CA2651032A1 - Control of arterial smooth muscle tone - Google Patents
Control of arterial smooth muscle tone Download PDFInfo
- Publication number
- CA2651032A1 CA2651032A1 CA002651032A CA2651032A CA2651032A1 CA 2651032 A1 CA2651032 A1 CA 2651032A1 CA 002651032 A CA002651032 A CA 002651032A CA 2651032 A CA2651032 A CA 2651032A CA 2651032 A1 CA2651032 A1 CA 2651032A1
- Authority
- CA
- Canada
- Prior art keywords
- electrode
- waveform
- controller
- bed
- generating
- 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
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36014—External stimulators, e.g. with patch electrodes
- A61N1/36017—External stimulators, e.g. with patch electrodes with leads or electrodes penetrating the skin
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/36007—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation of urogenital or gastrointestinal organs, e.g. for incontinence control
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/3605—Implantable neurostimulators for stimulating central or peripheral nerve system
- A61N1/3606—Implantable neurostimulators for stimulating central or peripheral nerve system adapted for a particular treatment
- A61N1/36114—Cardiac control, e.g. by vagal stimulation
- A61N1/36117—Cardiac control, e.g. by vagal stimulation for treating hypertension
Abstract
An apparatus for locally controlling smooth muscle tone includes a first electrode for insertion into an artery; a barrier for preventing the first electrode from contacting an arterial wall; a second electrode; a power supply; and a controller for coupling the power supply to the electrodes. The controller is configured to cause the electrode to maintain a waveform for controlling polarization of smooth muscle tone.
Description
CONTROL OF AR~ERIAL+ SMOOT~J MUS~.~LE l'ONE
~ ft.U) OF DISCLOSURE
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1 ;.,i_ diJc.,loaurc:=elat.i;s to F'x7 ~eti,c<3l dcvFc<: s, ..i~,i.i w Fll paF'LF~; ~ ~ ~GZ c~<., !Y-BACKGR~.'~'t'ND
:' ' <Fz"<.F.<-.. ~ ~`~ ,, u;-ll <. >J (collectively "t~ ' . Ct: t Fs "<~. =
- ~,~F~t,.,.~1.t ; ~+ > ,..,.,_' ) Ãl:~. . ,~~F,~'~i,~., , 'x" : =. ,~z.t~F ~<..~~. Ã'+.~:S..IFi.~ ,.. ...~.,.t. <'t ~7,~t?~F ;~ `tõ is L' i?i'F~4 33`~ ~a eci 4~r`,tll sT?1C]t1ti1 i711F4t:lS', r. ~1:y i`z..,i}iFt'# $t.:.~:?i:~.~. ~,;?,%iIe$.~.:~ ~::~G~
filo4W' a3 ,3:.iitt`<l i~looiz. R.cla.<,.Ft:i?I t)fthL 6F?7oi:4ffi t?:.?sLle dflcF.i<, ,:xiÃ:c;,i, :?i;#:il v.., st'l pi.,i.?.,;i:.Fl:,,~?firs.e ila;Li' of blood. Contraction of t}?c ?'2fz}f:,'slb, z%oi3'SF'sÃ'f..c`.s fll:~
l .uc~c? blood vetistil., t;3C ..t'i bL' L`;a`:$`Fr1,>õtn~ thc. tl(`?w C?f blood, R,..l.:,xabon_ and cl?':.?,'act.FiS? ii}? ~F~?i?iD~i3 1?Su.1el. also ,.?
1v~' 'i?a? S'..~. i:3 o,F: blood ,3f e,.<tÃ;>.<., x~: ~ ~? ~t:<Fa .?1c~F`e: si's, ti1:. t'f?:ltÃi?.3e of tile arterial ;"3l,. r3<: .=!i.ss11 tht.Fory = 't c) ,l ` f 7 \ ;<'. Such :?~it .Ã.~ ~i''l. "> `} ^\`~a.:~s i i.Fr`~. ~\c``~Iu said ~ii. `} ~3k .y= : . < ~r Fi.Le..F:..,.,- ~ :f L ti~ ~I'~:=.>~~., ~ ~`:<?i2+~"i3.~w:`i;aFÃ:, 1'cL.Li,cZ\ Elw v<?linrac of tlif:: ekFf-1-m< iblof>t-, vi;s:ii.l, thereby Fw.+`-efks#FtC blood F,?'-~::~4F,w"C;.
... .4= . . ., SFfirA blLiiF.: vessels Fl'c 4i3Fd to be "L':Fsocof39t1k.tcd:'=
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~t:~~. a F~ z: .FÃ. i-.r .:a~?~t = counteract this 5~.:.t~?<.Il~', ~:.
,.i~.Fi=~F~ts:I~:~t. F..~.`'~ .;~'S ~F ~..Z'4 33`.h ,nuscls..!i thr.',Flg"Ilti..lt #.i:.Ich C?ftt3.e vasea Aa:. s<%saem it?
S..iintF: ..~.. :11w msLFft ~4Slf iF# ~i. S'= 4a>'L?co,.1td.FL:-t(?i1. Ti::3w3 blood pT'`vxz'sl..1F'c.
A..?.>?:.?g f1hi` \,aSt?Z,.xFS~fici<:d i3.I't+..:ÃF~l biot;d vt,'sJois zl.e z.1e reÃ...,= z!ir. y,.,,iC: It:i c?JS.?cia35'C_.1e? i11 :lli,Fi?les. CoÃ3""'53'Fc1Fi#n r?~ th Jd: aF'tLf1'<Fl blZ:ui., viJ ck ?zi#.,t?oYS :#e .-~:~ .`L: i~ i~i~ t ' a. Z= ~~.lF y? 2\. :~cn,,.ova.. N TC.:.4.=:JZ f. > 6.
CFraui~'~t,~~~.? blood T ~?A J. ~A1,..:~,~cF~SL.:i .. ~. t vv~-<?s?
.,:
..~.~. i>.'3 EF~~hfs.i. : ~ 7 ~~F ?;:~.. ~d 11*.?m~.;;l lm; 3s, .E a?Z`= .`;-:Fn, :vx3it :F is already in wi:ki'-eF?.#<~3 l{'=W.i ??F.in}, i;`g t; ww`t`1ty t?f'blF:>C1d. .'s4 ,F I::SLIFt, th1S t ~,Lt,sB `C`.<3i?d c:Ln c3C;<::.Fm1...latc in thc 33':,,alt 'sFrlii i..FuSt.'= thi."~`= 1--lf_'.F?rt to p#.Finp, less 0111'Fu=nI.> : >..:: .Fdd;t;oFl. ~Z..3:i:`
c,iE.f.ss ?AL,,i..:F, .i_A=4-f.;u& Aj~S.is tS[r4 .t=i.r~'JF:}~~11lr ii.5 j,?12ffix`Fnaiy 4'ong\-s.~.o3: w1h2c.rT?
v Fz? 1F2iF'`;1 F,? zti' i:si,.l5t~ divv ',`Ii:a`ChFt.a;?;.
It is p-a. :aii`kC to pr;wis= d-ruf?S iEAi~: ~`Ctdti4f blood pr( s;iurC, a;iii tc~C<\ :Wt .a'Y'S.ti'm c.`.,,,Y <^i3?'d ffis..ef:3ro c{)iiii¾:Lr i:tetwhat Is, f{??'.~.3io4t pait4 <:. ti;e `!:'tL:i'3 3 4ShtcF]`f, an {,ffc.cFve Ã;4Ax3:-1:ie ti` i.hc drop ?:n bi{1o's.i pressure caused h{.2f ~
.1.,.#?#F'e.
It ..s u,s{3 known that sF37o{3Ih muSdc ti9F'ie T1aav t?i' locally con`..offle' by S ct?.#tacLi#i;õ flne aFtofial wGF12 with an cloct#.ode ai?d I?ro} td#n;:,#:
a, swit;a?lo e"ek t#ical sfi FI3ul's.`3iFt?,.# zH4?wev..i', this Fo`ti{u:I"i,s tS:1c3.t t io arterial :}F{>Ã?{3 vt.S`:{'z be : :i:'g{ a .~SS3: ~: t{:
pealn;t of an t;li.'.ct'.'i?d::< As s:, i'mllt., 1#, is dif:;.~Ã{;t1lt ti?
.z:i<7 this ti_.et:.^.t?d E:i`s S.?':Z?l?th .. i....:da. t<?:?:a . i# ttie .3 t`x':it',?le8. M.SF eC?i'iwI',!
there #i?'=e cF t C.a`.'. I'#`.FiF y <.l.F ti.r!o3t::s that will nv~t> to bu ;Y3..4?#:ME?tc:'.d. A proc:de.#E'e flha't T%'3#cs, z#r). 4s,3?3~ 3i ##Fzt~ the tsY1lz o#. 4~.cA#
c ,lf~.:# ~tF .Y.x<?l ;:'{'?uld _hL:fi be iii> p1aC'fle#:L
SUM:NN'.tARY OF ~~ VE`+ IlON
.x \:V =\ ;I?lVC1',.:t#.oi't is based ~ uIi Ãhy . F.'G F. . 2 f i'.
`'. ~4+..i.1~F:i#~'i~~l..~:~E C;{;G=i:ii.Ji. ax? Y`(.t?t?^':, ~,~~:,i;.~x14<..a;v 4,.FTF{?fF.zt.v:'. L?#3i'. caIl i fllo{;,t3Gi=iy c.;F{;1{nebFSE F>?4ti #{tii}:.s to smooth _2#F:sdc .Fs::Io i# xTatiõ
~ ffia' ,.ii"=fa.ifF> baos,Yd vs:.,.sels Uti?~~nf; the blood vesSE:'ls txlemsd44 as a 4aFaiii:Fe? I 3e3:J ?s, a4'ai#i,;f'fi:`,d by identifying t[^c loc~c^a{t`:I)1a of oIi(, or '3.1?t3a4 tai"i,ttod. ="3>~Fs?a:
~ r a c: the ~ia4l`~ t.a?i: ~:i<~C aÃI~; a .3 ;x of oli'.{ tLl?+~C'=S in such zi i tF.ti ~?~Fit t~..~ ma.ica ~#. of ;..:xFSt F`~1,a<Ãn L
' and ft>, u.iF.`.".t.4'i% ';1mvE#3g ;?ewci;I3 the two electrodes 1.3f:;~"t:Ed~.'s, the targeted z3d'<?o,a :i, {snti aiSMei i= the :,i3b:`#:d4>.3 t4:itaFlF`L:s :iu i?.#,p:.`+zcFE.3S
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~ ft.U) OF DISCLOSURE
?LF~.<3F', ii. ~:,.<. ~ f..,.
1 ;.,i_ diJc.,loaurc:=elat.i;s to F'x7 ~eti,c<3l dcvFc<: s, ..i~,i.i w Fll paF'LF~; ~ ~ ~GZ c~<., !Y-BACKGR~.'~'t'ND
:' ' <Fz"<.F.<-.. ~ ~`~ ,, u;-ll <. >J (collectively "t~ ' . Ct: t Fs "<~. =
- ~,~F~t,.,.~1.t ; ~+ > ,..,.,_' ) Ãl:~. . ,~~F,~'~i,~., , 'x" : =. ,~z.t~F ~<..~~. Ã'+.~:S..IFi.~ ,.. ...~.,.t. <'t ~7,~t?~F ;~ `tõ is L' i?i'F~4 33`~ ~a eci 4~r`,tll sT?1C]t1ti1 i711F4t:lS', r. ~1:y i`z..,i}iFt'# $t.:.~:?i:~.~. ~,;?,%iIe$.~.:~ ~::~G~
filo4W' a3 ,3:.iitt`<l i~looiz. R.cla.<,.Ft:i?I t)fthL 6F?7oi:4ffi t?:.?sLle dflcF.i<, ,:xiÃ:c;,i, :?i;#:il v.., st'l pi.,i.?.,;i:.Fl:,,~?firs.e ila;Li' of blood. Contraction of t}?c ?'2fz}f:,'slb, z%oi3'SF'sÃ'f..c`.s fll:~
l .uc~c? blood vetistil., t;3C ..t'i bL' L`;a`:$`Fr1,>õtn~ thc. tl(`?w C?f blood, R,..l.:,xabon_ and cl?':.?,'act.FiS? ii}? ~F~?i?iD~i3 1?Su.1el. also ,.?
1v~' 'i?a? S'..~. i:3 o,F: blood ,3f e,.<tÃ;>.<., x~: ~ ~? ~t:<Fa .?1c~F`e: si's, ti1:. t'f?:ltÃi?.3e of tile arterial ;"3l,. r3<: .=!i.ss11 tht.Fory = 't c) ,l ` f 7 \ ;<'. Such :?~it .Ã.~ ~i''l. "> `} ^\`~a.:~s i i.Fr`~. ~\c``~Iu said ~ii. `} ~3k .y= : . < ~r Fi.Le..F:..,.,- ~ :f L ti~ ~I'~:=.>~~., ~ ~`:<?i2+~"i3.~w:`i;aFÃ:, 1'cL.Li,cZ\ Elw v<?linrac of tlif:: ekFf-1-m< iblof>t-, vi;s:ii.l, thereby Fw.+`-efks#FtC blood F,?'-~::~4F,w"C;.
... .4= . . ., SFfirA blLiiF.: vessels Fl'c 4i3Fd to be "L':Fsocof39t1k.tcd:'=
`>.>f1 :E:=iS~ a w a a ' .. >>
3t. ~~t~ ~?i,., r~rt attack, a '~~.Ili~Ã..1 y- i:x.;,v ;~ for blood to .? r < t",~~ ` F3.~4~ a. 5 YÃ.-<= w) :,ts.
~t:~~. a F~ z: .FÃ. i-.r .:a~?~t = counteract this 5~.:.t~?<.Il~', ~:.
,.i~.Fi=~F~ts:I~:~t. F..~.`'~ .;~'S ~F ~..Z'4 33`.h ,nuscls..!i thr.',Flg"Ilti..lt #.i:.Ich C?ftt3.e vasea Aa:. s<%saem it?
S..iintF: ..~.. :11w msLFft ~4Slf iF# ~i. S'= 4a>'L?co,.1td.FL:-t(?i1. Ti::3w3 blood pT'`vxz'sl..1F'c.
A..?.>?:.?g f1hi` \,aSt?Z,.xFS~fici<:d i3.I't+..:ÃF~l biot;d vt,'sJois zl.e z.1e reÃ...,= z!ir. y,.,,iC: It:i c?JS.?cia35'C_.1e? i11 :lli,Fi?les. CoÃ3""'53'Fc1Fi#n r?~ th Jd: aF'tLf1'<Fl blZ:ui., viJ ck ?zi#.,t?oYS :#e .-~:~ .`L: i~ i~i~ t ' a. Z= ~~.lF y? 2\. :~cn,,.ova.. N TC.:.4.=:JZ f. > 6.
CFraui~'~t,~~~.? blood T ~?A J. ~A1,..:~,~cF~SL.:i .. ~. t vv~-<?s?
.,:
..~.~. i>.'3 EF~~hfs.i. : ~ 7 ~~F ?;:~.. ~d 11*.?m~.;;l lm; 3s, .E a?Z`= .`;-:Fn, :vx3it :F is already in wi:ki'-eF?.#<~3 l{'=W.i ??F.in}, i;`g t; ww`t`1ty t?f'blF:>C1d. .'s4 ,F I::SLIFt, th1S t ~,Lt,sB `C`.<3i?d c:Ln c3C;<::.Fm1...latc in thc 33':,,alt 'sFrlii i..FuSt.'= thi."~`= 1--lf_'.F?rt to p#.Finp, less 0111'Fu=nI.> : >..:: .Fdd;t;oFl. ~Z..3:i:`
c,iE.f.ss ?AL,,i..:F, .i_A=4-f.;u& Aj~S.is tS[r4 .t=i.r~'JF:}~~11lr ii.5 j,?12ffix`Fnaiy 4'ong\-s.~.o3: w1h2c.rT?
v Fz? 1F2iF'`;1 F,? zti' i:si,.l5t~ divv ',`Ii:a`ChFt.a;?;.
It is p-a. :aii`kC to pr;wis= d-ruf?S iEAi~: ~`Ctdti4f blood pr( s;iurC, a;iii tc~C<\ :Wt .a'Y'S.ti'm c.`.,,,Y <^i3?'d ffis..ef:3ro c{)iiii¾:Lr i:tetwhat Is, f{??'.~.3io4t pait4 <:. ti;e `!:'tL:i'3 3 4ShtcF]`f, an {,ffc.cFve Ã;4Ax3:-1:ie ti` i.hc drop ?:n bi{1o's.i pressure caused h{.2f ~
.1.,.#?#F'e.
It ..s u,s{3 known that sF37o{3Ih muSdc ti9F'ie T1aav t?i' locally con`..offle' by S ct?.#tacLi#i;õ flne aFtofial wGF12 with an cloct#.ode ai?d I?ro} td#n;:,#:
a, swit;a?lo e"ek t#ical sfi FI3ul's.`3iFt?,.# zH4?wev..i', this Fo`ti{u:I"i,s tS:1c3.t t io arterial :}F{>Ã?{3 vt.S`:{'z be : :i:'g{ a .~SS3: ~: t{:
pealn;t of an t;li.'.ct'.'i?d::< As s:, i'mllt., 1#, is dif:;.~Ã{;t1lt ti?
.z:i<7 this ti_.et:.^.t?d E:i`s S.?':Z?l?th .. i....:da. t<?:?:a . i# ttie .3 t`x':it',?le8. M.SF eC?i'iwI',!
there #i?'=e cF t C.a`.'. I'#`.FiF y <.l.F ti.r!o3t::s that will nv~t> to bu ;Y3..4?#:ME?tc:'.d. A proc:de.#E'e flha't T%'3#cs, z#r). 4s,3?3~ 3i ##Fzt~ the tsY1lz o#. 4~.cA#
c ,lf~.:# ~tF .Y.x<?l ;:'{'?uld _hL:fi be iii> p1aC'fle#:L
SUM:NN'.tARY OF ~~ VE`+ IlON
.x \:V =\ ;I?lVC1',.:t#.oi't is based ~ uIi Ãhy . F.'G F. . 2 f i'.
`'. ~4+..i.1~F:i#~'i~~l..~:~E C;{;G=i:ii.Ji. ax? Y`(.t?t?^':, ~,~~:,i;.~x14<..a;v 4,.FTF{?fF.zt.v:'. L?#3i'. caIl i fllo{;,t3Gi=iy c.;F{;1{nebFSE F>?4ti #{tii}:.s to smooth _2#F:sdc .Fs::Io i# xTatiõ
~ ffia' ,.ii"=fa.ifF> baos,Yd vs:.,.sels Uti?~~nf; the blood vesSE:'ls txlemsd44 as a 4aFaiii:Fe? I 3e3:J ?s, a4'ai#i,;f'fi:`,d by identifying t[^c loc~c^a{t`:I)1a of oIi(, or '3.1?t3a4 tai"i,ttod. ="3>~Fs?a:
~ r a c: the ~ia4l`~ t.a?i: ~:i<~C aÃI~; a .3 ;x of oli'.{ tLl?+~C'=S in such zi i tF.ti ~?~Fit t~..~ ma.ica ~#. of ;..:xFSt F`~1,a<Ãn L
' and ft>, u.iF.`.".t.4'i% ';1mvE#3g ;?ewci;I3 the two electrodes 1.3f:;~"t:Ed~.'s, the targeted z3d'<?o,a :i, {snti aiSMei i= the :,i3b:`#:d4>.3 t4:itaFlF`L:s :iu i?.#,p:.`+zcFE.3S
fiby lt?caHL
2 0 sIFFfIi.Aii a3'F{-446{. Ti'1e :'c"3s3ai"aiÃs includes a first t;'lL+:.t:E:#dc for FF>hc..InioI1 xnzfs ~aÃ':
artery; iF 3?u#:`'F{ for a`JiL* 4i?t#nÃ~ thL'. leSt 1' Ei ct3oC~i# ffi').i f?'z3t, iA7l:~,; .a`_.7 .x. ,..x3~E.: ~?`a;i~.~ a \{1Ca?.` i O4arC`.d{:.; a p3wi:l` s(32?:3l4< :F.#::d a +:t1F.It'F`i5?l`~.'F"
ioF' {'.43t1pl ii.`.w :il4 ts::?
y~+i{~' t `wfS 3ui. i= vy' Y~G ~6=\.x?~e`i~C7'ik3 t[~!}i4'4Y to t {.=(SW`~~tt~
Ttw~.'0 ~. n r''}a&.c k. t T5S~.iv.?t32 b s; 3#~ a t s~.4 .t ). ~,. .?:\).\=xlw~\. ~.~ 44 + [~) Ff.
wavdc?ix#. fi); xm..t-.?llF ng Ixr~ariz#itFon of smooth muscle t{?r:e.
b EFi?;): dF, .3'lk'`rli.: ?#?di.l{Af'. ths34f.:.= ,i, '<,xiAi:E.i tl1L'' first i:lE:fi:L_ii'de 3.n{..ald{aL4 x, SF:e#`., and dTstat i:i ? of i: c 1#.1et<:`'.
