Apparatus and method for ablating tissue

• US 8,211,096 B2
• Filed: 08/09/2007
• Issued: 07/03/2012
• Est. Priority Date: 09/21/1998
• Status: Expired due to Term

• Current Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Original Assignee: St. Jude Medical (Abbott Laboratories Incorporated)
• Inventors: Pless, Benjamin, Anderson, Scott C., Podmore, Jonathan L., Vaska, Matthias, Crowe, John E., Richman, Roxanne L., Ciciarelli, Timothy, Gallup, David A., Ulstad, Jack E. Jr.
• Primary Examiner(s): PEFFLEY, MICHAEL F
• Application Number:
  US11/836,500
• Publication Number:
  US 20070293854A1
• Time in Patent Office: 1,790 Days
• Field of Search: 606/27, 606/28, 606/41, 600/459, 600/461, 600/462, 600/466, 601/2
• US Class Current: 606/27
• 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 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 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• 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 2017/3419 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 2018/00392 : 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: A61N 1/06 : for high-frequency therapy
• CPC Class Codes: A61N 1/3629 : in combination with non-electric therapy
• CPC Class Codes: A61N 2007/0065 : Concave transducers
• CPC Class Codes: A61N 2007/0078 : with multiple treatment transducers
• CPC Class Codes: A61N 2007/027 : with multiple foci created simultaneously
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

A control system alters one or more characteristics of an ablating element to ablate tissue. In one aspect, the control system delivers energy nearer to the surface of the tissue by changing the frequency or power. In another aspect, the ablating element delivers focused ultrasound which is focused in at least one dimension. The ablating device may also have a number of ablating elements with different characteristics such as focal length. The invention provides an ablation apparatus and methods for ablating tissue wherein the ablation apparatus may have ablating elements that are moveable relative to the tissue to be ablated without the need to relocate the apparatus as a whole.

Claims

1. A tissue ablation device, comprising:

a plurality of ablating elements adapted to emit ultrasonic energy focused in at least one dimension towards tissue to be ablated, at least one of the plurality of ablating elements being moveable from a first position relative to the tissue to be ablated to at least a second position relative to the tissue to be ablated independent of others of the plurality of ablating elements; and

at least one adjustment structure coupled to the at least one movable ablating element, wherein the at least one adjustment structure is adapted to move the at least one movable ablating element from its first position to its second position, whereby a focus of the ultrasonic energy emitted by the at least one movable ablating element may be re-positioned at a desired location relative to the tissue to be ablated.

2. The tissue ablation device according to claim 1, wherein the at least one adjustment structure comprises an inflatable member having a deflated state and an inflated state, wherein, when the inflatable member is in the deflated state, the at least one movable ablating element is in the first position, and when the inflatable member is in an inflated state, the at least one movable ablating element is in the second position.

3. A tissue ablation device, comprising:

a plurality of ablating elements adapted to emit ultrasonic energy focused in at least one dimension towards tissue to be ablated, wherein at least one of the plurality of ablating elements is movable relative to the tissue to be ablated; and

at least one adjustment structure movable between a first configuration and a second configuration,

wherein the at least one adjustment structure is adapted to independently move at least one of the plurality of ablating elements between a first position relative to the tissue to be ablated and a second position relative to the tissue to be ablated, whereby a focus of the ultrasonic energy emitted by the at least one of the plurality of ablating elements may be moved to a desired location relative to the tissue to be ablated.

4. The tissue ablation device according to claim 3, wherein the at least one adjustment structure comprises an inflatable member, wherein, when the inflatable member is in a deflated state, the at least one of the plurality of ablating elements movable by the at least one adjustment structure is in the first position relative to the tissue to be ablated, and when the inflatable member is in an inflated state, the at least one of the plurality of ablating elements movable by the at least one adjustment structure is in the second position relative to the tissue to be ablated.

5. The tissue ablation device according to claim 4, wherein the inflatable member comprises at least one conformable membrane over the at least one of the plurality of ablating elements movable by the at least one adjustment structure.

6. The tissue ablation device according to claim 3, wherein the at least one adjustment structure comprises a movable foot coupled to the at least one of the plurality of ablating elements movable by the at least one adjustment structure, wherein, when the movable foot is in a retracted state, the at least one of the plurality of ablating elements movable by the at least one adjustment structure is in the first position relative to the tissue to be ablated, and when the movable foot is in an advanced state, the at least one of the plurality of ablating elements movable by the at least one adjustment structure is in the second position relative to the tissue to be ablated.

7. The tissue ablation device according to claim 3, wherein the at least one adjustment structure comprises a mechanical pivot coupled to the at least one of the plurality of ablating elements movable by the at least one adjustment structure, wherein, when the mechanical pivot is in a first orientation, the at least one of the plurality of ablating elements movable by the at least one adjustment structure is in the first position relative to the tissue to be ablated, and when the mechanical pivot is in a second orientation, the at least one of the plurality of ablating elements movable by the at least one adjustment structure is in the second position relative to the tissue to be ablated.

8. A tissue ablation device positionable on an epicardial surface of a heart, the device comprising:

a device body;

a plurality of ablating elements disposed along the device body and adapted to emit ultrasonic energy focused in at least one dimension; and

at least one adjustment structure coupled to at least one of the plurality of ablating elements, and configured to move a focus of the ultrasonic energy emitted by the at least one of the plurality of ablating elements relative to the heart without repositioning the device body on the epicardial surface of the heart,

wherein the at least one adjustment structure is configured to move the at least one of the plurality of the ablating elements relative to the heart independent of others of the plurality of ablating elements.

9. The tissue ablation device according to claim 8, wherein the at least one of the plurality of ablating elements is adapted to emit ultrasonic energy focused along a focal axis, and wherein the at least one adjustment structure is configured to reposition the focal axis relative to the at least one of the plurality of ablating elements.

10. The tissue ablation device according to claim 8, wherein the at least one adjustment structure comprises at least one inflatable member positioned between the at least one of the plurality of ablating elements and the epicardial surface.

11. The tissue ablation device according to claim 8, wherein the at least one adjustment structure comprises at least one movable foot.

12. The tissue ablation device according to claim 8, wherein the at least one adjustment structure comprises at least one mechanical pivot.