Method and apparatus for reducing the size of a hollow anatomical structure

• US 6,071,277 A
• Filed: 07/01/1997
• Issued: 06/06/2000
• Est. Priority Date: 03/05/1996
• Status: Expired due to Term

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: VNUS Medical Technologies Incorporated (Medtronic Plc)
• Inventors: Laufer, Michael D., Zikorus, Arthur W., Farley, Brian E.
• Primary Examiner(s): McDermott, Corrine
• Assistant Examiner(s): RODRIGUEZ, CRIS LOIREN
• Application Number:
  US08/886,498
• Time in Patent Office: 1,071 Days
• Field of Search: 606/27, 606/40, 606/32, 606/49, 128/642, 128/639, 604/104-107, 604/20, 604/21, 604/93, 604/507, 604/508, 604/500, 604/517, 604/516, 604/113, 607/1, 607/2, 607/96, 607/101, 607/103
• US Class Current: 606/27
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• 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 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2017/22097 Valve removal in veins
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00488 Esophagus
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00797 measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/1253 monopolar
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1465 Deformable electrodes
• CPC Class Codes: A61B 2018/1497 Electrodes covering only part of the probe circumference

Abstract

A catheter delivers an electrode within a hollow anatomical structure for a minimally invasive treatment which reduces the size of the structure. The catheter is introduced and positioned within a section of the hollow anatomical structure to be treated. The electrode radiates high frequency energy, and the surrounding tissue of the hollow anatomical structure becomes heated and begins to shrink. The catheter includes a controllable member for limiting the amount of shrinkage. The temperature of the surrounding hollow anatomical structure can be monitored while the electrode radiates high frequency energy. After treating one section of the hollow anatomical structure, the catheter and electrodes can be repositioned intraluminally to treat different sections of the hollow anatomical structure.

Claims

1. A method of reducing the size of a hollow anatomical structure, the method comprising the steps of:

applying energy to the hollow anatomical structure from a heating device to cause the hollow anatomical structure to durably assume a reduced size; and

preventing further reduction in the size of the hollow anatomical structure beyond the selected reduced size so that the hollow anatomical structure remains patent.

2. The method of claim 1, wherein the step of preventing further reduction comprises the steps of:

positioning a catheter in the hollow anatomical structure;

controlling an effective diameter of the catheter to equal the selected reduced size to which the hollow anatomical structure is to be reduced; and

preventing further reduction in the diameter of the hollow anatomical structure beyond the selected reduced size with the catheter.

3. The method of claim 2 further comprising the steps of occluding the hollow anatomical structure by inflating a balloon on the catheter.

4. The method of claim 1, wherein the step of applying energy further includes the steps of:

positioning a catheter in the hollow anatomical structure;

increasing an effective diameter of the catheter so that the catheter is placed in apposition with the wall of the hollow anatomical structure; and

reducing the effective diameter of the catheter in a controlled manner while maintaining apposition with the wall, until the selected reduced size for the hollow anatomical structure is reached.

5. The method of claim 1, further including the steps of:

positioning a catheter in the hollow anatomical structure;

compressing the area around the hollow anatomical structure so as to reduce the diameter of the hollow anatomical structure before the step of applying energy;

controlling an effective diameter of the catheter to equal the selected reduced size to which the hollow anatomical structure is to be reduced; and

preventing further reduction in the size of the hollow anatomical structure beyond the selected reduced size with the catheter.

6. The method of claim 1, further comprising the steps of:

introducing a catheter into the hollow anatomical structure; and

expanding the catheter to place an electrode in contact with a wall of the hollow anatomical structure;

wherein the step of applying energy includes the step of applying electrical energy from the electrode.

7. The method of claim 6 wherein the step of applying electrical energy from the electrode comprises the step of expanding the catheter to place a non-insulated portion of a bowable catheter member in contact with the wall of the hollow anatomical structure while an insulated portion of the bowable catheter member remains free of contact with the wall.

8. The method of claim 1, further comprising the steps of:

introducing a catheter into the hollow anatomical structure;

expanding the catheter to place a plurality of electrodes in apposition with a wall of the hollow anatomical structure;

the step of applying energy comprises the steps of polarizing adjacent electrodes differently and applying energy from those electrodes to the hollow anatomical structure;

whereby electrical energy flows between the oppositely polarized electrodes through the wall of the hollow anatomical structure to reduce the size of the hollow anatomical structure.

9. The method of claim 1, further comprising the step of occluding the hollow anatomical structure.

10. The method of claim 1, further comprising the step of delivering a fluid to the hollow anatomical structure.

11. The method of claim 1, further comprising the step of monitoring the reduction in the size of the hollow anatomical structure with ultrasound.

12. The method of claim 1, further comprising the step of monitoring the reduction in the size of the hollow anatomical structure with fluoroscopy.

13. The method of claim 1, further comprising the step of sensing the temperature of the hollow anatomical structure to which energy is being applied.

14. The method of claim 13, further comprising the step of controlling the application of energy to the hollow anatomical structure in accordance with the sensed temperature.

15. A method of reducing the size of a hollow anatomical structure, the method comprising the steps of:

introducing a catheter into the hollow anatomical structure;

applying energy from a heating device to durably reduce the size of the hollow anatomical structure; and

preventing shrinkage beyond a selected size defined by the catheter so that the hollow anatomical structure remains patent.

16. The method of claim 15, further including the step of increasing an effective diameter of the catheter, the catheter preventing the hollow anatomical structure from assuming a diameter less than the effective diameter defined by the catheter during the step of preventing further reduction.

