WO2014025620A1 - Shockwave catheter - Google Patents

Shockwave catheter Download PDF

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Publication number
WO2014025620A1
WO2014025620A1 PCT/US2013/053292 US2013053292W WO2014025620A1 WO 2014025620 A1 WO2014025620 A1 WO 2014025620A1 US 2013053292 W US2013053292 W US 2013053292W WO 2014025620 A1 WO2014025620 A1 WO 2014025620A1
Authority
WO
WIPO (PCT)
Prior art keywords
catheter
balloon
shock wave
wave source
inflatable balloon
Prior art date
Application number
PCT/US2013/053292
Other languages
French (fr)
Inventor
Daniel Hawkins
John Adams
Original Assignee
Shockwave Medical, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Shockwave Medical, Inc. filed Critical Shockwave Medical, Inc.
Priority to CN201380041288.0A priority Critical patent/CN104736073A/en
Priority to EP13748228.7A priority patent/EP2879597B1/en
Priority to JP2015526587A priority patent/JP6164705B2/en
Priority to CA2881184A priority patent/CA2881184C/en
Publication of WO2014025620A1 publication Critical patent/WO2014025620A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B2017/22005—Effects, e.g. on tissue
    • A61B2017/22007—Cavitation or pseudocavitation, i.e. creation of gas bubbles generating a secondary shock wave when collapsing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B2017/22025—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement applying a shock wave
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22051—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22098—Decalcification of valves

Definitions

  • a valvuloplasty catheter includes a balloon that is inflatable with a fluid. When the balloon is inflated, it is configured to be adjacent valve leaflets, such as the valve leaflets of an aortic valve. Within the balloon, there is disposed a shock wave generator.
  • the shock wave generator includes at least two electrodes. When a high voltage pulse is applied across the electrodes, an electrical arc is formed. The electrical arc creates a shock wave within the fluid that propagates to the balloon walls to impinge upon the valve leaflets and the calcification on the valve. Repeated shock waves cause the calcification to break-up.
  • shock wave generator the electrodes
  • valve leaflets of the catheter described above The distance between the shock wave generator (the electrodes) and the valve leaflets of the catheter described above is variable and not controlled. It has been found that shock wave therapy designed to break calcium deposits is most effective at certain distances from a radiating shock wave source. This is particularly the case when the source is a point source without a reflector. Generally, the effectiveness of the shock waves falls off or decreases with the square of the distance from the source.
  • a catheter which may find use, for example, in valvuloplasty, includes an elongated body and an inflatable balloon carried by the elongated body.
  • the balloon has an inner surface and an outer surface.
  • the catheter further includes at least one shock wave source within the inflatable balloon and a follower arrangement that maintains the at least one shock wave source a substantially fixed distance from the inner surface of the balloon.
  • the follower arrangement may be carried by the at least one shock wave source within the inflatable balloon.
  • the at least one shock wave source may be an arc generator including an electrode pair.
  • the follower arrangement may include at least one stand-off extending from the electrode pair.
  • the stand-off may be formed of flexible material.
  • the arc generator may include an elongated lead.
  • the electrode pair may be carried by the elongated lead, and the elongated lead may be biased in a direction towards the inner surface of the inflatable balloon.
  • the elongated lead may include at least one bend that biases the elongated lead towards the inner surface of the inflatable balloon.
  • the catheter may further include a biasing member carried by the elongated lead that biases the elongated lead towards the inner surface of the inflatable balloon.
  • the biasing member may be a spring.
  • the at least one shock wave source may include an arc generator.
  • the follower arrangement may include a stand-off carried by the arc generator and the arc generator may be biased towards the inner surface of the inflatable balloon.
  • the catheter may further include a frame structure that carries the at least one shock wave source.
  • the frame structure may be arranged to expand with inflation of the inflatable balloon to maintain the at least one shock wave source a substantially fixed distance from the inner surface of the balloon.
  • the frame structure may include at least one stand-off adjacent the at least one shock wave source to maintain the at least one shock wave source a substantially fixed distance from the inner surface of the balloon.
  • a method includes the steps of providing a catheter including an elongated body, an inflatable balloon carried by the elongated body and having an inner surface and an outer surface, and at least one shock wave source within the inflatable balloon.
  • the method further includes the steps of inserting the catheter into a vein or artery of a patient and placing the balloon adjacent to an anatomical structure to be treated, inflating the balloon with a fluid, causing the shock wave source to provide shock waves within the balloon that propagate through the liquid to treat the anatomical structure, and maintaining the at least one shock wave source a substantially fixed distance from the inner surface of the balloon while the shock waves are provided by the at least one shock wave source.
  • the catheter may further include a follower carried by the shock wave generator, and the maintaining step may include biasing the follower against the inner wall of the balloon.
  • the catheter may include a frame structure that carries the at least one shock wave source.
  • the maintaining step may include expanding the frame structure with inflation of the inflatable balloon to maintain the at least one shock wave source the substantially fixed distance from the inner surface of the balloon.
  • FIG. 1 is a partial cut away view of a heart and a catheter embodying aspects of the invention within the aortic valve of the heart;
  • FIG. 2 is a side view of a shock wave generator which may be used to advantage within the catheter of FIG. 1 and which embodies aspects of the invention;
  • FIG. 3 is a partial cut away view of the heart of FIG. 1 illustrating the catheter as it is delivering therapy to the aortic valve of the heart;
  • FIG. 4 is a partial cut away view of the heart of FIG. 1 illustrating the catheter upon completion of therapy to the aortic valve of the heart;
  • FIG. 5 is a partial cut away view of another heart and another catheter embodying further aspects of the invention within the aortic valve of the heart;
  • FIG. 6 is a partial view to an exploded scale illustrating particular aspects of the catheter of FIG. 5.
  • FIG. 1 it is a partial cut away view of the aorta 50 of a heart and a catheter 10 embodying aspects of the invention within the aortic valve 52 of the heart.
  • the catheter 10 generally includes an elongated body 12, an inflatable balloon 14 carried by the elongated body 12, at least one shock wave source 20 within the inflatable balloon 14, and a follower arrangement 30.
  • the balloon includes an inner surface 16 and an outer surface 18.
  • the follower arrangement 30 is carried by the shock wave source 20. As will be seen subsequently, the follower arrangement maintains the at least one shock wave source 20 a substantially fixed distance from the inner surface 16 of the balloon.
  • the balloon 14 is inflatable through the elongated body 12 with a fluid such as, for example, saline.
  • a fluid such as, for example, saline.
  • the balloon is configured so that when positioned within the aortic valve 52, its outer surface 18 substantially conforms to and is immediately adjacent to or in contact with the aortic valve leaflets 54 and the calcification 56 thereon.
  • the shock wave source 20 preferably is an arc generator that produces electrical arcs that form rapidly expanding and contracting steam bubbles within the balloon 14.
  • the rapidly expanding and contracting steam bubbles form shock waves within the balloon 14 that propagate through the fluid within the balloon and impinge upon the inner surface 16 of the balloon 14 and the calcification 56. After repeated shock waves, the calcification is broken up to permit the aortic valve 52 to function.
  • the follower arrangement 30 maintains the shock wave source a substantially fixed distance from the inner surface 16 of the balloon 14 and hence the valve leaflets 54 to maintain full effectiveness of the shock waves during the shock wave application procedure.
  • FIG. 1 also shows that the catheter 10 is arranged to accept a guide wire 70.
  • the guide passes through a guide wire lumen 72 and serves to guide the catheter into an artery or vein to place the balloon adjacent an anatomical structure to be treated such as an aortic valve. Once the balloon is thus positioned, it may be inflated and the shock wave therapy begun.
  • the shock wave source or generator 20 includes an elongated lead 22 and an electrode pair 24 carried by the lead 22.
  • the electrode pair 24 is formed by a pair of coaxially disposed electrodes including a ring electrode 26 and a center electrode 28. Voltage pulses are applied across electrodes 26 and 28 through the lead 22 to cause the arcs which produce the shock waves.
  • the catheter 10 of FIG. 1 includes two shock wave sources 20 and 20' .
  • the shock wave source 20' may be identical to the shock wave source 20.
  • Each shock wave source carries a follower arrangement.
  • a spring 38 is attached to and in between the leads 22 and 22' of the shock wave sources 20 and 20', respectively.
  • the spring 38 serves as a biasing member to force the electrode pairs of the shock wave sources and the follower arrangements off of the center axis 15 of the balloon 14 towards the inner surface 16 of the balloon 14.
  • the lead 22 may have permanent bends 34 and 35 formed therein. The bends bias the electrode pair 24 in the direction indicated by arrow 36 towards the inner surface 16 of the balloon 14.
  • FIG. 1 shows a valvuloplasty system having a catheter 10 according to some aspects of the invention that includes a valvuloplasty balloon 14 with two electrodes (electrode pair 24) disposed therein.
  • the system is shown within an aortic valve 52 for treating
  • the electrodes are urged away from the center axis 15 of the balloon 14 toward the perimeter of the balloon 14 by a spring member 38.
  • the spring member may be replaced by spring loading or biasing the leads 22 and 22' that carry the electrodes outwardly.
  • the balloon 14 is shown within a severely stenosed valve 52. Stand offs 32 carried on electrodes maintain a substantially constant distance between electrodes and the walls of the balloon 14 and hence between the electrodes and the valve leaflets 54.
  • FIG. 2 shows a detailed view of one electrode pair 24 and its lead 22.
  • the standoffs 32 are formed by soft flexible arms that are designed to hold the electrode pair 24 off the balloon wall in non-touching relation to the balloon material. They are also designed to hold the tip of the electrode pair 24 a substantially constant distance, for example, 1-2 mm, from the balloon wall.
  • the elongated lead 22 has bends 34 and 35 to provide a predetermined bias toward the outside (away from the center axis) of the balloon.
  • FIG. 3 is a partial sectional view showing the valvuloplasty balloon 14 placed in an aortic valve 52 and after providing some treatment to break up or sever the calcium deposits 56 on the valve leaflets 52.
  • the electrode pairs 24 have been held a substantially constant distance, for example about 1-2 mm, from the tissue by the stand offs since the electro-hydraulic shock therapy began. As the shock waves break the calcium, the opening 60 in the valve 52 slowly widens. Even though the valve is being opened wider, the distance between the electrode pairs 24 and the tissue of the leaflets 54 remains substantially constant, controlled by the stand offs 32 and the bends 34 and 35 in the electrode leads.
  • FIG. 4 shows a fully opened opening 60 of valve 52 expanded by the combination valvuloplasty balloon 14 and the shock wave therapy.
  • the bias in the catheter and the standoffs hold the electrode pairs a substantially constant distance from the tissue of the valve being treated. For simplicity, only two electrode pairs are shown. However, in actual practice, as many as 3-9 electrode pair may typically be used.
  • the electrode pairs 24 can be fired (provided with arc forming voltage) alternately or simultaneously.
  • the calcium on the valve 52 and its softened valve leaflets 54 (and valve cusps) is now cracked making the valve much better prepared for the placement of a TAVI (Transcatheter Aortic-Valve Implantation) valve.
  • the native valve 52 may function on its own without a replacement.
  • FIG. 5 shows an alternate embodiment.
  • a catheter 110 includes an elongated body 112 and an inflatable balloon 114, as in previous embodiments.
  • the shock wave sources 120 which may be electrode pairs, are mounted on a basket or frame structure 122 having basket arms or frame elements 124.
  • the basket arms 124 may be formed of Nitinol and may be set to expand with the balloon 114 as the stenosis of the aortic valve being treated is softened and expanded by the shock waves.
  • FIG.6 shows the Nitinol arms 124 in greater detail with respect to the shock wave sources 120.
  • the arms 124 may be configured with bumps or stand offs 132 to hold the shock wave sources 120 away from the balloon and tissue a substantially fix distance during the shock wave treatment.
  • FIG. 6 also shows that, as in previous embodiments, the catheter 112 may
  • the guide wire 170 may be received within a guide wire lumen 172 and used, as previously described, to guide the catheter into proper position.

