Apparatus and method for treatment of in-stent restenosis
First Claim
1. A system for delivering energy-based treatment for in-stent restenosis and other stenosis of the vasculature, the system comprising:
- an elongate flexible catheter body having a proximal end and a distal end with an axis therebetween;
a radially expandable structure near the distal end of the catheter body;
a plurality of electrodes positioned on the radially expandable structure so as to engage tissue upon expansion of the radially expandable structure, wherein the plurality of electrodes are included in one or more flex circuits, wherein the one or more flex circuits further comprise a temperature sensing structure mounted thereon adjacent to at least one of the electrodes;
a power source coupled with the electrodes such that when an electrode engages tissue an electrical circuit comprising the power source, the electrode, and the engaged tissue is defined; and
,a processor coupled with the power source and the temperature sensing structure, the processor configured to verify the presence of the electrical circuit, to selectively energize the engaged electrodes, and to control the delivery of energy by regulating one or more parameters of the electrical circuit based on monitoring feedback from the electrical circuit and the temperature sensing structure such that energy delivered to a tissue treatment zone heats tissue therein to a surface temperature of about 55°
C. to about 75°
C. while tissue collateral to the treatment zone 1 mm from the surface and deeper is heated to less than about 45°
C., thereby inducing a tissue response that remodels stenosis and avoids a subsequently occluding tissue response caused by thermal damage,wherein the processor is configured to monitor and modify energy delivery to at least one of the plurality of electrodes by the power source in response to a change in at least one of frequency range, impedance magnitude, impedance phase angle, temperature, power, voltage, and current, the change being associated with proximity to a metallic implanted structure.
1 Assignment
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Accused Products
Abstract
A catheter and catheter system can use energy tailored for remodeling and/or removal of target material proximate to a body lumen, often of stenotic material or tissue in the luminal wall of a blood vessel of a patient. An elongate flexible catheter body with a radially expandable structure may have a plurality of electrodes or other electrosurgical energy delivery surfaces to radially engage the luminal wall when the structure expands. Feedback using one or parameters of voltage, current, power, temperature, impedance magnitude, impedance phase angle, and frequency may be used to selectively control the delivery of energy.
1533 Citations
29 Claims
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1. A system for delivering energy-based treatment for in-stent restenosis and other stenosis of the vasculature, the system comprising:
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an elongate flexible catheter body having a proximal end and a distal end with an axis therebetween; a radially expandable structure near the distal end of the catheter body; a plurality of electrodes positioned on the radially expandable structure so as to engage tissue upon expansion of the radially expandable structure, wherein the plurality of electrodes are included in one or more flex circuits, wherein the one or more flex circuits further comprise a temperature sensing structure mounted thereon adjacent to at least one of the electrodes; a power source coupled with the electrodes such that when an electrode engages tissue an electrical circuit comprising the power source, the electrode, and the engaged tissue is defined; and
,a processor coupled with the power source and the temperature sensing structure, the processor configured to verify the presence of the electrical circuit, to selectively energize the engaged electrodes, and to control the delivery of energy by regulating one or more parameters of the electrical circuit based on monitoring feedback from the electrical circuit and the temperature sensing structure such that energy delivered to a tissue treatment zone heats tissue therein to a surface temperature of about 55°
C. to about 75°
C. while tissue collateral to the treatment zone 1 mm from the surface and deeper is heated to less than about 45°
C., thereby inducing a tissue response that remodels stenosis and avoids a subsequently occluding tissue response caused by thermal damage,wherein the processor is configured to monitor and modify energy delivery to at least one of the plurality of electrodes by the power source in response to a change in at least one of frequency range, impedance magnitude, impedance phase angle, temperature, power, voltage, and current, the change being associated with proximity to a metallic implanted structure. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A catheter for delivering energy-based treatment for in-stent restenosis and other stenosis of the vasculature, the system comprising:
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an elongate flexible catheter body having a proximal end and a distal end with an axis therebetween; a radially expandable structure near the distal end of the catheter body; a plurality of electrodes positioned on the radially expandable structure so as to engage tissue at an electrode position upon expansion of the radially expandable structure, the tissue in proximity to engaged electrodes defining a tissue treatment zone, wherein the electrodes are positioned on a flex circuit; and a temperature sensing structure mounted on the flex circuit adjacent at least one of said plurality of electrodes, the temperature sensing structure being electrically coupled to a processor so as to comprise a means of feedback for control by a power source by sensing temperature in proximity to at least one electrode, wherein the processor is configured to deliver energy to a tissue treatment zone to heat tissue therein to a surface temperature of about 55°
C. to about 75°
C. while tissue collateral to the treatment zone 1 mm from the surface and deeper is heated to less than about 45°
C., thereby inducing a tissue response that remodels stenosis and avoids a subsequently occluding tissue response caused by thermal damage,wherein the processor is configured to monitor and modify energy delivery to at least one of the plurality of electrodes by the power source in response to a change in at least one of frequency range, impedance magnitude, impedance phase angle, temperature, power, voltage, and current, the change being associated with proximity to a metallic implanted structure. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28)
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29. A system for delivering energy-based treatment for in-stent restenosis and other stenosis of the vasculature, the system comprising:
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an elongate flexible catheter body having a proximal end, a distal end, and a longitudinal axis extending therebetween; a radially expandable structure disposed on the catheter body near the distal end thereof; a plurality of electrodes positioned on the radially expandable structure so as to engage a tissue upon expansion of the radially expandable structure, the tissue in proximity to engaged electrodes defining a tissue treatment zone, wherein the plurality of electrodes are included in one or more flex circuits, wherein the one or more flex circuits further comprise a temperature sensing structure mounted thereon adjacent to at least one of the electrodes; a power source coupled with the electrodes such that when an electrode of the plurality engages the tissue, an electrical circuit comprising the power source, the engaged electrode, and the tissue engaged by the electrode can be defined; and a processor coupled with the power source and the temperature sensing structure, the processor configured to control the delivery of energy by regulating one or more parameters of the electrical circuit based on monitoring feedback acquired from the electrical circuit and the temperature sensing structure such that the controlled delivery of energy heats the tissue to be treated to a surface temperature of about 55°
C. to about 75°
C. while a collateral tissue adjacent the treatment zone 1 mm from the surface and deeper is heated to less than about 45°
C. thereby inducing a tissue response that remodels stenosis and avoids a subsequently occluding tissue response caused by thermal damage,wherein the processor is configured to monitor and modify energy delivery to at least one of the plurality of electrodes by the power source in response to a change in at least one of frequency range, impedance magnitude, impedance phase angle, temperature, power, voltage, and current, the change being associated with proximity to a metallic implanted structure.
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Specification