CN105377167A - Cyrocatheter with coolant fluid cooled thermoelectric module - Google Patents
Cyrocatheter with coolant fluid cooled thermoelectric module Download PDFInfo
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- CN105377167A CN105377167A CN201380076100.6A CN201380076100A CN105377167A CN 105377167 A CN105377167 A CN 105377167A CN 201380076100 A CN201380076100 A CN 201380076100A CN 105377167 A CN105377167 A CN 105377167A
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- electrothermal module
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- coolant fluid
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- cryoablation
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Abstract
Cryocatheter including an elongated flexible catheter member having a short rigid catheter tip for introduction to a therapy site, a thermoelectric module, and a heat exchange arrangement for freezing the catheter tip to a cryo-temperature from between about -15 DEG C to about -30 DEG C for freezing human tissue at the therapy site.
Description
Technical field
Present invention relates in general to conduit, and relate in particular to the cryoablation catheter (cryocatheter) for carrying out cryotherapy at therapentic part.
Background technology
The present invention relates to the conduit with elongated flexible parts of vessels and short rigid conduit tip (cathetertip).Determine according to expection clinical practice, approximately 0.5m to 1.5m is long usually for parts of vessels.Rigid conduit is most advanced and sophisticated, and approximately 0.8cm to 1.5cm is long usually.Parts of vessels and catheter tip have the external diameter of 2.3mm to 3.3mm, corresponding to French apertometer 7-10.Catheter tip is receiving end in guide catheter dome, and guide catheter dome is formed by the biocompatible materials of such as platinum, iridium and analog thereof usually.For some operative procedure, in single clinical procedure, catheter tip is intended to via being incorporated into human intracavity from the access interface of outside access (manipulation will perform along human intracavity), arrive therapentic part to perform treatment herein, then retract catheter tip along human intracavity, at access interface, human intracavity is left at place.More particularly, the present invention is directed to the cryoablation catheter for performing cryotherapy under cryogenic temperature at therapentic part, in the present case, cryogenic temperature is-10 DEG C and colder subzero tip temperature.
Joule-Thomson effect is utilized to implement cryoablation catheter at present, that is, make liquid, gas or vapor refrigerant by the pressure line of 70 bar to 150 bar, to be left by the attaching means at catheter tip place, thus the generation pressure loss, produce heat loss and cooling fast, so that catheter tip is chilled to cryogenic temperature thereupon.Exemplary prior art patent publication especially comprises the U.S. Patent No. 5 that the name of authorizing Wijkamp is called " cryoablation conduit (Cryo-AblationCatheter) ", 807, 391, the U.S. Patent Application Publication case No.2011/0196359 that name is called " having freezing and conduit (CatheterwithCryogenicandElectricalHeatingAblation) that is electrothermal ablation ", name is called PCT International Publication case No.WO2010/121739 of " being particularly suitable for the cryosurgery instrument (CryosurgicalInstrumentparticularlysuitablefortransbronch ialbiopsy) through bronchoscopic biopsies " etc.
Cryoablation catheter can buy from MedtronicCryoCath, Inc.www.cryocath.com by several brand name, wherein especially comprises
mAX myocardial refractoriness ablation catheter and
myocardial refractoriness ablation catheter.Cryoablation catheter utilizes nitrous oxide or argon cold-producing medium, and can at the heat energy of 4 to 5 minutes from tissue heat trnasfer tens watts, so low for catheter tip being chilled to-150 DEG C, to form the so-called ice hockey up to the size of 20mm diameter, for the freezing energy object of height, such as cryoablation etc.Cryoablation catheter also operates under partial freeze ability, for low freezing energy and medium freezing energy object, and such as, freezing mapping program under the narrow temperature range of usual-10 DEG C to-20 DEG C etc.Cryoablation catheter is considered to manipulation more difficult than non-frozen conduit, because its structure is able to take high pressure, more difficult manipulation conduit may be caused like this to be sent to the therapentic part of expectation.In addition, cryoablation catheter is very expensive.
Summary of the invention
The present invention is directed to the cryoablation catheter system comprising cryoablation catheter, described cryoablation catheter has elongated flexible parts of vessels and short rigid conduit is most advanced and sophisticated, for performing cryotherapy in treatment site.In single clinical procedure, catheter tip is usually via being incorporated into human intracavity, to shift therapentic part onto along human intracavity, for performing cryotherapy here from the access interface of outside access, then retract along human intracavity, make it leave human intracavity at access interface.Cryoablation catheter of the present invention comprises at least one electrothermal module, for the outer surface of catheter tip is directly chilled to next-door neighbour's 37 DEG C of human body temperature therapentic parts from the cryogenic temperature of-10 DEG C to-30 DEG C, so that interim freezing tissue is to perform freezing procedure, then catheter tip is thawed, to permit removing cryoablation catheter from human intracavity.Cryoablation catheter of the present invention comprises heat exchange in addition and arranges, it is communicated with external coolant fluid source stream, for providing downstream coolant fluid stream, to make coolant fluid stream pass wherein, with the hot side of the electrothermal module cooling at least one electrothermal module, so that the outer surface at cryoablation catheter tip.
