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 publicaciónUS20090228059 A1
Tipo de publicaciónSolicitud
Número de solicitudUS 12/430,211
Fecha de publicación10 Sep 2009
Fecha de presentación27 Abr 2009
Fecha de prioridad6 Jun 2006
También publicado comoEP2029003A2, US7526337, US20070282382, WO2007146489A2, WO2007146489A3
Número de publicación12430211, 430211, US 2009/0228059 A1, US 2009/228059 A1, US 20090228059 A1, US 20090228059A1, US 2009228059 A1, US 2009228059A1, US-A1-20090228059, US-A1-2009228059, US2009/0228059A1, US2009/228059A1, US20090228059 A1, US20090228059A1, US2009228059 A1, US2009228059A1
InventoresAllan C. Shuros, Michael J. Kane
Cesionario originalShuros Allan C, Kane Michael J
Exportar citaBiBTeX, EndNote, RefMan
Enlaces externos: USPTO, Cesión de USPTO, Espacenet
Method and device for lymphatic system monitoring
US 20090228059 A1
Resumen
A device and method are disclosed for physiological monitoring of the lymphatic system. An implantable device is configured with a lymphatic sensor disposed in a lymphatic vessel for sensing pressure, flow, and/or the concentration of particular markers within the vessel. The device may be further configured to deliver appropriate therapy in accordance with the lymphatic monitoring.
Imágenes(4)
Previous page
Next page
Reclamaciones(12)
1. A device, comprising:
monitoring and therapy circuitry contained within an implantable housing;
a lead electrically connected to the monitoring circuitry that is adapted for implantation into a lymphatic vessel, the lead having a lymphatic sensor incorporated therein for sensing a physiological parameter related to lymphatic function;
a controller interfaced to the therapy circuitry and interfaced to the monitoring circuitry for processing sensing signals generated by the lymphatic sensor;
wherein the controller is programmed to modify the delivery of therapy when edema is detected from the lymphatic sensor signals.
2. The device of claim 1 wherein the lymphatic sensor is a pressure sensor.
3. The device of claim 1 wherein the lymphatic sensor is a flow sensor.
4. The device of claim 1 wherein the lymphatic sensor is a chemo-sensor for generating a voltage proportional to the concentration of a particular chemical species in the lymphatic fluid.
5. The device of claim 1 further comprising a telemetry transceiver interfaced to the controller for enabling wireless communication with the controller.
6. The device of claim 5 wherein the controller is programmed to transmit an alarm message via the telemetry transceiver if a value sensed by the lymphatic sensor reaches a specified limit value.
7. The device of claim 1 wherein the therapy circuitry comprises:
cardiac pacing circuitry, including pulse generation circuitry and cardiac sensing circuitry;
one or more leads with pacing/sensing electrodes electrically connected to the cardiac pacing circuitry; and,
wherein the controller is programmed to deliver bradycardia pacing therapy based upon sensing signals generated by the lymphatic sensor.
8. The device of claim 1 wherein the therapy circuitry comprises:
pulse generation circuitry;
one or more leads with electrodes electrically connected to the pulse generation circuitry for delivering neural stimulation; and,
wherein the controller is programmed to deliver neural stimulation therapy based upon sensing signals generated by the lymphatic sensor.
9. The device of claim 1 wherein the therapy circuitry comprises:
a drug delivery device actuated by the therapy circuitry; and,
wherein the controller is programmed to deliver medication based upon sensing signals generated by the lymphatic sensor.
10. The device of claim 1 wherein the therapy circuitry comprises:
cardiac pacing circuitry, including pulse generation circuitry and cardiac sensing circuitry;
one or more leads with pacing/sensing electrodes electrically connected to the cardiac pacing circuitry; and,
wherein the controller is programmed to deliver cardiac resynchronization therapy based upon sensing signals generated by the lymphatic sensor.
11. The device of claim 10 wherein the controller is programmed to initiate, or increase, the delivery of cardiac resynchronization therapy upon sensing a lymphatic flow or pressure value indicative of edema.
12. The device of claim 10 wherein the controller is programmed to adjust one or more cardiac resynchronization parameters upon sensing a lymphatic flow or pressure value indicative of edema.
Descripción
    CROSS REFERENCE TO RELATED APPLICATIONS
  • [0001]
    This application is a divisional of U.S. application Ser. No. 11/422,417, filed Jun. 6, 2006, which is hereby incorporated by reference in its entirety.