11-1:t?4c ?lx 4:i ?cI` th{ fi3:t i'lC{=t"fJdC Fa1t S d~s a O.31Ci o!?"..C?diF.?Ien4w flidlat~e thoSz:U: wh1ctidF4 second dot..E..s,3fie x.Fa..t:Edu:i z:i;F,da.iS..t 7Fg p<id:. Ifit.F p.l.taE;'.e#3wii`' C>fi $.3G~ skha of a aa?at#Ã',d,t: and those m ws?.#a a the -sa.L`.o:Fid r C`-~-; -Y t>~:.3CiLs tip ~ ~ a {~!s'~x:J 1aof a Cbi4howi.
c.aL.V.`t.Y.#F.. ,F
~~ua a t3S?t.a ~i ??E't~r7?~ 3?n ~ include thC.3y(,. in stent i y E 3 [
L.<'.s~i;l:3?g a a{:Ã~.b?~.~~t). ~ia_.G3~=ii~~~._'' ih~a. ~?Ã~si ~`3l'ttrti\3t;~g those ~{;~i.~n?vhi3?.'Ubw.r.\.r ?.aoIvde'.~`~. a x?(?w'hintf S?,.rits..i??ffing :h`~..' fisÃ' ~.'li'L:txY?deg those in which pl3:i .3c]_I'i'?~=~ includes a +.'.ap s?E?i"331.d ndn g ta.. 'Ãf":~. +:'.lt.'.~oi.Ã~~o:,~?,`.. and those .if.i ~~='..~?1L;~1 ~.'~`~ti~ barrier ~.35..;+ #<~~.` a i?.1.r i3.3.r: bw:23sy(:=ns +.33spL)scd iJ.i sl'hi,'3 sido of the E..'3eÃ:=Ã'?.?de, .3.i?ao;irt.: fni 'vt3õÃL'us .:,nfl:3;3d1?;]e1it5 ai"c i.ha?s4: .en wllil`;:l?
:ho oi??t`:C?l,#c' is Ã<)2?.ig:3rt.d' to va<:'=E';iitt. a Wz. v?,'.?ornn ~;%Ãv?ng.pZ3lsUs, of t?luI::'#.Ã`2.it'n,'E: polarity, those .?
Wh:h the c??,t?33:u is tE3??fi?ua"e(~i to iFC i3``;it a 4Ycal>efC?Am Ec3: Ãx?g ~t,r#..l4'L:S s1., es s.n~,,~.s Ix>>saty, c#iid :it]se e..1 which ci>:~;.`i?flu is configured tck g4i:?Cic3.tc a w!'a!'e-fi} a..:i. that #3 s~r?;.s.>~~y ~:~:=c; with t~R~ cx:~?;~.~~ac cycle.
i:,.~3'~''.o F r 3'Jai ~ .,'~~.'F^,n:2 include a 7 0 st.z?ti?3~ '"~ -.t ~I
;?~~ ~ '#: :=4c7 , _.<.~., ~ ~ ic. ~ ~4~~: ?;
;YIz~>i?'laE.=~RFi.a ~,wi...aaÃ'.
~\
~G ' i::iir~E ~ j ~` S'. tti? ~L` S..? Ã.i=t- t i ' Y llf:`i cl.i~il;`f~' a local ~t} i~ ~iil..a i t? "LaacfS: C:~3'.:.i : ti:i~>r ~~ ":' 1C3#' j3i<J k1
artery; iF 3?u#:`'F{ for a`JiL* 4i?t#nÃ~ thL'. leSt 1' Ei ct3oC~i# ffi').i f?'z3t, iA7l:~,; .a`_.7 .x. ,..x3~E.: ~?`a;i~.~ a \{1Ca?.` i O4arC`.d{:.; a p3wi:l` s(32?:3l4< :F.#::d a +:t1F.It'F`i5?l`~.'F"
ioF' {'.43t1pl ii.`.w :il4 ts::?
y~+i{~' t `wfS 3ui. i= vy' Y~G ~6=\.x?~e`i~C7'ik3 t[~!}i4'4Y to t {.=(SW`~~tt~
Ttw~.'0 ~. n r''}a&.c k. t T5S~.iv.?t32 b s; 3#~ a t s~.4 .t ). ~,. .?:\).\=xlw~\. ~.~ 44 + [~) Ff.
wavdc?ix#. fi); xm..t-.?llF ng Ixr~ariz#itFon of smooth muscle t{?r:e.
b EFi?;): dF, .3'lk'`rli.: ?#?di.l{Af'. ths34f.:.= ,i, '<,xiAi:E.i tl1L'' first i:lE:fi:L_ii'de 3.n{..ald{aL4 x, SF:e#`., and dTstat i:i ? of i: c 1#.1et<:`'.
11-1:t?4c ?lx 4:i ?cI` th{ fi3:t i'lC{=t"fJdC Fa1t S d~s a O.31Ci o!?"..C?diF.?Ien4w flidlat~e thoSz:U: wh1ctidF4 second dot..E..s,3fie x.Fa..t:Edu:i z:i;F,da.iS..t 7Fg p<id:. Ifit.F p.l.taE;'.e#3wii`' C>fi $.3G~ skha of a aa?at#Ã',d,t: and those m ws?.#a a the -sa.L`.o:Fid r C`-~-; -Y t>~:.3CiLs tip ~ ~ a {~!s'~x:J 1aof a Cbi4howi.
c.aL.V.`t.Y.#F.. ,F
~~ua a t3S?t.a ~i ??E't~r7?~ 3?n ~ include thC.3y(,. in stent i y E 3 [
L.<'.s~i;l:3?g a a{:Ã~.b?~.~~t). ~ia_.G3~=ii~~~._'' ih~a. ~?Ã~si ~`3l'ttrti\3t;~g those ~{;~i.~n?vhi3?.'Ubw.r.\.r ?.aoIvde'.~`~. a x?(?w'hintf S?,.rits..i??ffing :h`~..' fisÃ' ~.'li'L:txY?deg those in which pl3:i .3c]_I'i'?~=~ includes a +.'.ap s?E?i"331.d ndn g ta.. 'Ãf":~. +:'.lt.'.~oi.Ã~~o:,~?,`.. and those .if.i ~~='..~?1L;~1 ~.'~`~ti~ barrier ~.35..;+ #<~~.` a i?.1.r i3.3.r: bw:23sy(:=ns +.33spL)scd iJ.i sl'hi,'3 sido of the E..'3eÃ:=Ã'?.?de, .3.i?ao;irt.: fni 'vt3õÃL'us .:,nfl:3;3d1?;]e1it5 ai"c i.ha?s4: .en wllil`;:l?
:ho oi??t`:C?l,#c' is Ã<)2?.ig:3rt.d' to va<:'=E';iitt. a Wz. v?,'.?ornn ~;%Ãv?ng.pZ3lsUs, of t?luI::'#.Ã`2.it'n,'E: polarity, those .?
Wh:h the c??,t?33:u is tE3??fi?ua"e(~i to iFC i3``;it a 4Ycal>efC?Am Ec3: Ãx?g ~t,r#..l4'L:S s1., es s.n~,,~.s Ix>>saty, c#iid :it]se e..1 which ci>:~;.`i?flu is configured tck g4i:?Cic3.tc a w!'a!'e-fi} a..:i. that #3 s~r?;.s.>~~y ~:~:=c; with t~R~ cx:~?;~.~~ac cycle.
i:,.~3'~''.o F r 3'Jai ~ .,'~~.'F^,n:2 include a 7 0 st.z?ti?3~ '"~ -.t ~I
;?~~ ~ '#: :=4c7 , _.<.~., ~ ~ ic. ~ ~4~~: ?;
;YIz~>i?'laE.=~RFi.a ~,wi...aaÃ'.
~\
~G ' i::iir~E ~ j ~` S'. tti? ~L` S..? Ã.i=t- t i ' Y llf:`i cl.i~il;`f~' a local ~t} i~ ~iil..a i t? "LaacfS: C:~3'.:.i : ti:i~>r ~~ ":' 1C3#' j3i<J k1
3 .~:.?,~~ v=
t.7 ..
Y '{
of Ã:~ii:Z:t~ p:-~.~ ~3.i3a _t:?..:i~ il3'~~..fi Ei'St electrode.
~I1 z,"af. 4..te:?' i:iJa'.~t`%t, tA <. :3?ve#^.1.f~-;?"? fi~#it1#:i',4 t3 rfei~flawd fi;i rZ:=gEll<fà Iiw; sI.>S3i3I?';
:..?4c, ;:f: .s."3~?~ 4` . ~, sl .?,.s ~.i't~~~.#i#l bed of a ~)i?:Ãoi1t ~~' iÃ;s..`~Ãf3~: a ~'3I'st ~?Lk`~zE;}t~z: ii;`.f.} aun ;,i~"t'..i'~~: ~5l ? ii:; i?ri~.,,c:i".~t. ~3. i.?i~{.~. a second ~:l ~`~,tÃ`i~C~~;. at a .Y.<~C::it.dt?tI SeleL=ss:'d 4,.ich ~ ` .-h~, r::a i ~Ã
~=~i'7?L.Ã3, ~f`t`a>`Ã Ã:a~. ~Ã:`3t va~:Lti+~i~C? tt? . :la~:= 5t'ktv?lÃ.'t electrode tr~tlr`t..a44 t`z; ~. .~:e.wr:.a. >_T~.s ~, r ..2., R ~;~ ., Y - n .F : ''. ` ~~ - r x ~ ~ ~ ~ 4 ~ tXC' ~ t.Ta~.Ii~i~~;; ;:3 ~ C3ÃLw~.L ~ ~ L C:s~?Ã~:; ~t`?..~i 4C`,:' the ~ir~~
ciEsf: ~t;~.=a???t. ~...Z)i iit,f:.`.. ~...t~ . R,3~~,:? ~
WtAVO;.o..31a.` s'Jt?cted ~.53 control polarization C?fS7.?o+: ul zF>w? c WÃtÃ?~.x the .: C, y3r'tefiiaf bcLa.
ztat so3.`s~v s'';`a(.aÃLe< of tl?o 3I` i%o23tE1n, P.'o11d'.ng a i`ti.4::f91.d i`.:5.:0.rzai C' ``a,3rC3t`d>Ãz& a surface e?iyL:t?'ode ff?..'' ple3ceimfi.lt on the P.16i:;f3CS skin, E..#. i?rawaiL "L'ti 3T2i? ` Z?~i Y a sZ.w.t3;Ã., ..~ i ~ , ~~ '~'R i C:.~, l~ .S ~~ t) a s~tik+1.~.. :.3 ~ i ~ ~tC.a;:`C?~a4 i \ + i patient's ~ ea ~.:~'Z?tiL~ ia~[:=~a3~.s,~it,.i~Ã:`Ã,.,~. ..~~ t +ric:3i1:=1l~s ve# ia.
25 . ~R,o .?'.ie ? .aL:Ã:it.s.'s of the invention also i?L:l?.id+,' swzea'':=tzi g ?:`so to be a .w'=2?.a~
at{ :i e', \C le4ta?õ ??v location of the second 4'lE 4=e?s`_iEi to be `~c,.`, cz`.f~i +?i.~t.?: 3.1f YhÃ+ a k1d,aey, A vir""E+,tv A wii-vef3:mi:. (;;.iT4bC: generated. In hoa-A`+..'pr.icttce t gz:,nC at:ng a v Y Z \~2 ' J } i -'~ C2\ 1 4 1. t.
t~~tiri.~_~Y? ~ '4 .~ ~.I~:',';{t...ia ..I +..3U'~~~:4 4} ~C.Ti< ~':~tft.i~.
a ~ i3~e3s,1f .~1"`:i~ i'3~~Y iu.3 ~-;L~::.., l(?sa. C ~..i :I;~ il o1~.al:ing wLc;.e. 3~~i od . 5; ;;enemt.ung a wavofo--#n Mo1u'de: g:nerallng ,3 :
. yC.=~i' t.~~...t tt <: ~'r,sl~Ss t.a~. diastole portion of the .~-~~4t#+:=d~t's :.ilÃ'i.z. kL cE'cli,'.
a Additional practices of i.ht= Ãw'mst1i-u :nG=li.F~le syncNE3.I1z11'ig :h::
">~.,Va:riw.3n' wd1E:;
:' ;~i A :.c2~~#.3r?..t ~.Lrs_2ai.G cycle.
~ { 1~~C r E (t t{1~+,t trt tI T` 3 ~(~[>T t .Z\~r C~:t.Qiv.~} 3~~.~.2 practices iii.clid~.\+ s~'lVVt'52t 1~g f{2(-2 F~= 4( 2~~LLv~`i+.[# S.?Zr'4.i to be i.zSti C3~,lZ~.iL~i. ~,'iv~l. L!SaZ
3t..`b'3;'s a fiu:3it;t, andlo.. 4t:lediI,g the artUr1%ll b[:CF tE,? #.nE
#l.ii' fL.,..=Lai.t14. a ?x3E;rti <au u ila3tL`:i=:?' sP.lec~#.I i. the artei'.i~l. bed to include thi'= p#.=r`#izt: WIt.z.ÃOS:
..( Y'L'%. other ::3:"ii[.t3cot of the hivC:23t13'1 l$3'L;lLId`h."' ob:.i:n:A`g. a mk.c3. ailiC:.~.3wi3:
.~ Y ,?lvZ. ~S.ft,~ ?..t: ~#:A:.i+.. r õ i7 c* G, '... ~.~3t . ~ t~o, i' 1TZ -.
~.3~`a-~~.%1`f;~F.Cly ~~FiÃ~ i ~4:sf~tTi:E~I]~ '# ~1~ '4' C3~ 3.~_ vS`c..
~.3t'r~.3 (:
:ia~3i.isiA:.
.':o f?:k:~\i~..~c~h=~:V~:i~z~~.~`~~it..
Ota3:i:a" a). <i.c.#.ca4 of %bc InL'L.81t;(3n ?f3cltFd4 ~ ~ te= ~ :?~ x o-3~~~1 a ~ ~'~ ~ a~ L= during ~ }' 's ~:el7e~..'t r'~'i t's". ~ ~'1a~ ~r~ 1a.i f :G,:E<at .. ~t }~t i= +.e;~ ;;1~if~.i~~>: :~ "`l~ Z7i~:. ~' i,~i~3, _ qv..,'.i..'.
h i, s.Li. S:, and , <)'L.~C ea `'~ '~'o>..:a ~
1 _15 Od>e~: .,4atuf'cti and fldYsjntagC:s of flne t.3:1va:;xt:ft?n 'tA'ill i`e c;p:?urQ:.z.. zf:?in ti2i:
13.t !`3ng dE:tzt`..G#: fl'w claims, ani.~ the i3E ~ s37I1~3C1I1Sp x1 5pui`~.`':v .}~l w>. ch:
BRIEF DESCRI,PTt.G ti OF THE DRA4V~~~~S
FFGS. 1, 12, and 13 3#1Ciw `at3ii7lt3iC~+t.4?I, 9ysiei1,,s, ~.`i .[{IG: 2 shows a balloon Cin<ilo:ill'Ig the 'C,.=aet:LFs'3de ftLi:.3.
thB.. 4:1T:'x..:lc3:3.#" .,yJwl.i.. of t}- >
i A~ S. Y ~ q Z.w..,. + \~, 1,.}.,~
F_[C>S. 3 wad 4, %t`c lÃx,,.gstuG.lnt?l and t3<].3svCisc of the Nal I i?i;.-u of F `G ' FIG. 5 :?how.4'i.ia ~:.3oi:=t:t3Lte surrounded by Mt C`.age:
H4_>. 6 `::{t;Ls an ~.:lC:ct.(?& surrounded by a }}s.'3.1si#'g>
Sht`.ws E1.Ir 4] o0"`od i'. p31v.emd by a p,it3' a:.i b i.1-n pe#'s, :m;a-1umar eaec;roft5 N~Y_;. 9 S.'#ows ea., i.alectTs3do placed witi"1I;i-1 a lumen taE:.`ez.I\C"L:
by ~~tonl;.
t.7 ..
Y '{
of Ã:~ii:Z:t~ p:-~.~ ~3.i3a _t:?..:i~ il3'~~..fi Ei'St electrode.
~I1 z,"af. 4..te:?' i:iJa'.~t`%t, tA <. :3?ve#^.1.f~-;?"? fi~#it1#:i',4 t3 rfei~flawd fi;i rZ:=gEll<fà Iiw; sI.>S3i3I?';
:..?4c, ;:f: .s."3~?~ 4` . ~, sl .?,.s ~.i't~~~.#i#l bed of a ~)i?:Ãoi1t ~~' iÃ;s..`~Ãf3~: a ~'3I'st ~?Lk`~zE;}t~z: ii;`.f.} aun ;,i~"t'..i'~~: ~5l ? ii:; i?ri~.,,c:i".~t. ~3. i.?i~{.~. a second ~:l ~`~,tÃ`i~C~~;. at a .Y.<~C::it.dt?tI SeleL=ss:'d 4,.ich ~ ` .-h~, r::a i ~Ã
~=~i'7?L.Ã3, ~f`t`a>`Ã Ã:a~. ~Ã:`3t va~:Lti+~i~C? tt? . :la~:= 5t'ktv?lÃ.'t electrode tr~tlr`t..a44 t`z; ~. .~:e.wr:.a. >_T~.s ~, r ..2., R ~;~ ., Y - n .F : ''. ` ~~ - r x ~ ~ ~ ~ 4 ~ tXC' ~ t.Ta~.Ii~i~~;; ;:3 ~ C3ÃLw~.L ~ ~ L C:s~?Ã~:; ~t`?..~i 4C`,:' the ~ir~~
ciEsf: ~t;~.=a???t. ~...Z)i iit,f:.`.. ~...t~ . R,3~~,:? ~
WtAVO;.o..31a.` s'Jt?cted ~.53 control polarization C?fS7.?o+: ul zF>w? c WÃtÃ?~.x the .: C, y3r'tefiiaf bcLa.
ztat so3.`s~v s'';`a(.aÃLe< of tl?o 3I` i%o23tE1n, P.'o11d'.ng a i`ti.4::f91.d i`.:5.:0.rzai C' ``a,3rC3t`d>Ãz& a surface e?iyL:t?'ode ff?..'' ple3ceimfi.lt on the P.16i:;f3CS skin, E..#. i?rawaiL "L'ti 3T2i? ` Z?~i Y a sZ.w.t3;Ã., ..~ i ~ , ~~ '~'R i C:.~, l~ .S ~~ t) a s~tik+1.~.. :.3 ~ i ~ ~tC.a;:`C?~a4 i \ + i patient's ~ ea ~.:~'Z?tiL~ ia~[:=~a3~.s,~it,.i~Ã:`Ã,.,~. ..~~ t +ric:3i1:=1l~s ve# ia.
25 . ~R,o .?'.ie ? .aL:Ã:it.s.'s of the invention also i?L:l?.id+,' swzea'':=tzi g ?:`so to be a .w'=2?.a~
at{ :i e', \C le4ta?õ ??v location of the second 4'lE 4=e?s`_iEi to be `~c,.`, cz`.f~i +?i.~t.?: 3.1f YhÃ+ a k1d,aey, A vir""E+,tv A wii-vef3:mi:. (;;.iT4bC: generated. In hoa-A`+..'pr.icttce t gz:,nC at:ng a v Y Z \~2 ' J } i -'~ C2\ 1 4 1. t.
t~~tiri.~_~Y? ~ '4 .~ ~.I~:',';{t...ia ..I +..3U'~~~:4 4} ~C.Ti< ~':~tft.i~.
a ~ i3~e3s,1f .~1"`:i~ i'3~~Y iu.3 ~-;L~::.., l(?sa. C ~..i :I;~ il o1~.al:ing wLc;.e. 3~~i od . 5; ;;enemt.ung a wavofo--#n Mo1u'de: g:nerallng ,3 :
. yC.=~i' t.~~...t tt <: ~'r,sl~Ss t.a~. diastole portion of the .~-~~4t#+:=d~t's :.ilÃ'i.z. kL cE'cli,'.
a Additional practices of i.ht= Ãw'mst1i-u :nG=li.F~le syncNE3.I1z11'ig :h::
">~.,Va:riw.3n' wd1E:;
:' ;~i A :.c2~~#.3r?..t ~.Lrs_2ai.G cycle.
~ { 1~~C r E (t t{1~+,t trt tI T` 3 ~(~[>T t .Z\~r C~:t.Qiv.~} 3~~.~.2 practices iii.clid~.\+ s~'lVVt'52t 1~g f{2(-2 F~= 4( 2~~LLv~`i+.[# S.?Zr'4.i to be i.zSti C3~,lZ~.iL~i. ~,'iv~l. L!SaZ
3t..`b'3;'s a fiu:3it;t, andlo.. 4t:lediI,g the artUr1%ll b[:CF tE,? #.nE
#l.ii' fL.,..=Lai.t14. a ?x3E;rti <au u ila3tL`:i=:?' sP.lec~#.I i. the artei'.i~l. bed to include thi'= p#.=r`#izt: WIt.z.ÃOS:
..( Y'L'%. other ::3:"ii[.t3cot of the hivC:23t13'1 l$3'L;lLId`h."' ob:.i:n:A`g. a mk.c3. ailiC:.~.3wi3:
.~ Y ,?lvZ. ~S.ft,~ ?..t: ~#:A:.i+.. r õ i7 c* G, '... ~.~3t . ~ t~o, i' 1TZ -.
~.3~`a-~~.%1`f;~F.Cly ~~FiÃ~ i ~4:sf~tTi:E~I]~ '# ~1~ '4' C3~ 3.~_ vS`c..
~.3t'r~.3 (:
:ia~3i.isiA:.
.':o f?:k:~\i~..~c~h=~:V~:i~z~~.~`~~it..