Non-frozen conduit use electrothermal module to cool for a long time always and/or heating duct most advanced and sophisticated to perform treatment at therapentic part.Exemplary prior art patent publication especially comprises US7,238184, WO94/19833, name is called " thermoelectric device (ThermoelectricDeviceswithRecuperativeHeatExchangers) with recuperative heat exchanger ", WO02/080766, name is called " lipid pool process (TreatmentofLipidPool) " etc.This type of non-frozen conduit adopts a series of heat sink technology that the hot side of electrothermal module of electrothermal module opposed for the electrothermal module cold side being used for cooling its catheter tip with electrothermal module is cooled to below human body temperature, but far away higher than the cryogenic temperature that cryoablation catheter of the present invention can realize.Heat sink technology especially comprises the real core radiator of heat conduction, uses blood pond of next-door neighbour's therapentic part etc.
WO02/080766 the 6th page of the 11st row discloses a kind of guide tube assembly part 70, it has " cold " bottom surface 200, is positioned at the inflammation of tremulous pulse 100 and the lipid pool 110 of instability for solidification or " freezing ".WO02/080766 guide tube assembly part 70 can adopt electrothermal module, such as, can buy from the TECMicrosystemsGmbH (www.tecmicrosystems.com) in Berlin, Germany-Erik Adlerz Hough district.Suitable electrothermal module especially comprises 1MD03-008-4,1MD03-036-4 and analog thereof, and it has the thermal efficiency of 25% to 30% under the hot side of its electrothermal module and 30 DEG C to 40 DEG C, the cold side two ends temperature difference.The larger temperature difference at electrothermal module two ends can make its thermal efficiency seriously reduce, and is regarded as not conforming to reality.WO02/080766 guide tube assembly part 70 is cooled by blood flow, therefore can show, bottom surface 200 can be cooled to such as about 10 DEG C by the aforementioned electrothermal module operated under such as 15% to 20% thermal efficiency, this is enough to solidification inflammation or unstable lipid pool, but bottom surface 200 can not be cooled to zubzero temperature.
The present invention is based on following understanding: can design heat exchange and arrange, to carry out sufficient heat trnasfer from the hot side of electrothermal module in the persistent period of 3 to 4 minutes, the outer surface of catheter tip to be chilled in the region of next-door neighbour's 37 DEG C of human body temperature therapentic parts the cryogenic temperature from-10 DEG C to-30 DEG C, to produce the freezing tissue of difformity and different size at therapentic part.This type of refrigerating capacity can freezing tissue to form the ice hockey of 6.0mm to 8.0mm diameter, it is suitable for low and medium freezing energy cold therapy program, such as, stop the biological activity in tissue, provide anchorage force of 50 grams etc.Cryoablation catheter of the present invention can not supply the height freezing energy identical with above-described Joule-Thomson cryoablation catheter, but it is envisaged that, cryoablation catheter of the present invention will be cheaply more a lot of than Joule-Thomson cryoablation catheter, therefore, be the preferred option of low and medium freezing energy cold therapy program.In addition, the cryoablation catheter based on electrothermal module of the present invention is easier than Joule-Thomson effect cryoablation catheter controls.
Can show, need within 3 to 4 minutes persistent period from about 1.5 watts of heat trnasfer to about 2.0 watts of heat energy partial body's tissue is chilled to from approximately-10 DEG C to approximately-25 DEG C 37 DEG C of human body temperature treatment site.Therefore, based on 30% thermal efficiency of aforementioned reality, need heat exchange of the present invention to arrange from the electrothermal module of at least one electrothermal module hot side heat trnasfer from the heat energy of about 6.5 watts to 7.5 watts.This heat energy is considered to be needed from the heat energy having tissue to be frozen to absorb with through applying with the electric energy operating at least one electrothermal module.In order to allow the electrothermal module cold side of electrothermal module, there is cryogenic temperature approximately between-10 DEG C to-30 DEG C, the hot side of its electrothermal module must have the temperature of about 10 DEG C, specified by 30 DEG C to the 40 DEG C temperature difference by the hot side of aforementioned electrothermal module and electrothermal module cold side two ends.Downstream coolant fluid stream can be cooled to be not less than the cryogenic temperature close to such as about 3 DEG C, in case it just may occur freezing before being delivered to catheter tip.Therefore, downstream coolant fluid stream has such as the downstream temperature of on average about 5 DEG C after it is delivered to catheter tip, to leave about 5 DEG C of temperature difference between downstream coolant fluid stream and the hot side of electrothermal module.According to the vertical or horizontal deployment of the electrothermal module in catheter tip, the hot side of its electrothermal module has 20+10mm
2area occupied.The vertical and horizontal of electrothermal module dispose correspondingly with the longitudinal axis of parts of vessels altogether to or transverse to the longitudinal axis of parts of vessels.The hot side area occupied of usual longitudinal electrothermal module is larger than horizontal electrothermal module.Therefore, heat exchange of the present invention is arranged and must be designed to be able to from 20+10mm
2the hot side draught of electrothermal module receives 7.5W heat energy, and what this represented is from about 250Kw/m
2to 750Kw/m
2the heat radiation of quite large heat density.
