (en) | 2010-07-30 | 2016-08-09 | Patrick A. Haverkost | RF electrodes on multiple flexible wires for renal nerve ablation |
US20120029512A1 (en) | 2010-07-30 | 2012-02-02 | Willard Martin R | Balloon with surface electrodes and integral cooling for renal nerve ablation |
US9463062B2 (en) | 2010-07-30 | 2016-10-11 | Boston Scientific Scimed, Inc. | Cooled conductive balloon RF catheter for renal nerve ablation |
US9155589B2 (en) | 2010-07-30 | 2015-10-13 | Boston Scientific Scimed, Inc. | Sequential activation RF electrode set for renal nerve ablation |
CA2807277C (en) | 2010-08-05 | 2020-05-12 | Medtronic Ardian Luxembourg S.A.R.L. | Cryoablation apparatuses, systems, and methods for renal neuromodulation |
EP2611476B1 (en) | 2010-09-02 | 2016-08-10 | Boston Scientific Scimed, Inc. | Coating process for drug delivery balloons using heat-induced rewrap memory |
US8974451B2 (en) | 2010-10-25 | 2015-03-10 | Boston Scientific Scimed, Inc. | Renal nerve ablation using conductive fluid jet and RF energy |
US20120143294A1 (en) | 2010-10-26 | 2012-06-07 | Medtronic Adrian Luxembourg S.a.r.l. | Neuromodulation cryotherapeutic devices and associated systems and methods |
US9060754B2 (en) | 2010-10-26 | 2015-06-23 | Medtronic Ardian Luxembourg S.A.R.L. | Neuromodulation cryotherapeutic devices and associated systems and methods |
US9220558B2 (en) | 2010-10-27 | 2015-12-29 | Boston Scientific Scimed, Inc. | RF renal denervation catheter with multiple independent electrodes |
US9028485B2 (en) | 2010-11-15 | 2015-05-12 | Boston Scientific Scimed, Inc. | Self-expanding cooling electrode for renal nerve ablation |
US9668811B2 (en) | 2010-11-16 | 2017-06-06 | Boston Scientific Scimed, Inc. | Minimally invasive access for renal nerve ablation |
US9089350B2 (en) | 2010-11-16 | 2015-07-28 | Boston Scientific Scimed, Inc. | Renal denervation catheter with RF electrode and integral contrast dye injection arrangement |
US9326751B2 (en) | 2010-11-17 | 2016-05-03 | Boston Scientific Scimed, Inc. | Catheter guidance of external energy for renal denervation |
US9060761B2 (en) | 2010-11-18 | 2015-06-23 | Boston Scientific Scime, Inc. | Catheter-focused magnetic field induced renal nerve ablation |
US9192435B2 (en) | 2010-11-22 | 2015-11-24 | Boston Scientific Scimed, Inc. | Renal denervation catheter with cooled RF electrode |
US9023034B2 (en) | 2010-11-22 | 2015-05-05 | Boston Scientific Scimed, Inc. | Renal ablation electrode with force-activatable conduction apparatus |
US11246653B2 (en) | 2010-12-07 | 2022-02-15 | Boaz Avitall | Catheter systems for cardiac arrhythmia ablation |
US20120157993A1 (en) | 2010-12-15 | 2012-06-21 | Jenson Mark L | Bipolar Off-Wall Electrode Device for Renal Nerve Ablation |
US9095262B2 (en) * | 2011-01-05 | 2015-08-04 | Mehdi Razavi | Guided ablation devices, systems, and methods |
WO2012100095A1 (en) | 2011-01-19 | 2012-07-26 | Boston Scientific Scimed, Inc. | Guide-compatible large-electrode catheter for renal nerve ablation with reduced arterial injury |
CA2832311A1 (en) | 2011-04-08 | 2012-11-29 | Covidien Lp | Iontophoresis drug delivery system and method for denervation of the renal sympathetic nerve and iontophoretic drug delivery |
EP2701623B1 (en) | 2011-04-25 | 2016-08-17 | Medtronic Ardian Luxembourg S.à.r.l. | Apparatus related to constrained deployment of cryogenic balloons for limited cryogenic ablation of vessel walls |
CN103813745B (en) | 2011-07-20 | 2016-06-29 | 波士顿科学西美德公司 | In order to visualize, be directed at and to melt transcutaneous device and the method for nerve |
JP6106669B2 (en) | 2011-07-22 | 2017-04-05 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | A neuromodulation system having a neuromodulation element that can be placed in a helical guide |
US8669360B2 (en) | 2011-08-05 | 2014-03-11 | Boston Scientific Scimed, Inc. | Methods of converting amorphous drug substance into crystalline form |
WO2013028208A1 (en) | 2011-08-25 | 2013-02-28 | Boston Scientific Scimed, Inc. | Medical device with crystalline drug coating |
WO2013055826A1 (en) | 2011-10-10 | 2013-04-18 | Boston Scientific Scimed, Inc. | Medical devices including ablation electrodes |
US10085799B2 (en) | 2011-10-11 | 2018-10-02 | Boston Scientific Scimed, Inc. | Off-wall electrode device and methods for nerve modulation |
US9420955B2 (en) | 2011-10-11 | 2016-08-23 | Boston Scientific Scimed, Inc. | Intravascular temperature monitoring system and method |
