CA1296589C - Catheter apparatus, system and method for intravascular two-dimensional ultrasonography - Google Patents
Catheter apparatus, system and method for intravascular two-dimensional ultrasonographyInfo
- Publication number
- CA1296589C CA1296589C CA000530748A CA530748A CA1296589C CA 1296589 C CA1296589 C CA 1296589C CA 000530748 A CA000530748 A CA 000530748A CA 530748 A CA530748 A CA 530748A CA 1296589 C CA1296589 C CA 1296589C
- Authority
- CA
- Canada
- Prior art keywords
- ultrasonic
- vessel
- housing
- tubular element
- rotatable
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320783—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions through side-hole, e.g. sliding or rotating cutter inside catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
- A61B8/4461—Features of the scanning mechanism, e.g. for moving the transducer within the housing of the probe
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00902—Material properties transparent or translucent
- A61B2017/00924—Material properties transparent or translucent for ultrasonic 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
- A61B2017/22038—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 a guide wire
-
- 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
- A61B2017/22038—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 a guide wire
- A61B2017/22045—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 a guide wire fixed to the catheter; guiding tip
-
- 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
- A61B2017/22052—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 eccentric
-
- 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
- A61B2017/22072—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 instrument channel, e.g. for replacing one instrument by the other
- A61B2017/22074—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 instrument channel, e.g. for replacing one instrument by the other the instrument being only slidable in a channel, e.g. advancing optical fibre through a channel
-
- 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
- A61B2017/22072—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 instrument channel, e.g. for replacing one instrument by the other
- A61B2017/22078—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 instrument channel, e.g. for replacing one instrument by the other for rotating the instrument within a channel, e.g. an optical fibre
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/376—Surgical systems with images on a monitor during operation using X-rays, e.g. fluoroscopy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/36—Image-producing devices or illumination devices not otherwise provided for
- A61B90/37—Surgical systems with images on a monitor during operation
- A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
- A61B2090/3782—Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument
- A61B2090/3784—Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument both receiver and transmitter being in the instrument or receiver being also transmitter
Abstract
Abstract Of The Invention Ultrasonic apparatus, system and method for high resolution intravascular imaging to assist indovascular lesions and to monitor the results of interventional therapy. An ultrasonic transducer is carried by the distal end of a catheter adapted for insertion into a vessel, and either the transducer or another element is rotated and/or translated relative to the catheter to image different portions of the vessel.
Description
1296~9 CATHETER APPARATUS, SYSTEM AND METHOD
FOR INTRAVASCULAR TWO-DIMENSIONAL ULTRASONOGRAPHY
This invention relates to a catheter apparatus, system and method for intravascular two-dimensional ultrasonography and more particularly to such an apparatus, system and method for providing high resolution imaging for assessing endovascular lesions and for monitoring the results of interventional therapy.
Ultrasonic two-dimensional imaging apparatus and systems have heretofore been provided for use in endoscopy for examining the gastrointestinal tract.
Such a device is disclosed in U.S. Patent No.
4,494,549.
Such devices have been relatively large and inflexible and are completely unsuitable for use in connection with the vascular system of the human body. In addition there is no provision for guiding such devices into specific branches of blood vessels. There is therefore a need for a new and improved catheter apparatus, system and method which can be utilized for performing intravascular two-dimension ultrasonography.
A 42771/PATl ~
lZ96589 In general, it is an object of the present invention to provide a catheter apparatus, system and method for intravascular two-dimensional ultrasonography.
Another object of the invention is to provide an apparatus, system and method of the above character which has a high resolution capability.
Another object of the invention is to provide an apparatus, system and method of the above character which can be utilized for assessing endovascular lesions.
Another object of the invention is to provide an apparatus, system and method of the above character which can be utilized for monitoring the results of interventional therapy.
Another object of the invention is to provide an apparatus, system and method of the above character which can be used with atherectomy devices.
Another object is to provide an apparatus, system and method capable of selective cannulation of branch vessels.
Additional objects and features of the invention will appear from the following description in which the preferred embodiments are set forth in detail in conjunction with the accompanying drawings.
Figure 1 is a side elevational view partially in cross section of a catheter apparatus incorporating the present invention.
Figure 2 is an enlarged cross sectional view of the distal extremity of the apparatus shown in Figure 1.
Figure 3 is an enlarged cross sectional view of an intermediate portion of the apparatus shown in Figure 1.
Figure 4 is an enlarged cross sectional view taken along the line 4-4 of Figure 1.
Figure 5 is an isometric view of the crystal assembly which forms a part of the apparatus shown in Figure 1.
Figure 6 is a schematic block diagram of the electrical and electronic apparatus utilized in the system.
Figure 7 is a two dimension display of an ultrasonogram which can be obtained with the apparatus and system shown in Figures 1-6.
Figure 8 is an enlarged cross-sectional view of another embodiment of a catheter apparatus incorporating the present invention.
Figure 9 is a cross-sectional view taken along the lines 9-9 of Figure 8.
Figure 10 is an enlarged cross-sectional view of still another embodiment of a catheter apparatus incorporating the present invention.
Figure 11 is an enlarged cross-sectional view of another embodiment of the catheter apparatus incorporating the present invention.
In general the catheter apparatus of the present invention consists of a flexible tubular element which is adapted to be inserted into a vessel in the vascular system. A flexible rotatable elongate element is disposed in the tubular element. An ultrasonic transducer is carried by the flexible tubular element.
Electrical circuitry is carried by the flexible tubular element and is connected to the ultrasonic transducer for supplying signals to and receiving signals from the transducer. In the system, a transmitter is provided for supplying signals to the ultrasonic transducer and a receiver is provided for receiving signals from the ultrasonic transducer. A motor is provided for rotating the flexible elongate element. Timing and control circuitry is provided for controlling the operation of the motor and the transmitter and receiver. A display is provided which is operated under the control of the timing and control circuitry for displaying the image information which is received by the receiver.
More in particular, the catheter apparatus 11 of the present invention consists of an elongate tubular assembly 12. The elongate tubular assembly 12 consists of an elongate tubular element 13 which is provided with four lumens 14, 16, 17 and 18 with the lumen 14 serving as a torque tube, lumen 16 serving as a balloon tube and lumens 17 and 18 serving as infusion tubes or lumens as hereinafter described. As can be seen the tubular element 13 is formed of a single extrusion which provides the four lumens with the lumens 14 and 16 being substantially circular in cross section and the lumens 17 and 18 being arcuate in shape with the configuration of each being determined by three arcs with one of the arcs being concentric with the outer A 42771/PATl ~` 1296589 diameter of the tubular element 13 and with the two smaller arcs being concentric with the lumens 14 and 16 respectively.
A braided shield 21 is provided on the exterior of the tubular element 13 and takes the form of one or more layers of braided strands 22 formed of a suitable magnetic material such as stainless steel strands. The shield 21 serves as an electrical shield. A cover tube 23 covers the braided shield 21 and extends the length of the tubular element 13. The cover tube 23 can be formed of a suitable material such as a heat shrinkable plastic which is shrunk tightly onto the braided shield 21 and provides a smooth outer surface so that the tubular assembly 12 can readily enter a vessel of the vascular system of a patient.
A work performing device consisting of a housing 27 is provided with a cut-out 28. A rotary cutter 29 is rotatably disposed within the housing 27 and is provided with a hub 31 that is secured to a flexible rotatable torque cable 32. The cable 32 is disposed in and extends through the torque tube lumen 14. The torque cable 32 is formed of a suitable material such as stainless steel. The housing 27 is provided with a rounded tip 33 having a recess 34 which is adapted to receive material which is removed by the rotary cutter 29 as the cutter 29 is advanced as hereinafter described. A spring tip guide or guide wire 36 capable of being shaped is secured to the rounded tip 33 and extends forwardly therefrom and lZ96589 serves to guide or steer the housing 27 as the tubular assembly 12 with the cutting device 26 secured thereto is introduced into the vessel of the vascular system of the patient. As shown, the spring tip guide 36 can be secured to the rounded tip 33 by suitable means such as solder 37. It thus can be seen that the guide wire 36 is associated with the housing 27. Alternatively a movable guide wire can be carried by the housing for facilitating steering of the housing into the desired vessel of the patient.
A balloon 41 of an expandable type is secured to the housing in a region opposite the cutout 28 and has its distal extremity bonded around the tip 33 by suitable means such as an adhesive 42. As shown in Figure 2, the balloon 41 underlies substantially the entire length of the housing 27. The balloon 41 is in communication with a balloon tube 43 which extends through the balloon tube lumen 16 in the tubular element 13. The balloon tube 43 is provided with a lumen 44 through which a medium can be introduced for inflating the balloon 41 and removed for deflating the balloon 41. The proximal extremity of the balloon 41 and the proximal extremity of the housing 27 is secured to the distal extremity of the tubular assembly 12 by suitable means such as heat shrinkable tubing 46.
Means is provided for imaging the region in which the work performing device 26 is located and in this particular case, with the present invention takes the form of a two-dimensional ultrasound image system 49.
The system 49 includes a single crystal 51 (see Figure 5) which is mounted on the hub 31 and is secured thereto by suitable means such as an adhesive. The crystal 51 is part of an assembly 52. The crystal 51 A 42771/PATl -` lZ96S89 should be capable of operating at a frequency range of 5 to 50 megahertz and typically can be formed of a suitable material such as barium titanate or cinnabar.
As can be seen from Figure 5, the crystal 51 has a rectangular block-like configuration and has two opposed surfaces covered by metallic conducting films 53 and 54 formed of a suitable material such as chrome or gold. The material of the films can be formed of a foil or can be in the form of films evaporated or sputtered onto the opposite surfaces of the crystal 51.
The films 53 and 54 serve as electrodes and are connected to connecting wires 56 and 57 by suitable means such as solder. Means is provided for damping out the oscillations from the backside of the crystal 51 and takes the form of a rectangular block 58 formed of a suitable backing material. This backing material can be formed in a conventional manner so as to cancel out oscillations from the side of a crystal in which the backing material is disposed.
The wires 56 and 57 are braided onto the torque cable 32 and rotate with the torque cable. The wires 56 and 57 extend towards the proximal extremity of the tubular assembly 12 and extend into a fitting 61 (see Figure 3) formed of a suitable material such as plastic. A pair of spaced apart slip rings 62 and 63 formed of a conducting material such as copper are secured to the torque cable 32. The wire 56 is bonded to the slip ring 62 and the wire 57 is bonded to the slip ring 63.
A fitting 66 is provided which has a threaded bore 67.
The tubular assembly 12 extends through the fitting 66 and a reinforcing sleeve 68 extends over the portion of the tubular assembly 12 extending therethrough. A pair of spring urged contacts 71 and 72 are carried by the fitting 66 and are adapted to slidably engage the slip A 42771/PATl ~Z~6589 rings 62 and 63. The contacts 71 and 72 are connected to conductors 73 and 74. A grounding lug 76 is provided on the fitting 66 and makes electrical contact with the braided shield 21. A conductor 77 is connected to the grounding lug 76.
A male fitting 78 (see Figure 1) is threaded into the threaded bore 67. A single arm adapter 81 is mounted in the male fitting 78 and carries an arm 82 having thereon a balloon inflation port 83 that is in communication with the lumen 44 in the balloon tube 43 disposed in the tubular assembly 12. The single arm adapter 81 is secured to a rotating adapter 86 of a conventional type and through which the tubular assembly 12 extends. Another single arm adapter 87 is mounted in the rotating adapter and is provided with a side arm 88 having an infusion port 89 disposed therein which is in communication with the infusion lumens 17 and 18 provided in the tubular assembly 12. A tapered fitting 91 is mounted in the single arm adapter 87 and is provided with a threaded bore 92 which carries an O-ring 93 that is adapted to be engaged by a male type fitting 94 to form a liquid-tight seal between the tubular assembly 12 and the torque cable 32 which extends therethrough. The torque cable 32 is secured to a suitable drive member such as a clutch member 98 of the type described in U.S. Patent 4,771,774. The clutch member 98 is adapted to be secured to motive drive means of the type described therein consisting of a motor drive unit which in the present application is identified as a motor 99 (see Figure 6). The motor 99 is driven by and is under the control of electronic lZ96589 circuitry forming a part of system 49. The part of the system 49 shown in block diagram form is substantially conventional and can be of a suitable type such as certain equipment identified as Model 851B manufactured by Advanced Technology Laboratories, Inc. of Bothel, Washington. As shown in Figure 5, ;Uc]l apI)c.lctls includes a timing and control block 102 which supplies pulses to a transmitter 103. The output of the transmitter 103 is supplied through a transmit receive switch 104 which supplies the signals on the conductors 73 and 74 through the slip rings 62 and 63 onto the conductors 56 and 57 connected to the crystal 51.
During the time that the transmitter 103 is supplying high frequency energy to the crystal, the crystal 52 is being rotated by the motor driving the torque cable 32 with the motor 99 being under the control of the timing and control block 102. The motor 99 is of a type such as an open loop stepping motor or a closed drop servo controlled motor which can be driven by the timing and control block 102.
The transmitter generates a high voltage pulse in the 100 to 300 volt range for excitation of the transducer crystal 51. Supplying high voltage pulses to the crystal causes the transducer to produce sonic waves which emanate therefrom into the surrounding tissue structure. Portions of the sonic energy wave reflected by the tissue structure back to the transducer and the transducer 51 acts as a receiver and picks up the sonic vibrations and converts them into electrical signals which are supplied by the conducting wires 56 and 57 back to the slip rings 62 and 63 through the conductors 73 and 74 and through the transmit receive switch 104 to a receiver 106. These signals are amplified and supplied to a display unit 107 which includes a CRT
lZ965~39 screen 108 under the control of the timing and control block 102 to supply an image 109 on the display 108 which can be of the type shown in Figure 7. As can be seen from Figure 7, as viewed through 360, the vessel wall 111 of the image 109 is shown as indicated having different cross sections depending upon the build-up of plaque therein. A central region 112 of the image is eclipsed because of the imaging catheter. Alternative-ly, if desired only a sector of a lesser angle than 360 can be viewed.
The catheter apparatus of the present invention can be constructed in various sizes. For example, in a 9 French size, the balloon can have a length of approximately 100 millimeters and a diameter of approximately 3 millimeters (9 French). Sizes down to 3 French can be accomplished with the construction of the present invention.
Operation and use of the catheter apparatus, system and method during intravascular ultrasonography can now be briefly described as follows. Let it be assumed that it is desired to utilize the apparatus, system and method of the present invention to remove the atheroma in a blood vessel of a patient. The catheter of the catheter apparatus of the present invention is introduced into a vessel of the patient as, for example, into the femoral artery and introducing the A
catheter into the artery by the use of the guide wire 36. The progress of the catheter into the vessel of the patient can be observed under x-ray fluoroscopy.
As soon as the cutting device has entered into a region which is desired to remove certain material from the vessel and before a cutting operation is commenced, the atheroma itself can be viewed by operation of the ultrasonic imaging system 49. This can be accomplished by operating the timing control block 102 to cause operation of the motor 99 which in turn causes rotation of the torque cable 32 and the crystal assembly 52 to S scan the interior of the vessel in which the crystal 51 is disposed. An image of what is being scanned will appear on the screen 108 of the display device 107.
During the time this rotary scanning is taking place, the cable 32 can be advanced to advance the cutter so that the entire region in which the material is to be removed can be scanned. After the scan, the cable 32 can be retracted slightly so that the proximal extremi-ty of the cutout 28 lies at the proximal extremity of the atheroma. In order to stabilize the cutting device, the balloon 41 can be inflated so as to urge the cutout 28 of the housing 27 towards the portion of the atheroma it is desired to remove. The motor 99 can then be energized to rotate the cutter 29. As the cutter 29 is rotated, it can be advanced to progres-sively remove the material which is disposed within thecutout 28 of the housing 27. As this material is removed it is pushed forwardly and eventually moves into the recess 34. The balloon 41 can then be deflat-ed and the catheter apparatus removed from the vessel after which the material which has been deposited in the recess 34 can be removed and the cutting device cleaned for reinsertion into the vessel of the patient for removal of additional material from the vessel if A
required.
During the time that the cutting operation is taking place, the cutting operation can be viewed ultrason-ically by the rotating crystal 51 which places an image on the screen 108. From this image it can be ascer-tained how well the cutter is performing in removing A 42771/PATl lZ96589 the material and whether or not an additional pass of the cutter is required. It should be appreciated that if necessary several passes of the cutter can be made and if necessary, the catheter assembly can be removed from the vessel of the patient to clean out material which has been removed and deposited in a recess 34.
Another embodiment of the catheter apparatus of the present invention is shown in Figure 8. Many of the parts are very similar to the parts utilized in the embodiment of the invention shown in Figure 1 and have been given the corresponding numerals. The distal extremity of the catheter apparatus shown-in Figure 8 differs from the apparatus shown in Figure 1 in that the conducting wires or leads connected to the ultrasonic crystal 52 are connected to the outside world at a point which is proximal of an adapter 122 whereas in the embodiment shown in Figure 1, the connectors are connected at a point which is distal of the adapters 82 and 88. Thus there is shown an adapter 122 which is provided with an arm 123 through which dye injection and pressure measurements can be made and another fitting 124 which can be utilized in inflating and deflating the balloon 41. Another adapter 126 is provided which is threaded into the proximal end of the adapter 22 and forms a sealing engagement with an O-ring 127 carried by the adapter 122. The torque cable 32 extends through the adapter 126 and is connected to a clutch member 128. The clutch member 128 which carries a finger operated member 129 is adapted to be secured to motorized drive means of the type hereinbefore described for causing rotation of the torque cable 32.
As hereinbefore explained, the conducting wires connected to the ultrasonic crystal 52 are braided into the guide wire 32. Means is carried by the adapter 126 which is adapted to make contact with the conducting wires connected to the crystal 52 and consists of brushes 131 and 132 which are yieldably urged by springs 133 towards the torque cable 32 so as to make contact with the conducting wires or leads carried by the guide wire 32. The springs 133 are held in place by pins 134 which are frictionally seated within the adapter 126. Conducting wires 136 and 137 are connected to the pins 134. These wires 136 and 137 are connected into the system in a manner hereinbefore described with the previous embodiments. The operation of this embodiment is very similar to that described in conjunction with the operation of the embodiment shown in Figure 1.
Operation of this embodiment of the invention is very similar to that hereinbefore described with the princi-pal advantage being that leads which are connected to the crystal 52 for supplying pulses of energy to the crystal and for receiving signals from the crystal are disposed proximally of the two arm adapter 122.
Still another embodiment of the catheter apparatus of the present invention is shown in Figure 10. Certain parts of this catheter apparatus 146 are very similar to those hereinbefore described and are identified by the same numbers. Thus there has been provided a housing 27 which has an outwardly facing cutout 28. A
coil spring guide wire 36 is secured to the distal extremity of the housing 27 as shown. The balloon 41 is carried by the housing and has its distal extremity secured to the housing by a band 92. The balloon 41 is A 42771/PATl disposed outside of the housing 27 on the side opposite the cutout 28. A flexible tubular assembly 151 is secured to the proximal end of the housing 27. A
three-arm adapter 152 is mounted on the proximal extremity of the tubular assembly 151. The tubular assembly 151 consists of a flexible tubular element 153 formed of a suitable material such as plastic which is provided with a balloon lumen 154 that is in communication with the interior of the balloon 41 and extends into a balloon inflation port 156 provided as a part of the three-arm adapter 152.
A crystal 157 is carried by the housing 27 in a stationary position. As shown, the crystal 157 is lS mounted vertically or in a direction which is at right angles to the longitudinal axis of the housing 27. It can be mounted in the proximal extremity of the housing 27 in a suitable manner such as by an adhesive. A
suitable sound absorbing material 158 is provided behind the ultrasonic crystal 157 and fills the space between the crystal 157 and the distal extremity of the housing 27. A pair of conducting wires 161 are con-nected to the ultrasonic crystal 157 and extend rear-wardly through the housing 27 and are connected into sockets 162 provided in a side arm 163 forming a part of the adapter 152.
