Búsqueda Imágenes Maps Play YouTube Noticias Gmail Drive Más »
Iniciar sesión
Usuarios de lectores de pantalla: deben hacer clic en este enlace para utilizar el modo de accesibilidad. Este modo tiene las mismas funciones esenciales pero funciona mejor con el lector.

Patentes

  1. Búsqueda avanzada de patentes
Número de publicaciónUS20070106296 A1
Tipo de publicaciónSolicitud
Número de solicitudUS 11/612,620
Fecha de publicación10 May 2007
Fecha de presentación19 Dic 2006
Fecha de prioridad7 Abr 1997
También publicado comoUS6488673, US7556624, US20030159700, US20090192508, WO2001003642A1
Número de publicación11612620, 612620, US 2007/0106296 A1, US 2007/106296 A1, US 20070106296 A1, US 20070106296A1, US 2007106296 A1, US 2007106296A1, US-A1-20070106296, US-A1-2007106296, US2007/0106296A1, US2007/106296A1, US20070106296 A1, US20070106296A1, US2007106296 A1, US2007106296A1
InventoresMichael Laufer, Keith Burger, Bryan Loomas, Don Tanaka
Cesionario originalAsthmatx, Inc.
Exportar citaBiBTeX, EndNote, RefMan
Enlaces externos: USPTO, Cesión de USPTO, Espacenet
Expandable electode devices and methods of treating bronchial tubes
US 20070106296 A1
Resumen
Methods are provided for treating collapsed bronchial tubes found in patients with chronic obstructive pulmonary diseases, such as asthma. The method includes heating the bronchial tube to cause tissue in the wall of the bronchial tube to undergo a structural transformation effective to render the wall capable of supporting a non-collapsed lumen. The procedure effectively reinforces the structural integrity of the bronchial tube wall and thereby prevents the lumen from collapsing.
Imágenes(6)
Previous page
Next page
Reclamaciones(17)
1. A method for treating an air passage in a lung, the method comprising:
delivering energy to an air passage in a lung to heat the air passage to cause a structural transformation resulting in improved lung function.
2. The method of claim 1, wherein the structural transformation comprises rendering the air passage capable of supporting a non-collapsed lumen such that air flow through the lumen increases.
3. The method of claim 1, wherein the structural transformation resulting in improved lung function ameliorates the effects of asthma.
4. The method of claim 1, wherein delivering energy to the air passage comprises heating the air passage to a temperature in a range between 60° C. and 95° C.
5. The method of claim 1, wherein delivering energy to the air passage comprises delivering between 1 watt to 25 watts of energy to the air passage.
6. The method of claim 1, wherein energy is delivered for a time period in a range between 1 second to about 60 seconds.
7. A method of treating asthma, the method comprising:
advancing a treatment apparatus into a lumen of an air passage in a lung;
expanding the apparatus to contact a wall of the air passage; and
energizing the apparatus to raise a temperature of the wall sufficiently to cause the air passage to undergo a structural transformation effective to treat asthma.
8. The method of claim 7, wherein advancing further comprises inserting the apparatus through a working channel of a bronchoscope.
9. The method of claim 7, wherein energizing the apparatus comprises applying monopolar or bipolar radio frequency energy.
10. The method of claim 7, wherein energizing the apparatus comprises simultaneously or sequentially activating electrodes.
11. The method of claim 7, further comprising monitoring a temperature or impedance of the air passage wall while delivering energy to the airway passage.
12. A device for delivering radio frequency energy to a wall of an air passage of a lung so as to treat asthma, the device comprising:
a tubular member having a proximal end, a distal end, and a lumen extending therebetween;
a plurality of expandable radio frequency electrodes attached to the distal end of the tubular member and terminating at a distal tip, each of the electrodes having an insulated sleeve and an exposed contact region; and
a deployment member attached to the distal tip and positioned in the lumen of the tubular member, the deployment member configured to move the expandable electrodes between a collapsed and a radially expanded configuration, wherein the electrode contact regions are configured to contact a wall in an air passage in a lung when in the expanded radial configuration and which when energized causes the air passage to undergo a structural transformation effective to treat asthma.
13. The device of claim 12, wherein the electrodes comprise wire shaped electrodes.
14. The device of claim 12, wherein the electrodes comprise four curved electrodes.
15. The device of claim 12, wherein the exposed contact region is located midway between a first and second end of each electrode.
16. An energy delivery system comprising:
the device of claim 12; and
a bronchoscope having an illumination element, a visualization element, and a working channel for slidably receiving the device.
17. The system of claim 16, further comprising a source of energy electrically connected to the electrodes for the delivery of monopolar or bipolar energy.
Descripción
    REFERENCE TO RELATED APPLICATION
  • [0001]
    This is a continuation application of U.S. application Ser. No. 10/232,909, filed Aug. 30, 2002, which is a continuation of U.S. application Ser. No. 09/349,715, filed Jul. 8, 1999 now U.S. Pat. No. 6,488,673, which is a continuation-in-part application of U.S. application Ser. No. 09/260,401 filed Mar. 1, 1999 now U.S. Pat. No. 6,283,988, which is a continuation-in-part of U.S. application Ser. No. 09/003,750 filed Jan. 7, 1998 now U.S. Pat. No. 5,972,026, which is a continuation-in-part of U.S. application Ser. No. 08/833,550, filed Apr. 7, 1997 now U.S. Pat. No. 6,273,907; U.S. application Ser. No. 09/349,715 is also a continuation-in-part of U.S. application Ser. No. 08/994,064, filed Dec. 19, 1997 now U.S. Pat. No. 6,083,255, each of which is incorporated herein by reference in their entirety.
  • FIELD OF THE INVENTION
  • [0002]
    The present invention relates to a device and method for treatment of the airway obstruction found in chronic obstructive pulmonary diseases (COPD), such as cystic fibrosis, chronic bronchitis, emphysema, and asthma.
  • BACKGROUND OF THE INVENTION
  • [0003]
    Chronic obstructive pulmonary diseases (COPD), which include such entities as cystic fibrosis, chronic bronchitis, emphysema, and asthma are steadily increasing in frequency, possibly due to continued smoking, increasing air pollution, and the continued aging of the population. COPD is characterized by edema of the mucous membranes, which line the interior walls of the tracheobronchial tree. When the mucosa accumulates an abnormal quantity of liquid, the profuse and thickened serous fluid excreted may seriously affect ventilation in the alveoli. The mucus resists movement up the walls of the tracheobronchial tree, normally efficiently accomplished by the cilia throughout the airways which are also destroyed. Consequently, the serous fluid can form mucus plugs, which can shut off alveoli or entire airways. in addition to secretion accumulation, airway obstruction can occur because the tubes collapse due to destruction of connective tissue. This reduces the ability to get oxygen into the blood and carbon dioxide out of the blood.
  • [0004]
    Asthma is the most common form of bronchoconstrictive disease and pathologically involves constriction of the bronchioles, hypertrophy of the muscles of the bronchioles, and a characteristic infiltrate of eosinophils. Both asthma and other COPI)s are characterized by the constriction or collapse of airway passages in the lungs that are not supported by cartilage. This condition is marked by labored breathing accompanied by wheezing, by a sense of constriction in the chest, and often by attacks of coughing and gasping.
