Methods and devices for ablation

• US 7,052,493 B2
• Filed: 09/24/2002
• Issued: 05/30/2006
• 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, Podmore, Jonathan L., Tansey, Casey, Champsaur, Gerard, Hoffman, Drew, Crowe, John E., Miller, Gary Henry
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US10/255,134
• Publication Number:
  US 20040054363A1
• Time in Patent Office: 1,344 Days
• Field of Search: 606/41, 606/42, 606/45, 606/46, 606 48- 50, 607/101, 607/102, 607/122
• 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 18/1402 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 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 2018/00023 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 2018/00232 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 2018/142 : 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 2018/1472 : for use with liquid electrolyte, e.g. virtual electrodes
• 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: A61M 2025/0293 : Catheter, guide wire or the like with means for holding, centering, anchoring or frictionally engaging the device within an artificial lumen, e.g. tube natural lumen, e.g. vessels A61M25/04
• CPC Class Codes: A61M 2025/1072 : having balloons with two or more compartments
• CPC Class Codes: A61M 25/0041 : pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04
• CPC Class Codes: A61M 25/0084 : being one or more injection needles
• CPC Class Codes: A61M 25/04 : in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/1002 : characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 25/1011 : Multiple balloon catheters
• 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 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

The invention is related to methods of sizing an area around the pulmonary veins along an epicardial surface. A sizing element is provided which has a plurality of indicators along its length which is used to size an area around the pulmonary veins. A sizing element is wrapped around the pulmonary veins along an epicardial location. The size of an ablating device is determined by using the indicators on the sizing element. An ablating device is then selected based on this measurement. The ablating device is then attached to the sizing element. The ablating device is then wrapped around the pulmonary veins while manipulating the sizing element.

Claims

1. A method of sizing an area around the pulmonary veins along an epicardial surface, the method comprising:

providing a sizing element having a plurality of indicators along a length to size an area around the pulmonary veins;

wrapping the sizing element around the pulmonary veins along an epicardial surface;

determining a size of an ablating device using the plurality of indicators on the sizing element after the wrapping step;

selecting an ablating device based on the determining step;

attaching the ablating device to the sizing element;

wrapping the ablating device around the pulmonary veins while manipulating the sizing element.

2. The method of claim 1, wherein:

the determining step is carried out by selecting a size of the ablating device based upon a number of ablating elements carried by the ablating device.

3. The method of claim 1, further comprising the step of:

locking a part of the ablating device to another part of the ablating device so that the ablating device encircles the pulmonary veins.

4. The method of claim 3, wherein:

the locking step is carried out with the ablating device having elongate elements, wherein tension is applied to the elongate elements to lock the two parts of the ablating device together.

5. The method of claim 1, wherein:

the wrapping step is carried out with the sizing element having a natural, unbiased shape, the natural unbiased shape forming a substantially closed loop.

6. The method of claim 1, wherein:

the wrapping step is carried out with the sizing element having a distal end which is offset with respect to the rest of the sizing element.

7. The method of claim 1, wherein:

the providing step is carried out with the ablating device having a plurality of focused ultrasound ablating elements, the ablating elements being angled toward adjacent ablating elements and being prevented from being directed parallel to one another.