Ota3:i:a" a). <i.c.#.ca4 of %bc InL'L.81t;(3n ?f3cltFd4 ~ ~ te= ~ :?~ x o-3~~~1 a ~ ~'~ ~ a~ L= during ~ }' 's ~:el7e~..'t r'~'i t's". ~ ~'1a~ ~r~ 1a.i f :G,:E<at .. ~t }~t i= +.e;~ ;;1~if~.i~~>: :~ "`l~ Z7i~:. ~' i,~i~3, _ qv..,'.i..'.
h i, s.Li. S:, and , <)'L.~C ea `'~ '~'o>..:a ~
1 _15 Od>e~: .,4atuf'cti and fldYsjntagC:s of flne t.3:1va:;xt:ft?n 'tA'ill i`e c;p:?urQ:.z.. zf:?in ti2i:
13.t !`3ng dE:tzt`..G#: fl'w claims, ani.~ the i3E ~ s37I1~3C1I1Sp x1 5pui`~.`':v .}~l w>. ch:
BRIEF DESCRI,PTt.G ti OF THE DRA4V~~~~S
FFGS. 1, 12, and 13 3#1Ciw `at3ii7lt3iC~+t.4?I, 9ysiei1,,s, ~.`i .[{IG: 2 shows a balloon Cin<ilo:ill'Ig the 'C,.=aet:LFs'3de ftLi:.3.
thB.. 4:1T:'x..:lc3:3.#" .,yJwl.i.. of t}- >
i A~ S. Y ~ q Z.w..,. + \~, 1,.}.,~
F_[C>S. 3 wad 4, %t`c lÃx,,.gstuG.lnt?l and t3<].3svCisc of the Nal I i?i;.-u of F `G ' FIG. 5 :?how.4'i.ia ~:.3oi:=t:t3Lte surrounded by Mt C`.age:
H4_>. 6 `::{t;Ls an ~.:lC:ct.(?& surrounded by a }}s.'3.1si#'g>
Sht`.ws E1.Ir 4] o0"`od i'. p31v.emd by a p,it3' a:.i b i.1-n pe#'s, :m;a-1umar eaec;roft5 N~Y_;. 9 S.'#ows ea., i.alectTs3do placed witi"1I;i-1 a lumen taE:.`ez.I\C"L:
by ~~tonl;.
4
5 PCT/US2007/067989 +'1G, 10 s..owv> z1 s:7`TÃl lai.ÃCZ'n, 4~~st[<hÃ1 fts1t #`s4 j pc1'L'a~ of ~Aoni5 as ~~lecf:'od}v.s, ~-:]~j e .s < \s an y 'L.i~t..Ãi e` jl~ll;.l y~~y[ $f.i2 [, use 3se L -xi~., the ~=, {t ~.~ yRSs i :~:i. `,~\S {~C~~~~t:a. }~ t~~'~.t ~{.~~eCh~rt.i~?Ã' w>~ ~, Z~"~`.i \.}~
ft I (K S, 1, .1'~,..~ an d 13, I Ii>. 14 shows a i:athÃ'4: iÃ:I4extui: iÃiW a bimod vessel.
w~ ~~~ ~ ~~ILED DESCRIPTION
:~..+_Ã,.;'{33 k3ftone iai <1E'k kl?".'cii:;l bed Ft, 11ct.:ei`ed by ius.Fj:;
~ \ ~ { ' ~ 4) the ~ `~~ y ~'',~p (`~"4 t Y ~ ~ is 5 ~Z Afi ...,~.i ti~`~,'S.. v .. ..:~a. ~'~~=. ~ `, ~=~t' ~.i:^i..Zr.~~~~
Lt,a:....4~~~i:a.E .~.~~W. ~.t4= ~t,.= 3.:3~L,~a~r~.., E.~:.~,::.~,=a.?.~
J..~.a~.'~=:~in .3,.dp, .tude to lia...?~ i.~>", 'v~~3Ã'3~~?'t ~. the ~: )L~. e:ll"1:t i3t1C?:.~ C3A fiS21f?:+Ji g~: ,i`z.k:~c,4s t;> s~ f f' ._ . f~~~c:.~:~ 3 .o, r tL-i~?~,+..:`
~, i? t .,a # o.
3?:'.C:i. Depa.iE.In<< on 11sf.. P+?;zS.t ty of flf1Ã: t:#.1=Ã'Ã'z'31t, smooth a3:luwi 1e`.i ci:.F`. be aof.al;:y ae:3f".11:3rb.;`.d or vv":?`~' ;3Ã)+.=ea3'ii.'.i.~., ~_ ...~. ;~:.t3E5t3:S ::`.c.'nE, tihow3"i .F3 FIG. 1, is Ff3.ef.ided to [oca3l'>' t.tkite z. _i=dz's? blood ;+.s`;lSt.i~..i3.t 8+...:e dac "emd :4ytiaei?'1, TEm> emb:.'.+dzltiel;t #nL:l:z.dL`=5 a :;at.FL.=1ee 9 !..i~lvan#: >
11.:>; 10 :2 ~ A its A . . A dÃst;~l tip. ~`I3e t;.~:~.:~~~:t~.:r 9 is id~sv,~< rt~:w t~~~~~~~0. a ~ :z,i~~>h~~~l E_~~~;,~~~ 1;~.
. .. ~. .
s?Ã?d :~~z~#?~ :1 ~3'i=~ z]nffl 01Q fiÃ'Si electrode 10 ruadics ,a p:t:Y.l..:?.l.. :ie:>Ã]. 33`tczy ~14, A
scLtz-nd i:I.-ct,ode 16 is Ã`z-en pk?ccd oti glic skin 18 ;.ici;am-A ;a fhe kidney 20.
i,~~Ã `3 ~ {i`='~I2U~ .: =L'~ to .t,~.~~ v : ..c Ã. ~+ :.z''t. sL` :>e}t~ . A 't ti~?CiL=S 10. 16 are p5:i:;t?vL.'~'i3.:3ii Ãmt',t.i~o M`i37.nax"', of a Powt`a >ti3pplZ` 22. . ,#
'?dict ` ti ~c~ ~~~ P Z <t- , :i# ~~ i iL~3 <'?'~a:~. seeks t.,s ~7I'~ii~l~,t<r t i]s(t:C)Eo...~.3?e:E#d)~S
i:?ti`~C.'i' ~t~.:2~ i z3 si,i,F, . Ã..iS i .. ~~~` 4i4 ' ~ '~,f~::*.
`'=..
-wiz'o~= is .,Zoa.`e(?, I l? S ~i 1~: ~~ ) ~j thus ~ ~= 1'f~~~i. ~?.~R_7 a.=E.i C i.:3:E>~L?'i.E.fl" ~F7. 16 `.~x~ ~i..a s ~~a'?t.f la ~ir l Gt=.
,,.r~?-.
However, bTp{.,.:d` or xT1E.?.:t3pcrliÃr 's:`SC:ctl'C)Z3es c.1:# also be used h1leti.;e fi1ere. is :to eql'<iiei13G,~ tx3 3t all tzin YlÃtC Ã of m E=le tÃodv bl s'f."sn,ait .C'd to a p+?}; t,`.d' s.# Yp z' 22.
hr, 4a33=.7.~.. embod?z71:.I2,.s, the first elC;ctxi)de 10 .s a bme p(:'si'i.?z?..'!, odhe?wise C..lei:a: icffl`C :>isu.Eated guide wire. 1'lowI:S=er, in such cases, L.~i+..tC.::re.l1c t#:4 s.. Pf,s?Ib liL) ~ o ~
. , 25 < lc+JÃ3::=.# :':e 3`;:,1`? f-l3c fim~I elLetà (3de 10 `eillt eho :ÃS'iei?z3z Such `~4?Ã.`a u~ ~s~,_, t:;.i 3s.:alt~, e: ;.~t t^3:i.i`#~:, ~..~..i'~`~::.i3t '~.~.Ãi4'~i~~g into zlart~.:"'a:i.1 wA.l instead of .,o-l the the iiIo3 .iiitr\.f.m: S`,.= at'micy K?rse1itZ#t:s do8Jnktri:amfram S~:Eae first`LrlC.'',~iroi4.i:..I'S3<
IiIG", athrt:s shows oÃ.c: ropiesmafiS'e e#~iho.ra~~icint f}Ã ;~ ca~~icter 9 hat ilg onw CiI' more L'.iLct:-d~`..'~~ 10 Ii23' plc1ceiI'~:.=.nt wI~..~.akl 's: blood vf.s:sec tNal. f=L'`%~.'3.s a l'iirga'tow, arterial bi.i:. C;.iG:Z`' f.t3m. ffii,.' L'=ift:iL,tti:Ã'-bi3me df'.:=ta)d1:~ 10 flot5s t>,[}Ã.IÃ=:h the mtZ'Ã,ae '3#:i> on . S ~va4'to ,.+,,f.i:i.".m c;:eL:rodi' p:'dtap t..'~cod~.~ai~he ~.>f?taenCs 5k:p, ?3v<:.r: nC.ao`;~io,.si#.pp, ...el i I~i L IW#S
by Kaugt:e:;4u ., . a?"to,~ bed. To ;iC:n~ ~l. t;t'i= ~'F1ti~Y~~3l~:3tii)ii, t.~ <~. ;:;:.i . Lt4~f-:7Y 'tz?.i ~.+ :<ii:..r~ t? ~3S.i ~
opt'.'#`tl :.E.`t. <a.., an c3.i"ii;dt.;, al?d ti:;e Tf'`.t1:Eri1 6cL`t1C.3dS>
pad 10 ,S Oponlt'L"'d .^t.s> a c<3:tht?dC:: :..'i3 tici'axevL Va;?ui.onst"ia 1c?Ã: the a4t's.ll:a electrode pad 10 is operated as t3i? anit~Ue, wiiI the k? fat.~t.ef<:r boa~`:3e Oli.:ctrodCv 10 is ti`.'apeTi.ated as a dwi~tE'aod`Sw', e~f3.c i,i"thotai.'-bomai;% C..eo..i?'2.~'L:e 10 S
i~.~l.~ the a~a,...~, C,~.'4~cti'~~`a~a' pi?(3 3 16 iir~:. "w`t,?I~Ef_ .Ig~k~T~4*d :i~S.?
that : ~iL= t;.~aS,.L.=tn+vait:l: E.Ãa3L.`'. ;.#.i3f:thord"b3'e c#.`srreir3.
f."'s,?W, t::1'v'i'.":it.~ the t:1?'gE'" anctlal '3oi,;:
Ii: ::'sth{ i iaInbt d?mellts a barrier :,L1II'oF:Ind:~ th'f.'. first ti:3t=.`viicxle 10. A s+,atabli'.
E:3caF'ri=L''.,7'i shown .n. FIG. 2, z5 a balloon 24 st2c-li as thest,.. ina balloon ...,.thmt:3. I hi:::
-4 balloon 24irtn.:ent5`fiL,' first 'tilmtrL?C3Ci1F) from actually cf;:A:
?ding Or:e . ......~~s *aJ'a-I..
FIG. 3 s1>ows, a longitudinal f:.i'o~ s ti4;GE#(,t. of Ã.. ~?i~lli?i.n E.:xt;i3G`lC;I` 26 w.idh the balloon 24 fully a.z:3`?lÃ:yed; f'i: the Z:ond'2gEII'ittlf?91 :iA]iko4'n.~ the balloon 24 l"`.ln".Ãc`:1'..='~ as a r i \r~i r Z eo ~~ i~= ~
~ci`"..~":+.'F a_, a'~.e.'~:a3, i~i:::~.er+P . L:~3~1~.cE:;`~.
:`~L.t;r'~:~~:t'i the ~~l<=~.'~i~'4~ ~`4~~ ~? at: the ~.iZl of f z~A4,;
~::'tG=}.~~ .1.4.
4u?'3p.u'tx ult'.`=L3.i'ÃF'.~ f.?,4ld, wh14ii in fimÃ, Z..L}~'7:;4;~3 .~t~f.
~='~
}YF.'~,:~=.~a.~f~.)..~iki z Li~'~~2;? $ji~~ G~.J~.~~~nt'sf~ri~1i~gi, f-~%a~'lli3~)~.iS:~r4t~.~-a:1~fi~~v'~i%~=:i> s.F:i~..~'.a~r~ and ) Yx $ j ~~i~..~Z=.~Zi:-Z)~.i.=.ti ~f~~y 6e a K.Y: 4 shows, a >3<ai754'C~~G ~Ii>~~-5~ i=~Ta~ti of tl- .t: baEl?(?:i catheter 26 in :`3C.3. 2.
~Pf-ic b~ffloo3a 24., ;1? `:ts d:t3lixyed. Sth. .3.'., bi3S a generally circular ::rC?sS SoctÃ:ti?z "hw .cadiw;
l?fw?'33ch i=.:an..i.,.. the l3,:=al~..'.~.~ theT:CZf.'eF'i~h m?nla3'?., at }7.'i?A}.n.i's.ll I , and Eaa...,. eadtis, of r: il :3 U :?al3tc u;': ,~=s~4.
~.~~~= baazC;oli 24 lu= 1;?$t':'<3' with a fluid, whic}3 can bo gas or hquid, and either 4>tih..T'!a affly a;=3sulafiI3g or c.mda.i.'.`lvt.. ~:~'ae Prt<=S4LF?`i.: of fh:y filidd -s >se:4ct::`,d t.. `;3:Z?': IC3e :uF'gi+Y3i.Y' i:i? 11F'C:\;d,.,.i. ~'a3~.` i.la:ctr[?d4~ 10 fF'om wl..f<'s::tIF ', d'se ba..li3o3: 24: but % ]t?i~~h flt.:~,dbflity .to, avoid Ilx]pa:I:niidg <3 Sm'go;?3:4s ab.tazy ta?
.1?<3,`}e43'+ G>' the wc1.E};1:: i: a' 26 2~.: MyÃ3u#:;h the v;mÃa:i3l ti ys"tem.
: ht 2z:iil<3+.3n 24 .s i.m?3t <3lh' al--mtdL: of a ~I.41~'i;1 3~F<s:f~3;~
.,#.a:4=r>~ ~il~~ as Itli+.:x or s22t\;m(e. Th~'N of (.!.2e balloon 20 is 3Sd fluid C~ idL a I)U)n}.? \iALit . howif, ..~Mt S~. ~;~~' I.?-Iia~lt~:s Ã=fÃ' C--`~~l::~'.i:=S [~1~' ~?sl~<<'Si;Fx, For this ~F?:3 ,1 f:~u, a flexible
ft I (K S, 1, .1'~,..~ an d 13, I Ii>. 14 shows a i:athÃ'4: iÃ:I4extui: iÃiW a bimod vessel.
w~ ~~~ ~ ~~ILED DESCRIPTION
:~..+_Ã,.;'{33 k3ftone iai <1E'k kl?".'cii:;l bed Ft, 11ct.:ei`ed by ius.Fj:;
~ \ ~ { ' ~ 4) the ~ `~~ y ~'',~p (`~"4 t Y ~ ~ is 5 ~Z Afi ...,~.i ti~`~,'S.. v .. ..:~a. ~'~~=. ~ `, ~=~t' ~.i:^i..Zr.~~~~
Lt,a:....4~~~i:a.E .~.~~W. ~.t4= ~t,.= 3.:3~L,~a~r~.., E.~:.~,::.~,=a.?.~
J..~.a~.'~=:~in .3,.dp, .tude to lia...?~ i.~>", 'v~~3Ã'3~~?'t ~. the ~: )L~. e:ll"1:t i3t1C?:.~ C3A fiS21f?:+Ji g~: ,i`z.k:~c,4s t;> s~ f f' ._ . f~~~c:.~:~ 3 .o, r tL-i~?~,+..:`
~, i? t .,a # o.
3?:'.C:i. Depa.iE.In<< on 11sf.. P+?;zS.t ty of flf1Ã: t:#.1=Ã'Ã'z'31t, smooth a3:luwi 1e`.i ci:.F`. be aof.al;:y ae:3f".11:3rb.;`.d or vv":?`~' ;3Ã)+.=ea3'ii.'.i.~., ~_ ...~. ;~:.t3E5t3:S ::`.c.'nE, tihow3"i .F3 FIG. 1, is Ff3.ef.ided to [oca3l'>' t.tkite z. _i=dz's? blood ;+.s`;lSt.i~..i3.t 8+...:e dac "emd :4ytiaei?'1, TEm> emb:.'.+dzltiel;t #nL:l:z.dL`=5 a :;at.FL.=1ee 9 !..i~lvan#: >
11.:>; 10 :2 ~ A its A . . A dÃst;~l tip. ~`I3e t;.~:~.:~~~:t~.:r 9 is id~sv,~< rt~:w t~~~~~~~0. a ~ :z,i~~>h~~~l E_~~~;,~~~ 1;~.
. .. ~. .
s?Ã?d :~~z~#?~ :1 ~3'i=~ z]nffl 01Q fiÃ'Si electrode 10 ruadics ,a p:t:Y.l..:?.l.. :ie:>Ã]. 33`tczy ~14, A
scLtz-nd i:I.-ct,ode 16 is Ã`z-en pk?ccd oti glic skin 18 ;.ici;am-A ;a fhe kidney 20.
i,~~Ã `3 ~ {i`='~I2U~ .: =L'~ to .t,~.~~ v : ..c Ã. ~+ :.z''t. sL` :>e}t~ . A 't ti~?CiL=S 10. 16 are p5:i:;t?vL.'~'i3.:3ii Ãmt',t.i~o M`i37.nax"', of a Powt`a >ti3pplZ` 22. . ,#
'?dict ` ti ~c~ ~~~ P Z <t- , :i# ~~ i iL~3 <'?'~a:~. seeks t.,s ~7I'~ii~l~,t<r t i]s(t:C)Eo...~.3?e:E#d)~S
i:?ti`~C.'i' ~t~.:2~ i z3 si,i,F, . Ã..iS i .. ~~~` 4i4 ' ~ '~,f~::*.
`'=..
-wiz'o~= is .,Zoa.`e(?, I l? S ~i 1~: ~~ ) ~j thus ~ ~= 1'f~~~i. ~?.~R_7 a.=E.i C i.:3:E>~L?'i.E.fl" ~F7. 16 `.~x~ ~i..a s ~~a'?t.f la ~ir l Gt=.
,,.r~?-.
However, bTp{.,.:d` or xT1E.?.:t3pcrliÃr 's:`SC:ctl'C)Z3es c.1:# also be used h1leti.;e fi1ere. is :to eql'<iiei13G,~ tx3 3t all tzin YlÃtC Ã of m E=le tÃodv bl s'f."sn,ait .C'd to a p+?}; t,`.d' s.# Yp z' 22.
hr, 4a33=.7.~.. embod?z71:.I2,.s, the first elC;ctxi)de 10 .s a bme p(:'si'i.?z?..'!, odhe?wise C..lei:a: icffl`C :>isu.Eated guide wire. 1'lowI:S=er, in such cases, L.~i+..tC.::re.l1c t#:4 s.. Pf,s?Ib liL) ~ o ~
. , 25 < lc+JÃ3::=.# :':e 3`;:,1`? f-l3c fim~I elLetà (3de 10 `eillt eho :ÃS'iei?z3z Such `~4?Ã.`a u~ ~s~,_, t:;.i 3s.:alt~, e: ;.~t t^3:i.i`#~:, ~..~..i'~`~::.i3t '~.~.Ãi4'~i~~g into zlart~.:"'a:i.1 wA.l instead of .,o-l the the iiIo3 .iiitr\.f.m: S`,.= at'micy K?rse1itZ#t:s do8Jnktri:amfram S~:Eae first`LrlC.'',~iroi4.i:..I'S3<
IiIG", athrt:s shows oÃ.c: ropiesmafiS'e e#~iho.ra~~icint f}Ã ;~ ca~~icter 9 hat ilg onw CiI' more L'.iLct:-d~`..'~~ 10 Ii23' plc1ceiI'~:.=.nt wI~..~.akl 's: blood vf.s:sec tNal. f=L'`%~.'3.s a l'iirga'tow, arterial bi.i:. C;.iG:Z`' f.t3m. ffii,.' L'=ift:iL,tti:Ã'-bi3me df'.:=ta)d1:~ 10 flot5s t>,[}Ã.IÃ=:h the mtZ'Ã,ae '3#:i> on . S ~va4'to ,.+,,f.i:i.".m c;:eL:rodi' p:'dtap t..'~cod~.~ai~he ~.>f?taenCs 5k:p, ?3v<:.r: nC.ao`;~io,.si#.pp, ...el i I~i L IW#S
by Kaugt:e:;4u ., . a?"to,~ bed. To ;iC:n~ ~l. t;t'i= ~'F1ti~Y~~3l~:3tii)ii, t.~ <~. ;:;:.i . Lt4~f-:7Y 'tz?.i ~.+ :<ii:..r~ t? ~3S.i ~
opt'.'#`tl :.E.`t. <a.., an c3.i"ii;dt.;, al?d ti:;e Tf'`.t1:Eri1 6cL`t1C.3dS>
pad 10 ,S Oponlt'L"'d .^t.s> a c<3:tht?dC:: :..'i3 tici'axevL Va;?ui.onst"ia 1c?Ã: the a4t's.ll:a electrode pad 10 is operated as t3i? anit~Ue, wiiI the k? fat.~t.ef<:r boa~`:3e Oli.:ctrodCv 10 is ti`.'apeTi.ated as a dwi~tE'aod`Sw', e~f3.c i,i"thotai.'-bomai;% C..eo..i?'2.~'L:e 10 S
i~.~l.~ the a~a,...~, C,~.'4~cti'~~`a~a' pi?(3 3 16 iir~:. "w`t,?I~Ef_ .Ig~k~T~4*d :i~S.?
that : ~iL= t;.~aS,.L.=tn+vait:l: E.Ãa3L.`'. ;.#.i3f:thord"b3'e c#.`srreir3.
f."'s,?W, t::1'v'i'.":it.~ the t:1?'gE'" anctlal '3oi,;:
Ii: ::'sth{ i iaInbt d?mellts a barrier :,L1II'oF:Ind:~ th'f.'. first ti:3t=.`viicxle 10. A s+,atabli'.
E:3caF'ri=L''.,7'i shown .n. FIG. 2, z5 a balloon 24 st2c-li as thest,.. ina balloon ...,.thmt:3. I hi:::
-4 balloon 24irtn.:ent5`fiL,' first 'tilmtrL?C3Ci1F) from actually cf;:A:
?ding Or:e . ......~~s *aJ'a-I..