The heat exchange that the present invention comprises two types is arranged to realize heat trnasfer degree high so as follows: the first, so-called heat spreader module.And the second, so-called jet impulse module.
The former comprises the radiator be connected with the electrothermal module of at least one electrothermal module hot side heat energy.Radiator is made up of high conductivity material, and this kind of material has the heat conductivity of at least 170w/m DEG C usually.Suitable material especially comprises metal, carbon back Heat Conduction Material and analog thereof.Fansink designs becomes to have the total heat exchange surface area of at least large four times of specific heat side area occupied, to absorb the heat energy of about 7.5 watts.The present invention imagines the several different embodiment of following fin: finned radiator.Coiled radiator.The radiator of traverse net disk is stacking.Porous radiator.
The latter adopts coolant fluid supply pipe, and it provides one or more coolant fluid jet, coolant fluid supply pipe preferably directly against the hot side of electrothermal module so that from electrothermal module hot side heat trnasfer 7.5 watts of heat energy.About the principle using jet to carry out heat energy heat radiation, please refer to two sections of jet impulse papers, these two sections of papers are incorporated herein by reference.Jet impulse paper is as follows: " initial laminar flow, transition and turbulent scheme to the localized heat transmission (LocalHeatTransfertoImpingingLiquidJetintheInitiallyLamin ar; TransitionalandTurbulentRegimes) impacting liquid jet ", author is B.Elison and B.W.Webb, " heat and mass transfer periodical (JournalofHeatandMassTransfer) ", 8th phase in 1994, the 37th volume." by impacting the convective heat transfer (ConvectiveHeatTransferbyImpingementofCircularLiquidJets) of round liquid jet ", author is X.Liu and J.H.Lienhard and J.S.Lombara, " heat trnasfer periodical (JournalofHeatTransfer) ", in August, 1991,113/571 volume.Or the hot side of electrothermal module can be covered by shock plate, described shock plate underlies with it direct thermo-contact of electrothermal module.
Cryoablation catheter system of the present invention may be embodied as open irrigating catheter system or circulation conduit system.In the former, the open inside of human body be flushed to around therapentic part of coolant fluid, and therefore coolant fluid must be biocompatible liquid, the normal saline of such as 0.9%NaCl and analog thereof.In the latter, cryoablation catheter comprises coolant fluid return duct, and itself and coolant fluid supply pipe extend jointly, for coolant fluid is transferred to external coolant fluid target from catheter tip.Coolant fluid target is preferably connected to coolant fluid source so that recirculation.Coolant fluid may not be biocompatible liquid, and it can be gas, such as nitrous oxide, argon and analog thereof.
Cryoablation catheter of the present invention can be disposed longitudinally and/or one or more horizontal electrothermal module in catheter tip.Can comprise the stacking of single Peltier device or two or more Peltier devices according to the electrothermal module of cryoablation catheter of the present invention, the hot side of electrothermal module of a Peltier device is towards the electrothermal module cold side of another Peltier device.