  • [0005]
    Individuals who are afflicted may attempt to compensate by blowing harder only to have the airways collapse further. A person with poor resulting ventilation suffers from a number of metabolic conditions including accumulation of carbon dioxide. These individuals also often have hyperinflated enlarged lungs and barrel-shaped chests.
  • [0006]
    A wide variety of drugs are available for treating the symptoms of COPD but none is curative. Cystic fibrosis, chronic bronchitis, and emphysema are typically treated with agents to thin and dry up the secretions and with antibiotics to combat infection and with bronchodilators. These drugs include potassium iodide, antihistamines, various antibiotics, beta agonists, and aminophylline. Unfortunately, a large number of patients are not responsive to these medications or become non-responsive after prolonged periods of treatment. For severe cases involving collapsed air passages, surgeons have endeavored to alleviate this disabling condition by either removing a portion of the lungs or constricting the volume of lung available for respiration by stapling off sections thereof. The result is that functionally the diaphragm and muscles in the chest wall operate on a smaller lung volume which may improve air movement for some individuals. These operations are quite risky and are associated with a large number of deaths. Patients undergoing these treatments are quite ill and these procedures are considered final options.
  • [0007]
    Notwithstanding the conventional treatments available, there exists a need in the art for an effective treatment for chronic obstructive pulmonary diseases, such as cystic fibrosis, chronic bronchitis, emphysema, and asthma. Specifically, there is a need for effective treatment for individuals with obstructed airway passages to restore pulmonary function which only requires minimal surgery.
  • SUMMARY OF THE INVENTION
  • [0008]
    Many types of tissue can be molded and remodeled to correct defects and dysfunction. One technique involves physical manipulation using mechanical instruments and/or balloons to effect selective shrinking, stretching, flattening, thinning, or thickening in addition to changing the material properties of the tissue. These changes of properties include alteration of the elastic coefficient of the tissue causing it to be stiffer, changing the tensile strength of the tissue, changing the shear strength of the tissue, and changing the floppiness or resiliency of the tissue. When the tissue is close to the surface of the skin or part of a non-critical organ, physical manipulation is feasible and can be executed with minimal trauma to the patient. However, when the tissue is in an internal organ, in particular, in the lungs or other vital organ, molding and remodeling by physical manipulation can involve complicated and often risky surgery.
  • [0009]
    The present invention is based, in part, on the development of a heat treatment apparatus having expandable electrodes that are capable of delivering energy to bronchial tubes uniformly. The heat is preferably inductively applied by directing electromagnetic energy, such as radio frequency, into the tissue to keep the bronchial tubes open.
  • [0010]
    In accordance with one aspect of the present invention, a method for treating a bronchial tube includes the steps of:
  • [0011]
    a) maneuvering a heating apparatus into a lumen of the bronchial tube;
  • [0012]
    b) heating tissue of the bronchial tube to cause tissue in a wall of the lumen to undergo a structural transformation effective to render the wall capable of supporting the lumen without collapsing; and
  • [0013]
    c) removing the apparatus from the bronchial tube.
  • [0014]
    Prior to treatment, the lumen can be non-collapsed, partially, or fully collapsed. Preferably, the bronchial tube is heated to a temperature in the range of about 60° C. to about 95° C. for about 0.1 to about 600 seconds. With the inventive procedure, extensive surgery and the accompanying trauma are avoided.
  • [0015]
    This invention is particularly useful for treating subjects experiencing difficulty in breathing as a result of obstructed airway passages caused by, for example, chronic obstructive pulmonary disease, including, for example, cystic fibrosis, chronic bronchitis, emphysema, and asthma. This invention ameliorates the affects of these diseases by improving lung function by keeping the airway passages open. Specifically, the present invention provides a device and method for effecting changes in soft tissue in the bronchial tubes or air passages of the lungs which have collapsed. The causes of the collapse may be the destruction of the connective tissue, the disease process, swelling, and/or muscle-dependant constriction. The invention is directed to a treatment process which effectively creates an internal bronchial stent which prevents the air passages from collapsing.
  • [0016]
    In one aspect, the invention is directed to an apparatus for treating a bronchial tube having a lumen, which includes:
  • [0017]
    a tubular member having a lumen;
  • [0018]
    an elongated shaft that is at least partially slidably positioned in the lumen of the tubular member;
  • [0019]
    at least one electrode supported by the elongated shaft, which when energized causes tissue in the wall of the bronchial tube to undergo a structural transformation effective to render the wall capable of supporting the bronchial tube in a non-collapsed configuration, wherein the at least one electrode is pivotally mounted on the elongated shaft and expandable radially outward to contact the wall of the bronchial tube; and
  • [0020]
    a source of energy electrically connected to the at least one electrode.
  • [0021]
    In another aspect, the invention is directed to a method of treating a bronchial tube comprising a lumen of an individual that includes the step of: advancing the above described treatment apparatus into the lumen of the bronchial tube; and activating the treatment device to raise the temperature of the wall to sufficiently effect a structural transformation in the tissue of the wall.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0022]
    As used herein, like reference numerals will designate similar elements in the various embodiments of the present invention wherein:
  • [0023]
    FIG. 1 is a schematic side view of one embodiment of a heat treatment apparatus of the present invention which employs two collapsible and retractable electrodes;
  • [0024]
    FIG. 2 is an enlarged partial cross sectional view of a distal end of another embodiment of a heat treatment having one collapsible electrode;
  • [0025]
    FIG. 3 is a side cross sectional view of an alternative embodiment of a heat treatment device having two wire shape electrodes;
  • [0026]
    FIG. 4 is a side cross sectional view of the device of FIG. 3 in an enlarged state within a bronchial tube;
  • [0027]
    FIG. 5 is a side cross sectional view of an alternative embodiment of a heat treatment device with four electrodes in an enlarged state within a bronchial tube;
  • [0028]
    FIG. 5A is an end view of the device of FIG. 5;
  • [0029]
    FIG. 6 is a side cross sectional view of an alternative embodiment of a heat treatment apparatus with a loop shaped electrode in a contracted state;
  • [0030]
    FIG. 7 is a side cross sectional view of the apparatus of FIG. 6 with the electrode in an expanded state within a bronchial tube;
  • [0031]
    FIG. 8 is a side cross sectional view of an alternative embodiment of the invention with a plate shaped electrode in a contracted state;
  • [0032]
    FIG. 9 is an end view of the apparatus of FIG. 8 in the contracted state;
  • [0033]
    FIG. 10 is a side cross sectional view of the apparatus of FIG. 8 with the plate shaped electrodes in an expanded configuration; and
  • [0034]
    FIG. 11 is an end view of the expanded apparatus of FIG. 10.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
  • [0035]
    FIG. 1 shows a first embodiment of a heat treatment apparatus 10 which is introduced through a catheter, bronchoscope, or other tubular introducer member 12. The heat treatment apparatus includes a shaft 14 and one or more electrodes 16. Electrically connected to the electrodes 16 is an RF generator 18 or other energy source. The RF generator is controlled by a controller 20. Although the invention will be described as employing an RF generator, other energy sources, such as alternating current and microwave may also be used.