FIG. 3 s1>ows, a longitudinal f:.i'o~ s ti4;GE#(,t. of Ã.. ~?i~lli?i.n E.:xt;i3G`lC;I` 26 w.idh the balloon 24 fully a.z:3`?lÃ:yed; f'i: the Z:ond'2gEII'ittlf?91 :iA]iko4'n.~ the balloon 24 l"`.ln".Ãc`:1'..='~ as a r i \r~i r Z eo ~~ i~= ~
~ci`"..~":+.'F a_, a'~.e.'~:a3, i~i:::~.er+P . L:~3~1~.cE:;`~.
:`~L.t;r'~:~~:t'i the ~~l<=~.'~i~'4~ ~`4~~ ~? at: the ~.iZl of f z~A4,;
~::'tG=}.~~ .1.4.
4u?'3p.u'tx ult'.`=L3.i'ÃF'.~ f.?,4ld, wh14ii in fimÃ, Z..L}~'7:;4;~3 .~t~f.
~='~
}YF.'~,:~=.~a.~f~.)..~iki z Li~'~~2;? $ji~~ G~.J~.~~~nt'sf~ri~1i~gi, f-~%a~'lli3~)~.iS:~r4t~.~-a:1~fi~~v'~i%~=:i> s.F:i~..~'.a~r~ and ) Yx $ j ~~i~..~Z=.~Zi:-Z)~.i.=.ti ~f~~y 6e a K.Y: 4 shows, a >3<ai754'C~~G ~Ii>~~-5~ i=~Ta~ti of tl- .t: baEl?(?:i catheter 26 in :`3C.3. 2.
~Pf-ic b~ffloo3a 24., ;1? `:ts d:t3lixyed. Sth. .3.'., bi3S a generally circular ::rC?sS SoctÃ:ti?z "hw .cadiw;
l?fw?'33ch i=.:an..i.,.. the l3,:=al~..'.~.~ theT:CZf.'eF'i~h m?nla3'?., at }7.'i?A}.n.i's.ll I , and Eaa...,. eadtis, of r: il :3 U :?al3tc u;': ,~=s~4.
~.~~~= baazC;oli 24 lu= 1;?$t':'<3' with a fluid, whic}3 can bo gas or hquid, and either 4>tih..T'!a affly a;=3sulafiI3g or c.mda.i.'.`lvt.. ~:~'ae Prt<=S4LF?`i.: of fh:y filidd -s >se:4ct::`,d t.. `;3:Z?': IC3e :uF'gi+Y3i.Y' i:i? 11F'C:\;d,.,.i. ~'a3~.` i.la:ctr[?d4~ 10 fF'om wl..f<'s::tIF ', d'se ba..li3o3: 24: but % ]t?i~~h flt.:~,dbflity .to, avoid Ilx]pa:I:niidg <3 Sm'go;?3:4s ab.tazy ta?
.1?<3,`}e43'+ G>' the wc1.E};1:: i: a' 26 2~.: MyÃ3u#:;h the v;mÃa:i3l ti ys"tem.
: ht 2z:iil<3+.3n 24 .s i.m?3t <3lh' al--mtdL: of a ~I.41~'i;1 3~F<s:f~3;~
.,#.a:4=r>~ ~il~~ as Itli+.:x or s22t\;m(e. Th~'N of (.!.2e balloon 20 is 3Sd fluid C~ idL a I)U)n}.? \iALit . howif, ..~Mt S~. ~;~~' I.?-Iia~lt~:s Ã=fÃ' C--`~~l::~'.i:=S [~1~' ~?sl~<<'Si;Fx, For this ~F?:3 ,1 f:~u, a flexible
6 tube 28 :."D3uallw -:!5.leE3& :1,.[3:"ig #}?f d:.a#~~~zetLt 26 beik3'C wl;.
#3tc p;.#:t"ttp and the ÃF?te.F'Ft?r of Eho baEk, ;3-z 20:
Wi3.~e a b: lli3i);1 24 ax,,, dest.i1b4d s3bC}vc wifl tc..Ãd to clui. as a barrl.t.: to Ji.:Z:yt.-z,cqu;>]cy c:#:tm3#, at h1gd:wi ftCqtI4Ã1:t,'=:Ãt:s :.~IorC> may bt c`d:yl :1g i?QvwQ.01) "'. flu: 6:iÃ3A..1ai?d;' 10 ,a:`.?d' the b:a~lot?n24. "yvi17s, i3 : turn, 171`sry cause suffilc.t'=T'ct ::3 :Ã'ge .+ be oF?
i~ b. surface . .. . y,r.i .. ~..~ t, ~ +. ~' ~ ~: e~..~1'~'.+~.. 2,. ~:hs A~> ~~c.=~:: '?~c'k.sl:. C'.i, Ã~ ,--stc~.Z%i ~ s~- s~. ~.;a the ~ ~ ~ ~ c .,t.~~.. ^c f F
~,~ ~Ã~~~y.C.\~r.Ã~ ~a:c~is., ae"F :.lio m?fi~=riaI ~vaI; may :isuh .nsomQ c:uÃcut within f1ai wÃll ..~wA~.
.iõi3tl-f.a C.m'1~:.npAc of a b~ir#"Ier is is a27i,:sh or net cage 30 ~uc:Ã.
as t#?iif. Jht+w."e in F?G: 5 3~i1c cage 30 cs~:i i~i Ãi~?:t~. or s.~~g~?#.$~" n~:t~~.i~:~i~:~, ~~1:#
i=4~'~i~i ~:,i1.~=i?o_, ,~~`N::#.~~z~t~c to <
cvis}1iolt :h~.= +~::~;t;a;:ri?d=:r 10 <3gaii3q aGi:Fd ~.',#i #:,:"ly ooI21ac`'Ing et`.c. cag''~`. 34). '_e + 'Ã.Ã5.: 30 can .y.
be of 7..:#..Z'~ \#" i:=t] .x7v>l.ixc`1t.f?w. Fi~s or a l.{3?"f6.S 7L1C:t1i"E.
~1c~.~:S.:l>.~l, 3~w~4r[:'.=`.r x F. 1.. :t' ~:16.:w;w'..= cage 'p .:+
~,. ,e0 is 331:i~.i<. of a ci:?nduC`:3s=o iT:s3lexial. it .4 beSt d:lotitr1i.i1.lly 1su.a~. ~i.~3 tat?;~#.i ti3e elL`C.vm& 10.
~ ` `"r?,3# k at the i-f~ fa:# d ilt?t i~3cai~.:~~ ; ~~iE. ' '~ ~;EiDtf_Il;. t r .:ti: < ~.U
:~ac.> t-~. ~i?.:::.._~54= 10 need ~t:,G:' 30.
3"~~~oy ondl shapQi>.. i,.':_i -10 is similar to, taea# of the b<:iS.f 3E1n.2 4 Gf>::fwai1.1a a~ E a~i.:S. r' 2. F~:?3' b~~i~;~`.t:,'~v.~7..y.~~ , ~`iÃ.~lr '~, `~L`A3i~y,`'t~.?i~~e3:o. Oi':'alS?ii;z' piC?vkhLS w%.?rty:
l'roffl:; Wh3z.~: n"cxuciA? s t:ic ,..kc~ihood of 1rauna:~ should tl?G= ca Ã
~~k:on;.ac! :he arterial w a H.
Yet 'i'`r.n.i;rt:3e' cxxanpli'. of i1'?a'aTTe, si1o4'v.11.Ã"i F3C3. 6, is a -h4;-tu4I'=:i 321 that ....clf?se. :,..o eaek.uo.~~ 10, 1, hehous3ng can coÃ`r~~~le#ely enclose th;, ,.~lectÃc?de 10, or ia _: ^ can >:av:. h:??os 34, as sbown in FIG. 6, through ,=vh xcEx t?lc}od can eÃ.tF,r aa..I .. ~i:' ÃE'i4, hi,u,sk: ng 32: `.:?c#.oby providing direct ~~ec'#I,cii-l contact :7o# weQ; .
"l3e cled#':?di: and thc NE?od, a..?... 4:{?u:'si:z;n..'~~2 fikC''~iiSL rms an ellÃp .~`(?id`e."`.~
(ZI' ovaloid .~ '.. #i3 #ms # de both a kow pi"od.,:e and tÃ? ;:~~vo.d #'?.au#e3i:E Shi)2.1kd #i1c housing ,..,ai:veÃ'tea't;? y r.C?#?tac# r'e utvn:a' Wa;
2 f5- Anc--t.`Ãayi' e1'.ilbedI:II3i.t?t, shown in FIG. '`, #lAcluwes E: :
.aÃ..EÃ.er in fl:tc >>~a"Ã'i1 :s# "a pair of e:3117npeÃ';? 35-5a, 35b d7q?i)sed p$'oxzI11al and distal to t.[lo-'fit...t L'_lect:'od;,' 10. this L.lubtA11 9 n:.; u ,<. i.fa&f3}_ii . 10 CaoTltckcts tli~.' blood lsircctly wlõfli'.= taee. bui:3;rten 352, .~~b n* the f::. i {C-i~ ~:~~,.ia~.Z~L;~~ 10 4~ F: }ri ~r~~ ~ ~+ a } arterial i'4,C~ye .~. t'~..x~~?. t L~L" contacting #f~..a::x _.
#3tc p;.#:t"ttp and the ÃF?te.F'Ft?r of Eho baEk, ;3-z 20:
Wi3.~e a b: lli3i);1 24 ax,,, dest.i1b4d s3bC}vc wifl tc..Ãd to clui. as a barrl.t.: to Ji.:Z:yt.-z,cqu;>]cy c:#:tm3#, at h1gd:wi ftCqtI4Ã1:t,'=:Ãt:s :.~IorC> may bt c`d:yl :1g i?QvwQ.01) "'. flu: 6:iÃ3A..1ai?d;' 10 ,a:`.?d' the b:a~lot?n24. "yvi17s, i3 : turn, 171`sry cause suffilc.t'=T'ct ::3 :Ã'ge .+ be oF?
i~ b. surface . .. . y,r.i .. ~..~ t, ~ +. ~' ~ ~: e~..~1'~'.+~.. 2,. ~:hs A~> ~~c.=~:: '?~c'k.sl:. C'.i, Ã~ ,--stc~.Z%i ~ s~- s~. ~.;a the ~ ~ ~ ~ c .,t.~~.. ^c f F
~,~ ~Ã~~~y.C.\~r.Ã~ ~a:c~is., ae"F :.lio m?fi~=riaI ~vaI; may :isuh .nsomQ c:uÃcut within f1ai wÃll ..~wA~.
.iõi3tl-f.a C.m'1~:.npAc of a b~ir#"Ier is is a27i,:sh or net cage 30 ~uc:Ã.
as t#?iif. Jht+w."e in F?G: 5 3~i1c cage 30 cs~:i i~i Ãi~?:t~. or s.~~g~?#.$~" n~:t~~.i~:~i~:~, ~~1:#
i=4~'~i~i ~:,i1.~=i?o_, ,~~`N::#.~~z~t~c to <
cvis}1iolt :h~.= +~::~;t;a;:ri?d=:r 10 <3gaii3q aGi:Fd ~.',#i #:,:"ly ooI21ac`'Ing et`.c. cag''~`. 34). '_e + 'Ã.Ã5.: 30 can .y.
be of 7..:#..Z'~ \#" i:=t] .x7v>l.ixc`1t.f?w. Fi~s or a l.{3?"f6.S 7L1C:t1i"E.
~1c~.~:S.:l>.~l, 3~w~4r[:'.=`.r x F. 1.. :t' ~:16.:w;w'..= cage 'p .:+
~,. ,e0 is 331:i~.i<. of a ci:?nduC`:3s=o iT:s3lexial. it .4 beSt d:lotitr1i.i1.lly 1su.a~. ~i.~3 tat?;~#.i ti3e elL`C.vm& 10.
~ ` `"r?,3# k at the i-f~ fa:# d ilt?t i~3cai~.:~~ ; ~~iE. ' '~ ~;EiDtf_Il;. t r .:ti: < ~.U
:~ac.> t-~. ~i?.:::.._~54= 10 need ~t:,G:' 30.
3"~~~oy ondl shapQi>.. i,.':_i -10 is similar to, taea# of the b<:iS.f 3E1n.2 4 Gf>::fwai1.1a a~ E a~i.:S. r' 2. F~:?3' b~~i~;~`.t:,'~v.~7..y.~~ , ~`iÃ.~lr '~, `~L`A3i~y,`'t~.?i~~e3:o. Oi':'alS?ii;z' piC?vkhLS w%.?rty:
l'roffl:; Wh3z.~: n"cxuciA? s t:ic ,..kc~ihood of 1rauna:~ should tl?G= ca Ã
~~k:on;.ac! :he arterial w a H.
Yet 'i'`r.n.i;rt:3e' cxxanpli'. of i1'?a'aTTe, si1o4'v.11.Ã"i F3C3. 6, is a -h4;-tu4I'=:i 321 that ....clf?se. :,..o eaek.uo.~~ 10, 1, hehous3ng can coÃ`r~~~le#ely enclose th;, ,.~lectÃc?de 10, or ia _: ^ can >:av:. h:??os 34, as sbown in FIG. 6, through ,=vh xcEx t?lc}od can eÃ.tF,r aa..I .. ~i:' ÃE'i4, hi,u,sk: ng 32: `.:?c#.oby providing direct ~~ec'#I,cii-l contact :7o# weQ; .
"l3e cled#':?di: and thc NE?od, a..?... 4:{?u:'si:z;n..'~~2 fikC''~iiSL rms an ellÃp .~`(?id`e."`.~
(ZI' ovaloid .~ '.. #i3 #ms # de both a kow pi"od.,:e and tÃ? ;:~~vo.d #'?.au#e3i:E Shi)2.1kd #i1c housing ,..,ai:veÃ'tea't;? y r.C?#?tac# r'e utvn:a' Wa;
2 f5- Anc--t.`Ãayi' e1'.ilbedI:II3i.t?t, shown in FIG. '`, #lAcluwes E: :
.aÃ..EÃ.er in fl:tc >>~a"Ã'i1 :s# "a pair of e:3117npeÃ';? 35-5a, 35b d7q?i)sed p$'oxzI11al and distal to t.[lo-'fit...t L'_lect:'od;,' 10. this L.lubtA11 9 n:.; u ,<. i.fa&f3}_ii . 10 CaoTltckcts tli~.' blood lsircctly wlõfli'.= taee. bui:3;rten 352, .~~b n* the f::. i {C-i~ ~:~~,.ia~.Z~L;~~ 10 4~ F: }ri ~r~~ ~ ~+ a } arterial i'4,C~ye .~. t'~..x~~?. t L~L" contacting #f~..a::x _.
7 1n ,,}rrz.q yj.s described r~j t3t }.~'t43`J t.i~r Sli F'~L2 ¾
the L,~>~.C~\1W:.3~r~rA~L~, t.=`~s~=+udt. 1~~1 y~},~ F i. .^Cis b`1.re.n a lonnÃ~:'~ of However, suitable electrodes Laii. assiD.C any z.wn:bu of shapcs.
For exa3 `:`~ic ..li: L'`l3 Ct +`_TC~ iD4 ~ :~: '1i~ ~?C. helical, ~].as ~
1~."rS~'l i $ :~ " ile4>i .~..~~ = ! r i ~ i ii 'e;~ t,~{3. S. o-`v.~=L i`i3i i ~ l~>:~ ::l~:c=tiiL.~a Li~i~1F.E:~, :'~~1ia~: ;-~i,l,~:taz'~M f~::t~ =<~i~t 4Ã~~~..=3h pr\?S':i~.~s s ~s.~,tlui" s~;:F'~.<1~:~L = Ã3t~. 1 ~ ~
+.o be re?dS.i.ym.i:aevZ='c:,`Ld.
E>ei :#'oi,eJ that a non-linear shape, S:a't:li :.1s t}laE zl1.n~:Ir a., ,.'IG, S. L_iS: be Ll.}>ifip1eLTZo rl..,S:i'L:=2 i1i:tfy i.i ,tii_f..(2.the S:AS.sFi .i\.i..t'ac(.ilil). 4}iC.lLJlo4 w ~k7,,..Mj4eo-:t\}[i3ti[e4&hI~.~,~.
In1iI;i'.iEve. .i3i distal t.lt"} of I110 ca:li'ti; to ii::, dC=.4ti[1atÃoI7.. In s3,:3.:x#. ccl,ses; tet4di: a <
?~3~`z~`i~.~i.,34.,;. ;:t. cause ti7L: ~:l~:~;C;:E?i?~~" 1~~ to i~,sst~ii~.
ztq i.ieõiit'eG shape 3Y}1on L>,,\,Ã.el<:d Z31. t:+~'.#.'L \i; } j~:=i:i'~a~
.y.i.'' of ..3C.. ~3~.
0t;w` such if)uL21r ix:s.3i ._3C 3 tdia an 4lei :rodt= Ã?Lttde,.+S1,.f Ã:1.1do of a s.2RipC:w munor. to Whtc=h, ttiU electrode 10 is mc:oh.irit: liy couplt:& ..Ã, wz:.t z.
C::w, the \hc?po 1,1 t tZ'zZ iO:<3i is c<3_!]fi-:a;~~.'d to lli.if,.'., F7:4 its :'t:.i;1Lmbe.iw=Za J:3'.;.po3 fl:~e \i.-irLSo- shape of p~ i .} t:= ~= rifC'.= and ~. :~\'C tl,.t ~ = s~~ ' C..z:,~.=il~i?~.:~: 10 ~..ii. ,~.at ~i'rt~:
:.:.~y= ~ ~t ~C.~:..,i~a.~ _~~~. When ~.}iLt'=}iL:i.~`fS.i.~L' ~iflt~'~~[='w e,c1.~:=ia:~:.
g ~ 3 ..' into t~:i~', io-i3C~i. 17~?~~~, wa-L= ~i..3~5' ~:=`tL~~C~v~:.. k Y~'~lit,'._'fi ti3~~i:~:3:f~tA ~.3L3\ p3ldSy wiE'c, is ti_xtf.21iaC;3.i otIt o& the `.3ha.,~ii.h, it cit+u'#.':me: its rem<'.nnberfõd s?7tipe; ihv.eby oausMg thi:'sw ~.L..yod'=. :o, W}37i%'h it is .?"::i.=}:han##...~~~ lS:i~, tt~ likst~'"a`:'S? ii '#.i~~1L
~e~c:Et ti~'>._l~?%. .''llFS
~' L:=~Z~'~ : .
~: } ~ =~ a,<?t? < .. t;te`f$?S3 a c3i ~Tl a s1 ' ..\f. , .~ r`` j f~
..3Ã'.,.a .YT
~:~.~5:._.~lr3t.i1.4~7t"f:i;;3T~L.i'~'r.. ~ i~''~ if~ ~3~::i:~. L.&
C.aL:=G:~^S..10 gii33 +ta"SY 2r\: is `Ãi\.~,:f.`.s:?; a r'.
21azo ?~.x,,t dL=r.$,odi.'= 10 can also be p3'eveIlti'd fi}5, 3 tfiz.,e x..:#.g iiw ;.in*-Oõzul vZ.3zl by, atÃ`t?. implanting an~ it.sll.eitod yten! 36 in ffie #;G=gii3$n, in W,.`.Lltwa,'~ic:d :1;~~ivti-`i3oÃi ~ .LaÃif~~Li ,~~ :~~lt~~'~~?#. ;.7i ~" ~:t.3. `~. Then, :.,~iL' f ti 9~:
~.'.~~.C.'tlE~(~Q 10 is ~,~.~(L<I~1G~~ ,_2~Z3I~; I:t t}tL ~a~.t~'d`rt 14 u:>;.tl it reaches miL s¾ent 36. Siawc tl>c, s.~.... 36 is :undlc< of an ~~~~tda$,ng material, ii.
F.iF?L_~.FÃ~I7~a t;s r barrier t;Z '..::}d t<r~to ` I~; 3 i) 5~7<~`4 5 a longitudinal i T~C?~+S s~~Cs.1$i~l of ~.~I~1~-~~iL'I~
kli.~~~st.~#i;~ :z. ~;:: \t ~3i~.'. a .yj\:3f.3*J includes at>..,.2siJ.ta}.iyi; 5.11yM1.1. 40 oii. w.ii_i\e}2 is placed ~, Z+J=RS3RSr1Ww ,.3hst\.'.tb4..iui(?e 10. A L yl':rzl? .} 4=<md electrode 1.6 ciii3 be placed f3ii ar. add .t.ion>s~
ste>tz 4<..- .~~, v?na..> [:
~~I 3I~'c'xt ii`isi#:l:i:.cC3:7. Ii3y<:F and pAat;(:CI i.ii ::IwT.hc;:
blo+.)d, vessel 46 .T. flu::~
2<3.:i<.;l;iI..iTsy`ii:L'T3-i.. An 'iI`ai?lania. .d power supply 22 provides i. S't3a`;;:3ge d:fft.:dcitoc
the L,~>~.C~\1W:.3~r~rA~L~, t.=`~s~=+udt. 1~~1 y~},~ F i. .^Cis b`1.re.n a lonnÃ~:'~ of However, suitable electrodes Laii. assiD.C any z.wn:bu of shapcs.
For exa3 `:`~ic ..li: L'`l3 Ct +`_TC~ iD4 ~ :~: '1i~ ~?C. helical, ~].as ~
1~."rS~'l i $ :~ " ile4>i .~..~~ = ! r i ~ i ii 'e;~ t,~{3. S. o-`v.~=L i`i3i i ~ l~>:~ ::l~:c=tiiL.~a Li~i~1F.E:~, :'~~1ia~: ;-~i,l,~:taz'~M f~::t~ =<~i~t 4Ã~~~..=3h pr\?S':i~.~s s ~s.~,tlui" s~;:F'~.<1~:~L = Ã3t~. 1 ~ ~
+.o be re?dS.i.ym.i:aevZ='c:,`Ld.
E>ei :#'oi,eJ that a non-linear shape, S:a't:li :.1s t}laE zl1.n~:Ir a., ,.'IG, S. L_iS: be Ll.}>ifip1eLTZo rl..,S:i'L:=2 i1i:tfy i.i ,tii_f..(2.the S:AS.sFi .i\.i..t'ac(.ilil). 4}iC.lLJlo4 w ~k7,,..Mj4eo-:t\}[i3ti[e4&hI~.~,~.
