Systems for treating a hollow anatomical structure

• US 7,837,678 B2
• Filed: 02/24/2010
• 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:
  US12/712,157
• Publication Number:
  US 20100145327A1
• Time in Patent Office: 272 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 conjunction with a reference location to treat a blood vessel, the catheter comprising:

an elongate member having a distal end and a proximal end, the elongate member configured for insertion, with the distal end leading, into a blood vessel;

an energy treatment element toward the distal end of the elongate member, the energy treatment element having a distal and a proximal end and a treatment length;

a plurality of index markings marked on the elongate member and configured to be movably indexed in a distal to proximal direction adjacent the reference location to position the energy treatment element at sequential locations along the length of the blood vessel via movement of the elongate shaft in the distal to proximal direction;

at least one final marking that indicates a final distance from said final marking to the proximal end of the energy treatment element, the final distance comprising approximately the length of an introducer sheath and a safety zone; and

a warning section along the elongate member and wherein the at least one final marking is located on the elongate member between the energy treatment element 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;

wherein consecutive index markings are spaced apart by a movement length that is related to, but smaller than the treatment length, such that the movement length is about 1% to about 15% less than the treatment length and is thus configured to provide overlap of consecutive treated segments of the blood vessel when the energy treatment element is moved along the blood vessel;

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

2. 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.

3. The catheter of claim 1, wherein the treatment length is between approximately 2 to approximately 10 centimeters.

4. Apparatus for use in treating a blood vessel, the apparatus comprising:

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

a treating element having a distal and a proximal end and a first length and located adjacent the distal section of the elongate member;

a plurality of index markings marked on the elongate member and configured to be movably indexed in a distal to proximal direction to sequentially position the treating element along the length of the blood vessel via movement of the elongate shaft in the distal to proximal direction;

at least one final marking that indicates a final distance from said final marking to the proximal end of the energy treatment element; and

a warning section along 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 from approximately 0.1 centimeter to approximately 1.5 centimeters less than the first length to ensure overlap of consecutive treated segments of the blood vessel when the treating element is moved along the blood vessel.

5. The apparatus of claim 4, wherein the final distance includes a safety factor distance.

6. The apparatus of claim 5, 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.

7. The apparatus of claim 4, wherein the at least one final marking is located on the elongate member between the treating element and the warning track.

8. The apparatus of claim 4, wherein the first length is between about 2 to 10 centimeters.

9. An apparatus for treating a blood vessel, the apparatus comprising:

an elongate member having a distal section and a proximal section;

a treating element having a treatment length located on the distal section of the elongate member; and

a plurality of index markings marked on the elongate member;

wherein consecutive index markings are spaced apart by an index length, the index length being less than the treatment length to ensure overlap of consecutive treated segments of the blood vessel;

at least one final marking marked on the elongate member to indicate a final distance from the proximal end of the treating element; and

a warning section marked on the elongate member;

wherein the index markings, the at least one final marking, and the warning section are each distinct from one another and from other markings on the elongate member.

10. The apparatus of claim 9, wherein the final distance includes a safety factor distance.

11. The apparatus of claim 9, 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.

12. The apparatus of claim 9, wherein the at least one final marking is located on the elongate member between the treating element and the warning track.

13. The apparatus of claim 9, wherein the treatment length is between about 2 to 10 centimeters.

14. The apparatus of claim 9, wherein the warning section is located between the treating element and the index markings.

15. The apparatus of claim 9, further configured for withdrawal from a human or animal body having the blood vessel, and wherein;

the plurality of index markings are sequentially marked along the elongate member toward the proximal section of the elongate member such that the index markings are configured to become sequentially visible before any other markings as the elongate member is withdrawn in the proximal direction;

the at least one final marking is marked on the elongate member toward the distal section of the elongate member; and

the warning section is marked on the elongate member between the index markings and the at least one final marking such that, as the elongate member is withdrawn in the proximal direction, the warning section is configured to become visible after the index markings and before the at least one final marking.

16. The apparatus of claim 9, wherein the treating element has a proximal and a distal end, and wherein at least one final marking is located a final marking distance from the proximal end of the treating element, the final marking distance corresponding to at least the length of an introducer sheath.

17. The apparatus of claim 16, wherein the final marking distance corresponds to not only the length of an introducer sheath but also comprises a safety factor distance.

18. The apparatus of claim 16, wherein the at least one final marking comprises a first final marking indicating correspondence to a first introducer sheath and a second final marking indicating correspondence to a second introducer sheath that is shorter than the first introducer sheath.