WO2009010964A3 - Methods and apparatus for treating the prostate - Google Patents

Methods and apparatus for treating the prostate Download PDF

Info

Publication number
WO2009010964A3
WO2009010964A3 PCT/IL2008/000973 IL2008000973W WO2009010964A3 WO 2009010964 A3 WO2009010964 A3 WO 2009010964A3 IL 2008000973 W IL2008000973 W IL 2008000973W WO 2009010964 A3 WO2009010964 A3 WO 2009010964A3
Authority
WO
WIPO (PCT)
Prior art keywords
treating
occluding
prostate
methods
groin
Prior art date
Application number
PCT/IL2008/000973
Other languages
French (fr)
Other versions
WO2009010964A2 (en
Inventor
Yigal Gat
Menachem Goren
Original Assignee
Yigal Gat
Menachem Goren
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US11/826,283 external-priority patent/US20090018486A1/en
Application filed by Yigal Gat, Menachem Goren filed Critical Yigal Gat
Priority to US12/668,696 priority Critical patent/US20100286106A1/en
Priority to CA2693227A priority patent/CA2693227A1/en
Publication of WO2009010964A2 publication Critical patent/WO2009010964A2/en
Priority to IL203271A priority patent/IL203271A/en
Publication of WO2009010964A3 publication Critical patent/WO2009010964A3/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0068Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
    • A61M25/007Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09Guide wires
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M25/1011Multiple balloon catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M29/00Dilators with or without means for introducing media, e.g. remedies
    • A61M29/02Dilators made of swellable material
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/20Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
    • A61B18/22Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
    • A61B18/24Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09Guide wires
    • A61M2025/09175Guide wires having specific characteristics at the distal tip
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09Guide wires
    • A61M2025/09175Guide wires having specific characteristics at the distal tip
    • A61M2025/09183Guide wires having specific characteristics at the distal tip having tools at the distal tip
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1052Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1095Balloon catheters with special features or adapted for special applications with perfusion means for enabling blood circulation while the balloon is in an inflated state or in a deflated state, e.g. permanent by-pass within catheter shaft

Abstract

Treating and/or preventing prostate problems and/or metastases, by selectively occluding various groin vessels and tools for selective occluding of various groin veins, including, for example, the deferential vein. Optionally providing anti-androgen treatment after such occluding.
PCT/IL2008/000973 2007-07-13 2008-07-13 Methods and apparatus for treating the prostate WO2009010964A2 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
US12/668,696 US20100286106A1 (en) 2008-03-10 2008-07-13 Methods and apparatus for treating the prostate
CA2693227A CA2693227A1 (en) 2007-07-13 2008-07-13 Methods and apparatus for treating the prostate
IL203271A IL203271A (en) 2007-07-13 2010-01-12 Apparatus for treating the prostate

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US11/826,283 2007-07-13
US11/826,283 US20090018486A1 (en) 2007-07-13 2007-07-13 Diagnosis and treatment of vericocele and prostate disorders
US6451108P 2008-03-10 2008-03-10
US61/064,511 2008-03-10

Publications (2)

Publication Number Publication Date
WO2009010964A2 WO2009010964A2 (en) 2009-01-22
WO2009010964A3 true WO2009010964A3 (en) 2010-02-25

Family

ID=40260179

Family Applications (3)

Application Number Title Priority Date Filing Date
PCT/IL2008/000972 WO2009010963A2 (en) 2007-07-13 2008-07-13 Methods and apparatuses for vascular and prostate treatment
PCT/IL2008/000971 WO2009010962A2 (en) 2007-07-13 2008-07-13 Diagnosis and treatment of varicocele and prostate disorders
PCT/IL2008/000973 WO2009010964A2 (en) 2007-07-13 2008-07-13 Methods and apparatus for treating the prostate

Family Applications Before (2)

Application Number Title Priority Date Filing Date
PCT/IL2008/000972 WO2009010963A2 (en) 2007-07-13 2008-07-13 Methods and apparatuses for vascular and prostate treatment
PCT/IL2008/000971 WO2009010962A2 (en) 2007-07-13 2008-07-13 Diagnosis and treatment of varicocele and prostate disorders

Country Status (6)

Country Link
EP (2) EP2178594A4 (en)
JP (1) JP2010533052A (en)
CN (1) CN101801289A (en)
AU (2) AU2008277251A1 (en)
CA (3) CA2693735A1 (en)
WO (3) WO2009010963A2 (en)