In1iI;i'.iEve. .i3i distal t.lt"} of I110 ca:li'ti; to ii::, dC=.4ti[1atÃoI7.. In s3,:3.:x#. ccl,ses; tet4di: a <
?~3~`z~`i~.~i.,34.,;. ;:t. cause ti7L: ~:l~:~;C;:E?i?~~" 1~~ to i~,sst~ii~.
ztq i.ieõiit'eG shape 3Y}1on L>,,\,Ã.el<:d Z31. t:+~'.#.'L \i; } j~:=i:i'~a~
.y.i.'' of ..3C.. ~3~.
0t;w` such if)uL21r ix:s.3i ._3C 3 tdia an 4lei :rodt= Ã?Lttde,.+S1,.f Ã:1.1do of a s.2RipC:w munor. to Whtc=h, ttiU electrode 10 is mc:oh.irit: liy couplt:& ..Ã, wz:.t z.
C::w, the \hc?po 1,1 t tZ'zZ iO:<3i is c<3_!]fi-:a;~~.'d to lli.if,.'., F7:4 its :'t:.i;1Lmbe.iw=Za J:3'.;.po3 fl:~e \i.-irLSo- shape of p~ i .} t:= ~= rifC'.= and ~. :~\'C tl,.t ~ = s~~ ' C..z:,~.=il~i?~.:~: 10 ~..ii. ,~.at ~i'rt~:
:.:.~y= ~ ~t ~C.~:..,i~a.~ _~~~. When ~.}iLt'=}iL:i.~`fS.i.~L' ~iflt~'~~[='w e,c1.~:=ia:~:.
g ~ 3 ..' into t~:i~', io-i3C~i. 17~?~~~, wa-L= ~i..3~5' ~:=`tL~~C~v~:.. k Y~'~lit,'._'fi ti3~~i:~:3:f~tA ~.3L3\ p3ldSy wiE'c, is ti_xtf.21iaC;3.i otIt o& the `.3ha.,~ii.h, it cit+u'#.':me: its rem<'.nnberfõd s?7tipe; ihv.eby oausMg thi:'sw ~.L..yod'=. :o, W}37i%'h it is .?"::i.=}:han##...~~~ lS:i~, tt~ likst~'"a`:'S? ii '#.i~~1L
~e~c:Et ti~'>._l~?%. .''llFS
~' L:=~Z~'~ : .
~: } ~ =~ a,<?t? < .. t;te`f$?S3 a c3i ~Tl a s1 ' ..\f. , .~ r`` j f~
..3Ã'.,.a .YT
~:~.~5:._.~lr3t.i1.4~7t"f:i;;3T~L.i'~'r.. ~ i~''~ if~ ~3~::i:~. L.&
C.aL:=G:~^S..10 gii33 +ta"SY 2r\: is `Ãi\.~,:f.`.s:?; a r'.
21azo ?~.x,,t dL=r.$,odi.'= 10 can also be p3'eveIlti'd fi}5, 3 tfiz.,e x..:#.g iiw ;.in*-Oõzul vZ.3zl by, atÃ`t?. implanting an~ it.sll.eitod yten! 36 in ffie #;G=gii3$n, in W,.`.Lltwa,'~ic:d :1;~~ivti-`i3oÃi ~ .LaÃif~~Li ,~~ :~~lt~~'~~?#. ;.7i ~" ~:t.3. `~. Then, :.,~iL' f ti 9~:
~.'.~~.C.'tlE~(~Q 10 is ~,~.~(L<I~1G~~ ,_2~Z3I~; I:t t}tL ~a~.t~'d`rt 14 u:>;.tl it reaches miL s¾ent 36. Siawc tl>c, s.~.... 36 is :undlc< of an ~~~~tda$,ng material, ii.
F.iF?L_~.FÃ~I7~a t;s r barrier t;Z '..::}d t<r~to ` I~; 3 i) 5~7<~`4 5 a longitudinal i T~C?~+S s~~Cs.1$i~l of ~.~I~1~-~~iL'I~
kli.~~~st.~#i;~ :z. ~;:: \t ~3i~.'. a .yj\:3f.3*J includes at>..,.2siJ.ta}.iyi; 5.11yM1.1. 40 oii. w.ii_i\e}2 is placed ~, Z+J=RS3RSr1Ww ,.3hst\.'.tb4..iui(?e 10. A L yl':rzl? .} 4=<md electrode 1.6 ciii3 be placed f3ii ar. add .t.ion>s~
ste>tz 4<..- .~~, v?na..> [:
~~I 3I~'c'xt ii`isi#:l:i:.cC3:7. Ii3y<:F and pAat;(:CI i.ii ::IwT.hc;:
blo+.)d, vessel 46 .T. flu::~
2<3.:i<.;l;iI..iTsy`ii:L'T3-i.. An 'iI`ai?lania. .d power supply 22 provides i. S't3a`;;:3ge d:fft.:dcitoc
8 b;;twim ihe :w.? eEowt:'[?dc~ 10,16. SteTtt-mot:sn.ed t:ticÃr<?dos of .~q,?Q
are ; sicliaso'c;
E ~2 2. { 2- ~~.. M, }:~ the ` tt-.A.\ ;. :.,.=:~ =x , ,f.~. a~.,:?~~;{G-~{~it?~~ t~' ~ :~~s~, I.~ :~il~:<I ~~~
'~~~~a~~~,}~.r= .~ r' ~~~Ã~~:.{
i a 'p. h. i?. . <.=1 t-,an incorporated by refC?eI?o4.
~.~~Iw rG~.`> ~-,:t%a1 z `i etr~w1.~'"l:. ~. '~ ~ f a 3311 ;~ ?YG =' ~~e~1~~#
~:~~I1e~s-'~il.`,'t.C 3i? in 1xc'~~5{i:{? a 33r;it '\~. 9 Z' .i.. ,~.a~ . r..
7 L=,C;}v'trodt:~ 10 is implanted in an artery feeding a targeted ii1`tu..til:
bed, .:{I.:k. a ti,--.i:ijFed 3.=10.i"trod('i 16 is 1?ix3:i3z'iÃ',d IÃ;' i7. b"s:ln draining the Eftr:SSw,C
d z;rte.`'i.{;. LSi,d~ .. hL. pt'tirt;:"
)UFA ~ 22. wh{Z h :tt wimijv ciF.iei?ei?~y st\>F.aw:.Si 03cwnent or tmT\.i..?erWili: aJ:v b . ; . \ = \ ' Y 4 of $i a ,- a;= ? g ~'Y 3 .w.=%3ti '2 a._=~> .4 ~?~3<.=L~{>.~.t; ;a?..=S.is C:={~if~{:.a' 5.3~2`v ('~v ~f:.4 ~.{"{'~~i(${ ~~C, ~ F::cLZi'Q-ti. 10, Y~ ,~l i Y=\ qaz~~;?fc1{a1 p 5 ) } ~ S i~.Y
i 4ZT
~{id;=~a ~:~5,~~;a?`~'.t.~~.it the t3~~ j,'".1 ,~<:(.~ v3i'+C:~13"_3t$4 ~~, 10 IYCI~id.? a i:=a3F{k.t3~:~.Z \,s :~{Str {=e, Ahi:m{h i:xt ti{a power supply .e2<u i_:f7d eilxy t:Z3r.FT'E1l t=lG
tit7'4`rT?ls.,:1 are Ia??p;c faat.i::d :{# a ::hi.i:ti ~~3w=~AFi..{? ` < - : . ~ ~ ~a ~ ' a, ~ ~ ~:..: ~..{>,~`.,,`L=e .o'=t` to .hC'. ia~l+~ai~~~tG t` ~.etf 3?~~~s 1~~
1~? by E C)I C~l.. t;F' , si?.~t{ial.~~=~
wi>ck. Tine poweT s a~~~ly 22 uui be recharged by an etit.e{".na. ;,ot:>oc of e.eAy;yf, stÃ...a as an R: Ã >{?.5??..ti~~ F'< Aftti r t12 t14 o3 J \ flne power q4piC .22 can be F" .t%}?aI g4d t> : i::zi i?{x pia;?to,{s b:{4?t:ii:=etI l.: `=~~.,e1?.L.=rt{.lt:)"' that tai:illtfoIIa"`ts body {'llotii?n or bf.F,,> heat {a?ti;?
. > C=~~ L Ã~~~ <?.i iC.``gi+, ar"`C;I?3C; Lx14c5, the implanted electrodes 10, ~'. `slri: powered e,-1. i:i?%y f:t}rnai{ Vr\5en+al power sm~~ly.~Y such Lts[a (}. RF 6Ctl.rAs>.i.'Stte{.
jI.{.tAc ><i?p2an~cd4'{JSiC2,ol cIi:cÃ;'i?n{c> :-t?z. v bQ ,}.<?gt`amineti fre?rn uri[side Ã~ic body.
3 electrode , ,~~ ~e~{e3'571:? E.i ~'~.~:E. ) the second ecÃrod4 16 C::1?1 be c? s`.{r:ci4e such 4.. a ctsnd{..a..t ve p<?.i' p2c`{c,o on the ~skl{?.. A ;ncUt?.{?:Eh 4lc;dmd`l.' 16 pz.-cc+a{ umi .tw s:.1{, .s ps{rt{~'~'?ha:13't' i.,sL..uF .11, t{i%i{.mmii- oi'C{.ct'ate Lx~isodo~oA
t:awi?i?tal For .s } \ , "~.. .~ :r\C:tià can P ~F+.' ¾t~i...c~.> . .;~s . ..
~s~.rs>ilÃ~7{+,.F.... ~.:i' 4.,.#ti:t;3V.. F<i1:~C3C:;3`i15~I"#~;: f.~:):3, ~~lt,', .'s~."U\13I1~ ~:;v?f~~: 16 (tz? ,) 1t::' z?
C~.,?Z'i::'{,.,~.3 ;.a '~ ui:?, ~:~ ~S~ FIG. }i { r t'~;5;':?t.'=t`~ by n~'~10, oi ?n tTs:iuL-. i hQ YC:l<#Ãivt p.Fali.e?,3{4`1t of the first and :~~=# t?z?Ca ~'.~_~=~~i?e~~'. i 10, ~6 .ti selected ;i`s.{Glat ti"tC ~?c{~~, t?~ ~S iI~? ~ a~C~:iL=t{
? i~s`;it:it~i..`~e bt.v"i'i;eI{ Ã1he two a.,evt're{.?`f's .10,i 16 _k=#ch1dE.> the mlL:tiili bhood vi.iSe o that . are to be d?.i`s3 a+~d..
'+.ine;`='ti?.c powe >tipa~ly 22 is ts3m{;d on, a Zo:zL.Ã.'s~leÃ' 48, SA?<?w"i in FIG. 3..
I..:,i3du1eltL~ :.2Ie flow off electric current fd'(?m the fi1':;et L.li:.ctTode 10 2o ti1o :secLon::I
5,..ieS,;. a 16. ~~r" s:1~), t~,`L S a ~ \aa."~',"~.~?t S ; ~ ~
\#"~?~i.~i. {~, On ,\ \.~u ~'c,\W'~,'.4 t~?~~~7~ i:?E1 t3:C'= i'G.F.:{~
w{#"~.~`i.'{'1~~, i ?-~:Z:
t?.o3,~gih the. awnai:llt?deI off the a:i'teI 1.tL`i blood i'L'~sel4 s\.rt iF.:-g thJ'"i:.'nc.{=. Si>Sst:..J.1:.. Thi;i f ~er;i` 14 amd "<u {.'=l.c;r;.t.. Co.s~-i flm5 pt1si. E{Y?<3t`,th muscle cells l1'Ill.: ' the tFx?<al a ~
afta`:i'ii?les. 'Th` ?iL:=st;:..3t.,e of positive chr3l'~f,1", ]:_i b``l1C:v4'_`d 4L,+ hi''p<:=Lpoluld'e flnL.4¾ si;Ia AE:
, ~y..} ~~:,=~,l ~ ~ ~sfiy `~.d i $.. expected to ..i.~' ~: t~.,>1>;, i a.~~~~i~3~ ~.~3'ti8i l~. ; .~i~',:~~ ~~`:~ relax. '~ `~a1,r :Tt turn, `vkr~,a ~ i ~ i cnc~
i7a.
the a:ti;r;a-a ;.~loLtit3 seT'vi?;g the renal s4Jteii2. As a rC3<lÃ-l , Ols'',:' kda3Ã.:Qy; 20 A.r4 Aib1.c7.o i,{u1ti ft?.,'1n tF.feZF_lood 1. \an ^.as L(lomiF:3i2.[1ti.,}.n[' \!f i.fAe v:,si?c#.if.(Ex S'v ~~MxZ? iLfi?z"x:ia4 v w i t:Ã~k~.itF`iLled, In Lhw L.i;nfigi.it`%it.iF3'f? :~hZ`wn :n F[l..F. iA, the polFi.f:~.`y of }.hc E:3L.Lii'1! 11iL.Ad, It't such as to hy pQN~,>3C'#..i-,C% t,'IC rV~."~d{ithelia3 'Vell. Si.ifL:;ea i..'li2i~ge i.k the mt-~rnb:.~mo po!tl::i'`dLll43f ~ ~ ~t 't t<, ~.Ãa~::3* ~~hiL.?ial c\ is transmitted ."?' aCsi3s5 ~ 4r ,<7~".tu¾i2~'Ã'I~_::.
*n5 Ã _E3 Ã' .c: lf~ Ã3 *~ y r`I.z~if,~, cells ;1..:.SL:iQ Z.kfflzs. it i~ ;?ossil"slw to contraction t1f the ti3`2;.['s7th muscle by, rh.o5'nd'F3the:hi'`.~ ailb#ai.:.
t ~~ Y~ j > r> Y"t. ~ ~:~ f 3 ~~ i ~
FIG. i . h.'i~ri~ a ~L'~rlv<lb ~ir~~.;i~~;: t~ [3Zi::iC)i'ii`~ provided .~r ~:3:.: a.:ti~. ~'.nkE.f ,.?"j:3s.ie 10, 11,G. iF:oa3tro..}i;:r 48 causes Oic power supply 22 to nneSinEa.,3 poSsi..i:vc v: zzut`f,4:
' a ~ T;~E33'i~ ~ ~ } ,?;. i~: tl~a:li..~c. The ~#, i; .; ,~~ ~~si~~~?~ and .#i :*~.~:~.~ ._#~=~'6'f..~.c.t~~C. at . ~}.~, i`~~AE.. <,5pu:s.i#c3l i;::?a.#1'c VoataY,<: \ p'S31'fi4:~.~+hai`ay 24C:.ful to rf =duc'Z''ft3`idh:l:g of the S..lGti"=tri?Zat'L:. 10. In So'...v pi:ec>iE.ti=s,.
~. W^ ~.Ik t.a inA:t?31 of the 1ze3;atdvC 3'oi>%Ãge is Ãl2t1seIl so that tEt~' iEc.delivered :%i`~:i;,f t~~~' l"4.'4~..~1vo pt;Ã-tzt.`.n of :'a:o m`i~vcfo.t.`32 Nali3d3cGS I.lio charge delivered d1w=ing if#.S 1osit#vL-_` ~~ ~ ;a x `'`~#
L~ w,l.`s r. ~ t:~-' ~. ~i5i~~, ~.~ <, por:3.on t}f t":e wuii;;i. "~r~Y' a~, S #21~ tu ~:i. V~. ~ltil i3 ~ ~ ~:wk454:
e1~.7 a G.a.~~.~.~ ='~~lt. }.~.~;i.i .~.
to 2,000 vE>lft'inwtcA'. G#Z-t:::3 Ow conductivity of ~~loWY >~:i`,`~~ ;~:It:
~sr~.ri=s to current .
' " =5 r, ~" 'a1f ~i~ ~t i ~ ~ ~.: ~ Y t i,t..,~,l I,:~:} ~,3. ?::a~`.'t~#. .~v~ i a / ~3111~ ~,C 3i 'iil =~~I`.
~~t)4,e` D.t ~
2 0; n3 ad:3t'e'.i:l#? vo3tagoL ~.'~f I OC to 1000 0 (4ts;;"Mf;t[;r, I~F
hli:h. trza11silat`i..s i:3tZ? 4::i.f:i'm.#. 4,_.f.:l';s1 ii:s ., of 5?:i '.~00,:3~3~~`i?~~% i1~ 7 41 4i:,ia1e pwFÃc.#a.~.<S, :$i least f:x.i3a:. PaopeÃ"t`:' of the i o.~~.a g..
wsiv,.If)3#ti is ,yach.i'3:,i a.i>:.s~~ }ifdl'h Il4iti"t Ã'4tto. Syn+:hmml xaE1:rtr can b<.
3c}iiei'cd using 4i"t ;rly, mc&,muTo%i bloo(> ~.~t w, uloodp1cssta.EÃ=; or iiil - C4D
. .;
~
~~s.'3~=~'.
25 ~ .#w= 13s.3Sx~. ,'c r`s,'3l~:43.~;.. I~ ~5%,3>~C}il~' ~t[?~~iÃt d d!FÃa:2y a$?er;od i?f ?LZw blood w';icb.. in ,~~ri;3:.ena; .k.tori'~..s occurs primarily durznM~ d:a:-,f.olc.
The ap,~lica6io:? Ãr~ ~
L)$~\~;{3).C ){) .>t:t} rtiJ.tfftat W tj<=?~ ~Z..^ 5(. }``lv.:s~ =1} (~l S) 4)~I zc~4l~~#i]1il x o- {}~: '${l . ]
~ ~ii~4 \~. ` ^w.]L3 ,~.~ti:.i. .3 l~l.=i t.=S'4~I:Y to ~: ~`~+!=v}t-Fw~~+ C
{~~t,. i :.TYlVr t~~?,TiS.~
~ . . . . . i . . .
velocity i ssi.cic.im;a, with :i4`~~~~le teEIds to sw+.'er, ti-i`.. ~ l'i-3.d?s"w`A' particles .n, tI3i;.' bJ.;i.,d m:s:) :~.~ ,.':'... E'.~~ ~3.~L .~~:~ L. Since Tiailsi.i~f t~1GtiL`~~3>t1clos z#i~=~?Cgb ,vt y ll?ilÃ'4eC~ , t:i~
~~i~1a~~~' al3.+1~~ 4='tl.>~.=~~:~` t...li:'i3~~y ~.t.:'s3~~t.:i the i.~FtGnt1.: v~'rEl.F+. t::t.l,k.laF~<3.~~~i4 F7.~5'.~:~l~_FI# i.~3 ÃiLF~Ãt ;
systole. In cZ?:i3t'na5t., during t,.iistz3l#,. w:3ti'i A:i SlÃ1wi:=3' fl,>Fs;
fl^::;"~ Vk.h'.ciF ', t)10 negatively cbutia .rL~:: A~u.2k:7~.3i.~~s L1.:F1.... to L:l~.F~if,l~:l;i~~.'~. on t.:~fia.'. wall, :~~f:~~i"~.b~r t-~;: ~~iF'F.:~ to neutralize the _~ . a. . . . 4 . . .
Po:Y2CS v'c 4hYdc wsa on iy:2V } i Sti.l. 'I 1' 2tF'J, it is \Lu.f iS2g kdiiL4toRV th'L=6po:i2d + e 4'hL=i FI..,~.Ts is ~ 2~ t~St ?1Ã:~i..iz: f~;.' mÃ:Ftnts.Fai`tÃ.Ea," h} po:`pi31ai'il;F1ioIl.
Fhf.~Ww"QiCfrn}. of FT2L...,. ` "caFn be v..F>F(.F,t 1 ore'1%FmplOy .FÃi S}jme V ' S
there ' Y ~[: =i) ' i ~ ?~ -C Y
C is TFSr F~.~:~j;i~..~ i, l~'tF~;~:. Instead, t~ i~-2~. xt..wt_i'i>dc 10 :s nF:.i:it:
1Ã-i oale 1#::>~:~ the pC?`.37~-1vv p11h;c is- r5,.'ducl~A i~.n s,liliph.+udc w> ,C:ndi:d , z ;.Il other imp tGÃ31ek1es$tÃonh, the P.'Ist:s and the U
,."L?i.~'t ~...v.'~4syrclh:r Z nz ~i`.
In :.3-me appIic~~iol'm tlle po1w,~~y of flae zleot.odes is .olvornsÃ.d. :,:
..x.h Qa's'gs,.
.:
t+'f'l in FIG. ` :1, ~Zlii Z~ke*~; ~?f3.i..`3`t:C: F'S~:i:xwCi~, ~ k~.,`Ã
~= ~. ;r~ts ?FkQ ftat shown `z ~~~'f.
tlio sta;:Il~ iFt:.t I
py?la, a~y is rc''v. ~ed, sti.nuiak#fs,: :is typically peF`fn-n.t,.3 uLF:r.:ng si =Fsi;?i.: :nm:.d fsf d#:'<'13t(3 E Ã.'v ~\ ; ... ` S 1y ii` C'=~ also be (~C.Ã .td4<3Ã , in tÃ. _ ;L_,+.C..i;? `, `.