  • [0002]
    This application is related to co-pending application Ser. Nos. 11/422,423, 11/422,414, 11/422,418, and 11/422,421 all filed Jun. 6, 2006 and hereby incorporated by reference.
  • FIELD OF THE INVENTION
  • [0003]
    This invention pertains to methods and systems for diagnosing and treating disease with implantable devices.
  • BACKGROUND
  • [0004]
    The lymphatic system and the cardiovascular system are closely related structures that are joined by a capillary system. The lymphatic system is important to the body's defense mechanisms by filtering out organisms that cause disease and producing lymphocytes that attack foreign organisms and generate antibodies. It is also important for the distribution of fluids and nutrients in the body, because it drains excess fluids and protein from interstitial tissues. Lymph is the fluid that seeps outside the blood vessels in interstitial spaces of body tissues and is then absorbed by lymphatic capillaries to flow back into the bloodstream through the lymphatic vessels. The terminal structures of the lymphatic vessels include the right lymphatic duct, which drains lymph fluid from the upper right quarter of the body above the diaphragm and down the midline, and the thoracic duct, located in the mediastinum of the pleural cavity which drains the rest of the body. Through the flow of blood in and out of arteries, into the veins, and through the lymph vessels and nodes, the body is able to eliminate the products of cellular breakdown and bacterial invasion.
  • SUMMARY
  • [0005]
    A device and method are disclosed for physiological monitoring of the lymphatic system. An implantable device is configured with a lymphatic sensor disposed in a lymphatic vessel for sensing pressure, flow, and/or the concentration of particular markers within the vessel. The device may be further configured to deliver appropriate therapy in accordance with the lymphatic monitoring.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • [0006]
    FIG. 1 illustrates the physical placement of an implanted monitoring device and attached lead.
  • [0007]
    FIG. 2 illustrates the components of an exemplary system for physiological monitoring of the lymphatic system.
  • [0008]
    FIG. 3 illustrates a block diagram of the components of an exemplary implantable monitoring device.
  • [0009]
    FIG. 4 illustrates an embodiment for delivering cardiac pacing therapy.
  • DETAILED DESCRIPTION
  • [0010]
    This disclosure relates to a device and method for monitoring lymphatic function. The lymphatic vessels are part of the body's circulatory system and serve as a pathway by which fluids can flow from the interstitial spaces into blood. Lymphatic vessels also communicate with lymph nodes and facilitate the body's immune function by transporting foreign antigens to the lymph nodes from the interstitial spaces. As described below, an implantable device may be used to monitor lymphatic function and thereby detect particular conditions such as increased inflammation and edema.
  • [0011]
    One of the functions performed by the lymphatic system is the conveying back to the blood of fluid and proteins exuded from the blood vessels into the interstitial space. Exuded fluid and proteins are absorbed by lymphatic capillaries and then flow into the venous system through lymphatic vessels. The lymphatic system is normally very efficient at removing excess fluid from the interstitial space and is even able to maintain a slight negative pressure. Under certain conditions, however, the lymphatic system is so overwhelmed with fluid that a buildup occurs, referred to as edema. When edema occurs, pressure and flow within the lymphatic vessels increases. As described below, an implantable device may be configured to measure these parameters and detect edema. The concentration of particular molecules in the lymphatic fluid may also be detected by the device in order to further characterize edema or detect other clinical states of interest. The device may also be configured to deliver a specific therapy in response to the monitoring of lymphatic function, such as when edema is detected.
  • [0012]
    In one embodiment, a lymphatic function monitor may be incorporated as part of a cardiac pacing device configured to deliver cardiac resynchronization therapy (CRT) in which pacing pulses are used to overcome conduction deficits and cause the heart to contract in a more coordinated manner (e.g., biventricular pacing). CRT is commonly used to treat patients with chronic heart failure. When chronic heart failure worsens, the decreased cardiac output causes diminished renal perfusion. The kidneys compensate for this by absorbing more salt and water from the renal filtrate which raises venous pressure. The increased venous pressure then results in edema when the fluid buildup into the interstitial space overcomes the lymphatic system's ability to remove it. Edema due to heart failure may occur, for example, in the lung or in the extremities. In one embodiment, an implantable device configured to monitor lymphatic function may be further configured to initiate, increase, or modulate the delivery of CRT when edema is detected. The device could also be programmed to adjust certain CRT parameters such as the atrio-ventricular delay interval when edema is detected.
