Method for ablating body tissue

• US 8,511,317 B2
• Filed: 02/27/2012
• Issued: 08/20/2013
• Est. Priority Date: 05/12/2006
• Status: Active Grant

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: VytronUS, Inc. (Johnson & Johnson)
• Inventors: Thapliyal, Hira V., Gallup, David A., Arenson, James W.
• Primary Examiner(s): ROANE, AARON F
• Application Number:
  US13/405,712
• Publication Number:
  US 20120157984A1
• Time in Patent Office: 540 Days
• Field of Search: 128/898, 601/2, 601/3, 606/27, 606/28, 606 41- 49
• US Class Current: 128/898
• 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 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• 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 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/22024 with a part reflecting mechanical vibrations, e.g. for focusing
• CPC Class Codes: A61B 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61N 2007/0078 with multiple treatment transducers
• CPC Class Codes: A61N 7/02 Localised ultrasound hyperthermia hyperthermia in general A61F7/00
• CPC Class Codes: A61N 7/022 intracavitary

Abstract

A tissue ablation system for treating fibrillation in a patient comprises a steerable interventional catheter having an energy source that emits a beam of energy to ablate tissue thereby creating a conduction block for aberrant electrical pathways. The system also includes a handle disposed near a proximal end of the interventional catheter and has an actuation mechanism for steering the interventional catheter. A console allows the system to be controlled and provides power to the system, and a display pod is electrically coupled with the console. The display pod has a display panel to display system information to a user and allows the user to control the system. A catheter pod is releasably coupled with the handle electrically and mechanically, and also electrically coupled with the display pod.

Claims

1. A method for ablating a region of a target tissue, said method comprising:

positioning a treatment catheter adjacent the target tissue, the treatment catheter comprising an ultrasound emitter disposed near a distal end thereof;

ablating the target tissue with ultrasound energy delivered to the target tissue from the ultrasound emitter to form a lesion,

wherein the ultrasound energy from the ultrasound emitter comprises a collimated beam of ultrasound energy;

sweeping the collimated beam of ultrasound energy in a continuous fashion to form the lesion in a continuous pattern,

wherein the lesion is formed without direct contact between the ultrasound emitter and the target tissue,

wherein sweeping the collimated beam of ultrasound energy comprises at least one of the following;

linear movement, or rotation about a longitudinal axis of the treatment catheter or a distal end thereof while ablating the target tissue;

cooling the ultrasound emitter with a fluid wherein the fluid is in contact with the ultrasound emitter; and

providing a separation medium between the ultrasound emitter and blood in proximity to the target tissue to prevent the blood from coagulating on the ultrasound emitter,

wherein the separation medium comprises the fluid, wherein the ultrasound energy delivered to the target tissue is reflected by the target tissue back towards the ultrasound emitter; and

further comprising analyzing the ultrasound energy reflected by the target tissue, while sweeping the collimated beam of ultrasound energy, to sense information about the target tissue.

2. The method of claim 1, wherein the positioning comprises at least one of the following:

linear movement, bending, or rotation of the treatment catheter.

3. The method of claim 1, wherein the positioning comprises at least one of the following:

linear movement, bending, or rotation of a distal portion of the treatment catheter.

4. The method of claim 1, further comprising sensing depth of ablation in the target tissue and adjusting the ultrasound energy delivered to the target tissue based on the sensed depth.

5. The method of claim 4, wherein the ultrasound emitter comprises an ultrasound transducer and sensing the depth of ablation comprises sensing the depth of ablation with the ultrasound transducer.

6. The method of claim 1, further comprising controlling lesion depth by adjusting the ultrasound energy delivered to the target tissue.

7. The method of claim 1, further comprising controlling lesion depth by adjusting the rate the ultrasound energy is delivered to the target tissue.

8. The method of claim 1, further comprising controlling lesion depth by adjusting the frequency of the ultrasound energy delivered to the target tissue.

9. The method of claim 1, further comprising sensing thickness of the target tissue and controlling depth of the lesion by adjusting the ultrasound energy delivered to the target tissue based on the sensed thickness.

10. The method of claim 1, wherein the target tissue comprises cardiac tissue.

11. The method of claim 1, wherein the target tissue comprises vascular tissue.

12. The method of claim 1, wherein ablating the target tissue creates a conduction block of a signal pathway.

13. The method of claim 1, wherein ablating the target tissue creates a conduction block of an aberrant electrical pathway, to reduce atrial fibrillation.

14. The method of claim 1, further comprising rotating the ultrasound emitter about a rotation axis such that the lesion at least in part encircles an anatomical structure.

15. The method of claim 14, wherein the anatomical structure is an artery.

16. The method of claim 1, wherein the fluid is saline.

17. The method of claim 1, wherein ultrasound energy is directed from a distally facing surface of the ultrasound emitter.

18. The method of claim 1, wherein ultrasound energy is directed from a distally facing surface of the ultrasound emitter and is reflected by a reflecting element, in a relatively radial manner.

19. The method of claim 1, further comprising:

sensing a gap distance, the gap distance extending between the ultrasound emitter and the target tissue; and

based on the sensed gap distance, controlling re-positioning of the ultrasound emitter position by adjusting the gap distance between the ultrasound emitter and the target tissue while maintaining the gap distance therebetween within an ablation window length, wherein adjusting comprises proximal or distal axial movement of the ultrasound emitter relative to the target tissue.

20. The method of claim 14, wherein the rotation axis is a longitudinal axis of the treatment catheter or distal end thereof.

21. The method of claim 18, wherein sweeping the collimated beam of ultrasound energy further comprises rotating the reflecting element.

22. The method of claim 1, wherein while sweeping the collimated beam of ultrasound energy the treatment catheter or the distal end thereof is free to move relative to the target tissue.

23. The method of claim 1, further comprising controlling formation of the lesion by adjusting the ultrasound energy and/or a rate of sweeping the collimated beam ultrasound energy, based on the sensed information, thereby facilitating continuous ablation of the target tissue.