The flexible tubular element 153 is provided with a large lumen 163 extending the length thereof and which has a rototable flexible drive cable 166 disposed therein. The flexible drive cable 166 is formed in the manner hereinbefore described and is secured to a generally cylindrical member 167 which as hereinafter described serves as a reflector mount and also serves to carry the cutter. Thus as shown, the member 167 is ~ ~296S89 provided with a surface 168 which is inclined at an angle of approximately 45 and faces the crystal 157 in such a manner so that sound waves propagated by the crystal impinge upon the surface 168 and are propagated outwardly in a direction substantially at right angles to the longitudinal axis of the housing. Since the reflector surface 168 is provided on the distal end of the member 167, the circular cutting edge 169 is provided on the member 167 at the proximal extremity thereof. A truncated conical recess 171 is provided in the proximal extremity of the member 167. The conical recess 171 can be used as a reservoir for collecting material as it is removed by the circular cutting edge 169.
The three-arm adapter 152 is provided with another arm 173 which serves as an infusion port and which is in communication with the lumen 164 through which the drive cable 166 extends. This lumen 164 opens into the interior of the housing 127 and is in communication with the cutout 28. Another adapter 176 is provided which is threaded into the proximal extremity of the adapter 162 and engages an O-ring 177. The drive cable 166 extends through the adapter 176 and has its distal extremity secured to the clutch member 128. As hereinbefore explained, the clutch member 128 can be secured to a motorized drive means for causing rotational movement of the cutter and mirror member 167.
Operation of the catheter apparatus shown in Pigure 10 may now be described as follows. The operation of this device in many respects is very similar to that herein-before described with respect to the placement of the catheter in the vessel. The housing can be positioned A 42771/PATl in the stenosis hereinbefore described and ultrasonic imaging can be carried out by supplying pulses of electrical energy to the ultrasonic crystal 157 which emanates ultrasonic energy and directs the same onto the 45 reflector 168 which reflects the ultrasonic energy up into the tissue which is immediately opposite the cutout 28. Rotation of the mirror 168 causes an image to be formed which can be viewed in the manner hereinbefore described. This imaging can be carried out by rotating the cable 166 and at the same time advancing the drive cable 166 throughout the length of the cutout 28 to view the stenosis. After the viewing operation has been accomplished and it is ascertained that it is desirable to remove the material creating the stenosis by use of the work performing device in the form of the cutter member 167, the cutter member 167 can be advanced to the distal extremity of the cut-out 28. With the cut-out in the proper location, the balloon 41 can then be inflated through the balloon inflation port 156 to urge the housing 27 in a direction so that the stenosis enters the cutout. As soon as this has been accomplished, the cutter member 157 can be rotated at a high rate of speed and gradually retracted to cause the material forming the stenosis to be removed by the cutter member 157 and collected within the recess 171. This cutting and col-lecting operation can be continued until the cutter member 167 has been advanced to the extreme proximal position. At this time, the catheter apparatus can be removed and the tissue collected within the recesses 171 can be removed. Thereafter, additional insertions of the catheter apparatus can be made and the same cutting operations performed until the desired amount of material has been removed from the area of the stenosis to provide for increased blood flow through the vessel.
Another embodiment of a catheter apparatus incorporat-ing the present invention is shown in Figure 11 which is utilized solely for imaging purposes and in which the crystal remains in a fixed longitudinal position.
As can be seen from Figure 11, the catheter apparatus is constructed very similar to the catheter apparatus 180 shown in Figure 10 with the exception that the cutting mechanism has been eliminated. The use of such a catheter apparatus 180 is desirable where it is unnecessary to provide a cutting function. The cathe-ter apparatus 181 also has many parts which are similar to the catheter apparatus herebefore described. Thus there is provided a housing 181 which carries on its distal extremity a coil spring guide 36. A crystal 182 is provided in the distal extremity of the housing 27 and is disposed vertically or in a direction which is perpendicular to the longitudinal axis of the housing.
A sound absorbing backing material 183 is provided in the distal extremity of the housing behind the crystal 182. Conducting wires or leads 184 are connected to the crystal 182. The proximal extremity of the housing 27 is connected to the distal extremity of flexible elongate tubular element 186 which is connected to a two-arm adapter 187. The leads 184 extend through the tubular element 186 and are connected to sockets 188 provided in the arm 189 of the two-arm adapter 187.
The tubular element 186 is provided with a large lumen 191 which carries the drive cable 192. The drive cable 192 is connected to a clutch member 193 of the type hereinbefore described which is adapted to be driven by motive means in the manner hereinbefore described. The clutch member 193 is provided with a flange 194 which iZ9~589 cooperates with a flange 196 on the adapter 187. The adapter 187 carries an O-ring 197 seated against another flange 198 forming a part of the adapter 187.
The O-ring 197 forms a liquid-tight seal with respect to the drive cable 192. The clutch member 193 is thus held in a fixed longitudinal position while still permitting rotation of the same. The adapter 187 is provided with a tapered surface 199 adapted to fit into the motive drive means.
The drive cable 192 has its distal extremity secured to a rotating member 203 which is provided with a surface 204 inclined at an angle of 45 which serves as a reflector for reflecting ultrasonic energy generated by the crystal 182 in a direction which is substantially perpendicular to the longitudinal axis of the housing 27. The rotating member 193 as being rotated by the drive cable 192 remains in a fixed longitudinal position and cannot be advanced or retracted with respect to the ultrasonic crystal 182. The large lumen 191 is in communication with a side arm port 206 which forms a part of the two-arm adapter 187. The housing 181 as shown encloses the surface 204 and thus must be formed of a suitable material which is substantially transparent to ultrasonic energy. Alternatively, if desired, a cutout 207 as shown by the dashed lines can be provided through which the ultrasonic energy can pass.
The operation of the catheter apparatus 180 shown in Figure 11 is very similar to that hereinbefore described with the exception that the cutting operation is omitted. With this catheter apparatus, the device can be inserted in the same manner as with respect to the other devices hereinbefore described. When the A 42771/PATl lZ96589 device is in the desired location, as for example, in the stenosis, the stenosis can be imaged ultrasonically by causing the rotating member 203 to be rotated with respect to the crystal 182 to cause ultrasonic energy to be directed upwardly and outwardly through the housing 181 to impinge upon the sidewalls of the vessel in which the catheter apparatus 180 is positioned. If a different longitudinal position is desired to be scanned, the entire catheter apparatus 181 can be shifted longitudinally in the vessel to the desired location. After the ultrasonic imaging has been completed, the catheter apparatus 180 can be removed and other operations performed if desired with other instruments.
It should be appreciated that if desired another embodiment of catheter apparatus used solely for imaging can be provided by mounting the crystal at the end of the torque cable as illustrated in Figure 8 so that the crystal is rotated about an axis parallel to the longitudinal axis of the housing.
From the foregoing it can be seen that a two-dimensional ultrasound image is generated by rotating a crystal or a mirror which is located at the tip of the catheter. Good resolution is obtained because of the relatively high frequency i.e., 5 to 50 megahertz that is used. The image which is created is perpendicular to the longer axis of the catheter. The motor which is utilized for rotating the crystal is external to the patient. Rotation of the crystal is made possible because of the electrical connection made with the brush contacts. The use of the balloon stabilizes the housing so that the cutting operation can be readily accomplished.
12965~39 The apparatus and system of the present invention makes it possible to obtain images in very small vessels and has made it possible to accomplish the same by utiliz-ing the precision driving of a very flexible cable.
The catheter apparatus in addition to being capable of imaging is also capable of being steered by the flexi-ble guide wire secured to the tip.
It is apparent from the foregoing that there has been provided a catheter apparatus, system and method which is particularly useful for intravascular two-dimension ultrasonography which can be utilized with many differ-ent types of operations, as for example, in performing atherectomies.
FOR INTRAVASCULAR TWO-DIMENSIONAL ULTRASONOGRAPHY
This invention relates to a catheter apparatus, system and method for intravascular two-dimensional ultrasonography and more particularly to such an apparatus, system and method for providing high resolution imaging for assessing endovascular lesions and for monitoring the results of interventional therapy.
Ultrasonic two-dimensional imaging apparatus and systems have heretofore been provided for use in endoscopy for examining the gastrointestinal tract.
Such a device is disclosed in U.S. Patent No.
4,494,549.
Such devices have been relatively large and inflexible and are completely unsuitable for use in connection with the vascular system of the human body. In addition there is no provision for guiding such devices into specific branches of blood vessels. There is therefore a need for a new and improved catheter apparatus, system and method which can be utilized for performing intravascular two-dimension ultrasonography.
A 42771/PATl ~
lZ96589 In general, it is an object of the present invention to provide a catheter apparatus, system and method for intravascular two-dimensional ultrasonography.
Another object of the invention is to provide an apparatus, system and method of the above character which has a high resolution capability.
Another object of the invention is to provide an apparatus, system and method of the above character which can be utilized for assessing endovascular lesions.
Another object of the invention is to provide an apparatus, system and method of the above character which can be utilized for monitoring the results of interventional therapy.
Another object of the invention is to provide an apparatus, system and method of the above character which can be used with atherectomy devices.
Another object is to provide an apparatus, system and method capable of selective cannulation of branch vessels.
Additional objects and features of the invention will appear from the following description in which the preferred embodiments are set forth in detail in conjunction with the accompanying drawings.
Figure 1 is a side elevational view partially in cross section of a catheter apparatus incorporating the present invention.
Figure 2 is an enlarged cross sectional view of the distal extremity of the apparatus shown in Figure 1.
Figure 3 is an enlarged cross sectional view of an intermediate portion of the apparatus shown in Figure 1.
Figure 4 is an enlarged cross sectional view taken along the line 4-4 of Figure 1.
Figure 5 is an isometric view of the crystal assembly which forms a part of the apparatus shown in Figure 1.
Figure 6 is a schematic block diagram of the electrical and electronic apparatus utilized in the system.
Figure 7 is a two dimension display of an ultrasonogram which can be obtained with the apparatus and system shown in Figures 1-6.
Figure 8 is an enlarged cross-sectional view of another embodiment of a catheter apparatus incorporating the present invention.
Figure 9 is a cross-sectional view taken along the lines 9-9 of Figure 8.
Figure 10 is an enlarged cross-sectional view of still another embodiment of a catheter apparatus incorporating the present invention.
Figure 11 is an enlarged cross-sectional view of another embodiment of the catheter apparatus incorporating the present invention.
In general the catheter apparatus of the present invention consists of a flexible tubular element which is adapted to be inserted into a vessel in the vascular system. A flexible rotatable elongate element is disposed in the tubular element. An ultrasonic transducer is carried by the flexible tubular element.
Electrical circuitry is carried by the flexible tubular element and is connected to the ultrasonic transducer for supplying signals to and receiving signals from the transducer. In the system, a transmitter is provided for supplying signals to the ultrasonic transducer and a receiver is provided for receiving signals from the ultrasonic transducer. A motor is provided for rotating the flexible elongate element. Timing and control circuitry is provided for controlling the operation of the motor and the transmitter and receiver. A display is provided which is operated under the control of the timing and control circuitry for displaying the image information which is received by the receiver.
More in particular, the catheter apparatus 11 of the present invention consists of an elongate tubular assembly 12. The elongate tubular assembly 12 consists of an elongate tubular element 13 which is provided with four lumens 14, 16, 17 and 18 with the lumen 14 serving as a torque tube, lumen 16 serving as a balloon tube and lumens 17 and 18 serving as infusion tubes or lumens as hereinafter described. As can be seen the tubular element 13 is formed of a single extrusion which provides the four lumens with the lumens 14 and 16 being substantially circular in cross section and the lumens 17 and 18 being arcuate in shape with the configuration of each being determined by three arcs with one of the arcs being concentric with the outer A 42771/PATl ~` 1296589 diameter of the tubular element 13 and with the two smaller arcs being concentric with the lumens 14 and 16 respectively.
A braided shield 21 is provided on the exterior of the tubular element 13 and takes the form of one or more layers of braided strands 22 formed of a suitable magnetic material such as stainless steel strands. The shield 21 serves as an electrical shield. A cover tube 23 covers the braided shield 21 and extends the length of the tubular element 13. The cover tube 23 can be formed of a suitable material such as a heat shrinkable plastic which is shrunk tightly onto the braided shield 21 and provides a smooth outer surface so that the tubular assembly 12 can readily enter a vessel of the vascular system of a patient.
A work performing device consisting of a housing 27 is provided with a cut-out 28. A rotary cutter 29 is rotatably disposed within the housing 27 and is provided with a hub 31 that is secured to a flexible rotatable torque cable 32. The cable 32 is disposed in and extends through the torque tube lumen 14. The torque cable 32 is formed of a suitable material such as stainless steel. The housing 27 is provided with a rounded tip 33 having a recess 34 which is adapted to receive material which is removed by the rotary cutter 29 as the cutter 29 is advanced as hereinafter described. A spring tip guide or guide wire 36 capable of being shaped is secured to the rounded tip 33 and extends forwardly therefrom and lZ96589 serves to guide or steer the housing 27 as the tubular assembly 12 with the cutting device 26 secured thereto is introduced into the vessel of the vascular system of the patient. As shown, the spring tip guide 36 can be secured to the rounded tip 33 by suitable means such as solder 37. It thus can be seen that the guide wire 36 is associated with the housing 27. Alternatively a movable guide wire can be carried by the housing for facilitating steering of the housing into the desired vessel of the patient.
A balloon 41 of an expandable type is secured to the housing in a region opposite the cutout 28 and has its distal extremity bonded around the tip 33 by suitable means such as an adhesive 42. As shown in Figure 2, the balloon 41 underlies substantially the entire length of the housing 27. The balloon 41 is in communication with a balloon tube 43 which extends through the balloon tube lumen 16 in the tubular element 13. The balloon tube 43 is provided with a lumen 44 through which a medium can be introduced for inflating the balloon 41 and removed for deflating the balloon 41. The proximal extremity of the balloon 41 and the proximal extremity of the housing 27 is secured to the distal extremity of the tubular assembly 12 by suitable means such as heat shrinkable tubing 46.
Means is provided for imaging the region in which the work performing device 26 is located and in this particular case, with the present invention takes the form of a two-dimensional ultrasound image system 49.
The system 49 includes a single crystal 51 (see Figure 5) which is mounted on the hub 31 and is secured thereto by suitable means such as an adhesive. The crystal 51 is part of an assembly 52. The crystal 51 A 42771/PATl -` lZ96S89 should be capable of operating at a frequency range of 5 to 50 megahertz and typically can be formed of a suitable material such as barium titanate or cinnabar.
As can be seen from Figure 5, the crystal 51 has a rectangular block-like configuration and has two opposed surfaces covered by metallic conducting films 53 and 54 formed of a suitable material such as chrome or gold. The material of the films can be formed of a foil or can be in the form of films evaporated or sputtered onto the opposite surfaces of the crystal 51.
The films 53 and 54 serve as electrodes and are connected to connecting wires 56 and 57 by suitable means such as solder. Means is provided for damping out the oscillations from the backside of the crystal 51 and takes the form of a rectangular block 58 formed of a suitable backing material. This backing material can be formed in a conventional manner so as to cancel out oscillations from the side of a crystal in which the backing material is disposed.
The wires 56 and 57 are braided onto the torque cable 32 and rotate with the torque cable. The wires 56 and 57 extend towards the proximal extremity of the tubular assembly 12 and extend into a fitting 61 (see Figure 3) formed of a suitable material such as plastic. A pair of spaced apart slip rings 62 and 63 formed of a conducting material such as copper are secured to the torque cable 32. The wire 56 is bonded to the slip ring 62 and the wire 57 is bonded to the slip ring 63.
A fitting 66 is provided which has a threaded bore 67.
The tubular assembly 12 extends through the fitting 66 and a reinforcing sleeve 68 extends over the portion of the tubular assembly 12 extending therethrough. A pair of spring urged contacts 71 and 72 are carried by the fitting 66 and are adapted to slidably engage the slip A 42771/PATl ~Z~6589 rings 62 and 63. The contacts 71 and 72 are connected to conductors 73 and 74. A grounding lug 76 is provided on the fitting 66 and makes electrical contact with the braided shield 21. A conductor 77 is connected to the grounding lug 76.
A male fitting 78 (see Figure 1) is threaded into the threaded bore 67. A single arm adapter 81 is mounted in the male fitting 78 and carries an arm 82 having thereon a balloon inflation port 83 that is in communication with the lumen 44 in the balloon tube 43 disposed in the tubular assembly 12. The single arm adapter 81 is secured to a rotating adapter 86 of a conventional type and through which the tubular assembly 12 extends. Another single arm adapter 87 is mounted in the rotating adapter and is provided with a side arm 88 having an infusion port 89 disposed therein which is in communication with the infusion lumens 17 and 18 provided in the tubular assembly 12. A tapered fitting 91 is mounted in the single arm adapter 87 and is provided with a threaded bore 92 which carries an O-ring 93 that is adapted to be engaged by a male type fitting 94 to form a liquid-tight seal between the tubular assembly 12 and the torque cable 32 which extends therethrough. The torque cable 32 is secured to a suitable drive member such as a clutch member 98 of the type described in U.S. Patent 4,771,774. The clutch member 98 is adapted to be secured to motive drive means of the type described therein consisting of a motor drive unit which in the present application is identified as a motor 99 (see Figure 6). The motor 99 is driven by and is under the control of electronic lZ96589 circuitry forming a part of system 49. The part of the system 49 shown in block diagram form is substantially conventional and can be of a suitable type such as certain equipment identified as Model 851B manufactured by Advanced Technology Laboratories, Inc. of Bothel, Washington. As shown in Figure 5, ;Uc]l apI)c.lctls includes a timing and control block 102 which supplies pulses to a transmitter 103. The output of the transmitter 103 is supplied through a transmit receive switch 104 which supplies the signals on the conductors 73 and 74 through the slip rings 62 and 63 onto the conductors 56 and 57 connected to the crystal 51.
During the time that the transmitter 103 is supplying high frequency energy to the crystal, the crystal 52 is being rotated by the motor driving the torque cable 32 with the motor 99 being under the control of the timing and control block 102. The motor 99 is of a type such as an open loop stepping motor or a closed drop servo controlled motor which can be driven by the timing and control block 102.
The transmitter generates a high voltage pulse in the 100 to 300 volt range for excitation of the transducer crystal 51. Supplying high voltage pulses to the crystal causes the transducer to produce sonic waves which emanate therefrom into the surrounding tissue structure. Portions of the sonic energy wave reflected by the tissue structure back to the transducer and the transducer 51 acts as a receiver and picks up the sonic vibrations and converts them into electrical signals which are supplied by the conducting wires 56 and 57 back to the slip rings 62 and 63 through the conductors 73 and 74 and through the transmit receive switch 104 to a receiver 106. These signals are amplified and supplied to a display unit 107 which includes a CRT
lZ965~39 screen 108 under the control of the timing and control block 102 to supply an image 109 on the display 108 which can be of the type shown in Figure 7. As can be seen from Figure 7, as viewed through 360, the vessel wall 111 of the image 109 is shown as indicated having different cross sections depending upon the build-up of plaque therein. A central region 112 of the image is eclipsed because of the imaging catheter. Alternative-ly, if desired only a sector of a lesser angle than 360 can be viewed.
The catheter apparatus of the present invention can be constructed in various sizes. For example, in a 9 French size, the balloon can have a length of approximately 100 millimeters and a diameter of approximately 3 millimeters (9 French). Sizes down to 3 French can be accomplished with the construction of the present invention.
Operation and use of the catheter apparatus, system and method during intravascular ultrasonography can now be briefly described as follows. Let it be assumed that it is desired to utilize the apparatus, system and method of the present invention to remove the atheroma in a blood vessel of a patient. The catheter of the catheter apparatus of the present invention is introduced into a vessel of the patient as, for example, into the femoral artery and introducing the A
catheter into the artery by the use of the guide wire 36. The progress of the catheter into the vessel of the patient can be observed under x-ray fluoroscopy.
As soon as the cutting device has entered into a region which is desired to remove certain material from the vessel and before a cutting operation is commenced, the atheroma itself can be viewed by operation of the ultrasonic imaging system 49. This can be accomplished by operating the timing control block 102 to cause operation of the motor 99 which in turn causes rotation of the torque cable 32 and the crystal assembly 52 to S scan the interior of the vessel in which the crystal 51 is disposed. An image of what is being scanned will appear on the screen 108 of the display device 107.