Accompanying drawing explanation
In fact how can perform the present invention to understand the present invention and understanding, only will describe preferred embodiment by means of limiting examples referring to accompanying drawing now, wherein represent similar part by identical numbering, and wherein:
Fig. 1 is the block diagram of open flushing cryoablation catheter system, and it comprises open flushing cryoablation catheter, and the described open cryoablation catheter that rinses comprises horizontal electrothermal module and heat exchange layout, for forming ice hockey at therapentic part;
Fig. 2 is the open cross section rinsing cryoablation catheter of the Fig. 1 along the line A-A in Fig. 1;
Fig. 3 is the block diagram of circulating frozen conduit system, and described circulating frozen conduit system comprises circulating frozen conduit, for forming ice hockey at therapentic part;
Fig. 4 is the cross section of circulating frozen conduit along the line B-B in Fig. 3 of Fig. 3;
Fig. 5 is the longitudinal section of the catheter tip of Fig. 1, and described catheter tip comprises longitudinal electrothermal module and heat spreader module;
Fig. 6 is the longitudinal section of the catheter tip of Fig. 1, and described catheter tip comprises horizontal electrothermal module and coiled radiator;
Fig. 7 is the top orthogonal view of the coiled radiator of Fig. 6;
Fig. 8 is the longitudinal section of the catheter tip of Fig. 1, and described catheter tip comprises longitudinal electrothermal module and porous radiator;
Fig. 9 is the longitudinal section of the catheter tip of Fig. 1, and described catheter tip comprises longitudinal electrothermal module and finned radiator;
Figure 10 is the cross section of finned radiator along the C-C line in Fig. 9 of Fig. 9;
Figure 11 is the longitudinal section of the catheter tip of Fig. 3, and described catheter tip comprises horizontal electrothermal module and alternative coiled radiator;
Figure 12 is the top orthogonal view of the coiled radiator of Fig. 1;
Figure 13 is the longitudinal section of the catheter tip of Fig. 3, and the radiator that described catheter tip comprises horizontal electrothermal module and traverse net dish is stacking;
Figure 14 is the top orthogonal view of the stacking traverse net dish of the radiator of Figure 13;
Figure 15 is the perspective cross-sectional view of the catheter tip of Fig. 1, and described catheter tip comprises horizontal electrothermal module and has the jet impulse module of single-nozzle;
Figure 16 A is the anterior elevational view of the jet impulse module of Figure 15;
Figure 16 B is the top orthogonal view of the impact zone of the nozzle of the jet impulse module of Figure 15 on the hot side of electrothermal module;
Figure 17 is the longitudinal section of the catheter tip of Fig. 1, and described catheter tip comprises longitudinal electrothermal module and has the jet impulse module of three nozzles;
Figure 18 is the cross section along the E-E line in Figure 17 of the catheter tip of Figure 17;
Figure 19 is the perspective cross-sectional view of the catheter tip of Fig. 3, and described catheter tip comprises horizontal electrothermal module and has the jet impulse module of single-nozzle;
Figure 20 is the longitudinal section of the catheter tip of Fig. 3, and described catheter tip is used for the portion of hangover district at cryoablation catheter tip;
Figure 21 is the longitudinal section of the catheter tip of Fig. 1, and described catheter tip comprises longitudinal electrothermal module and horizontal electrothermal module and heat spreader module;
Figure 22 is the open block diagram rinsing cryoablation catheter system, and described open flushing cryoablation catheter system comprises cryoablation catheter and the RF for melting at therapentic part execution RF melts device;
Figure 23 is the cross section along the F-F line in Figure 22 of the parts of vessels of Figure 22;
Figure 24 is the open block diagram rinsing cryoablation catheter system, and described open cryoablation catheter system of rinsing comprises the cryoablation catheter with catheter tip, and described catheter tip has sensor;
Figure 25 is the cross section along the G-G line in Figure 24 of the parts of vessels of Figure 24;
Figure 26 is the open longitudinal section rinsing cryoablation catheter, and the described open cryoablation catheter that rinses comprises a pair blank pipe chamber, for introducing operation tool at therapentic part; And
Figure 27 is the cross section along the H-H line in Figure 26 of the parts of vessels of Figure 26.
Detailed description of the invention
Fig. 1 illustrates open flushing cryoablation catheter system 100A, itself and opening are rinsed together with cryoablation catheter 130A and are used, the open cryoablation catheter 130A that rinses comprises and openly rinses elongated flexible parts of vessels 131A and openly rinse the most advanced and sophisticated 132A of short rigid conduit, for forming ice hockey IB at therapentic part.Cryoablation catheter system 100A must utilize biocompatible liquid for cooling object, so that be flushed to inside of human body tissue therapentic part is open.Described biocompatible liquid is preferably 0.9%NaCl normal saline and analog thereof.
Parts of vessels 131A has the length of about 0.5m to 1.5m, is denoted as E, and this length depends on the cryotherapy application that parts of vessels is expected.Catheter tip 132A has the length of about 0.8cm to 1.5cm.Parts of vessels 131A and catheter tip 132A has the external diameter of about 2.3mm to 3.3mm.Catheter tip 132A is in guide catheter dome 133 receiving end.Conduit dome 133 can have smooth spherical form.Alternatively, conduit dome 133 can be formed as different facings and shape, is similar to commercially available RF ablation catheter and diagnostic catheter.For example, Medtronic
cryoablation conduit and St.JudeMedical's
diagnostic catheter has difform conduit dome 133.
