Systems for treating a hollow anatomical structure

• US 7,837,677 B2
• Filed: 01/12/2010
• Issued: 11/23/2010
• Est. Priority Date: 07/21/2005
• Status: Active Grant

• Current Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Original Assignee: Tyco Healthcare Group LP (Medtronic Plc)
• Inventors: Thompson, Russell Blake, Esch, Brady David, Dhaka, Vijay Kumar, Sander, Fiona Maria
• Primary Examiner(s): Sweet; Thomas J
• Assistant Examiner(s): HUPCZEY, JR, RONALD JAMES
• Application Number:
  US12/686,323
• Publication Number:
  US 20100106150A1
• Time in Patent Office: 315 Days
• Field of Search: 606 27- 52
• US Class Current: 606/32
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• 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 18/20 using laser
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00026 Conductivity or impedance, e.g. of tissue
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/00123 and automatic shutdown
• CPC Class Codes: A61B 2017/00132 Setting operation time of a device A61B2017/00123 takes precedence
• CPC Class Codes: A61B 2018/00636 Sensing and controlling the application of energy
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00779 Power or energy
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00827 Current
• CPC Class Codes: A61B 2018/046 in liquid form
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/3925 ultrasonic
• CPC Class Codes: A61B 2090/3937 Visible markers
• CPC Class Codes: A61B 2090/3945 Active visible markers, e.g. light emitting diodes
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers

Abstract

A working end of a catheter includes at least one therapeutic element, such as a resistive heating element, usable to deliver energy for ligating, or reducing the diameter of, a hollow anatomical structure. In certain examples, the catheter includes a lumen to accommodate a guide wire or to allow fluid delivery. In certain embodiments, a balloon is inflated to place resistive element(s) into apposition with a hollow anatomical structure and to occlude the structure. Indexing devices and methods are also disclosed for successively treating portions of the hollow anatomical structure. In certain examples, marks along the catheter shaft provide visual verification to the physician of the relative position of the therapeutic element of the catheter. Embodiments of indexing devices may include pairs of rings and/or hinged arms that move a catheter a desired indexed position between successive treatments.

Claims

1. A catheter for use in treating a length of a blood vessel together with an introducer sheath having a reference location configured to be located outside the patient, the catheter comprising:

an elongated shaft having a distal section and a proximal section, the shaft being sized for insertion into a blood vessel;

a resistive heating coil;

wherein the resistive heating coil has a distal and a proximal end and is configured to apply energy along a length of the blood vessel in consecutive treated segments of the blood vessel to thereby occlude the length of the blood vessel;

the heating coil located adjacent the distal section of the shaft, and having a coil length from about 2 centimeters to about 10 centimeters;

a plurality of index markings marked on the shaft of the catheter;

wherein the index markings are configured to be sequentially indexed in a distal to proximal direction adjacent the introducer reference location via movement of the elongate shaft in the distal to proximal direction to sequentially position the resistive heating coil axially along the length of the blood vessel;

at least one final marking that indicates a final shaft distance from said final marking to the proximal end of the coil, the final shaft distance comprising approximately the length of the introducer sheath and a safety zone distance on the shaft;

wherein consecutive index markings are spaced apart by an index marking length, the index marking length being from about 0.1 centimeter to about 1.5 centimeters less than the coil length to ensure overlap of consecutive treated segments of the blood vessel as the resistive coil is moved via movement of the elongated shaft in the distal to proximal direction along the blood vessel by successive index marking lengths;

wherein between consecutive index markings, the shaft lacks any markings similar to the index markings; and

a warning section along the shaft comprising a distinct marking different from the plurality of index markings and different from the at least one final marking, the at least one final marking located on the shaft between the heating coil and the warning section.

2. The catheter of claim 1, wherein the coil length is at least ten times the width of the resistive coil.

3. The catheter of claim 1, wherein the at least one final marking comprises at least two final markings and each final marking corresponds to a different length of introducer sheath.