During the time this rotary scanning is taking place, the cable 32 can be advanced to advance the cutter so that the entire region in which the material is to be removed can be scanned. After the scan, the cable 32 can be retracted slightly so that the proximal extremi-ty of the cutout 28 lies at the proximal extremity of the atheroma. In order to stabilize the cutting device, the balloon 41 can be inflated so as to urge the cutout 28 of the housing 27 towards the portion of the atheroma it is desired to remove. The motor 99 can then be energized to rotate the cutter 29. As the cutter 29 is rotated, it can be advanced to progres-sively remove the material which is disposed within thecutout 28 of the housing 27. As this material is removed it is pushed forwardly and eventually moves into the recess 34. The balloon 41 can then be deflat-ed and the catheter apparatus removed from the vessel after which the material which has been deposited in the recess 34 can be removed and the cutting device cleaned for reinsertion into the vessel of the patient for removal of additional material from the vessel if A
required.
During the time that the cutting operation is taking place, the cutting operation can be viewed ultrason-ically by the rotating crystal 51 which places an image on the screen 108. From this image it can be ascer-tained how well the cutter is performing in removing A 42771/PATl lZ96589 the material and whether or not an additional pass of the cutter is required. It should be appreciated that if necessary several passes of the cutter can be made and if necessary, the catheter assembly can be removed from the vessel of the patient to clean out material which has been removed and deposited in a recess 34.
Another embodiment of the catheter apparatus of the present invention is shown in Figure 8. Many of the parts are very similar to the parts utilized in the embodiment of the invention shown in Figure 1 and have been given the corresponding numerals. The distal extremity of the catheter apparatus shown-in Figure 8 differs from the apparatus shown in Figure 1 in that the conducting wires or leads connected to the ultrasonic crystal 52 are connected to the outside world at a point which is proximal of an adapter 122 whereas in the embodiment shown in Figure 1, the connectors are connected at a point which is distal of the adapters 82 and 88. Thus there is shown an adapter 122 which is provided with an arm 123 through which dye injection and pressure measurements can be made and another fitting 124 which can be utilized in inflating and deflating the balloon 41. Another adapter 126 is provided which is threaded into the proximal end of the adapter 22 and forms a sealing engagement with an O-ring 127 carried by the adapter 122. The torque cable 32 extends through the adapter 126 and is connected to a clutch member 128. The clutch member 128 which carries a finger operated member 129 is adapted to be secured to motorized drive means of the type hereinbefore described for causing rotation of the torque cable 32.
As hereinbefore explained, the conducting wires connected to the ultrasonic crystal 52 are braided into the guide wire 32. Means is carried by the adapter 126 which is adapted to make contact with the conducting wires connected to the crystal 52 and consists of brushes 131 and 132 which are yieldably urged by springs 133 towards the torque cable 32 so as to make contact with the conducting wires or leads carried by the guide wire 32. The springs 133 are held in place by pins 134 which are frictionally seated within the adapter 126. Conducting wires 136 and 137 are connected to the pins 134. These wires 136 and 137 are connected into the system in a manner hereinbefore described with the previous embodiments. The operation of this embodiment is very similar to that described in conjunction with the operation of the embodiment shown in Figure 1.
Operation of this embodiment of the invention is very similar to that hereinbefore described with the princi-pal advantage being that leads which are connected to the crystal 52 for supplying pulses of energy to the crystal and for receiving signals from the crystal are disposed proximally of the two arm adapter 122.
Still another embodiment of the catheter apparatus of the present invention is shown in Figure 10. Certain parts of this catheter apparatus 146 are very similar to those hereinbefore described and are identified by the same numbers. Thus there has been provided a housing 27 which has an outwardly facing cutout 28. A
coil spring guide wire 36 is secured to the distal extremity of the housing 27 as shown. The balloon 41 is carried by the housing and has its distal extremity secured to the housing by a band 92. The balloon 41 is A 42771/PATl disposed outside of the housing 27 on the side opposite the cutout 28. A flexible tubular assembly 151 is secured to the proximal end of the housing 27. A
three-arm adapter 152 is mounted on the proximal extremity of the tubular assembly 151. The tubular assembly 151 consists of a flexible tubular element 153 formed of a suitable material such as plastic which is provided with a balloon lumen 154 that is in communication with the interior of the balloon 41 and extends into a balloon inflation port 156 provided as a part of the three-arm adapter 152.
A crystal 157 is carried by the housing 27 in a stationary position. As shown, the crystal 157 is lS mounted vertically or in a direction which is at right angles to the longitudinal axis of the housing 27. It can be mounted in the proximal extremity of the housing 27 in a suitable manner such as by an adhesive. A
suitable sound absorbing material 158 is provided behind the ultrasonic crystal 157 and fills the space between the crystal 157 and the distal extremity of the housing 27. A pair of conducting wires 161 are con-nected to the ultrasonic crystal 157 and extend rear-wardly through the housing 27 and are connected into sockets 162 provided in a side arm 163 forming a part of the adapter 152.
The flexible tubular element 153 is provided with a large lumen 163 extending the length thereof and which has a rototable flexible drive cable 166 disposed therein. The flexible drive cable 166 is formed in the manner hereinbefore described and is secured to a generally cylindrical member 167 which as hereinafter described serves as a reflector mount and also serves to carry the cutter. Thus as shown, the member 167 is ~ ~296S89 provided with a surface 168 which is inclined at an angle of approximately 45 and faces the crystal 157 in such a manner so that sound waves propagated by the crystal impinge upon the surface 168 and are propagated outwardly in a direction substantially at right angles to the longitudinal axis of the housing. Since the reflector surface 168 is provided on the distal end of the member 167, the circular cutting edge 169 is provided on the member 167 at the proximal extremity thereof. A truncated conical recess 171 is provided in the proximal extremity of the member 167. The conical recess 171 can be used as a reservoir for collecting material as it is removed by the circular cutting edge 169.
The three-arm adapter 152 is provided with another arm 173 which serves as an infusion port and which is in communication with the lumen 164 through which the drive cable 166 extends. This lumen 164 opens into the interior of the housing 127 and is in communication with the cutout 28. Another adapter 176 is provided which is threaded into the proximal extremity of the adapter 162 and engages an O-ring 177. The drive cable 166 extends through the adapter 176 and has its distal extremity secured to the clutch member 128. As hereinbefore explained, the clutch member 128 can be secured to a motorized drive means for causing rotational movement of the cutter and mirror member 167.
Operation of the catheter apparatus shown in Pigure 10 may now be described as follows. The operation of this device in many respects is very similar to that herein-before described with respect to the placement of the catheter in the vessel. The housing can be positioned A 42771/PATl in the stenosis hereinbefore described and ultrasonic imaging can be carried out by supplying pulses of electrical energy to the ultrasonic crystal 157 which emanates ultrasonic energy and directs the same onto the 45 reflector 168 which reflects the ultrasonic energy up into the tissue which is immediately opposite the cutout 28. Rotation of the mirror 168 causes an image to be formed which can be viewed in the manner hereinbefore described. This imaging can be carried out by rotating the cable 166 and at the same time advancing the drive cable 166 throughout the length of the cutout 28 to view the stenosis. After the viewing operation has been accomplished and it is ascertained that it is desirable to remove the material creating the stenosis by use of the work performing device in the form of the cutter member 167, the cutter member 167 can be advanced to the distal extremity of the cut-out 28. With the cut-out in the proper location, the balloon 41 can then be inflated through the balloon inflation port 156 to urge the housing 27 in a direction so that the stenosis enters the cutout. As soon as this has been accomplished, the cutter member 157 can be rotated at a high rate of speed and gradually retracted to cause the material forming the stenosis to be removed by the cutter member 157 and collected within the recess 171. This cutting and col-lecting operation can be continued until the cutter member 167 has been advanced to the extreme proximal position. At this time, the catheter apparatus can be removed and the tissue collected within the recesses 171 can be removed. Thereafter, additional insertions of the catheter apparatus can be made and the same cutting operations performed until the desired amount of material has been removed from the area of the stenosis to provide for increased blood flow through the vessel.
Another embodiment of a catheter apparatus incorporat-ing the present invention is shown in Figure 11 which is utilized solely for imaging purposes and in which the crystal remains in a fixed longitudinal position.
As can be seen from Figure 11, the catheter apparatus is constructed very similar to the catheter apparatus 180 shown in Figure 10 with the exception that the cutting mechanism has been eliminated. The use of such a catheter apparatus 180 is desirable where it is unnecessary to provide a cutting function. The cathe-ter apparatus 181 also has many parts which are similar to the catheter apparatus herebefore described. Thus there is provided a housing 181 which carries on its distal extremity a coil spring guide 36. A crystal 182 is provided in the distal extremity of the housing 27 and is disposed vertically or in a direction which is perpendicular to the longitudinal axis of the housing.
A sound absorbing backing material 183 is provided in the distal extremity of the housing behind the crystal 182. Conducting wires or leads 184 are connected to the crystal 182. The proximal extremity of the housing 27 is connected to the distal extremity of flexible elongate tubular element 186 which is connected to a two-arm adapter 187. The leads 184 extend through the tubular element 186 and are connected to sockets 188 provided in the arm 189 of the two-arm adapter 187.
The tubular element 186 is provided with a large lumen 191 which carries the drive cable 192. The drive cable 192 is connected to a clutch member 193 of the type hereinbefore described which is adapted to be driven by motive means in the manner hereinbefore described. The clutch member 193 is provided with a flange 194 which iZ9~589 cooperates with a flange 196 on the adapter 187. The adapter 187 carries an O-ring 197 seated against another flange 198 forming a part of the adapter 187.
The O-ring 197 forms a liquid-tight seal with respect to the drive cable 192. The clutch member 193 is thus held in a fixed longitudinal position while still permitting rotation of the same. The adapter 187 is provided with a tapered surface 199 adapted to fit into the motive drive means.
The drive cable 192 has its distal extremity secured to a rotating member 203 which is provided with a surface 204 inclined at an angle of 45 which serves as a reflector for reflecting ultrasonic energy generated by the crystal 182 in a direction which is substantially perpendicular to the longitudinal axis of the housing 27. The rotating member 193 as being rotated by the drive cable 192 remains in a fixed longitudinal position and cannot be advanced or retracted with respect to the ultrasonic crystal 182. The large lumen 191 is in communication with a side arm port 206 which forms a part of the two-arm adapter 187. The housing 181 as shown encloses the surface 204 and thus must be formed of a suitable material which is substantially transparent to ultrasonic energy. Alternatively, if desired, a cutout 207 as shown by the dashed lines can be provided through which the ultrasonic energy can pass.
The operation of the catheter apparatus 180 shown in Figure 11 is very similar to that hereinbefore described with the exception that the cutting operation is omitted. With this catheter apparatus, the device can be inserted in the same manner as with respect to the other devices hereinbefore described. When the A 42771/PATl lZ96589 device is in the desired location, as for example, in the stenosis, the stenosis can be imaged ultrasonically by causing the rotating member 203 to be rotated with respect to the crystal 182 to cause ultrasonic energy to be directed upwardly and outwardly through the housing 181 to impinge upon the sidewalls of the vessel in which the catheter apparatus 180 is positioned. If a different longitudinal position is desired to be scanned, the entire catheter apparatus 181 can be shifted longitudinally in the vessel to the desired location. After the ultrasonic imaging has been completed, the catheter apparatus 180 can be removed and other operations performed if desired with other instruments.
It should be appreciated that if desired another embodiment of catheter apparatus used solely for imaging can be provided by mounting the crystal at the end of the torque cable as illustrated in Figure 8 so that the crystal is rotated about an axis parallel to the longitudinal axis of the housing.
From the foregoing it can be seen that a two-dimensional ultrasound image is generated by rotating a crystal or a mirror which is located at the tip of the catheter. Good resolution is obtained because of the relatively high frequency i.e., 5 to 50 megahertz that is used. The image which is created is perpendicular to the longer axis of the catheter. The motor which is utilized for rotating the crystal is external to the patient. Rotation of the crystal is made possible because of the electrical connection made with the brush contacts. The use of the balloon stabilizes the housing so that the cutting operation can be readily accomplished.
12965~39 The apparatus and system of the present invention makes it possible to obtain images in very small vessels and has made it possible to accomplish the same by utiliz-ing the precision driving of a very flexible cable.
The catheter apparatus in addition to being capable of imaging is also capable of being steered by the flexi-ble guide wire secured to the tip.
It is apparent from the foregoing that there has been provided a catheter apparatus, system and method which is particularly useful for intravascular two-dimension ultrasonography which can be utilized with many differ-ent types of operations, as for example, in performing atherectomies.
Claims (42)
1. A catheter apparatus for obtaining an image of a patient's vessel having a wall comprising:
a flexible tubular element adapted for insertion into the body lumen, the tubular element having distal and proximal extremities;
a housing having distal and proximal ends and a longitudinal axis, the proximal end of the housing being secured to the distal extremity of the tubular element, the housing having a portion thereof that is substantially transparent to ultrasonic energy;
ultrasonic means for generating ultrasonic signals and directing the ultrasonic signals in a direction that is substantially perpendicular to the longitudinal axis of the housing and for receiving reflections of the signals generated, the ultrasonic means including a rotatable member that is movable longitudinally and rotatably relative to the housing during scanning to permit scanning a discrete length of the vessel wall;
drive means extending through the tubular element and connected to the rotatable member for causing both longitudinal and rotational movement of the rotatable member with respect to the housing about the longitudinal axis of the housing whereby the ultrasonic signals generated by the ultrasonic means are directed onto the vessel wall and the ultrasonic signals reflected by the vessel wall are received by the ultrasonic means;
and a cutting element secured to said rotatable member for longitudinal movement relative to the housing, said cutting element having a circular cutting edge lying in a plane which is substantially perpendicular to the longitudinal axis of the housing.
a flexible tubular element adapted for insertion into the body lumen, the tubular element having distal and proximal extremities;
a housing having distal and proximal ends and a longitudinal axis, the proximal end of the housing being secured to the distal extremity of the tubular element, the housing having a portion thereof that is substantially transparent to ultrasonic energy;
ultrasonic means for generating ultrasonic signals and directing the ultrasonic signals in a direction that is substantially perpendicular to the longitudinal axis of the housing and for receiving reflections of the signals generated, the ultrasonic means including a rotatable member that is movable longitudinally and rotatably relative to the housing during scanning to permit scanning a discrete length of the vessel wall;
drive means extending through the tubular element and connected to the rotatable member for causing both longitudinal and rotational movement of the rotatable member with respect to the housing about the longitudinal axis of the housing whereby the ultrasonic signals generated by the ultrasonic means are directed onto the vessel wall and the ultrasonic signals reflected by the vessel wall are received by the ultrasonic means;
and a cutting element secured to said rotatable member for longitudinal movement relative to the housing, said cutting element having a circular cutting edge lying in a plane which is substantially perpendicular to the longitudinal axis of the housing.
2. Apparatus as in claim 1 together with means carried by the housing for collecting material which is removed by the cutting edge.
3. Apparatus as in claim 1 wherein the cutting element includes a recess formed therein for receiving material removed by the cutting edge.
4. Apparatus as in claim 1 together with flexible guide wire means associated with the housing for facilitating steering of the catheter apparatus.
5. Apparatus as in claim 1 wherein the circular cutting edge faces in a direction towards the distal extremity of the housing.
6. Apparatus as in claim 1 wherein the circular cutting edge faces in a direction toward the proximal extremity of the housing.
7. In a catheter apparatus for obtaining an image of a vessel in the vascular system of a patient, a flexible tubular element adapted to be inserted into the vessel and having a longitudinal axis, a flexible rotatable element disposed within the tubular element for rotational movement about the longitudinal axis relative to the tubular element, an ultrasonic transducer carried by the flexible tubular element for generating and receiving ultrasonic signals, electrical circuit means carried by the tubular element and connected to the transducer for supplying signals to and receiving signals from the transducer, and drive means for imparting longitudinal and rotational movement to the rotatable element and directing means mounted on the rotatable element for causing the ultrasonic signals to be directed outwardly and received inwardly relative to the axis of rotation of the rotatable element during rotational and longitudinal movement of the rotatable element so that the ultrasonic signals are rotated and moved longitudinally to provide an image of the portion of the vessel being viewed.
8. A catheter apparatus as in claim 7 together with means for displaying an image from the signals received from the transducer during rotating of the rotatable element.
9. A catheter apparatus as in claim 7 wherein said reducing means is a cutting device.
10. A catheter apparatus as in claim 7 wherein said ultrasonic transducer includes a crystal together with a backing material carried by the crystal for inhibiting propagation of sonic waves from the crystal in the direction of the backing material.
11. A catheter apparatus as in claim 7 wherein said circuit means is carried by the tubular element.
12. In a catheter apparatus for obtaining in image of a vessel in the vascular system of a patient, a flexible tubular element adapted to be inserted into the vessel, a flexible rotatable element disposed within the tubular element for rotational movement relative to the tubular element, an ultrasonic transducer carried by the flexible tubular element for generating ultrasonic signals, electrical circuit means carried by the tubular element and connected to the transducer for supplying signals to and receiving signals from the transducer, and drive means for imparting rotational movement to the rotatable element and directing means mounted on the rotatable element for causing the ultrasonic signals to be directed outwardly and received inwardly relative to the axis of rotation of the rotatable element during rotation of the rotatable element to provide information with respect to an image of the portion of the vessel being viewed and reducing means secured to the rotatable element for reducing a stenosis within the vessel, the ultrasonic transducer being disposed in relatively close proximity to the reducing means.
13. A catheter apparatus as in claim 12 together with inflatable balloon carried by the reducing means and adapted to be inflated to stabilize the reducing means, and wherein said tubular element includes means for inflating and deflating the balloon.
14. In a catheter system for obtaining an image of a vessel in a vascular system, an elongate flexible element adapted to enter the vessel, a flexible rotatable elongate element disposed in the tubular element, an ultrasonic transducer carried by the flexible rotatable element and being rotatable therewith for scanning the vessel, motor means for rotating the flexible rotatable element, the flexible rotatable element and the transducer carried thereby being movable longitudinally with respect to the tubular element, transmitter means coupled to the ultrasonic transducer and producing electrical signals and supplying the same to the ultrasonic transducer to cause ultrasonic waves to be propagated therefrom and to be shifted longitudinally as the rotatable element is moved longitudinally and rotated as the rotatable element is rotated, receiver means coupled to the ultrasonic transducer, the ultrasonic transducer being capable of receiving reflected ultrasonic waves and supplying electrical signals to the receiver means, timing control means for causing operation of the transmitter means, the receiver means and the motor means and means connected to the receiver means for creating a visual display of the vessel being scanned by the ultrasonic transducer.
15. A system as in claim 14 together with a work performing device carried by the flexible rotatable element.
16. In a method for obtaining an image of a vessel in the vascular system of a patient using a vascularly interventional catheter having a cutting means for reducing a stenosis within the vessel, and a housing that carries an ultrasonic transducer, introducing the catheter into the vessel, scanning the vessel ultrasonically both rotationally and longitudinally while the cutting means is being operated and creating an image from the scan.
17. A catheter apparatus for obtaining an image of a vascular vessel having a wall comprising:
an elongate flexible tubular element having distal and proximal extremities;
a housing having distal and proximal ends and a longitudinal axis, the proximal end of the housing being secured to the distal extremity of the tubular element, the housing having a portion thereof that is substantially transparent to ultrasonic energy;
ultrasonic means for generating ultrasonic signals and directing the ultrasonic signals in a direction that is substantially perpendicular to the longitudinal axis of the housing and toward the wall of the vessel and for receiving reflections from the walls of the vessel of the ultrasonic signals generated, the ultrasonic means including a rotatable member that is movable longitudinally and rotatably relative to the housing during scanning to permit scanning a discrete length of the vessel; and motorized drive means extending through the tubular element and connected to the rotatable member and being movable longitudinally and for causing rotational movement of the rotatable member with respect to the housing about the longitudinal axis of the housing so that the ultrasonic signals generated are rotated and can be moved longitudinally with respect to the wall of the vessel.
an elongate flexible tubular element having distal and proximal extremities;
a housing having distal and proximal ends and a longitudinal axis, the proximal end of the housing being secured to the distal extremity of the tubular element, the housing having a portion thereof that is substantially transparent to ultrasonic energy;
ultrasonic means for generating ultrasonic signals and directing the ultrasonic signals in a direction that is substantially perpendicular to the longitudinal axis of the housing and toward the wall of the vessel and for receiving reflections from the walls of the vessel of the ultrasonic signals generated, the ultrasonic means including a rotatable member that is movable longitudinally and rotatably relative to the housing during scanning to permit scanning a discrete length of the vessel; and motorized drive means extending through the tubular element and connected to the rotatable member and being movable longitudinally and for causing rotational movement of the rotatable member with respect to the housing about the longitudinal axis of the housing so that the ultrasonic signals generated are rotated and can be moved longitudinally with respect to the wall of the vessel.