Catheter tip 132A comprises horizontal electrothermal module 134, and it is transverse to the longitudinal axis of parts of vessels 131A.Suitable electrothermal module 134 comprises the dash number 1MD03-008-4 of such as TECMicrosystemsGmbH, can buy from the TECMicrosystemsGmbH (www.tecmicrosystems.com) in Berlin, Germany-Erik Adlerz Hough district.Electrothermal module 134 has the hot side 136 of electrothermal module and electrothermal module cold side 137 during the operation of the most advanced and sophisticated 132A of its cryoablation catheter.Catheter tip 132A comprises heat exchange and arranges 138, for carrying out heat trnasfer from the hot side 136 of electrothermal module.Catheter tip 132A comprises critesistor 139, for monitoring the temperature of the hot side 136 of electrothermal module or electrothermal module cold side 137.Catheter tip 132A comprises one or more flushing hole 141, and the coolant fluid be provided for from catheter tip 132A can flow to the inside of human body around therapentic part.The heat exchange of catheter tip 132A arranges that 138 may be embodied as heat spreader module or jet impulse module, as mentioned below.
Conduit dome 133 contacts with electrothermal module cold side 137 high heat conductor, so that freezing tissue is to form ice hockey IB.Conduit dome 133 is formed by the high heat conductor material of biocompatibility, the heat conductivity at least >50w/m DEG C of this material, and preferably higher.Suitable conduit dome material comprises metal, such as platinum, iridium, gold etc. and high-termal conductivity plastics.Gold is particularly suitable for some application, because the heat conductivity of gold is high, and k>250w/m DEG C.Conduit dome 133 preferably uses high-termal conductivity packing material to be glued on electrothermal module cold side 137, to reduce the temperature drop from electrothermal module cold side 137 to conduit dome 133.Suitable commercially available high-level gap fill material has the high thermal conductivity coefficient k of about 10w/m DEG C.
Fig. 2 illustrates parts of vessels 131A and has extrusion molding structure, and it comprises following longitudinal tube chamber: the first, central lumen 142, and for accommodating coolant fluid supply pipe 143, it is for being delivered to catheter tip 132A by downstream coolant fluid stream.Second, a pair opposed tube chamber 144, for accommodating manipulation wire 146, to pass through therapentic part to help catheter tip 132A.3rd, tube chamber 147, for accommodating power transmission line to 148, it is connected to electrothermal module 134.And the 4th, tube chamber 149, for accommodating thermal resistor wire to 151, it is connected to critesistor 139.Tube chamber 149 can also be used for accommodating other pilot.
Cryoablation catheter system 100A comprises: external coolant fluid source 101, for biocompatibility coolant fluid is delivered to cryoablation catheter 130A so that the most advanced and sophisticated 132A of cryoablation catheter; Electrothermal module power supply 102, it is connected to power transmission line to 148; And controller 103, for controlling the operation of external coolant fluid source 101 and electrothermal module power supply 102.Controller 103 comprises on/off switch 104, for the icing control 106 of the most advanced and sophisticated 132A of cryoablation catheter and thaw control 107 and the temperature levels control 108 for thawing to catheter tip 132A, and be connected to thermal resistor wire to 151.The control 107 that thaws make power transmission line to 148 polarity inversion, to cool the hot side of electrothermal module 136 and heating electrothermal module cold side 137.
External coolant fluid source 101 comprises coolant fluid reservoir 109, such as, 0.9%NaCl normal saline transfusion bag under 17 DEG C to 24 DEG C ambient temperatures.External coolant fluid source 101 comprises chiller 111, makes it preferably close to cryogenic temperature for cooling normal saline, and for example, 3 DEG C to 4 DEG C to guarantee that normal saline can not be freezing.Cryoablation catheter system 100A can operate under higher coolant fluid temperature, for example 10 DEG C, but its refrigerating capacity straight line can be made like this to decline.External coolant fluid source 101 also comprises peristaltic pump 112, for downstream coolant fluid stream being delivered to cryoablation catheter 130A with the acceptable peak flow rate (PFR) of about 35cc/min (consider and rinse the open of inside of human body environment).
Coolant fluid supply pipe 143 has the typical internal diameter in 0.4mm to 0.7mm scope.The flow velocity of the downstream coolant fluid stream in coolant fluid supply pipe 143 is approximately 1.5-4.5m/s, makes it have the Reynolds number of about 700-1200 of laminar flow domain.This flow velocity can cause the pressure drop up to 40-70psi usually, the maximum permissible value of this medical grade conduit set that is near the mark.
Parts of vessels 131A has near-end 152, opposed with catheter tip 132A, and near-end 152 comprises end and arranges 153.End arrange 153 can comprise be connected to manipulation wire 146 handle 154, connect 156 and electric connection 157 for being connected to controller 103 for the Rule being connected to external coolant fluid source 101.
