Tissue ablation system with a sliding ablating device and method

• US 20030069575A1
• Filed: 06/21/2002
• Published: 04/10/2003
• Est. Priority Date: 12/29/2000
• Status: Abandoned Application

• Current Assignee: Maquet Cardiovascular LLC (Getinge AB)
• Original Assignee: AFX, Inc. (Boston Scientific Corporation)
• Inventors: Dany, Berube, Mody, Dinesh I., Chin, Sing Fatt, Norris, Nancy
• Application Number:
  US10/177,840
• Publication Number:
  US 20030069575A1
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2018/00375 Ostium, e.g. ostium of pulmonary vein or artery
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/1497 Electrodes covering only part of the probe circumference

Abstract

A system and method for ablating a selected portion of a contact surface of biological tissue is provided. The system includes an elongated ablation sheath having a preformed shape adapted to substantially conform a predetermined surface thereof with the contact surface of the tissue. The ablation sheath defines an ablation lumen sized to slideably receive an elongated ablative device longitudinally therethrough. The ablative device includes a flexible ablation element selectively generating an ablative field sufficiently strong to cause tissue ablation. Advancement of the ablation element slideably through the ablation lumen of the ablation sheath selectively places the ablation element along the ablation path for guide ablation on the contact surface when the predetermined surface is in strategic contact therewith. The ablation lumen and the ablative device cooperate to position the ablation element proximate to the ablation sheath predetermined surface for selective ablation of the selected portion within the ablative field.

Claims

1. An ablation system, comprising:

a handle portion having proximal and distal ends;

a flexible elongated tubular member having at least one lumen therethrough operably attached to the distal end of the handle portion;

an energy delivery device comprising at least one ablative element, the energy delivery device operably attached to the handle portion and adapted to translate within a first of the at least one lumen of the tubular member; and

an ablative energy source operably attached to the at least one ablative element.

2. The system of claim 1, further comprising a means for positioning the energy delivery device at one of a plurality of positions within the flexible elongated tubular member.

3. The system of claim 2, wherein the positioning means comprises an actuating member operably attached to the handle portion and the energy delivery device, whereby translation of the actuating member results in translation of the energy delivery device within the tubular member.

4. The system of claim 3, wherein the actuating member is an actuating ring.

5. The system of claim 3, wherein the positioning means comprises a means for indicating the relative position of the energy delivery device with respect to the flexible elongated tubular member.

6. The system of claim 5, wherein the indicating means is tactile.

7. The system of claim 5, wherein the indicating means is visual.

8. The system of claim 5, wherein the indicating means is audible.

9. The system of claim 6, wherein the positioning means further comprises a plurality of indentions formed on the surface of the handle, the plurality of indentions adapted to operably interface with the actuating member, whereby the actuating member can be selectively translated to one of a plurality of positions along the handle portion.

10. The system of claim 9, wherein, each one of the plurality of positions corresponds to at least one of the plurality of indentions.

11. The system of claim 9, wherein the indicating means includes a plurality of alphanumeric symbols on the handle portion corresponding to a plurality of energy delivery device positions within the elongated tubular member.

12. The system of claim 10, wherein the indicating means further comprises a plurality of indicators which define the plurality of energy delivery device positions.

13. The system of claim 12, wherein the plurality of indicators are ink based markings upon an outer surface of the tubular member.

14. The system of claim 12, wherein the plurality of indicators fluoresce.

15. The system of claim 14, wherein the plurality of indicators are adapted to indicate rotational orientation of the tubular member.

16. The system of claim 7, wherein the indicating means comprises at least one illuminating device operably attached to the actuating member.

17. The system of claim 16, wherein the at least one illuminating device is a light emitting diode.

18. The system of claim 17, wherein the light emitting diode is adapted to flash in a predetermined manner indicative of one of a plurality of positions along the handle portion, each one of the plurality of positions corresponding to one of a plurality of energy delivery device positions within the flexible elongated tubular member.

19. The system of claim 18, wherein the indicating means further comprises a plurality of indicators as part of the flexible elongated tubular member which define the plurality of energy delivery device positions.

20. The system of claim 19, wherein the plurality of indicators comprises visible markings.

21. The system of claim 19, wherein the plurality of indicators comprise elements which fluoresce.

22. The system of claim 21, wherein the fluorescing elements are adapted to indicate rotational orientation of the flexible elongated tubular member.

23. The system of claim 8, wherein the indicating means comprises at least one audio transducer operably attached to the actuating member and adapted to emit audible sound.

24. The system of claim 23, wherein the at least one audio transducer is adapted to emit one or more audible pulses in a predetermined manner indicative of one of a plurality of positions along the handle portion, each one of the plurality of positions corresponding to one of a plurality of energy delivery device positions within the flexible elongated tubular member.

25. The system of claim 24, wherein the indicating means further comprises a plurality of indicators as part of the flexible elongated tubular member which define the plurality of energy delivery device positions.

26. The system of claim 25, wherein the plurality of indicators comprises visible markings.

27. The system of claim 25, wherein the plurality of indicators comprise elements which fluoresce.

28. The system of claim 27 wherein the fluorescing elements are adapted to indicate rotational orientation of the flexible elongated tubular member.

29. The system of claim 1, further comprising a means for positioning the flexible elongated tubular member adjacent to at least a portion of a target tissue to be ablated.

30. The system of claim 29, wherein the flexible elongated tubular member is in contact with at least a portion of the target tissue.