18. Apparatus as recited in claim 17 wherein said rotatable member carries the ultrasonic transducer.
19. Apparatus as in claim 17 wherein said rotatable member is a reflector inclined at an angle of approximately 45° and wherein the transducer is disposed in a direction which is perpendicular to the longitudinal axis of the housing and is mounted in a fixed position in the housing, whereby ultrasonic energy from the transducer is directed onto the reflector and reflected ultrasonic energy is received by the reflector and directed onto the transducer.
20. Apparatus as in claim 17 wherein the housing is provided with a cutout on one side, together with an inflatable balloon carried by the housing and disposed on the exterior of the housing on the side of the housing opposite the cutout and means carried by the tubular element for inflating and deflating the inflatable balloon.
21. A catheter apparatus for obtaining an image of a vascular vessel having a stenosis therein comprising:
a flexible tubular element adapted for insertion into the vascular vessel, the tubular element having distal and proximal extremities;
a housing having distal and proximal ends and a longitudinal axis, the proximal end of the housing being secured to the distal extremity of the tubular element, the housing having a portion thereof that is substantially transparent to ultrasonic energy;
ultrasonic means for generating ultrasonic signals and directing the ultrasonic signals in a direction that is substantially perpendicular to the longitudinal axis of the housing and for receiving reflections of the signals generated, the ultrasonic means including a rotatable member that is movable longitudinally and rotatably relative to the housing during scanning to permit scanning a discrete length of the vessel;
drive means extending through the tubular element and connected to the rotatable member permitting longitudinal movement and for causing rotational movement of the rotatable member with respect to the housing about the longitudinal axis of the housing so that the ultrasonic signals generated by the ultrasonic means are directed onto the vessel and the ultrasonic signals reflected by the vessel are received by the ultrasonic means; and means coupled to said drive means for removing materials from the stenosis including a cutter having an annular cutting edge.
a flexible tubular element adapted for insertion into the vascular vessel, the tubular element having distal and proximal extremities;
a housing having distal and proximal ends and a longitudinal axis, the proximal end of the housing being secured to the distal extremity of the tubular element, the housing having a portion thereof that is substantially transparent to ultrasonic energy;
ultrasonic means for generating ultrasonic signals and directing the ultrasonic signals in a direction that is substantially perpendicular to the longitudinal axis of the housing and for receiving reflections of the signals generated, the ultrasonic means including a rotatable member that is movable longitudinally and rotatably relative to the housing during scanning to permit scanning a discrete length of the vessel;
drive means extending through the tubular element and connected to the rotatable member permitting longitudinal movement and for causing rotational movement of the rotatable member with respect to the housing about the longitudinal axis of the housing so that the ultrasonic signals generated by the ultrasonic means are directed onto the vessel and the ultrasonic signals reflected by the vessel are received by the ultrasonic means; and means coupled to said drive means for removing materials from the stenosis including a cutter having an annular cutting edge.
22. A catheter apparatus for obtaining an image of a vascular vessel having a wall comprising:
a flexible tubular member adapted for insertion into the vascular vessel and having a longitudinal axis;
ultrasonic means for generating ultrasonic signals and detecting reflections of the ultrasonic signals, the ultrasonic means including a rotatable element disposed within the tubular member and adapted for rotational and longitudinal movement relative to the longitudinal axis of the tubular member, the rotatable element directing the ultrasonic signals outwardly from the catheter apparatus towards the wall of the vessel;
drive means connected to the rotatable element and extending through the tubular member for rotating the rotational element relative to the longitudinal axis of the tubular member, and permitting longitudinal movement of the rotatable element along the longitudinal axis; and reducing means carried by the tubular member for reducing a stenosis within the vessel, the reducing means and the ultrasonic means being adapted so that imaging of the vessel can occur simultaneously while reducing the stenosis.
a flexible tubular member adapted for insertion into the vascular vessel and having a longitudinal axis;
ultrasonic means for generating ultrasonic signals and detecting reflections of the ultrasonic signals, the ultrasonic means including a rotatable element disposed within the tubular member and adapted for rotational and longitudinal movement relative to the longitudinal axis of the tubular member, the rotatable element directing the ultrasonic signals outwardly from the catheter apparatus towards the wall of the vessel;
drive means connected to the rotatable element and extending through the tubular member for rotating the rotational element relative to the longitudinal axis of the tubular member, and permitting longitudinal movement of the rotatable element along the longitudinal axis; and reducing means carried by the tubular member for reducing a stenosis within the vessel, the reducing means and the ultrasonic means being adapted so that imaging of the vessel can occur simultaneously while reducing the stenosis.
23. In a catheter apparatus for obtaining an image of a vessel in a body and reducing a stenosis within the vessel the vessel having a vessel wall;
a flexible tubular element adapted for insertion into the vessel and having a longitudinal axis;
a cutter rotatable relative to the tubular element with respect to the longitudinal axis of the tubular element for reducing the stenosis;
ultrasonic means for generating ultrasonic signals and detecting reflections of the ultrasonic signals, the ultrasonic means including a rotatable element adapted for rotational movement with the cutter relative to the longitudinal axis of the tubular member for directing the ultrasonic signals outwardly from the catheter apparatus towards the vessel wall; and drive means connected to the cutter and rotatable element and extending through the tubular member for rotating the cutter and rotatable element relative to the tubular member.
a flexible tubular element adapted for insertion into the vessel and having a longitudinal axis;
a cutter rotatable relative to the tubular element with respect to the longitudinal axis of the tubular element for reducing the stenosis;
ultrasonic means for generating ultrasonic signals and detecting reflections of the ultrasonic signals, the ultrasonic means including a rotatable element adapted for rotational movement with the cutter relative to the longitudinal axis of the tubular member for directing the ultrasonic signals outwardly from the catheter apparatus towards the vessel wall; and drive means connected to the cutter and rotatable element and extending through the tubular member for rotating the cutter and rotatable element relative to the tubular member.
24. A catheter apparatus as in claim 23, further comprising a motor means for rotating the drive means.
25. In a catheter apparatus for obtaining an image of the wall of a vessel in the vascular system of a patient, an elongate flexible tubular element having distal and proximal extremities, said distal extremity having a longitudinal axis, flexible guide wire means adapted to extend beyond the distal extremity of the tubular element longitudinally of the longitudinal axis of the distal extremity of the tubular element, the flexible guide wire means and the tubular element being of a size such that they can be readily introduced into the vessel, the tubular element and the flexible guide wire means having a flexibility so that the distal extremity of the tubular element can be advanced in the vessel and follow the path of the vessel, the distal extremity of the tubular element having a portion thereof which is substantially transparent to ultrasonic energy, means including an ultrasonic transducer disposed within the distal extremity of the tubular element for generating ultrasonic energy and for directing the same through said portion toward the wall of the vessel, electrical circuit means connected to the ultrasonic transducer and carried by the tubular element and motor-driven elongate flexible drive means extending through the flexible tubular element and connected to said means for generating and directing ultrasonic energy.
26. A catheter apparatus as in claim 25 wherein said distal extremity of the tubular element is in the form of a housing.
27. A catheter apparatus as in claim 26 wherein the flexible guide wire means is secured to the housing.
28. A catheter apparatus as in claim 25 wherein the means disposed within the tubular element for generating ultrasonic energy and for directing the same also includes a rotatable mirror connected to the flexible drive means.
29. A method for imaging the interior wall of a blood vessel, said method comprising:
generating an ultrasonic signal within the blood vessel;
sweeping the signal in a predetermined pattern about the interior wall of the blood vessel;
receiving ultrasonic signal reflected from the interior wall of the blood vessel; and producing an image from the reflected signal.
generating an ultrasonic signal within the blood vessel;
sweeping the signal in a predetermined pattern about the interior wall of the blood vessel;
receiving ultrasonic signal reflected from the interior wall of the blood vessel; and producing an image from the reflected signal.
30. A method as in claim 29, wherein the ultrasonic signal has a frequency in the range from about 5 to 50 megahertz.
31. A method as in claim 29, wherein the generated ultrasonic signal is directed generally axially relative to the blood vessel and deflected transversely by a rotating reflective surface.
32. A method as in claim 29, wherein the generated signal is directed generally transversely by a rotating transducer.
33. A method as in claim 29, wherein the ultrasonic signal is directed at a forward angle of from about 10° to 85° relative to the axis of the blood vessel, whereby a conical scan is performed.
34. A method as in claim 29, further comprising axially advancing the ultrasonic signal within the blood vessel.
35. A method for imaging the interior of a blood vessel, said method comprising:
positioning a distal end of a flexible tubular member proximate a preselected region within a blood vessel;
sweeping a transducer element through a preselected pattern within said distal end;
generating an ultrasonic signal from the transducer, which signal impinges against the interior wall of the blood vessel;
receiving ultrasonic energy reflected from the wall with the transducer; and producing an image based on the reflected ultrasonic energy.
positioning a distal end of a flexible tubular member proximate a preselected region within a blood vessel;
sweeping a transducer element through a preselected pattern within said distal end;
generating an ultrasonic signal from the transducer, which signal impinges against the interior wall of the blood vessel;
receiving ultrasonic energy reflected from the wall with the transducer; and producing an image based on the reflected ultrasonic energy.
36. A method as in claim 35, wherein the transducer is oriented to direct the ultrasonic signal substantially transversely to the axis of the tubular member, whereby a transverse planar scan is performed.
37. A method as in claim 35, wherein the transducer is oriented to direct the ultrasonic signal at a forward angle in the range from about 10° to 85° relative to the axis of the tubular member, whereby a conical scan is performed.
38. A method as in claim 35, further comprising axially advancing the distal end of the flexible tubular member within the blood vessel to produce successive cross-sectional images.
39. A method for imaging the interior of a blood vessel, said method comprising:
positioning a distal end of a flexible tubular member proximate a preselected region within a blood vessel;
directing an ultrasonic signal against a reflective surface within the distal end of the flexible tubular member;
manipulating the reflective surface to reflect the ultrasonic signal in a preselected pattern within the blood vessel;
receiving ultrasonic energy reflected from within the blood vessel; and producing an image based on the reflected ultrasonic energy.
positioning a distal end of a flexible tubular member proximate a preselected region within a blood vessel;
directing an ultrasonic signal against a reflective surface within the distal end of the flexible tubular member;
manipulating the reflective surface to reflect the ultrasonic signal in a preselected pattern within the blood vessel;
receiving ultrasonic energy reflected from within the blood vessel; and producing an image based on the reflected ultrasonic energy.
40. A method as in claim 39, wherein the reflective surface is inclined at a fixed angle relative to the tubular axis and wherein manipulating the reflective surface comprises rotating said surface about said axis.
41. A method as in claim 40, wherein the ultrasonic signal is directed substantially axially and said mirror is inclined at about 45°, whereby a transverse cross-sectional image is produced.
42. A method as in claim 40, wherein the ultrasonic signal is directed substantially axially and said mirror is inclined at an angle between about 5° and 45°, whereby the ultrasonic signal is swept about a conical pattern.
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US834,893 | 1986-02-28 | ||
US06/834,893 US4794931A (en) | 1986-02-28 | 1986-02-28 | Catheter apparatus, system and method for intravascular two-dimensional ultrasonography |
Publications (1)
Publication Number | Publication Date |
---|---|
CA1296589C true CA1296589C (en) | 1992-03-03 |
Family
ID=25268066
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA000530748A Expired - Lifetime CA1296589C (en) | 1986-02-28 | 1987-02-27 | Catheter apparatus, system and method for intravascular two-dimensional ultrasonography |
Country Status (7)
Country | Link |
---|---|
US (1) | US4794931A (en) |
EP (2) | EP0234951B2 (en) |
JP (3) | JPH0757222B2 (en) |
CA (1) | CA1296589C (en) |
DE (2) | DE3752336T2 (en) |
DK (1) | DK105187A (en) |
NO (1) | NO176123C (en) |
Families Citing this family (527)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5002553A (en) * | 1984-05-14 | 1991-03-26 | Surgical Systems & Instruments, Inc. | Atherectomy system with a clutch |
US4894051A (en) * | 1984-05-14 | 1990-01-16 | Surgical Systems & Instruments, Inc. | Atherectomy system with a biasing sleeve and method of using the same |
US4957111A (en) * | 1985-09-13 | 1990-09-18 | Pfizer Hospital Products Group, Inc. | Method of using a doppler catheter |
US5000185A (en) | 1986-02-28 | 1991-03-19 | Cardiovascular Imaging Systems, Inc. | Method for intravascular two-dimensional ultrasonography and recanalization |
US5582178A (en) * | 1986-02-28 | 1996-12-10 | Cardiovascular Imaging Systems, Inc. | Method and apparatus for intravascular ultrasonography |
US4794931A (en) * | 1986-02-28 | 1989-01-03 | Cardiovascular Imaging Systems, Inc. | Catheter apparatus, system and method for intravascular two-dimensional ultrasonography |
US5350395A (en) * | 1986-04-15 | 1994-09-27 | Yock Paul G | Angioplasty apparatus facilitating rapid exchanges |
US4920967A (en) * | 1986-07-18 | 1990-05-01 | Pfizer Hospital Products Group, Inc. | Doppler tip wire guide |
US4841977A (en) * | 1987-05-26 | 1989-06-27 | Inter Therapy, Inc. | Ultra-thin acoustic transducer and balloon catheter using same in imaging array subassembly |
US4917097A (en) * | 1987-10-27 | 1990-04-17 | Endosonics Corporation | Apparatus and method for imaging small cavities |
GB2212267B (en) * | 1987-11-11 | 1992-07-29 | Circulation Res Ltd | Methods and apparatus for the examination and treatment of internal organs |
DE3854570T2 (en) * | 1987-11-13 | 1996-05-02 | Advanced Diagnostic Med Syst | Ultrasonic probe. |
US4870953A (en) * | 1987-11-13 | 1989-10-03 | Donmicheal T Anthony | Intravascular ultrasonic catheter/probe and method for treating intravascular blockage |
US4899757A (en) * | 1988-02-22 | 1990-02-13 | Intertherapy, Inc. | Ultrasound imaging probe with zero dead space |
US5368035A (en) * | 1988-03-21 | 1994-11-29 | Boston Scientific Corporation | Ultrasound imaging guidewire |
US5372138A (en) | 1988-03-21 | 1994-12-13 | Boston Scientific Corporation | Acousting imaging catheters and the like |
US4911172A (en) * | 1988-03-28 | 1990-03-27 | Telectronics Pacing Systems, Inc. | Probe tip ultrasonic transducers and method of manufacture |
EP0347098B1 (en) * | 1988-06-13 | 1996-02-28 | Samuel Shiber | Atherectomy system with a guide-wire |
US4886059A (en) * | 1988-06-23 | 1989-12-12 | Applied Biometrics, Incorporated | Endotracheal tube with asymmetric balloon |
US4911170A (en) * | 1988-08-22 | 1990-03-27 | General Electric Company | High frequency focused ultrasonic transducer for invasive tissue characterization |
DE3829603A1 (en) * | 1988-09-01 | 1990-03-15 | Kontron Holding Ag | ULTRASONIC DOSCOPE DEVICE |
US4947852A (en) * | 1988-10-05 | 1990-08-14 | Cardiometrics, Inc. | Apparatus and method for continuously measuring volumetric blood flow using multiple transducer and catheter for use therewith |
US5178159A (en) * | 1988-11-02 | 1993-01-12 | Cardiometrics, Inc. | Torqueable guide wire assembly with electrical functions, male and female connectors rotatable with respect to one another |
