System and method for treating a therapeutic site

• US 9,220,488 B2
• Filed: 09/14/2012
• Issued: 12/29/2015
• Est. Priority Date: 10/20/2005
• Status: Active Grant

• Current Assignee: Otsuka Medical Devices Co., Ltd. (Otsuka Holdings Company Limited)
• Original Assignee: Kona Medical, Inc.
• Inventors: Emery, Charles, Augustine, Larry, Lahman, Robyn, Perozek, David M., Zhang, Jimin
• Primary Examiner(s): Luong, Peter
• Application Number:
  US13/618,361
• Publication Number:
  US 20130012839A1
• Time in Patent Office: 1,201 Days
• Field of Search: 600/407, 600/437, 600/439, 600/459
• US Class Current: 1/1
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• 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 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00641 for closing fistulae, e.g. anorectal fistulae
• CPC Class Codes: A61B 2090/372 Details of monitor hardware
• CPC Class Codes: A61B 2090/3784 both receiver and transmitter being in the instrument or receiver being also transmitter
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/397 electromagnetic other than visible, e.g. microwave
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 50/13 Trolleys, e.g. carts
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/4405 Device being mounted on a trolley
• CPC Class Codes: A61B 8/445 Details of catheter construction
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61M 25/10 Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

A targeting catheter is used to locate an arteriotomy, such as is formed during a femoral artery catheterization procedure. The targeting catheter includes one or more targeting aids, such as an inflatable balloon or sensor (e.g., Doppler or temperature sensor), to locate the arteriotomy. The targeting aid may be positioned at the arteriotomy. An ultrasonic beacon on the catheter may then be located relative to a therapeutic ultrasonic applicator (e.g., by using acoustic time-of-flight) so that the focus of ultrasonic energy from the applicator can be aligned with the arteriotomy.

Claims

1. A method of treating an adventitia of a blood vessel within a patient, comprising:

inserting a targeting catheter into a patient;

positioning the targeting catheter proximate to the adventitia of the blood vessel;

emitting at least one signal from the targeting catheter from within the patient;

receiving the at least one signal with a plurality of receivers on a therapeutic applicator that is positioned external to the patient, wherein the therapeutic applicator comprises one or more therapeutic ultrasound transducers and the plurality of receivers are spaced apart from each other on the therapeutic applicator;

determining an acoustic time-of-flight from the targeting catheter to the therapeutic applicator based at least in part on the at least one signal;

determining a location of a portion of the targeting catheter relative to the therapeutic ultrasound applicator based at least in part on the acoustic time-of-flight determination;

adjusting a focus of the one or more therapeutic ultrasound transducers based on the determined location of the portion of the targeting catheter, wherein the focus is adjusted to target the adventitia of the blood vessel; and

emitting a dose of focused ultrasound from the therapeutic applicator to the adventitia of the blood vessel.

2. The method of claim 1, wherein determining the location of the portion of the targeting catheter relative to the therapeutic applicator comprises using triangulation of the at least one signal emitted from the targeting catheter.

3. The method of claim 1, wherein the at least one signal is emitted from a beacon disposed on the targeting catheter.

4. The method of claim 1, wherein the at least one signal comprises a tone burst of sound.

5. The method of claim 1, wherein the at least one signal is an ultrasound signal.

6. The method of claim 1, further comprising providing a user interface to assist a user in adjusting the focus of the therapeutic applicator.

7. The method of claim 6, further comprising displaying graphical elements on the user interface.

8. A method of treating an adventitia of a blood vessel within a patient, comprising:

inserting a targeting catheter into a patient, the targeting catheter comprising a receiver;

positioning the targeting catheter proximate to the adventitia of the blood vessel;

emitting at least one signal from a therapeutic ultrasound applicator that is positioned external to the patient, the at least one signal being emitted from a plurality of transmitters, wherein the therapeutic applicator comprises one or more therapeutic ultrasound transducers and the plurality of transmitters are spaced apart from each other on the therapeutic applicator;

receiving the at least one signal with the receiver;

determining an acoustic time-of-flight from the plurality of transmitters to the receiver based at least in part on the at least one signal;

determining a location of a portion of the targeting catheter relative to the therapeutic applicator based at least in part on the acoustic time-of-flight determination;

adjusting a focus of the one or more therapeutic ultrasound transducers based on the determined location of the portion of the targeting catheter, wherein the focus is adjusted to target the adventitia of the blood vessel; and

emitting a dose of focused ultrasound from the therapeutic applicator to the adventitia of the blood vessel.

9. The method of claim 8, wherein determining the location of the portion of the targeting catheter relative to the therapeutic applicator comprises using triangulation.

10. The method of claim 8, wherein the at least one signal comprises a tone burst of sound.

11. The method of claim 8, wherein the at least one signal is an ultrasound signal.

12. The method of claim 8, further comprising providing a user interface to assist a user in adjusting the focus of the therapeutic applicator.

13. The method of claim 12, further comprising displaying graphical elements on the user interface.