  • [0036]
    In accordance with the embodiment of FIG. 1, the electrodes include a first conical electrode 16A connected to an inner shaft 22 and a second conical electrode 16B connected to an outer shaft 24. The conical electrodes 16A, 16B are positioned with their axes aligned and may be fixed or movable with respect to each other. Each of the conical electrodes 16A, 16B, includes at least two overlapping sections 26. The sections 26 are flexible and overlap one another to allow the electrodes 16A, 16B to be compressed within the lumen of the catheter 12 for insertion into the bronchial tube of a patient. Once the catheter 12 is positioned with a distal end at a desired treatment location within the bronchial tubes, the shaft 14 is used to push the electrodes 16A, 16B out of the distal end of the catheter. Once deployed from the catheter 12 the electrodes 16A, 16B expand radially outwardly until the distal ends of the electrodes contact the walls of the bronchial tube.
  • [0037]
    The electrodes 16A, 16B are electrically connected to the RF generator 18 by electrical cables 28, 30. When the heat treatment apparatus 10 employs two electrodes 16A, 16B the two electrodes are preferably oppositely charged with one of the electrodes connected to a negative output of the RF generator and the other electrode connected to a positive output of the RF generator. Alternatively, both the electrodes 16A, 16B or a single electrode 16 may be connected to the same output of the RF generator and an external electrode 34 may be used. The external electrode 34 is connected to an output of the RF generator 18 having an opposite polarity of the output connected to the internal electrode 16.
  • [0038]
    The present invention is based in part on the discovery that the structural integrity of bronchial tubes, especially those which do not have significant amounts of cartilage present, can be significantly recreated by subjecting the bronchial tube to a sufficient amount of heat to cause at least a portion of the soft tissue to undergo a structural transformation thereby causing the tubes to remain patent. This structural transformation may be due to a variety of sources such as, scar tissue buildup, collagen restructuring, or the like. This heating procedure changes the structure of the tissue and the shape of the tube.
  • [0039]
    As used herein, the term “bronchial tube” or “air passage” refers to the sub-segments that branch from the main stem bronchus of the lungs. The term “collapsed lumen” refers to a condition of lumen of a bronchial tube wherein the lumen is occluded to the extent that substantial blockage of air flow through the lumen exists. The diameter of a non-collapsed lumen may be substantially equal to that of a normal bronchial tube or may be less as in the case of a partially collapsed but functional lumen. It is understood that the term “collapsed lumen” encompasses partially collapsed lumens. Cartilage is not present around these air passages in appreciable amounts so they have little intrinsic supportive structures.
  • [0040]
    FIG. 2 shows an alternative embodiment of a heat treatment apparatus 40 having a single electrode 16 positioned on a shaft 14. The electrode 16 is shown as it is deployed from the distal end of a catheter 12 for heat treatment of the lumen of bronchial tubes.
  • [0041]
    The electrodes 16 of the embodiment of FIGS. 1 and 2 are formed of a suitable conductive material such as metal, plastic with a metal coating, or the like. The two or more sections 26 of each of the cone shaped electrodes is fixed to the shaft 14 and biased outwardly so that the sections expand or unfold to an enlarged diameter upon release from the distal end of the catheter 12. The electrodes 16 preferably have an enlarged diameter which is equal to or slightly greater than an interior diameter of the bronchial tube to be treated. As shown most clearly in FIG. 2, the sides of the sections 26 overlap one another even in the expanded state.
  • [0042]
    In operation of the embodiments of FIGS. 1 and 2, the distal end of the catheter 10 is first positioned at the treatment site by known catheter tracking methods. The catheter 10 is then retracted over the heat treatment apparatus to exposed and expand the electrodes 16. Each electrode 16 of the energy emitting apparatus 10 expands radially outward upon retraction of the catheter 12 until the electrodes come into contact with the wall of the bronchial tube. In the embodiment of FIG. 2, the distance between the two energy emitting electrodes 16A, 16B may be fixed or may be changeable by sliding the inner shaft 22 within the outer shaft 24. When treatment is completed the heat treatment apparatus 10 is retracted back inside the catheter 12 by sliding the catheter over the electrodes. As the heat treatment apparatus 10 is retracted the sides of the sections 26 of the electrode 16 slide over each other upon coming into contact with a distal edge of the catheter 12.
  • [0043]
    FIGS. 3 and 4 illustrate an alternative embodiment of a heat treatment apparatus 50. The heat treatment apparatus may be delivered to a treatment site in a collapsed configuration illustrated in FIG. 3. The heat treatment apparatus 50 includes two leaf spring or wire shaped electrodes 54A and 54B. The electrodes 54A, 54B are connected to an insulating end cap 56 of a hollow shaft 58. The electrodes 54A, 54B are electrically connected to the RF generator or other energy source by electric cables 60, 62. The heat treatment apparatus 50 is provided with a central shaft 64 which is slidable within the hollow shaft 58. The central shaft 64 has a shaft tip 48 which is connected to a distal end of each of the electrodes 54A, 54B.
  • [0044]
    Each of the electrodes 54A, 54B is preferably insulated with an insulating sleeve 66 except for an exposed contact section 68. The heat treatment apparatus 50 is delivered to the lumen of a bronchial tube to be treated either alone or through a catheter, bronchoscope, or other channel. The electrodes 54A, 54B are expanded radially outwardly by moving the central shaft 64 proximally with respect to the hollow shaft 58 of the heat treatment apparatus 50. Upon expansion, the exposed contact sections 68 of the electrodes 54A, 54B come into contact with the walls of the bronchial tube B, shown in FIG. 4. The electrodes 54A, 54B may be configured to bend at a predetermined location forming a sharp bend as shown in FIG. 4. Alternatively, the electrodes 54A, 54B may form a more gradual curve in the expanded configuration. The electrodes 54A, 54B are preferably connected to opposite poles of the energy source. Alternatively, both of the electrodes 54A, 54B may be connected to the same lead of the energy source and the external electrode 34 may be used. Upon completion of the treatment process the electrodes 54 are retracted back into the catheter for removal or moving to a subsequent treatment site.
  • [0045]
    FIGS. 5 and 5 a illustrate an alternative embodiment of the invention in which the heat treatment apparatus 50 includes four electrodes 54A, 5413, 54C, 54D. The four electrode embodiment of FIGS. 5 and 5 a operates in the same manner as the embodiments of FIGS. 3 and 4 with a slidable central shaft 64 employed to move the electrodes from a compressed configuration to the expanded configuration illustrated in FIGS. 5 and 5 a. Each electrode 54A-54D is connected at a proximal end to the insulating end cap 56 of the hollow shaft 58 and at a distal end to the central shaft 64. Relative motion of the hollow shaft 58 with respect to the central shaft 64 moves the electrodes 54 from the collapsed to the expanded position.