GB8829182D0 (en) | 1988-12-14 | 1989-01-25 | Univ Birmingham | Surgical instrument |
US5049130A (en) * | 1988-12-23 | 1991-09-17 | Cardiovascular Imaging Systems, Inc. | System and method for pressure filling of catheters |
US5728129A (en) * | 1989-02-17 | 1998-03-17 | American Biomed, Inc. | Distal atherectomy catheter |
US5087265A (en) * | 1989-02-17 | 1992-02-11 | American Biomed, Inc. | Distal atherectomy catheter |
US4994067A (en) * | 1989-02-17 | 1991-02-19 | American Biomed, Inc. | Distal atherectomy catheter |
DE3914619A1 (en) * | 1989-05-03 | 1990-11-08 | Kontron Elektronik | DEVICE FOR TRANSOESOPHAGEAL ECHOCARDIOGRAPHY |
US5078723A (en) * | 1989-05-08 | 1992-01-07 | Medtronic, Inc. | Atherectomy device |
US5022399A (en) * | 1989-05-10 | 1991-06-11 | Biegeleisen Ken P | Venoscope |
US5284148A (en) * | 1989-05-16 | 1994-02-08 | Hewlett-Packard Company | Intracavity ultrasound diagnostic probe using fiber acoustic waveguides |
GB2233094B (en) * | 1989-05-26 | 1994-02-09 | Circulation Res Ltd | Methods and apparatus for the examination and treatment of internal organs |
US5029588A (en) * | 1989-06-15 | 1991-07-09 | Cardiovascular Imaging Systems, Inc. | Laser catheter with imaging capability |
US5269793A (en) * | 1989-07-20 | 1993-12-14 | Devices For Vascular Intervention, Inc. | Guide wire systems for intravascular catheters |
EP0483270A4 (en) * | 1989-07-20 | 1992-09-09 | Devices For Vascular Intervention, Inc. | Improved guide wire systems for intravascular catheters |
US5010886A (en) * | 1989-08-18 | 1991-04-30 | Intertherapy, Inc. | Medical probe assembly having combined ultrasonic imaging and laser ablation capabilities |
US5115814A (en) | 1989-08-18 | 1992-05-26 | Intertherapy, Inc. | Intravascular ultrasonic imaging probe and methods of using same |
US5125410A (en) * | 1989-10-13 | 1992-06-30 | Olympus Optical Co., Ltd. | Integrated ultrasonic diagnosis device utilizing intra-blood-vessel probe |
US5240003A (en) * | 1989-10-16 | 1993-08-31 | Du-Med B.V. | Ultrasonic instrument with a micro motor having stator coils on a flexible circuit board |
US5024234A (en) * | 1989-10-17 | 1991-06-18 | Cardiovascular Imaging Systems, Inc. | Ultrasonic imaging catheter with guidewire channel |
US5344395A (en) * | 1989-11-13 | 1994-09-06 | Scimed Life Systems, Inc. | Apparatus for intravascular cavitation or delivery of low frequency mechanical energy |
US5085662A (en) * | 1989-11-13 | 1992-02-04 | Scimed Life Systems, Inc. | Atherectomy catheter and related components |
US5069664A (en) * | 1990-01-25 | 1991-12-03 | Inter Therapy, Inc. | Intravascular ultrasonic angioplasty probe |
US5916210A (en) * | 1990-01-26 | 1999-06-29 | Intraluminal Therapeutics, Inc. | Catheter for laser treatment of atherosclerotic plaque and other tissue abnormalities |
US5108411A (en) * | 1990-03-28 | 1992-04-28 | Cardiovascular Imaging Systems, Inc. | Flexible catheter drive cable |
US5117831A (en) * | 1990-03-28 | 1992-06-02 | Cardiovascular Imaging Systems, Inc. | Vascular catheter having tandem imaging and dilatation components |
US5095911A (en) * | 1990-05-18 | 1992-03-17 | Cardiovascular Imaging Systems, Inc. | Guidewire with imaging capability |
US5558093A (en) * | 1990-05-18 | 1996-09-24 | Cardiovascular Imaging Systems, Inc. | Guidewire with imaging capability |
US5100424A (en) * | 1990-05-21 | 1992-03-31 | Cardiovascular Imaging Systems, Inc. | Intravascular catheter having combined imaging abrasion head |
US5520189A (en) * | 1990-07-13 | 1996-05-28 | Coraje, Inc. | Intravascular ultrasound imaging guidewire |
US5156155A (en) * | 1990-07-25 | 1992-10-20 | Hewlett-Packard Company | Transesophageal probe shaft |
WO1992003095A1 (en) * | 1990-08-21 | 1992-03-05 | Boston Scientific Corporation | Acoustic imaging catheter and the like |
US5254112A (en) * | 1990-10-29 | 1993-10-19 | C. R. Bard, Inc. | Device for use in laser angioplasty |
JPH04183461A (en) * | 1990-11-19 | 1992-06-30 | Aloka Co Ltd | Ultrasonic diagnostic and therapeutic device |
JPH0738853B2 (en) * | 1990-11-19 | 1995-05-01 | アロカ株式会社 | Ultrasonic probe |
US5269291A (en) * | 1990-12-10 | 1993-12-14 | Coraje, Inc. | Miniature ultrasonic transducer for plaque ablation |
US5054492A (en) * | 1990-12-17 | 1991-10-08 | Cardiovascular Imaging Systems, Inc. | Ultrasonic imaging catheter having rotational image correlation |
ATE157269T1 (en) | 1990-12-17 | 1997-09-15 | Cardiovascular Imaging Systems | VASCULAR CATHETER HAVING A LOW PROFILE DISTAL END |
US5167233A (en) * | 1991-01-07 | 1992-12-01 | Endosonics Corporation | Dilating and imaging apparatus |
US5957882A (en) * | 1991-01-11 | 1999-09-28 | Advanced Cardiovascular Systems, Inc. | Ultrasound devices for ablating and removing obstructive matter from anatomical passageways and blood vessels |
US5267954A (en) * | 1991-01-11 | 1993-12-07 | Baxter International Inc. | Ultra-sound catheter for removing obstructions from tubular anatomical structures such as blood vessels |
US5380274A (en) * | 1991-01-11 | 1995-01-10 | Baxter International Inc. | Ultrasound transmission member having improved longitudinal transmission properties |
US5304115A (en) * | 1991-01-11 | 1994-04-19 | Baxter International Inc. | Ultrasonic angioplasty device incorporating improved transmission member and ablation probe |
US5405318A (en) * | 1992-05-05 | 1995-04-11 | Baxter International Inc. | Ultra-sound catheter for removing obstructions from tubular anatomical structures such as blood vessels |
US5447509A (en) * | 1991-01-11 | 1995-09-05 | Baxter International Inc. | Ultrasound catheter system having modulated output with feedback control |
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 |
US5368557A (en) * | 1991-01-11 | 1994-11-29 | Baxter International Inc. | Ultrasonic ablation catheter device having multiple ultrasound transmission members |
US5368558A (en) * | 1991-01-11 | 1994-11-29 | Baxter International Inc. | Ultrasonic ablation catheter device having endoscopic component and method of using same |
US5243988A (en) * | 1991-03-13 | 1993-09-14 | Scimed Life Systems, Inc. | Intravascular imaging apparatus and methods for use and manufacture |
WO1992016147A1 (en) * | 1991-03-13 | 1992-10-01 | Scimed Life Systems, Inc. | Intravascular imaging apparatus and method |
US5438997A (en) * | 1991-03-13 | 1995-08-08 | Sieben; Wayne | Intravascular imaging apparatus and methods for use and manufacture |
US5353798A (en) * | 1991-03-13 | 1994-10-11 | Scimed Life Systems, Incorporated | Intravascular imaging apparatus and methods for use and manufacture |
US5201316A (en) * | 1991-03-18 | 1993-04-13 | Cardiovascular Imaging Systems, Inc. | Guide wire receptacle for catheters having rigid housings |
US5193546A (en) * | 1991-05-15 | 1993-03-16 | Alexander Shaknovich | Coronary intravascular ultrasound imaging method and apparatus |
US5152293A (en) * | 1991-07-01 | 1992-10-06 | Northwestern University | Finger-mounted intraoperative imaging device |
US6029671A (en) * | 1991-07-16 | 2000-02-29 | Heartport, Inc. | System and methods for performing endovascular procedures |
ATE190821T1 (en) * | 1991-09-04 | 2000-04-15 | David S Zimmon | BIOPSY APPARATUS |
US5209235A (en) * | 1991-09-13 | 1993-05-11 | Cardiovascular Imaging Systems, Inc. | Ultrasonic imaging catheter assembly and method for identification of the same |
US5249580A (en) * | 1991-10-08 | 1993-10-05 | Griffith James M | Method for ultrasound imaging |
US5327885A (en) * | 1991-10-08 | 1994-07-12 | Griffith James M | Combination catheter for invasive probe delivery and balloon dilation |
US5201315A (en) * | 1991-10-08 | 1993-04-13 | Griffith James M | Ultrasound imaging sheath |
WO1993008750A2 (en) * | 1991-11-04 | 1993-05-13 | Baxter International Inc. | Ultrasonic ablation device adapted for guidewire passage |
US5713363A (en) * | 1991-11-08 | 1998-02-03 | Mayo Foundation For Medical Education And Research | Ultrasound catheter and method for imaging and hemodynamic monitoring |
US5704361A (en) * | 1991-11-08 | 1998-01-06 | Mayo Foundation For Medical Education And Research | Volumetric image ultrasound transducer underfluid catheter system |
ES2241210T3 (en) * | 1991-11-08 | 2005-10-16 | Mayo Foundation For Medical Education And Research | ULTRASOUND TRANSVASCULAR HEMODINAMIC CATHETER. |
US5325860A (en) | 1991-11-08 | 1994-07-05 | Mayo Foundation For Medical Education And Research | Ultrasonic and interventional catheter and method |
EP0625266B1 (en) | 1992-02-07 | 1999-05-06 | WINSTON, Thomas R. | Method and apparatus for ultrasonic inspection of inaccessible areas |
WO1993016642A1 (en) * | 1992-02-21 | 1993-09-02 | Boston Scientific Corporation | Ultrasound imaging guidewire |
US5226421A (en) * | 1992-03-06 | 1993-07-13 | Cardiometrics, Inc. | Doppler elongate flexible member having an inflatable balloon mounted thereon |
US5246007A (en) * | 1992-03-13 | 1993-09-21 | Cardiometrics, Inc. | Vascular catheter for measuring flow characteristics and method |
US5331947A (en) * | 1992-05-01 | 1994-07-26 | Shturman Cardiology Systems, Inc. | Inflatable sheath for introduction of ultrasonic catheter through the lumen of a fiber optic endoscope |
US5190046A (en) * | 1992-05-01 | 1993-03-02 | Shturman Cardiology Systems, Inc. | Ultrasound imaging balloon catheter |
US5271402A (en) * | 1992-06-02 | 1993-12-21 | Hewlett-Packard Company | Turbine drive mechanism for steering ultrasound signals |
US6996432B2 (en) * | 1992-06-30 | 2006-02-07 | Scimed Life Systems, Inc. | Automated longitudinal position translator for ultrasonic imaging probes, and methods of using same |
US5361768A (en) * | 1992-06-30 | 1994-11-08 | Cardiovascular Imaging Systems, Inc. | Automated longitudinal position translator for ultrasonic imaging probes, and methods of using same |
US5382228A (en) * | 1992-07-09 | 1995-01-17 | Baxter International Inc. | Method and device for connecting ultrasound transmission member (S) to an ultrasound generating device |
US5242386A (en) * | 1992-08-27 | 1993-09-07 | Sontech Limited | Echographic suction cannula |
US5383460A (en) * | 1992-10-05 | 1995-01-24 | Cardiovascular Imaging Systems, Inc. | Method and apparatus for ultrasound imaging and atherectomy |
US5356418A (en) * | 1992-10-28 | 1994-10-18 | Shturman Cardiology Systems, Inc. | Apparatus and method for rotational atherectomy |
US5360432A (en) * | 1992-10-16 | 1994-11-01 | Shturman Cardiology Systems, Inc. | Abrasive drive shaft device for directional rotational atherectomy |
US5312427A (en) * | 1992-10-16 | 1994-05-17 | Shturman Cardiology Systems, Inc. | Device and method for directional rotational atherectomy |
WO1995022283A1 (en) * | 1992-10-26 | 1995-08-24 | Ultrasonic Sensing & Monitoring Systems, Inc. | Catheter using optical fibers to transmit laser and ultrasonic energy |
US5314408A (en) * | 1992-11-13 | 1994-05-24 | Cardiovascular Imaging Systems, Inc. | Expandable member for a catheter system |
US5364347A (en) * | 1992-11-13 | 1994-11-15 | Cardiovascular Imaging Systems, Inc. | Catheter system having a balloon angioplasty device disposed over a work element lumen and method of use |
US6712783B1 (en) * | 1992-11-13 | 2004-03-30 | Cardiovascular Imaging, Inc. | Catheter system having a balloon angioplasty device disposed over a work element lumen |
US5373849A (en) * | 1993-01-19 | 1994-12-20 | Cardiovascular Imaging Systems, Inc. | Forward viewing imaging catheter |
US5306261A (en) * | 1993-01-22 | 1994-04-26 | Misonix, Inc. | Catheter with collapsible wire guide |
US20070016071A1 (en) * | 1993-02-01 | 2007-01-18 | Volcano Corporation | Ultrasound transducer assembly |
US5453575A (en) * | 1993-02-01 | 1995-09-26 | Endosonics Corporation | Apparatus and method for detecting blood flow in intravascular ultrasonic imaging |
US5368037A (en) * | 1993-02-01 | 1994-11-29 | Endosonics Corporation | Ultrasound catheter |
US5429136A (en) * | 1993-04-21 | 1995-07-04 | Devices For Vascular Intervention, Inc. | Imaging atherectomy apparatus |
US5441510A (en) * | 1993-09-01 | 1995-08-15 | Technology Development Center | Bi-axial cutter apparatus for catheter |
US5409000A (en) * | 1993-09-14 | 1995-04-25 | Cardiac Pathways Corporation | Endocardial mapping and ablation system utilizing separately controlled steerable ablation catheter with ultrasonic imaging capabilities and method |
US5462529A (en) * | 1993-09-29 | 1995-10-31 | Technology Development Center | Adjustable treatment chamber catheter |
US5417672A (en) * | 1993-10-04 | 1995-05-23 | Baxter International Inc. | Connector for coupling an ultrasound transducer to an ultrasound catheter |
US5427118A (en) * | 1993-10-04 | 1995-06-27 | Baxter International Inc. | Ultrasonic guidewire |
US5421334A (en) * | 1993-10-06 | 1995-06-06 | Cardiovascular Imaging Systems, Inc. | Pre-filled imaging catheter |
US5390678A (en) * | 1993-10-12 | 1995-02-21 | Baxter International Inc. | Method and device for measuring ultrasonic activity in an ultrasound delivery system |
US5427107A (en) * | 1993-12-07 | 1995-06-27 | Devices For Vascular Intervention, Inc. | Optical encoder for catheter device |
AU1399995A (en) * | 1993-12-09 | 1995-06-27 | Devices For Vascular Intervention, Inc. | Composite drive shaft |
US5377685A (en) * | 1993-12-17 | 1995-01-03 | Baylis Medical Company, Inc. | Ultrasound catheter with mechanically steerable beam |
DE69432510T2 (en) * | 1993-12-24 | 2003-12-24 | Olympus Optical Co | Device for ultrasound diagnosis and treatment, wherein the focal point of the therapeutic ultrasound wave is locked in a predetermined position within the ultrasound observation area |
US5503155A (en) * | 1994-01-26 | 1996-04-02 | Cardiovascular Imaging Systems, Inc. | Drive cable having internal lead wires |
US5363850A (en) * | 1994-01-26 | 1994-11-15 | Cardiovascular Imaging Systems, Inc. | Method for recognition and reduction of blood speckle in blood vessel imaging system |
US5363849A (en) * | 1994-01-26 | 1994-11-15 | Cardiovascular Imaging Systems, Inc. | Enhancing intravascular ultrasonic blood vessel image |
US5485840A (en) * | 1994-03-15 | 1996-01-23 | Bauman; Robert P. | Method of precise guidance for directional atherectomy using ultrasound |
US5388584A (en) * | 1994-04-15 | 1995-02-14 | Hewlett-Packard Company | Method and apparatus for prevention of fluid intrusion in a probe shaft |
US5919161A (en) * | 1994-05-04 | 1999-07-06 | Devices For Vascular Intervention | Guidewire migration controller |
US5499632A (en) * | 1994-05-04 | 1996-03-19 | Devices For Vascular Intervention | Guide wire migration controller |
US5733277A (en) * | 1994-06-22 | 1998-03-31 | Pallarito; Allan L. | Optical fibre and laser for removal of arterial or vascular obstructions |
US5606975A (en) * | 1994-09-19 | 1997-03-04 | The Board Of Trustees Of The Leland Stanford Junior University | Forward viewing ultrasonic imaging catheter |
US5503154A (en) * | 1994-10-13 | 1996-04-02 | Cardiovascular Imaging Systems, Inc. | Transducer for intraluminal ultrasound imaging catheter with provision for electrical isolation of transducer from the catheter core |
US6689086B1 (en) | 1994-10-27 | 2004-02-10 | Advanced Cardiovascular Systems, Inc. | Method of using a catheter for delivery of ultrasonic energy and medicament |
US5507294A (en) * | 1995-01-17 | 1996-04-16 | Hewlett Packard Company | Ultrasound diagnostic probe having non-rotating acoustic imaging waveguide |
US5509418A (en) * | 1995-01-17 | 1996-04-23 | Hewlett-Packard Co. | Ultrasound diagnostic probe having acoustically driven turbin |
AU708976B2 (en) * | 1995-03-30 | 1999-08-19 | Edwards Lifesciences Ag | System and methods for performing endovascular procedures |
US5707354A (en) * | 1995-04-17 | 1998-01-13 | Cardiovascular Imaging Systems, Inc. | Compliant catheter lumen and methods |
US5485845A (en) * | 1995-05-04 | 1996-01-23 | Hewlett Packard Company | Rotary encoder for intravascular ultrasound catheter |
US5596990A (en) | 1995-06-06 | 1997-01-28 | Yock; Paul | Rotational correlation of intravascular ultrasound image with guide catheter position |
JP2705643B2 (en) * | 1995-06-06 | 1998-01-28 | 松下電器産業株式会社 | Ultrasound diagnostic equipment |
US6377846B1 (en) | 1997-02-21 | 2002-04-23 | Medtronic Ave, Inc. | Device for delivering localized x-ray radiation and method of manufacture |
EP0847249A4 (en) | 1995-08-24 | 2004-09-29 | Medtronic Ave Inc | X-ray catheter |
AU709432B2 (en) | 1995-09-20 | 1999-08-26 | California Institute Of Technology | Detecting thermal discrepancies in vessel walls |
US6615071B1 (en) | 1995-09-20 | 2003-09-02 | Board Of Regents, The University Of Texas System | Method and apparatus for detecting vulnerable atherosclerotic plaque |
US6763261B2 (en) | 1995-09-20 | 2004-07-13 | Board Of Regents, The University Of Texas System | Method and apparatus for detecting vulnerable atherosclerotic plaque |
US5640961A (en) * | 1995-09-25 | 1997-06-24 | Hewlett-Packard Company | Device with aspherical compensation for focusing ultrasound |
US6375615B1 (en) | 1995-10-13 | 2002-04-23 | Transvascular, Inc. | Tissue penetrating catheters having integral imaging transducers and their methods of use |
US6302875B1 (en) * | 1996-10-11 | 2001-10-16 | Transvascular, Inc. | Catheters and related devices for forming passageways between blood vessels or other anatomical structures |
IL151563A0 (en) | 1995-10-13 | 2003-04-10 | Transvascular Inc | A longitudinal compression apparatus for compressing tissue |
US6283951B1 (en) | 1996-10-11 | 2001-09-04 | Transvascular, Inc. | Systems and methods for delivering drugs to selected locations within the body |
US5830222A (en) * | 1995-10-13 | 1998-11-03 | Transvascular, Inc. | Device, system and method for intersititial transvascular intervention |
US5749848A (en) * | 1995-11-13 | 1998-05-12 | Cardiovascular Imaging Systems, Inc. | Catheter system having imaging, balloon angioplasty, and stent deployment capabilities, and method of use for guided stent deployment |
US5868685A (en) * | 1995-11-14 | 1999-02-09 | Devices For Vascular Intervention | Articulated guidewire |
US5671747A (en) * | 1996-01-24 | 1997-09-30 | Hewlett-Packard Company | Ultrasound probe having interchangeable accessories |
US5733296A (en) * | 1996-02-06 | 1998-03-31 | Devices For Vascular Intervention | Composite atherectomy cutter |
