Systems and methods for electrosurgical treatment of vascular disorders

• US 6,228,082 B1
• Filed: 12/03/1998
• Issued: 05/08/2001
• Est. Priority Date: 11/22/1995
• Status: Expired due to Term

• Current Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Original Assignee: ArthroCare Corporation (Smith & Nephew PLC)
• Inventors: Baker, Michael A., Underwood, Ronald A., Brunell, Stephen M.
• Primary Examiner(s): COHEN, LEE S
• Application Number:
  US09/205,640
• Time in Patent Office: 887 Days
• Field of Search: 606/41, 606/49, 606/50
• US Class Current: 606/49
• CPC Class Codes: A61B 18/042 using additional gas becoming plasma
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/00148 with metal
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/0047 Upper parts of the skin, e.g. skin peeling or treatment of wrinkles
• CPC Class Codes: A61B 2018/00476 Hair follicles
• CPC Class Codes: A61B 2018/00583 Coblation, i.e. ablation using a cold plasma
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00625 Vaporization
• CPC Class Codes: A61B 2018/00797 measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00815 measured by a thermistor
• CPC Class Codes: A61B 2018/00821 measured by a thermocouple
• CPC Class Codes: A61B 2018/1213 creating an arc
• CPC Class Codes: A61B 2018/1467 using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/162 located on the probe body
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 2218/007 Aspiration

Abstract

Systems and methods are provided for treating a discolored blood vessel in tissue under the surface of the skin. In this method, one or more active electrode(s) are positioned in close proximity to a target region of the blood vessel, and a sufficient high frequency voltage is applied to the electrode terminal(s) to cause thermal damage to a target region within the blood vessel. The thermal injury causes the vessel to shrink or to thrombose and collapse so that blood flow through the vessel is restricted or completely interrupted. Preferably, the vessel is injured with minimal thermal energy being applied to the surrounding tissue, which prevents the tissue discoloration or scarring associated with prior art thermal processes. The electrode terminal(s) may be positioned on the external surface of the skin, or they may be introduced through a percutaneous penetration in the outer skin surface to the blood vessel. In the latter embodiment, the percutaneous penetration may be formed by advancing one or more needle electrodes through the outer surface of the skin to the target region of the vessel.

Claims

1. A method of treating a discolored blood vessel located in tissue under the surface of the skin comprising:

positioning an active electrode in close proximity to a target region of the blood vessel; and

applying high frequency electrical energy to the active electrode, the electrical energy being sufficient to effect coagulation of blood within at least a portion of the target region of the vessel, wherein the positioning step comprises applying sufficient high frequency voltage to the outer surface of the skin to remove a portion of the skin and form a hole to the blood vessel, inserting the active electrode through the hole to a position adjacent the target region of the blood vessel, and applying sufficient high frequency voltage to the active electrode to coagulate blood within the vessel.

2. The method of claim 1 wherein the active electrode is introduced through a percutaneous penetration in the outer surface of the skin, and delivered to a location adjacent to or near the target region of the blood vessel.

3. The method of claim 1 further comprising positioning a return electrode on the outer surface of the skin.

4. The method of claim 1 further comprising inserting a return electrode through the outer surface of the skin to a location near the target region and a distal portion of the active electrode.

5. The method of claim 4 wherein the return electrode comprises a hollow shaft, the method further comprising introducing a fluid through the hollow shaft into the blood vessel.

6. The method of claim 4 further comprising spacing a distal end of the return electrode from an exposed portion of the active electrode by a distance of about 0.05 to about 5.0 mm.

7. The method of claim 5 wherein the fluid comprises an electrically conductive fluid.

8. The method of claim 5 wherein the fluid comprises an anesthetic.

9. The method of claim 4 further comprising varying a distance between a distal portion of the return electrode and an exposed region of the active electrode to control a size of tissue coagulation or necrosis around the blood vessel.

10. The method of claim 1 wherein the blood vessel comprises a vascular lesion.

11. The method of claim 1 further comprising applying sufficient electrical energy to coagulate the target region of the blood vessel without causing permanent thermal injury to the tissue between the skin surface and said region of the blood vessel.

12. An apparatus for treating a discolored blood vessel located in tissue under the surface of the skin comprising:

an instrument having proximal and distal end portions and an active electrode on the distal end portion configured for insertion into an interior of a blood vessel;

a return electrode comprising a hollow shaft having an inner lumen for receiving the active electrode, and a distal end configured for insertion through the outer surface of the skin to a location underneath the skin and outside of the interior the blood vessel; and

a high frequency power supply coupled to the active and return electrodes for applying a high frequency voltage difference therebetween, the high frequency voltage difference being sufficient to coagulate a target region of the blood vessel.

13. The apparatus of claim 12 wherein the active electrode comprises a conductive needle having an insulated proximal portion and an exposed distal portion, the needle having a diameter less than about 0.05 to 2.0 mm.

14. The apparatus of claim 13 wherein the exposed distal portion has a length of about 0.5 to about 5.0 mm.

15. The apparatus of claim 12 wherein the hollow shaft has a fluid lumen for delivering an electrically conductive fluid to the target site.

16. The apparatus of claim 12 wherein the active electrode is axially movable relative to the hollow shaft.

17. The apparatus of claim 12 further comprising depth markings on either the instrument or the return electrode for determining a depth of penetration beneath the outer surface of the skin.