  • [0046]
    FIGS. 6 and 7 illustrate a further embodiment of a heat treatment apparatus 90 employing one or more wire or leaf spring shaped loop electrodes 94. As in the previous embodiments, the loop electrode 94 expands from a contracted positioned within a catheter 92 as illustrated in FIG. 10 to an expanded position illustrated in FIG. 7. In the expanded position, the loop shaped electrode 94 comes into contact with the walls of the bronchial tube B. Although the embodiment of FIGS. 6 and 7 has been illustrated with a single loop shaped electrode 94, it should be understood that multiple loop shaped electrodes may also be use. The loop shaped electrode 92 is connected to the shaft 96 of the heat treatment apparatus 90 by an end cap 98 and is electrically connected to the energy source by the electric cables 100.
  • [0047]
    FIGS. 8-11 illustrate an alternative embodiment of a heat treatment apparatus 110 having a flexible plate shaped electrode 114. The flexible plate shaped electrode 114 is substantially flower shaped in plan having a plurality of petals 116 with curved distal ends extending from a central section 120. The petals 116 flex along a hinge line 118 to the compressed insertion configuration illustrated in FIG. 8 in which the petals 116 extend substantially perpendicularly from the central section 120 of the flexible plate shaped electrode 114.
  • [0048]
    As illustrated in FIGS. 10 and 11, when the heat treatment apparatus 110 is moved distally with respect to the catheter 112 to deploy the electrode 114 the petals 116 move outwardly until the petal tips come into contact with the walls of the bronchial tube B. The flexible plate shaped electrode 114 is preferably formed of a conductive material and fixed to the end of a shaft 122. Electric cables 124 connect the plate shaped electrode 114 to the energy source.
  • [0049]
    The electrodes in each of the forgoing embodiments may be fabricated of any material which when compressed will return to an expanded configuration upon release of the compression forces. For example, one method of controlling the expansion of the electrodes is the use of shape memory alloy electrodes. With a shape memory alloy, the constraint of the electrodes within a catheter may not be necessary. The shape memory alloy electrodes may be formed to expand to an expanded energy delivery configuration upon heating to body temperature within the body. The expansion of the electrodes is limited by the size of the bronchial tube in which the electrode is positioned.
  • [0050]
    The heat treatment apparatus according to the present invention may be employed in a bipolar mode in which two different expandable electrodes are connected to two different outputs of the RF generator 18 having opposite polarities. For example, the electrodes 16A, 16B may be connected by the electrical cables 28, 30 to different terminals of the RF generator 18. Alternatively, when more than two electrodes 16 are employed, multiple electrodes may be connected to one terminal of the RF generator. In each of the embodiments of the heat treatment apparatus, the oppositely charged electrodes are separated by an insulating material. For example, in the embodiment of FIG. 1, the inner shaft 22 and outer shaft 24 are formed of an insulating material. Further, in the embodiments of FIGS. 3-5 the end cap 56 and central shaft distal tip 82 are formed of insulating materials.
  • [0051]
    In the case where the apparatus includes only one electrode 16 as shown in FIG. 2, the electrode will be connected to the positive or negative terminal of the RF generator 18 and the opposite terminal of the RF generator will be connected to the external electrode 32.
  • [0052]
    The frequency range of RF radiation useful in the present invention is typically about 10 KHz to about 100 MHz, preferably in the range of about 200 KHz to about 800 KHz. However, frequencies outside this range may be used at the discretion of the operating surgeon. Typically, the amount of power employed will be from about 0.01 to 100 watts and preferably in the range of about 1 to 25 watts for about 1 to 60 seconds. Alternatively, alternating current or microwave radiation typically in the frequency range of about 1,000 MHz to about 2,000 MHz and preferably from about 1, 100 MHz to about 1,500 MHz may be used in place of RF radiation. In the latter case, the RF generator 18 is replaced with a microwave generator, and the electric cables 28, 30 are replaced with waveguides.
  • [0053]
    When the heat treatment apparatus with the bipolar electrodes is positioned inside the lumen of a bronchial tube, activation of the RF generator 18 causes tissue in the lumen wall to increase in temperature. The heating may be caused by resistance heating of the electrodes themselves and/or power losses through the tissue of the bronchial wall. The particular heat pattern in the tissue will depend on the path of the electric field created by the positioning and configuration of the electrodes.
  • [0054]
    In the monopolar mode, the external electrode 34, shown in FIG. 1, having a much larger surface area than the inner electrodes is placed on the outer surface of the patient's body. For example, the external electrode 34 can be an external metal mesh or a solid plate that is placed on the skin. Both the internal and external electrodes are connected to the RF generator 18 which produces an electric field at a high frequency. Because the collective surface area of the internal electrodes is much smaller than that of the outer electrode 34, the density of the high frequency electric field is much higher around the internal electrodes. The electric field reaches its highest density in the region near the internal electrodes. The increased density of the field around the internal electrodes produces localized heating of the tissue around the bronchial tube without causing significant heating of the body tissue between the bronchial tube and the external electrode.
  • [0055]
    In use, after the operating surgeon has placed the heat treatment apparatus within the lumen of a bronchial tube to be treated, if necessary, the catheter is retracted to expose the electrodes. In the case where the lumen of the bronchial tube has collapsed or is partially collapsed, the size of the energy emitting device is designed so that expansion of the electrodes causes the lumen to expand to its normal or non-collapsed diameter due to contact of the electrodes with the inner surface of the lumen. Alternatively, in the case where the lumen has not collapsed, the device is designed so that upon expansion the electrodes are in substantial contact with the inner surface of the lumen. Indeed, only minimum expansion may be necessary in treating a non-collapsed bronchial lumen.
  • [0056]
    The degree of expansion of the electrodes of the heat treatment apparatus can be monitored by means of endoscopy, fluoroscopy, or by other suitable imaging methods of the art. Generally, the heat required is induced in the tissue of the bronchial tube wall by the RF or microwave radiation emitting from the electrodes. The RF or microwave energy is applied while observing the tissue for changes via simultaneous endoscopy, or other suitable imaging methods of the art.
  • [0057]
    As is apparent, the inventive heat treatment apparatus can be employed to treat a bronchial tube regardless of whether the tube lumen has collapsed or not. Specifically, the devices can be used to treat bronchial tubes that have not collapsed, are partially collapsed, or are fully collapsed. Moreover, bronchial tubes may exhibit different degrees of closure depending on the state of respiration. For example, a bronchial tube may have a fully expanded lumen after inhalation but partially or completely closed during exhalation.
  • [0058]
    The electrodes employed in the present invention are constructed of a suitable current conducting metal or alloys such as, for example, copper, steel, platinum, and the like or of a plastic material with a conductive metal insert. The electrodes can also be constructed of a shape memory alloy which is capable of assuming a predetermined, i.e., programmed, shape upon reaching a predetermined, i.e., activation temperature. Such metals are well known in the art as described, for example, in U.S. Pat. Nos. 4,621,882 and 4,772,112 which are incorporated herein by reference. For the present invention, the shape memory metal used should have the characteristic of assuming a deflection away (i.e., expands) from the elongated rod when activated, i.e., heated in excess of the normal body temperature and preferably between 60° C. and 95° C. A preferred shape memory alloy is available as NITINOL from Raychem Corp., Menlo Park, Calif. In one embodiment, the electrodes are constructed of NITINOL in a predetermined shape and in the alloy's super elastic phase which can withstand very large deflections without deformation.