  • [0013]
    Edema can also be caused by kidney disease or liver disease that results in decreased plasma proteins, particularly albumin. This causes increases osmotic pressure that forces more fluid from the blood capillaries into the interstitium. In another embodiment, the device is configured to deliver an appropriate medication when edema is detected (e.g., an ACE inhibitor or angiotensin receptor blocker for the treatment of kidney disease.)
  • [0014]
    The composition of lymphatic fluid may also be monitored to determine if particular clinical states exist. For example, the concentration of cytokines and immunoglobulins may be used to assess certain autoimmune diseases and cancer. When the concentration of such substances reaches a particular level, the device may then be configured to deliver an appropriate medication.
  • [0015]
    FIG. 1 shows an exemplary physical placement of an implantable monitoring device as described herein. In one embodiment, an implantable monitoring device 105 is placed subcutaneously on the patient's chest or abdomen, similar to a standard cardiac pacemaker. The monitoring device is connected to one or more leads 110, each having a distal member that incorporates an electrode or sensor for sensing physiological parameter(s) related to lymphatic function, referred to herein as a lymphatic sensor. The lead is positioned within the lymphatic system using a venous approach which involves initial entry into the venous blood system. In the embodiment depicted in FIG. 1, the lead 110 passes subcutaneously from the device housing 130 to a point of venous access in the upper chest or neck such as the subclavian vein. The lead is then guided into the thoracic duct ostium using standard fluoroscopy techniques and positioned at a selected location within the lymphatic system. An alternative implantation approach includes placing the lymphatic sensor using a direct surgical approach.
  • [0016]
    FIG. 2 shows an exemplary monitoring system. The pulse monitoring device 105 includes a hermetically sealed housing 130 that is placed subcutaneously or submuscularly in a patient's chest or other convenient location as noted above. The housing 130 may be formed from a conductive metal, such as titanium, and may serve as an electrode for delivering electrical stimulation with a unipolar lead. A header 140, which may be formed of an insulating material, is mounted on the housing 130 for receiving the leads 110 which are electrically connected to the circuitry within the housing. Contained within the housing 130 is the electronic circuitry 132 for providing the functionality to the device as described herein which may include a power supply, monitoring circuitry, therapy circuitry, and a programmable electronic controller for controlling the operation of the device.
  • [0017]
    FIG. 3 illustrates exemplary components of the electronic circuitry 132 depicted in FIG. 2. A controller 135 is provided which may be made up of discrete circuit elements but is preferably a processing element such as a microprocessor together with associated memory for program and data storage which may be programmed to perform algorithms for delivering therapy. (As the terms are used herein, “circuitry” and “controller” may refer either to a programmed processor or to dedicated hardware components configured to perform a particular task.) The controller is interfaced to monitoring circuitry 136 from which it receives data generated by one or more lymphatic sensors 137. The monitoring circuitry may include, for example, circuitry for amplification, filtering, and/or analog-to-digital conversion of voltages generated by a lymphatic sensor.
  • [0018]
    In one embodiment, the lymphatic sensor 137 is a flow or pressure sensor for sensing conditions within a lymphatic vessel that indicate edema may be present. As noted above, edema may be diagnosed when the lymphatic vessels are overwhelmed with fluid due to, for example, elevated venous pressure caused by heart failure and renal compensation thereof, kidney disease, or liver disease. Under such conditions, the pressure and/or flow of lymph within the lymphatic vessels may be increased. In another embodiment, the lymphatic sensor is a chemo-sensor designed to generate a voltage proportional to the concentration of a particular chemical species. The chemo-sensor may be used to provide the controller an indication of the concentration of a particular molecule in the lymphatic fluid that is of interest, referred to as a marker. Examples of markers whose concentrations may be of diagnostic value include immunoglobulins, cytokines, or specific proteins that could be used to characterize a particular disease state. Such chemo-sensors may use immobilized antibodies with binding affinities specific for the different marker antigens. Upon formation of an Ab-Ag complex between the antibody and the marker, the chemo-sensor may produce an electrical signal by, for example, incorporating a piezoelectric transducer that responds to mechanical stresses induced by the Ab-Ag complex or a transducer that responds to potential changes resulting from the Ab-Ag complex.
