CA2160640A1 - Detachable endovascular occlusion device activated by alternating electric current - Google Patents

Detachable endovascular occlusion device activated by alternating electric current

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Publication number
CA2160640A1
CA2160640A1 CA002160640A CA2160640A CA2160640A1 CA 2160640 A1 CA2160640 A1 CA 2160640A1 CA 002160640 A CA002160640 A CA 002160640A CA 2160640 A CA2160640 A CA 2160640A CA 2160640 A1 CA2160640 A1 CA 2160640A1
Authority
CA
Canada
Prior art keywords
coil
detachable
delivery wire
alternating current
current generator
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA002160640A
Other languages
French (fr)
Inventor
Guido Guglielmi
Cheng Ji
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
University of California
Original Assignee
Guido Guglielmi
Cheng Ji
The Regents Of The University Of California
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Guido Guglielmi, Cheng Ji, The Regents Of The University Of California filed Critical Guido Guglielmi
Publication of CA2160640A1 publication Critical patent/CA2160640A1/en
Abandoned legal-status Critical Current

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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/08Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • A61B18/082Probes or electrodes therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • AHUMAN NECESSITIES
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    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/1214Coils or wires
    • AHUMAN NECESSITIES
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
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    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • AHUMAN NECESSITIES
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    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • AHUMAN NECESSITIES
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    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205Introduction devices
    • AHUMAN NECESSITIES
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    • A61B2017/1205Introduction devices
    • A61B2017/12054Details concerning the detachment of the occluding device from the introduction device
    • A61B2017/12063Details concerning the detachment of the occluding device from the introduction device electrolytically detachable
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    • A61B2017/22038Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
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    • A61B2018/00666Sensing and controlling the application of energy using a threshold value
    • A61B2018/00678Sensing and controlling the application of energy using a threshold value upper
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    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/1226Generators therefor powered by a battery
    • AHUMAN NECESSITIES
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    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/1253Generators therefor characterised by the output polarity monopolar
    • AHUMAN NECESSITIES
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    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/1246Generators therefor characterised by the output polarity
    • A61B2018/126Generators therefor characterised by the output polarity bipolar
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/1206Generators therefor
    • A61B2018/1266Generators therefor with DC current output
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1405Electrodes having a specific shape
    • A61B2018/1435Spiral
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B2018/1495Electrodes being detachable from a support structure
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3966Radiopaque markers visible in an X-ray image
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    • A61B90/39Markers, e.g. radio-opaque or breast lesions markers

Abstract

An apparatus is provided for electrocoagulating blood and tissue at an occlusion site by means of application of an alternating signal or current through a detachable coil on the end of a microcatheter. A Guglielmi Detachable Coil (GDC)is preferably used in the combination with radio frequency energy to cause localheating at the coil. Once carbonization of blood at the detachment zone of the GDC coil occurs, the impedance of the entire system increases. The impedance increase is detected to automatically turn off the alternating current and then to apply a direct current to electrolytically detach the GDC coil from the microcatheter.

Description

., Patent 216 0 6 ~ O G~glie1mi et al. (UCIl,AD
~.

DETACH~BLE ENDOVASCUI~R OCCLUSION DEVIOE ACTIVATED BY
AI~TERNATING ELECTRIC CURRENT

Background of the Invention 5 1. Field of the Invenhon The invention relates to the field of electroco~ hon, and in particular to the use of altelnali-lg ~ lellls to form endovascular occ111sion.c.
2. D~ ion of the PriorArt Occlllcion of vascular structures by endovascular catheters is ~ enlly re~ d though the use of detachable balloons, injectable glue, llet~h~kle or p11ch~ble coils, and inject~ble particles. Det~ch~ble balloons are of such a nature that they can only be pMctl-~11y used in large vessels. The use of inject~ble glue is 1imitc~ by the difficulty of controllable delivery to the desired oc~l~lcion site.
15 Det~h~l~le and p~lch~blç coils are effective, but in some cases are not sufficiently thrombogenic. The use of inject~kle particles suffers from their relative invisibility in fluoroscopy and the ~iffi~l1ty in controlling their ~1ltim~te disposition at the desired occlllcio~ site. In many prior art tecllno1Ogies the co~l1~tion wire must be ripped out of the clot, usually c~ ing concitlerable disruption or even reopening the 20 OCC111~Cion The use of both ~l~e~ g and direct current for clc;a i~g electroco~11~t1'on is well known. See, Gold et al., '~ransarterial Electroco~ Iq~7Qn Therapy of a Ps~ on~leurysm .r. the Head of the P..,.~,e.~s, n American Journal of Roentgenology, Patent _ 216 0 6 4 0 G~l~içlmi et al. (UCLA~