Fig. 3 shows circulating frozen conduit system 100B, and it comprises circulating frozen conduit 130B, and circulating frozen conduit 130B has circulation conduit parts 131B and the most advanced and sophisticated 132B of circulation conduit, for forming ice hockey IB at therapentic part.The structure of cryoablation catheter system 100B and operation and cryoablation catheter system 100A similar and therefore use same reference numeral similar portions.Circulating frozen conduit system 100B can utilize the coolant fluid of gas, steam or liquid form, and this point is different from open flushing cryoablation catheter system 100A.With reference to liquid coolant, this cryoablation catheter system 100B is described.The cryoablation catheter system 100B utilizing gaseous coolant easily can be revised out by native system.Based on cryoablation catheter system 100B air inclusion pump instead of the peristaltic pump of gas.Cryoablation catheter system 100B based on gas under high pressure operates, but does not have Joule-Thomson effect cryoablation catheter system so high.
Circulating frozen conduit system 100B is with open difference of rinsing cryoablation catheter system 100A, and circulating frozen conduit system 100B comprises coolant fluid target 113.The difference of cryoablation catheter 130B and cryoablation catheter 130A is, the parts of vessels 131B of cryoablation catheter 130B comprises another tube chamber 158, for accommodating coolant fluid return duct 159 (see Fig. 4) and its catheter tip 132B does not have flushing hole.Coolant fluid return duct 159 is connected to coolant fluid target 113, and coolant fluid target 113 is preferably connected to again coolant fluid reservoir 109.Compared with the coolant fluid supply pipe 143 of cryoablation catheter 130A, due to the cause of external refrigerating system conduit diameter constraint, coolant fluid supply pipe 143 and coolant fluid return duct 159 have less cross-sectional area usually in cryoablation catheter 130B.The heat exchange of catheter tip 132B arranges that 138 may be embodied as heat spreader module or jet impulse module, to cool the hot side 136 of electrothermal module, as described below.
The usage of cryoablation catheter system 100A is as follows:
Surgeon is via being incorporated into human intracavity by catheter tip from the access interface of outside access.Surgeon makes catheter tip pass through therapentic part.Controller is switched to icing pattern by surgeon, continues 3 to 5 minutes, with most advanced and sophisticated at treatment site cryoablation catheter.Catheter tip is in the freezing tissue in catheter tip place, and to form ice hockey, tissue is attached to catheter tip by ice hockey.Freezing process itself can be the cryotherapy expected, or surgeon can perform other medical procedure.At the end of medical procedure, controller is switched to defrost mode by surgeon, continue about 30-60 second, with tissue of thawing at catheter tip place, in case when catheter tip still freezing on tissue time pull off catheter tip from tissue tissue generation torn tissue, especially in vascular program.
the thermodynamic analysis that heat exchange is arranged
Heat exchange arranges that 138 have the downstream coolant fluid stream imported into and the coolant fluid stream spread out of, this fluid stream is flow to inside of human body environment in open flushing cryoablation catheter system 100A, or is flow to coolant fluid target 113 in circulating frozen conduit system 100B.
Heat exchange arranges that 138 have following specification:
H: heat transfer coefficient
Ah: heat exchange area
Use symbol below:
Q is the necessary total heat energy of heat trnasfer of the coolant fluid stream carried out from the hot side of electrothermal module to heat exchange layout, that is, about 7.5 watts.Total heat energy Q=Q1+Q2, wherein Q1 is must from the human body heat energy having tissue to be frozen to absorb, and the Q2 electric energy that to be at least one electrothermal module of operation required.
Tin imports downstream coolant fluid into flow to the temperature reached when heat exchange arranges 138.Based on Tin be initially cooled to before being incorporated in cryoablation catheter for example 2 DEG C to 3 DEG C and its along in parts of vessels traveling process with post-heating, Tin estimate at 4 DEG C to 5 DEG C.
Tout spreads out of coolant fluid stream to leave temperature when heat exchange arranges 138.Tout estimates at 6 DEG C to 9 DEG C after by the hot side 136 of electrothermal module directly or indirectly heating.
