Methods and devices for ablation

• US 6,840,936 B2
• Filed: 02/15/2002
• Issued: 01/11/2005
• Est. Priority Date: 10/22/1996
• Status: Expired due to Fees

• Current Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Original Assignee: Epicor Medical, Inc. (Abbott Laboratories Incorporated)
• Inventors: Vaska, Matthias, Morse, Stephen A., Anderson, Scott C., Podmore, Jonathan L., Sliwa, John W. Jr., Champsaur, Gerard, Crowe, John E., Miller, Gary Henry
• Primary Examiner(s): Peffley, Michael
• Application Number:
  US10/077,470
• Publication Number:
  US 20020173784A1
• Time in Patent Office: 1,061 Days
• Field of Search: 606 27- 32, 606/34, 606/41, 606/42, 607/101, 607/102, 607/115, 607/116, 607/122, 600/439, 600/459, 600/461, 600/462, 600/466, 601/2, 601/3
• US Class Current: 606/41
• CPC Class Codes: A61B 17/22012 in direct contact with, or very close to, the obstruction or concrement for removing obstructions in blood vessels by laser A61B18/245
• CPC Class Codes: A61B 17/2202 the ultrasound transducer being inside patient's body at the distal end of the catheter
• CPC Class Codes: A61B 17/2251 characterised by coupling elements between the apparatus, e.g. shock wave apparatus or locating means, and the patient, e.g. details of bags, pressure control of bag on patient
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/1402 Probes for open surgery
• CPC Class Codes: A61B 18/148 having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/1815 using microwaves
• 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 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/2253 using a coupling gel or liquid
• CPC Class Codes: A61B 2017/3419 : Sealing means between cannula and body
• CPC Class Codes: A61B 2018/00005 : Cooling or heating of the probe or tissue immediately surrounding the probe
• CPC Class Codes: A61B 2018/00023 : closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/0016 : Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00214 : Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00232 : having an irregular shape
• CPC Class Codes: A61B 2018/00261 : arranged in a line
• CPC Class Codes: A61B 2018/00285 : Balloons
• CPC Class Codes: A61B 2018/00291 : using suction
• CPC Class Codes: A61B 2018/00351 : Heart
• CPC Class Codes: A61B 2018/00363 : Epicardium
• CPC Class Codes: A61B 2018/00375 : Ostium, e.g. ostium of pulmonary vein or artery
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/00577 : Ablation
• CPC Class Codes: A61B 2018/00654 : with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00797 : measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00839 : Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00898 : Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/00982 : combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1213 : creating an arc
• CPC Class Codes: A61B 2018/142 : at least partly surrounding the target, e.g. concave, curved or in the form of a cave
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2018/147 : Electrodes transferring energy by capacitive coupling, i.e. with a dielectricum between electrode and target tissue
• CPC Class Codes: A61B 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2018/1861 : with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61B 2018/2283 : with pivotable mirrors
• CPC Class Codes: A61B 2090/3614 : using optical fibre
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2090/395 : with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 2218/007 : Aspiration
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/287 : Holders for multiple electrodes, e.g. electrode catheters for electrophysiological study [EPS]
• CPC Class Codes: A61N 1/056 : Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 1/3629 : in combination with non-electric therapy
• CPC Class Codes: A61N 2007/0078 : with multiple treatment transducers
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

An ablating device has a cover which holds an interface material such as a gel. The cover contains the interface material during initial placement of the device. The ablating device may also have a removable tip or a membrane filled with fluid. In still another aspect, the ablating device may be submerged in liquid during operation.

Claims

1. A method of ablating tissue, comprising the steps of:

providing an ablation device having a plurality of ultrasound ablating elements and a control system;

positioning the ablating device against a target tissue at an epicardial location;

emitting energy from an emitter which is at least one of the plurality of ultrasound ablating elements so that the energy passes through the target tissue, the plurality of ultrasound ablating elements being positioned to create a continuous elongate lesion;

measuring the energy which passes through the target tissue with a receiver which is at least one of the plurality of ultrasound ablating elements; and

ablating the target tissue with the plurality of ultrasound ablating elements;

wherein the measuring step is used to monitor the progress of the ablating step by detecting a change in at least one of an energy magnitude and frequency.

2. The method of claim 1, wherein:

the ablating step is carried out to electrically isolate a portion of the heart.

3. The method of claim 1, wherein the emitting and measuring steps is carried out with the same ablating element.

4. The method of claim 1, wherein the emitting step is carried out intermittently when the ablating step is temporarily stopped.

5. The method of claim 1, wherein the measuring step is carried out intermittently when the ablating step is temporarily stopped.

6. The method of claim 1, wherein:

the providing step is carried out with an intravascular device;

introducing the intravascular device into the patient'"'"'s vascular system;

wherein at least one of the emitting and measuring steps are carried out with the intravascular device.

7. The method of claim 1, wherein:

the emitting step is carried out by emitting energy from at least one of the ablating elements; and

the measuring step is carried out by receiving energy at a plurality of receivers.

8. The method of claim 1, wherein:

the providing step is carried out with the ablating device forming a closed loop; and

the positioning step is carried out to form the closed loop around a portion of the heart.

9. The method of claim 1, wherein:

the emitting and ablating steps are carried out at the same time with the energy being used to ablate the target tissue.

10. The method of claim 1, wherein:

the emitting step is carried out with the ultrasound energy being different than the ablating step.

11. The method of claim 1, wherein:

the providing step is carried out with the ablating element producing focused ultrasound.