17. The method of claim 15, wherein the step of applying energy further includes the steps of:

increasing an effective diameter of the catheter so that the catheter is placed in apposition with the wall of the hollow anatomical structure; and

reducing the effective diameter of the catheter in a controlled manner while maintaining apposition with the wall, until the selected reduced size for the hollow anatomical structure is reached.

18. The method of claim 15, further including the steps of:

compressing the area around the hollow anatomical structure so as to reduce the diameter of the hollow anatomical structure before the step of applying energy;

controlling an effective diameter of the catheter to equal the selected reduced size to which the hollow anatomical structure is to be reduced; and

preventing further reduction in the diameter of the hollow anatomical structure beyond the selected reduced size with the catheter.

19. The method of claim 15 further comprising the steps of occluding the hollow anatomical structure by inflating a balloon on the catheter.

20. The method of claim 15, further comprising the step of occluding the hollow anatomical structure.

21. The method of claim 15, further comprising the steps of:

expanding the catheter to place an electrode in contact with a wall of the hollow anatomical structure;

wherein the step of applying energy includes the step of applying electrical energy from the electrode.

22. The method of claim 21 wherein the step of applying electrical energy from the electrode comprises the step of expanding the catheter to place a non-insulated portion of a bowable catheter member in contact with the wall of the hollow anatomical structure while a insulated portion of the bowable catheter member remains free of contact with the wall.

23. The method of claim 15, further comprising the steps of:

expanding the catheter to place a plurality of electrodes in apposition with a wall of the hollow anatomical structure;

the step of applying energy comprises the steps of polarizing adjacent electrodes differently and applying energy from those electrodes to the hollow anatomical structure;

whereby electrical energy flows between the oppositely polarized electrodes through the wall of the hollow anatomical structure to reduce the size of the hollow anatomical structure.

24. The method of claim 15, further comprising the step of delivering a fluid to the hollow anatomical structure.

25. The method of claim 15, further comprising the step of monitoring the reduction in the size of the hollow anatomical structure with ultrasound.

26. The method of claim 15, further comprising the step of monitoring the reduction in the diameter of the hollow anatomical structure with fluoroscopy.

27. The method of claim 15, further comprising the step of sensing the temperature of the hollow anatomical structure to which energy is being applied.

28. The method of claim 27, further comprising the step of controlling the application of energy to the hollow anatomical structure in accordance with the sensed temperature.

29. A method of reducing the diameter of a hollow anatomical structure, the method comprising the steps of:

introducing a catheter into the hollow anatomical structure, the catheter having a heating device;

placing the heating device in apposition with a wall of the hollow anatomical structure;

applying energy from the heating device to cause the hollow anatomical structure to durably assume a reduced diameter;

preventing shrinkage beyond a selected reduced diameter so that the hollow anatomical structure remains patent.

30. The method of claim 29, wherein the step of preventing further reduction comprises the steps of:

controlling an effective diameter of the catheter to equal the selected reduced size to which the hollow anatomical structure is to be reduced; and

preventing further reduction in the diameter of the hollow anatomical structure beyond the selected reduced size with the catheter.

31. The method of claim 29, wherein the step of applying energy further includes the steps of:

increasing an effective diameter of the catheter so that the catheter is placed in apposition with the wall of the hollow anatomical structure; and

reducing the effective diameter of the catheter in a controlled manner while maintaining apposition with the wall, until the selected reduced size for the hollow anatomical structure is reached.

32. The method of claim 29, further including the steps of:

compressing the area around the hollow anatomical structure so as to reduce the diameter of the hollow anatomical structure before the step of applying energy;

controlling an effective diameter of the catheter to equal the selected reduced size to which the hollow anatomical structure is to be reduced; and

preventing further reduction in the diameter of the hollow anatomical structure beyond the selected reduced size with the catheter.

33. The method of claim 29, further comprising the steps of:

expanding the catheter to place an electrode in contact with a wall of the hollow anatomical structure;

wherein the step of applying energy includes the step of applying electrical energy from the electrode.

34. The method of claim 32 wherein the step of applying electrical energy from the electrode comprises the step of expanding the catheter to place a non-insulated portion of a bowable catheter member in contact with the wall of the hollow anatomical structure while an insulated portion of the bowable catheter member remains free of contact with the wall.

35. The method of claim 29, further comprising the steps of:

expanding the catheter to place a plurality of electrodes in apposition with a wall of the hollow anatomical structure;

the step of applying energy comprises the steps of polarizing adjacent electrodes differently and applying energy from those electrodes to the hollow anatomical structure;

whereby electrical energy flows between the oppositely polarized electrodes through the wall of the hollow anatomical structure to reduce the size of the hollow anatomical structure.

36. The method of claim 29, further comprising the step of occluding the hollow anatomical structure.

37. The method of claim 29, further comprising the step of inflating a balloon on the catheter placed within the hollow anatomical structure to occlude the hollow anatomical structure.

38. The method of claim 29, further comprising the step of delivering fluid to the hollow anatomical structure.

39. The method of claim 29, further comprising the step of monitoring the reduction in the diameter of the hollow anatomical structure with ultrasound.

40. The method of claim 29, further comprising the step of monitoring the reduction in the diameter of the hollow anatomical structure with fluoroscopy.

41. The method of claim 29, further comprising the step of sensing the temperature of the hollow anatomical structure to which energy is being applied.

42. The method of claim 41, further comprising the step of controlling the application of energy to the hollow anatomical structure in accordance with the sensed temperature.