Families Citing this family (22)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7972354B2 (en) * 2005-01-25 2011-07-05 Tyco Healthcare Group Lp Method and apparatus for impeding migration of an implanted occlusive structure
AU2011224640B2 (en) 2010-03-06 2015-05-07 Nfusion Vascular Systems, Llc Recovery catheter assembly
US9108029B2 (en) 2012-05-21 2015-08-18 Nfusion Vascular Systems, Llc Recovery catheter assembly and method
US9597205B2 (en) 2012-06-06 2017-03-21 Magenta Medical Ltd. Prosthetic renal valve
CA3126978A1 (en) 2013-03-13 2014-09-18 Magenta Medical Ltd. Impeller for use with an axial support member
US10583231B2 (en) 2013-03-13 2020-03-10 Magenta Medical Ltd. Blood pump
RU2525219C1 (en) * 2013-04-02 2014-08-10 Государственное бюджетное образовательное учреждение высшего профессионального образования "Тверская государственная медицинская академия" Министерства здравоохранения Российской Федерации Method for retrograde sclerotherapy of varicocele in mesenteric-testicular anastomoses
US9764113B2 (en) 2013-12-11 2017-09-19 Magenta Medical Ltd Curved catheter
WO2015100393A1 (en) * 2013-12-27 2015-07-02 Renalpro Medical, Inc. Devices and methods for treating acute kidney injury
RU2572553C1 (en) * 2014-08-01 2016-01-20 Леонид Зиновьевич Вельшер Method of treating prostate cancer
US11291824B2 (en) 2015-05-18 2022-04-05 Magenta Medical Ltd. Blood pump
JP6981967B2 (en) 2015-08-31 2021-12-17 ジェンテュイティ・リミテッド・ライアビリティ・カンパニーGentuity, LLC Imaging system including imaging probe and delivery device
WO2018061002A1 (en) 2016-09-29 2018-04-05 Magenta Medical Ltd. Blood vessel tube
JP7383476B2 (en) 2016-10-25 2023-11-20 マジェンタ・メディカル・リミテッド ventricular assist device
CN110049792B (en) 2016-11-23 2022-01-18 马真塔医药有限公司 Blood pump
JP7160935B2 (en) 2017-11-28 2022-10-25 ジェンテュイティ・リミテッド・ライアビリティ・カンパニー Imaging system
US10905808B2 (en) 2018-01-10 2021-02-02 Magenta Medical Ltd. Drive cable for use with a blood pump
EP4039321A1 (en) 2018-01-10 2022-08-10 Magenta Medical Ltd. Ventricular assist device
CN108158654B (en) * 2018-01-12 2020-06-12 郑州大学第一附属医院 Portable magnetic induction positioning and guiding device and method thereof
US10893927B2 (en) 2018-03-29 2021-01-19 Magenta Medical Ltd. Inferior vena cava blood-flow implant
WO2020152611A2 (en) 2019-01-24 2020-07-30 Magenta Medical Ltd Ventricular assist device
RU2729431C1 (en) * 2019-12-27 2020-08-06 Федеральное государственное бюджетное образовательное учреждение высшего образования "Тихоокеанский государственный медицинский университет" Министерства здравоохранения Российской Федерации Method of laparoscopic treatment of varicocele

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5683411A (en) * 1994-04-06 1997-11-04 William Cook Europe A/S Medical article for implantation into the vascular system of a patient
US6384017B1 (en) * 1995-12-15 2002-05-07 Praecis Pharmaceuticals, Inc. Methods for treating sex hormone-dependent conditions with Lhrh antagonists
US20020165195A1 (en) * 2001-05-01 2002-11-07 Schering Corporation Method of treating androgen-dependent disorders
US20030208223A1 (en) * 2000-03-23 2003-11-06 Kleiner Daniel Eduard Device incorporating a hollow element for being positioned along a body cavity of a patient and method of positioning the same
US20040062750A1 (en) * 1999-09-14 2004-04-01 The General Hospital Corporation Use of mullerian inhibiting substance for treating excess androgen states
US20040267258A1 (en) * 1997-09-11 2004-12-30 Vnus Medical Technologies, Inc. Expandable vein ligator catheter having multiple leads, and method
US20050182342A1 (en) * 2004-02-13 2005-08-18 Medtronic, Inc. Monitoring fluid flow in the gastrointestinal tract
US20060052823A1 (en) * 2004-08-31 2006-03-09 Mirizzi Michael S Apparatus, material compositions, and methods for permanent occlusion of a hollow anatomical structure