  • [0059]
    The function of the heat treatment apparatus is to apply a sufficient amount of energy to the walls of air passages to cause tissue in the walls to undergo a structural transformation to create more rigid walls that can support a non-collapsed, patent lumen. RF energy is no longer applied after there has been sufficient transformation, e.g., shrinkage, of the tissue fibers which may be gauged by removing the heating device from the treatment site and visually determining whether the lumen remains noncollapsed. Sufficient shrinkage may also be detected by fluoroscopy, external ultrasound scanning, pulse-echo ultrasound scanning, sensing the collapsing or straightening of the heating element with appropriate feedback variables, impedance monitoring or any other suitable method.
  • [0060]
    Substantial tissue transformation may be achieved very rapidly, depending upon the specific treatment conditions. Because the transformation can proceed at a rather rapid rate, the RF energy should be applied at low power levels. Preferably, the RF energy is applied for a length of time in the range of about 0.1 second to about 600 seconds, and preferably about 1 to about 60 seconds. Suitable RF power sources are commercially available and well known to those skilled in the art. In one embodiment the RF generator 18 employed has a single channel, delivering approximately 1 to 100 watts, preferably 1 to 25 watts, and most preferably 2 to 8 watts of RF energy and possessing continuous flow capability. The rate of collagen transformation can be controlled by varying the energy delivered to the heat treatment device. Regardless of the source of energy used during treatment, the lumen or the bronchial tube is maintained at a temperature of at least about 45° C., preferably between ° C. and 95° C. and more preferably between 70° C. and 85° C.
  • [0061]
    When the heat treatment apparatus includes multiple energy emitting devices, not all the electrodes need to be activated at the same time, that is, different combinations of electrodes can be employed sequentially. For example, in the case of the embodiment shown in FIG. 1, with two electrodes 16A, 16B, the electrodes can be activated simultaneously or sequentially.
  • [0062]
    In addition, when a heat treatment apparatus includes multiple energy emitting devices, the apparatus can operate in the monopolar, bipolar mode, or both modes at the same time. For instance, one of the electrodes can be designed to operate in the bipolar mode while another electrode operates in the monopolar mode.
  • [0063]
    When treating a person with obstructed air passages, a preliminary diagnosis is made to identify the air passages or bronchial tube that can be treated. In treating a particular site, excessive fluid is first removed from the obstructed air passage by conventional means such as with a suction catheter. Thereafter, the inventive heat treatment device is maneuvered to the treatment site. Depending on the diameter of the lumen of the bronchial tube, the device can be positioned directly at the treatment site or it can be positioned into place with a bronchoscope. The elongated shafts 22, 24 and outer catheter 12 are preferably made of a flexible material so that the catheter can be maneuvered through a bronchoscope. A bronchoscope is a modified catheter which includes an illuminating and visualization instrument for monitoring the treatment site and a channel for passing instruments (e.g., the treatment device) into the bronchial tubes.
  • [0064]
    In operation, the bronchoscope is advanced from the person's nasal or oral cavity, through the trachea, main stem bronchus, and into an obstructed air passage. The heat treatment apparatus is advanced forward through the bronchoscope to expose the tip of the heat treatment device before the treatment device is energized. Depending on the size of the treatment device, the treatment device can be moved to another position for further heat treatment of the air passage. This process can be repeated as many times as necessary to form a series of patency bands supporting an air passage. This procedure is applied to a sufficient number of air passages until the physician determines that he is finished. As is apparent, the procedure can be completed in one treatment or multiple treatments. After completion of the treatment, energy is discontinued and the treatment device is removed from the patient.
  • [0065]
    The heating apparatus can be made to provide protection against overheating of the connective tissue which will cause the collagen to denature. Temperature monitoring and impedance monitoring can be utilized in a system which provides feedback to the user in the form of sounds, lights, other displays or a mechanism which shuts down the application of energy from the heating element to the treatment site when sufficient tissue transformation is detected and to avoid burning of the treatment site. The amount of energy applied can be decreased or eliminated manually or automatically under certain conditions. For example, the temperature of the wall of the air passage, or of the heating element can be monitored and the energy being applied adjusted accordingly. The surgeon can, if desired, override the feedback control system. A microprocessor can be included and incorporated into the feedback control system to switch the power on and off, as well as to modulate the power. The microprocessor can serve as a controller to monitor the temperature and modulate the power.
  • [0066]
    The invention is also directed to the demonstration or instruction of the inventive surgical techniques including, but not limited to, written instructions, actual instructions involving patients, audio-visual presentations, animal demonstrations, and the like.
  • [0067]
    While the invention has been described in detail with reference to the preferred embodiments thereof, it will be apparent to one skilled in the art that various changes and modifications can be made and equivalents employed, without departing from the present invention.