Abstract

A catheter (10), for use, for example, in valvuloplasty, includes an elongated body (12) and an inflatable balloon (14) carried by the elongated body (12). The balloon (14) has an inner surface (16) and an outer surface (18). The catheter (10) further includes at least one shock wave source (20) within the inflatable balloon (14) and a follower arrangement (30) that maintains the at least one shock wave source (20) a substantially fixed distance from the inner surface (16).of the balloon.

Description

SHOCKWAVE CATHETER
CLAIM OF PRIORITY
[0001] The present application claims the benefit of copending United States provisional patent application Serial No. 61/679,911, filed August 6, 2012, which application is incorporated herein by reference in its entirety.
BACKGROUND
[0002] Patients suffering from aortic valve stenosis often have calcified aortic valve leaflets. Shockwave therapy for the treatment of aortic valve stenosis has been previously described in, for example U.S. Pat. Pub. No. 2010/0114020A1, the disclosure of which is incorporated herein by reference. As described therein, a valvuloplasty catheter includes a balloon that is inflatable with a fluid. When the balloon is inflated, it is configured to be adjacent valve leaflets, such as the valve leaflets of an aortic valve. Within the balloon, there is disposed a shock wave generator. The shock wave generator includes at least two electrodes. When a high voltage pulse is applied across the electrodes, an electrical arc is formed. The electrical arc creates a shock wave within the fluid that propagates to the balloon walls to impinge upon the valve leaflets and the calcification on the valve. Repeated shock waves cause the calcification to break-up.
[0003] The distance between the shock wave generator (the electrodes) and the valve leaflets of the catheter described above is variable and not controlled. It has been found that shock wave therapy designed to break calcium deposits is most effective at certain distances from a radiating shock wave source. This is particularly the case when the source is a point source without a reflector. Generally, the effectiveness of the shock waves falls off or decreases with the square of the distance from the source.
[0004] When a valvuloplasty balloon and a shock wave generator are combined as described above, the distance between the shock wave generator and the balloon walls generally increases as the valve is opened by balloon expansion occasioned by effective treatment and valvuloplasty pressure. As the distance changes and becomes greater, the effectiveness of the therapy decreases. This increases both the time and the number of shock waves required for complete and effective treatment. Hence, there is a need for a shock wave valvuloplasty catheter that maintains therapy effectiveness at a desired level until the valve being treated is dilated the desired amount.
SUMMARY
[0005] According to embodiments shown and described herein, a catheter, which may find use, for example, in valvuloplasty, includes an elongated body and an inflatable balloon carried by the elongated body. The balloon has an inner surface and an outer surface. The catheter further includes at least one shock wave source within the inflatable balloon and a follower arrangement that maintains the at least one shock wave source a substantially fixed distance from the inner surface of the balloon.
[0006] The follower arrangement may be carried by the at least one shock wave source within the inflatable balloon. The at least one shock wave source may be an arc generator including an electrode pair.
[0007] The follower arrangement may include at least one stand-off extending from the electrode pair. The stand-off may be formed of flexible material.
[0008] The arc generator may include an elongated lead. The electrode pair may be carried by the elongated lead, and the elongated lead may be biased in a direction towards the inner surface of the inflatable balloon. The elongated lead may include at least one bend that biases the elongated lead towards the inner surface of the inflatable balloon.
[0009] The catheter may further include a biasing member carried by the elongated lead that biases the elongated lead towards the inner surface of the inflatable balloon. The biasing member may be a spring.
[0010] The at least one shock wave source may include an arc generator. The follower arrangement may include a stand-off carried by the arc generator and the arc generator may be biased towards the inner surface of the inflatable balloon.
[0011] The catheter may further include a frame structure that carries the at least one shock wave source. The frame structure may be arranged to expand with inflation of the inflatable balloon to maintain the at least one shock wave source a substantially fixed distance from the inner surface of the balloon. The frame structure may include at least one stand-off adjacent the at least one shock wave source to maintain the at least one shock wave source a substantially fixed distance from the inner surface of the balloon.
[0012] In other embodiments, a method includes the steps of providing a catheter including an elongated body, an inflatable balloon carried by the elongated body and having an inner surface and an outer surface, and at least one shock wave source within the inflatable balloon. The method further includes the steps of inserting the catheter into a vein or artery of a patient and placing the balloon adjacent to an anatomical structure to be treated, inflating the balloon with a fluid, causing the shock wave source to provide shock waves within the balloon that propagate through the liquid to treat the anatomical structure, and maintaining the at least one shock wave source a substantially fixed distance from the inner surface of the balloon while the shock waves are provided by the at least one shock wave source.
[0013] The catheter may further include a follower carried by the shock wave generator, and the maintaining step may include biasing the follower against the inner wall of the balloon.
[0014] The catheter may include a frame structure that carries the at least one shock wave source. The maintaining step may include expanding the frame structure with inflation of the inflatable balloon to maintain the at least one shock wave source the substantially fixed distance from the inner surface of the balloon.
BRIEF DESCRIPTION OF THE DRAWINGS
[0015] The features of the present invention which are believed to be novel are set forth with particularity in the appended claims. The various described embodiments of the invention, together with representative features and advantages thereof, may best be understood by making reference to the following description taken in conjunction with the accompanying drawings, in the several figures of which like reference numerals identify identical elements, and wherein:
[0016] FIG. 1 is a partial cut away view of a heart and a catheter embodying aspects of the invention within the aortic valve of the heart;
[0017] FIG. 2 is a side view of a shock wave generator which may be used to advantage within the catheter of FIG. 1 and which embodies aspects of the invention; [0018] FIG. 3 is a partial cut away view of the heart of FIG. 1 illustrating the catheter as it is delivering therapy to the aortic valve of the heart;
[0019] FIG. 4 is a partial cut away view of the heart of FIG. 1 illustrating the catheter upon completion of therapy to the aortic valve of the heart;
[0020] FIG. 5 is a partial cut away view of another heart and another catheter embodying further aspects of the invention within the aortic valve of the heart; and
[0021] FIG. 6 is a partial view to an exploded scale illustrating particular aspects of the catheter of FIG. 5.
