SYSTEMS FOR TREATING A HOLLOW ANATOMICAL STRUCTURE

• US 20100106150A1
• Filed: 01/12/2010
• Published: 04/29/2010
• Est. Priority Date: 07/21/2005
• Status: Active Grant

• Current Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Thompson, Russell Blake, Esch, Brady David, Dhaka, Vijay Kumar, Sander, Fiona Maria
• Granted Patent: US 7,837,677 B2
• Time in Patent Office: Days
• US Class Current: 606/29
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• 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 18/20 using laser
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/00123 and automatic shutdown
• CPC Class Codes: A61B 2017/00132 Setting operation time of a device A61B2017/00123 takes precedence
• CPC Class Codes: A61B 2018/00636 Sensing and controlling the application of energy
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00827 Current
• CPC Class Codes: A61B 2018/046 in liquid form
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/3925 ultrasonic
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers

Abstract

A working end of a catheter includes at least one therapeutic element, such as a resistive heating element, usable to deliver energy for ligating, or reducing the diameter of, a hollow anatomical structure. In certain examples, the catheter includes a lumen to accommodate a guide wire or to allow fluid delivery. In certain embodiments, a balloon is inflated to place resistive element(s) into apposition with a hollow anatomical structure and to occlude the structure. Indexing devices and methods are also disclosed for successively treating portions of the hollow anatomical structure. In certain examples, marks along the catheter shaft provide visual verification to the physician of the relative position of the therapeutic element of the catheter. Embodiments of indexing devices may include pairs of rings and/or hinged arms that move a catheter a desired indexed position between successive treatments.

Claims

1. A catheter for use in treating a length of a blood vessel together with an introducer sheath having a reference location configured to be located outside the patient, the catheter comprising:

an elongated shaft having a distal section and a proximal section, the shaft being sized for insertion into a blood vessel;

a resistive heating coil;

wherein the resistive heating coil is for applying energy along a length of a blood vessel in consecutive treated segments of the blood vessel to thereby occlude the length of the blood vessel;

the heating coil located adjacent the distal section of the shaft, and having a coil length from about 2 centimeters to about 10 centimeters;

a plurality of index markings along the shaft of the catheter;

wherein the index markings are configured to be sequentially indexed in a distal to proximal direction adjacent the introducer reference location to sequentially position the resistive heating coil axially along the length of the blood vessel; and

at least one final marking that indicates a final shaft distance from said final marking to the proximal end of the coil, the final shaft distance comprising approximately the length of an introducer sheath and a safety zone distance on the shaft;

wherein consecutive index markings are spaced apart by an index marking length, the index marking length being from about 0.1 centimeter to about 1.5 centimeters less than the coil length to ensure overlap of consecutive treated segments of the blood vessel, re-treatment of the blood vessel occurring at the overlap when the resistive coil is retracted along the blood vessel by successive index marking lengths.

2. The catheter of claim 1, wherein between consecutive index markings, the shaft lacks any markings similar to the index markings.

3. The catheter of claim 1, wherein the coil length is at least ten times the width of the resistive coil.

4. The catheter of claim 1, wherein the at least one final marking comprises at least two final markings and each final marking corresponds to a different length of introducer sheath.

5. The catheter of claim 1, further comprising a warning track along the shaft and wherein the at least one final marking is located on the shaft between the heating coil and the warning track.

6. Apparatus for use in treating a blood vessel together with a reference location, the apparatus comprising:

an elongate member having a distal section and a proximal section, the elongate member being sized for insertion into a blood vessel;

a resistive heating coil;

wherein the resistive heating coil is for applying energy along a length of a blood vessel in consecutive treated segments of the blood vessel to thereby occlude the length of the blood vessel;

the heating coil located adjacent the distal section of the elongate member, the heating coil having a first length from about 2 centimeters to about 10 centimeters;

a plurality of index markings located on the elongate member;

wherein the index markings are configured to be movably indexed in a distal to proximal direction adjacent a reference location to sequentially position the resistive heating coil axially along the length of the blood vessel; and

at least one final marking that indicates a final distance from said final marking to the proximal end of the coil, the final distance comprising approximately the length of an introducer sheath and a safety zone;

wherein consecutive index markings are spaced apart by a second length, the second length being from about 1% to about 15% less than the first length to ensure overlap of consecutive treated segments of the blood vessel when the resistive coil is moved along the blood vessel.

7. The apparatus of claim 6, wherein the elongate member lacks any markings similar to the index markings and located between consecutive index markings.

8. The apparatus of claim 6, wherein the first length is at least ten times the width of the resistive coil.

9. The apparatus of claim 6, wherein the at least one final marking comprises at least two final markings and each final marking corresponds to a different length of introducer sheath.

10. The apparatus of claim 6, further comprising a warning track along the elongate member and wherein the at least one final marking is located on the elongate member between the heating coil and the warning track.

11. Apparatus for use in treating a blood vessel, the apparatus comprising:

an elongate member having a distal section and a proximal section, the elongate member being sized for insertion into a blood vessel;

a resistive heating coil;

wherein the resistive heating coil is for applying energy along a length of a blood vessel in consecutive treated segments of the blood vessel to thereby occlude the length of the blood vessel;

the heating coil located adjacent the distal section of the elongate member, the heating coil having a first length from approximately 2 centimeters to approximately 10 centimeters;

a plurality of index markings located on the elongate member;

wherein the index markings are configured to be movably indexed in a distal to proximal direction to sequentially position the resistive heating coil axially along the length of the blood vessel; and

at least one final marking that indicates a final distance from said final marking to the proximal end of the coil, the final distance including a safety factor distance;

wherein consecutive index markings are spaced apart by a second length, the second length being from approximately 0.1 centimeter to approximately 1.5 centimeters less than the first length to ensure overlap of consecutive treated segments of the blood vessel when the resistive coil is moved along the blood vessel.

12. The apparatus of claim 11, wherein the elongate member lacks any markings similar to the index markings and located between consecutive index markings.

13. The apparatus of claim 11, wherein the first length is at least ten times the width of the resistive coil.

14. The apparatus of claim 11, wherein the at least one final marking comprises at least two final markings and each final marking corresponds to a different length of introducer sheath.

15. The apparatus of claim 11, further comprising a warning track along the elongate member and wherein the at least one final marking is located on the elongate member between the heating coil and the warning track.