31. The system of claim 29, wherein the means for positioning the tubular member comprises an elongated positioning member.

32. The system of claim 31, further comprises an adapting element interfacing the elongated tubular member to the tubular member positioning means.

33. The system of claim 32, wherein the elongated positioning member has a diameter smaller than the elongated tubular member and the adapting element is a reducer.

34. The system of claim 32, wherein the elongated positioning member has a diameter larger than the elongated tubular member and the adapting element is an enlarger.

35. The system of claim 32, wherein the adapting element is formed from metal.

36. The system of claim 35, wherein the adapting element is stainless steel.

37. The system of claim 32, wherein the elongated positioning member comprises at least one lumen passing therethrough.

38. The system of claim 37, wherein the elongated positioning member further comprises an elongated flexible member within the at least one lumen.

39. The system of claim 32, wherein the elongated positioning member comprises an end portion.

40. The system of claim 39, wherein the end portion is adapted to have a blunt distal end.

41. The system of claim 39, wherein the end portion further comprises at least one suture line further facilitating positioning of the elongated positioning member.

42. The system of claim 1, wherein the flexible elongated tubular member is constructed from porous expanded PTFE.

43. The system of claim 42, wherein the flexible elongated tubular member has a cross-sectional geometry adapted to minimize the distance between the at least one ablative element and the target tissue.

44. The system of claim 43, wherein the cross-sectional geometry of the flexible elongated tubular member comprises a substantially flat surface at the point of contact with the target tissue.

45. The system of claim 44, wherein the cross-sectional geometry of the flexible elongated tubular member comprises a substantially curvilinear top surface, whereby damage to adjacent tissue is minimized during placement of the flexible elongated tubular member.

46. The system of claim 42, wherein the first of the at least one lumen of the tubular member is adapted to minimize rotation of the energy delivery device translating therein.

47. The system of claim 43, wherein the cross-sectional geometry of the first of the at least one lumen of the tubular member has at least one substantially flat surface, whereby rotation is minimized.

48. The system of claim 47, wherein the substantially flat surface is parallel to the surface of the target tissue.

49. An ablation system for ablating a target tissue, comprising:

a handle portion having proximal and distal ends;

a flexible elongated tubular member having at least two lumens therethrough operably attached to the distal end of the handle portion;

an energy delivery device within a first of the at least one lumen of the elongated tubular member, the energy delivery device operably attached to the handle portion and comprising at least one translatable ablative element; and

an ablative energy source operably attached to the at least one ablative element.

50. The system of claim 49, wherein the flexible elongated tubular member is formed from a material compressible in at least one geometric axis.

51. The system of claim 50, wherein the flexible elongated tubular member is compressible along its longitudinal axis.

52. The system of claim 51, wherein the flexible elongated tubular member is formed from expanded PTFE.

53. The system of claim 50, further comprising a first retaining member operably placed within the second of at least one lumen of the elongated tubular member.

54. The system of claim 53, wherein the first retaining member is malleable.

55. The system of claim 53, wherein the first retaining member substantially prohibits the compression of the elongated tubular member along its longitudinal axis.

56. The system of claim 55, wherein the first retaining member is formed from silicone.

57. The system of claim 55, further comprising a second retaining member which substantially prohibits the expansion of the elongated tubular member along its longitudinal axis.

58. The system of claim 57, wherein the second retaining member is formed from a metal.

59. The system of claim 58, wherein the retaining member is nitinol.

60. An ablation system incorporating a sliding ablating element, comprising:

a handle portion having proximal and distal ends;

an elongated sheath having at least one lumen therethrough operably attached to the handle portion;

an energy delivery device adapted to translate within a first of the at least one lumen of the elongated sheath, the energy delivery device comprising at least one ablative element; and

an ablative energy source operably attached to the at least one ablative element.

61. The system of claim 60, wherein the energy delivery device comprises a means for aligning the at least one ablative element.

62. The system of claim 61, wherein the aligning means is formed from a material which is substantially transparent with respect to the ablative energy.

63. The system of claim 62, wherein the aligning means comprises a longitudinal groove, adapted to accept the at least one ablative element therein, the longitudinal groove dynamically aligning the one ablative element while the energy delivery device is being manipulated.

64. The system of claim 63, further comprising a tubular retaining member placed about the energy delivery device, and wherein the longitudinal groove is formed along the outer surface of the aligning means, whereby the tubular retaining member retain the at least one ablative element within the groove during use.

65. The system of claim 64, further comprising a transmission line having an inner and outer conductor, the transmission line operably attaching the ablative energy source to the at least one ablative element, wherein a first of the at least one ablative element is a linear antenna electrically connected to the inner conductor of the transmission line.

66. The system of claim 65, wherein the energy delivery portion further comprises a shielding member.

67. The system of claim 66, wherein the shielding member prevents the passing of substantially all the ablative energy therethrough. whereby adjacent tissue is protected during ablation of the target tissue.

68. The system of claim 67, wherein the shielding member is electrically attached to the outer conductor of the transmission line.

69. The system of claim 68, wherein the shielding member reflects at least a portion of the ablative energy toward the target tissue.

70. The system of claim 69, wherein the energy delivery device further comprises a means for impedance matching the at least one ablative element, the transmission line, and the ablative energy source, whereby energy delivery from the at least one ablative element to the target tissue is maximized.

71. The system of claim 70, wherein the impedance matching means is capacitive.

72. The system of claim 70, wherein the impedance matching means is inductive.