DETAILED DESCRIPTION
[0022] Referring now to FIG. 1, it is a partial cut away view of the aorta 50 of a heart and a catheter 10 embodying aspects of the invention within the aortic valve 52 of the heart. The catheter 10 generally includes an elongated body 12, an inflatable balloon 14 carried by the elongated body 12, at least one shock wave source 20 within the inflatable balloon 14, and a follower arrangement 30. The balloon includes an inner surface 16 and an outer surface 18. The follower arrangement 30 is carried by the shock wave source 20. As will be seen subsequently, the follower arrangement maintains the at least one shock wave source 20 a substantially fixed distance from the inner surface 16 of the balloon.
[0023] The balloon 14 is inflatable through the elongated body 12 with a fluid such as, for example, saline. The balloon is configured so that when positioned within the aortic valve 52, its outer surface 18 substantially conforms to and is immediately adjacent to or in contact with the aortic valve leaflets 54 and the calcification 56 thereon.
[0024] The shock wave source 20 preferably is an arc generator that produces electrical arcs that form rapidly expanding and contracting steam bubbles within the balloon 14. The rapidly expanding and contracting steam bubbles form shock waves within the balloon 14 that propagate through the fluid within the balloon and impinge upon the inner surface 16 of the balloon 14 and the calcification 56. After repeated shock waves, the calcification is broken up to permit the aortic valve 52 to function. The follower arrangement 30 maintains the shock wave source a substantially fixed distance from the inner surface 16 of the balloon 14 and hence the valve leaflets 54 to maintain full effectiveness of the shock waves during the shock wave application procedure.
[0025] FIG. 1 also shows that the catheter 10 is arranged to accept a guide wire 70. The guide passes through a guide wire lumen 72 and serves to guide the catheter into an artery or vein to place the balloon adjacent an anatomical structure to be treated such as an aortic valve. Once the balloon is thus positioned, it may be inflated and the shock wave therapy begun.
[0026] As may be seen in FIG. 2, the shock wave source or generator 20 includes an elongated lead 22 and an electrode pair 24 carried by the lead 22. The electrode pair 24 is formed by a pair of coaxially disposed electrodes including a ring electrode 26 and a center electrode 28. Voltage pulses are applied across electrodes 26 and 28 through the lead 22 to cause the arcs which produce the shock waves.
[0027] The catheter 10 of FIG. 1 includes two shock wave sources 20 and 20' . The shock wave source 20' may be identical to the shock wave source 20. Each shock wave source carries a follower arrangement. In the embodiment of FIG. 1, a spring 38 is attached to and in between the leads 22 and 22' of the shock wave sources 20 and 20', respectively. The spring 38 serves as a biasing member to force the electrode pairs of the shock wave sources and the follower arrangements off of the center axis 15 of the balloon 14 towards the inner surface 16 of the balloon 14.
[0028] Alternatively, or in addition, as may be seen in FIG. 2, the lead 22 may have permanent bends 34 and 35 formed therein. The bends bias the electrode pair 24 in the direction indicated by arrow 36 towards the inner surface 16 of the balloon 14.
[0029] Hence, FIG. 1 shows a valvuloplasty system having a catheter 10 according to some aspects of the invention that includes a valvuloplasty balloon 14 with two electrodes (electrode pair 24) disposed therein. The system is shown within an aortic valve 52 for treating
calcification 56 on the valve leaflets 54. The electrodes are urged away from the center axis 15 of the balloon 14 toward the perimeter of the balloon 14 by a spring member 38. As may be appreciated, the spring member may be replaced by spring loading or biasing the leads 22 and 22' that carry the electrodes outwardly. The balloon 14 is shown within a severely stenosed valve 52. Stand offs 32 carried on electrodes maintain a substantially constant distance between electrodes and the walls of the balloon 14 and hence between the electrodes and the valve leaflets 54.
[0030] Further, FIG. 2 shows a detailed view of one electrode pair 24 and its lead 22. The standoffs 32 are formed by soft flexible arms that are designed to hold the electrode pair 24 off the balloon wall in non-touching relation to the balloon material. They are also designed to hold the tip of the electrode pair 24 a substantially constant distance, for example, 1-2 mm, from the balloon wall. At the same time, according to this embodiment, the elongated lead 22 has bends 34 and 35 to provide a predetermined bias toward the outside (away from the center axis) of the balloon.
[0031] FIG. 3 is a partial sectional view showing the valvuloplasty balloon 14 placed in an aortic valve 52 and after providing some treatment to break up or sever the calcium deposits 56 on the valve leaflets 52. The electrode pairs 24 have been held a substantially constant distance, for example about 1-2 mm, from the tissue by the stand offs since the electro-hydraulic shock therapy began. As the shock waves break the calcium, the opening 60 in the valve 52 slowly widens. Even though the valve is being opened wider, the distance between the electrode pairs 24 and the tissue of the leaflets 54 remains substantially constant, controlled by the stand offs 32 and the bends 34 and 35 in the electrode leads.
[0032] FIG. 4 shows a fully opened opening 60 of valve 52 expanded by the combination valvuloplasty balloon 14 and the shock wave therapy. The bias in the catheter and the standoffs hold the electrode pairs a substantially constant distance from the tissue of the valve being treated. For simplicity, only two electrode pairs are shown. However, in actual practice, as many as 3-9 electrode pair may typically be used. The electrode pairs 24 can be fired (provided with arc forming voltage) alternately or simultaneously. The calcium on the valve 52 and its softened valve leaflets 54 (and valve cusps) is now cracked making the valve much better prepared for the placement of a TAVI (Transcatheter Aortic-Valve Implantation) valve. In addition, the native valve 52 may function on its own without a replacement.
[0033] FIG. 5 shows an alternate embodiment. Here, a catheter 110 includes an elongated body 112 and an inflatable balloon 114, as in previous embodiments. Here, however, the shock wave sources 120, which may be electrode pairs, are mounted on a basket or frame structure 122 having basket arms or frame elements 124. The basket arms 124 may be formed of Nitinol and may be set to expand with the balloon 114 as the stenosis of the aortic valve being treated is softened and expanded by the shock waves.
[0034] FIG.6 shows the Nitinol arms 124 in greater detail with respect to the shock wave sources 120. Here it may be seen that the arms 124 may be configured with bumps or stand offs 132 to hold the shock wave sources 120 away from the balloon and tissue a substantially fix distance during the shock wave treatment.
[0035] FIG. 6 also shows that, as in previous embodiments, the catheter 112 may
accommodate a guide wire 170. The guide wire 170 may be received within a guide wire lumen 172 and used, as previously described, to guide the catheter into proper position.
[0036] While particular embodiments of the present invention have been shown and described, modifications may be made, and it is therefore intended to cover in the appended claims all such changes and modifications which fall within the true spirit and scope of the invention.