~._ 11 ~ ~i. ..:z+,f,.. :.C;i:>.. ,.'F~T~w~li~$F i,, :~Ta ~;:is ; ..?iF>
cC1.i1WÃI? '\hapC:.i: featL'3,t:.,i.i and/or 3:W.hC:S havR^A"Ãg bflfl'l positive and Y1vgc.FtF~'~`v' pt.Fci'#`f.i>i+
Ã.`Z ~`.,.L3>3QF. .~.;ti t one ~ ~i it.. ~ ~` ~ #-. i r ; > ~ ' a ?: ~`'k 3 . F7i;F"F~' ~.7'`~:'C.'i.1f.F~.~.::iti>: T~iE'. ~=a4t.t~'lti:i~ s~`x "{~lF.a.t.C Ie lQs.(E not be Z`'_='~;
cC .33aF7:n$. .. hQe4w T?`>r"1); betfT3w #.F"ikGd'i'F3.ls dliF":i7:g 4vhFCh ti1c, st1:znW<:iC3i`F 1s turned II, uY_.7 i':ftz.3'#t...~ >. .yo-Fk"i= Y , . shown in 1' I~:3 ~. 121, ::~~ zt~
...7I~:~~', { ~y;:. r '~l+.'F n !'}~ , a ~.f:l~~~.`,Lsf~~~2~p .i7~. ~~?~47?~i':a ~3 1..:, 'c:
20 fco:ib::tck coupled to a sC:F7uo7' 50, The soilso. 24 is co1ifigti:f;i3. to .f4 w:::.Lt an i.idFi:itE,l of the ccarL`s"ls c cyL:k c`; id tcF ptf5vTdÃ- c<iF"<i1ati cycle data i:? `._h S i~a x ,mi:t:F"' 48;
Suatal-.slo Ãnd:watoF';; of zau'dit~e cyz:l.c Ã.F:tcludi~~ ~icart bua!, blood pr(: s,-,LiYz`Y flow ve?.}c;Fy, or fuiv physical iyp:z:#.`ttitv' ffilf~.~ which the olFÃ"Ã"<:F"it. state slf¾h:e. ;.: aa(hFc cycle i;:lEi be detiv~.a~.~, The controller 48 i# ~ t, ht5 cardiac Qvc (e data w ;~i~ ap.ive;
y .1:~:= :z ~~ t 'itl v S bet,`tcei. positive p~W~::s, :n. FI~.~, 10, ~ ~~)ical pt.:~se widths range belwes:,n [3r Ef i.ht. car:>:tac S:1`cit .azld 40 1'1-iffl15ei,:onds, h-: raF-F.o iia:x' S:.in.>E?:3.F$T1vFli, shown in 1~~~IG. I ?, the t,t:Fn.:i'EF! t~'.oÃ.` 48 rvca?Ei eS :i'eedb<li;k fh3'In a lf`.:s.:i ~'senui:Ã" 51- kat Ã.7Ã't3si~3'eS a F3F'E3p+'.F`ty r.. .
04i,. LaFgt.;t ..;i4> ltst,~.., F;bF 'L fii3':tF13e' tr{~.}'S.S~~ 10 may ` ~ ~i. t.,,r~RiaI ~tC.~C: r tf ~' ~ = .'rz#:t~ t ~ ~4Y Iis ~ t~l7h.. L`koF`nti of Z:=3$~.`=4 a. w~`w ~2i:':kC~> < ,~~. i.{;.
4L.F"L`L'..1~. i ~.Z~~ :[I.
~~
~` ~~=a o a si-i~'1"ti?t~nt~ai?Ã~ ~5,i>E ~ ,~~ri~ ,\a. ? :3 L1~~31{~ i::'S..=~.;~si~'4 heating, the local sensor 52 :.;3"i ~:~u ~a 4t.:.i4v{3i'?T.1C?3.#ntt:d at the distal tip of ~.:Yt` {:tltht'tu: TlF~~
w1.]p'L.z:3`iuFo sw:1:*o;' Pif, r'iiii::s. #3 tt:mper;~~IIIo h,.gla` to the i:=t?I3'3`C?~leF' 48. In response to the Eet'i3pa,,,eilu~'~.t:
..~..'c =a ~>r\'<irf\FSc.~.~~ 48 ~t the '~t ~=c~ ~.t~->.,.~.1 , so `~ as p Li.
~' ~. x:i~.5ii_ af.. .. ~ ~t +. ~\., Zt. i \
~#S ~~~S.. v 'v%2,i3~1{,~.: C~3i3.w.L~:~ iA~~':~~~~<?~~ S'<. ~.rl\.\..... ~
.~.4=iil * A`."#eà sffcili L:A3st#',.if::~'L.Tisi7i.:4 C:ai? <?lso be1ii.c,~su"'4d by the >>r+:;c#, bZ::`?St`,i 52. à {;r ilxi.i.mp:Z, til+.' :o+....i3? .`ai.,.:?oA: 52 'L:a#? >+i:. %i pI`CS."543rC;
sxi7,.So that ;3. {s`c'7.SaC:@ a pmas.:lra` \iS.s,.$i5.?e t..i,: E::ie basis {r t4`~?#ti~? the L'{3Ã1tÃoll t ~ 48 i~i ier ~3~3e5 6~??Fo.~ai" a dt #Ãed l*3cFal b Etsod <
~~iL'Li:~l1:#'L ~~a." i;.t.=Ã: E3:G:]Y+;.Z'i::d.
A :r'3>F. =EÃl i:~Et;l{st~t:3"9 shown :t1. ~'I~ i `xt. fC.~t:tt:li'w'N a flt;.~.t `,.3l~' :LF~?C':s~ ~.r.i~''#.:'ÃF~,,~
%:i''.~i;.ar end 56 i.:76t:ict,:,ie{i t'so, a dl.ttal tip assembly 58a?':d c3.
prCZ:4i1?a'i?,l f li.d 60 4f.;S,urnk.t3 t5;^ a 1m:'3dlt; 62. W;tbin thi.. {:ik1=3l tip <3ssLnA)lv 58 are the tlà 5t Ã:lecÃaz?i.E~ 10 ;aa?is .w', i:r` Ãhe i_iii~e~lari dL`Si;=iÃb4'Cf. a~..~f.#w. Extending t;.)r<?F.ttl?ti~ tube 54 ;s, l~l,?~~i;-:d3_IG
64, a dz-,,t.Ãz cr~E3 of wi?#cl7, 1a sc33_i'i.e {;ia?bi`,din:1e??t., also fu11ctit3as as t:Ac . i.Ã's, i k.ti.''f?iai.<
: ~a ~~~~, A ~~r~.:~.ix~~.~~l ~,~~~~: of the ;.~i..if1~:-i~~i~"~:. 64 is ~;~~Li;?l~:{.~ t~.3 ti?~. i~.A.~~:;.~. ~s2, A Ã>>_~:~= 66 . A., \i '~ ~S Z
i#:L?Ã.,a7.w~3 ~:~?? ~t;?e ~,.a.~i'~l\ ~~ ~3.~ Lr'?~i~'?l9 ~4> a ;;~3L ~il.lF~
to ~ sx...~s~cti~`{.'.l~' i.a~:'3i'?tt ~.;i ~3.~TC,.; stip '22 to tht, .:::t: tllid si:i.t_?i d {. .lC',#.:ti'f)&.cs 10, 16, B{3tli the vat~~.i{:%t<.Ã 9 and ..s distal tip , , sõ;s4za?rtlz :~ . ~ are sirG'cl ~.t~at~ sz1~a;d to ~{?s~ ta~~'t~tIt~fl~. ;:1 (j8 ~;ji~~
~ ~i vcssca t,lr c:1: ? Ã~1~_. 14 ts dict~ei;-i{anal ai'wrv 12.
.3~.'L.~..~i~4~i. 43i_?t~...i.if a ,`~ C, Addktt{.z .Icz <a ifppi3 ii,'at1L f: "i">, \? r'~ tht.= ". f3v4~,~.Y.
Ss ~r~' a Si~A? t~ rc`,i???ii`x u..'a~~~#..,~ias ,~i . w t cCtr\in<i.i v ..n~vi.v iZ1i{w distal to :anoZrf.:JusioiZ: fil pijl:caaislAliÃinfy t.i~oin .al.,iate i n7'lic+.~rdii:i;
iIxfc1AclT\bl.. Sz:t h di;t?.IoÃ1 uluy i3astC:31 I'i.-peffÃ1h7o:Ã1.'s.3n+:3 pE"e5'cifi,t i~'~i~ff? C=#?'?~C`.A>>r C3\.dlb:>Itj.i distal to f.3a occlusion, tATe'ebv iI7_Ãt?I??_z.E$1a loss of tnyt,acat d3 Ea2:i3. D#?:3t3on of flsc 4iÃL&..i E.il, bed tI3 wt3.l to an ds#.=hO?'?1ic s:Tokc'.iA3.$ y t3tlba dh.:
25 same bei3s:f:ts LC} a.:~i+`..iyt~.`d btcl.123 x9GiIench'P;'dT?a.
DEliitit)II of \ik;aS..t..:ar i3iõd, supplying 1110 k#fdF' ibl xtiA 13?le bv c.l? { 3t".C i1'udi i#??pli7.i3tt'd into x3e pe11.121E lw. y i.:Ãt~. y> _ i;~.\ ~.~.3 ~~~A' x.ei:t{i-lfi..n3 of PÃii.a?sin._fui.i;~zii~i~.i~.? 3i~'~~3f'.r~i~.A~;ii:~~;. ~
'.is"dA.:i~:;~rt*.'d{..i.>it.~ii~ f~~ }~'v'2s.i~f.= ~'ra?~iC'.ai''.'~
i#1;.~ ~3lintod stimulator may hec.3 i:i.so9+'`~~'i;= i.lyi:;. ;iZ..-sund dy~h.i~.:#:3cI.oI's.. Sys1i"J? it E~rxli'bL ci.ml-a;li;d b4'd.la¾ioil of skit,.cte<i 3Ee' pS,I"lp.3i.=rx33 :riL,=n?i?l b'L.ds. fii this application, lmpl.i,:3cd S..llt.i:Ãit;i.ts.e::? mt?*' sLi, ,a..,ne ~
I ~W
dflcF.t]':i. .:? `vsi3x? ?so t(s in i#' Fp:.i#:E?tC .d brol?d pr(',SsFd[ e 5(:E?sL's:', Ã33 V;wF Fmt,?".S.' a,rZb g?ia.?'mai.'t'14F of #.Fl?}?hmie'Li ci}n sri1l S,:Fri:(FM;', ia, oflFeT ar?p.rÃõi:#i.iFis, sÃ1#:'1F.flzt:#t:1n ca31 bc `<`'..pp;ed to aF.:Ão.1.:;F'>31: .?'3.ef'v('s <
to Ã.e .> a ~ra~~:~;t'~' c? n1Ã;;{.?rt~~;r4. I~s sFioIi a~a~~l,(::~ci~J#~?ti, ~~z -t~rst x.F~F~~ s:Ã~Ct~:Ã~ ..; ~...;:~~)~F:S .Ã 0Y
16 ::re ~ las.>:is FFw .<3:i' diFmilY.~.f,oC tissue enervated by aE'atoaFt?aiF1:c nel'vS'., flne (A.lS:i:~triiS.eS 10w 16 ,2rt: bS(`F..g:~t near =iw region witlxer by pastiiTtg fhe#.. bl(?od .'\
s4e.. tA#:,it a 1<>a~
tb.;r. t dc xia ~ ~.3:'1?..If:r { ~ <a~n~3.a(?..'# ~#F..fi ~:? #.}ii% ~acF
<~# x \ a .(.. ..~t =L3.; vF a :iC.T'~ ~..:.:: :?#. :ca4rt., r.'.+i:~ ~ '3~ <~F_a~4~`~i~i #F;:S\.~~~c:%f`.~.',~.(a.,.ry:a .:.i?3 S.TFzlWa#.F(t.Fa::~#F# bi:~ applied to ';y#~~?~pa4}l: FC
t}i'~z<~Ica~v'I`,?~?sa~l`l4=~t~. t=ffG3a.,,,,:nC.Ae,; to <
S.##;~i.~~.c~t>,'; Z?'3 i'a...s x ::F\vEF~.6 :L.~~Fr.tii~t ~.~i Y`i or ~."S
;F11'e}"i.'.l~lt. IFt n~'%'.i fC? ~I::-mF.,.Ei ,(ta..Fi:o[? _ft3;3'F
.?. ~ :1.a: bi'<:i n t?F' iF3 :?I (?(.'sk y#gzn a-aI s .G..?.&;h as '~,~~,a1#3 f-rf3YI-i FE'.=%lS:;hlm, t~> 'S.. ~`31=:i.Fa, F4mr examnp^e ffic apparatus (?i it-3t: pr(.'~:1`4Flt znvonmwa can ~.`s(''.
..#.4;:d it3 block pain z_.,~S k~#i .~ i. .! . . ,~ r When Z ~A" t:~;l_.e.l.k ~+ \ the 'N~t-?
;:3~izi^s:~.~.?.Fac3 .Fx. FFxF$i.+i"33F?~'~., Fk~:.:l :8:,~. ~rt+~~#~#x ~.t%is ~i> .,1'. ~~I;a.zFz.~.Fk (.>f ffii::
R..ei: :IC;ti.Ã;ti 10r 16 (.<.Fl'#.'.'^'.'('< cIFI;i('Tlt to fl(3o-v .#?#Si the ~~z4:ZxIS:, <.
A~t~z#?
~ aF e#~t ~:~Pa, ?(3~<~ 1~.W tj'3'i I?C7~3(:t ~StIv"~' i?e# 3'(as, `t}i<7(':)5' ~?k't:v(#..I?i~~4.~ t~..~-i,il f .~. 3 d(:poiclrFLI:t`g: s#:wt ihei1iSc L 3t:: i;`. nerves provide fliL. :
f..l'zss3iÃ(sn. i?~ ~mIn >.: ~liv b;i3.1:a"'a:.
a....5 bLo.... '&<#,kd. I:nt'#om bf.Fn~gis' about a cessation, or significant d?II.:iI1LFzlcm, i#f pa.Fni. bi _.~Ã.#.tm., ourrmi dfi:..rt\eIG:d th:.9`il.'.h i3rte:'FiF: blood Z'i'.14el4 `:'t..ti'#F#.3w at:: iF'kjt.#zi:d bi~sue (t.lai.as ~IhÃ3s(' blood vessels. As a #'o?itit, mcwe blood 1W a4'a`"ls "MÃ.;
to nE.:}i.iiisl, the tl.#:(,Ã:F
;itiSa3e, 3t:I2g `.4 l3f,`=alixlg.
2 ,. -.'f#.n aTF` ibos.r of f#lt d ~ ~~ t?? I}loisd :3L.p,r~1ly to F:o(:s`.SlI
4 ~',t . .C3 $i#.s4.xÃ~~
caI ?w ;D # ciye,~ in W:3#0F Z)3]z v. `4ht'S tf) al:li1Fd bA;`i'~i fi<;`st ft?, F#F` g#(}mz# i?z 4' F#4tõatlvel`+ (.h'aAi:eM ~~~c blood i+,5<e: vv`aFll, tt?C.i.'#:blr svW(;i`+~'LI'Us4im R~-1'L.T'S:x1 of p(?'lwF`i t #LS~(tL`sz#g dhe r?,.4FFj<# #tu(x(` e:?f the I?1LÃ1~~~1"~;>C' ~3F? ~.[y 1 F~, and poss Flt.ial. t +.t3:1:siFA`r It ,s F3.dtait#on:`llv( p(? itiFbIQ to Fff?dFIt e: lt?l:c:l +.Ã3nis:i'#.f tio#.; iIt u#' : \lii.= s,'?f =`5 ti1i1,',it?I11.Tl;itFi14 e-If'.'i:tit?d:` r;4 slFx?'1(F:i3tlI1g t:3dw syI`u1pathcdc'nvF4C: that ca3iFstx1d'`a t'x`34' lF:E3~F?~i f?Fusel~.'~. By Mfi,..l=L'c t.Fi'('.1,{ c(.~iFst#.Ã4t1#lg iT.it(:nL,s, t?21o o#Fn zf"duLG I'li?w ofa_i#I[ i'1ai No;s l w, i fici( (a tFwOl3vs, :hCl6yt Fn~11~?itFSI~; ~T"{awth 5.3f"5 x.:.ld pÃ,.....7a:;)`+ L,a>.iti f1g ,'s+`.ÃF.Ã:fn#c d"eudi of ia3otid fitiS::#c.S. This is ;?&FtxcF.:ii3:rI5' F:[:sef1.Fi whe.El t#Zie solcct`,`d t.ts5#._Fs,. 1s: ff`r f..'xGin1p L, a ea .t.a,'s'i-$;.i3 tumor, pa:#Ã#.cFa'.iiÃ'iZ=', i3#le dFat has yet to m'G't-ast.F4#t.':G. Yei. 3?l\Z0ht:r 3 {' <~ppl"#ft'atio?3 of Svl :C;t.,ve viFsC]m?4ta Fc¾1E?.F3. is that of j.I':Ã.iFt.Fx`s`Ã' va1.(?cC.I`~vri(.Oo;:~.* to .G_=d.uÃ;e 'Lf~ ~ ~Z.] s9' f ` p s," ;~' y~` ]t = { 1.~.<~xFz ~c~ ~ ~}i~., .A ~Cka=`= of $. FL.:C>t\?3.A:{~ i¾ e~y ,~2` crt~ iy q:~ Ãw ` ~.~~)~'~'i~~'j`~' ~\.A~ E~~~] ,Z. {~5:`~.<~ 4' ~ li 1~n,~.~. ~.w-Ltrn~ .tl~'~? ~lS the .~.i .
Li1i~.~:~Fi..(.4~
us,c;sul ti>r tzi aÃÃtaw a hentorrha;=:jc stroke.
A`i iapi9ildati.,s as iI:Ls;.i'1bC:d iaS~=`re3,1i can bs usoe.F to de.vZ.'i~
:~~.s Srilni4,t-v C4k ihelas.f1:;ti un ~ti4"] i"~ _ ti~t.~~i}~~ ,:! but not 2~ ]F..F~ .\...- ~,`3=.
t~2.=~a44 ~~~~~A3>k={~~.a ~t'.C~~~2~~~ is~=2.7.~a~i. ~~~t.,1~ ~~s ~~~~==i~tav ~> i i ~Z+.~
3 sC=lL.'::'t13L i:tl;i'itt:tC)n 33I .flla.'. .3rbitthTt%3':%i=l i:?'tGnii.il beds to :n%:t'#;.'ciSC u3'.il.dõ olEtpuE. and .S .duce blc:Fod t i1alciJn o-30 Ein artei-ial bed d:sf=~. to ~ ~lovLvj;i~: a..~ ~
coronary; <:'~cbra1 ;?r i>thi:r as ~.=~,,.= ~r =->r 1i. P:f?vÃde 4,i~. `'[vi:3sf:Y. i ~ = t?
iSl:l'~~..lYz m `:. ~ { lsy ` blood a ~~~.~v~' ~t+. ~~)~af3 ~`_ink ::C:'.Is3) c_:.cs~r ..
:hz.` 1.'F'fU`.:3.i;i#`:~,; stenosis, and t, affl?w flushing ifild passage of 's3ll blood vessels . xl;Ai1l to the bltSG;kagt'.; and vl.4f3c\9ianb:ii..;.t3n of 3:"#:~c`~rl:.J fei:d~I g tmc }y >^-{t ' ,:.t v> ( 4t(* >t ..,c.r \Jii~.'\F2 L 1\.~2..:..~.L1i`~.ilii~~b= .]F.1,l}yi..
m,Ã'+.. a$k=d- as doSL'ribm; hoI"t.Itl can :ihso be ;s4Cd 3.i3 Z,C'>.,Z f;..:, ti-;.s t .:.py i,h.,~t3:3ic~illy- or periodically. Such tht:'i'i3`y7iw.s z71el Wi::? mut iti'i:= a:t?t ;.~iIEi.et: V vaNo+_la2\.s#.L`s::
of 4cl.fi,.af:'d pa:1p~imaa art':::I.Eill bals., f:s''.Iti;E1.t Sy~t<.F:STi;
hypeartt.',Fi :Ot; v .E:: `+?iZ.I<.i...z3.?n of svdcLu~, arterial beds Zo treat local ~Zaiitl.~. A>~~1s fi3r +.s56.ex#2p C.
primary putI-nonaIi`
hy 3eI'tS i1.,1:i5n i'asL?L3datzo#> of th: p%Ii1e arteries to sÃ'.at t 3alr sexual dy~xuu~:tkil: ~'i;.~
vaai;e?s.st3':i:'t`.o.a, t3z a'i art:enal bed fG;(ji.~ig a tlllhlz3i to treat c1..?cu? ;
1hav7: "M d4'Si.,Ii7+:d, ;}tw:1111':71tii317 and a prE.=fi:'m3' =bc:dia]-ic.r, fhe.i0o " 'Sh w clc,#:I:i'.i as new, i3#?d;,,oC.ier'ed by Leti#.`.,"+,':i Pe.ItoI?r it;
are ; sicliaso'c;
E ~2 2. { 2- ~~.. M, }:~ the ` tt-.A.\ ;. :.,.=:~ =x , ,f.~. a~.,:?~~;{G-~{~it?~~ t~' ~ :~~s~, I.~ :~il~:<I ~~~
'~~~~a~~~,}~.r= .~ r' ~~~Ã~~:.{
i a 'p. h. i?. . <.=1 t-,an incorporated by refC?eI?o4.
~.~~Iw rG~.`> ~-,:t%a1 z `i etr~w1.~'"l:. ~. '~ ~ f a 3311 ;~ ?YG =' ~~e~1~~#
~:~~I1e~s-'~il.`,'t.C 3i? in 1xc'~~5{i:{? a 33r;it '\~. 9 Z' .i.. ,~.a~ . r..