Thot is the temperature of the hot side 136 of electrothermal module of at least one electrothermal module at cryoablation catheter tip, wherein
(1)Thot＝Tin+Δt1+Δt2+…+Δtn
Wherein Δ t1, Δ t2 ... Δ tn is the temperature difference, and it depends on the structure that catheter tip and its heat exchange are arranged
Tcold is the temperature of electrothermal module cold side 137, wherein considers for reality
(2)Tcold＝Thot-35℃
Δ t1 is through the convection current temperature difference between the coolant fluid stream of heat exchange layout 138 and heat exchange area Ah, and account form is as follows:
Heat exchange is arranged and 138 must can be produced from the convection current temperature difference t1 in the scope of about 4 DEG C to about 10 DEG C, and heat exchange is arranged, and 138 the cryogenic temperature about-15 DEG C to about-30 DEG C from the hot side of the electrothermal module of the outer surface for cryoablation catheter tip 133 136 to the tissue for cold therapy position can carry out heat trnasfer.
The radiator embodiment that heat exchange of the present invention is arranged has relatively low heat transfer coefficient h, and is therefore designed to, compared with side area occupied Af hot with electrothermal module, to have larger heat exchange area Ah.The jet impulse embodiment that heat exchange of the present invention is arranged has relatively high heat transfer coefficient h, and therefore can be designed to utilize the available hot side area occupied Af of electrothermal module as heat exchange area Ah, and need other heat exchange area unlike according to radiator embodiment.
the radiator embodiment that heat exchange is arranged
Fig. 5 illustrates the most advanced and sophisticated 132A of open irrigating catheter, and it comprises the longitudinal electrothermal module 134 with the longitudinal axis equidirectional of parts of vessels 131A, and forms the heat spreader module 200 that heat exchange arranges 138.Exemplary electrothermal module 134 is dash number 1MD03-036-4 of TECMicrosystemsGmbH, and it has close to 20mm
2electrothermal module hot side area occupied.
Catheter tip 132A is designed to guarantee that the minimum temperature difference crossing over adjacent assemblies is so that freezing tissue.Therefore, catheter tip 132A utilizes high-level gap fill material, and it has the heat conductivity k within the scope of about 10w/m DEG C.Suitable gap fill material especially comprises the ultra-high conducting hot epoxy paste shape binding agent ME7159 of AIthecnologyInc, www.aithecnology.com.
Catheter tip 132A comprises duct wall 180, and it has longitudinal cut 181, and described longitudinal cut 181 extends with duct wall 180, for receiving longitudinal electrothermal module 134 and heat spreader module 200.Electrothermal module 134 has the hot side 136 of electrothermal module, and it is opposed with electrothermal module cold side 137, and electrothermal module cold side 137 faces duct wall 180, with cryoablation catheter sidewall 180, thus cryoablation catheter dome 133.Catheter tip 132A comprises: the first gap filling material layer 182, for electrothermal module cold side 137 is arranged on duct wall 180; And the second gap filling material layer 183, for heat spreader module 200 being arranged on the hot side 136 of electrothermal module.Gap fill material layer 182 and 183 has thickness L, and thickness L is usually in the scope of 50 μm to 100 μm.Heat spreader module 200 has the most lower wall 201 facing the hot side 136 of electrothermal module.
This catheter tip configuration introduces two extra temperature difference t2 and Δ t3, makes the account form of hot side temperature Thot as follows:
(1)Thot＝Tin+Δt1+Δt2+Δt3
Wherein Δ t2 is the temperature difference at the second gap filling layer 183 two ends, and account form is as follows:
And wherein Δ t3 is the temperature difference at lowest surface 201 two ends of heat spreader module 200, and is estimated as 3 DEG C, this is due to from the hot side 136 of electrothermal module to about 400Kw/m of most lower wall 201
2very high heat flux density.
Suppose that heat spreader module 200 has heat transfer coefficient h=10000w/m
2dEG C, and heat exchange area Ah equals the hot side area occupied 20mm of electrothermal module
2=20 × 10
-6m
2, then according to equation (3).
Based on above ins and outs, the account form of Δ t2 is as follows:
The value of Tin, Δ t1, Δ t2 and Δ t3 be updated to after in equation (1), the hot side of electrothermal module 136 has following hot side temperature Thot:
Thot＝Tin+Δt1+Δt2+Δt3＝5℃+2℃+3℃+37℃＝47℃
Its electrothermal module cold side 137 is made to have higher than cryogenic temperature according to equation (2):
Tcold＝Thot-35℃＝47℃-35℃＝+12℃
For illustration purposes, in order to catheter tip 132A is chilled to-17 DEG C, hot side temperature Thot must terminate in 18 DEG C.Can realize this point by providing heat spreader module 200, heat spreader module 200 has 94mm
2heat exchange area Ah, make convection current temperature difference t1 to be:
And hot side temperature Thot is therefore:
Thot＝Tin+Δt1+Δt2+Δt3＝5℃+2℃+3℃+8℃＝18℃
Thus obtain the electrothermal module cold side cryogenic temperature of expectation:
Tcold＝Thot-35℃＝18℃-35℃＝-17℃
The the first gap filling material layer 182 be arranged on by electrothermal module cold side 137 on duct wall 180 arranges 138 by there being human body heat energy Q1 to be absorbed from there being tissue to be frozen to be delivered to heat exchange.As mentioned above, Q1 is between about 1.5W and 2W, and this is approximately 1/4th of the heat energy Q that must be dissipated to heat exchange layout 138 from the hot side 136 of electrothermal module.First gap filling material layer 182 produces the insignificant temperature drop of about 0.5 DEG C at its two ends, make duct wall 180 almost identical with electrothermal module cold side 137 with the temperature of conduit dome 133.