Volume 125, No. 2, at 422 (1975); Thompson et al., "Vessel Occlusion with Tn.,.s~ t~, Electroco~ la~iQn: ~nitial Clinical Experience, " Di~enostic Radiology at 335 (November 1979); Thompson et al., 'Transcatheter Ele~l~vcong~ tion. A
Thera~eutic Angiographic Technique for Vessel Occlusion, " Investi~ive Radiology at 146 (March-April 1977); Phillips, ~T~ C~ Electrocong7l~nfiQn of Blood Vessels, "Investi~tive Radiology at 295 (September-October 1973); and Phillips et aL, "E~ al Closure of Ateriovenous Fistula by Transcatheter Electrocongv~ntion,"
Di~ostic Radiology 115:319 (May 1975). However, each of these eXperiment~l i~vestig~tionC were generally performetl in larger vessels and did not est~hlishcontroll~hility~ nor efficacy for use in ~m~ller vessels.
Thererore, what is nee~ed is a clinical occlusive device which is visible, bioco...~ le, controllable in that it can be detached at will at a desired site even distal to the delivery _icrocatheter, which is directable, effica~ous in CQ~ hngblood and vessel and usable in small vessels without the risk of c~ ;.,g ~lisl~lion or 15 reopening the occ~ ion at the end of the treatment.

Brief Summar~ of the Invention The invention is an apparatus for selectively providing endovascular ocrhl~iQn in a patient co",~ g a delivery wire guidable to or near an 20 endovascular ocrlllsion site. A detachable coil is temporarily and selectively coupled to the delivery wire. An alte~ g cullen~ generator selectively is coupled to the (let~rh~hle coil to provide current to the coil to effect elêctroco~ll~hon. As a result, a controllable occlusive a~al~l ls em~cious and usable in small vessels is provided.

Patent 21 6 0 6 4 0 Gn~ielmi et al. (UCL~
_ The apparatus further comprises a direct current generator selectively coupled to the det~h~ble coil. A switch selectively couples either the ~ltçrn~tin~
~iullc~l generator and direct current generator to the detachable coil or both. In the plefel-ed embo~liment the coil is a GDC coil. The ~ltel"~t;~ and direct ~ullelllS genelatol~ are variably controllable and the controllable ~lte~ ullenl generator is frequency controllable.
The al,paralus further co~ ises a sçn~ing circuit for detç-",;";"~ when a predetermined state of electroco~ tion is achieved at or near the detachable coil.
The sçn~in~ circuit senses imped~nce of the det~çhakle coil within the patient. The 10 appalalus fur~er co" '1~ ;ces a control circuit for selectively initi~ting det~mP-Ilt of the coil when the se-ncing circuit determines the predete~nined state of electroco~l~hon has been achieved.
The alle.na~i~g CullCllt generator serves to ohmically heat the detachable coil and SullOu lding blood tissues and/or dielectricly heat the detachable coil and 15 Su~ 3;~-~, blood tissues at a radio frequenq.
The invention is also ~çfine~l as an ~palallls for creating an endovascular occ~ n at a selectively occ~ ion site COlu~lisillg a con~ ctive delive~y wire and a sclc~tively disl,osable and detachable co~dllctive coil coupled to the delivery wire and dis~osable by the delivery wire at or near the occlusion site. An alternating 20 ;ullellt signal source is electrically coupled to the delivery wire and coil for providing a source of heat~n~ energy at the coil. As a result, the a~a,~alus is a controllable occlusive device usable and efficacious in small vessels.
The detachable coil is electrolytically detachal-le or mech~n~ y detachable.
The ap~alalùs further conl~ises a control circuit for dete~".;n;.~ when a 25 predetermine~l degree of electroco~ tion has occurred at the coil and then for . ~ , , Patent - 2 1 6 0 6 4 O Guglielmi et al. (UCLA~ ~