Claims

CLAIMS What is claimed is:
1. A catheter comprising:
an elongated body;
an inflatable balloon carried by the elongated body, the balloon having an inner surface and an outer surface;
at least one shock wave source within the inflatable balloon; and
a follower arrangement that maintains the at least one shock wave source a substantially fixed distance from the inner surface of the balloon.
2. The catheter of claim 1, wherein the follower arrangement is carried by the at least one shock wave source within the inflatable balloon.
3. The catheter of claim 1, wherein the at least one shock wave source is an arc generator.
4. The catheter of claim 3, wherein the arc generator comprises an electrode pair.
5. The catheter of claim 4, wherein the follower arrangement includes at least one stand-off extending from the electrode pair.
6. The catheter of claim 5, wherein the stand-off is formed of flexible material.
7. The catheter of claim 5, wherein the arc generator includes an elongated lead, wherein the electrode pair is carried by the elongated lead, and wherein the elongated lead is biased in a direction towards the inner surface of the inflatable balloon.
8. The catheter of claim 7, wherein the elongated lead includes at least one bend that biases the elongated lead towards the inner surface of the inflatable balloon.
9. The catheter of claim 7, further including a biasing member carried by the elongated lead that biases the elongated lead towards the inner surface of the inflatable balloon.
10. The catheter of claim 9, wherein the biasing member comprises a spring.
11. The catheter of claim 1, wherein the at least one shock wave source comprises an arc generator, wherein the follower arrangement includes a stand-off carried by the arc generator, and wherein the arc generator is biased towards the inner surface of the inflatable balloon.
12. The catheter of claim 1, further including a frame structure that carries the at least on shock wave source, wherein the frame structure expands with inflation of the inflatable balloon to maintain the at least one shock wave source the substantially fixed distance from the inner surface of the balloon.
13. The catheter of claim 12, wherein the frame structure includes at least one standoff adjacent the at least one shock wave source to maintain the at least one shock wave source a substantially fixed distance from the inner surface of the balloon.
14. A method comprising:
providing a catheter including an elongated body, an inflatable balloon carried by the elongated body, the balloon having an inner surface and an outer surface, and at least one shock wave source within the inflatable balloon;
inserting the catheter into a vein or artery of a patient and placing the balloon adjacent to an anatomical structure to be treated;
inflating the balloon with a liquid;
causing the shock wave source to provide shock waves within the balloon that propagate through the liquid to treat the anatomical structure; and
maintaining the at least one shock wave source a substantially fixed distance from the inner surface of the balloon while the shock waves are provided by the at least one shock wave source.
15. The method of claim 14, wherein the catheter further includes a follower carried by the shock wave generator, and wherein the maintaining step includes biasing the follower against the inner wall of the balloon.
16. The method of claim 14, wherein the catheter further includes a frame structure that carries the at least on shock wave source, and wherein the maintaining step includes expanding frame structure with inflation of the inflatable balloon to maintain the at least one shock wave source a substantially fixed distance from the inner surface of the balloon.
17. A catheter comprising :
an elongated body;
an inflatable balloon carried by the elongated body, the balloon having an inner surface and an outer surface;
an elongated lead carrying at least one shock wave source located within the inflatable balloon; and
a stand-off attached to the lead and configured to space the shock wave source away from the inner surface of the balloon.
18. The catheter of claim 17 wherein the stand-off is formed from a flexible material.
19. The catheter of claim 17, wherein the at least one shock wave source is an arc generator.
20. The catheter of claim 19, wherein the arc generator comprises an electrode pair.
PCT/US2013/053292 2012-08-06 2013-08-01 Shockwave catheter WO2014025620A1 (en)