Family Cites Families (28)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4714460A (en) * 1983-07-29 1987-12-22 Reynaldo Calderon Methods and systems for retrograde perfusion in the body for curing it of the disease or immume deficiency
CH668192A5 (en) * 1985-11-29 1988-12-15 Schneider Medintag Ag CATHETER FOR TREATING NARROW BODIES, FOR EXAMPLE IN A BLOOD VESSEL.
US4762128A (en) * 1986-12-09 1988-08-09 Advanced Surgical Intervention, Inc. Method and apparatus for treating hypertrophy of the prostate gland
AU4191989A (en) * 1988-08-24 1990-03-23 Marvin J. Slepian Biodegradable polymeric endoluminal sealing
FR2639237B1 (en) * 1988-11-23 1997-10-31 Boussignac Georges CATHETER FOR INTRODUCTION INTO A BODY CHANNEL
CN2086610U (en) * 1991-03-05 1991-10-16 陆秉仁 Double-bag prostatic urethreurynter
US5529574A (en) * 1992-08-21 1996-06-25 Frackelton; James P. Method and apparatus for treatment of the prostate
US5779673A (en) * 1995-06-26 1998-07-14 Focal, Inc. Devices and methods for application of intraluminal photopolymerized gels
US5989230A (en) * 1996-01-11 1999-11-23 Essex Technology, Inc. Rotate to advance catheterization system
US5947985A (en) * 1997-11-12 1999-09-07 Imran; Mir A. Apparatus and method for cleaning diseased vein grafts
US6036689A (en) * 1998-09-24 2000-03-14 Tu; Lily Chen Ablation device for treating atherosclerotic tissues
US6319251B1 (en) * 1998-09-24 2001-11-20 Hosheng Tu Medical device and methods for treating intravascular restenosis
US6575932B1 (en) * 1999-12-02 2003-06-10 Ottawa Heart Institute Adjustable multi-balloon local delivery device
ATE357878T1 (en) * 1999-12-22 2007-04-15 Boston Scient Ltd ENDOLUMINAL OCCLUSION FLUSH CATHETER
US20050107738A1 (en) * 2000-07-21 2005-05-19 Slater Charles R. Occludable intravascular catheter for drug delivery and method of using the same
GB2369996B (en) * 2000-12-18 2004-06-23 S T D Pharmaceutical Products Method and apparatus for producing an injectable foam
US7169161B2 (en) * 2001-11-06 2007-01-30 Possis Medical, Inc. Guidewire having occlusive device and repeatably crimpable proximal end
EP1483008B1 (en) * 2002-03-09 2008-02-20 BRODERSEN, Jens P. Sclerosing catheter for sclerosing blood vessels, especially veins
US7077801B2 (en) * 2003-02-19 2006-07-18 Corlife Gbr Methods and devices for improving cardiac output
US20040180855A1 (en) * 2003-02-19 2004-09-16 Schumacher William A. Methods of treating thrombosis with reduced risk of increased bleeding times
DE502004009815D1 (en) * 2003-10-29 2009-09-10 Celon Ag Medical Instruments Medical device for the electrotomy
US7824408B2 (en) * 2004-08-05 2010-11-02 Tyco Healthcare Group, Lp Methods and apparatus for coagulating and/or constricting hollow anatomical structures
US20060079923A1 (en) * 2004-08-09 2006-04-13 Manik Chhabra Aneurysm treatment using semi-compliant balloon
EP1781354A4 (en) * 2004-08-19 2008-04-09 Vein Rx Inc An occludable intravascular catheter for drug delivery and method of using the same
US20060159767A1 (en) * 2004-12-22 2006-07-20 Elan Pharma International Limited Nanoparticulate bicalutamide formulations
US7972354B2 (en) * 2005-01-25 2011-07-05 Tyco Healthcare Group Lp Method and apparatus for impeding migration of an implanted occlusive structure
JP2008173137A (en) * 2005-03-03 2008-07-31 Goodman Co Ltd Double balloon catheter
WO2006099121A2 (en) * 2005-03-10 2006-09-21 Elan Pharma International Limited Formulations of a nanoparticulate finasteride, dutasteride and tamsulosin hydrochloride, and mixtures thereof