US9364284B2 (en) | 2011-10-12 | 2016-06-14 | Boston Scientific Scimed, Inc. | Method of making an off-wall spacer cage |
WO2013058962A1 (en) | 2011-10-18 | 2013-04-25 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
EP2768568B1 (en) | 2011-10-18 | 2020-05-06 | Boston Scientific Scimed, Inc. | Integrated crossing balloon catheter |
EP2775948B1 (en) | 2011-11-08 | 2018-04-04 | Boston Scientific Scimed, Inc. | Ostial renal nerve ablation |
US9119600B2 (en) | 2011-11-15 | 2015-09-01 | Boston Scientific Scimed, Inc. | Device and methods for renal nerve modulation monitoring |
US9119632B2 (en) | 2011-11-21 | 2015-09-01 | Boston Scientific Scimed, Inc. | Deflectable renal nerve ablation catheter |
US9265969B2 (en) | 2011-12-21 | 2016-02-23 | Cardiac Pacemakers, Inc. | Methods for modulating cell function |
WO2013096916A2 (en) | 2011-12-23 | 2013-06-27 | Vessix Vascular, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US9433760B2 (en) | 2011-12-28 | 2016-09-06 | Boston Scientific Scimed, Inc. | Device and methods for nerve modulation using a novel ablation catheter with polymeric ablative elements |
US9050106B2 (en) | 2011-12-29 | 2015-06-09 | Boston Scientific Scimed, Inc. | Off-wall electrode device and methods for nerve modulation |
US9241752B2 (en) | 2012-04-27 | 2016-01-26 | Medtronic Ardian Luxembourg S.A.R.L. | Shafts with pressure relief in cryotherapeutic catheters and associated devices, systems, and methods |
EP2840991B1 (en) | 2012-04-27 | 2019-05-15 | Medtronic Ardian Luxembourg S.à.r.l. | Cryotherapeutic devices for renal neuromodulation |
US10660703B2 (en) | 2012-05-08 | 2020-05-26 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices |
US10321946B2 (en) | 2012-08-24 | 2019-06-18 | Boston Scientific Scimed, Inc. | Renal nerve modulation devices with weeping RF ablation balloons |
US9173696B2 (en) | 2012-09-17 | 2015-11-03 | Boston Scientific Scimed, Inc. | Self-positioning electrode system and method for renal nerve modulation |
US10549127B2 (en) | 2012-09-21 | 2020-02-04 | Boston Scientific Scimed, Inc. | Self-cooling ultrasound ablation catheter |
US10398464B2 (en) | 2012-09-21 | 2019-09-03 | Boston Scientific Scimed, Inc. | System for nerve modulation and innocuous thermal gradient nerve block |
CN104869930B (en) | 2012-10-10 | 2020-12-25 | 波士顿科学国际有限公司 | Renal neuromodulation apparatus and methods |
US9095321B2 (en) | 2012-11-21 | 2015-08-04 | Medtronic Ardian Luxembourg S.A.R.L. | Cryotherapeutic devices having integral multi-helical balloons and methods of making the same |
US9017317B2 (en) | 2012-12-06 | 2015-04-28 | Medtronic Ardian Luxembourg S.A.R.L. | Refrigerant supply system for cryotherapy including refrigerant recompression and associated devices, systems, and methods |
US9956033B2 (en) | 2013-03-11 | 2018-05-01 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9693821B2 (en) | 2013-03-11 | 2017-07-04 | Boston Scientific Scimed, Inc. | Medical devices for modulating nerves |
US9808311B2 (en) | 2013-03-13 | 2017-11-07 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US9297845B2 (en) | 2013-03-15 | 2016-03-29 | Boston Scientific Scimed, Inc. | Medical devices and methods for treatment of hypertension that utilize impedance compensation |
EP2967734B1 (en) | 2013-03-15 | 2019-05-15 | Boston Scientific Scimed, Inc. | Methods and apparatuses for remodeling tissue of or adjacent to a body passage |
US10265122B2 (en) | 2013-03-15 | 2019-04-23 | Boston Scientific Scimed, Inc. | Nerve ablation devices and related methods of use |
CN105473092B (en) | 2013-06-21 | 2019-05-17 | 波士顿科学国际有限公司 | The medical instrument for renal nerve ablation with rotatable shaft |
EP3010437A1 (en) | 2013-06-21 | 2016-04-27 | Boston Scientific Scimed, Inc. | Renal denervation balloon catheter with ride along electrode support |
US9707036B2 (en) | 2013-06-25 | 2017-07-18 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation using localized indifferent electrodes |
WO2015002787A1 (en) | 2013-07-01 | 2015-01-08 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
EP3019106A1 (en) | 2013-07-11 | 2016-05-18 | Boston Scientific Scimed, Inc. | Medical device with stretchable electrode assemblies |
WO2015006480A1 (en) | 2013-07-11 | 2015-01-15 | Boston Scientific Scimed, Inc. | Devices and methods for nerve modulation |
WO2015010074A1 (en) | 2013-07-19 | 2015-01-22 | Boston Scientific Scimed, Inc. | Spiral bipolar electrode renal denervation balloon |