det~ching the coil from the delivery wire. A direct ~;u~lent signal source is elecir~r~lly coupled to the detachable coil and the control circuit tu~s the altell,ali~g cullent signal source off when the predete.rmined degree of electroco~ll~tiQn has occurred and turns the direct current signal source on to 5 detach the coil from the delivery wire.
The invention is also characterized as a method of forming a vascular ocrl-lsion co~ ising providing a con(l~lctive delivery ~,vire and disposing a conductive coil coupled to the delivery wire at or near a selected occlusion site. An ~lle~ ;.,e ~;ullenl is applied to the coil to co~ te the occlusion site. A
10 detel~il~alion is made whether a predetermined amount of electroco~ h'on has occurred at the ocrlllcion site. The ~ltern~ting cLlllent through the coil is tel",;.,~te~l when the step of detel~ g est~blicl~es that the predeterrnined electrocoa~ tlQn has occ~rred. The coil is then detached from the deliveIy wire to leave the coil at the occlucion site. As a result, an occlusion is efficaciously provided 15 in a small vessel.
In the ~refe~led embo~liment det~ in~ the coil from the deliveIy wire is l.e-- I'u~ ed ~ o...~ic~lly and the coil is electrolytically separated from the delivery wire.
The invention may be better vicn~li7ed by now l""~ g to the following 20 dlawill~ wherein like elemP-ntc are rcfercnced by like numerals.

Brief Description of the D~a~ gs Figure 1 is an i(le~li7e~ diagram of the al)paralus of the invention.
Figure 2 is an enlarged view of one embodiment of the catheter for use in 25 connPction w~th the a~pa-alus of ~igure 1.

Patent - 216 0 6 4 ~ GllgliPlmi et al. (UC:I1AD

The invention and its various embo-liment~ may now be better understood by 1,., ..;.~ to the following detailed description.

Detailed Description of the ~ d Embodiments S An ap~ us is pronded for electroco~ ting blood and tissue at an ocrl-lcion site by means of application of an alternating signal or ~;Ullent through a let~h~ble conductive coil on the end of a delivery wire. A Guglielmi DetachableCoil ~GDC) is prefelably used in the comhin~tion ~nth radio frequency energy to cause local he~ting at the coil. Once carboni7~tion of blood at the det~chment zone of the GDC coil occurs, the impedance of the entire system increases. The impedance increase is detected to automatically turn off the alternating ;Ullelll and then to apply a direct ~;Ullelll to electrolytically detach the GDC coil from the delivery wire.
The ~ar~lus of the invention uses a detachable microcatheter coil system and a source of ~lle---~ , and direct electric ~ lent. The electrolytically ~et~l~h~ble coil system is commerci~li7e~1 by Target Therapeutics of C~liforni~ as the Gn~ lmi Det~ch~le Coil System (here~arler ~e-fine~l as the GDC coil or system) and in~ des a source of direct ~ relll coupled to a microcatheter-guidedwire with a m~ch~nic~lly or electrolytically ~let~-h~ble distal coil. Any one of the embo~limPnt~ described in U.S. Patents 5,1æ,136; 5,226,911; and/or (pending as allowed U.S. Patent Appli- ~tion serial no. 07/840,211) may be used in the present a~ar~lus. All of the U.S. Patents 5,1æ,136; 5,226,911;
, and (pending as allowed U.S. Patent Applic~tion serial no.
07/840,211) are incorporated herein by referel-ce as if set forth in their en~i~ely.

