Electrical means to normalize ablational energy transmission to a luminal tissue surface of varying size

• US 8,784,338 B2
• Filed: 06/20/2008
• Issued: 07/22/2014
• Est. Priority Date: 06/22/2007
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Wallace, Michael P., Garabedian, Robert, Gerberding, Brent C.
• Primary Examiner(s): DOUGHERTY, SEAN PATRICK
• Application Number:
  US12/143,404
• Publication Number:
  US 20080319350A1
• Time in Patent Office: 2,223 Days
• Field of Search: 600/300, 600/560, 600/561, 600587-595, 606 32- 52, 607115-138
• US Class Current: 600/587
• CPC Class Codes: A61B 18/0218 with open-end cryogenic probe, e.g. for spraying fluid directly on tissue or via a tissue-contacting porous tip
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 18/14 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 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/20 using laser
• CPC Class Codes: A61B 2018/00017 with gas
• 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 2018/00488 Esophagus
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• CPC Class Codes: A61B 2018/00714 Temperature
• CPC Class Codes: A61B 2018/00755 Resistance or impedance
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2562/0257 Proximity sensors
• CPC Class Codes: A61B 5/053 Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0538 invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/1076 for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence

Abstract

Methods and devices for measuring the size of a body lumen and a method for ablating tissue that uses the measurement to normalize delivery of ablational energy from an expandable operative element to a luminal target of varying circumference are provided. The method includes inserting into the lumen an expandable operative element having circuitry with resistivity or inductance that varies according to the circumference of the operative element, varying the expansion of the operative element with an expansion medium, measuring the resistivity of the circuitry, and relating the resistivity or inductance to a value for the circumference of the operative element. In some embodiments the sizing circuit includes a conductive elastomer wrapped around the operative element. Other embodiments of the method apply to operative elements that include an overlapping energy delivery element support in which the overlap varies inversely with respect to the state of expansion, and which is configured with sizing electrodes that sense the amount of the overlap.

Claims

1. A device for measuring the size of a body lumen comprising:

an expandable operative element including an inflatable balloon and an ablation energy delivery element support arranged around the inflatable balloon, the support having a longitudinal first edge and a second longitudinal edge that overlap each other to form an area of mutual overlap; and

a sensing circuitry whose resistivity varies according to the area of mutual overlap.

2. The device of claim 1, wherein the expandable operative element includes an expandable balloon.

3. The device of claim 1, wherein the operative element further includes an ablative energy delivery element.

4. The device of claim 3, wherein the ablative energy delivery element includes any of a radiofrequency electrode, a radio frequency electrode array, or solid-state circuitry.

5. The device of claim 1, wherein the circuitry comprises a portion of a band of conductive elastomer wrapped around the operative element such that when the operative element is contracted a length of the conductive elastomer band is also contracted, and when the operative element is expanded, the length of the conductive elastomeric band is stretched.

6. The device of claim 1, wherein the support is circumferentially expandable by the balloon such that the area of mutual overlap is inversely related to an amount of expansion of the balloon.

7. The device of claim 1, wherein the circuitry includes sensing elements on both longitudinal edges of the ablational energy delivery element support in the area of mutual overlap, such elements configured to connect across the area of mutual overlap to form a circuit with a particular resistivity, the elements further configured such that the connection formed between sensing elements varies according to an amount of mutual overlap of the two longitudinal edges.

8. The device of claim 7, wherein the first edge includes a single sensing element and the second edge includes a plurality of spaced-apart sensing elements, the particular element among the plurality of elements on the second edge that connects to the element on the first edge varying according to an amount of mutual overlap of the two edges, the resistivity of circuit thus formed varying according to the particular element on the second edge that is included in the circuit.

9. The device of claim 7, wherein the first edge includes a single sensing element and the second edge includes a plurality of closely-spaced sensing elements, the elements configured such that the element on the first edge connects with one of the plurality of the elements on the second edge or with a pair of adjacent elements on the second edge, the resistivity of circuit formed varying according to which of the one or which adjacent pair of the elements on the second edge is included in the circuit.

10. The device of claim 7, wherein the first edge includes a single sensing element and the second edge includes an elongated sensing element, the elements configured such that the single element on the first edge forms a circuit by connecting with the elongated element on the second edge at a point that varies along the length of the elongated element thereby creating a circuit of varying length, the resistivity of the circuit varying according to the length of the element on the second edge that is included in the circuit.

11. The device of claim 1, wherein the ablation energy delivery element support is furled around the inflatable balloon in a deployable configuration.

12. The device of claim 1, wherein the operative element is configured for delivery of energy to tissue at a target tissue area.

13. A device for measuring the size of a body lumen comprising:

an expandable operative element including an inflatable balloon and an ablation energy delivery element support arranged around the inflatable balloon, the support having a longitudinal first edge and a second longitudinal edge that overlap each other to form an area of mutual overlap; and

a sensing circuitry whose inductance varies according to the area of mutual overlap.

14. The device of claim 13, wherein the circuitry includes sensing elements on both longitudinal edges of the ablational energy delivery element support in the area of mutual overlap, such elements configured to connect across the area of mutual overlap to form a circuit with a particular resistivity, the elements further configured such that the connection formed between sensing elements varies according to an amount of mutual overlap of the two longitudinal edges.

15. The device of claim 13, wherein the ablation energy delivery element support is furled around the inflatable balloon in a deployable configuration.

16. The device of claim 13, wherein the operative element further includes an ablative energy delivery element.

17. The device of claim 16, wherein the ablative energy delivery element includes any of a radiofrequency electrode, a radiofrequency electrode array, or solid-state circuitry.

18. The device of claim 13, wherein the operative element is configured for delivery of energy to tissue at a target tissue area.