WO2015013205A1 (en) | 2013-07-22 | 2015-01-29 | Boston Scientific Scimed, Inc. | Medical devices for renal nerve ablation |
US10695124B2 (en) | 2013-07-22 | 2020-06-30 | Boston Scientific Scimed, Inc. | Renal nerve ablation catheter having twist balloon |
WO2015027096A1 (en) | 2013-08-22 | 2015-02-26 | Boston Scientific Scimed, Inc. | Flexible circuit having improved adhesion to a renal nerve modulation balloon |
EP3041425B1 (en) | 2013-09-04 | 2022-04-13 | Boston Scientific Scimed, Inc. | Radio frequency (rf) balloon catheter having flushing and cooling capability |
WO2015038947A1 (en) | 2013-09-13 | 2015-03-19 | Boston Scientific Scimed, Inc. | Ablation balloon with vapor deposited cover layer |
US11246654B2 (en) | 2013-10-14 | 2022-02-15 | Boston Scientific Scimed, Inc. | Flexible renal nerve ablation devices and related methods of use and manufacture |
CN105592778B (en) | 2013-10-14 | 2019-07-23 | 波士顿科学医学有限公司 | High-resolution cardiac mapping electrod-array conduit |
AU2014334574B2 (en) | 2013-10-15 | 2017-07-06 | Boston Scientific Scimed, Inc. | Medical device balloon |
US9770606B2 (en) | 2013-10-15 | 2017-09-26 | Boston Scientific Scimed, Inc. | Ultrasound ablation catheter with cooling infusion and centering basket |
CN105636538B (en) | 2013-10-18 | 2019-01-15 | 波士顿科学国际有限公司 | Foley's tube with flexible wire and its correlation technique for using and manufacturing |
CN105658163B (en) | 2013-10-25 | 2020-08-18 | 波士顿科学国际有限公司 | Embedded thermocouple in denervation flexible circuit |
WO2015103617A1 (en) | 2014-01-06 | 2015-07-09 | Boston Scientific Scimed, Inc. | Tear resistant flex circuit assembly |
JP6325121B2 (en) | 2014-02-04 | 2018-05-16 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Alternative placement of temperature sensors on bipolar electrodes |
US11000679B2 (en) | 2014-02-04 | 2021-05-11 | Boston Scientific Scimed, Inc. | Balloon protection and rewrapping devices and related methods of use |
US10492842B2 (en) | 2014-03-07 | 2019-12-03 | Medtronic Ardian Luxembourg S.A.R.L. | Monitoring and controlling internally administered cryotherapy |
US10709490B2 (en) | 2014-05-07 | 2020-07-14 | Medtronic Ardian Luxembourg S.A.R.L. | Catheter assemblies comprising a direct heating element for renal neuromodulation and associated systems and methods |
US11331140B2 (en) | 2016-05-19 | 2022-05-17 | Aqua Heart, Inc. | Heated vapor ablation systems and methods for treating cardiac conditions |
WO2020227540A1 (en) * | 2019-05-08 | 2020-11-12 | Atricure, Inc. | Biological tissue position location and marking |
CN110974398A (en) * | 2019-12-04 | 2020-04-10 | 宁波胜杰康生物科技有限公司 | Cryoablation system with magnetic navigation |
Citations (27)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5391199A (en) * | 1993-07-20 | 1995-02-21 | Biosense, Inc. | Apparatus and method for treating cardiac arrhythmias |
US6024740A (en) * | 1997-07-08 | 2000-02-15 | The Regents Of The University Of California | Circumferential ablation device assembly |
US6139544A (en) * | 1999-05-26 | 2000-10-31 | Endocare, Inc. | Computer guided cryosurgery |
US6164283A (en) * | 1997-07-08 | 2000-12-26 | The Regents Of The University Of California | Device and method for forming a circumferential conduction block in a pulmonary vein |
US6183468B1 (en) * | 1998-09-10 | 2001-02-06 | Scimed Life Systems, Inc. | Systems and methods for controlling power in an electrosurgical probe |
US6235019B1 (en) * | 1997-02-27 | 2001-05-22 | Cryocath Technologies, Inc. | Cryosurgical catheter |
US6241722B1 (en) * | 1998-06-17 | 2001-06-05 | Cryogen, Inc. | Cryogenic device, system and method of using same |
US6314962B1 (en) * | 1996-10-22 | 2001-11-13 | Epicor, Inc. | Method of ablating tissue around the pulmonary veins |
US6432102B2 (en) * | 1999-03-15 | 2002-08-13 | Cryovascular Systems, Inc. | Cryosurgical fluid supply |
US6502576B1 (en) * | 1997-07-08 | 2003-01-07 | The Regents Of The University Of California | Device and method for forming a circumferential conduction block in a pulmonary vein |
US6514245B1 (en) * | 1999-03-15 | 2003-02-04 | Cryovascular Systems, Inc. | Safety cryotherapy catheter |
US6514249B1 (en) * | 1997-07-08 | 2003-02-04 | Atrionix, Inc. | Positioning system and method for orienting an ablation element within a pulmonary vein ostium |
