Expandable vein ligator catheter having multiple electrode leads, and method

• US 8,679,110 B2
• Filed: 07/28/2008
• Issued: 03/25/2014
• Est. Priority Date: 09/11/1997
• Status: Expired due to Fees

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Zikorus, Arthur W., Parker, Mark P., Jones, Christopher S., Petty, Douglas M., Farley, Brian E., Tartaglia, Joseph M.
• Primary Examiner(s): GIBSON, ROY DEAN
• Application Number:
  US12/181,277
• Publication Number:
  US 20090137998A1
• Time in Patent Office: 2,066 Days
• Field of Search: 128/898, 606 27- 32, 606/34, 606/41, 606/42, 606 45- 50, 607/98, 607101-102
• US Class Current: 606/41
• 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 2017/00084 Temperature
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/124 switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1253 monopolar
• CPC Class Codes: A61B 2018/126 bipolar
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2218/002 Irrigation

Abstract

A catheter includes a plurality of primary leads to deliver energy for ligating a hollow anatomical structure. Each of the primary leads includes an electrode located at the working end of the catheter. Separation is maintained between the primary leads such that each primary lead can individually receive power of selected polarity. The primary leads are constructed to expand outwardly to place the electrodes into apposition with an anatomical structure. High frequency energy can be applied from the leads to create a heating effect in the surrounding tissue of the anatomical structure. The diameter of the hollow anatomical structure is reduced by the heating effect, and the electrodes of the primary leads are moved closer to one another. Where the hollow anatomical structure is a vein, energy is applied until the diameter of the vein is reduced to the point where the vein is occluded. In one embodiment, a secondary lead is surrounded by the primary leads, and extends beyond the primary leads. The secondary lead includes an electrode at the working end of the catheter. The secondary lead can have a polarity opposite to the polarity of the primary leads in a bipolar configuration. The polarity of the leads can be switched and the catheter can be moved during treatment to ligate an extended length of the vein. The catheter can include a lumen to accommodate a guide wire or to allow fluid delivery.

Claims

1. A method of treating a vein, the method comprising:

introducing an elongate energy delivery device into a vein having an inner wall;

pre-shaping the vein by moving the inner wall of the vein toward a distal portion of the energy delivery device, independently of the energy delivery device;

applying energy from the distal portion of the energy delivery device to the vein to create a thermal effect in the vein so as to effectively occlude the vein;

moving the energy delivery device along the vein during the application of energy to form an effective occlusion along the area of the vein where the energy delivery device is moved during the application of energy.

2. The method of claim 1, wherein pre-shaping the vein comprises reducing the diameter of the vein, and applying energy comprises causing the vein to durably assume a diameter at least as small as the reduced diameter achieved via the pre-shaping.

3. The method of claim 1 or 2, wherein the elongate energy delivery device comprises a fiber optic and applying energy comprises applying light energy with the fiber optic.

4. The method of claim 1 or 2, wherein the elongate energy delivery device comprises a catheter and applying energy comprises delivering electrical energy to the catheter.

5. The method of claim 4, wherein the catheter has electrodes and applying energy comprises applying electrical energy from the electrodes.

6. The method of claim 1, further comprising forming a lengthy occlusion along the area of the vein where the elongate energy delivery device is moved during the application of energy.

7. The method of claim 1, further comprising delivering fluid to the vein where the distal portion of the elongate energy delivery device is located.

8. The method of claim 1, wherein pre-shaping the vein comprises compressing the anatomy surrounding the vein at the location of the distal portion of the elongate energy delivery device.

9. The method of claim 1, wherein pre-shaping the vein comprises using an elastic compressive wrap around the anatomy surrounding the vein at the location of the distal portion of the elongate energy delivery device.

10. The method of claim 1, wherein applying energy is performed while the vein is pre-shaped.

11. A method of treating a vein, the method comprising:

inserting an elongate energy delivery device into a lumen of the vein and advancing the elongate energy delivery device along the lumen to a treatment site;

narrowing the vein at the treatment site while the energy delivery device is present, independently of the energy delivery device;

applying energy from the energy delivery device to the vein to create a thermal effect in the vein so as to occlude the vein;

retracting the energy delivery device along the vein during the application of energy to form an occlusion along the area of the vein where the energy delivery device is retracted during the application of energy.

12. The method of claim 11, wherein narrowing the vein comprises reducing the diameter of the vein, and applying energy comprises causing the vein to durably assume a diameter at least as small as the reduced diameter achieved via the narrowing.

13. The method of claim 11 or 12, wherein the elongate energy delivery device comprises a fiber optic and applying energy comprises applying light energy with the fiber optic.

14. The method of claim 11 or 12, wherein the elongate energy delivery device comprises a catheter and applying energy comprises delivering electrical energy to the catheter.

15. The method of claim 14, wherein the catheter has electrodes and applying energy comprises applying electrical energy from the electrodes.

16. The method of claim 11, further comprising forming a lengthy occlusion along the area of the vein where the elongate energy delivery device is retracted during the application of energy.

17. The method of claim 11, further comprising delivering fluid to the vein at the treatment site.

18. The method of claim 11, wherein narrowing the vein comprises compressing the anatomy surrounding the vein at the treatment site.

19. The method of claim 11, wherein narrowing the vein comprises using an elastic compressive wrap around the anatomy surrounding the vein at the treatment site.

20. The method of claim 11, wherein applying energy is performed while the vein is narrowed.

21. A method of treating a vein, the method comprising:

compressing the vein by forcing the inner wall of the vein inwardly, independently of an elongate energy delivery device;

introducing the elongate energy delivery device into the vein;

applying energy from a distal portion of the energy delivery device to the compressed portion of the vein to create a thermal effect in the vein so as to reduce the diameter of the vein and lead to effective occlusion of the vein; and

moving the energy delivery device along the vein during the application of energy to form an effective occlusion along the area of the vein where the energy delivery device is moved during the application of energy.

22. The method of claim 21, wherein compressing the vein comprises reducing the diameter of the vein, and applying energy comprises causing the vein to durably assume a diameter at least as small as the reduced diameter achieved via the compression.

23. The method of claim 21 or 22, wherein the elongate energy delivery device comprises a fiber optic and applying energy comprises applying light energy with the fiber optic.

24. The method of claim 21 or 22, wherein the elongate energy delivery device is electrically driven and applying energy comprises delivering electrical energy to the device.

25. The method of claim 24, wherein the device has electrodes and applying energy comprises applying electrical energy from the electrodes.

26. The method of claim 21, further comprising forming a lengthy occlusion along the area of the vein where the elongate energy delivery device is moved during the application of energy.

27. The method of claim 21, further comprising delivering fluid to the vein at a treatment site.

28. The method of claim 27, further comprising exsanguinating the vein at the treatment site via the delivered fluid.

29. The method of claim 27, wherein applying energy comprises applying light energy.

30. The method of claim 29, wherein the elongate energy delivery device comprises a fiber optic and applying light energy comprises applying light energy with the fiber optic.

31. The method of claim 30, wherein introducing the elongate energy delivery device is performed before compressing the vein.

32. The method of claim 21, wherein compressing the vein comprises compressing the anatomy surrounding the vein at the location of the distal portion of the elongate energy delivery device.

33. The method of claim 21, wherein compressing the vein comprises using an elastic compressive wrap around the anatomy surrounding the vein at the location of the distal portion of the elongate energy delivery device.

34. The method of claim 21, wherein applying energy is performed while the vein is compressed.