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5683411A (en) * 1994-04-06 1997-11-04 William Cook Europe A/S Medical article for implantation into the vascular system of a patient
US6384017B1 (en) * 1995-12-15 2002-05-07 Praecis Pharmaceuticals, Inc. Methods for treating sex hormone-dependent conditions with Lhrh antagonists
US20040267258A1 (en) * 1997-09-11 2004-12-30 Vnus Medical Technologies, Inc. Expandable vein ligator catheter having multiple leads, and method
US20040062750A1 (en) * 1999-09-14 2004-04-01 The General Hospital Corporation Use of mullerian inhibiting substance for treating excess androgen states
US20030208223A1 (en) * 2000-03-23 2003-11-06 Kleiner Daniel Eduard Device incorporating a hollow element for being positioned along a body cavity of a patient and method of positioning the same
US20020165195A1 (en) * 2001-05-01 2002-11-07 Schering Corporation Method of treating androgen-dependent disorders
US20050182342A1 (en) * 2004-02-13 2005-08-18 Medtronic, Inc. Monitoring fluid flow in the gastrointestinal tract
US20060052823A1 (en) * 2004-08-31 2006-03-09 Mirizzi Michael S Apparatus, material compositions, and methods for permanent occlusion of a hollow anatomical structure

Also Published As

Publication number Publication date
EP2178594A2 (en) 2010-04-28
EP2170180A2 (en) 2010-04-07
WO2009010962A3 (en) 2010-09-16
WO2009010963A2 (en) 2009-01-22
WO2009010963A3 (en) 2010-01-14
AU2008277252A1 (en) 2009-01-22
CA2693225A1 (en) 2009-01-22
CA2693227A1 (en) 2009-01-22
WO2009010964A2 (en) 2009-01-22
CN101801289A (en) 2010-08-11
CA2693735A1 (en) 2009-01-22
EP2178594A4 (en) 2011-02-23
WO2009010962A2 (en) 2009-01-22
EP2170180A4 (en) 2011-02-23
AU2008277251A1 (en) 2009-01-22
JP2010533052A (en) 2010-10-21

Similar Documents

Publication Publication Date Title
WO2009010964A3 (en) Methods and apparatus for treating the prostate
WO2011037643A3 (en) Compositions and methods for detecting and treating prostate carcinoma
WO2009108860A3 (en) Microrna-based methods and compositions for the diagnosis, pronosis and treatment of prostate related disorders
EP3714845A4 (en) Shunt catheter for improving anchoring, and catheter
WO2008137785A3 (en) Water treatment system and downstream cleaning methods
WO2008122048A3 (en) Removal of contrast agents from blood
WO2010071846A3 (en) Compounds for treating neuropsychiatric conditions
WO2011146879A3 (en) Methods and compositions related to modulating autophagy
WO2006017063A3 (en) Process control oxidation
MX2009009292A (en) Ppar active compounds.
EP3259009A4 (en) Improved urinary catheter, kit and method
WO2006023649A3 (en) Treatment of severe multiple sclerosis
WO2010108973A3 (en) Use of synthetic and biological fungicides in combination for controlling harmful fungi
GB0808467D0 (en) Systems, methods and components for water treatment and remediation
BRPI0815747A2 (en) METHOD FOR TREATING WASTE WATER AND METHOD FOR INTENSIFYING WASTE WATER TREATMENT OPERATIONS.
EP3269687A4 (en) Method for treating scrubber effluent, and apparatus for treating scrubber effluent
WO2008082887A3 (en) Inhibitors of poly(adp-ribose)polymerase
WO2009064938A9 (en) Method of treating arthritis
EP3369713A4 (en) Nitrogen removal method, nitrification-reaction promoting agent for water treatment, and water treatment method
BRPI0811236A2 (en) VESSEL, AND, MOORING METHOD.
EP3378837A4 (en) Ship, ballast water treatment system, and ballast water treatment method
EP3572534A4 (en) Desulfurization treatment method for molten steel, and desulfurization agent
EP3962344A4 (en) Devices, systems, and methods for treating kidney stones
WO2010037095A3 (en) Agents and methods for the treatment of cancer
WO2006105502A3 (en) Catheter

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 08776608

Country of ref document: EP

Kind code of ref document: A2

WWE Wipo information: entry into national phase

Ref document number: 2693227

Country of ref document: CA

Ref document number: 203271

Country of ref document: IL

NENP Non-entry into the national phase

Ref country code: DE

WWE Wipo information: entry into national phase

Ref document number: 12668696

Country of ref document: US

122 Ep: pct application non-entry in european phase

Ref document number: 08776608

Country of ref document: EP

Kind code of ref document: A2