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Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104367367A (en) * 2014-11-12 2015-02-25 陈良龙 Percutaneous aortic valve incision device
WO2016077627A1 (en) * 2014-11-14 2016-05-19 Shockwave Medical, Inc. Shock wave valvuloplasty device and methods
US9421025B2 (en) 2008-11-05 2016-08-23 Shockwave Medical, Inc. Shockwave valvuloplasty catheter system
US9554815B2 (en) 2012-08-08 2017-01-31 Shockwave Medical, Inc. Shockwave valvuloplasty with multiple balloons
US9814476B2 (en) 2011-11-08 2017-11-14 Shockwave Medical, Inc. Shock wave valvuloplasty device with moveable shock wave generator
US10201387B2 (en) 2013-03-13 2019-02-12 The Spectranetics Corporation Laser-induced fluid filled balloon catheter
US10357264B2 (en) 2016-12-06 2019-07-23 Shockwave Medical, Inc. Shock wave balloon catheter with insertable electrodes
US10646240B2 (en) 2016-10-06 2020-05-12 Shockwave Medical, Inc. Aortic leaflet repair using shock wave applicators
US10786661B2 (en) 2013-03-13 2020-09-29 The Spectranetics Corporation Apparatus and method for balloon angioplasty
US10842567B2 (en) 2013-03-13 2020-11-24 The Spectranetics Corporation Laser-induced fluid filled balloon catheter
US10850078B2 (en) 2014-12-30 2020-12-01 The Spectranetics Corporation Electrically-induced fluid filled balloon catheter
US10898213B2 (en) 2014-12-30 2021-01-26 The Spectranetics Corporation Electrically-induced pressure wave emitting catheter sheath
US11058492B2 (en) 2014-12-30 2021-07-13 The Spectranetics Corporation Laser-induced pressure wave emitting catheter sheath
US11246659B2 (en) 2014-08-25 2022-02-15 The Spectranetics Corporation Liquid laser-induced pressure wave emitting catheter sheath
US11771449B2 (en) 2008-06-13 2023-10-03 Shockwave Medical, Inc. Shockwave balloon catheter system

Families Citing this family (28)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10226265B2 (en) 2016-04-25 2019-03-12 Shockwave Medical, Inc. Shock wave device with polarity switching
US10456283B2 (en) 2016-07-13 2019-10-29 Boston Scientific Scimed, Inc. Apparatus and method for maintaining patency in a vessel adjacent to nearby surgery
US10966737B2 (en) * 2017-06-19 2021-04-06 Shockwave Medical, Inc. Device and method for generating forward directed shock waves
NL2019807B1 (en) 2017-10-26 2019-05-06 Boston Scient Scimed Inc Shockwave generating device
US11071557B2 (en) 2017-10-19 2021-07-27 Medtronic Vascular, Inc. Catheter for creating pulse wave within vasculature
US10765440B2 (en) * 2017-11-14 2020-09-08 Sonic Vascular, Inc. Focused intraluminal lithectomy catheter device and methods
US11103262B2 (en) 2018-03-14 2021-08-31 Boston Scientific Scimed, Inc. Balloon-based intravascular ultrasound system for treatment of vascular lesions
US11819229B2 (en) 2019-06-19 2023-11-21 Boston Scientific Scimed, Inc. Balloon surface photoacoustic pressure wave generation to disrupt vascular lesions
US11622779B2 (en) 2018-10-24 2023-04-11 Boston Scientific Scimed, Inc. Photoacoustic pressure wave generation for intravascular calcification disruption
US11464658B2 (en) 2018-10-25 2022-10-11 Medtronic Vascular, Inc. Implantable medical device with cavitation features
US11266817B2 (en) 2018-10-25 2022-03-08 Medtronic Vascular, Inc. Cavitation catheter
US11357958B2 (en) 2018-10-25 2022-06-14 Medtronic Vascular, Inc. Devices and techniques for cardiovascular intervention
US11717139B2 (en) 2019-06-19 2023-08-08 Bolt Medical, Inc. Plasma creation via nonaqueous optical breakdown of laser pulse energy for breakup of vascular calcium
US11660427B2 (en) 2019-06-24 2023-05-30 Boston Scientific Scimed, Inc. Superheating system for inertial impulse generation to disrupt vascular lesions
US20200406009A1 (en) 2019-06-26 2020-12-31 Boston Scientific Scimed, Inc. Focusing element for plasma system to disrupt vascular lesions
US11583339B2 (en) 2019-10-31 2023-02-21 Bolt Medical, Inc. Asymmetrical balloon for intravascular lithotripsy device and method
US11672599B2 (en) 2020-03-09 2023-06-13 Bolt Medical, Inc. Acoustic performance monitoring system and method within intravascular lithotripsy device
US20210290286A1 (en) 2020-03-18 2021-09-23 Bolt Medical, Inc. Optical analyzer assembly and method for intravascular lithotripsy device
US11707323B2 (en) 2020-04-03 2023-07-25 Bolt Medical, Inc. Electrical analyzer assembly for intravascular lithotripsy device
US11672585B2 (en) 2021-01-12 2023-06-13 Bolt Medical, Inc. Balloon assembly for valvuloplasty catheter system
US11648057B2 (en) 2021-05-10 2023-05-16 Bolt Medical, Inc. Optical analyzer assembly with safety shutdown system for intravascular lithotripsy device
CN115363689A (en) * 2021-05-21 2022-11-22 上海微创心通医疗科技有限公司 Medical catheter and medical device
US11806075B2 (en) 2021-06-07 2023-11-07 Bolt Medical, Inc. Active alignment system and method for laser optical coupling
US11877761B2 (en) 2021-08-05 2024-01-23 Nextern Innovation, Llc Systems, devices and methods for monitoring voltage and current and controlling voltage of voltage pulse generators
US11801066B2 (en) 2021-08-05 2023-10-31 Nextern Innovation, Llc Systems, devices and methods for selection of arc location within a lithoplasty balloon spark gap
US11896248B2 (en) 2021-08-05 2024-02-13 Nextern Innovation, Llc Systems, devices and methods for generating subsonic pressure waves in intravascular lithotripsy
CN113842190A (en) * 2021-10-27 2021-12-28 上海微创旋律医疗科技有限公司 Electrode balloon catheter
US11839391B2 (en) 2021-12-14 2023-12-12 Bolt Medical, Inc. Optical emitter housing assembly for intravascular lithotripsy device