4. The apparatus of claim 1, wherein the warning section comprises a warning section length equal to the index marking length.

5. The apparatus of claim 1, wherein the warning section is located on the shaft proximal of the at least one final marking.

6. The apparatus of claim 1, wherein the warning section is between the plurality of index markings and the at least one final marking.

7. Apparatus for use in treating a blood vessel together with a reference location, the apparatus comprising:

an elongate member having a distal section and a proximal section, the elongate member being sized for insertion into a blood vessel;

a resistive heating coil;

wherein the resistive heating coil has a distal section and a proximal section and is configured to apply energy along a length of a blood vessel in consecutive treated segments of the blood vessel;

the heating coil located adjacent the distal section of the elongate member, the heating coil having a first length;

a plurality of index markings marked on the elongate member;

wherein the index markings are configured to be movably indexed in a distal to proximal direction adjacent a reference location via movement of the elongate member in the distal to proximal direction to sequentially position the resistive heating coil axially along the length of the blood vessel;

at least one final marking that indicates a final distance from said final marking to the proximal section of the coil;

wherein consecutive index markings are spaced apart by a second length, the second length being less than the first length to ensure overlap of consecutive treated segments of the blood vessel when the resistive coil is moved in the distal to proximal direction along the blood vessel;

wherein the elongate member lacks any markings similar to the index markings located between consecutive index markings; and

a warning section along the elongate member and wherein the at least one final marking is located on the elongate member between the heating coil and the warning section, the warning section comprising a distinct marking different from the plurality of index markings and the at least one final marking.

8. The apparatus of claim 7, wherein the first length is at least ten times the width of the resistive coil.

9. The apparatus of claim 7, wherein the at least one final marking comprises at least two final markings and each final marking corresponds to a different length of introducer sheath.

10. The apparatus of claim 7, wherein the resistive heating coil is configured to apply energy along a length of a blood vessel in consecutive treated segments of the blood vessel to thereby occlude the length of the blood vessel.

11. The apparatus of claim 7, wherein the heating coil first length is from about 2 centimeters to about 10 centimeters.

12. The apparatus of claim 7, wherein the final distance comprises approximately the length of an introducer sheath and a safety zone.

13. The apparatus of claim 7, wherein the second length is from about 1% to about 15% less than the first length.

14. Apparatus for use in treating a hollow anatomical structure (HAS), the apparatus comprising:

an elongate member having a distal section and a proximal section, the elongate member being sized for insertion into a HAS;

a heating element;

wherein the heating element has a distal section and a proximal section and is configured to apply energy along a length of a HAS in consecutive treatment segments of the HAS;

the heating element located adjacent the distal section of the elongate member, the heating element having a first length;

a plurality of index markings marked on the elongate member;

wherein the index markings are configured to be movably indexed in a distal to proximal direction via movement of the elongate member in the distal to proximal direction to sequentially position the heating element axially along the length of the HAS;

at least one final marking marked on the elongate member that indicates a final distance from said final marking to the proximal section of the heating element; and

a warning section marked on the elongate member, the warning section comprising a distinct marking different from the plurality of index markings and the at least one final marking;

wherein consecutive index markings are spaced apart by a second length, the second length being less than the first length; and

wherein the index markings are distinct from any other markings marked on the elongate member.

15. The apparatus of claim 14, wherein the first length is at least ten times the width of the resistive coil.

16. The apparatus of claim 14, wherein the at least one final marking comprises at least two final markings and each final marking corresponds to a different length of introducer sheath.

17. The apparatus of claim 14, wherein the final distance includes a safety factor distance.

18. The apparatus of claim 14, wherein the warning section comprises a warning section length equal to the index marking length.

19. The apparatus of claim 14, wherein the warning section is located on the elongate member proximal of the at least one final marking.

20. The apparatus of claim 14, wherein the warning section is between the plurality of index markings and the at least one final marking.