CA2246284C (en) * | 1996-02-15 | 2008-01-29 | Biosense, Inc. | Catheter with lumen |
US6270477B1 (en) * | 1996-05-20 | 2001-08-07 | Percusurge, Inc. | Catheter for emboli containment |
US5779643A (en) * | 1996-11-26 | 1998-07-14 | Hewlett-Packard Company | Imaging guidewire with back and forth sweeping ultrasonic source |
US5647367A (en) * | 1996-05-31 | 1997-07-15 | Hewlett-Packard Company | Scanning ultrasonic probe with locally-driven sweeping ultrasonic source |
US5699805A (en) * | 1996-06-20 | 1997-12-23 | Mayo Foundation For Medical Education And Research | Longitudinal multiplane ultrasound transducer underfluid catheter system |
US5662671A (en) | 1996-07-17 | 1997-09-02 | Embol-X, Inc. | Atherectomy device having trapping and excising means for removal of plaque from the aorta and other arteries |
US5924997A (en) * | 1996-07-29 | 1999-07-20 | Campbell; Thomas Henderson | Catheter and method for the thermal mapping of hot spots in vascular lesions of the human body |
US20020077564A1 (en) * | 1996-07-29 | 2002-06-20 | Farallon Medsystems, Inc. | Thermography catheter |
US6245026B1 (en) | 1996-07-29 | 2001-06-12 | Farallon Medsystems, Inc. | Thermography catheter |
US5906636A (en) | 1996-09-20 | 1999-05-25 | Texas Heart Institute | Heat treatment of inflamed tissue |
US5830145A (en) | 1996-09-20 | 1998-11-03 | Cardiovascular Imaging Systems, Inc. | Enhanced accuracy of three-dimensional intraluminal ultrasound (ILUS) image reconstruction |
US7603166B2 (en) | 1996-09-20 | 2009-10-13 | Board Of Regents University Of Texas System | Method and apparatus for detection of vulnerable atherosclerotic plaque |
US5916170A (en) * | 1996-09-24 | 1999-06-29 | The Board Of Trustees Of The Leland Stanford Junior University | Method and apparatus for curvature detection in vessels from phase shifts of a plurality of input electrical signals |
US5827313A (en) | 1996-09-27 | 1998-10-27 | Boston Scientific Corporation | Device for controlled longitudinal movement of an operative element within a catheter sheath and method |
US5957941A (en) | 1996-09-27 | 1999-09-28 | Boston Scientific Corporation | Catheter system and drive assembly thereof |
US5699806A (en) * | 1996-10-01 | 1997-12-23 | Hewlett-Packard Company | Ultrasound system with nonuniform rotation corrector |
US5701901A (en) * | 1996-11-26 | 1997-12-30 | Hewlett Packard Company | Ultrasonic probe with back and forth sweeping ultrasonic source |
US5857974A (en) * | 1997-01-08 | 1999-01-12 | Endosonics Corporation | High resolution intravascular ultrasound transducer assembly having a flexible substrate |
US5846205A (en) * | 1997-01-31 | 1998-12-08 | Acuson Corporation | Catheter-mounted, phased-array ultrasound transducer with improved imaging |
US5795299A (en) * | 1997-01-31 | 1998-08-18 | Acuson Corporation | Ultrasonic transducer assembly with extended flexible circuits |
US5797848A (en) * | 1997-01-31 | 1998-08-25 | Acuson Corporation | Ultrasonic transducer assembly with improved electrical interface |
US5938616A (en) | 1997-01-31 | 1999-08-17 | Acuson Corporation | Steering mechanism and steering line for a catheter-mounted ultrasonic transducer |
US5954654A (en) * | 1997-01-31 | 1999-09-21 | Acuson Corporation | Steering mechanism and steering line for a catheter-mounted ultrasonic transducer |
US6464645B1 (en) | 1997-01-31 | 2002-10-15 | Acuson Corporation | Ultrasonic transducer assembly controller |
EP1007139A4 (en) | 1997-02-12 | 2000-06-14 | Prolifix Medical Inc | Apparatus for removal of material from stents |
US5882329A (en) * | 1997-02-12 | 1999-03-16 | Prolifix Medical, Inc. | Apparatus and method for removing stenotic material from stents |
DE69823406T2 (en) * | 1997-02-21 | 2005-01-13 | Medtronic AVE, Inc., Santa Rosa | X-ray device provided with a strain structure for local irradiation of the interior of a body |
US6183487B1 (en) | 1997-03-06 | 2001-02-06 | Scimed Life Systems, Inc. | Ablation device for reducing damage to vessels and/or in-vivo stents |
US5814064A (en) * | 1997-03-06 | 1998-09-29 | Scimed Life Systems, Inc. | Distal protection device |
US7094249B1 (en) | 1997-03-06 | 2006-08-22 | Boston Scientific Scimed, Inc. | Distal protection device and method |
US6042553A (en) | 1997-04-15 | 2000-03-28 | Symbiosis Corporation | Linear elastic member |
US6676682B1 (en) * | 1997-05-08 | 2004-01-13 | Scimed Life Systems, Inc. | Percutaneous catheter and guidewire having filter and medical device deployment capabilities |
US5911734A (en) | 1997-05-08 | 1999-06-15 | Embol-X, Inc. | Percutaneous catheter and guidewire having filter and medical device deployment capabilities |
US6171247B1 (en) | 1997-06-13 | 2001-01-09 | Mayo Foundation For Medical Education And Research | Underfluid catheter system and method having a rotatable multiplane transducer |
US6095976A (en) * | 1997-06-19 | 2000-08-01 | Medinol Ltd. | Method for enhancing an image derived from reflected ultrasound signals produced by an ultrasound transmitter and detector inserted in a bodily lumen |
US5854822A (en) * | 1997-07-25 | 1998-12-29 | Xrt Corp. | Miniature x-ray device having cold cathode |
GB2329709B (en) * | 1997-09-26 | 2001-12-19 | Roke Manor Research | Catheter localisation system |
ES2253832T3 (en) | 1997-09-29 | 2006-06-01 | Boston Scientific Limited | GUIDE WIRE FOR TAKING INTRAVASCULAR IMAGES. |
US5951480A (en) * | 1997-09-29 | 1999-09-14 | Boston Scientific Corporation | Ultrasound imaging guidewire with static central core and tip |
US6078831A (en) * | 1997-09-29 | 2000-06-20 | Scimed Life Systems, Inc. | Intravascular imaging guidewire |
US6066149A (en) * | 1997-09-30 | 2000-05-23 | Target Therapeutics, Inc. | Mechanical clot treatment device with distal filter |
US5954649A (en) * | 1997-10-20 | 1999-09-21 | Irvine Biomedical, Inc. | Catheter system having ultrasound locating capabilities |
US6126607A (en) * | 1997-11-03 | 2000-10-03 | Barzell-Whitmore Maroon Bells, Inc. | Ultrasound interface control system |
IL122839A0 (en) * | 1997-12-31 | 1998-08-16 | Ultra Guide Ltd | Calibration method and apparatus for calibrating position sensors on scanning transducers |
CN1285900A (en) | 1997-12-31 | 2001-02-28 | 杰克·W·罗马诺 | Method and apparatus for transferring drilling energy to cutting member |
US6081738A (en) | 1998-01-15 | 2000-06-27 | Lumend, Inc. | Method and apparatus for the guided bypass of coronary occlusions |
WO1999035980A1 (en) | 1998-01-15 | 1999-07-22 | Lumend, Inc. | Catheter apparatus for guided transvascular treatment of arterial occlusions |
US5865748A (en) * | 1998-01-16 | 1999-02-02 | Guidant Corporation | Guided directional coronary atherectomy distal linear encoder |
US6108402A (en) * | 1998-01-16 | 2000-08-22 | Medtronic Ave, Inc. | Diamond vacuum housing for miniature x-ray device |
AU1927399A (en) | 1998-01-16 | 1999-08-02 | Lumend, Inc. | Catheter apparatus for treating arterial occlusions |
US6344037B1 (en) * | 1998-02-03 | 2002-02-05 | Scimed Life Systems, Inc. | Integrated coaxial transmission line and flexible drive cable |
US6120454A (en) * | 1998-02-03 | 2000-09-19 | Boston Scientific Corporation | Annular array ultrasound catheter |
US6017312A (en) * | 1998-02-03 | 2000-01-25 | Boston Scientific Corporation | Multi-channel rotary transformer |
US6096054A (en) * | 1998-03-05 | 2000-08-01 | Scimed Life Systems, Inc. | Expandable atherectomy burr and method of ablating an occlusion from a patient's blood vessel |
US6069938A (en) * | 1998-03-06 | 2000-05-30 | Chornenky; Victor Ivan | Method and x-ray device using pulse high voltage source |
ATE392858T1 (en) | 1998-03-31 | 2008-05-15 | Medtronic Vascular Inc | CATHETER AND SYSTEMS FOR A PERCUTANE INSITU ARTERIO-VENOUS BYPASS |
US6482217B1 (en) * | 1998-04-10 | 2002-11-19 | Endicor Medical, Inc. | Neuro thrombectomy catheter |
US6666874B2 (en) * | 1998-04-10 | 2003-12-23 | Endicor Medical, Inc. | Rotational atherectomy system with serrated cutting tip |
US6001112A (en) | 1998-04-10 | 1999-12-14 | Endicor Medical, Inc. | Rotational atherectomy device |
US6004271A (en) | 1998-05-07 | 1999-12-21 | Boston Scientific Corporation | Combined motor drive and automated longitudinal position translator for ultrasonic imaging system |
US6019726A (en) * | 1998-06-10 | 2000-02-01 | Hewlett-Packard Company | Catheter having probes for correcting for non-uniform rotation of a transducer located within the catheter |
US5989191A (en) * | 1998-06-19 | 1999-11-23 | Hewlettt-Packard Company | Using doppler techniques to measure non-uniform rotation of an ultrasound transducer |
US6113546A (en) | 1998-07-31 | 2000-09-05 | Scimed Life Systems, Inc. | Off-aperture electrical connection for ultrasonic transducer |
US6319227B1 (en) | 1998-08-05 | 2001-11-20 | Scimed Life Systems, Inc. | Automatic/manual longitudinal position translator and rotary drive system for catheters |
US6059731A (en) * | 1998-08-19 | 2000-05-09 | Mayo Foundation For Medical Education And Research | Simultaneous side-and-end viewing underfluid catheter |
US6419644B1 (en) | 1998-09-08 | 2002-07-16 | Scimed Life Systems, Inc. | System and method for intraluminal imaging |
US6626852B2 (en) | 1998-09-08 | 2003-09-30 | Scimed Life Systems, Inc. | System for intraluminal imaging |
DE69942436D1 (en) | 1998-10-23 | 2010-07-08 | Boston Scient Ltd | Improved system for intraluminal imaging |
US6793634B2 (en) | 1998-10-23 | 2004-09-21 | Scimed Life Systems, Inc. | System and method for intraluminal imaging |
US6231515B1 (en) | 1999-01-13 | 2001-05-15 | Scimed Life Systems, Inc. | Safety mechanism and method to prevent rotating imaging guide device from exiting a catheter |
US6171327B1 (en) * | 1999-02-24 | 2001-01-09 | Scimed Life Systems, Inc. | Intravascular filter and method |
WO2000051503A1 (en) * | 1999-03-01 | 2000-09-08 | Endicor Medical, Inc. | Rotational atherectomy system with side balloon |
US6398736B1 (en) | 1999-03-31 | 2002-06-04 | Mayo Foundation For Medical Education And Research | Parametric imaging ultrasound catheter |
US6233476B1 (en) * | 1999-05-18 | 2001-05-15 | Mediguide Ltd. | Medical positioning system |
US9572519B2 (en) | 1999-05-18 | 2017-02-21 | Mediguide Ltd. | Method and apparatus for invasive device tracking using organ timing signal generated from MPS sensors |
US6306097B1 (en) | 1999-06-17 | 2001-10-23 | Acuson Corporation | Ultrasound imaging catheter guiding assembly with catheter working port |
US7426409B2 (en) * | 1999-06-25 | 2008-09-16 | Board Of Regents, The University Of Texas System | Method and apparatus for detecting vulnerable atherosclerotic plaque |
US20030150821A1 (en) * | 1999-07-16 | 2003-08-14 | Bates Mark C. | Emboli filtration system and methods of use |
US6315732B1 (en) * | 1999-07-20 | 2001-11-13 | Scimed Life Systems, Inc. | Imaging catheter and methods of use for ultrasound-guided ablation |
US6406433B1 (en) | 1999-07-21 | 2002-06-18 | Scimed Life Systems, Inc. | Off-aperture electrical connect transducer and methods of making |
US6371970B1 (en) | 1999-07-30 | 2002-04-16 | Incept Llc | Vascular filter having articulation region and methods of use in the ascending aorta |
US6616679B1 (en) | 1999-07-30 | 2003-09-09 | Incept, Llc | Rapid exchange vascular device for emboli and thrombus removal and methods of use |
US6530939B1 (en) | 1999-07-30 | 2003-03-11 | Incept, Llc | Vascular device having articulation region and methods of use |
US6544279B1 (en) * | 2000-08-09 | 2003-04-08 | Incept, Llc | Vascular device for emboli, thrombus and foreign body removal and methods of use |
US20020022858A1 (en) * | 1999-07-30 | 2002-02-21 | Demond Jackson F. | Vascular device for emboli removal having suspension strut and methods of use |
US7320697B2 (en) * | 1999-07-30 | 2008-01-22 | Boston Scientific Scimed, Inc. | One piece loop and coil |
EP1199986B1 (en) | 1999-07-30 | 2005-06-01 | Boston Scientific Limited | Rotational and translational drive coupling for catheter assembly |
US6620182B1 (en) | 1999-07-30 | 2003-09-16 | Incept Llc | Vascular filter having articulation region and methods of use in the ascending aorta |
US6589263B1 (en) | 1999-07-30 | 2003-07-08 | Incept Llc | Vascular device having one or more articulation regions and methods of use |
US6142987A (en) | 1999-08-03 | 2000-11-07 | Scimed Life Systems, Inc. | Guided filter with support wire and methods of use |
US6168579B1 (en) | 1999-08-04 | 2001-01-02 | Scimed Life Systems, Inc. | Filter flush system and methods of use |
US6235044B1 (en) * | 1999-08-04 | 2001-05-22 | Scimed Life Systems, Inc. | Percutaneous catheter and guidewire for filtering during ablation of mycardial or vascular tissue |
US6299622B1 (en) * | 1999-08-19 | 2001-10-09 | Fox Hollow Technologies, Inc. | Atherectomy catheter with aligned imager |
US7713279B2 (en) * | 2000-12-20 | 2010-05-11 | Fox Hollow Technologies, Inc. | Method and devices for cutting tissue |
US8328829B2 (en) * | 1999-08-19 | 2012-12-11 | Covidien Lp | High capacity debulking catheter with razor edge cutting window |
US7708749B2 (en) * | 2000-12-20 | 2010-05-04 | Fox Hollow Technologies, Inc. | Debulking catheters and methods |
US6559934B1 (en) * | 1999-09-14 | 2003-05-06 | Visx, Incorporated | Method and apparatus for determining characteristics of a laser beam spot |
US6358211B1 (en) | 1999-10-12 | 2002-03-19 | Scimed Life Systems, Inc. | Ultrasound lucent apparatus and methods of using |
US6371971B1 (en) | 1999-11-15 | 2002-04-16 | Scimed Life Systems, Inc. | Guidewire filter and methods of use |
US6408649B1 (en) * | 2000-04-28 | 2002-06-25 | Gyrotron Technology, Inc. | Method for the rapid thermal treatment of glass and glass-like materials using microwave radiation |
JP5110751B2 (en) | 2000-08-24 | 2012-12-26 | セイコーインスツル株式会社 | Ultrasonic diagnostic equipment |
US6616681B2 (en) * | 2000-10-05 | 2003-09-09 | Scimed Life Systems, Inc. | Filter delivery and retrieval device |
US6451037B1 (en) | 2000-11-22 | 2002-09-17 | Scimed Life Systems, Inc. | Expandable atherectomy burr with metal reinforcement |
US6494843B2 (en) * | 2000-12-19 | 2002-12-17 | Ge Medical Systems Global Technology Company, Llc | Transesophageal ultrasound probe with expandable scanhead |
ATE499054T1 (en) | 2000-12-20 | 2011-03-15 | Fox Hollow Technologies Inc | REDUCTION CATHETER |
US6663651B2 (en) | 2001-01-16 | 2003-12-16 | Incept Llc | Systems and methods for vascular filter retrieval |
US6805669B2 (en) | 2001-01-25 | 2004-10-19 | Rebecca L. Swanbom | Method and device for marking skin during an ultrasound examination |
US7223238B2 (en) | 2001-01-25 | 2007-05-29 | Swanbom Rebecca L | Method and device for marking skin during an ultrasound examination |
US6689151B2 (en) * | 2001-01-25 | 2004-02-10 | Scimed Life Systems, Inc. | Variable wall thickness for delivery sheath housing |
US20070225605A1 (en) * | 2001-01-25 | 2007-09-27 | Swanbom Rebecca L | Method and Device for Marking Skin During an Ultrasound Examination |
US6694181B2 (en) | 2001-02-12 | 2004-02-17 | Scimed Life Systems, Inc. | Methods and devices for detecting vulnerable plaque |
US6514214B2 (en) | 2001-02-13 | 2003-02-04 | Scimed Life Systems, Inc. | Intravascular temperature sensor |
US6840950B2 (en) * | 2001-02-20 | 2005-01-11 | Scimed Life Systems, Inc. | Low profile emboli capture device |
US6537295B2 (en) * | 2001-03-06 | 2003-03-25 | Scimed Life Systems, Inc. | Wire and lock mechanism |
US6800083B2 (en) | 2001-04-09 | 2004-10-05 | Scimed Life Systems, Inc. | Compressible atherectomy burr |
US6716178B1 (en) | 2001-05-31 | 2004-04-06 | Advanced Cardiovascular Systems, Inc. | Apparatus and method for performing thermal and laser doppler velocimetry measurements |
US7532920B1 (en) | 2001-05-31 | 2009-05-12 | Advanced Cardiovascular Systems, Inc. | Guidewire with optical fiber |
US6697667B1 (en) | 2001-05-31 | 2004-02-24 | Advanced Cardiovascular Systems, Inc. | Apparatus and method for locating coronary sinus |
US7329223B1 (en) * | 2001-05-31 | 2008-02-12 | Abbott Cardiovascular Systems Inc. | Catheter with optical fiber sensor |
US6702744B2 (en) * | 2001-06-20 | 2004-03-09 | Advanced Cardiovascular Systems, Inc. | Agents that stimulate therapeutic angiogenesis and techniques and devices that enable their delivery |
US6951570B2 (en) * | 2001-07-02 | 2005-10-04 | Rubicon Medical, Inc. | Methods, systems, and devices for deploying a filter from a filter device |
US6997939B2 (en) * | 2001-07-02 | 2006-02-14 | Rubicon Medical, Inc. | Methods, systems, and devices for deploying an embolic protection filter |
US6962598B2 (en) * | 2001-07-02 | 2005-11-08 | Rubicon Medical, Inc. | Methods, systems, and devices for providing embolic protection |
US20030023263A1 (en) * | 2001-07-24 | 2003-01-30 | Incept Llc | Apparatus and methods for aspirating emboli |
US20030023261A1 (en) * | 2001-07-30 | 2003-01-30 | Scimed Life Systems Inc. | Chronic total occlusion device with variable stiffness shaft |
US6878151B2 (en) * | 2001-09-27 | 2005-04-12 | Scimed Life Systems, Inc. | Medical retrieval device |
US6755847B2 (en) | 2001-10-05 | 2004-06-29 | Scimed Life Systems, Inc. | Emboli capturing device and method of manufacture therefor |
US20030069597A1 (en) * | 2001-10-10 | 2003-04-10 | Scimed Life Systems, Inc. | Loading tool |
US20030078614A1 (en) * | 2001-10-18 | 2003-04-24 | Amr Salahieh | Vascular embolic filter devices and methods of use therefor |
US7749243B2 (en) * | 2001-10-19 | 2010-07-06 | Boston Scientific Scimed, Inc. | Embolus extractor |
US7052500B2 (en) | 2001-10-19 | 2006-05-30 | Scimed Life Systems, Inc. | Embolus extractor |
US20030083692A1 (en) * | 2001-10-29 | 2003-05-01 | Scimed Life Systems, Inc. | Distal protection device and method of use thereof |
US7594926B2 (en) * | 2001-11-09 | 2009-09-29 | Boston Scientific Scimed, Inc. | Methods, systems and devices for delivering stents |
JP4350515B2 (en) | 2001-11-09 | 2009-10-21 | ルビコン・メデイカル・インコーポレイテツド | Stent delivery device |
US8608661B1 (en) | 2001-11-30 | 2013-12-17 | Advanced Cardiovascular Systems, Inc. | Method for intravascular delivery of a treatment agent beyond a blood vessel wall |
US7247162B1 (en) | 2002-01-14 | 2007-07-24 | Edwards Lifesciences Corporation | Direct access atherectomy devices |