US6527798B2 (en) * | 1993-02-10 | 2003-03-04 | Radiant Medical, Inc. | Method and apparatus for regional and whole body temperature modification |
US6540740B2 (en) * | 1997-02-27 | 2003-04-01 | Cryocath Technologies Inc. | Cryosurgical catheter |
US6575966B2 (en) * | 1999-08-23 | 2003-06-10 | Cryocath Technologies Inc. | Endovascular cryotreatment catheter |
US6602247B2 (en) * | 1997-02-27 | 2003-08-05 | Cryocath Technologies Inc. | Apparatus and method for performing a treatment on a selected tissue region |
US6602276B2 (en) * | 1998-03-31 | 2003-08-05 | Innercool Therapies, Inc. | Method and device for performing cooling- or cryo-therapies for, e.g., angioplasty with reduced restenosis or pulmonary vein cell necrosis to inhibit atrial fibrillation |
US20030199861A1 (en) * | 2002-04-19 | 2003-10-23 | Scimed Life Systems, Inc | Cryo balloon |
US6648879B2 (en) * | 1999-02-24 | 2003-11-18 | Cryovascular Systems, Inc. | Safety cryotherapy catheter |
US6663622B1 (en) * | 2000-02-11 | 2003-12-16 | Iotek, Inc. | Surgical devices and methods for use in tissue ablation procedures |
US6666858B2 (en) * | 2001-04-12 | 2003-12-23 | Scimed Life Systems, Inc. | Cryo balloon for atrial ablation |
US6685732B2 (en) * | 1998-03-31 | 2004-02-03 | Innercool Therapies, Inc. | Method and device for performing cooling- or cryo-therapies for, e.g., angioplasty with reduced restenosis or pulmonary vein cell necrosis to inhibit atrial fibrillation employing microporous balloon |
US20040044334A1 (en) * | 2002-08-30 | 2004-03-04 | Scimed Life Systems, Inc. | Cryo ablation coil |
US6755822B2 (en) * | 2001-06-01 | 2004-06-29 | Cryocor, Inc. | Device and method for the creation of a circumferential cryogenic lesion in a pulmonary vein |
US6893433B2 (en) * | 2002-12-11 | 2005-05-17 | Cryocor, Inc. | System and method for performing a single step cryoablation |
US20050182393A1 (en) * | 2003-02-11 | 2005-08-18 | Cryocath Technologies Inc. | Multi-energy ablation station |
US20050224086A1 (en) * | 2004-03-31 | 2005-10-13 | Daniel Nahon | Method and apparatus for preventing atrial fibrillation |
Family Cites Families (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5647868A (en) * | 1994-02-02 | 1997-07-15 | Chinn; Douglas Owen | Cryosurgical integrated control and monitoring system and method |
US6142991A (en) * | 1998-03-31 | 2000-11-07 | Galil Medical, Ltd. | High resolution cryosurgical method and apparatus |
JP2005503227A (en) * | 2001-09-27 | 2005-02-03 | ガリル メディカル リミテッド | Apparatus and method for cryosurgical treatment of breast tumors |
-
2004
- 2004-09-28 US US10/954,136 patent/US20060069385A1/en not_active Abandoned
-
2008
- 2008-04-16 US US12/104,095 patent/US8080006B2/en active Active
Patent Citations (29)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6527798B2 (en) * | 1993-02-10 | 2003-03-04 | Radiant Medical, Inc. | Method and apparatus for regional and whole body temperature modification |
US5391199A (en) * | 1993-07-20 | 1995-02-21 | Biosense, Inc. | Apparatus and method for treating cardiac arrhythmias |
US5443489A (en) * | 1993-07-20 | 1995-08-22 | Biosense, Inc. | Apparatus and method for ablation |
US6314962B1 (en) * | 1996-10-22 | 2001-11-13 | Epicor, Inc. | Method of ablating tissue around the pulmonary veins |
US6540740B2 (en) * | 1997-02-27 | 2003-04-01 | Cryocath Technologies Inc. | Cryosurgical catheter |
US6602247B2 (en) * | 1997-02-27 | 2003-08-05 | Cryocath Technologies Inc. | Apparatus and method for performing a treatment on a selected tissue region |
US6235019B1 (en) * | 1997-02-27 | 2001-05-22 | Cryocath Technologies, Inc. | Cryosurgical catheter |
US6416511B1 (en) * | 1997-05-09 | 2002-07-09 | The Regents Of The University Of California | Circumferential ablation device assembly |
US6164283A (en) * | 1997-07-08 | 2000-12-26 | The Regents Of The University Of California | Device and method for forming a circumferential conduction block in a pulmonary vein |
US6502576B1 (en) * | 1997-07-08 | 2003-01-07 | The Regents Of The University Of California | Device and method for forming a circumferential conduction block in a pulmonary vein |
US6024740A (en) * | 1997-07-08 | 2000-02-15 | The Regents Of The University Of California | Circumferential ablation device assembly |
US6514249B1 (en) * | 1997-07-08 | 2003-02-04 | Atrionix, Inc. | Positioning system and method for orienting an ablation element within a pulmonary vein ostium |
