Method for endoscopic blood flow detection by the use of ultrasonic energy
First Claim
1. A method for determining the location of the retroduodenal artery relative to the papilla of Vater during endoscopic papillotomy, said method comprising the steps of:
- inserting a flexible, side-viewing endoscope into the duodenum;
visualizing the papilla through the endoscope;
passing a catheter including an ultrasonic probe having a transverse, sectorial, range-limited field through a biopsy channel of the endoscope, through the papilla, and into the common bile duct so that said ultrasonic field is directed towards the retroduodenal artery;
advancing the catheter and monitoring a Doppler signal obtained from the probe until the Doppler signal is characteristic of arterial blood flow; and
,visualizing, through the endoscope, the amount by which the catheter has been advanced past the papilla.
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Accused Products
Abstract
Various forms of a catheter that is sized to pass through the biopsy channel of an endoscope include an elongated catheter tube of flexible material and an ultrasonic probe carried by the catheter tube adjacent its tip. The forms include: a papillotome catheter (FIGS. 1 and 3); catheters for general endoscopic and nonendoscopic applications (FIGS. 4, 7A through 7C, 8A through 8B, 10A through 10B, and 11); and, a sclerosing catheter (FIGS. 13 through 15). These catheters may be used to determine the location of the retroduodenal artery in endoscopic papillotomy (FIGS. 2, 5, and 6), to evaluate and treat esophageal varices (FIGS. 9 and 12), or generally to detect blood flow in a biological structure within the body. Depending on the application, the ultrasonic field provided by the ultrasonic probe may be either transverse or parallel to the longitudinal axis of the catheter tube and may be either highly directional, omnidirectional, or sectorial. The ultrasonic probe is coupled to a pulsed Doppler circuit (FIG. 16) by an isolation circuit (FIGS. 17 through 20) that provides electrical isolation and RFI suppression. The Doppler circuit is designed to enhance close proximity detection of blood flow, to limit the range of the probe'"'"'s ultrasonic field, and to distinguish between arterial blood flow, venous blood flow, and vessel wall motion.
348 Citations
4 Claims
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1. A method for determining the location of the retroduodenal artery relative to the papilla of Vater during endoscopic papillotomy, said method comprising the steps of:
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inserting a flexible, side-viewing endoscope into the duodenum; visualizing the papilla through the endoscope; passing a catheter including an ultrasonic probe having a transverse, sectorial, range-limited field through a biopsy channel of the endoscope, through the papilla, and into the common bile duct so that said ultrasonic field is directed towards the retroduodenal artery; advancing the catheter and monitoring a Doppler signal obtained from the probe until the Doppler signal is characteristic of arterial blood flow; and
,visualizing, through the endoscope, the amount by which the catheter has been advanced past the papilla.
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2. A method for determining the location of the retroduodenal artery relative to the papilla of Vater during endoscopic paillotomy, said method comprising the steps of:
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inserting a flexible, side-viewing endoscope into the duodenum; visualizing the papilla through the endoscope; passing a catheter including an ultrasonic probe having a transverse, range-limited ultrasonic field through a biopsy channel of the endoscope and into contact with the duodenum; advancing the catheter along the duodenum and monitoring a Doppler signal obtained from the probe until the Doppler signal is characteristic of arterial blood flow; and
,visualizing, through the endoscope, the location of the probe relative to the papilla.
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3. A method for evaluating esophageal varices, said method comprising the steps of:
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inserting a flexible, end-viewing endoscope into the esophagus; visualizing a protrusion in the esophagus through the endoscope; passing a catheter including an ultrasonic probe having a range-limited ultrasonic field through a biopsy channel of the endoscope and into the esophagus until the probe contacts the protrusion; and monitoring a Doppler signal obtained from the ultrasonic probe for that Doppler signal characteristic of venous blood flow.
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4. A method for identifying and monitoring an intracorporeal biological structure, said method comprising the steps of:
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inserting an endoscope into the body; visualizing, through the endoscope, the location of the biological structure; passing a catheter including an ultrasonic probe through a biopsy channel of the endoscope and into proximity to the biological structure; and
,monitoring a Doppler signal obtained from the ultrasonic probe for that Doppler signal characteristic of blood flow in the biological structure.
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Specification