Citas de patentes
Patente citada Fecha de presentación Fecha de publicación Solicitante Título
US599955 *12 May 18971 Mar 1898 Catamenial sack and womb-supporter
US4493320 *2 Abr 198215 Ene 1985Treat Michael RBipolar electrocautery surgical snare
US4502490 *23 Oct 19815 Mar 1985Antec Systems LimitedPatient monitoring equipment, probe for use therewith, and method of measuring anesthesia based on oesophagal contractions
US4565200 *4 May 198221 Ene 1986Cosman Eric RUniversal lesion and recording electrode system
US4567882 *10 Dic 19844 Feb 1986Vanderbilt UniversityMethod for locating the illuminated tip of an endotracheal tube
US4584998 *11 Sep 198129 Abr 1986Mallinckrodt, Inc.Multi-purpose tracheal tube
US4643186 *30 Oct 198517 Feb 1987Rca CorporationPercutaneous transluminal microwave catheter angioplasty
US4739759 *26 Feb 198526 Abr 1988Concept, Inc.Microprocessor controlled electrosurgical generator
US4802492 *11 Mar 19877 Feb 1989National Jewish Center For Immunology And Respiratory MedicineMethod for determining respiratory function
US4817586 *24 Nov 19874 Abr 1989Nimbus Medical, Inc.Percutaneous bloom pump with mixed-flow output
US4895557 *7 Dic 198723 Ene 1990Nimbus Medical, Inc.Drive mechanism for powering intravascular blood pumps
US4906229 *3 May 19886 Mar 1990Nimbus Medical, Inc.High-frequency transvalvular axisymmetric blood pump
US4908012 *8 Ago 198813 Mar 1990Nimbus Medical, Inc.Chronic ventricular assist system
US4985014 *11 Jul 198915 Ene 1991Orejola Wilmo CVentricular venting loop
US4991603 *30 Oct 198912 Feb 1991Siemens-Pacesetter, Inc.Transvenously placed defibrillation leads via an inferior vena cava access site and method of use
US5084044 *14 Jul 198928 Ene 1992Ciron CorporationApparatus for endometrial ablation and method of using same
US5098916 *29 Mar 199024 Mar 1992G. D. Searle & Co.Propanobicyclic amine derivatives for cns disorders
US5188602 *8 Jun 199223 Feb 1993Interventional Thermodynamics, Inc.Method and device for delivering heat to hollow body organs
US5191883 *22 May 19909 Mar 1993Prutech Research And Development Partnership IiDevice for heating tissue in a patient's body
US5281218 *5 Jun 199225 Ene 1994Cardiac Pathways CorporationCatheter having needle electrode for radiofrequency ablation
US5292331 *24 Ago 19898 Mar 1994Applied Vascular Engineering, Inc.Endovascular support device
US5293889 *19 Jun 199215 Mar 1994Hall Terrance ABeach umbrella
US5383917 *5 Jul 199124 Ene 1995Jawahar M. DesaiDevice and method for multi-phase radio-frequency ablation
US5393207 *21 Ene 199328 Feb 1995Nimbus, Inc.Blood pump with disposable rotor assembly
US5396887 *23 Sep 199314 Mar 1995Cardiac Pathways CorporationApparatus and method for detecting contact pressure
US5400778 *18 Jun 199128 Mar 1995Siemens-Elema AbMethod and device for reduction of rebreathing of gas from dead space
US5400783 *12 Oct 199328 Mar 1995Cardiac Pathways CorporationEndocardial mapping apparatus with rotatable arm and method
US5496271 *16 Jun 19935 Mar 1996American Medical Systems, Inc.Combined hyperthermia and dilation catheter
US5496311 *2 May 19945 Mar 1996Boston Scientific CorporationPhysiologic low stress angioplasty
US5496312 *7 Oct 19935 Mar 1996Valleylab Inc.Impedance and temperature generator control
US5595183 *17 Feb 199521 Ene 1997Ep Technologies, Inc.Systems and methods for examining heart tissue employing multiple electrode structures and roving electrodes
US5598848 *31 Mar 19944 Feb 1997Ep Technologies, Inc.Systems and methods for positioning multiple electrode structures in electrical contact with the myocardium
US5599345 *24 Ago 19944 Feb 1997Zomed International, Inc.RF treatment apparatus
US5601088 *17 Feb 199511 Feb 1997Ep Technologies, Inc.Systems and methods for filtering artifacts from composite signals
US5605157 *17 Feb 199525 Feb 1997Ep Technologies, Inc.Systems and methods for filtering signals derived from biological events
US5607419 *24 Abr 19954 Mar 1997Angiomedics Ii Inc.Method and apparatus for treating vessel wall with UV radiation following angioplasty
US5607462 *7 Jul 19944 Mar 1997Cardiac Pathways CorporationCatheter assembly, catheter and multi-catheter introducer for use therewith
US5707218 *13 Sep 199613 Ene 1998Nimbus, Inc.Implantable electric axial-flow blood pump with blood cooled bearing
US5707336 *9 Ene 199513 Ene 1998Cardassist IncorporatedVentricular assist device
US5707362 *3 Abr 199513 Ene 1998Yoon; InbaePenetrating instrument having an expandable anchoring portion for triggering protrusion of a safety member and/or retraction of a penetrating member
US5722401 *13 Nov 19953 Mar 1998Cardiac Pathways CorporationEndocardial mapping and/or ablation catheter probe
US5722403 *28 Oct 19963 Mar 1998Ep Technologies, Inc.Systems and methods using a porous electrode for ablating and visualizing interior tissue regions
US5722416 *17 Feb 19953 Mar 1998Ep Technologies, Inc.Systems and methods for analyzing biopotential morphologies in heart tissue to locate potential ablation sites
US5727589 *28 Nov 199417 Mar 1998Teisan K.K.Gas supply system equipped with cylinders
US5728094 *3 May 199617 Mar 1998Somnus Medical Technologies, Inc.Method and apparatus for treatment of air way obstructions
US5730128 *24 Sep 199624 Mar 1998Cardiac Pathways CorporationEndocardial mapping apparatus
US5730704 *6 May 199624 Mar 1998Avitall; BoazLoop electrode array mapping and ablation catheter for cardiac chambers
US5730741 *7 Feb 199724 Mar 1998Eclipse Surgical Technologies, Inc.Guided spiral catheter
US5855577 *7 Feb 19975 Ene 1999Eclipse Surgical Technologies, Inc.Bow shaped catheter
US5860974 *11 Feb 199719 Ene 1999Boston Scientific CorporationHeart ablation catheter with expandable electrode and method of coupling energy to an electrode on a catheter shaft
US5863291 *8 Abr 199626 Ene 1999Cardima, Inc.Linear ablation assembly
US5865791 *23 Jun 19972 Feb 1999E.P. Technologies Inc.Atrial appendage stasis reduction procedure and devices
US5868740 *24 Mar 19959 Feb 1999Board Of Regents-Univ Of NebraskaMethod for volumetric tissue ablation
US5871443 *14 Nov 199616 Feb 1999Ep Technologies, Inc.Cardiac mapping and ablation systems
US5871523 *12 Ago 199616 Feb 1999Ep Technologies, Inc.Helically wound radio-frequency emitting electrodes for creating lesions in body tissue
US5873852 *10 Ene 199723 Feb 1999Interventional TechnologiesDevice for injecting fluid into a wall of a blood vessel
US5873865 *7 Feb 199723 Feb 1999Eclipse Surgical Technologies, Inc.Spiral catheter with multiple guide holes
US5876399 *28 May 19972 Mar 1999Irvine Biomedical, Inc.Catheter system and methods thereof
US5881727 *4 Ene 199616 Mar 1999Ep Technologies, Inc.Integrated cardiac mapping and ablation probe