216 0 6 g 0 Gllglielmi et al. (UC

Mech~nir~l means for detachment of the coil from the catheter is tlisclosed in U.S.
Paten~ 5,234,437 and 5,261,916 also incorporated herein by rcference.
Figure 1 is a highly diagr~mm~tic depiction of the a~a~ s as applied to form an endovascular oc~ cion. The GDC system, generally denoted by refere,lce S numeral 10, includes a ~ kle microcatheter 12, which in the illusl~ated embodiment is a tracker endovascular catheter as m~mlf~ctmed by Target Therapeutics, Inc. of Fremont, California. A GDC coil 14 is positioned at or pr- Yim~te to a selected occlusion site 16, which is typically in a small vessel. GDC
coil 14 is generally fabricated from pl~timlm and may ~ccume any physical shape,form or composition described in the foregoing incorporated patent rcferences orknown in the art. For example, GDC coil 14 may be straight~ curved, circular, spiral, biased to form a prcfelled shaped, or completely limp and pii~ble~ and may incolpolate fibers or other equivalent micro-obstructive structures. The a~ al-ls of Figure 1 is particularly useful for arterial feeder occlusion of arteriovenous m~lro. ,,.~I;on.c, arteriovenous fistulae and vascular tumors.
For example, in the embodime.nt of Figure 2, microcatheter 12 is shown as C~l~g an inc~ ted guidewire 18 eYten-ling from catheter tip 20. At a predetermine-l pocition, inclllated guidewire 18 is stripped of its ;nc~ tion toprovide a bare wire æ co~ected at junction 24 to GDC coil 14.
GDC coil 14 is positioned at or near site 16 and an altern~ting signal generator 26 is connected through swilclling circuit 28 to a pr~al end of delivery wire 22. As is col,velllional in the art, the altel~aling ~;ulleLl is applied at a frequency, voltage, cullcnl repetition time, wave shape and other sig~al char~cterictic as may be desired to induce electroco~ul~tion of blood and body tissue in contact with and in the imInediate vicinity of the llninslll~ted exposed ~ 6 216 0 6 ~ 0 Gn~ielmi et al. (U

portiorl of GDC coil 14 and wire 22 at the distal end of microcatheter 12. No electroco~ tion occurs in contact with or in the immetli~te vicinity of the inc~ ted portion 18 of delivery wire 22.
A ground electrode 30 is provided to the patient through means of a S co~lnctlve derm~l a&esive pad, symbolically shown in Figure 1 sche-m~tic~lly as an electric~l ground 30. The altern~ting signal or current applied through GDC coil 14 in-hlres he~ting in the ~ro~ly of the noninc~ te~ pl~tinllm portion of the GDC
coil and/or the tissue such as the arterial or vessel wall and blood sullol-nding GDC
coil 14. The incnl~te~l portion of the delivery wire should extend to almost 0.5mm of 10 the solder joint 24 hol(ling coil 14, so that when alternating ~;ullelll or ;RF is applied, a clot will form subst~nti~lly only around the detachable coil 14 and not the delivery wire. The frequency which is cont~-mplated as being used and the present a~palalus incllldes very low freqn~-n~iec just above direct current to radio frequencies sl)A~ ing the spectrum from less than 1 Hertz to many Gigahertz. For example, a frequency 15 can be chosen to match a radio frequency absorption peak for any of the co..~ "~nt.c at occhlcio~ site 16, such as water. The proteins of the vascular stnucture or the blood are de. ~IL~.~ed by the heat and the chrink~e of the vascular wall and/or clotting of blood wili occur. For example, it is well known that c~ gen fibers in the vascular wall are shrinkable at temperalules above 60 degrees 20 centigrade.
The power provided by altern~tin signal generator 26 is variable by the ope~alor through an interface unit 32 coupled thereto either directly or throughswilcl~ g circuit 28. Variability of the power, the voltage, cLlllent and repeddon rate through interface 32 of the output of alternadng current generator 26 is used to 25 achieve vascular occlllsion without ~l~m~ng the vessel wall, and to ..~;n;.n;~.e or - 216 0 6 ~ O Gllglielmi et al. (UC

even sul~s~lially avoid nninten~ed or ~ wanted heating of the sullou~ding tissues.
-g signal generator 26 is a variable alternating Cul~ellt generator with a voltage now only in the range of 0 to 70 volts and is prefelably battery operated with recl~algeable batteries. The wavefollll shape is selectable through interface 32 and 5 typically _ay be sine wasre, square wave, triangular wave or ~-u~lO~ ";,ecl shapes with a variable frequency pulse rate.
The w~vefo~ of the alternating current signal is continuously mol~ilored through interface 32 and vessel occlusion is i"~ ly detected by changes in the shape of the w~vefo~l.l due to carboni7~hon of the blood on the det~chmçnt zone in 10 the ~r~ly of junction 24 on GDC coil 14. This w~ve~olll~ change due to blood c~l,o";~l;on is dete-rminP.d by a change in the impedance of the system shown inFigure 1. There~orc, interf~ce 32 is contemplated as incl~ ed an impe~l~n~e ~letector which will auloJl,aLically sound an audible signal to the operator or trigger an ~ o~ ;c turn off of the alte."~t;"g ~ enl generator 26. Once suffiçient 15 coa~ tion has been determin~d to have occurred, GDC coil 14 is detached as describèd in the incorporated patent references by means of a direct current generated by direct ;ullelll generator 34 and coupled through switching circuit 28 to delivery wiré 22. Switching circuit 28 may be m~nl~lly activated by the operator, or ~ olllAl~c~lly progr~mmed to switch over to deliver the proper direct ;ulle~t 20 sep~alillg ~ elll at thé completion of alternating current electroco~ tion.
GDC coils 14 are particularly effective in the a~ lus of Figure 1. In collllasl to other types of endovascular coils, GDC coils 14 are detaçh~le in place and distal from delivery catheter 12 after vessel occlusion has been achieved. Coils of various sizes, ranging from 0.005 to 0.2 inch in diameter, various shapes and25 configurations and softness utilizing platinum wire diameters in the range of 0.001 to 216 0 6 ~ ~ G~ ielmi et aL (uc ~,_ P281 0.004 or more inch can be used as desired for coil 14. Pl~timlm wires with di~ere-lt electrical resistances may be ~lhli~e-l Although the embo~limçnt of Figure 1 has been shown with Alte..~ g cul~ent generator 26 and direct ~ullen~ generator 34 as separate units, it is ~A~rcssly S contemplated that both units, as well as interface 32 together with an impe-lAnce detection circuit as described above, will be integrally incorporated within a single circuit. The impedance detector subcircuit thus automAtic~Ally will turn off theAltel..~l;,,~ cullellt signal and activate the direct current signal to detach the GDC
coil 14. In this emborliment~ the operator, after setting the initial pa.~Lueters, need 10 only then to turn on a single activate switch to cycle through a complete procedure.
Acoustic or audio visual fee~1b~ can be provided to display both 2lte~ l;..g ~;ulrelll vessel occlusion and det~chme-nt of GDC coil 14. For example, both thedirect cullelll and Altern~ting ~ le-ll components of the signal may be digitally generated through a personal colllpù~er soflware controlled interface. Power levels are low, being typically in the range of 0.1 to 20 watts so that the use of broAdb3n~
generators is feasible. ~lte~ n~ l ;vely, interface 32 may be used to selectively couple two or more s~alale generators to catheter 12 to completely cover the desire freq~lency bands liccllcced above.
While a convt;~-l;onAl guide~-vire 22 is adequate for ~ ",;Ccion of direct 20 cullclll to MHz ci~A1c, it is conceivable that power losses at higher frequen~ies in ~e GHz bands may become unacceptable. Therefore, guidewire æ in these cases may be Alte~..At;vely fAbri~te~l in the form of a flçYible micro-coaxial cable, ~uc~owave ll~n~...ic~ion strirline or other ll~"~",;c~ion means now known or later devised as may be ~plopliate for carrying the power levels and frequ~o-nriçs 25 .lisclosed ~ ,, 9 216 0 6 4 G~lglito.lmi et al. (U

.

Many alterations and mo~lifi-~tions may be made by those having ordinary skill in the art without departing from the spilit and scope of the invention.
Therefore, it must be understood that the illustrated embodiment has been set forth only for the purposes o example and that it should not be taken as limiting the5 invention as defined by the following claims.
The words used in this speçific~tion to describe the invention and its various embo~limentc are to be understood not only in the sense of their commonly defined me~ , but to include by special definition structure, material or acts beyond the scope of the commonly defined me~ningc The definitions of the words or elelnent~10 of the following claims are, therefore, defined in this specific~tion to in~ 1e not only the co.~.~ination of elements which are literally set forth, but all equivalent structure, m~teri~l or acts for pe.fio-...;n~ subst~nti~lly the same function insubst~nti~lly the same way to obtain sllbst~nti~lly the same result.
In addition to the equivalents of the claimed elemçntc, obvious substtt~ltion~
15 now or later known to one with ordinary skill in the art are defined to be within the scope of the ~lefine~l elemen-s The claims are thus to be understood to inclll~e what is specifir~lly ated and described above, what is conceptionally equivalent, what can be obviously substituted and also what essenti~lly incorporates the essential idea of the 20 invention.

