Ablation in the Gastrointestinal Tract to Achieve Hemostasis and Eradicate Lesions With a Propensity for Bleeding
First Claim
1. A method of treating an area of bleeding in a gastrointestinal tract comprising:
- identifying the area of bleeding;
positioning a therapy device in the gastrointestinal tract adjacent to a target site within the area of bleeding;
pressuring the bleeding area to diminish the amount of blood within blood vessels in the bleeding area; and
applying a non-surgical hemostatic therapy to a target site in the area while continuing to pressure the area.
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Accused Products
Abstract
Devices and methods are provided for the ablation of regions of the digestive tract to achieve hemostasis and to eradicate chronically bleeding lesions as occur with gastric antral vascular ectasia (GAVE), portal hypertensive gastropathy (PHG), radiation proctopathy and colopathy, arteriovenous malformations, and angiodysplasia. Ablation is typically provided in a wide-field manner, and in conjunction with sufficient pressure to achieve coaptive coagulation. Ablation, as provided the invention, starts at the mucosa and penetrates deeper into the gastrointestinal wall in a controlled manner. Ablation control may be exerted by way of electrode design and size, energy density, power density, number of applications, pattern of applications, and pressure. Control may also be provided by a fractional ablation that ablates some tissue within a target region and leaves a portion substantially unaffected. Embodiments of the device include an ablational electrode array that spans 360 degrees and an array that spans an arc of less than 360 degrees.
189 Citations
62 Claims
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1. A method of treating an area of bleeding in a gastrointestinal tract comprising:
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identifying the area of bleeding; positioning a therapy device in the gastrointestinal tract adjacent to a target site within the area of bleeding; pressuring the bleeding area to diminish the amount of blood within blood vessels in the bleeding area; and applying a non-surgical hemostatic therapy to a target site in the area while continuing to pressure the area. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. A method of ablationally-treating a target site within an area of bleeding in a gastrointestinal tract comprising:
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pressuring the bleeding area to diminish the amount of blood within blood vessels in the bleeding area; and delivering radiofrequency energy to a tissue surface within the target area, the target area being a contiguous radial portion of the gastrointestinal tract; and controlling the delivery of radiofrequency energy across the tissue surface within the target area and into a depth of tissue within the target area. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51)
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52. An ablation system treating a target site within an area of bleeding in a gastrointestinal tract comprising:
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an electrode pattern including a plurality of electrodes; a longitudinal support member supporting the electrode pattern; a generator coupled to the plurality of electrodes; a computer controller in communication with the generator, the controller having programming to direct the generator to deliver energy to the plurality of electrodes, the programming including the ability to direct delivery of energy to a subset of the electrodes, the electrodes of the pattern configured such that, when receiving energy from the generator and in therapeutic contact with a tissue target area, delivery of energy across the surface of the target area and into a depth tissue layers from the tissue surface is controlled. - View Dependent Claims (53, 54, 55, 56, 57, 58, 59, 60, 61)
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62. An ablation system for vascular tissue at a target area in a gastrointestinal tract of a patient comprising:
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an ablation structure supported by an instrument, a non-penetrating electrode pattern on the ablation support structure, the electrode pattern configured to control the delivery of energy to a target tissue such that a portion of the surface of the target area receives sufficient radiofrequency energy to achieve ablation and another portion of the surface of the target receives insufficient energy to achieve ablation; means supported by the instrument by which to bring the ablation structure to make therapeutic contact with tissue at the target area.
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Specification