  • [0019]
    In another embodiment, the lymphatic sensor is a stretch or volume sensor that monitors the degree of stretch or change in volume within a lymphatic vessel using impedance, ultrasonics, acoustic, capacitance, inductance, or optical-type instruments. In another embodiment, the lymphatic sensor is a pulsatile rate sensor using impedance, ultrasonics, acoustic, piezoelectric, piezoresistive, capacitance, inductance, or optical type instruments to monitor pulsatile flow within a lymphatic vessel or a pulsatile contractility sensor that measures intensity of peristaltic wave motion using impedance, ultrasonics, acoustic, capacitance, inductance, or optical type instruments. In another embodiment, the lymphatic sensor is a density sensor for detecting the concentration of dissolved and suspended particulates in the lymph fluid using an optical, acoustic, or electrical instrument. In another embodiment, the lymphatic sensor is a cell counting sensor that detects the density of lymphocytes in the lymph fluid.
  • [0020]
    In the embodiment illustrated in FIG. 3, the controller 135 is also interfaced to therapy circuitry 140 in order to control the delivery of therapy by the device in response to conditions sensed by the monitoring circuitry. The therapy circuitry 135 may include circuitry for delivery of one or more therapy modalities such as cardiac resynchronization therapy, neural stimulation, and drug therapy. In one embodiment, shown in FIG. 4, the device includes circuitry for delivering bradycardia cardiac pacing and/or cardiac resynchronization therapy and includes pulse generation circuitry 140, cardiac sensing circuitry 142, and pacing/sensing electrodes 111 electrically connected to the device by leads (i.e., intravenous leads such as shown in FIG. 1) adapted for disposition in the heart. In another embodiment, the device includes a drug delivery device 145 actuated by the therapy circuitry that may be used to deliver medication in response detection of particular conditions. Such medications could include anti-inflammatory drugs, cancer chemotherapeutic agents, diuretics, or cardiac drugs.
  • [0021]
    Also interfaced to the controller in FIG. 3 is a telemetry transceiver 150 capable of communicating with an external programmer or a remote monitoring device 190 as illustrated in FIG. 2. An external programmer wirelessly communicates with the device 105 and enables a clinician to receive data and modify the programming of the controller. A remote monitoring device similarly communicates with the device 105 and is further interfaced to a network 195 (e.g., an internet connection) for communicating with a patient management server 196 that allows clinical personnel at remote locations to receive data from the remote monitoring device as well as issue commands. The controller may be programmed such when particular conditions are detected by the monitoring circuitry (such as when a measured parameter exceeds or falls below a specified limit value), the device transmits an alarm message to the remote monitoring device and to the patient management server to alert clinical personnel.
  • [0022]
    In order to implant a lead incorporating a lymphatic sensor(s) into a selected location within lymphatic vessel, the lymphatic system may be visualized using lymphangiography. In this technique, dye is injected into the subcutaneous tissue of an extremity such as the foot, or other peripheral lymph vessel, and the lymphatic system drains the dye making the lymphatic vessels visible. A lymphatic vessel is cannulated, and radiopaque contrast is injected to illuminate major lymph vessels including the thoracic duct and its ostium into the subclavian vein. A catheter or the lead may then be guided into the thoracic duct ostium via the venous system using fluoroscopy techniques and positioned at a selected location within the lymphatic system. Initial cannulation of the lymph ostium with a guide wire or catheter may be achieved through the left or right subclavian vein, the left jugular veins, the epigastric/mammary veins or the femoral veins. In order to facilitate navigation through the lymphatic vessels and position the sensor at a selected anatomical location, an overlapping technique may be employed whereby fluoroscopic images produced by the injected dye are used in conjunction with anatomical images of the patient produced by other modalities such as conventional x-ray, CAT scans, MRI scans, or ultrasonic scans. The fluoroscopic image may be overlaid with the anatomical image and the lead then guided to the selected location.