US6946410B2 (en) * | 2002-04-05 | 2005-09-20 | E. I. Du Pont De Nemours And Company | Method for providing nano-structures of uniform length |
JP3954888B2 (en) | 2002-04-11 | 2007-08-08 | テルモ株式会社 | Ultrasound catheter |
AU2003239375A1 (en) * | 2002-05-07 | 2003-11-11 | Volcano Therapeutics, Inc. | Systems and methods for detecting vulnerable plaque |
US7179269B2 (en) * | 2002-05-20 | 2007-02-20 | Scimed Life Systems, Inc. | Apparatus and system for removing an obstruction from a lumen |
JP4018450B2 (en) * | 2002-05-27 | 2007-12-05 | キヤノン株式会社 | Document management system, document management apparatus, authentication method, computer readable program, and storage medium |
US7361368B2 (en) | 2002-06-28 | 2008-04-22 | Advanced Cardiovascular Systems, Inc. | Device and method for combining a treatment agent and a gel |
US20040054287A1 (en) * | 2002-08-29 | 2004-03-18 | Stephens Douglas Neil | Ultrasonic imaging devices and methods of fabrication |
JP2005538805A (en) * | 2002-09-18 | 2005-12-22 | ザ・ボード・オブ・トラスティーズ・オブ・ザ・レランド・スタンフォード・ジュニア・ユニバーシティ | Tubular compliant mechanism for ultrasound imaging system and endovascular interventional device |
US20070167804A1 (en) * | 2002-09-18 | 2007-07-19 | Byong-Ho Park | Tubular compliant mechanisms for ultrasonic imaging systems and intravascular interventional devices |
US8468678B2 (en) | 2002-10-02 | 2013-06-25 | Boston Scientific Scimed, Inc. | Expandable retrieval device |
US7998163B2 (en) * | 2002-10-03 | 2011-08-16 | Boston Scientific Scimed, Inc. | Expandable retrieval device |
US7734332B2 (en) * | 2002-10-18 | 2010-06-08 | Ariomedica Ltd. | Atherectomy system with imaging guidewire |
US20040133109A1 (en) * | 2003-01-07 | 2004-07-08 | Scimed Life Systems, Inc. | Systems and methods for acoustic thermal imaging |
US20040138694A1 (en) * | 2003-01-15 | 2004-07-15 | Scimed Life Systems, Inc. | Intravascular filtering membrane and method of making an embolic protection filter device |
US20040199201A1 (en) * | 2003-04-02 | 2004-10-07 | Scimed Life Systems, Inc. | Embolectomy devices |
US8383158B2 (en) * | 2003-04-15 | 2013-02-26 | Abbott Cardiovascular Systems Inc. | Methods and compositions to treat myocardial conditions |
US8821473B2 (en) | 2003-04-15 | 2014-09-02 | Abbott Cardiovascular Systems Inc. | Methods and compositions to treat myocardial conditions |
US8038991B1 (en) | 2003-04-15 | 2011-10-18 | Abbott Cardiovascular Systems Inc. | High-viscosity hyaluronic acid compositions to treat myocardial conditions |
US8246640B2 (en) | 2003-04-22 | 2012-08-21 | Tyco Healthcare Group Lp | Methods and devices for cutting tissue at a vascular location |
US20040220612A1 (en) * | 2003-04-30 | 2004-11-04 | Swainston Kyle W | Slidable capture catheter |
US7780611B2 (en) * | 2003-05-01 | 2010-08-24 | Boston Scientific Scimed, Inc. | Medical instrument with controlled torque transmission |
US7909766B2 (en) * | 2003-05-21 | 2011-03-22 | Scimed Life Systems, Inc. | Systems and methods for improving the imaging resolution of an imaging transducer |
US20040260182A1 (en) * | 2003-06-23 | 2004-12-23 | Zuluaga Andres F. | Intraluminal spectroscope with wall contacting probe |
US8535344B2 (en) * | 2003-09-12 | 2013-09-17 | Rubicon Medical, Inc. | Methods, systems, and devices for providing embolic protection and removing embolic material |
US6949072B2 (en) * | 2003-09-22 | 2005-09-27 | Infraredx, Inc. | Devices for vulnerable plaque detection |
CA2449080A1 (en) * | 2003-11-13 | 2005-05-13 | Centre Hospitalier De L'universite De Montreal - Chum | Apparatus and method for intravascular ultrasound image segmentation: a fast-marching method |
US7651514B2 (en) * | 2003-12-11 | 2010-01-26 | Boston Scientific Scimed, Inc. | Nose rider improvement for filter exchange and methods of use |
US20050159773A1 (en) * | 2004-01-20 | 2005-07-21 | Scimed Life Systems, Inc. | Expandable retrieval device with dilator tip |
US20050159772A1 (en) * | 2004-01-20 | 2005-07-21 | Scimed Life Systems, Inc. | Sheath for use with an embolic protection filtering device |
DE102004008370B4 (en) * | 2004-02-20 | 2006-06-01 | Siemens Ag | Catheter for performing and monitoring rotablation |
DE102004008368B4 (en) * | 2004-02-20 | 2006-05-24 | Siemens Ag | Catheter for performing and monitoring rotablation |
US7811294B2 (en) * | 2004-03-08 | 2010-10-12 | Mediguide Ltd. | Automatic guidewire maneuvering system and method |
US7473265B2 (en) | 2004-03-15 | 2009-01-06 | Boston Scientific Scimed, Inc. | Filter media and methods of manufacture |
US20050240215A1 (en) * | 2004-04-21 | 2005-10-27 | Scimed Life Systems, Inc. | Magnetic embolic protection device and method |
US20050267453A1 (en) * | 2004-05-27 | 2005-12-01 | Wong Serena H | High intensity focused ultrasound for imaging and treatment of arrhythmias |
US20060293612A1 (en) * | 2004-06-24 | 2006-12-28 | Boston Scientific Scimed, Inc. | Apparatus and method for treating occluded vasculature |
US8241315B2 (en) * | 2004-06-24 | 2012-08-14 | Boston Scientific Scimed, Inc. | Apparatus and method for treating occluded vasculature |
US20060030777A1 (en) * | 2004-07-30 | 2006-02-09 | Liang David H | T-statistic method for suppressing artifacts in blood vessel ultrasonic imaging |
US7794472B2 (en) * | 2004-08-11 | 2010-09-14 | Boston Scientific Scimed, Inc. | Single wire intravascular filter |
EP1792213A2 (en) * | 2004-09-11 | 2007-06-06 | The Board of Trustees of The Leland Stanford Junior University | Method and apparatus for modeling the modal properties of optical waveguides |
US8617163B2 (en) * | 2004-10-15 | 2013-12-31 | Baxano Surgical, Inc. | Methods, systems and devices for carpal tunnel release |
US8062300B2 (en) * | 2006-05-04 | 2011-11-22 | Baxano, Inc. | Tissue removal with at least partially flexible devices |
US20080103504A1 (en) * | 2006-10-30 | 2008-05-01 | Schmitz Gregory P | Percutaneous spinal stenosis treatment |
US20080161809A1 (en) * | 2006-10-03 | 2008-07-03 | Baxano, Inc. | Articulating Tissue Cutting Device |
US7738969B2 (en) * | 2004-10-15 | 2010-06-15 | Baxano, Inc. | Devices and methods for selective surgical removal of tissue |
US7938830B2 (en) * | 2004-10-15 | 2011-05-10 | Baxano, Inc. | Powered tissue modification devices and methods |
US20100331883A1 (en) * | 2004-10-15 | 2010-12-30 | Schmitz Gregory P | Access and tissue modification systems and methods |
EP1799129B1 (en) * | 2004-10-15 | 2020-11-25 | Baxano, Inc. | Devices for tissue removal |
US20090171381A1 (en) * | 2007-12-28 | 2009-07-02 | Schmitz Gregory P | Devices, methods and systems for neural localization |
US8430881B2 (en) * | 2004-10-15 | 2013-04-30 | Baxano, Inc. | Mechanical tissue modification devices and methods |
US8257356B2 (en) * | 2004-10-15 | 2012-09-04 | Baxano, Inc. | Guidewire exchange systems to treat spinal stenosis |
US8221397B2 (en) | 2004-10-15 | 2012-07-17 | Baxano, Inc. | Devices and methods for tissue modification |
US20060122458A1 (en) * | 2004-10-15 | 2006-06-08 | Baxano, Inc. | Devices and methods for tissue access |
US20110190772A1 (en) | 2004-10-15 | 2011-08-04 | Vahid Saadat | Powered tissue modification devices and methods |
US7578819B2 (en) * | 2005-05-16 | 2009-08-25 | Baxano, Inc. | Spinal access and neural localization |
US9101386B2 (en) | 2004-10-15 | 2015-08-11 | Amendia, Inc. | Devices and methods for treating tissue |
US9247952B2 (en) * | 2004-10-15 | 2016-02-02 | Amendia, Inc. | Devices and methods for tissue access |
US7887538B2 (en) * | 2005-10-15 | 2011-02-15 | Baxano, Inc. | Methods and apparatus for tissue modification |
US8048080B2 (en) | 2004-10-15 | 2011-11-01 | Baxano, Inc. | Flexible tissue rasp |
US20070213734A1 (en) * | 2006-03-13 | 2007-09-13 | Bleich Jeffery L | Tissue modification barrier devices and methods |
US20080147084A1 (en) * | 2006-12-07 | 2008-06-19 | Baxano, Inc. | Tissue removal devices and methods |
US7553307B2 (en) | 2004-10-15 | 2009-06-30 | Baxano, Inc. | Devices and methods for tissue modification |
US7621904B2 (en) * | 2004-10-21 | 2009-11-24 | Boston Scientific Scimed, Inc. | Catheter with a pre-shaped distal tip |
US20060095067A1 (en) * | 2004-11-01 | 2006-05-04 | Horng-Ban Lin | Lubricious filter |
US8038696B2 (en) * | 2004-12-06 | 2011-10-18 | Boston Scientific Scimed, Inc. | Sheath for use with an embolic protection filter |
US7854944B2 (en) | 2004-12-17 | 2010-12-21 | Advanced Cardiovascular Systems, Inc. | Tissue regeneration |
US7478465B1 (en) | 2005-01-10 | 2009-01-20 | Boston Scientific Scimed, Inc. | Method of securing a restraining member on a medical device |
US7204464B2 (en) * | 2005-01-21 | 2007-04-17 | Boston Scientific Scimed, Inc. | Medical wire holder |
US8480629B2 (en) * | 2005-01-28 | 2013-07-09 | Boston Scientific Scimed, Inc. | Universal utility board for use with medical devices and methods of use |
US8007440B2 (en) * | 2005-02-08 | 2011-08-30 | Volcano Corporation | Apparatus and methods for low-cost intravascular ultrasound imaging and for crossing severe vascular occlusions |
US8303972B2 (en) * | 2005-04-19 | 2012-11-06 | Advanced Cardiovascular Systems, Inc. | Hydrogel bioscaffoldings and biomedical device coatings |
US8828433B2 (en) | 2005-04-19 | 2014-09-09 | Advanced Cardiovascular Systems, Inc. | Hydrogel bioscaffoldings and biomedical device coatings |
US20080125745A1 (en) | 2005-04-19 | 2008-05-29 | Shubhayu Basu | Methods and compositions for treating post-cardial infarction damage |
US9539410B2 (en) | 2005-04-19 | 2017-01-10 | Abbott Cardiovascular Systems Inc. | Methods and compositions for treating post-cardial infarction damage |
US8187621B2 (en) | 2005-04-19 | 2012-05-29 | Advanced Cardiovascular Systems, Inc. | Methods and compositions for treating post-myocardial infarction damage |
US20070016062A1 (en) * | 2005-05-04 | 2007-01-18 | Byong-Ho Park | Multiple transducers for intravascular ultrasound imaging |
US9445784B2 (en) * | 2005-09-22 | 2016-09-20 | Boston Scientific Scimed, Inc | Intravascular ultrasound catheter |
US7450241B2 (en) * | 2005-09-30 | 2008-11-11 | Infraredx, Inc. | Detecting vulnerable plaque |
US8083726B1 (en) | 2005-09-30 | 2011-12-27 | Advanced Cardiovascular Systems, Inc. | Encapsulating cells and lumen |
US20080091227A1 (en) * | 2006-08-25 | 2008-04-17 | Baxano, Inc. | Surgical probe and method of making |
US20080086034A1 (en) | 2006-08-29 | 2008-04-10 | Baxano, Inc. | Tissue Access Guidewire System and Method |
US8092456B2 (en) * | 2005-10-15 | 2012-01-10 | Baxano, Inc. | Multiple pathways for spinal nerve root decompression from a single access point |
US8366712B2 (en) | 2005-10-15 | 2013-02-05 | Baxano, Inc. | Multiple pathways for spinal nerve root decompression from a single access point |
US8062298B2 (en) * | 2005-10-15 | 2011-11-22 | Baxano, Inc. | Flexible tissue removal devices and methods |
US8047996B2 (en) * | 2005-10-31 | 2011-11-01 | Volcano Corporation | System and method for reducing angular geometric distortion in an imaging device |
US7785286B2 (en) * | 2006-03-30 | 2010-08-31 | Volcano Corporation | Method and system for imaging, diagnosing, and/or treating an area of interest in a patient's body |
US7612773B2 (en) * | 2006-05-22 | 2009-11-03 | Magnin Paul A | Apparatus and method for rendering for display forward-looking image data |
US20070276419A1 (en) * | 2006-05-26 | 2007-11-29 | Fox Hollow Technologies, Inc. | Methods and devices for rotating an active element and an energy emitter on a catheter |
US7732190B2 (en) * | 2006-07-31 | 2010-06-08 | Advanced Cardiovascular Systems, Inc. | Modified two-component gelation systems, methods of use and methods of manufacture |
EP2465439A1 (en) * | 2006-08-14 | 2012-06-20 | Volcano Corporation | Imaging device, imaging system, and methods of imaging |
US9867530B2 (en) | 2006-08-14 | 2018-01-16 | Volcano Corporation | Telescopic side port catheter device with imaging system and method for accessing side branch occlusions |
US9242005B1 (en) | 2006-08-21 | 2016-01-26 | Abbott Cardiovascular Systems Inc. | Pro-healing agent formulation compositions, methods and treatments |
US8092384B2 (en) * | 2006-09-28 | 2012-01-10 | Tyco Healthcare Group Lp | System and method for continuous detection of an analyte in bloodstream |
US20080097408A1 (en) * | 2006-10-20 | 2008-04-24 | Infraredx, Inc. | Pullback Carriage Interlock System and Method for Catheter System |
US20080097224A1 (en) * | 2006-10-20 | 2008-04-24 | Infraredx, Inc. | Manual and Motor Driven Optical Pullback and Rotation System and Method |
US20080097223A1 (en) * | 2006-10-20 | 2008-04-24 | Infraredx, Inc. | Optical Catheter Carriage Interlock System and Method |
US9005672B2 (en) * | 2006-11-17 | 2015-04-14 | Abbott Cardiovascular Systems Inc. | Methods of modifying myocardial infarction expansion |
US8741326B2 (en) * | 2006-11-17 | 2014-06-03 | Abbott Cardiovascular Systems Inc. | Modified two-component gelation systems, methods of use and methods of manufacture |
US8192760B2 (en) | 2006-12-04 | 2012-06-05 | Abbott Cardiovascular Systems Inc. | Methods and compositions for treating tissue using silk proteins |
US8104483B2 (en) * | 2006-12-26 | 2012-01-31 | The Spectranetics Corporation | Multi-port light delivery catheter and methods for the use thereof |
US8460195B2 (en) * | 2007-01-19 | 2013-06-11 | Sunnybrook Health Sciences Centre | Scanning mechanisms for imaging probe |
CA2675619C (en) * | 2007-01-19 | 2016-08-16 | Sunnybrook Health Sciences Centre | Scanning mechanisms for imaging probe |
US20080221448A1 (en) * | 2007-03-07 | 2008-09-11 | Khuri-Yakub Butrus T | Image-guided delivery of therapeutic tools duing minimally invasive surgeries and interventions |
WO2008157513A1 (en) * | 2007-06-15 | 2008-12-24 | Baxano, Inc. | Devices and methods for measuring the space around a nerve root |
WO2009009621A2 (en) * | 2007-07-09 | 2009-01-15 | Baxano, Inc. | Spinal access system and method |
US9596993B2 (en) | 2007-07-12 | 2017-03-21 | Volcano Corporation | Automatic calibration systems and methods of use |
WO2009009802A1 (en) | 2007-07-12 | 2009-01-15 | Volcano Corporation | Oct-ivus catheter for concurrent luminal imaging |
WO2009009799A1 (en) | 2007-07-12 | 2009-01-15 | Volcano Corporation | Catheter for in vivo imaging |
US8702609B2 (en) * | 2007-07-27 | 2014-04-22 | Meridian Cardiovascular Systems, Inc. | Image-guided intravascular therapy catheters |
EP2194861A1 (en) * | 2007-09-06 | 2010-06-16 | Baxano, Inc. | Method, system and apparatus for neural localization |
US9848952B2 (en) | 2007-10-24 | 2017-12-26 | The Spectranetics Corporation | Liquid light guide catheter having biocompatible liquid light guide medium |
JP5004771B2 (en) * | 2007-11-22 | 2012-08-22 | 株式会社リコー | Image forming apparatus |
US8192436B2 (en) | 2007-12-07 | 2012-06-05 | Baxano, Inc. | Tissue modification devices |
US8784440B2 (en) | 2008-02-25 | 2014-07-22 | Covidien Lp | Methods and devices for cutting tissue |
US9713448B2 (en) | 2008-04-03 | 2017-07-25 | Infraredx, Inc. | System and method for intravascular structural analysis compensation of chemical analysis modality |
EP2282676A2 (en) * | 2008-05-07 | 2011-02-16 | InfraReDx, Inc. | Catheter with spinning ultrasound transceiver board |
US8409206B2 (en) | 2008-07-01 | 2013-04-02 | Baxano, Inc. | Tissue modification devices and methods |
US9314253B2 (en) | 2008-07-01 | 2016-04-19 | Amendia, Inc. | Tissue modification devices and methods |
US8398641B2 (en) | 2008-07-01 | 2013-03-19 | Baxano, Inc. | Tissue modification devices and methods |
MX348805B (en) * | 2008-07-14 | 2017-06-28 | Baxano Inc | Tissue modification devices. |
US20100130835A1 (en) * | 2008-09-30 | 2010-05-27 | Rox Medical, Inc. | Methods for screening and treating patients with compromised cardiopulmonary function |
KR101645754B1 (en) * | 2008-10-13 | 2016-08-04 | 코비디엔 엘피 | Devices and methods for manipulating a catheter shaft |
US9408665B2 (en) * | 2008-12-12 | 2016-08-09 | The Spectranetics Corporation | Offset catheter |
US8444669B2 (en) | 2008-12-15 | 2013-05-21 | Boston Scientific Scimed, Inc. | Embolic filter delivery system and method |
US20100152711A1 (en) * | 2008-12-15 | 2010-06-17 | Boston Scientific Scimed, Inc. | Offset coupling region |
US9089287B2 (en) * | 2008-12-30 | 2015-07-28 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Image-guided ablation system and method for monitoring an ablation procedure |
EP2405823A4 (en) | 2009-03-13 | 2012-07-04 | Baxano Inc | Flexible neural localization devices and methods |
US9039626B2 (en) * | 2009-03-31 | 2015-05-26 | Sunnybrook Health Sciences Centre | Medical device with means to improve transmission of torque along a rotational drive shaft |
US8298149B2 (en) * | 2009-03-31 | 2012-10-30 | Boston Scientific Scimed, Inc. | Systems and methods for making and using a motor distally-positioned within a catheter of an intravascular ultrasound imaging system |
CN102625673B (en) | 2009-04-29 | 2014-12-24 | 泰科保健集团有限合伙公司 | Methods and devices for cutting and abrading tissue |
AU2010248909B2 (en) | 2009-05-14 | 2013-03-21 | Covidien Lp | Easily cleaned atherectomy catheters and methods of use |
US8394102B2 (en) * | 2009-06-25 | 2013-03-12 | Baxano, Inc. | Surgical tools for treatment of spinal stenosis |
AU2010326063B2 (en) | 2009-12-02 | 2013-07-04 | Covidien Lp | Methods and devices for cutting tissue |
JP5511107B2 (en) | 2009-12-11 | 2014-06-04 | コヴィディエン リミテッド パートナーシップ | Substance removal device and method with improved substance capture efficiency |
US9301690B2 (en) | 2010-04-22 | 2016-04-05 | University Of Houston System | Device, system, and method for a stress sensing medical needle |
US9119662B2 (en) | 2010-06-14 | 2015-09-01 | Covidien Lp | Material removal device and method of use |
CA2815186C (en) | 2010-10-28 | 2015-12-29 | Covidien Lp | Material removal device and method of use |
EP2637555B1 (en) | 2010-11-08 | 2021-09-15 | Conavi Medical Inc. | Systems for improved visualization during minimally invasive procedures |
AU2011326420B2 (en) | 2010-11-11 | 2014-11-27 | Covidien Lp | Flexible debulking catheters with imaging and methods of use and manufacture |
US11141063B2 (en) | 2010-12-23 | 2021-10-12 | Philips Image Guided Therapy Corporation | Integrated system architectures and methods of use |