US5882346 *15 Jul 199616 Mar 1999Cardiac Pathways CorporationShapable catheter using exchangeable core and method of use
US6009877 *19 Feb 19984 Ene 2000Edwards; Stuart D.Method for treating a sphincter
US6010500 *21 Jul 19974 Ene 2000Cardiac Pathways CorporationTelescoping apparatus and method for linear lesion ablation
US6014579 *21 Jul 199711 Ene 2000Cardiac Pathways Corp.Endocardial mapping catheter with movable electrode
US6016437 *21 Ago 199818 Ene 2000Irvine Biomedical, Inc.Catheter probe system with inflatable soft shafts
US6023638 *22 May 19988 Feb 2000Scimed Life Systems, Inc.System and method for conducting electrophysiological testing using high-voltage energy pulses to stun tissue
US6024740 *8 Jul 199715 Feb 2000The Regents Of The University Of CaliforniaCircumferential ablation device assembly
US6033397 *26 Sep 19967 Mar 2000Vnus Medical Technologies, Inc.Method and apparatus for treating esophageal varices
US6036687 *5 Mar 199614 Mar 2000Vnus Medical Technologies, Inc.Method and apparatus for treating venous insufficiency
US6039731 *29 Oct 199821 Mar 2000Engineering & Research Associates, Inc.Apparatus and method for determining the extent of ablation
US6179833 *24 Ago 199930 Ene 2001Engineering & Research Associates, Inc.Apparatus for thermal ablation
US6198970 *25 Ene 19996 Mar 2001Esd Limited Liability CompanyMethod and apparatus for treating oropharyngeal respiratory and oral motor neuromuscular disorders with electrical stimulation
US6200311 *20 Ene 199813 Mar 2001Eclipse Surgical Technologies, Inc.Minimally invasive TMR device
US6200332 *9 Jul 199913 Mar 2001Ceramoptec Industries, Inc.Device and method for underskin laser treatments
US6200333 *31 Dic 199813 Mar 2001Broncus Technologies, Inc.Bronchial stenter
US6273907 *7 Abr 199714 Ago 2001Broncus Technologies, Inc.Bronchial stenter
US6338836 *28 Sep 199915 Ene 2002Siemens AktiengesellschaftAsthma analysis method employing hyperpolarized gas and magnetic resonance imaging
US6346104 *30 Abr 199712 Feb 2002Western Sydney Area Health ServiceSystem for simultaneous unipolar multi-electrode ablation
US6355031 *4 May 199912 Mar 2002Curon Medical, Inc.Control systems for multiple electrode arrays to create lesions in tissue regions at or near a sphincter
US6514246 *7 Jul 19984 Feb 2003Ep Technologies, Inc.Systems and methods for forming large lesions in body tissue using curvilinear electrode elements
US6526320 *16 May 200125 Feb 2003United States Surgical CorporationApparatus for thermal treatment of tissue
US6673068 *12 Abr 20006 Ene 2004Afx, Inc.Electrode arrangement for use in a medical instrument
US6692492 *28 Nov 200117 Feb 2004Cardiac Pacemaker, Inc.Dielectric-coated ablation electrode having a non-coated window with thermal sensors
US6699243 *19 Sep 20012 Mar 2004Curon Medical, Inc.Devices, systems and methods for treating tissue regions of the body
US6714822 *30 May 200230 Mar 2004Medtronic, Inc.Apparatus and method for expanding a stimulation lead body in situ
US6837888 *25 Feb 20024 Ene 2005Arthrocare CorporationElectrosurgical probe with movable return electrode and methods related thereto
US6840243 *18 Abr 200311 Ene 2005Emphasys Medical, Inc.Methods and devices for use in performing pulmonary procedures
US6849073 *24 Abr 20021 Feb 2005Medtronic, Inc.Apparatus and method for creating, maintaining, and controlling a virtual electrode used for the ablation of tissue
US6852091 *15 Abr 20028 Feb 2005Medtronic Vidamed, Inc.Medical probe device and method
US6852110 *1 Ago 20028 Feb 2005Solarant Medical, Inc.Needle deployment for temperature sensing from an electrode
US6866662 *23 Jul 200215 Mar 2005Biosense Webster, Inc.Ablation catheter having stabilizing array
US7186251 *25 Feb 20046 Mar 2007Cierra, Inc.Energy based devices and methods for treatment of patent foramen ovale
US7198635 *14 Abr 20033 Abr 2007Asthmatx, Inc.Modification of airways by application of energy
US20040010289 *14 Abr 200315 Ene 2004Broncus Technologies, Inc.Control system and process for application of energy to airway walls and other mediums
US20040031494 *13 Ago 200319 Feb 2004Broncus Technologies, Inc.Methods of treating asthma
US20050010270 *26 Mar 200413 Ene 2005Asthmatx, Inc.Method of treating airways in the lung
US20060062808 *30 Sep 200423 Mar 2006Asthmatx, Inc.Inactivation of smooth muscle tissue
US20080004596 *25 May 20073 Ene 2008Palo Alto InstituteDelivery of agents by microneedle catheter
US20090018538 *12 Jul 200715 Ene 2009Asthmatx, Inc.Systems and methods for delivering energy to passageways in a patient
US20090030477 *24 Jul 200829 Ene 2009Asthmatx, Inc.System and method for controlling power based on impedance detection, such as controlling power to tissue treatment devices
US20090043301 *8 Ago 200812 Feb 2009Asthmatx, Inc.Monopolar energy delivery devices and methods for controlling current density in tissue
US20090069797 *8 Sep 200812 Mar 2009Asthmatx, Inc.Bipolar devices for modification of airways by transfer of energy
Citada por
Patente citante Fecha de presentación Fecha de publicación Solicitante Título
US7740017 *29 Abr 200522 Jun 2010Asthmatx, Inc.Method for treating an asthma attack
US77705844 Dic 200810 Ago 2010Asthmatx, Inc.Modification of airways by application of microwave energy
US783767917 Jul 200623 Nov 2010Asthmatx, Inc.Control system and process for application of energy to airway walls and other mediums
US785333125 May 200614 Dic 2010Asthmatx, Inc.Medical device with procedure improvement features
US785473417 Jul 200621 Dic 2010Asthmatx, Inc.Control system and process for application of energy to airway walls and other mediums
US790612430 Sep 200415 Mar 2011Asthmatx, Inc.Inactivation of smooth muscle tissue
US7921855 *11 Dic 200612 Abr 2011Asthmatx, Inc.Method for treating an asthma attack
US793164720 Oct 200626 Abr 2011Asthmatx, Inc.Method of delivering energy to a lung airway using markers
US79381231 Dic 200810 May 2011Asthmatx, Inc.Modification of airways by application of cryo energy
US794940729 Dic 200624 May 2011Asthmatx, Inc.Energy delivery devices and methods
US79925727 Nov 20069 Ago 2011Asthmatx, Inc.Methods of evaluating individuals having reversible obstructive pulmonary disease
US80881278 May 20093 Ene 2012Innovative Pulmonary Solutions, Inc.Systems, assemblies, and methods for treating a bronchial tree
US8161978 *18 Mar 201024 Abr 2012Asthmatx, Inc.Methods for treating asthma by damaging nerve tissue
US81728271 Jun 20068 May 2012Innovative Pulmonary Solutions, Inc.Apparatus for treating asthma using neurotoxin
US818165623 Feb 200622 May 2012Asthmatx, Inc.Methods for treating airways
US822663826 Sep 201124 Jul 2012Innovative Pulmonary Solutions, Inc.Systems, assemblies, and methods for treating a bronchial tree