  • [0023]
    To implant the lead, a catheter or the lead by itself may be introduced into the venous system and from there into the thoracic duct ostium using conventional over-the-wire techniques that employ a guide wire. The guide wire is manually or mechanically pushed and manipulated to guide its travel and upon which catheters and/or leads may be advanced. A stereotaxis technique in which external magnets or other means are used to guide the catheter may also be used to improve maneuverability and precision as well as provide increased safety. An example of this technique is described in U.S. Pat. No. 6,475,223, hereby incorporated by reference. Once the catheter or lead is in the lymphatic system, it must also traverse valves in the lymphatic vessels whose function is to allow flow of lymphatic fluid in only one direction to the thoracic duct. In the case where a catheter is employed, as the catheter is guided through a vessel to one of these valves, the catheter may incorporate a vacuum system to open the valves. When the vacuum system is actuated, it draws negative pressure to create a pressure gradient that opens the valve. An alternative technique for opening lymphatic valves involves using a catheter incorporating a compliant balloon on its distal tip. When the catheter reaches a lymphatic valve, the balloon is inflated to mechanically dilate the vessel which opens the valve and allows a wire or the catheter to pass through. In still another technique, the catheter incorporates an electrode at its tip that is used to cause smooth muscle contraction of the lymphatic vessel. Such smooth muscle contraction can create a pressure gradient that opens the valve and allows the catheter to advance past the valve.
  • [0024]
    Although the invention has been described in conjunction with the foregoing specific embodiments, many alternatives, variations, and modifications will be apparent to those of ordinary skill in the art. Such alternatives, variations, and modifications are intended to fall within the scope of the following appended claims.
Citas de patentes
Patente citada Fecha de presentación Fecha de publicación Solicitante Título
US3814080 *13 Nov 19724 Jun 1974Becton Dickinson CoVessel cannulator and clamp for lymphangiography
US3916875 *2 Ene 19744 Nov 1975Toch HerbertLymph duct cannulation facilitator
US4650467 *22 Ago 198517 Mar 1987Sarcem S.A.Remote control catheter
US4792330 *13 Jul 198720 Dic 1988Lazarus Medical Innovations, Inc.Combination catheter and duct clamp apparatus and method
US4909787 *11 Ago 198820 Mar 1990Danforth John WControllable flexibility catheter with eccentric stiffener
US4957484 *26 Jul 198818 Sep 1990Automedix Sciences, Inc.Lymph access catheters and methods of administration
US5112303 *2 May 199112 May 1992Pudenz-Schulte Medical Research CorporationTumor access device and method for delivering medication into a body cavity
US5284153 *14 Abr 19928 Feb 1994Brigham And Women's HospitalMethod for locating a nerve and for protecting nerves from injury during surgery
US5305745 *2 Abr 199226 Abr 1994Fred ZacoutoDevice for protection against blood-related disorders, notably thromboses, embolisms, vascular spasms, hemorrhages, hemopathies and the presence of abnormal elements in the blood
US5333609 *19 May 19922 Ago 1994Minnesota Mining And Manufacturing CompanyCatheter and probe-catheter assembly
US5387231 *3 Jun 19947 Feb 1995Sporer; PatsyElectrotherapy method
US5391143 *12 Mar 199321 Feb 1995Kensey Nash CorporationMethod and system for effecting weight reduction of living beings
US5405363 *21 Jun 199411 Abr 1995Angelon CorporationImplantable cardioverter defibrillator having a smaller displacement volume
US5596988 *7 Dic 199428 Ene 1997Biomedical Sensors, Ltd.Multi-parameter sensor apparatus
US5655548 *16 Sep 199612 Ago 1997Circulation, Inc.Method for treatment of ischemic heart disease by providing transvenous myocardial perfusion
US5658318 *28 Sep 199519 Ago 1997Pacesetter AbMethod and apparatus for detecting a state of imminent cardiac arrhythmia in response to a nerve signal from the autonomic nerve system to the heart, and for administrating anti-arrhythmia therapy in response thereto