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080077165A1 (en) * 2006-02-24 2008-03-27 National University Of Ireland, Galway Minimally Invasive Intravascular Treatment Device
US20090312768A1 (en) * 2008-06-13 2009-12-17 Aspen Medtech, Inc. Shockwave balloon catheter system
WO2010014515A2 (en) * 2008-07-27 2010-02-04 Klein, David Fracturing calcifications in heart valves
US20100114020A1 (en) * 2008-11-05 2010-05-06 Daniel Hawkins Shockwave valvuloplasty catheter system
WO2013070750A1 (en) * 2011-11-08 2013-05-16 Shockwave Medical, Inc. Shock wave valvuloplasty device with moveable shock wave generator

Family Cites Families (112)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
AT309663B (en) 1971-05-14 1973-08-27 Phil Heinz Schmidt Kloiber Dr Device for destroying stones in the bladder, ureter, kidney and the like. like
US3902499A (en) 1974-01-02 1975-09-02 Hoffman Saul Stone disintegrator
US4027674A (en) 1975-06-06 1977-06-07 Tessler Arthur N Method and device for removing concretions within human ducts
US4030505A (en) 1975-11-28 1977-06-21 Calculus Instruments Ltd. Method and device for disintegrating stones in human ducts
DE3038445A1 (en) 1980-10-11 1982-05-27 Dornier Gmbh, 7990 Friedrichshafen Pressure wave generator for diagnosis and therapy - has spark gap in inflatable balloon at end of catheter
US4685458A (en) 1984-03-01 1987-08-11 Vaser, Inc. Angioplasty catheter and method for use thereof
JPS61135648A (en) * 1984-12-05 1986-06-23 オリンパス光学工業株式会社 Discharge stone crushing probe
US5176675A (en) 1985-04-24 1993-01-05 The General Hospital Corporation Use of lasers to break down objects for removal from within the body
DE3543881C1 (en) 1985-12-12 1987-03-26 Dornier Medizintechnik Underwater electrode for non-contact lithotripsy
JPS62275446A (en) 1986-05-21 1987-11-30 オリンパス光学工業株式会社 Discharge stone crushing apparatus
US4662126A (en) 1986-05-23 1987-05-05 Fike Corporation Vibration resistant explosion control vent
US5154722A (en) 1988-05-05 1992-10-13 Circon Corporation Electrohydraulic probe having a controlled discharge path
EP0355177A1 (en) 1988-08-17 1990-02-28 Siemens Aktiengesellschaft Apparatus for the contactless desintegration of concrements in a living thing body
US4955377A (en) 1988-10-28 1990-09-11 Lennox Charles D Device and method for heating tissue in a patient's body
US5246447A (en) 1989-02-22 1993-09-21 Physical Sciences, Inc. Impact lithotripsy
US5425735A (en) 1989-02-22 1995-06-20 Psi Medical Products, Inc. Shielded tip catheter for lithotripsy
US5281231A (en) 1989-02-22 1994-01-25 Physical Sciences, Inc. Impact lithotrypsy
US5078717A (en) 1989-04-13 1992-01-07 Everest Medical Corporation Ablation catheter with selectively deployable electrodes
US5046503A (en) 1989-04-26 1991-09-10 Advanced Cardiovascular Systems, Inc. Angioplasty autoperfusion catheter flow measurement method and apparatus
US5002085A (en) 1990-02-12 1991-03-26 Bs&B Safety Systems, Inc. Low pressure non-fragmenting rupture disks
DE4016054A1 (en) 1990-05-18 1991-11-21 Dornier Medizintechnik SPARK RANGE FOR LITHOTRIPSY
US5103804A (en) 1990-07-03 1992-04-14 Boston Scientific Corporation Expandable tip hemostatic probes and the like
US5152767A (en) 1990-11-23 1992-10-06 Northgate Technologies, Inc. Invasive lithotripter with focused shockwave
US5324255A (en) 1991-01-11 1994-06-28 Baxter International Inc. Angioplasty and ablative devices having onboard ultrasound components and devices and methods for utilizing ultrasound to treat or prevent vasopasm
US5152768A (en) 1991-02-26 1992-10-06 Bhatta Krishna M Electrohydraulic lithotripsy
US5295958A (en) 1991-04-04 1994-03-22 Shturman Cardiology Systems, Inc. Method and apparatus for in vivo heart valve decalcification
US5395335A (en) 1991-05-24 1995-03-07 Jang; G. David Universal mode vascular catheter system
US6406486B1 (en) 1991-10-03 2002-06-18 The General Hospital Corporation Apparatus and method for vasodilation
WO1993006780A1 (en) 1991-10-03 1993-04-15 The General Hospital Corporation Apparatus and method for vasodilation
EP0571306A1 (en) 1992-05-22 1993-11-24 LASER MEDICAL TECHNOLOGY, Inc. Apparatus and method for removal of deposits from the walls of body passages
JPH06125915A (en) 1992-10-21 1994-05-10 Inter Noba Kk Catheter type medical instrument
ATE178218T1 (en) 1993-02-05 1999-04-15 Joe W And Dorothy Dorsett Brow ULTRASONIC BALLOON CATHETER FOR ANGIOPLASTY
CA2118886C (en) 1993-05-07 1998-12-08 Dennis Vigil Method and apparatus for dilatation of a stenotic vessel
US5417208A (en) 1993-10-12 1995-05-23 Arrow International Investment Corp. Electrode-carrying catheter and method of making same
US8025661B2 (en) 1994-09-09 2011-09-27 Cardiofocus, Inc. Coaxial catheter instruments for ablation with radiant energy
US6113560A (en) 1994-09-21 2000-09-05 Hmt High Medical Techologies Method and device for generating shock waves for medical therapy, particularly for electro-hydraulic lithotripsy
US5603731A (en) 1994-11-21 1997-02-18 Whitney; Douglass G. Method and apparatus for thwarting thrombosis
DE19504261A1 (en) 1995-02-09 1996-09-12 Krieg Gunther Angioplasty catheter for dilating and / or opening blood vessels
US5582578A (en) 1995-08-01 1996-12-10 Duke University Method for the comminution of concretions
US6544276B1 (en) 1996-05-20 2003-04-08 Medtronic Ave. Inc. Exchange method for emboli containment
US5846218A (en) 1996-09-05 1998-12-08 Pharmasonics, Inc. Balloon catheters having ultrasonically driven interface surfaces and methods for their use
US6352535B1 (en) 1997-09-25 2002-03-05 Nanoptics, Inc. Method and a device for electro microsurgery in a physiological liquid environment
US6083232A (en) 1996-09-27 2000-07-04 Advanced Cardivascular Systems, Inc. Vibrating stent for opening calcified lesions
DE19717790A1 (en) 1997-04-26 1998-10-29 Convergenza Ag Device with a therapeutic catheter
US6024740A (en) 1997-07-08 2000-02-15 The Regents Of The University Of California Circumferential ablation device assembly
US6500174B1 (en) 1997-07-08 2002-12-31 Atrionix, Inc. Circumferential ablation device assembly and methods of use and manufacture providing an ablative circumferential band along an expandable member
CN1282230A (en) 1997-10-21 2001-01-31 加利福尼亚大学董事会 Photoacoustic removal for occlusions from blood vessels
EP0911804B1 (en) 1997-10-24 2007-05-09 MTS Europe GmbH Method for the automatic adjustment of the distance between the electrodes of a spark gap in electrohydraulic shock wave generators
US6083239A (en) * 1998-11-24 2000-07-04 Embol-X, Inc. Compliant framework and methods of use
US6755821B1 (en) 1998-12-08 2004-06-29 Cardiocavitational Systems, Inc. System and method for stimulation and/or enhancement of myocardial angiogenesis
US6210408B1 (en) 1999-02-24 2001-04-03 Scimed Life Systems, Inc. Guide wire system for RF recanalization of vascular blockages
US6277138B1 (en) 1999-08-17 2001-08-21 Scion Cardio-Vascular, Inc. Filter for embolic material mounted on expandable frame
US6398792B1 (en) 1999-06-21 2002-06-04 O'connor Lawrence Angioplasty catheter with transducer using balloon for focusing of ultrasonic energy and method for use