US6602276B2 (en) * | 1998-03-31 | 2003-08-05 | Innercool Therapies, Inc. | Method and device for performing cooling- or cryo-therapies for, e.g., angioplasty with reduced restenosis or pulmonary vein cell necrosis to inhibit atrial fibrillation |
US6685732B2 (en) * | 1998-03-31 | 2004-02-03 | Innercool Therapies, Inc. | Method and device for performing cooling- or cryo-therapies for, e.g., angioplasty with reduced restenosis or pulmonary vein cell necrosis to inhibit atrial fibrillation employing microporous balloon |
US6241722B1 (en) * | 1998-06-17 | 2001-06-05 | Cryogen, Inc. | Cryogenic device, system and method of using same |
US6183468B1 (en) * | 1998-09-10 | 2001-02-06 | Scimed Life Systems, Inc. | Systems and methods for controlling power in an electrosurgical probe |
US6648879B2 (en) * | 1999-02-24 | 2003-11-18 | Cryovascular Systems, Inc. | Safety cryotherapy catheter |
US6514245B1 (en) * | 1999-03-15 | 2003-02-04 | Cryovascular Systems, Inc. | Safety cryotherapy catheter |
US6432102B2 (en) * | 1999-03-15 | 2002-08-13 | Cryovascular Systems, Inc. | Cryosurgical fluid supply |
US6139544A (en) * | 1999-05-26 | 2000-10-31 | Endocare, Inc. | Computer guided cryosurgery |
US6575966B2 (en) * | 1999-08-23 | 2003-06-10 | Cryocath Technologies Inc. | Endovascular cryotreatment catheter |
US6663622B1 (en) * | 2000-02-11 | 2003-12-16 | Iotek, Inc. | Surgical devices and methods for use in tissue ablation procedures |
US6666858B2 (en) * | 2001-04-12 | 2003-12-23 | Scimed Life Systems, Inc. | Cryo balloon for atrial ablation |
US6755822B2 (en) * | 2001-06-01 | 2004-06-29 | Cryocor, Inc. | Device and method for the creation of a circumferential cryogenic lesion in a pulmonary vein |
US20030199861A1 (en) * | 2002-04-19 | 2003-10-23 | Scimed Life Systems, Inc | Cryo balloon |
US20040044334A1 (en) * | 2002-08-30 | 2004-03-04 | Scimed Life Systems, Inc. | Cryo ablation coil |
US6893433B2 (en) * | 2002-12-11 | 2005-05-17 | Cryocor, Inc. | System and method for performing a single step cryoablation |
US20050182393A1 (en) * | 2003-02-11 | 2005-08-18 | Cryocath Technologies Inc. | Multi-energy ablation station |
US20050224086A1 (en) * | 2004-03-31 | 2005-10-13 | Daniel Nahon | Method and apparatus for preventing atrial fibrillation |
Cited By (106)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10369339B2 (en) | 2004-07-19 | 2019-08-06 | Broncus Medical Inc. | Devices for delivering substances through an extra-anatomic opening created in an airway |
US11357960B2 (en) | 2004-07-19 | 2022-06-14 | Broncus Medical Inc. | Devices for delivering substances through an extra-anatomic opening created in an airway |
US11350979B2 (en) | 2005-05-20 | 2022-06-07 | Pacira Cryotech, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US20100198207A1 (en) * | 2005-05-20 | 2010-08-05 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US7850683B2 (en) | 2005-05-20 | 2010-12-14 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US10363080B2 (en) | 2005-05-20 | 2019-07-30 | Pacira Cryotech, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US9345526B2 (en) | 2005-05-20 | 2016-05-24 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US9072498B2 (en) | 2005-05-20 | 2015-07-07 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US20080183164A1 (en) * | 2005-05-20 | 2008-07-31 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US7998137B2 (en) | 2005-05-20 | 2011-08-16 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US7713266B2 (en) | 2005-05-20 | 2010-05-11 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US7862558B2 (en) | 2005-05-20 | 2011-01-04 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US20090171334A1 (en) * | 2005-05-20 | 2009-07-02 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US20110144631A1 (en) * | 2005-05-20 | 2011-06-16 | Myoscience, Inc. | Subdermal cryogenic remodeling of muscles, nerves, connective tissue, and/or adipose tissue (fat) |
US20100004661A1 (en) * | 2006-07-12 | 2010-01-07 | Les Hopitaux Universitaires De Geneve | Medical device for tissue ablation |
WO2008010039A2 (en) * | 2006-07-12 | 2008-01-24 | Les Hôpitaux Universitaires De Geneve | Medical device for tissue ablation |
US8048072B2 (en) | 2006-07-12 | 2011-11-01 | Les Hospitaux Universitaires de Geneva | Medical device for tissue ablation |
WO2008010039A3 (en) * | 2006-07-12 | 2008-04-17 | Hopitaux Universitaires De Gen | Medical device for tissue ablation |