US5662689 *8 Sep 19952 Sep 1997Medtronic, Inc.Method and apparatus for alleviating cardioversion shock pain
US5697953 *11 Ene 199616 Dic 1997Angeion CorporationImplantable cardioverter defibrillator having a smaller displacement volume
US5817138 *27 Nov 19966 Oct 1998Suzuki; James Y.Multi-channel, interferential wave, micro current device and methods for treatment using micro current
US5865744 *16 Sep 19962 Feb 1999Lemelson; Jerome H.Method and system for delivering therapeutic agents
US5891084 *27 Ene 19976 Abr 1999Lee; Vincent W.Multiple chamber catheter delivery system
US6024704 *30 Abr 199815 Feb 2000Medtronic, IncImplantable medical device for sensing absolute blood pressure and barometric pressure
US6077227 *28 Dic 199820 Jun 2000Medtronic, Inc.Method for manufacture and implant of an implantable blood vessel cuff
US6106477 *28 Dic 199822 Ago 2000Medtronic, Inc.Chronically implantable blood vessel cuff with sensor
US6115637 *22 Dic 19985 Sep 2000Universities Research Association, Inc.Microcurrent therapeutic technique for treatment of radiation toxicity
US6129685 *27 Jun 199710 Oct 2000The University Of Iowa Research FoundationStereotactic hypothalamic obesity probe
US6238423 *30 Sep 199929 May 2001Medtronic, Inc.Apparatus and method for treating chronic constipation
US6272370 *7 Ago 19987 Ago 2001The Regents Of University Of MinnesotaMR-visible medical device for neurological interventions using nonlinear magnetic stereotaxis and a method imaging
US6292695 *17 Jun 199918 Sep 2001Wilton W. Webster, Jr.Method and apparatus for transvascular treatment of tachycardia and fibrillation
US6321109 *14 Feb 199720 Nov 2001Biosense, Inc.Catheter based surgery
US6347247 *7 May 199912 Feb 2002Genetronics Inc.Electrically induced vessel vasodilation
US6368274 *8 May 20009 Abr 2002Medtronic Minimed, Inc.Reusable analyte sensor site and method of using the same
US6370417 *22 Sep 19999 Abr 2002Siemens AkiengesellschaftMethod for positioning a catheter in a vessel, and device for implementing the method
US6475223 *20 Jul 19995 Nov 2002Stereotaxis, Inc.Method and apparatus for magnetically controlling motion direction of a mechanically pushed catheter
US6584362 *30 Ago 200024 Jun 2003Cardiac Pacemakers, Inc.Leads for pacing and/or sensing the heart from within the coronary veins
US6629534 *7 Abr 20007 Oct 2003Evalve, Inc.Methods and apparatus for cardiac valve repair
US6676686 *25 Abr 200113 Ene 2004Harumi NaganumaNoninvasive detection and activation of the lymphatic system in treating disease and alleviating pain
US6741882 *4 Dic 200025 May 2004Koninklijke Philips Electronics N.V.MR device and MR method for localizing and/or visualizing a medical instrument provided with a passive magnet device
US6804558 *18 Ene 200112 Oct 2004Medtronic, Inc.System and method of communicating between an implantable medical device and a remote computer system or health care provider
US6835194 *27 Jun 200228 Dic 2004Durect CorporationImplantable devices and methods for treatment of pain by delivery of fentanyl and fentanyl congeners
US6893429 *30 Ago 200117 May 2005Medtronic, Inc.Convection enhanced delivery catheter to treat brain and other tumors
US6918873 *19 Sep 200219 Jul 2005Millar Instruments, Inc.Inverted sensor module
US7123961 *7 May 200417 Oct 2006Pacesetter, Inc.Stimulation of autonomic nerves
US7260431 *20 May 200421 Ago 2007Cardiac Pacemakers, Inc.Combined remodeling control therapy and anti-remodeling therapy by implantable cardiac device
US7277761 *11 Jun 20032 Oct 2007Pacesetter, Inc.Vagal stimulation for improving cardiac function in heart failure or CHF patients
US7526337 *6 Jun 200628 Abr 2009Cardiac Pacemakers, Inc.Method and device for lymphatic system monitoring
US7616991 *30 Dic 200410 Nov 2009Pacesetter, Inc.Method for digital cardiac rhythm management
US7734341 *6 Jun 20068 Jun 2010Cardiac Pacemakers, Inc.Method and apparatus for gastrointestinal stimulation via the lymphatic system
US7774055 *7 Nov 200510 Ago 2010Pacesetter, Inc.Left atrial pressure-based criteria for monitoring intrathoracic impedance
US20010007924 *28 Dic 200012 Jul 2001Tanita CorporationApparatus for detemining degree of restoration of diseased part
