Catheter with electrosurgical cutter
First Claim
Patent Images
1. A method for dilating a non-vascular body conduit, comprising:
- inserting into the non-vascular conduit a dilation catheter assembly comprising an elongate tubular body having a distal end carrying a radially dilatable member adapted to be positioned in the conduit and to exert pressure on surrounding body tissue to provide a substantially uniform tangential tension in the tissue, and a cutting element carried on the dilatable member;
dilating the dilatable member to simultaneously stress the tissue and engage the tissue with the cutting element;
electrically activating the cutting element;
incising the stressed tissue with the cutting element;
radially contracting the dilatable member to cause the dilatable member and cutting element to disengage the tissue; and
withdrawing the dilation catheter assembly from the conduit.
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Accused Products
Abstract
A catheter assembly which permits simultaneous dilatation and incision of tissue whereby trauma and damage to the tissue due to uncontrolled tearing is reduced or eliminated comprising an elongated tubular body having a distal end that carries a dilatation balloon and cutting element carried on the exterior of the balloon and that moves radially in concert with the exterior of the bladder as the bladder is inflated and deflated. A radiofrequency current is directed through the cutting element to incise proximate tissue. Pressure can be applied to the tissue prior to cutting to facilitate separation and subsequent to cutting to inhibit bleeding.
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Citations
64 Claims
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1. A method for dilating a non-vascular body conduit, comprising:
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inserting into the non-vascular conduit a dilation catheter assembly comprising an elongate tubular body having a distal end carrying a radially dilatable member adapted to be positioned in the conduit and to exert pressure on surrounding body tissue to provide a substantially uniform tangential tension in the tissue, and a cutting element carried on the dilatable member; dilating the dilatable member to simultaneously stress the tissue and engage the tissue with the cutting element; electrically activating the cutting element; incising the stressed tissue with the cutting element; radially contracting the dilatable member to cause the dilatable member and cutting element to disengage the tissue; and withdrawing the dilation catheter assembly from the conduit. - View Dependent Claims (2, 3, 4)
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5. A method for enlarging the diameter of a ureteral passage defined by body tissue, comprising:
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inserting into the ureteral passage a catheter having a catheter body, a cutting element in the form of an elongate wire, and means for advancing the cutting element laterally of the catheter body; advancing the cutting element into proximity with the tissue; and electrically activating the cutting element to cut the tissue and enlarge the diameter of the ureteral passage. - View Dependent Claims (6, 7, 8, 9, 10, 11, 12)
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13. A method for enlarging the diameter of a passage defined by body tissue and having a longitudinal axis, comprising:
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inserting into the passage a catheter having an inflatable balloon and a cutting element in the form of an electrosurgical wire disposed in contact with the outer surface of the balloon; inflating the balloon to move the cutting element into proximity with the body tissue; activating electrically the cutting element to cut the body tissue in only a substantially axial direction; deflating the balloon to withdraw the cutting element from proximity with the body tissue; and withdrawing the catheter from the passage. - View Dependent Claims (14, 15, 16, 17, 18, 19)
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20. A method for enlarging the diameter of a passage defined by body tissue, comprising:
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inserting into the passage a catheter having a wall defining a lumen extending between a distal end of the catheter and a proximal end of the catheter, and an electrosurgical wire having first portions disposed exteriorly of the catheter and second portions disposed interiorly of the catheter, the wire including a first end fixed to the catheter and a second end movable within the lumen of the catheter to vary the length of the first portions of the wire relative to the length of the second portions of the wire; moving the second end of the wire distally within the lumen of the catheter to increase the length of the first portions of the wire and thereby move the first portions laterally of the catheter wall into proximity with the tissue; activating the electrosurgical wire to cut the tissue in proximity to the wire; and moving the second end of the wire proximally within the lumen of the catheter to decrease the length of the first portions of the wire and thereby move the first portions laterally of the catheter wall into proximity with the catheter wall. - View Dependent Claims (21, 22, 23, 24, 25)
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26. A catheter assembly adapted for use in the urinary system and comprising in combination:
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an elongate tubular body having a lumen and an axis extending to a distal end; a dilatable member having an outwardly facing exterior surface and being disposed to surround the distal end of the tubular body in communication with the lumen of the tubular body, the dilatable member being adapted for disposition in the urinary system and being dilatable in response to fluid pressure in the lumen of the tubular body to exert pressure on surrounding body tissue in order to create tension in the body tissue; cutting means disposed substantially only axially to extend in close contacting relationship with the exterior surface of the dilatable member and having characteristics for being moved into proximity with the surrounding tissue when the dilatable member is dilated, for incising said tissue axially along the tubular body to relieve the tension in the body tissue and to enlarge the body conduit; and means for electrically energizing the cutting means to permit incision and cauterization of the tissue. - View Dependent Claims (27, 28, 29, 30, 31, 32, 33)
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34. A catheter adapted to cut tissue, comprising:
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a tube having a longitudinal axis extending between a distal end and a proximal end of the catheter; cutting means disposed generally at the distal end of the tube for cutting the tissue, the cutting means including only a single axially oriented wire, having no point of intersection with any second cutting wire, the single wire having portions movable radially of the axis of the catheter; means for moving the cutting means portions radially into close proximity to the tissue to be cut; means for electrically activating the cutting means to cut the tissue in proximity to the cutting means; and means for exposing previously uncut tissue to the cutting means. - View Dependent Claims (35, 36, 37, 38, 39, 40, 41)
