Systems for treating a hollow anatomical structure

• US 8,852,178 B2
• Filed: 09/12/2011
• Issued: 10/07/2014
• Est. Priority Date: 07/21/2005
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Thompson, Russell Blake, Esch, Brady David, Dhaka, Vijay Kumar, Sander, Fiona Maria
• Primary Examiner(s): HUPCZEY, JR, RONALD JAMES
• Application Number:
  US13/230,017
• Publication Number:
  US 20120071873A1
• Time in Patent Office: 1,121 Days
• Field of Search: 606/32, 606/34, 606 37- 42, 606 45- 50, 604/117, 604/164.01, 604/158, 604/264, 607/92, 607/96, 607/113, 607/115
• 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, wherein the energy treatment element comprises an expandable resistive element on a balloon, the balloon being configured to expand and collapse the energy treatment element;

a plurality of index markings marked on the elongate member and configured to be movably indexed in a distal to proximal direction 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; and

at least one final marking on the elongate member that indicates a distance from the final marking to the proximal end of the energy treatment element;

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; and

wherein relative axial positions of the energy treatment element and the plurality of index markings along a length of the elongate member are fixed.

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

3. The catheter of claim 1, 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 as the elongate member is withdrawn in the distal to proximal direction.

4. The catheter of claim 1, wherein the energy treatment element is a resistive coil.

5. The catheter of claim 1, wherein the expandable resistive element is a serpentine component.

6. The catheter of claim 1, further comprising an indicator that shows a state of inflation of the balloon.

7. Apparatus for 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, a first length, and secured to the distal section of the elongate member, wherein the treating element comprises an expandable and collapsible metal braid wire;

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; and

at least one final marking having an appearance different from each of the index markings, the final marking being located distally of the index markings on the elongate member;

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.

8. The apparatus of claim 7, wherein the first length is between about 2 to 10 centimeters.

9. The apparatus of claim 7, 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 as the elongate member is withdrawn in the distal to proximal direction.

10. The apparatus of claim 7, wherein the treating element is a resistive coil.

11. The apparatus of claim 7, further comprising an access sheath configured to receive the elongate member as it is inserted into the blood vessel.

12. The apparatus of claim 7, wherein the treatment length is between about 2 to 10 centimeters.

13. The apparatus of claim 7, 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 as the elongate member is withdrawn in the proximal direction.

14. The apparatus of claim 7, wherein the heating element is a resistive coil.

15. The apparatus of claim 7, further comprising an access sheath configured to receive the elongate member as it is inserted into the blood vessel.

16. The apparatus of claim 7, wherein the metal braid wire comprises a shape memory material.

17. The apparatus of claim 7, further comprising a balloon configured to expand and collapse the metal braid wire.

18. The apparatus of claim 17 wherein the balloon is pre-stretched axially prior to anchoring on the apparatus so that it is expandable radially with little to no axial expansion.

19. The apparatus of claim 7, wherein the splines comprise two sets of axially spaced splines.

20. The apparatus of claim 7, further comprising an outer sheath configured for collapsing the splines.

21. The apparatus of claim 7, wherein at least one of the splines has a resistive coil wire wrapped around it.

22. The apparatus of claim 7, wherein each of the splines is individually wired for power such that the splines can be used in a multiplexing or cascading heating process.

23. Apparatus for treating a blood vessel, the apparatus comprising:

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

a heating element having a treatment length located on the distal section of the elongate member, the heating element comprising a plurality of expandable resistive splines attached radially about the elongate member;

a plurality of index markings marked on the elongate member; and

at least one final marking having an appearance different from each of the index markings, the final marking being located distally of the index markings 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; and

wherein a distance between the heating element and each of the plurality of index markings, as measured along a length of the elongate member, is constant.