US20010037061 *26 Ene 20011 Nov 2001Rolf EckmillerMicrocontact structure for neuroprostheses for implantation on nerve tissue and method therefor
US20010041870 *31 Mar 199915 Nov 2001Edward M. GillisImplantable device for access to a treatment site
US20020016615 *1 Oct 20017 Feb 2002Dev Nagendu B.Electrically induced vessel vasodilation
US20020029037 *6 Sep 20017 Mar 2002Kim Young D.Method and apparatus for percutaneous trans-endocardial reperfusion
US20020123674 *27 Feb 20025 Sep 2002Gianni PlicchiProcess and implantable device for the intrapulmonary assessing of density dependant physical properties of the lung tissue
US20020156462 *15 Mar 200224 Oct 2002Stultz Mark R.Programmable implantable pump with accessory reservoirs and multiple independent lumen catheter
US20020188253 *7 Jun 200112 Dic 2002Pharmaspec CorporationMethod and apparatus for drug delivery in veins
US20030018247 *24 Jul 200123 Ene 2003George GonzalezProcess for testing and treating aberrant sensory afferents and motors efferents
US20030036773 *2 Ago 200220 Feb 2003Whitehurst Todd K.Systems and methods for treatment of coronary artery disease
US20030078623 *22 Oct 200124 Abr 2003Weinberg Lisa P.Implantable lead and method for stimulating the vagus nerve
US20030105506 *4 Dic 20015 Jun 2003Cardiac Pacemakers, Inc.Apparatus and method for stabilizing an implantable lead
US20030113303 *28 Oct 200219 Jun 2003Yitzhack SchwartzHoming of embryonic stem cells to a target zone in tissue using active therapeutics or substances
US20030204185 *26 Abr 200230 Oct 2003Sherman Marshall L.System and method for monitoring use of disposable catheters
US20040006795 *11 Jun 20038 Ene 2004Mcgonigle BrianMethods to increase the isoflavonoid levels in plants and plants producing increased levels of isoflavonoids
US20040102804 *17 Ene 200327 May 2004Chin Albert K.Apparatus and methods for endoscopic surgical procedures
US20040106953 *6 Oct 20033 Jun 2004Yomtov Barry M.Medical device for controlled drug delivery and cardiac monitoring and/or stimulation
US20040158297 *2 Feb 200412 Ago 2004George GonzalezProcess for testing and treating motor and muscle function, sensory, autonomic, cognitive and neurologic disorders
US20040172080 *3 Dic 20032 Sep 2004Stadler Robert W.Method and apparatus for detecting change in intrathoracic electrical impedance
US20040172102 *30 Dic 20032 Sep 2004Cochlear LimitedAt least partially implantable system for rehabilitation of a hearing disorder
US20040210118 *18 Abr 200321 Oct 2004Michel LetortIn situ detection of endoleak and endotension
US20050043675 *21 Ago 200324 Feb 2005Pastore Joseph M.Method and apparatus for modulating cellular metabolism during post-ischemia or heart failure
US20050043894 *22 Ago 200324 Feb 2005Fernandez Dennis S.Integrated biosensor and simulation system for diagnosis and therapy
US20050049472 *29 Ago 20033 Mar 2005Medtronic, Inc.Implantable biosensor devices for monitoring cardiac marker molecules
US20050075701 *8 Abr 20047 Abr 2005Medtronic, Inc.Device and method for attenuating an immune response
US20050075702 *8 Abr 20047 Abr 2005Medtronic, Inc.Device and method for inhibiting release of pro-inflammatory mediator
US20050080346 *13 Sep 200414 Abr 2005The Regents Of The University Of MichiganAntenna stent device for wireless, intraluminal monitoring
US20050143765 *12 Oct 200430 Jun 2005Endoart SaTelemetrically controlled band for regulating functioning of a body organ or duct, and methods of making, implantation and use
US20050149014 *15 Feb 20057 Jul 2005Quantumcor, Inc.Cardiac valve leaflet attachment device and methods thereof
US20050187584 *22 Abr 200525 Ago 2005Stephen DenkerVagal nerve stimulation using vascular implanted devices for treatment of atrial fibrillation
US20050240243 *25 Feb 200527 Oct 2005Giancarlo BarolatSystem and method for neurological stimulation of peripheral nerves to treat low back pain
US20050246006 *1 Oct 20043 Nov 2005Algotec LimitedElectrical nerve stimulation device
US20050261741 *20 May 200424 Nov 2005Imad LibbusCombined remodeling control therapy and anti-remodeling therapy by implantable cardiac device