US9913969B2 (en) | 2006-10-05 | 2018-03-13 | Broncus Medical Inc. | Devices for delivering substances through an extra-anatomic opening created in an airway |
US20080140066A1 (en) * | 2006-11-02 | 2008-06-12 | Davison Paul O | Electric plasma-mediated cutting and coagulation of tissue and surgical apparatus |
US9254162B2 (en) | 2006-12-21 | 2016-02-09 | Myoscience, Inc. | Dermal and transdermal cryogenic microprobe systems |
US10939947B2 (en) | 2006-12-21 | 2021-03-09 | Pacira Cryotech, Inc. | Dermal and transdermal cryogenic microprobe systems |
US8409185B2 (en) | 2007-02-16 | 2013-04-02 | Myoscience, Inc. | Replaceable and/or easily removable needle systems for dermal and transdermal cryogenic remodeling |
US9113855B2 (en) | 2007-02-16 | 2015-08-25 | Myoscience, Inc. | Replaceable and/or easily removable needle systems for dermal and transdermal cryogenic remodeling |
US20130046198A1 (en) * | 2007-09-19 | 2013-02-21 | Edmund J. Roschak | Methods for maintaining the patency of collateral channels in the lungs using cryo-energy |
US9603660B2 (en) | 2007-11-12 | 2017-03-28 | Intermountain Invention Management, Llc | Magnetically coupling devices for mapping and/or ablating |
US8641710B2 (en) | 2007-11-12 | 2014-02-04 | Intermountain Invention Management, Llc | Magnetically coupling devices for mapping and/or ablating |
US8100899B2 (en) | 2007-11-12 | 2012-01-24 | Ihc Intellectual Asset Management, Llc | Combined endocardial and epicardial magnetically coupled ablation device |
US9101346B2 (en) | 2007-11-14 | 2015-08-11 | Myoscience, Inc. | Pain management using cryogenic remodeling |
US20090248001A1 (en) * | 2007-11-14 | 2009-10-01 | Myoscience, Inc. | Pain management using cryogenic remodeling |
US10869779B2 (en) | 2007-11-14 | 2020-12-22 | Pacira Cryotech, Inc. | Pain management using cryogenic remodeling |
US11672694B2 (en) | 2007-11-14 | 2023-06-13 | Pacira Cryotech, Inc. | Pain management using cryogenic remodeling |
US9907693B2 (en) | 2007-11-14 | 2018-03-06 | Myoscience, Inc. | Pain management using cryogenic remodeling |
US10864112B2 (en) | 2007-11-14 | 2020-12-15 | Pacira Cryotech, Inc. | Pain management using cryogenic remodeling |
US8715275B2 (en) | 2007-11-14 | 2014-05-06 | Myoscience, Inc. | Pain management using cryogenic remodeling |
US8298216B2 (en) | 2007-11-14 | 2012-10-30 | Myoscience, Inc. | Pain management using cryogenic remodeling |
US20100292687A1 (en) * | 2007-11-21 | 2010-11-18 | Kauphusman James V | Methods and Systems for Occluding Vessels During Cardiac Ablation |
US9572583B2 (en) * | 2007-11-21 | 2017-02-21 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Methods and systems for occluding vessels during cardiac ablation |
US8128617B2 (en) * | 2008-05-27 | 2012-03-06 | Boston Scientific Scimed, Inc. | Electrical mapping and cryo ablating with a balloon catheter |
US20090299355A1 (en) * | 2008-05-27 | 2009-12-03 | Boston Scientific Scimed, Inc. | Electrical mapping and cryo ablating with a balloon catheter |
US20120165803A1 (en) * | 2008-05-27 | 2012-06-28 | Boston Scientific Scimed, Inc. | Electrical mapping and cryo ablating with a balloon catheter |
US9060756B2 (en) * | 2008-05-27 | 2015-06-23 | Boston Scientific Scimed, Inc. | Balloon catheter with flexible electrode assemblies |
US20090326526A1 (en) * | 2008-06-27 | 2009-12-31 | Boston Scientific Scimed, Inc. | Methods and devices for monitoring tissue ablation |
US8821484B2 (en) * | 2008-06-27 | 2014-09-02 | Boston Scientific Scimed, Inc. | Methods and devices for monitoring tissue ablation |
WO2010007600A1 (en) * | 2008-07-17 | 2010-01-21 | Maestroheart Sa | Medical device for tissue ablation |
US9795784B2 (en) | 2008-08-11 | 2017-10-24 | Cibiem, Inc. | Systems and methods for treating dyspnea, including via electrical afferent signal blocking |
US9066712B2 (en) | 2008-12-22 | 2015-06-30 | Myoscience, Inc. | Integrated cryosurgical system with refrigerant and electrical power source |
WO2012078612A3 (en) * | 2010-12-07 | 2012-09-13 | Boaz Avitall | Catheter systems for cardiac arrhythmia ablation |
US10631938B2 (en) | 2011-05-13 | 2020-04-28 | Broncus Medical Inc. | Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall |
US9486229B2 (en) | 2011-05-13 | 2016-11-08 | Broncus Medical Inc. | Methods and devices for excision of tissue |
US9993306B2 (en) | 2011-05-13 | 2018-06-12 | Broncus Medical Inc. | Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall |