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42. A catheter adapted to cut tissue, comprising:
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a tube having a longitudinal axis extending between a distal end and a proximal end of the catheter; cutting means disposed generally at the distal end of the tube for cutting the tissue, the cutting means including only a single axially oriented wire having no point of intersection with any second cutting wire, the single wire having portions movable radially of the axis of the catheter; means for moving the cutting means portions radially into close proximity to the tissue to be cut, comprising a balloon inflatable through the tube and having portions disposed in a fixed relationship with the tube of the catheter, the balloon having an outer surface and the wire being movable radially with the outer surface when the balloon is inflated, the balloon having first and second ends fixed to the tube, and the wire having a first end fixed relative to the first end of the balloon and a second end movable relative to the second end of the balloon; and means for activating the cutting means to cut the tissue in proximity to the cutting means; and
means for exposing previously uncut tissue to the cutting means. - View Dependent Claims (43)
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44. Apparatus for cutting a non-vascular body conduit comprising:
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a supporting structure having an outer surface; an electrosurgical cutter in the form of a wire having first portions disposed in a fixed relationship with the supporting structure and second portions disposed outwardly of the outer surface in a movable relationship with the supporting structure; means disposed between the supporting structure and the second portions of the cutter for moving the second portions of the cutter into proximity with the tissue to be cut; and means for electrically activating the cutter to cut the non-vascular body conduit. - View Dependent Claims (45)
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46. Tissue cutting apparatus, comprising:
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a supporting structure including portions defining a lumen and having an outer surface; an electrosurgical cutter in the form of a wire having first portions disposed in a fixed relationship with the supporting structure, and second portions disposed outwardly of the outer surface in a movable relationship with the supporting structure; means disposed between the supporting structure and the second portions of the cutter for moving the second portions of the cutter into proximity with the tissue to be cut, the moving means comprising a balloon inflatable through the lumen of the supporting structure; means for electrically activating the cutter to cut the tissue; and means disposed between the cutter and the balloon for directing energy from the electrical cutter away from the balloon and toward the tissue. - View Dependent Claims (47, 48, 49, 50, 51, 52, 53)
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54. A catheter having a longitudinal axis extending between a proximal end of the catheter and a distal end of the catheter, comprising:
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a catheter body defining a lumen and a hole extending from the lumen exteriorly of the catheter; an elongate cutting element in the form of a wire having a distal end with a fixed relationship to the catheter body, a proximal end extending through the hole into the lumen, and intermediate portions disposed between the proximal end and distal end of the wire; and means for moving the proximal end of the wire towards the distal end of the wire for advancing the intermediate portions of the wire laterally of the axis of the catheter. - View Dependent Claims (55, 56, 57, 58, 59)
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60. A catheter having a longitudinal axis extending between a proximal end of the catheter and a distal end of the catheter, comprising:
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a catheter body defining a lumen and a hole extending from the lumen exteriorly of the catheter; an elongate cutting element in the form of a wire having a proximal end with a fixed to the catheter body, a distal end extending through the hole into the lumen, and intermediate portions disposed between the proximal end and distal end of the wire; and means for moving the distal end of the wire toward the proximal end of the wire for advancing the intermediate portions of the wire laterally of the axis of the catheter.
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61. A catheter assembly comprising in combination:
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an elongate tubular body having a lumen and an axis extending to a distal end; a dilatable member having an outwardly facing exterior surface and being disposed to surround the distal end of the tubular body in communication with the lumen of the tubular body, the dilatable member being adapted for disposition in the urinary system and being dilatable in response to fluid pressure in the lumen of the tubular body to exert pressure on surrounding body tissue in order to create substantially circumferentially uniform tension in the body tissue; cutting means comprising a wire and being disposed to extend substantially only axially along at least one half of the length of the dilatable member, and having characteristics for being moved into proximity with the surrounding tissue when the dilatable member is dilated, for incising said tissue along the tubular body to relieve the tension in the body tissue and to enlarge the body conduit. - View Dependent Claims (62)
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63. A catheter having a longitudinal axis extending between a proximal end of the catheter and a distal end of the catheter, comprising:
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a catheter body defining a lumen and a hole extending from the lumen exteriorly of the catheter; an elongate cutting element, at least a portion of which is always disposed exteriorly of the catheter body, said cutting element having a proximal end with a fixed relationship with the catheter body, a distal end extending through the hole into the lumen, and intermediate portions disposed between the proximal end and distal end of the cutting element; and means for moving the distal end of the cutting element toward the proximal end of the cutting element for advancing the intermediate portions of the cutting element laterally of the axis of the catheter.
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64. Tissue cutting apparatus, comprising:
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a supporting structure having an outer surface; an electrosurgical cutter in the form of a wire having first portions disposed in a fixed relationship with the supporting structure and second portions disposed outwardly of the outer surface in a movable relationship with the supporting structure, at least a portion of said second portions of the wire being disposed exteriorly of the supporting structure at all times; means disposed between the supporting structure and the second portions of the cutter for moving the second portions of the cutter into proximity with the tissue to be cut; and means for electrically activating the cutter to cut the tissue.
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Specification