DE19929112A1 (en) 1999-06-24 2001-01-11 Ferton Holding Sa Medical instrument for the treatment of biological tissue and method for transmitting pressure waves
US20040097996A1 (en) 1999-10-05 2004-05-20 Omnisonics Medical Technologies, Inc. Apparatus and method of removing occlusions using an ultrasonic medical device operating in a transverse mode
US6524251B2 (en) 1999-10-05 2003-02-25 Omnisonics Medical Technologies, Inc. Ultrasonic device for tissue ablation and sheath for use therewith
US20040249401A1 (en) 1999-10-05 2004-12-09 Omnisonics Medical Technologies, Inc. Apparatus and method for an ultrasonic medical device with a non-compliant balloon
US6652547B2 (en) 1999-10-05 2003-11-25 Omnisonics Medical Technologies, Inc. Apparatus and method of removing occlusions using ultrasonic medical device operating in a transverse mode
US6371971B1 (en) 1999-11-15 2002-04-16 Scimed Life Systems, Inc. Guidewire filter and methods of use
US6589253B1 (en) 1999-12-30 2003-07-08 Advanced Cardiovascular Systems, Inc. Ultrasonic angioplasty transmission wire
US6440061B1 (en) 2000-03-24 2002-08-27 Donald E. Wenner Laparoscopic instrument system for real-time biliary exploration and stone removal
US20010044596A1 (en) 2000-05-10 2001-11-22 Ali Jaafar Apparatus and method for treatment of vascular restenosis by electroporation
US7744595B2 (en) 2000-08-01 2010-06-29 Arqos Surgical, Inc. Voltage threshold ablation apparatus
US6367203B1 (en) 2000-09-11 2002-04-09 Oklahoma Safety Equipment Co., Inc. Rupture panel
US6638246B1 (en) 2000-11-28 2003-10-28 Scimed Life Systems, Inc. Medical device for delivery of a biologically active material to a lumen
US6514203B2 (en) 2001-02-12 2003-02-04 Sonata Technologies Ltd. Method for ultrasonic coronary thrombolysis
US6607003B1 (en) 2001-04-23 2003-08-19 Oklahoma Safety Equipment Co, Gasket-lined rupture panel
US7674258B2 (en) 2002-09-24 2010-03-09 Endoscopic Technologies, Inc. (ESTECH, Inc.) Electrophysiology electrode having multiple power connections and electrophysiology devices including the same
US6740081B2 (en) 2002-01-25 2004-05-25 Applied Medical Resources Corporation Electrosurgery with improved control apparatus and method
US7815596B2 (en) 2002-02-28 2010-10-19 Cordis Corporation Localized fluid delivery having a porous applicator and methods for using the same
US6989009B2 (en) 2002-04-19 2006-01-24 Scimed Life Systems, Inc. Cryo balloon
US7829029B2 (en) 2002-05-29 2010-11-09 NanoVibronix, Inv. Acoustic add-on device for biofilm prevention in urinary catheter
US7153315B2 (en) 2002-06-11 2006-12-26 Boston Scientific Scimed, Inc. Catheter balloon with ultrasonic microscalpel blades
US20040082859A1 (en) 2002-07-01 2004-04-29 Alan Schaer Method and apparatus employing ultrasound energy to treat body sphincters
JP2004081374A (en) 2002-08-26 2004-03-18 Dairin Kk Instrument for removing sediment in tubular organ
JP2004357792A (en) 2003-06-02 2004-12-24 Keio Gijuku Vascular restenosis preventive therapeutic apparatus by sound pressure wave induced by irradiation of high strength pulse light
US7628785B2 (en) 2003-06-13 2009-12-08 Piezo Technologies Endoscopic medical treatment involving acoustic ablation
US7744620B2 (en) 2003-07-18 2010-06-29 Intervalve, Inc. Valvuloplasty catheter
US7247269B2 (en) 2003-07-21 2007-07-24 Biosense Webster, Inc. Method for making a spiral array ultrasound transducer
JP4072580B2 (en) 2003-09-25 2008-04-09 ケイセイ医科工業株式会社 Thrombectomy catheter
WO2005065563A1 (en) 2003-12-31 2005-07-21 Biosense Webster, Inc Circumferential ablation device assembly with an expandable member
US7720521B2 (en) 2004-04-21 2010-05-18 Acclarent, Inc. Methods and devices for performing procedures within the ear, nose, throat and paranasal sinuses
CN101043914A (en) 2004-07-14 2007-09-26 旁路公司 Material delivery system
EP1773439A4 (en) 2004-07-14 2010-01-20 By Pass Inc Material delivery system
AU2004324043A1 (en) 2004-10-02 2006-04-20 Christoph Hans Huber Methods and devices for repair or replacement of heart valves or adjacent tissue without the need for full cardiopulmonary support
US20060184076A1 (en) 2004-12-01 2006-08-17 Gill Robert P Ultrasonic device and method for treating stones within the body
WO2006063199A2 (en) 2004-12-09 2006-06-15 The Foundry, Inc. Aortic valve repair
US20060241524A1 (en) 2005-03-11 2006-10-26 Qi Yu Intravascular ultrasound catheter device and method for ablating atheroma
US8162859B2 (en) 2005-06-09 2012-04-24 General Patent , LLC Shock wave treatment device and method of use
US20070088380A1 (en) 2005-10-14 2007-04-19 Endocross Ltd. Balloon catheter system for treating vascular occlusions
US20070239082A1 (en) 2006-01-27 2007-10-11 General Patent, Llc Shock Wave Treatment Device
US20090227992A1 (en) 2006-02-02 2009-09-10 Releaf Medical Ltd Shock-Wave Generating Device, Such as for the Treatment of Calcific Aortic Stenosis
US8221303B2 (en) * 2006-04-24 2012-07-17 Yoel Ovil Intra-ventricular cardiac assist device and related method of use
EP2540246B8 (en) * 2006-05-12 2020-10-07 Vytronus, Inc. Device for ablating body tissue
US20080097251A1 (en) 2006-06-15 2008-04-24 Eilaz Babaev Method and apparatus for treating vascular obstructions
JP2009540954A (en) 2006-06-20 2009-11-26 エーオーテックス， インコーポレイテッド Prosthetic valve implantation site preparation technology
EP2040791A4 (en) 2006-06-21 2011-05-04 Intrapace Inc Endoscopic device delivery system
CA2703345C (en) 2007-10-22 2016-04-12 Endocross Ltd. Balloons and balloon catheter systems for treating vascular occlusions
US20090247933A1 (en) 2008-03-27 2009-10-01 The Regents Of The University Of California; Angiodynamics, Inc. Balloon catheter method for reducing restenosis via irreversible electroporation
US20100036294A1 (en) 2008-05-07 2010-02-11 Robert Mantell Radially-Firing Electrohydraulic Lithotripsy Probe
US20130030431A1 (en) 2008-06-13 2013-01-31 Adams John M Shock wave balloon catheter system with off center shock wave generator
US9072534B2 (en) 2008-06-13 2015-07-07 Shockwave Medical, Inc. Non-cavitation shockwave balloon catheter system
WO2010042869A1 (en) 2008-10-10 2010-04-15 Intervalve, Inc. Valvuloplasty catheter and methods
ES2394197T3 (en) * 2008-10-31 2013-01-23 Ferton Holding Sa Instrument for generating pressure waves as a shock wave for the treatment of biological tissue
EP3117784B1 (en) 2009-07-08 2018-12-26 Sanuwave, Inc. Usage of intracorporeal pressure shock waves in medicine
EP2506781B1 (en) 2009-12-05 2018-03-21 Pi-R-Squared Ltd. Device for fracturing calcifications in heart valves
JP5792802B2 (en) 2010-05-12 2015-10-14 シファメド・ホールディングス・エルエルシー Low profile electrode assembly
WO2012064404A1 (en) 2010-11-09 2012-05-18 Daniel Hawkins Shockwave valvuloplasty device with guidewire and debris basket
US9642673B2 (en) 2012-06-27 2017-05-09 Shockwave Medical, Inc. Shock wave balloon catheter with multiple shock wave sources
ES2715678T3 (en) 2012-08-06 2019-06-05 Shockwave Medical Inc Low profile electrodes for an angioplasty shock wave catheter
US9554815B2 (en) 2012-08-08 2017-01-31 Shockwave Medical, Inc. Shockwave valvuloplasty with multiple balloons
US9333000B2 (en) 2012-09-13 2016-05-10 Shockwave Medical, Inc. Shockwave catheter system with energy control