US10272260B2 (en) | 2011-11-23 | 2019-04-30 | Broncus Medical Inc. | Methods and devices for diagnosing, monitoring, or treating medical conditions through an opening through an airway wall |
US9155584B2 (en) | 2012-01-13 | 2015-10-13 | Myoscience, Inc. | Cryogenic probe filtration system |
US9241753B2 (en) | 2012-01-13 | 2016-01-26 | Myoscience, Inc. | Skin protection for subdermal cryogenic remodeling for cosmetic and other treatments |
US10213244B2 (en) | 2012-01-13 | 2019-02-26 | Myoscience, Inc. | Cryogenic needle with freeze zone regulation |
US11857239B2 (en) | 2012-01-13 | 2024-01-02 | Pacira Cryotech, Inc. | Cryogenic needle with freeze zone regulation |
US10188444B2 (en) | 2012-01-13 | 2019-01-29 | Myoscience, Inc. | Skin protection for subdermal cryogenic remodeling for cosmetic and other treatments |
US9314290B2 (en) | 2012-01-13 | 2016-04-19 | Myoscience, Inc. | Cryogenic needle with freeze zone regulation |
US9017318B2 (en) | 2012-01-20 | 2015-04-28 | Myoscience, Inc. | Cryogenic probe system and method |
US11413089B2 (en) | 2012-02-24 | 2022-08-16 | Cardiofocus, Inc. | Ablation techniques for the treatment of atrial fibrillation |
US10517669B2 (en) * | 2012-02-24 | 2019-12-31 | Isolase Ltd. | Ablation techniques for the treatment of atrial fibrillation |
US20160095656A1 (en) * | 2012-02-24 | 2016-04-07 | Omer Peled | Ablation techniques for the treatment of atrial fibrillation |
US9757180B2 (en) | 2012-04-24 | 2017-09-12 | Cibiem, Inc. | Endovascular catheters and methods for carotid body ablation |
US10219855B2 (en) | 2012-04-24 | 2019-03-05 | Cibiem, Inc. | Endovascular catheters and methods for carotid body ablation |
US9808303B2 (en) * | 2012-06-01 | 2017-11-07 | Cibiem, Inc. | Methods and devices for cryogenic carotid body ablation |
EP2854680A4 (en) * | 2012-06-01 | 2016-07-20 | Cibiem Inc | Methods and devices for cryogenic carotid body ablation |
US20160338753A1 (en) * | 2012-06-01 | 2016-11-24 | Eric Ryba | Methods and devices for cryogenic carotid body ablation |
US10758255B2 (en) | 2012-08-08 | 2020-09-01 | Shockwave Medical, Inc. | Shock wave valvuloplasty with multiple balloons |
US20140046353A1 (en) * | 2012-08-08 | 2014-02-13 | Shockwave Medical, Inc. | Shockwave valvuloplasty with multiple balloons |
CN104519809A (en) * | 2012-08-08 | 2015-04-15 | 冲击波医疗公司 | Shockwave valvuloplasty with multiple balloons |
US11766271B2 (en) | 2012-08-08 | 2023-09-26 | Shockwave Medical, Inc. | Shock wave valvuloplasty with multiple balloons |
US9554815B2 (en) * | 2012-08-08 | 2017-01-31 | Shockwave Medical, Inc. | Shockwave valvuloplasty with multiple balloons |
US11253393B2 (en) | 2013-03-15 | 2022-02-22 | Pacira Cryotech, Inc. | Methods, systems, and devices for treating neuromas, fibromas, nerve entrapment, and/or pain associated therewith |
US11865038B2 (en) | 2013-03-15 | 2024-01-09 | Pacira Cryotech, Inc. | Methods, systems, and devices for treating nerve spasticity |
US11642241B2 (en) | 2013-03-15 | 2023-05-09 | Pacira Cryotech, Inc. | Cryogenic enhancement of joint function, alleviation of joint stiffness and/or alleviation of pain associated with osteoarthritis |
US10085789B2 (en) | 2013-03-15 | 2018-10-02 | Myoscience, Inc. | Methods and systems for treatment of occipital neuralgia |
US10596030B2 (en) | 2013-03-15 | 2020-03-24 | Pacira Cryotech, Inc. | Cryogenic enhancement of joint function, alleviation of joint stiffness and/or alleviation of pain associated with osteoarthritis |
US9295512B2 (en) | 2013-03-15 | 2016-03-29 | Myoscience, Inc. | Methods and devices for pain management |
US10085881B2 (en) | 2013-03-15 | 2018-10-02 | Myoscience, Inc. | Methods, systems, and devices for treating neuromas, fibromas, nerve entrapment, and/or pain associated therewith |
US9668800B2 (en) | 2013-03-15 | 2017-06-06 | Myoscience, Inc. | Methods and systems for treatment of spasticity |
US11134999B2 (en) | 2013-03-15 | 2021-10-05 | Pacira Cryotech, Inc. | Methods and systems for treatment of occipital neuralgia |
US10314739B2 (en) | 2013-03-15 | 2019-06-11 | Myoscience, Inc. | Methods and devices for pain management |
US9610112B2 (en) | 2013-03-15 | 2017-04-04 | Myoscience, Inc. | Cryogenic enhancement of joint function, alleviation of joint stiffness and/or alleviation of pain associated with osteoarthritis |
US10888366B2 (en) | 2013-03-15 | 2021-01-12 | Pacira Cryotech, Inc. | Cryogenic blunt dissection methods and devices |