7 L=,C;}v'trodt:~ 10 is implanted in an artery feeding a targeted ii1`tu..til:
bed, .:{I.:k. a ti,--.i:ijFed 3.=10.i"trod('i 16 is 1?ix3:i3z'iÃ',d IÃ;' i7. b"s:ln draining the Eftr:SSw,C
d z;rte.`'i.{;. LSi,d~ .. hL. pt'tirt;:"
)UFA ~ 22. wh{Z h :tt wimijv ciF.iei?ei?~y st\>F.aw:.Si 03cwnent or tmT\.i..?erWili: aJ:v b . ; . \ = \ ' Y 4 of $i a ,- a;= ? g ~'Y 3 .w.=%3ti '2 a._=~> .4 ~?~3<.=L~{>.~.t; ;a?..=S.is C:={~if~{:.a' 5.3~2`v ('~v ~f:.4 ~.{"{'~~i(${ ~~C, ~ F::cLZi'Q-ti. 10, Y~ ,~l i Y=\ qaz~~;?fc1{a1 p 5 ) } ~ S i~.Y
i 4ZT
~{id;=~a ~:~5,~~;a?`~'.t.~~.it the t3~~ j,'".1 ,~<:(.~ v3i'+C:~13"_3t$4 ~~, 10 IYCI~id.? a i:=a3F{k.t3~:~.Z \,s :~{Str {=e, Ahi:m{h i:xt ti{a power supply .e2<u i_:f7d eilxy t:Z3r.FT'E1l t=lG
tit7'4`rT?ls.,:1 are Ia??p;c faat.i::d :{# a ::hi.i:ti ~~3w=~AFi..{? ` < - : . ~ ~ ~a ~ ' a, ~ ~ ~:..: ~..{>,~`.,,`L=e .o'=t` to .hC'. ia~l+~ai~~~tG t` ~.etf 3?~~~s 1~~
1~? by E C)I C~l.. t;F' , si?.~t{ial.~~=~
wi>ck. Tine poweT s a~~~ly 22 uui be recharged by an etit.e{".na. ;,ot:>oc of e.eAy;yf, stÃ...a as an R: Ã >{?.5??..ti~~ F'< Aftti r t12 t14 o3 J \ flne power q4piC .22 can be F" .t%}?aI g4d t> : i::zi i?{x pia;?to,{s b:{4?t:ii:=etI l.: `=~~.,e1?.L.=rt{.lt:)"' that tai:illtfoIIa"`ts body {'llotii?n or bf.F,,> heat {a?ti;?
. > C=~~ L Ã~~~ <?.i iC.``gi+, ar"`C;I?3C; Lx14c5, the implanted electrodes 10, ~'. `slri: powered e,-1. i:i?%y f:t}rnai{ Vr\5en+al power sm~~ly.~Y such Lts[a (}. RF 6Ctl.rAs>.i.'Stte{.
jI.{.tAc ><i?p2an~cd4'{JSiC2,ol cIi:cÃ;'i?n{c> :-t?z. v bQ ,}.<?gt`amineti fre?rn uri[side Ã~ic body.
3 electrode , ,~~ ~e~{e3'571:? E.i ~'~.~:E. ) the second ecÃrod4 16 C::1?1 be c? s`.{r:ci4e such 4.. a ctsnd{..a..t ve p<?.i' p2c`{c,o on the ~skl{?.. A ;ncUt?.{?:Eh 4lc;dmd`l.' 16 pz.-cc+a{ umi .tw s:.1{, .s ps{rt{~'~'?ha:13't' i.,sL..uF .11, t{i%i{.mmii- oi'C{.ct'ate Lx~isodo~oA
t:awi?i?tal For .s } \ , "~.. .~ :r\C:tià can P ~F+.' ¾t~i...c~.> . .;~s . ..
~s~.rs>ilÃ~7{+,.F.... ~.:i' 4.,.#ti:t;3V.. F<i1:~C3C:;3`i15~I"#~;: f.~:):3, ~~lt,', .'s~."U\13I1~ ~:;v?f~~: 16 (tz? ,) 1t::' z?
C~.,?Z'i::'{,.,~.3 ;.a '~ ui:?, ~:~ ~S~ FIG. }i { r t'~;5;':?t.'=t`~ by n~'~10, oi ?n tTs:iuL-. i hQ YC:l<#Ãivt p.Fali.e?,3{4`1t of the first and :~~=# t?z?Ca ~'.~_~=~~i?e~~'. i 10, ~6 .ti selected ;i`s.{Glat ti"tC ~?c{~~, t?~ ~S iI~? ~ a~C~:iL=t{
? i~s`;it:it~i..`~e bt.v"i'i;eI{ Ã1he two a.,evt're{.?`f's .10,i 16 _k=#ch1dE.> the mlL:tiili bhood vi.iSe o that . are to be d?.i`s3 a+~d..
'+.ine;`='ti?.c powe >tipa~ly 22 is ts3m{;d on, a Zo:zL.Ã.'s~leÃ' 48, SA?<?w"i in FIG. 3..
I..:,i3du1eltL~ :.2Ie flow off electric current fd'(?m the fi1':;et L.li:.ctTode 10 2o ti1o :secLon::I
5,..ieS,;. a 16. ~~r" s:1~), t~,`L S a ~ \aa."~',"~.~?t S ; ~ ~
\#"~?~i.~i. {~, On ,\ \.~u ~'c,\W'~,'.4 t~?~~~7~ i:?E1 t3:C'= i'G.F.:{~
w{#"~.~`i.'{'1~~, i ?-~:Z:
t?.o3,~gih the. awnai:llt?deI off the a:i'teI 1.tL`i blood i'L'~sel4 s\.rt iF.:-g thJ'"i:.'nc.{=. Si>Sst:..J.1:.. Thi;i f ~er;i` 14 amd "<u {.'=l.c;r;.t.. Co.s~-i flm5 pt1si. E{Y?<3t`,th muscle cells l1'Ill.: ' the tFx?<al a ~
afta`:i'ii?les. 'Th` ?iL:=st;:..3t.,e of positive chr3l'~f,1", ]:_i b``l1C:v4'_`d 4L,+ hi''p<:=Lpoluld'e flnL.4¾ si;Ia AE:
, ~y..} ~~:,=~,l ~ ~ ~sfiy `~.d i $.. expected to ..i.~' ~: t~.,>1>;, i a.~~~~i~3~ ~.~3'ti8i l~. ; .~i~',:~~ ~~`:~ relax. '~ `~a1,r :Tt turn, `vkr~,a ~ i ~ i cnc~
i7a.
the a:ti;r;a-a ;.~loLtit3 seT'vi?;g the renal s4Jteii2. As a rC3<lÃ-l , Ols'',:' kda3Ã.:Qy; 20 A.r4 Aib1.c7.o i,{u1ti ft?.,'1n tF.feZF_lood 1. \an ^.as L(lomiF:3i2.[1ti.,}.n[' \!f i.fAe v:,si?c#.if.(Ex S'v ~~MxZ? iLfi?z"x:ia4 v w i t:Ã~k~.itF`iLled, In Lhw L.i;nfigi.it`%it.iF3'f? :~hZ`wn :n F[l..F. iA, the polFi.f:~.`y of }.hc E:3L.Lii'1! 11iL.Ad, It't such as to hy pQN~,>3C'#..i-,C% t,'IC rV~."~d{ithelia3 'Vell. Si.ifL:;ea i..'li2i~ge i.k the mt-~rnb:.~mo po!tl::i'`dLll43f ~ ~ ~t 't t<, ~.Ãa~::3* ~~hiL.?ial c\ is transmitted ."?' aCsi3s5 ~ 4r ,<7~".tu¾i2~'Ã'I~_::.
*n5 Ã _E3 Ã' .c: lf~ Ã3 *~ y r`I.z~if,~, cells ;1..:.SL:iQ Z.kfflzs. it i~ ;?ossil"slw to contraction t1f the ti3`2;.['s7th muscle by, rh.o5'nd'F3the:hi'`.~ ailb#ai.:.
t ~~ Y~ j > r> Y"t. ~ ~:~ f 3 ~~ i ~
FIG. i . h.'i~ri~ a ~L'~rlv<lb ~ir~~.;i~~;: t~ [3Zi::iC)i'ii`~ provided .~r ~:3:.: a.:ti~. ~'.nkE.f ,.?"j:3s.ie 10, 11,G. iF:oa3tro..}i;:r 48 causes Oic power supply 22 to nneSinEa.,3 poSsi..i:vc v: zzut`f,4:
' a ~ T;~E33'i~ ~ ~ } ,?;. i~: tl~a:li..~c. The ~#, i; .; ,~~ ~~si~~~?~ and .#i :*~.~:~.~ ._#~=~'6'f..~.c.t~~C. at . ~}.~, i`~~AE.. <,5pu:s.i#c3l i;::?a.#1'c VoataY,<: \ p'S31'fi4:~.~+hai`ay 24C:.ful to rf =duc'Z''ft3`idh:l:g of the S..lGti"=tri?Zat'L:. 10. In So'...v pi:ec>iE.ti=s,.
~. W^ ~.Ik t.a inA:t?31 of the 1ze3;atdvC 3'oi>%Ãge is Ãl2t1seIl so that tEt~' iEc.delivered :%i`~:i;,f t~~~' l"4.'4~..~1vo pt;Ã-tzt.`.n of :'a:o m`i~vcfo.t.`32 Nali3d3cGS I.lio charge delivered d1w=ing if#.S 1osit#vL-_` ~~ ~ ;a x `'`~#
L~ w,l.`s r. ~ t:~-' ~. ~i5i~~, ~.~ <, por:3.on t}f t":e wuii;;i. "~r~Y' a~, S #21~ tu ~:i. V~. ~ltil i3 ~ ~ ~:wk454:
e1~.7 a G.a.~~.~.~ ='~~lt. }.~.~;i.i .~.
to 2,000 vE>lft'inwtcA'. G#Z-t:::3 Ow conductivity of ~~loWY >~:i`,`~~ ;~:It:
~sr~.ri=s to current .
' " =5 r, ~" 'a1f ~i~ ~t i ~ ~ ~.: ~ Y t i,t..,~,l I,:~:} ~,3. ?::a~`.'t~#. .~v~ i a / ~3111~ ~,C 3i 'iil =~~I`.
~~t)4,e` D.t ~
2 0; n3 ad:3t'e'.i:l#? vo3tagoL ~.'~f I OC to 1000 0 (4ts;;"Mf;t[;r, I~F
hli:h. trza11silat`i..s i:3tZ? 4::i.f:i'm.#. 4,_.f.:l';s1 ii:s ., of 5?:i '.~00,:3~3~~`i?~~% i1~ 7 41 4i:,ia1e pwFÃc.#a.~.<S, :$i least f:x.i3a:. PaopeÃ"t`:' of the i o.~~.a g..
wsiv,.If)3#ti is ,yach.i'3:,i a.i>:.s~~ }ifdl'h Il4iti"t Ã'4tto. Syn+:hmml xaE1:rtr can b<.
3c}iiei'cd using 4i"t ;rly, mc&,muTo%i bloo(> ~.~t w, uloodp1cssta.EÃ=; or iiil - C4D
. .;
~
~~s.'3~=~'.
25 ~ .#w= 13s.3Sx~. ,'c r`s,'3l~:43.~;.. I~ ~5%,3>~C}il~' ~t[?~~iÃt d d!FÃa:2y a$?er;od i?f ?LZw blood w';icb.. in ,~~ri;3:.ena; .k.tori'~..s occurs primarily durznM~ d:a:-,f.olc.
The ap,~lica6io:? Ãr~ ~
L)$~\~;{3).C ){) .>t:t} rtiJ.tfftat W tj<=?~ ~Z..^ 5(. }``lv.:s~ =1} (~l S) 4)~I zc~4l~~#i]1il x o- {}~: '${l . ]
~ ~ii~4 \~. ` ^w.]L3 ,~.~ti:.i. .3 l~l.=i t.=S'4~I:Y to ~: ~`~+!=v}t-Fw~~+ C
{~~t,. i :.TYlVr t~~?,TiS.~
~ . . . . . i . . .
velocity i ssi.cic.im;a, with :i4`~~~~le teEIds to sw+.'er, ti-i`.. ~ l'i-3.d?s"w`A' particles .n, tI3i;.' bJ.;i.,d m:s:) :~.~ ,.':'... E'.~~ ~3.~L .~~:~ L. Since Tiailsi.i~f t~1GtiL`~~3>t1clos z#i~=~?Cgb ,vt y ll?ilÃ'4eC~ , t:i~
~~i~1a~~~' al3.+1~~ 4='tl.>~.=~~:~` t...li:'i3~~y ~.t.:'s3~~t.:i the i.~FtGnt1.: v~'rEl.F+. t::t.l,k.laF~<3.~~~i4 F7.~5'.~:~l~_FI# i.~3 ÃiLF~Ãt ;
systole. In cZ?:i3t'na5t., during t,.iistz3l#,. w:3ti'i A:i SlÃ1wi:=3' fl,>Fs;
fl^::;"~ Vk.h'.ciF ', t)10 negatively cbutia .rL~:: A~u.2k:7~.3i.~~s L1.:F1.... to L:l~.F~if,l~:l;i~~.'~. on t.:~fia.'. wall, :~~f:~~i"~.b~r t-~;: ~~iF'F.:~ to neutralize the _~ . a. . . . 4 . . .
Po:Y2CS v'c 4hYdc wsa on iy:2V } i Sti.l. 'I 1' 2tF'J, it is \Lu.f iS2g kdiiL4toRV th'L=6po:i2d + e 4'hL=i FI..,~.Ts is ~ 2~ t~St ?1Ã:~i..iz: f~;.' mÃ:Ftnts.Fai`tÃ.Ea," h} po:`pi31ai'il;F1ioIl.
Fhf.~Ww"QiCfrn}. of FT2L...,. ` "caFn be v..F>F(.F,t 1 ore'1%FmplOy .FÃi S}jme V ' S
there ' Y ~[: =i) ' i ~ ?~ -C Y
C is TFSr F~.~:~j;i~..~ i, l~'tF~;~:. Instead, t~ i~-2~. xt..wt_i'i>dc 10 :s nF:.i:it:
1Ã-i oale 1#::>~:~ the pC?`.37~-1vv p11h;c is- r5,.'ducl~A i~.n s,liliph.+udc w> ,C:ndi:d , z ;.Il other imp tGÃ31ek1es$tÃonh, the P.'Ist:s and the U
,."L?i.~'t ~...v.'~4syrclh:r Z nz ~i`.
In :.3-me appIic~~iol'm tlle po1w,~~y of flae zleot.odes is .olvornsÃ.d. :,:
..x.h Qa's'gs,.
.:
t+'f'l in FIG. ` :1, ~Zlii Z~ke*~; ~?f3.i..`3`t:C: F'S~:i:xwCi~, ~ k~.,`Ã
~= ~. ;r~ts ?FkQ ftat shown `z ~~~'f.
tlio sta;:Il~ iFt:.t I
py?la, a~y is rc''v. ~ed, sti.nuiak#fs,: :is typically peF`fn-n.t,.3 uLF:r.:ng si =Fsi;?i.: :nm:.d fsf d#:'<'13t(3 E Ã.'v ~\ ; ... ` S 1y ii` C'=~ also be (~C.Ã .td4<3Ã , in tÃ. _ ;L_,+.C..i;? `, `.
~._ 11 ~ ~i. ..:z+,f,.. :.C;i:>.. ,.'F~T~w~li~$F i,, :~Ta ~;:is ; ..?iF>
cC1.i1WÃI? '\hapC:.i: featL'3,t:.,i.i and/or 3:W.hC:S havR^A"Ãg bflfl'l positive and Y1vgc.FtF~'~`v' pt.Fci'#`f.i>i+
Ã.`Z ~`.,.L3>3QF. .~.;ti t one ~ ~i it.. ~ ~` ~ #-. i r ; > ~ ' a ?: ~`'k 3 . F7i;F"F~' ~.7'`~:'C.'i.1f.F~.~.::iti>: T~iE'. ~=a4t.t~'lti:i~ s~`x "{~lF.a.t.C Ie lQs.(E not be Z`'_='~;
cC .33aF7:n$. .. hQe4w T?`>r"1); betfT3w #.F"ikGd'i'F3.ls dliF":i7:g 4vhFCh ti1c, st1:znW<:iC3i`F 1s turned II, uY_.7 i':ftz.3'#t...~ >. .yo-Fk"i= Y , . shown in 1' I~:3 ~. 121, ::~~ zt~
...7I~:~~', { ~y;:. r '~l+.'F n !'}~ , a ~.f:l~~~.`,Lsf~~~2~p .i7~. ~~?~47?~i':a ~3 1..:, 'c:
20 fco:ib::tck coupled to a sC:F7uo7' 50, The soilso. 24 is co1ifigti:f;i3. to .f4 w:::.Lt an i.idFi:itE,l of the ccarL`s"ls c cyL:k c`; id tcF ptf5vTdÃ- c<iF"<i1ati cycle data i:? `._h S i~a x ,mi:t:F"' 48;
Suatal-.slo Ãnd:watoF';; of zau'dit~e cyz:l.c Ã.F:tcludi~~ ~icart bua!, blood pr(: s,-,LiYz`Y flow ve?.}c;Fy, or fuiv physical iyp:z:#.`ttitv' ffilf~.~ which the olFÃ"Ã"<:F"it. state slf¾h:e. ;.: aa(hFc cycle i;:lEi be detiv~.a~.~, The controller 48 i# ~ t, ht5 cardiac Qvc (e data w ;~i~ ap.ive;
y .1:~:= :z ~~ t 'itl v S bet,`tcei. positive p~W~::s, :n. FI~.~, 10, ~ ~~)ical pt.:~se widths range belwes:,n [3r Ef i.ht. car:>:tac S:1`cit .azld 40 1'1-iffl15ei,:onds, h-: raF-F.o iia:x' S:.in.>E?:3.F$T1vFli, shown in 1~~~IG. I ?, the t,t:Fn.:i'EF! t~'.oÃ.` 48 rvca?Ei eS :i'eedb<li;k fh3'In a lf`.:s.:i ~'senui:Ã" 51- kat Ã.7Ã't3si~3'eS a F3F'E3p+'.F`ty r.. .
04i,. LaFgt.;t ..;i4> ltst,~.., F;bF 'L fii3':tF13e' tr{~.}'S.S~~ 10 may ` ~ ~i. t.,,r~RiaI ~tC.~C: r tf ~' ~ = .'rz#:t~ t ~ ~4Y Iis ~ t~l7h.. L`koF`nti of Z:=3$~.`=4 a. w~`w ~2i:':kC~> < ,~~. i.{;.
4L.F"L`L'..1~. i ~.Z~~ :[I.
~~
~` ~~=a o a si-i~'1"ti?t~nt~ai?Ã~ ~5,i>E ~ ,~~ri~ ,\a. ? :3 L1~~31{~ i::'S..=~.;~si~'4 heating, the local sensor 52 :.;3"i ~:~u ~a 4t.:.i4v{3i'?T.1C?3.#ntt:d at the distal tip of ~.:Yt` {:tltht'tu: TlF~~
w1.]p'L.z:3`iuFo sw:1:*o;' Pif, r'iiii::s. #3 tt:mper;~~IIIo h,.gla` to the i:=t?I3'3`C?~leF' 48. In response to the Eet'i3pa,,,eilu~'~.t:
..~..'c =a ~>r\'<irf\FSc.~.~~ 48 ~t the '~t ~=c~ ~.t~->.,.~.1 , so `~ as p Li.
~' ~. x:i~.5ii_ af.. .. ~ ~t +. ~\., Zt. i \
~#S ~~~S.. v 'v%2,i3~1{,~.: C~3i3.w.L~:~ iA~~':~~~~<?~~ S'<. ~.rl\.\..... ~
.~.4=iil * A`."#eà sffcili L:A3st#',.if::~'L.Tisi7i.:4 C:ai? <?lso be1ii.c,~su"'4d by the >>r+:;c#, bZ::`?St`,i 52. à {;r ilxi.i.mp:Z, til+.' :o+....i3? .`ai.,.:?oA: 52 'L:a#? >+i:. %i pI`CS."543rC;
sxi7,.So that ;3. {s`c'7.SaC:@ a pmas.:lra` \iS.s,.$i5.?e t..i,: E::ie basis {r t4`~?#ti~? the L'{3Ã1tÃoll t ~ 48 i~i ier ~3~3e5 6~??Fo.~ai" a dt #Ãed l*3cFal b Etsod <
~~iL'Li:~l1:#'L ~~a." i;.t.=Ã: E3:G:]Y+;.Z'i::d.
A :r'3>F. =EÃl i:~Et;l{st~t:3"9 shown :t1. ~'I~ i `xt. fC.~t:tt:li'w'N a flt;.~.t `,.3l~' :LF~?C':s~ ~.r.i~''#.:'ÃF~,,~
%:i''.~i;.ar end 56 i.:76t:ict,:,ie{i t'so, a dl.ttal tip assembly 58a?':d c3.
prCZ:4i1?a'i?,l f li.d 60 4f.;S,urnk.t3 t5;^ a 1m:'3dlt; 62. W;tbin thi.. {:ik1=3l tip <3ssLnA)lv 58 are the tlà 5t Ã:lecÃaz?i.E~ 10 ;aa?is .w', i:r` Ãhe i_iii~e~lari dL`Si;=iÃb4'Cf. a~..~f.#w. Extending t;.)r<?F.ttl?ti~ tube 54 ;s, l~l,?~~i;-:d3_IG
64, a dz-,,t.Ãz cr~E3 of wi?#cl7, 1a sc33_i'i.e {;ia?bi`,din:1e??t., also fu11ctit3as as t:Ac . i.Ã's, i k.ti.''f?iai.<
: ~a ~~~~, A ~~r~.:~.ix~~.~~l ~,~~~~: of the ;.~i..if1~:-i~~i~"~:. 64 is ~;~~Li;?l~:{.~ t~.3 ti?~. i~.A.~~:;.~. ~s2, A Ã>>_~:~= 66 . A., \i '~ ~S Z
i#:L?Ã.,a7.w~3 ~:~?? ~t;?e ~,.a.~i'~l\ ~~ ~3.~ Lr'?~i~'?l9 ~4> a ;;~3L ~il.lF~
to ~ sx...~s~cti~`{.'.l~' i.a~:'3i'?tt ~.;i ~3.~TC,.; stip '22 to tht, .:::t: tllid si:i.t_?i d {. .lC',#.:ti'f)&.cs 10, 16, B{3tli the vat~~.i{:%t<.Ã 9 and ..s distal tip , , sõ;s4za?rtlz :~ . ~ are sirG'cl ~.t~at~ sz1~a;d to ~{?s~ ta~~'t~tIt~fl~. ;:1 (j8 ~;ji~~
~ ~i vcssca t,lr c:1: ? Ã~1~_. 14 ts dict~ei;-i{anal ai'wrv 12.