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20080077165A1 (en) * 2006-02-24 2008-03-27 National University Of Ireland, Galway Minimally Invasive Intravascular Treatment Device
US20090312768A1 (en) * 2008-06-13 2009-12-17 Aspen Medtech, Inc. Shockwave balloon catheter system
WO2010014515A2 (en) * 2008-07-27 2010-02-04 Klein, David Fracturing calcifications in heart valves
US20100114020A1 (en) * 2008-11-05 2010-05-06 Daniel Hawkins Shockwave valvuloplasty catheter system
WO2013070750A1 (en) * 2011-11-08 2013-05-16 Shockwave Medical, Inc. Shock wave valvuloplasty device with moveable shock wave generator

Cited By (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11771449B2 (en) 2008-06-13 2023-10-03 Shockwave Medical, Inc. Shockwave balloon catheter system
US11000299B2 (en) 2008-11-05 2021-05-11 Shockwave Medical, Inc. Shockwave valvuloplasty catheter system
US10149690B2 (en) 2008-11-05 2018-12-11 Shockwave Medical, Inc. Shockwave valvuloplasty catheter system
US9421025B2 (en) 2008-11-05 2016-08-23 Shockwave Medical, Inc. Shockwave valvuloplasty catheter system
US10478202B2 (en) 2011-11-08 2019-11-19 Shockwave Medical, Inc. Shock wave valvuloplasty device with moveable shock wave generator
US9814476B2 (en) 2011-11-08 2017-11-14 Shockwave Medical, Inc. Shock wave valvuloplasty device with moveable shock wave generator
US11766271B2 (en) 2012-08-08 2023-09-26 Shockwave Medical, Inc. Shock wave valvuloplasty with multiple balloons
US10758255B2 (en) 2012-08-08 2020-09-01 Shockwave Medical, Inc. Shock wave valvuloplasty with multiple balloons
US9554815B2 (en) 2012-08-08 2017-01-31 Shockwave Medical, Inc. Shockwave valvuloplasty with multiple balloons
US10201387B2 (en) 2013-03-13 2019-02-12 The Spectranetics Corporation Laser-induced fluid filled balloon catheter
US10786661B2 (en) 2013-03-13 2020-09-29 The Spectranetics Corporation Apparatus and method for balloon angioplasty
US10842567B2 (en) 2013-03-13 2020-11-24 The Spectranetics Corporation Laser-induced fluid filled balloon catheter
US11246659B2 (en) 2014-08-25 2022-02-15 The Spectranetics Corporation Liquid laser-induced pressure wave emitting catheter sheath
CN104367367A (en) * 2014-11-12 2015-02-25 陈良龙 Percutaneous aortic valve incision device
WO2016077627A1 (en) * 2014-11-14 2016-05-19 Shockwave Medical, Inc. Shock wave valvuloplasty device and methods
US10898213B2 (en) 2014-12-30 2021-01-26 The Spectranetics Corporation Electrically-induced pressure wave emitting catheter sheath
US11058492B2 (en) 2014-12-30 2021-07-13 The Spectranetics Corporation Laser-induced pressure wave emitting catheter sheath
US10850078B2 (en) 2014-12-30 2020-12-01 The Spectranetics Corporation Electrically-induced fluid filled balloon catheter
US11517337B2 (en) 2016-10-06 2022-12-06 Shockwave Medical, Inc. Aortic leaflet repair using shock wave applicators
US10646240B2 (en) 2016-10-06 2020-05-12 Shockwave Medical, Inc. Aortic leaflet repair using shock wave applicators
US10357264B2 (en) 2016-12-06 2019-07-23 Shockwave Medical, Inc. Shock wave balloon catheter with insertable electrodes

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US9220521B2 (en) 2015-12-29
EP2879597B1 (en) 2016-09-21
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US20140163592A1 (en) 2014-06-12
JP2015528329A (en) 2015-09-28
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CA2881184C (en) 2019-06-04

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