US10016229B2 (en) | 2013-03-15 | 2018-07-10 | Myoscience, Inc. | Methods and systems for treatment of occipital neuralgia |
US10130409B2 (en) | 2013-11-05 | 2018-11-20 | Myoscience, Inc. | Secure cryosurgical treatment system |
US10864033B2 (en) | 2013-11-05 | 2020-12-15 | Pacira Cryotech, Inc. | Secure cryosurgical treatment system |
US11690661B2 (en) | 2013-11-05 | 2023-07-04 | Pacira Cryotech, Inc. | Secure cryosurgical treatment system |
US9955946B2 (en) | 2014-03-12 | 2018-05-01 | Cibiem, Inc. | Carotid body ablation with a transvenous ultrasound imaging and ablation catheter |
CN106572876A (en) * | 2014-07-18 | 2017-04-19 | 美敦力 | Cardiac cryolipolysis for the treatment of cardiac arrhythmia |
US9743972B2 (en) * | 2014-07-18 | 2017-08-29 | Medtronic Cryocath Lp | Cardiac cryolipolysis for the treatment of cardiac arrhythmia |
US20160015444A1 (en) * | 2014-07-18 | 2016-01-21 | Medtronic Cryocath Lp | Cardiac cryolipolysis for the treatment of cardiac arrhythmia |
EP3169259A4 (en) * | 2014-07-18 | 2018-03-21 | Medtronic Cryocath LP | Cardiac cryolipolysis for the treatment of cardiac arrhythmia |
US20170086919A1 (en) * | 2015-09-30 | 2017-03-30 | Fiab S.P.A. | Esophageal probe with the temperature change speed detection system |
US10105178B2 (en) * | 2015-09-30 | 2018-10-23 | Fiab S.P.A. | Esophageal probe with the temperature change speed detection system |
US11311327B2 (en) | 2016-05-13 | 2022-04-26 | Pacira Cryotech, Inc. | Methods and systems for locating and treating nerves with cold therapy |
US10646240B2 (en) | 2016-10-06 | 2020-05-12 | Shockwave Medical, Inc. | Aortic leaflet repair using shock wave applicators |
US11517337B2 (en) | 2016-10-06 | 2022-12-06 | Shockwave Medical, Inc. | Aortic leaflet repair using shock wave applicators |
US11083519B2 (en) | 2016-10-17 | 2021-08-10 | Innoblative Designs, Inc. | Treatment devices and methods |
US11786295B2 (en) | 2016-11-08 | 2023-10-17 | Innoblative Designs, Inc. | Electrosurgical tissue and vessel sealing device |
US11737820B2 (en) * | 2017-01-06 | 2023-08-29 | St. Jude Medical, Cardiology Division, Inc. | Pulmonary vein isolation balloon catheter |
US11832829B2 (en) | 2017-04-20 | 2023-12-05 | Medtronic, Inc. | Stabilization of a transseptal delivery device |
US11786297B2 (en) | 2017-07-26 | 2023-10-17 | Innoblative Designs, Inc. | Minimally invasive articulating assembly having ablation capabilities |
EP3658053A4 (en) * | 2017-07-26 | 2021-04-14 | Innoblative Designs, Inc. | Minimally invasive articulating assembly having ablation capabilities |
US11134998B2 (en) | 2017-11-15 | 2021-10-05 | Pacira Cryotech, Inc. | Integrated cold therapy and electrical stimulation systems for locating and treating nerves and associated methods |
US20220409255A1 (en) * | 2019-12-27 | 2022-12-29 | Lifetech Scientific (Shenzhen) Co., Ltd. | Left atrial appendage occluder and occlusion system |
Also Published As
Publication number | Publication date |
---|---|
US20080208182A1 (en) | 2008-08-28 |
US8080006B2 (en) | 2011-12-20 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US8080006B2 (en) | Method for tissue cryotherapy | |
US7101368B2 (en) | Cryo balloon for atrial ablation | |
US9888953B2 (en) | Nested balloon cryotherapy | |
US9743973B2 (en) | Triple balloon catheter | |
US8439906B2 (en) | Regulating internal pressure of a cryotherapy balloon catheter | |
US8870859B2 (en) | Therapeutic apparatus having insulated region at the insertion area | |
US8579889B2 (en) | Linear ablation devices and methods of use | |
US7740627B2 (en) | Surgical method and apparatus for treating atrial fibrillation | |
US20060135953A1 (en) | Tissue ablation system including guidewire with sensing element | |
US20190159835A1 (en) | Cryopad |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: SCIMED LIFE SYSTEMS, INC., MINNESOTA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:LAFONTAINE, DANIEL M.;AVITALL, BOAZ;REEL/FRAME:015859/0946;SIGNING DATES FROM 20040901 TO 20040910 |
|
AS | Assignment |
Owner name: BOSTON SCIENTIFIC SCIMED, INC., MINNESOTA Free format text: CHANGE OF NAME;ASSIGNOR:SCIMED LIFE SYSTEMS, INC.;REEL/FRAME:018505/0868 Effective date: 20050101 Owner name: BOSTON SCIENTIFIC SCIMED, INC.,MINNESOTA Free format text: CHANGE OF NAME;ASSIGNOR:SCIMED LIFE SYSTEMS, INC.;REEL/FRAME:018505/0868 Effective date: 20050101 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |