CA2392194A1 - Loop structures for supporting diagnostic and therapeutic elements in contact with body tissue and expandable push devices for use with same - Google Patents

Loop structures for supporting diagnostic and therapeutic elements in contact with body tissue and expandable push devices for use with same Download PDF

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Publication number
CA2392194A1
CA2392194A1 CA002392194A CA2392194A CA2392194A1 CA 2392194 A1 CA2392194 A1 CA 2392194A1 CA 002392194 A CA002392194 A CA 002392194A CA 2392194 A CA2392194 A CA 2392194A CA 2392194 A1 CA2392194 A1 CA 2392194A1
Authority
CA
Canada
Prior art keywords
probe
defines
sheath
expandable push
distal
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.)
Granted
Application number
CA002392194A
Other languages
French (fr)
Other versions
CA2392194C (en
Inventor
Thomas R. Jenkins
Russell B. Thompson
Robert Burnside
Anant V. Hegde
David K. Swanson
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.)
Boston Scientific Ltd Barbados
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Individual
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 Individual filed Critical Individual
Publication of CA2392194A1 publication Critical patent/CA2392194A1/en
Application granted granted Critical
Publication of CA2392194C publication Critical patent/CA2392194C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

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Classifications

    • 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
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • 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
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00107Coatings on the energy applicator
    • 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
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00214Expandable means emitting energy, e.g. by elements carried thereon
    • 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
    • A61B2018/00053Mechanical features of the instrument of device
    • A61B2018/00273Anchoring means for temporary attachment of a device to tissue
    • A61B2018/00279Anchoring means for temporary attachment of a device to tissue deployable
    • A61B2018/00285Balloons
    • 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
    • A61B2018/00315Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345Vascular system
    • A61B2018/00351Heart
    • 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
    • A61B2018/00571Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00577Ablation
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00791Temperature
    • A61B2018/00797Temperature measured by multiple temperature sensors
    • 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
    • A61B2018/00636Sensing and controlling the application of energy
    • A61B2018/00773Sensed parameters
    • A61B2018/00839Bioelectrical parameters, e.g. ECG, EEG
    • 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
    • A61B2018/1407Loop

Abstract

An apparatus that facilitates the creation of circumferential lesions in bod y tissue. The apparatus includes a first probe having a loop structure that supports electrodes or other operative elements against the body tissue and a second probe with an expandable push structure that may be used to urge the loop structure against body tissue.

Claims (47)