US823598312 Jul 20077 Ago 2012Asthmatx, Inc.Systems and methods for delivering energy to passageways in a patient
US82510704 Abr 200628 Ago 2012Asthmatx, Inc.Methods for treating airways
US825741322 Sep 20064 Sep 2012Asthmatx, Inc.Modification of airways by application of energy
US8267094 *4 Dic 200818 Sep 2012Asthmatx, Inc.Modification of airways by application of ultrasound energy
US844381020 Jun 200621 May 2013Asthmatx, Inc.Methods of reducing mucus in airways
US845926824 Abr 201211 Jun 2013Asthmatx, Inc.Methods for treating airways
US846472328 Jun 201118 Jun 2013Asthmatx, Inc.Methods of evaluating individuals having reversible obstructive pulmonary disease
US846548625 Jul 201218 Jun 2013Asthmatx, Inc.Modification of airways by application of energy
US848066725 May 20069 Jul 2013Asthmatx, Inc.Medical device with procedure improvement features
US848383117 Feb 20099 Jul 2013Holaira, Inc.System and method for bronchial dilation
US848919214 Jun 201216 Jul 2013Holaira, Inc.System and method for bronchial dilation
US853429131 May 200617 Sep 2013Asthmatx, Inc.Methods of treating inflammation in airways
US8584681 *22 Abr 201019 Nov 2013Asthmatx, Inc.Method for treating an asthma attack
US86407119 Dic 20104 Feb 2014Asthmatx, Inc.Method for treating an asthma attack
US873167218 Jun 201320 May 2014Holaira, Inc.System and method for bronchial dilation
US873336728 Mar 201327 May 2014Asthmatx, Inc.Methods of treating inflammation in airways
US874089528 Jun 20133 Jun 2014Holaira, Inc.Delivery devices with coolable energy emitting assemblies
US877794328 Jun 201315 Jul 2014Holaira, Inc.Delivery devices with coolable energy emitting assemblies
US880828020 Abr 201219 Ago 2014Holaira, Inc.Systems, assemblies, and methods for treating a bronchial tree
US882148920 Abr 20122 Sep 2014Holaira, Inc.Systems, assemblies, and methods for treating a bronchial tree
US88289451 Feb 20119 Sep 2014Asthmatx, Inc.Inactivation of smooth muscle tissue
US888876911 Nov 201018 Nov 2014Asthmatx, Inc.Control system and process for application of energy to airway walls and other mediums
US891143911 Nov 201016 Dic 2014Holaira, Inc.Non-invasive and minimally invasive denervation methods and systems for performing the same
US892041325 May 200630 Dic 2014Asthmatx, Inc.Energy delivery devices and methods
US893228926 Sep 201113 Ene 2015Holaira, Inc.Delivery devices with coolable energy emitting assemblies
US894407120 Ago 20123 Feb 2015Asthmatx, Inc.Method for treating an asthma attack
US896150720 Abr 201224 Feb 2015Holaira, Inc.Systems, assemblies, and methods for treating a bronchial tree
US896150820 Abr 201224 Feb 2015Holaira, Inc.Systems, assemblies, and methods for treating a bronchial tree
US900519526 Sep 201114 Abr 2015Holaira, Inc.Delivery devices with coolable energy emitting assemblies
US901732428 Jun 201328 Abr 2015Holaira, Inc.Delivery devices with coolable energy emitting assemblies
US902756410 May 201312 May 2015Asthmatx, Inc.Method for treating a lung
US903397616 May 201319 May 2015Asthmatx, Inc.Modification of airways by application of energy
US912564330 Abr 20148 Sep 2015Holaira, Inc.System and method for bronchial dilation
US914932811 Nov 20106 Oct 2015Holaira, Inc.Systems, apparatuses, and methods for treating tissue and controlling stenosis
US927213231 Oct 20131 Mar 2016Boston Scientific Scimed, Inc.Medical device for treating airways and related methods of use
US92833745 Nov 201315 Mar 2016Boston Scientific Scimed, Inc.Devices and methods for delivering energy to body lumens
US93396185 Nov 201217 May 2016Holaira, Inc.Method and apparatus for controlling narrowing of at least one airway
US935802414 May 20137 Jun 2016Asthmatx, Inc.Methods for treating airways
US939893327 Dic 201326 Jul 2016Holaira, Inc.Methods for improving drug efficacy including a combination of drug administration and nerve modulation
US957261920 Ene 201621 Feb 2017Boston Scientific Scimed, Inc.Medical device for treating airways and related methods of use
US959208615 May 201314 Mar 2017Boston Scientific Scimed, Inc.Electrodes for tissue treatment
US964915327 Oct 201016 May 2017Holaira, Inc.Delivery devices with coolable energy emitting assemblies
US964915414 Nov 201416 May 2017Holaira, Inc.Non-invasive and minimally invasive denervation methods and systems for performing the same
US966880922 Ago 20126 Jun 2017Holaira, Inc.Systems, assemblies, and methods for treating a bronchial tree
US967541231 Oct 201413 Jun 2017Holaira, Inc.Delivery devices with coolable energy emitting assemblies
US20060062808 *30 Sep 200423 Mar 2006Asthmatx, Inc.Inactivation of smooth muscle tissue
US20060247619 *25 May 20062 Nov 2006Asthmatx, Inc.Medical device with procedure improvement features
US20080015574 *28 Mar 200717 Ene 2008Karpiel John AElectrosurgical cutting device
US20090192508 *20 Feb 200930 Jul 2009Asthmatx, Inc.Modification of airways by application of mechanical energy
US20100160906 *17 Dic 200924 Jun 2010Asthmatx, Inc.Expandable energy delivery devices having flexible conductive elements and associated systems and methods
US20110184330 *1 Feb 201128 Jul 2011Asthmatx, Inc.Inactivation of smooth muscle tissue
CN103815961A *28 Feb 201428 May 2014中国人民解放军第二军医大学Electrocoagulation probe passing through bronchoscope
Clasificaciones
Clasificación de EE.UU.606/50, 607/101, 606/46
Clasificación internacionalA61M29/00, A61M25/00, A61B18/04, A61B18/08, A61N1/40, A61B17/22, A61B17/00, A61N1/06, A61B18/18, A61B18/00, A61B18/14
Clasificación cooperativaA61B18/1492, A61B2018/1407, A61B18/00, A61B2018/046, A61M2025/0096, A61M29/02, A61B18/14, A61M2210/1039, A61B2018/044, A61B2017/00115, A61B2018/00541, A61B2018/1807, A61B2017/22062, A61B2018/00214, A61N1/06, A61N1/403, A61M25/0043, A61B18/08
Clasificación europeaA61B18/14V, A61M25/00S, A61M29/02, A61N1/06, A61N1/40T, A61B18/00
Eventos legales
FechaCódigoEventoDescripción
24 Jul 2007ASAssignment
Owner name: ASTHMATX, INC., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:LAUFER, MICHAEL D.;BURGER, KEITH M.;LOOMAS, BRYAN E.;AND OTHERS;REEL/FRAME:019606/0349;SIGNING DATES FROM 19990225 TO 20031226
31 Ago 2010ASAssignment
Owner name: ASTHMATX, INC., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:BRONCUS TECHNOLOGIES, INC.;REEL/FRAME:024916/0034
Effective date: 20031226
Owner name: BRONCUS TECHNOLOGIES, INC., CALIFORNIA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:LAUFER, MICHAEL D.;BURGER, KEITH M.;LOOMAS, BRYAN E.;AND OTHERS;SIGNING DATES FROM 19990225 TO 19990226;REEL/FRAME:024914/0953
28 Oct 2016ASAssignment
Owner name: BOSTON SCIENTIFIC SCIMED, INC., MINNESOTA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:ASTHMATX, INC.;REEL/FRAME:040510/0149
Effective date: 20101026