Claims (21)

1. An apparatus for selectively providing endovascular occlusion in a patient comprising:
a delivery wire guidable to or near an endovascular occlusion site;

a detachable coil temporarily and selectively coupled to said delivery wire;
and an alternating current generator selectively coupled to said detachable coil, whereby a controllable occlusive apparatus efficacious and usable in small vessels is provided.
2. The apparatus of Claim 1 further comprising:
a direct current generator selectively coupled to said detachable coil; and a switch for selectively coupling said alternating current generator and direct current generator to said detachable coil.
3. The apparatus of Claim 1 wherein said coil is a GDC coil.
4. The apparatus of Claim 1 wherein said alternating current generator is variably controllable.
5. The apparatus of Claim 2 wherein said direct current generator is variably controllable.
6. The apparatus of Claim 2 wherein, said alternating and direct current generators are variably controllable.
7. The apparatus of Claim 4 wherein said controllable alternating current generator is frequency controllable.
8. The apparatus of Claim 1 further comprising a sensing circuit for determining when a predetermined state of electrocoagulation is achieved at or near said detachable coil.
9. The apparatus of Claim 8 wherein said sensing circuit senses impedance of said detachable coil within said patient.
10. The apparatus of Claim 8 further comprising a control circuit for selectively initiating detachment of said coil when said sensing circuit determines said predetermined state of electrocoagulation has been achieved.
11. The apparatus of Claim 1 wherein said alternating current generator serves to ohmically heat said detachable coil and surrounding blood tissues.
12. The apparatus of Claim 1 wherein said alternating current generator serves dielectricly heat said detachable coil and surrounding blood tissues at a radio frequency.
13. An apparatus for creating an endovascular occlusion at a selectively occlusion site comprising:
a conductive delivery wire;

a selectively disposable and detachable conductive coil coupled to said delivery wire and disposable by said delivery wire at or near said occlusion site; and an alternating current signal source electrically coupled to said delivery wire and coil for providing a source of heating energy at said coil, whereby said apparatus is a controllable occlusive device usable and efficacious in small vessels.
14. The apparatus of Claim 13 wherein said detachable coil is a GDC coil.
15. The apparatus of Claim 13 wherein said detachable coil is electrolytically detachable.
16. The apparatus of Claim 13 wherein said detachable coil is mechanically detachable.
17. The apparatus of Claim 13 wherein said alternating current signal source is a radio frequency signal source.
18. The apparatus of Claim 13 further comprising a control circuit for determining when a predetermined degree of electrocoagulation has occurred at said coil and then for detaching said coil from said delivery wire.
19. The apparatus of Claim 18 further comprising a direct current signal source electrically coupled to said detachable coil and wherein said control circuit turns said alternating current signal source off when said predetermineddegree of electrocoagulation has occurred and turns said direct current signal source on to detach said coil from said delivery wire.
20. A method of forming a vascular occlusion comprising:
providing a conductive delivery wire;

disposing a conductive coil coupled to said delivery wire at or near a selected occlusion site;
applying an alternating current to said coil to coagulate said occlusion site;

determining whether a predetermined amount of electrocoagulation has occurred at said occlusion site;

terminating said alternating current through said coil when said step of determining establishes that said predetermined electrocoagulation has occurred;and detaching said coil from said delivery wire to leave said coil at said occlusionsite, whereby an occlusion is efficaciously provided in a small vessel.
21. The method of Claim 20 where detaching said coil from said delivery wire comprises automatically electrolytically separating said coil from said delivery wire.
CA002160640A 1994-10-17 1995-10-16 Detachable endovascular occlusion device activated by alternating electric current Abandoned CA2160640A1 (en)

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US08/323,662 US5569245A (en) 1990-03-13 1994-10-17 Detachable endovascular occlusion device activated by alternating electric current
US08/323,662 1994-10-17

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JP (1) JP3871070B2 (en)
AT (1) ATE199307T1 (en)
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EP0707830A1 (en) 1996-04-24
JPH08196544A (en) 1996-08-06
US5569245A (en) 1996-10-29
DE69520186D1 (en) 2001-04-05
EP0707830B1 (en) 2001-02-28
IL115609A (en) 1999-07-14
AU704583B2 (en) 1999-04-29
TW340793B (en) 1998-09-21
ATE199307T1 (en) 2001-03-15
JP3871070B2 (en) 2007-01-24
DE69520186T2 (en) 2001-06-21
IL115609A0 (en) 1996-01-19
AU3429195A (en) 1996-05-02

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