Method and apparatus for applying energy to biological tissue including the use of tumescent tissue compression

• US 6,752,803 B2
• Filed: 07/06/2001
• Issued: 06/22/2004
• Est. Priority Date: 09/11/1997
• Status: Expired due to Term

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: VNUS Medical Technologies Incorporated (Medtronic Plc)
• Inventors: Goldman, Mitchel P., Weiss, Robert A., Chandler, James G., Zikorus, Arthur W.
• Primary Examiner(s): ROLLINS, ROSILAND STACIE
• Application Number:
  US09/899,885
• Publication Number:
  US 20010041888A1
• Time in Patent Office: 1,082 Days
• Field of Search: 128/898, 606/27-29, 606/31, 606/32, 606/34, 606/41, 606/42, 607/96, 607/98, 607/100-102, 607/104-106
• US Class Current: 606/32
• 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 2017/22038 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 2017/22067 Blocking; Occlusion A61B2017/22054 takes 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 2018/00488 Esophagus
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• 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 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: G02F 1/134363 for applying an electric field parallel to the substrate, i.e. in-plane switching [IPS]
• CPC Class Codes: G02F 1/136213 Storage capacitors associated with the pixel electrode
• CPC Class Codes: G02F 1/136259 Repairing; Defects
• CPC Class Codes: G02F 2201/12 electrode

Abstract

An electrode catheter is introduced into a hollow anatomical structure, such as a vein, and is positioned at a treatment site within the structure. Tumescent fluid is injected into the tissue surrounding the treatment site to produce tumescence of the surrounding tissue which then compresses the vein. The solution may include an anesthetic, and may further include a vasoconstrictive drug that shrinks blood vessels. The tumescent swelling in the surrounding tissue causes the hollow anatomical structure to become compressed, thereby exsanguinating the treatment site. Energy is applied by an electrode catheter in apposition with the vein wall to create a heating effect. The heating effect causes the hollow anatomical structure to become molded and durably assume the compressed dimensions caused by the tumescent technique. The electrode catheter can be moved within the structure so as to apply energy to a large section of the hollow anatomic structure. In a further aspect, the location of the electrodes is determined by impedance monitoring. Also, temperature sensors at the treatment site are averaged to determine the site temperature.

Claims

1. A method of applying energy to a hollow anatomical structure comprising the steps of:

introducing a catheter having a working end into the hollow anatomical structure;

positioning the working end of the catheter at a treatment site within the hollow anatomical structure;

administering a fluid into the tissue near the treatment site to cause swelling and compress the hollow anatomical structure to a reduced size around the catheter; and

applying energy to the hollow anatomical structure at the treatment site from the working end of the catheter such that the hollow anatomical structure durably assumes a reduced size to effectively occlude the hollow anatomical structure.

2. The method of claim 1 further comprising the step of moving the working end of the catheter along the hollow anatomical structure during the step of applying energy.

3. The method of claim 1 further comprising the steps of:

ceasing the step of applying energy;

moving the working end of the catheter to a new treatment site along the hollow anatomical structure;

applying energy to the hollow anatomical structure at the new treatment site from the working end of the catheter.

4. The method of claim 1 wherein the step of applying energy includes the step of applying electrical energy.

5. The method of claim 1 wherein the step of applying energy includes the step of applying RF energy.

6. The method of claim 1 wherein the step of applying energy includes the step of applying microwave energy.

7. The method of claim 1 wherein the step of applying energy includes the step of applying light energy.

8. The method of claim 1 wherein the step of applying energy includes the step of applying thermal energy.

9. The method of claim 1 wherein the fluid thermally insulates the tissue near the treatment site.

10. The method of claim 1 wherein the fluid thermally insulates nerve tissue near the treatment site.

11. The method of claim 1 wherein the fluid limits thermal damage to the tissue near the treatment site during the step of applying energy.

12. A method of applying energy to a hollow anatomical structure comprising the steps of:

introducing a catheter having a working end with an energy application device at the working end into the hollow anatomical structure;

positioning the working end of the catheter at the treatment site within the hollow anatomical structure;

administering a fluid into the tissue near the treatment site to cause swelling and compress the hollow anatomical structure to a reduced size around the catheter; and

applying energy to the hollow anatomical structure at the treatment site via the energy application device such that the hollow anatomical structure durably assumes a reduced size to effectively occlude the hollow anatomical structure, wherein the fluid limits the thermal effect on the tissue near the treatment site from heat generated during the step of applying energy.

13. The method of claim 12 wherein the tissue near the treatment site includes nerves.

14. The method of claim 12 further comprising the step of moving the energy application device along the hollow anatomical structure during the step of applying energy.

15. The method of claim 12 further comprising the steps of:

ceasing the step of applying energy;

moving the energy application device to a new treatment site along the hollow anatomical structure;

applying energy to the hollow anatomical structure at the new treatment site via the energy application device.

16. The method of claim 12 wherein the step of applying energy includes the step of applying electrical energy circumferentially from within the hollow anatomical structure.

17. The method of claim 12 wherein the step of applying energy includes the step of applying RF energy.

18. The method of claim 12 wherein the step of applying energy includes the step of applying microwave energy.

19. The method of claim 12 wherein the step of applying energy includes the step of applying light energy.

20. The method of claim 12 wherein the step of applying energy includes the step of applying thermal energy.