1. An apparatus, comprising:
a first probe including a first probe body defining a proximal portion and a distal portion and a loop structure associated with the distal portion;
at least one operative element associated with the loop structure; and a second probe including a second probe body defining a proximal portion and a distal portion and an expandable push structure associated with the distal portion.
2. An apparatus as claimed in claim 1, wherein at least one of the first and second probe bodies comprises a catheter body.
3. An apparatus as claimed in claim 1, wherein the first probe body defines a distal end and the loop structure is associated with the distal end of the first probe body.
4. An apparatus as claimed in claim 1, wherein the loop structure defines an opening having a width, the expandable push structure defines a maximum width and the maximum width of the expandable push structure is greater than the width of the opening.
5. An apparatus as claimed in claim 1, wherein the at least one operative element comprises a plurality of spaced electrodes.
6. An apparatus as claimed in claim 1, wherein the proximal portion of the first probe body is less flexible than the distal portion of the first probe body.
7. An apparatus as claimed in claim 1, wherein the first probe body defines a longitudinal axis and the loop structure defines a plane oriented at a non-zero angle to the longitudinal axis.
8. An apparatus as claimed in claim 7, wherein the plane is perpendicular to the longitudinal axis.
9. An apparatus as claimed in claim 1, wherein the first probe body defines a distal end and includes a pull wire extending distally from the distal end.
10. An apparatus as claimed in claim 9, wherein the first probe body defines an aperture located in spaced relation to the distal end and the pull wire extends into the aperture and to the proximal portion of the first probe body.
11. An apparatus as claimed in claim 9, wherein the first probe includes a sheath, the first probe body is located at least partially within the sheath and defines an exterior, and the pull wire extends into the sheath and to the proximal portion of the first probe body along the exterior.
12. An apparatus as claimed in claim 1, wherein the loop structure defines a closed loop.
13. An apparatus as claimed in claim 12, wherein the distal portion of the first probe body defines an aperture and the closed loop passes through the aperture.
14. An apparatus as claimed in claim 12, wherein the closed loop is fixedly secured to the distal portion of the first probe body.
15. An apparatus as claimed in claim 1, wherein the expandable push structure comprises a basket structure including a plurality of flexible splines.
16. An apparatus as claimed in claim 15, wherein second probe body defines a longitudinal axis and the splines are symmetrically spaced about the longitudinal axis.
17. An apparatus as claimed in claim 15, wherein the basket structure defines a generally ellipsoidal shape.
18. An apparatus as claimed in claim 15, wherein the basket structure defines a generally spheroidal shape.
19. An apparatus as claimed in claim 15, wherein the basket structure includes a conical portion and a flared portion.
20. An apparatus as claimed in claim 15, wherein the basket structure defines a funnel shape.
21. An apparatus as claimed in claim 1, wherein the expandable push structure comprises an inflatable structure.
22. An apparatus as claimed in claim 21, wherein the second probe includes an infusion lumen operatively connected to the inflatable structure.
23. An apparatus as claimed in claim 21, wherein the inflatable structure defines a spherical shape.
24. An apparatus as claimed in claim 21, wherein the inflatable structure includes a plurality of radially extending members.
25. An apparatus as claimed in claim 21, wherein the inflatable structure defines an ellipso-toroidal shape.
26. An apparatus as claimed in claim 1, wherein the second probe body defines a longitudinally extending lumen and a distal opening associated with the lumen.
27. An apparatus as claimed in claim 26, wherein the second probe body defines a distal end and the expandable push structure comprises a plurality of arms that bow outwardly when the proximal portion and distal end of the second probe body are moved closer together.
28. An apparatus as claimed in claim 26, wherein the expandable push structure comprises an inflatable push structure.
29. An apparatus as claimed in claim 1, wherein the second probe includes an anchor distal of the expandable push structure.
30. An apparatus as claimed in claim 29, further comprising:
a diagnostic device carried by the anchor.
31. A method of forming a lesion in body tissue, comprising the steps of:
positioning a first probe including a first probe body defining a proximal portion and a distal portion, a loop structure associated with the distal portion, and at least one operative element associated with the loop structure such that the loop structure is at least adjacent the tissue;
positioning a second probe including a second probe body defining a proximal portion and a distal portion and an expandable push structure associated with the distal portion such that the expandable push structure is adjacent the loop structure; and urging the loop structure in the direction of the tissue with the expandable push structure.
32. A method as claimed in claim 31, further comprising the step of:
inserting a predetermined portion of the second probe through the loop structure.
33. A method as claimed in claim 32, further comprising the step of:
inserting the first and second probes into a sheath.
34. A method as claimed in claim 32, wherein the tissue is associated with a body orifice, the method further comprising the step of:
inserting the predetermined portion of the second probe into body orifice.
35. A method as claimed in claim 31, further comprising the step of:
inserting a predetermined portion of the second probe through the loop structure prior to positioning the first probe adjacent the body tissue.
36. A method as claimed in claim 31, wherein the step of positioning a first probe adjacent tissue comprises positioning the first probe adjacent heart tissue or adjacent pulmonary vein tissue.
37. A method as claimed in claim 31, wherein the step of positioning a first probe adjacent tissue comprises passing the first probe through a lumen in the second probe.
38. A sheath use with a probe including at least one operative element, the sheath comprising:
an elongate body defining a probe lumen, a proximal portion, a distal portion, and a distal opening; and an expandable push structure associated with the distal portion.
39. A sheath as claimed in claim 38, wherein the elongate body defines a distal end and the expandable push structure is located in spaced relation to the distal end.
40. A sheat as claimed in claim 38, wherein the elongate body includes an anchor distal of the expandable push structure.
41. A sheath as claimed in claim 40, further comprising:
a diagnostic device carried by the anchor.
42. A sheath as claimed in claim 38, wherein the expandable push structure comprises a basket structure including a plurality of flexible splines.
43. A sheath as claimed in claim 42, wherein elongate body defines a longitudinal axis and the splines are symmetrically spaced about the longitudinal axis.
44. A sheath as claimed in claim 38, wherein the expandable push structure comprises an inflatable structure.
45. A sheath as claimed in claim 44, wherein the elongate body includes an infusion lumen operatively connected to the inflatable structure.
46. A sheath as claimed in claim 44, wherein the inflatable structure defines an ellipso-toroidal shape.
47. A sheath as claimed in claim 38, wherein the elongate body defines a distal end and the expandable push structure comprises a plurality of arms that bow outwardly when the proximal portion and distal end of the second probe body are moved closer together.
CA2392194A 1999-11-22 2000-11-22 Loop structures for supporting diagnostic and therapeutic elements in contact with body tissue and expandable push devices for use with same Expired - Fee Related CA2392194C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US09/447,180 US6645199B1 (en) 1999-11-22 1999-11-22 Loop structures for supporting diagnostic and therapeutic elements contact with body tissue and expandable push devices for use with same
US09/447,180 1999-11-22
PCT/EP2000/011638 WO2001037925A2 (en) 1999-11-22 2000-11-22 Atrial annulus ablation loop with expandable pusher

Publications (2)

Publication Number Publication Date
CA2392194A1 true CA2392194A1 (en) 2001-05-31
CA2392194C CA2392194C (en) 2010-10-26

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Family Applications (1)

Application Number Title Priority Date Filing Date
CA2392194A Expired - Fee Related CA2392194C (en) 1999-11-22 2000-11-22 Loop structures for supporting diagnostic and therapeutic elements in contact with body tissue and expandable push devices for use with same

Country Status (8)

Country Link
US (2) US6645199B1 (en)
EP (1) EP1233717B1 (en)
JP (1) JP4404513B2 (en)
AT (1) ATE336955T1 (en)
CA (1) CA2392194C (en)
DE (1) DE60030314T2 (en)
ES (1) ES2270892T3 (en)
WO (1) WO2001037925A2 (en)

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WO2001037925A3 (en) 2001-12-13
ES2270892T3 (en) 2007-04-16
EP1233717A2 (en) 2002-08-28
JP2003514635A (en) 2003-04-22
US20040059327A1 (en) 2004-03-25
ATE336955T1 (en) 2006-09-15
US6645199B1 (en) 2003-11-11
DE60030314D1 (en) 2006-10-05
DE60030314T2 (en) 2007-08-23
US6908464B2 (en) 2005-06-21
EP1233717B1 (en) 2006-08-23
WO2001037925A2 (en) 2001-05-31
CA2392194C (en) 2010-10-26
JP4404513B2 (en) 2010-01-27

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