.3~.'L.~..~i~4~i. 43i_?t~...i.if a ,`~ C, Addktt{.z .Icz <a ifppi3 ii,'at1L f: "i">, \? r'~ tht.= ". f3v4~,~.Y.
Ss ~r~' a Si~A? t~ rc`,i???ii`x u..'a~~~#..,~ias ,~i . w t cCtr\in<i.i v ..n~vi.v iZ1i{w distal to :anoZrf.:JusioiZ: fil pijl:caaislAliÃinfy t.i~oin .al.,iate i n7'lic+.~rdii:i;
iIxfc1AclT\bl.. Sz:t h di;t?.IoÃ1 uluy i3astC:31 I'i.-peffÃ1h7o:Ã1.'s.3n+:3 pE"e5'cifi,t i~'~i~ff? C=#?'?~C`.A>>r C3\.dlb:>Itj.i distal to f.3a occlusion, tATe'ebv iI7_Ãt?I??_z.E$1a loss of tnyt,acat d3 Ea2:i3. D#?:3t3on of flsc 4iÃL&..i E.il, bed tI3 wt3.l to an ds#.=hO?'?1ic s:Tokc'.iA3.$ y t3tlba dh.:
25 same bei3s:f:ts LC} a.:~i+`..iyt~.`d btcl.123 x9GiIench'P;'dT?a.
DEliitit)II of \ik;aS..t..:ar i3iõd, supplying 1110 k#fdF' ibl xtiA 13?le bv c.l? { 3t".C i1'udi i#??pli7.i3tt'd into x3e pe11.121E lw. y i.:Ãt~. y> _ i;~.\ ~.~.3 ~~~A' x.ei:t{i-lfi..n3 of PÃii.a?sin._fui.i;~zii~i~.i~.? 3i~'~~3f'.r~i~.A~;ii:~~;. ~
'.is"dA.:i~:;~rt*.'d{..i.>it.~ii~ f~~ }~'v'2s.i~f.= ~'ra?~iC'.ai''.'~
i#1;.~ ~3lintod stimulator may hec.3 i:i.so9+'`~~'i;= i.lyi:;. ;iZ..-sund dy~h.i~.:#:3cI.oI's.. Sys1i"J? it E~rxli'bL ci.ml-a;li;d b4'd.la¾ioil of skit,.cte<i 3Ee' pS,I"lp.3i.=rx33 :riL,=n?i?l b'L.ds. fii this application, lmpl.i,:3cd S..llt.i:Ãit;i.ts.e::? mt?*' sLi, ,a..,ne ~
I ~W
dflcF.t]':i. .:? `vsi3x? ?so t(s in i#' Fp:.i#:E?tC .d brol?d pr(',SsFd[ e 5(:E?sL's:', Ã33 V;wF Fmt,?".S.' a,rZb g?ia.?'mai.'t'14F of #.Fl?}?hmie'Li ci}n sri1l S,:Fri:(FM;', ia, oflFeT ar?p.rÃõi:#i.iFis, sÃ1#:'1F.flzt:#t:1n ca31 bc `<`'..pp;ed to aF.:Ão.1.:;F'>31: .?'3.ef'v('s <
to Ã.e .> a ~ra~~:~;t'~' c? n1Ã;;{.?rt~~;r4. I~s sFioIi a~a~~l,(::~ci~J#~?ti, ~~z -t~rst x.F~F~~ s:Ã~Ct~:Ã~ ..; ~...;:~~)~F:S .Ã 0Y
16 ::re ~ las.>:is FFw .<3:i' diFmilY.~.f,oC tissue enervated by aE'atoaFt?aiF1:c nel'vS'., flne (A.lS:i:~triiS.eS 10w 16 ,2rt: bS(`F..g:~t near =iw region witlxer by pastiiTtg fhe#.. bl(?od .'\
s4e.. tA#:,it a 1<>a~
tb.;r. t dc xia ~ ~.3:'1?..If:r { ~ <a~n~3.a(?..'# ~#F..fi ~:? #.}ii% ~acF
<~# x \ a .(.. ..~t =L3.; vF a :iC.T'~ ~..:.:: :?#. :ca4rt., r.'.+i:~ ~ '3~ <~F_a~4~`~i~i #F;:S\.~~~c:%f`.~.',~.(a.,.ry:a .:.i?3 S.TFzlWa#.F(t.Fa::~#F# bi:~ applied to ';y#~~?~pa4}l: FC
t}i'~z<~Ica~v'I`,?~?sa~l`l4=~t~. t=ffG3a.,,,,:nC.Ae,; to <
S.##;~i.~~.c~t>,'; Z?'3 i'a...s x ::F\vEF~.6 :L.~~Fr.tii~t ~.~i Y`i or ~."S
;F11'e}"i.'.l~lt. IFt n~'%'.i fC? ~I::-mF.,.Ei ,(ta..Fi:o[? _ft3;3'F
.?. ~ :1.a: bi'<:i n t?F' iF3 :?I (?(.'sk y#gzn a-aI s .G..?.&;h as '~,~~,a1#3 f-rf3YI-i FE'.=%lS:;hlm, t~> 'S.. ~`31=:i.Fa, F4mr examnp^e ffic apparatus (?i it-3t: pr(.'~:1`4Flt znvonmwa can ~.`s(''.
..#.4;:d it3 block pain z_.,~S k~#i .~ i. .! . . ,~ r When Z ~A" t:~;l_.e.l.k ~+ \ the 'N~t-?
;:3~izi^s:~.~.?.Fac3 .Fx. FFxF$i.+i"33F?~'~., Fk~:.:l :8:,~. ~rt+~~#~#x ~.t%is ~i> .,1'. ~~I;a.zFz.~.Fk (.>f ffii::
R..ei: :IC;ti.Ã;ti 10r 16 (.<.Fl'#.'.'^'.'('< cIFI;i('Tlt to fl(3o-v .#?#Si the ~~z4:ZxIS:, <.
A~t~z#?
~ aF e#~t ~:~Pa, ?(3~<~ 1~.W tj'3'i I?C7~3(:t ~StIv"~' i?e# 3'(as, `t}i<7(':)5' ~?k't:v(#..I?i~~4.~ t~..~-i,il f .~. 3 d(:poiclrFLI:t`g: s#:wt ihei1iSc L 3t:: i;`. nerves provide fliL. :
f..l'zss3iÃ(sn. i?~ ~mIn >.: ~liv b;i3.1:a"'a:.
a....5 bLo.... '&<#,kd. I:nt'#om bf.Fn~gis' about a cessation, or significant d?II.:iI1LFzlcm, i#f pa.Fni. bi _.~Ã.#.tm., ourrmi dfi:..rt\eIG:d th:.9`il.'.h i3rte:'FiF: blood Z'i'.14el4 `:'t..ti'#F#.3w at:: iF'kjt.#zi:d bi~sue (t.lai.as ~IhÃ3s(' blood vessels. As a #'o?itit, mcwe blood 1W a4'a`"ls "MÃ.;
to nE.:}i.iiisl, the tl.#:(,Ã:F
;itiSa3e, 3t:I2g `.4 l3f,`=alixlg.
2 ,. -.'f#.n aTF` ibos.r of f#lt d ~ ~~ t?? I}loisd :3L.p,r~1ly to F:o(:s`.SlI
4 ~',t . .C3 $i#.s4.xÃ~~
caI ?w ;D # ciye,~ in W:3#0F Z)3]z v. `4ht'S tf) al:li1Fd bA;`i'~i fi<;`st ft?, F#F` g#(}mz# i?z 4' F#4tõatlvel`+ (.h'aAi:eM ~~~c blood i+,5<e: vv`aFll, tt?C.i.'#:blr svW(;i`+~'LI'Us4im R~-1'L.T'S:x1 of p(?'lwF`i t #LS~(tL`sz#g dhe r?,.4FFj<# #tu(x(` e:?f the I?1LÃ1~~~1"~;>C' ~3F? ~.[y 1 F~, and poss Flt.ial. t +.t3:1:siFA`r It ,s F3.dtait#on:`llv( p(? itiFbIQ to Fff?dFIt e: lt?l:c:l +.Ã3nis:i'#.f tio#.; iIt u#' : \lii.= s,'?f =`5 ti1i1,',it?I11.Tl;itFi14 e-If'.'i:tit?d:` r;4 slFx?'1(F:i3tlI1g t:3dw syI`u1pathcdc'nvF4C: that ca3iFstx1d'`a t'x`34' lF:E3~F?~i f?Fusel~.'~. By Mfi,..l=L'c t.Fi'('.1,{ c(.~iFst#.Ã4t1#lg iT.it(:nL,s, t?21o o#Fn zf"duLG I'li?w ofa_i#I[ i'1ai No;s l w, i fici( (a tFwOl3vs, :hCl6yt Fn~11~?itFSI~; ~T"{awth 5.3f"5 x.:.ld pÃ,.....7a:;)`+ L,a>.iti f1g ,'s+`.ÃF.Ã:fn#c d"eudi of ia3otid fitiS::#c.S. This is ;?&FtxcF.:ii3:rI5' F:[:sef1.Fi whe.El t#Zie solcct`,`d t.ts5#._Fs,. 1s: ff`r f..'xGin1p L, a ea .t.a,'s'i-$;.i3 tumor, pa:#Ã#.cFa'.iiÃ'iZ=', i3#le dFat has yet to m'G't-ast.F4#t.':G. Yei. 3?l\Z0ht:r 3 {' <~ppl"#ft'atio?3 of Svl :C;t.,ve viFsC]m?4ta Fc¾1E?.F3. is that of j.I':Ã.iFt.Fx`s`Ã' va1.(?cC.I`~vri(.Oo;:~.* to .G_=d.uÃ;e 'Lf~ ~ ~Z.] s9' f ` p s," ;~' y~` ]t = { 1.~.<~xFz ~c~ ~ ~}i~., .A ~Cka=`= of $. FL.:C>t\?3.A:{~ i¾ e~y ,~2` crt~ iy q:~ Ãw ` ~.~~)~'~'i~~'j`~' ~\.A~ E~~~] ,Z. {~5:`~.<~ 4' ~ li 1~n,~.~. ~.w-Ltrn~ .tl~'~? ~lS the .~.i .
Li1i~.~:~Fi..(.4~
us,c;sul ti>r tzi aÃÃtaw a hentorrha;=:jc stroke.
A`i iapi9ildati.,s as iI:Ls;.i'1bC:d iaS~=`re3,1i can bs usoe.F to de.vZ.'i~
:~~.s Srilni4,t-v C4k ihelas.f1:;ti un ~ti4"] i"~ _ ti~t.~~i}~~ ,:! but not 2~ ]F..F~ .\...- ~,`3=.
t~2.=~a44 ~~~~~A3>k={~~.a ~t'.C~~~2~~~ is~=2.7.~a~i. ~~~t.,1~ ~~s ~~~~==i~tav ~> i i ~Z+.~
3 sC=lL.'::'t13L i:tl;i'itt:tC)n 33I .flla.'. .3rbitthTt%3':%i=l i:?'tGnii.il beds to :n%:t'#;.'ciSC u3'.il.dõ olEtpuE. and .S .duce blc:Fod t i1alciJn o-30 Ein artei-ial bed d:sf=~. to ~ ~lovLvj;i~: a..~ ~
coronary; <:'~cbra1 ;?r i>thi:r as ~.=~,,.= ~r =->r 1i. P:f?vÃde 4,i~. `'[vi:3sf:Y. i ~ = t?
iSl:l'~~..lYz m `:. ~ { lsy ` blood a ~~~.~v~' ~t+. ~~)~af3 ~`_ink ::C:'.Is3) c_:.cs~r ..
:hz.` 1.'F'fU`.:3.i;i#`:~,; stenosis, and t, affl?w flushing ifild passage of 's3ll blood vessels . xl;Ai1l to the bltSG;kagt'.; and vl.4f3c\9ianb:ii..;.t3n of 3:"#:~c`~rl:.J fei:d~I g tmc }y >^-{t ' ,:.t v> ( 4t(* >t ..,c.r \Jii~.'\F2 L 1\.~2..:..~.L1i`~.ilii~~b= .]F.1,l}yi..
m,Ã'+.. a$k=d- as doSL'ribm; hoI"t.Itl can :ihso be ;s4Cd 3.i3 Z,C'>.,Z f;..:, ti-;.s t .:.py i,h.,~t3:3ic~illy- or periodically. Such tht:'i'i3`y7iw.s z71el Wi::? mut iti'i:= a:t?t ;.~iIEi.et: V vaNo+_la2\.s#.L`s::
of 4cl.fi,.af:'d pa:1p~imaa art':::I.Eill bals., f:s''.Iti;E1.t Sy~t<.F:STi;
hypeartt.',Fi :Ot; v .E:: `+?iZ.I<.i...z3.?n of svdcLu~, arterial beds Zo treat local ~Zaiitl.~. A>~~1s fi3r +.s56.ex#2p C.
primary putI-nonaIi`
hy 3eI'tS i1.,1:i5n i'asL?L3datzo#> of th: p%Ii1e arteries to sÃ'.at t 3alr sexual dy~xuu~:tkil: ~'i;.~
vaai;e?s.st3':i:'t`.o.a, t3z a'i art:enal bed fG;(ji.~ig a tlllhlz3i to treat c1..?cu? ;
1hav7: "M d4'Si.,Ii7+:d, ;}tw:1111':71tii317 and a prE.=fi:'m3' =bc:dia]-ic.r, fhe.i0o " 'Sh w clc,#:I:i'.i as new, i3#?d;,,oC.ier'ed by Leti#.`.,"+,':i Pe.ItoI?r it;
Claims (27)
1. An apparatus for locally controlling smooth muscle tone, the apparatus comprising:
a first electrode for insertion into an artery;
a barrier for preventing the first electrode from contacting an arterial wall;
a second electrode;
a power supply; and a controller for coupling the power supply to the electrodes, the controller being configured to cause the electrode to maintain a waveform for controlling polarization of smooth muscle tone.
a first electrode for insertion into an artery;
a barrier for preventing the first electrode from contacting an arterial wall;
a second electrode;
a power supply; and a controller for coupling the power supply to the electrodes, the controller being configured to cause the electrode to maintain a waveform for controlling polarization of smooth muscle tone.
2. The apparatus of claim 1, wherein the first electrode comprises a stent.
3. The apparatus of claim 1, wherein the first electrode comprises a distal tip of a catheter.
4. The apparatus of claim 1, wherein the second electrode comprises conducting pads for placement on the skin of a patient.
5. The apparatus of claim 1, wherein the second electrode comprises a distal tip of a catheter.
6. The apparatus of claim 1, wherein the barrier comprises a stent defining a lumen for receiving the first electrode.
7. The apparatus of claim 1, wherein the barrier comprises a housing surrounding the first electrode.
8. The apparatus of claim 1, wherein the barrier comprises a cage surrounding the first electrode.
9. The apparatus of claim 1, wherein the controller is configured to generate a waveform having pulses of alternating polarity.
10. The apparatus of claim 1, wherein the controller is configured to generate a waveform having pulses of a single polarity.
11. The apparatus of claim 1, wherein the controller is configured to generate a waveform that is synchronized with the cardiac cycle.
12. The apparatus of claim 1, further comprising a sensor for providing data indicative of the cardiac cycle to the controller.
11. ri,\'+ ap.pay.:2{a:eo'. c}'t:..an 1, further co.`.'npr,{s.{iÃg a local ;wÃ..:?os a4~.Ã-r pÃ.3viYAÃa{g data {# :;xtiadvc of bli-Eod põeshtÃrZlC7ca.~ to the finst ~lleiiro'ta`t'=.
14a A $iwth5,d, ~`~3' Ãs~':.Ã~tl 1:~~? REioZStb mI.1jC:lC'.tt1n5 S't-lffiT.n an ar.e,it~~l bed of a im~'vV >iia ; a i:~as:.'~'Sv~.~.I'\~}(i~ ~ 1_c~~.li an cÃrt~~r~'~ of t.F7'~.
~F~:$:.{C'T{~, r~..~(i<,' at $ c ~~`~`.L.~Ãtiot~. y~,~t~.'.t;t~.'~5., RkÃ+.:~~A .~.t.Ã~
>v.","el~..r .~."~?;.`.'Ã ~~13E:-pio' 4?Iiz'~`-~, tr:. .3, a :iC;~',(~3.1F~ rl~'[:~' 4 A t ~ 4t.~L:{'ili~S; to the second 4s { Cf:'~:aÃi. i': { i:o{L+~ .~.~;r i .^ .3 {ia ~- :,`+.~t4s:~r .za t k:.
Ã:3. -ad"3d CYr~nC.Ã.+~.,:Ã~ a~ tCY a ~'L 3it3~4 5' i, ~. tY y <~c sft~Ã':i3 bt c~ f5 Y Yf C-aI7. '~1:~~ a .~~aFs: i_ :<~ ~~ Y s= _.r~-~ s,3~1C~ i ix a , ? .~1~ a~
~,v~~ i~ U~i?E~
-voltagFv wavefoxan, being selected to ..;w't.Tt~l p(}ltE.ÃÃ!'.-;."r`ios, tYa `timnt3.}:.h, ?aw; C-lG tÃs~4 within :.3w a:t'tC:rial bed.
~F~:$:.{C'T{~, r~..~(i<,' at $ c ~~`~`.L.~Ãtiot~. y~,~t~.'.t;t~.'~5., RkÃ+.:~~A .~.t.Ã~
>v.","el~..r .~."~?;.`.'Ã ~~13E:-pio' 4?Iiz'~`-~, tr:. .3, a :iC;~',(~3.1F~ rl~'[:~' 4 A t ~ 4t.~L:{'ili~S; to the second 4s { Cf:'~:aÃi. i': { i:o{L+~ .~.~;r i .^ .3 {ia ~- :,`+.~t4s:~r .za t k:.
Ã:3. -ad"3d CYr~nC.Ã.+~.,:Ã~ a~ tCY a ~'L 3it3~4 5' i, ~. tY y <~c sft~Ã':i3 bt c~ f5 Y Yf C-aI7. '~1:~~ a .~~aFs: i_ :<~ ~~ Y s= _.r~-~ s,3~1C~ i ix a , ? .~1~ a~
~,v~~ i~ U~i?E~
-voltagFv wavefoxan, being selected to ..;w't.Tt~l p(}ltE.ÃÃ!'.-;."r`ios, tYa `timnt3.}:.h, ?aw; C-lG tÃs~4 within :.3w a:t'tC:rial bed.
15~ 11h[3 nnl-ffif;3d .i'i``cli31iÃ'i 14, .i'hLrS'Ãn pTC1Lidli1~: a ,zixolÃ.d olG'it`.{)de F..onÃ'?pris:.`
Pri3!';t1.Ãng a SÃ.EÃ fclct '~lei'v,"'rC?(ae for pl%lcG;=-me{~t oIl skin }.~~~ho ptli:i:'.n_t,
Pri3!';t1.Ãng a SÃ.EÃ fclct '~lei'v,"'rC?(ae for pl%lcG;=-me{~t oIl skin }.~~~ho ptli:i:'.n_t,
16, a riC.' t>3L.`Ãc:odl .)f f.'l<13In 1 5, VShorfi..ln prC2vldiI1g a :*uLAiI-iaI tslC'ct 'iZdw Gompr.ÃSL4 ri h>.zIa11g a s ~,~r~~:~7 e1e~'t.z<~c3s. tt>t<~ a ~'~:.i:i of tl~.c ~3~:~,aeri t
17. The nneÃs?od : f cl;:ii-m 14, luta :}1eF' c3iÃ7pTi4a?'tk it^.c ftc,. y, to bi a n=,al
18. The method of claim 14, further comprising selecting the location of the second electrode to be skin adjacent to the a kidney.
19. The method of claim 14, wherein inserting a first electrode comprises inserting a stent coupled to a power supply.
20. The method of claim 14, wherein generating a voltage waveform comprises generating a waveform having an excitation cycle and a cleaning cycle.
21. The method of claim 14, further comprising synchronizing the waveform with the patient's cardiac cycle.
22. The method of claim 14, further comprising generating a waveform having an excitation cycle that overlaps the diastole portion of the patient's cardiac cycle.
23. The method of claim 14, further comprising selecting the arterial bed to be an arterial bed that serves a tumor.
24. The method of claim 14, further comprising selecting the arterial bed to include arteries feeding a hemorrhage.
25. The method of claim 14, further comprising selecting the arterial bed to include the penile arteries.
26. The method of claim 14, further comprising obtaining a measurement indicative of systemic hypertension, and generating the voltage waveform in response to the measurement.
27. The method of claim 20, further comprising generating a positive voltage during the excitation cycle.
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-
2006
- 2006-05-02 US US11/381,238 patent/US8019435B2/en not_active Expired - Fee Related
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2007
- 2007-05-02 WO PCT/US2007/067989 patent/WO2007131015A2/en active Application Filing
- 2007-05-02 CA CA002651032A patent/CA2651032A1/en not_active Abandoned
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WO2007131015A3 (en) | 2008-02-14 |
US8391971B2 (en) | 2013-03-05 |
JP2009535188A (en) | 2009-10-01 |
US9808300B2 (en) | 2017-11-07 |
WO2007131015A2 (en) | 2007-11-15 |
US20130172882A1 (en) | 2013-07-04 |
US20110319968A1 (en) | 2011-12-29 |
US8019435B2 (en) | 2011-09-13 |
US20070260281A1 (en) | 2007-11-08 |
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