US11040140B2 (en) | 2010-12-31 | 2021-06-22 | Philips Image Guided Therapy Corporation | Deep vein thrombosis therapeutic methods |
US8821478B2 (en) | 2011-03-04 | 2014-09-02 | Boston Scientific Scimed, Inc. | Catheter with variable stiffness |
US10136914B2 (en) | 2011-03-15 | 2018-11-27 | Henry William Lupton | Anchoring device for anchoring a boring tool in a lumen or vessel |
WO2013033489A1 (en) | 2011-08-31 | 2013-03-07 | Volcano Corporation | Optical rotary joint and methods of use |
US8992717B2 (en) | 2011-09-01 | 2015-03-31 | Covidien Lp | Catheter with helical drive shaft and methods of manufacture |
WO2013055917A1 (en) | 2011-10-12 | 2013-04-18 | Volcano Corporation | Rotational shape-memory actuators and associated devices, systems, and methods |
ES2864221T3 (en) * | 2011-11-28 | 2021-10-13 | Nipro Corp | Atherectomy catheter |
US9164084B2 (en) | 2012-01-31 | 2015-10-20 | Purdue Research Foundation | Methods for determining aggressiveness of a cancer and treatment thereof |
US10342699B2 (en) | 2012-08-03 | 2019-07-09 | J.D. Franco & Co., Llc | Systems and methods for treating eye diseases |
US9579157B2 (en) | 2012-09-13 | 2017-02-28 | Covidien Lp | Cleaning device for medical instrument and method of use |
US10070827B2 (en) | 2012-10-05 | 2018-09-11 | Volcano Corporation | Automatic image playback |
US9307926B2 (en) | 2012-10-05 | 2016-04-12 | Volcano Corporation | Automatic stent detection |
JP2015532536A (en) | 2012-10-05 | 2015-11-09 | デイビッド ウェルフォード, | System and method for amplifying light |
US9286673B2 (en) | 2012-10-05 | 2016-03-15 | Volcano Corporation | Systems for correcting distortions in a medical image and methods of use thereof |
US9292918B2 (en) | 2012-10-05 | 2016-03-22 | Volcano Corporation | Methods and systems for transforming luminal images |
US11272845B2 (en) | 2012-10-05 | 2022-03-15 | Philips Image Guided Therapy Corporation | System and method for instant and automatic border detection |
US10568586B2 (en) | 2012-10-05 | 2020-02-25 | Volcano Corporation | Systems for indicating parameters in an imaging data set and methods of use |
US9858668B2 (en) | 2012-10-05 | 2018-01-02 | Volcano Corporation | Guidewire artifact removal in images |
US9324141B2 (en) | 2012-10-05 | 2016-04-26 | Volcano Corporation | Removal of A-scan streaking artifact |
US9367965B2 (en) | 2012-10-05 | 2016-06-14 | Volcano Corporation | Systems and methods for generating images of tissue |
US9840734B2 (en) | 2012-10-22 | 2017-12-12 | Raindance Technologies, Inc. | Methods for analyzing DNA |
US9943329B2 (en) | 2012-11-08 | 2018-04-17 | Covidien Lp | Tissue-removing catheter with rotatable cutter |
CA2891061C (en) | 2012-11-08 | 2018-05-01 | Covidien Lp | Tissue-removing catheter including operational control mechanism |
EP2931132B1 (en) | 2012-12-13 | 2023-07-05 | Philips Image Guided Therapy Corporation | System for targeted cannulation |
US11406498B2 (en) | 2012-12-20 | 2022-08-09 | Philips Image Guided Therapy Corporation | Implant delivery system and implants |
US9709379B2 (en) | 2012-12-20 | 2017-07-18 | Volcano Corporation | Optical coherence tomography system that is reconfigurable between different imaging modes |
WO2014099899A1 (en) | 2012-12-20 | 2014-06-26 | Jeremy Stigall | Smooth transition catheters |
US10939826B2 (en) | 2012-12-20 | 2021-03-09 | Philips Image Guided Therapy Corporation | Aspirating and removing biological material |
JP2016506276A (en) | 2012-12-20 | 2016-03-03 | ジェレミー スティガール, | Locate the intravascular image |
US10942022B2 (en) | 2012-12-20 | 2021-03-09 | Philips Image Guided Therapy Corporation | Manual calibration of imaging system |
US10413317B2 (en) | 2012-12-21 | 2019-09-17 | Volcano Corporation | System and method for catheter steering and operation |
US10166003B2 (en) | 2012-12-21 | 2019-01-01 | Volcano Corporation | Ultrasound imaging with variable line density |
WO2014099672A1 (en) | 2012-12-21 | 2014-06-26 | Andrew Hancock | System and method for multipath processing of image signals |
US10993694B2 (en) | 2012-12-21 | 2021-05-04 | Philips Image Guided Therapy Corporation | Rotational ultrasound imaging catheter with extended catheter body telescope |
US9383263B2 (en) | 2012-12-21 | 2016-07-05 | Volcano Corporation | Systems and methods for narrowing a wavelength emission of light |
US9486143B2 (en) | 2012-12-21 | 2016-11-08 | Volcano Corporation | Intravascular forward imaging device |
CA2895993A1 (en) | 2012-12-21 | 2014-06-26 | Jason Spencer | System and method for graphical processing of medical data |
WO2014100579A1 (en) | 2012-12-21 | 2014-06-26 | David Anderson | Functional gain measurement technique and representation |
US10191220B2 (en) | 2012-12-21 | 2019-01-29 | Volcano Corporation | Power-efficient optical circuit |
US9612105B2 (en) | 2012-12-21 | 2017-04-04 | Volcano Corporation | Polarization sensitive optical coherence tomography system |
US10058284B2 (en) | 2012-12-21 | 2018-08-28 | Volcano Corporation | Simultaneous imaging, monitoring, and therapy |
WO2014110460A1 (en) | 2013-01-10 | 2014-07-17 | Intervene, Inc. | Systems and methods for endoluminal valve creation |
WO2014112238A1 (en) * | 2013-01-16 | 2014-07-24 | オリンパスメディカルシステムズ株式会社 | Ultrasound probe system |
JP6243453B2 (en) | 2013-03-07 | 2017-12-06 | ボルケーノ コーポレイション | Multimodal segmentation in intravascular images |
US10226597B2 (en) | 2013-03-07 | 2019-03-12 | Volcano Corporation | Guidewire with centering mechanism |
US20140276923A1 (en) | 2013-03-12 | 2014-09-18 | Volcano Corporation | Vibrating catheter and methods of use |
CN105228518B (en) | 2013-03-12 | 2018-10-09 | 火山公司 | System and method for diagnosing coronal microvascular diseases |
US9301687B2 (en) | 2013-03-13 | 2016-04-05 | Volcano Corporation | System and method for OCT depth calibration |
US10758207B2 (en) | 2013-03-13 | 2020-09-01 | Philips Image Guided Therapy Corporation | Systems and methods for producing an image from a rotational intravascular ultrasound device |
US11026591B2 (en) | 2013-03-13 | 2021-06-08 | Philips Image Guided Therapy Corporation | Intravascular pressure sensor calibration |
US10292677B2 (en) | 2013-03-14 | 2019-05-21 | Volcano Corporation | Endoluminal filter having enhanced echogenic properties |
US20160030151A1 (en) | 2013-03-14 | 2016-02-04 | Volcano Corporation | Filters with echogenic characteristics |
US10219887B2 (en) | 2013-03-14 | 2019-03-05 | Volcano Corporation | Filters with echogenic characteristics |
CN105744902A (en) | 2013-11-18 | 2016-07-06 | 皇家飞利浦有限公司 | Guided thrombus dispersal catheter |
US10687832B2 (en) | 2013-11-18 | 2020-06-23 | Koninklijke Philips N.V. | Methods and devices for thrombus dispersal |
US20150196271A1 (en) | 2014-01-10 | 2015-07-16 | Volcano Corporation | Detecting endoleaks associated with aneurysm repair |
WO2015106197A2 (en) | 2014-01-10 | 2015-07-16 | Volcano Corporation | Detecting endoleaks associated with aneurysm repair |
WO2015108941A1 (en) | 2014-01-14 | 2015-07-23 | Volcano Corporation | Devices and methods for forming vascular access |
US20150297097A1 (en) | 2014-01-14 | 2015-10-22 | Volcano Corporation | Vascular access evaluation and treatment |
JP2017509366A (en) | 2014-01-14 | 2017-04-06 | ボルケーノ コーポレイション | Catheter assembly for vascular access site creation |
EP3094241B1 (en) | 2014-01-14 | 2018-07-04 | Volcano Corporation | Systems and methods for evaluating hemodialysis arteriovenous fistula maturation |
WO2015108957A1 (en) | 2014-01-14 | 2015-07-23 | Volcano Corporation | Systems for improving an av access site |
WO2015108973A1 (en) | 2014-01-14 | 2015-07-23 | Volcano Corporation | Methods and systems for clearing thrombus from a vascular access site |
US9526519B2 (en) | 2014-02-03 | 2016-12-27 | Covidien Lp | Tissue-removing catheter with improved angular tissue-removing positioning within body lumen |
US9456843B2 (en) | 2014-02-03 | 2016-10-04 | Covidien Lp | Tissue-removing catheter including angular displacement sensor |
JP6303557B2 (en) * | 2014-02-06 | 2018-04-04 | ニプロ株式会社 | catheter |
CN111298271B (en) | 2014-02-06 | 2022-10-04 | 尼普洛株式会社 | Catheter tube |
WO2015156945A1 (en) | 2014-04-11 | 2015-10-15 | Jeremy Stigall | Imaging and treatment device |
US20150359510A1 (en) * | 2014-06-17 | 2015-12-17 | Koninklijke Philips N.V. | Design and method for intravascular catheter |
WO2015200702A1 (en) | 2014-06-27 | 2015-12-30 | Covidien Lp | Cleaning device for catheter and catheter including the same |
JP6400826B2 (en) | 2014-07-15 | 2018-10-03 | コーニンクレッカ フィリップス エヌ ヴェKoninklijke Philips N.V. | Device and method for intrahepatic shunt |
CN107072636A (en) | 2014-08-21 | 2017-08-18 | 皇家飞利浦有限公司 | Apparatus and method for break-through occlusion |
WO2016132241A1 (en) | 2015-02-20 | 2016-08-25 | Koninklijke Philips N.V. | Atherectomy apparatus with imaging |
US10314667B2 (en) | 2015-03-25 | 2019-06-11 | Covidien Lp | Cleaning device for cleaning medical instrument |
US10668299B2 (en) * | 2015-04-10 | 2020-06-02 | Nucletron Operations B.V. | Brachytherapy applicators having ultrasound elements |
EP3285653B1 (en) | 2015-04-20 | 2019-12-18 | Koninklijke Philips N.V. | Dual lumen diagnostic catheter |
US10292721B2 (en) | 2015-07-20 | 2019-05-21 | Covidien Lp | Tissue-removing catheter including movable distal tip |
US10314664B2 (en) | 2015-10-07 | 2019-06-11 | Covidien Lp | Tissue-removing catheter and tissue-removing element with depth stop |
CN109068995B (en) | 2016-02-26 | 2022-05-13 | 新宁研究院 | Imaging probe with rotatable core |
US10646247B2 (en) | 2016-04-01 | 2020-05-12 | Intervene, Inc. | Intraluminal tissue modifying systems and associated devices and methods |
EP3573538A4 (en) | 2017-01-25 | 2020-12-16 | J.D. Franco & Co., LLC | Blood vessel access and closure devices and related methods of use |
US9848906B1 (en) | 2017-06-20 | 2017-12-26 | Joe Michael Eskridge | Stent retriever having an expandable fragment guard |
US10188368B2 (en) | 2017-06-26 | 2019-01-29 | Andreas Hadjicostis | Image guided intravascular therapy catheter utilizing a thin chip multiplexor |
US10492760B2 (en) | 2017-06-26 | 2019-12-03 | Andreas Hadjicostis | Image guided intravascular therapy catheter utilizing a thin chip multiplexor |
US11109909B1 (en) | 2017-06-26 | 2021-09-07 | Andreas Hadjicostis | Image guided intravascular therapy catheter utilizing a thin ablation electrode |
US10779929B2 (en) | 2017-10-06 | 2020-09-22 | J.D. Franco & Co., Llc | Treating eye diseases by deploying a stent |
JP2018043038A (en) * | 2017-12-06 | 2018-03-22 | ニプロ株式会社 | Catheter and medical instrument |
US10758254B2 (en) | 2017-12-15 | 2020-09-01 | J.D. Franco & Co., Llc | Medical systems, devices, and related methods |
US11129702B2 (en) | 2018-05-09 | 2021-09-28 | Boston Scientific Scimed, Inc. | Pedal access embolic filtering sheath |
CN112584774A (en) | 2018-06-28 | 2021-03-30 | 皇家飞利浦有限公司 | Internally ultrasound assisted local therapy delivery |
CN112351743A (en) | 2018-06-28 | 2021-02-09 | 皇家飞利浦有限公司 | External targeted delivery of active therapeutic agents |
US10792478B2 (en) | 2018-12-31 | 2020-10-06 | J.D. Franco & Co., Llc | Intravascular devices, systems, and methods to address eye disorders |
EP4181998A2 (en) * | 2020-07-16 | 2023-05-24 | Intervene, Inc. | Intravascular devices for delivery of fluids and therapeutic agents into blood vessel walls and intravascular structures |
WO2022126101A2 (en) | 2020-12-07 | 2022-06-16 | Frond Medical Inc. | Methods and systems for body lumen medical device location |
WO2023212373A2 (en) * | 2022-04-29 | 2023-11-02 | Intervene, Inc. | Intravascular devices and methods for delivery of fluids and therapeutic agents into blood vessel walls and intravascular structures |
Family Cites Families (33)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3817089A (en) * | 1971-06-30 | 1974-06-18 | Interscience Res Inst | Rotating probe high data acquistion rate apparatus |
US3938502A (en) * | 1972-02-22 | 1976-02-17 | Nicolaas Bom | Apparatus with a catheter for examining hollow organs or bodies with the ultrasonic waves |
DE2308443A1 (en) * | 1972-02-22 | 1973-08-30 | Univ Erasmus | EXAMINATION DEVICE WITH CATHETER FOR EXAMINING A HOLLOW ORGAN WITH THE AID OF ULTRASOUND WAVES AND METHOD OF MAKING THE CATHETER |
DK131541B (en) * | 1973-09-03 | 1975-08-04 | Akad Tekn Videnskaber | Prostate rectoscope. |
US4020847A (en) * | 1975-11-05 | 1977-05-03 | Clark Iii William T | Rotating cutter catheter |
JPS5385982A (en) * | 1977-01-10 | 1978-07-28 | Tokyo Shibaura Electric Co | Explorer for inspecting body cavity |
US4275597A (en) * | 1977-07-11 | 1981-06-30 | Smithkline Instruments, Inc. | Ultrasonic beam scanning technique and apparatus |
FR2424733A1 (en) * | 1978-05-05 | 1979-11-30 | Inst Nat Sante Rech Med | Flexible ultra-sonic probe - has inflatable plastics envelope over section of shaft to hold emitter in position without it touching sides of oesophagus |
JPS565645A (en) * | 1979-06-27 | 1981-01-21 | Olympus Optical Co | Endoscope for biomicroscopy |
GB2063474B (en) * | 1979-10-24 | 1984-06-06 | Olympus Optical Co | Coeliac cavity ultrasonic diagnosis apparatus |
JPS579439A (en) * | 1980-06-18 | 1982-01-18 | Tokyo Shibaura Electric Co | Ultrasonic scanner |
JPS5734828A (en) * | 1980-08-12 | 1982-02-25 | Olympus Optical Co | Endoscope |
US4351341A (en) * | 1980-08-15 | 1982-09-28 | Uresil Company | Balloon catheter |
JPS5757535A (en) * | 1980-09-22 | 1982-04-06 | Olympus Optical Co | Ultrasonic diagnostic apparatus |
JPS57134147A (en) * | 1981-02-16 | 1982-08-19 | Olympus Optical Co | Ultrasonic diagnostic apparatus for body cavity |
JPS57168648A (en) * | 1981-04-08 | 1982-10-18 | Olympus Optical Co | Ultrasonic diagnostic apparatus for body cavity |
JPS57190552A (en) * | 1981-05-20 | 1982-11-24 | Olympus Optical Co | Ultrasonic diagnostic apparatus |
JPS58152547A (en) * | 1982-03-05 | 1983-09-10 | オリンパス光学工業株式会社 | Ultrasonic diagnostic apparatus for body cavity |
JPS58157432A (en) * | 1982-03-15 | 1983-09-19 | オリンパス光学工業株式会社 | Ultrasonic diagnostic apparatus of body cavity |
US4493321A (en) * | 1982-05-25 | 1985-01-15 | Leather Robert P | Venous valve cutter for the incision of valve leaflets in situ |
JPS58218945A (en) * | 1982-06-15 | 1983-12-20 | オリンパス光学工業株式会社 | Ultrasonic endoscope |
US4475553A (en) * | 1982-07-09 | 1984-10-09 | Yokogawa Hokushin Electric Corporation | Ultrasonic needle housing probe with continuous locator array |
US4572203A (en) * | 1983-01-27 | 1986-02-25 | Feinstein Steven B | Contact agents for ultrasonic imaging |
US4576177A (en) * | 1983-02-18 | 1986-03-18 | Webster Wilton W Jr | Catheter for removing arteriosclerotic plaque |
JPS59166137A (en) * | 1983-03-11 | 1984-09-19 | 株式会社日立製作所 | Endoscopic ultrasonic diagnostic apparatus |
JPS60129055A (en) * | 1983-12-16 | 1985-07-10 | 井上 清 | Thrombus dissolving catheter |
JPS6049517U (en) * | 1983-09-12 | 1985-04-08 | 富士写真光機株式会社 | Endoscope with fixation balloon |
FR2552652B3 (en) * | 1983-09-29 | 1985-12-13 | Fornage Bruno | IMPROVEMENT IN ENDOCAVITY MEDICAL ECHOGRAPHY PROBES |
EP0163502B1 (en) * | 1984-05-30 | 1990-07-18 | Devices For Vascular Intervention Inc. | Atherectomy device |
US4587972A (en) * | 1984-07-16 | 1986-05-13 | Morantte Jr Bernardo D | Device for diagnostic and therapeutic intravascular intervention |
US4794931A (en) * | 1986-02-28 | 1989-01-03 | Cardiovascular Imaging Systems, Inc. | Catheter apparatus, system and method for intravascular two-dimensional ultrasonography |
US4669469A (en) * | 1986-02-28 | 1987-06-02 | Devices For Vascular Intervention | Single lumen atherectomy catheter device |
JPH0757222A (en) * | 1993-08-16 | 1995-03-03 | Sony Corp | Magneto-resistance effect type magnetic head |
-
1986
- 1986-02-28 US US06/834,893 patent/US4794931A/en not_active Expired - Lifetime
-
1987
- 1987-02-26 NO NO870819A patent/NO176123C/en not_active IP Right Cessation
- 1987-02-27 EP EP87301757A patent/EP0234951B2/en not_active Expired - Lifetime
- 1987-02-27 CA CA000530748A patent/CA1296589C/en not_active Expired - Lifetime
- 1987-02-27 DE DE3752336T patent/DE3752336T2/en not_active Expired - Lifetime
- 1987-02-27 DE DE3750268T patent/DE3750268T3/en not_active Expired - Lifetime
- 1987-02-27 EP EP93203529A patent/EP0600568B1/en not_active Expired - Lifetime
- 1987-02-27 DK DK105187A patent/DK105187A/en not_active Application Discontinuation
- 1987-02-28 JP JP62046625A patent/JPH0757222B2/en not_active Expired - Lifetime
-
1996
- 1996-10-16 JP JP8273577A patent/JP2763526B2/en not_active Expired - Lifetime
- 1996-10-16 JP JP8273576A patent/JP2763525B2/en not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
DK105187A (en) | 1987-08-29 |
JP2763526B2 (en) | 1998-06-11 |
NO176123C (en) | 1995-02-08 |
DE3750268T2 (en) | 1995-03-23 |
JPH09182754A (en) | 1997-07-15 |
DK105187D0 (en) | 1987-02-27 |
EP0234951B1 (en) | 1994-07-27 |
JP2763525B2 (en) | 1998-06-11 |
DE3752336T2 (en) | 2002-06-20 |
EP0600568B1 (en) | 2001-09-26 |
NO870819D0 (en) | 1987-02-26 |
JPH09182753A (en) | 1997-07-15 |
EP0234951A1 (en) | 1987-09-02 |
EP0600568A1 (en) | 1994-06-08 |
DE3750268T3 (en) | 1999-07-01 |
JPS62270140A (en) | 1987-11-24 |
EP0234951B2 (en) | 1999-04-28 |
NO176123B (en) | 1994-10-31 |
DE3752336D1 (en) | 2001-10-31 |
DE3750268D1 (en) | 1994-09-01 |
JPH0757222B2 (en) | 1995-06-21 |
US4794931A (en) | 1989-01-03 |
NO870819L (en) | 1987-08-31 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CA1296589C (en) | Catheter apparatus, system and method for intravascular two-dimensional ultrasonography | |
US7131948B2 (en) | Method and apparatus for intravascular two-dimensional ultrasonography | |
US5429136A (en) | Imaging atherectomy apparatus | |
US5115814A (en) | Intravascular ultrasonic imaging probe and methods of using same | |
US5582178A (en) | Method and apparatus for intravascular ultrasonography | |
EP0681454B1 (en) | Forward viewing imaging catheter system | |
US5010886A (en) | Medical probe assembly having combined ultrasonic imaging and laser ablation capabilities | |
CA2089656A1 (en) | Acoustic imaging catheter and the like | |
JPH0556977A (en) | Ultrasonic probe | |
CA2027391C (en) | Disposable intra-luminal ultrasonic instrument |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
MKLC | Lapsed (correction) | ||
MKLA | Lapsed | ||
MKEC | Expiry (correction) |
Effective date: 20121205 |