US20050267440 *1 Jun 20051 Dic 2005Herman Stephen JDevices and methods for measuring and enhancing drug or analyte transport to/from medical implant
US20060020333 *5 May 200526 Ene 2006Lashinski Randall TMethod of in situ formation of translumenally deployable heart valve support
US20060030837 *28 Ene 20059 Feb 2006The Charles Stark Draper Laboratory, Inc.Drug delivery apparatus
US20060074453 *4 Oct 20046 Abr 2006Cvrx, Inc.Baroreflex activation and cardiac resychronization for heart failure treatment
US20060149331 *30 Dic 20046 Jul 2006Brian MannMethod for digital cardiac rhythm management
US20060149337 *20 Ene 20066 Jul 2006John Michael SSystems and methods for tissue stimulation in medical treatment
US20060247601 *18 Abr 20062 Nov 2006Ellin Philip JMethod of improved drug delivery and for treatment of cellulitis
US20070021731 *27 Jun 200625 Ene 2007Garibaldi Jeffrey MMethod of and apparatus for navigating medical devices in body lumens
US20070027460 *26 Jul 20061 Feb 2007Cook IncorporatedImplantable remodelable materials comprising magnetic material
US20070255340 *28 Abr 20061 Nov 2007Medtronic, Inc.Electrical stimulation of iliohypogastric nerve to alleviate chronic pelvic pain
US20070270675 *17 May 200622 Nov 2007Michael John KaneImplantable Medical Device with Chemical Sensor and Related Methods
US20080009719 *6 Jun 200610 Ene 2008Shuros Allan CMethod and apparatus for introducing endolymphatic instrumentation
US20080260861 *7 Abr 200523 Oct 2008The General Hospital CorporationModulating Lymphatic Function
US20100042170 *22 Oct 200918 Feb 2010Shuros Allan CMethod and apparatus for neural stimulation via the lymphatic system
US20100217346 *6 May 201026 Ago 2010Shuros Allan CMethod and apparatus for gastrointestinal stimulation via the lymphatic system
US20100227807 *15 Mar 20079 Sep 2010The Brigham And Women's Hospital, Inc.Use of Gelsolin to Diagnose and Treat Inflammatory Desease (Stossel)
US20110106202 *10 Ene 20115 May 2011Jiang DingMethod and system for setting cardiac resynchronization therapy parameters
Citada por
Patente citante Fecha de presentación Fecha de publicación Solicitante Título
US77343416 Jun 20068 Jun 2010Cardiac Pacemakers, Inc.Method and apparatus for gastrointestinal stimulation via the lymphatic system
US78949066 Jun 200622 Feb 2011Cardiac Pacemakers, Inc.Amelioration of chronic pain by endolymphatic stimulation
US81265386 Jun 200628 Feb 2012Cardiac Pacemakers, Inc.Method and apparatus for introducing endolymphatic instrumentation
US836994322 Oct 20095 Feb 2013Cardiac Pacemakers, Inc.Method and apparatus for neural stimulation via the lymphatic system
US88978786 May 201025 Nov 2014Cardiac Pacemakers, Inc.Method and apparatus for gastrointestinal stimulation via the lymphatic system
US89059991 Sep 20069 Dic 2014Cardiac Pacemakers, Inc.Method and apparatus for endolymphatic drug delivery
US903724413 Feb 200819 May 2015Virender K. SharmaMethod and apparatus for electrical stimulation of the pancreatico-biliary system
US9421316 *3 May 201123 Ago 2016Stephen A. LeeflangApparatus and methods for accessing the lymphatic system
US20070282386 *6 Jun 20066 Dic 2007Shuros Allan CMethod and apparatus for gastrointestinal stimulation via the lymphatic system
US20070282390 *6 Jun 20066 Dic 2007Shuros Allan CAmelioration of chronic pain by endolymphatic stimulation
US20080009719 *6 Jun 200610 Ene 2008Shuros Allan CMethod and apparatus for introducing endolymphatic instrumentation
US20080195171 *13 Feb 200814 Ago 2008Sharma Virender KMethod and Apparatus for Electrical Stimulation of the Pancreatico-Biliary System
US20110276023 *3 May 201110 Nov 2011Leeflang Stephen AApparatus and Methods for Accessing the Lymphatic System
WO2015200797A3 *26 Jun 201518 Feb 2016The Trustees Of The University Of PennsylvaniaDevices and methods for alleviating lymphatic system congestion
Clasificaciones
Clasificación de EE.UU.607/17, 604/66
Clasificación internacionalA61M37/00, A61N1/365
Clasificación cooperativaA61B5/076, A61B5/4839, A61N1/36514, A61B5/418, A61N1/3627, A61B5/0031, A61B5/03, A61B5/415, A61B5/14546
Clasificación europeaA61B5/145P, A61B5/48J2, A61B5/41J8, A61B5/41J2, A61B5/07D, A61B5/03, A61N1/365B