Fig. 6 to Figure 14 illustrates five kinds of different heat spreader modules 200, and it easily can be designed to the heat exchange area of large at least four times of the hot side area occupied had than electrothermal module.
Fig. 6 and Fig. 7 illustrates catheter tip 132A, and it has horizontal electrothermal module and heat spreader module 200, and heat spreader module 200 is embodied as coiled radiator 202.Coiled radiator 202 comprises coil pipe 203, and it is coiled on central cylindrical core body 204, and central cylindrical core body 204 is arranged on the hot side 136 of electrothermal module.Coil pipe 203 has the average diameter AD1 of about 2.5mm and overall tubular length LI, wherein:
L1＝ΠxAD1xN
Wherein N is the number of turn around core body 204.The coiled radiator 202 of 8 circles has heat exchange area Ah=II × 0.5 × 63=99mm
2.
Fig. 8 shows catheter tip 132A, and it has longitudinal electrothermal module 134 and heat spreader module 200, and heat spreader module 200 is embodied as porous radiator 206.Porous radiator 206 can be formed by a series of Heat Conduction Material, such as metal, carbon-based material and analog thereof.Porous radiator 206 has by its material specific area (m
2/ gram) heat exchange area determined.
Fig. 9 and Figure 10 shows catheter tip 132A, and it has longitudinal electrothermal module 134 and heat spreader module 200, and heat spreader module 200 is embodied as finned radiator 207.Finned radiator 207 comprises base member 208, and it has many fins 209.Finned radiator 207 has heat exchange area Ah, and wherein Ah=2 × [NF × B+ (NF-1) × S] × L, wherein NF is fin number, and B is fin height, the interval between S fin, and L is fin length.
Figure 11 and Figure 12 illustrates catheter tip 132B, and it has horizontal electrothermal module 134 and heat spreader module 200, and heat spreader module 200 is also embodied as coiled radiator 202.Coiled radiator 202 comprises coil pipe 211, and it has two or more windings 212, by the operative connection process Installation of such as welding on the hot side 136 of electrothermal module.Coil pipe 211 has the pipe fitting internal diameter of about 0.5mm and the overall tubular length approximately between 40mm to 60mm, makes its heat exchange area approximate 90mm greatly
2.
Figure 13 and Figure 14 shows catheter tip 132B, and it has horizontal electrothermal module 134 and heat spreader module 200, and heat spreader module 200 is embodied as the radiator stacking 213 of horizontal wire net means 214.Figure 13 and Figure 14 shows traverse net parts 214, and it adopts the form of traverse net dish, usually has the diameter of about 2mm to 3mm, and is formed by the metal that 0.11mm is thick.Radiator stacking 213 can comprise traverse net parts vertical equally.Traverse net parts can be formed as difformity, especially comprise rectangle, ellipse and analog thereof.
Traverse net dish 214 has the netted density of per inch 100 wires usually.For example, the dash number 100x100C0022W48T of copper one-tenth can be bought from the TWP of California, USA Berkeley 94710, Inc..Radiator stacking 213 comprises about 30 disks, and total height is 3mm to 3.5mm.Radiator stacking 213 has the heat exchange area determined by N × AS, and wherein N is disk number, and AS is the total surface area of each traverse net dish.
the jet impulse embodiment that heat exchange is arranged
Jet impulse module is to the impact of shock surface based on one or more coolant fluid jet, to provide heat trnasfer more more effective than heat spreader module, thus make jet impulse module catheter tip can be chilled to the cryogenic temperature lower than heat spreader module.
Figure 15, Figure 16 A and Figure 16 B shows open flushing cryoablation catheter 130A, and it has catheter tip 132A, and catheter tip 132A has horizontal electrothermal module 134 and jet impulse module 300, and it forms heat exchange and arranges 138, for the formation of ice hockey IB.Jet impulse module 300 comprises housing 301, and it is sealed on electrothermal module 134 to form heat exchange cavity 302.Housing 301 can be formed by non-thermally conductive material, such as biological plastics, and its ratio is as cheaply a lot of in the biocompatible materials of platinum, iridium and analog thereof.Housing 301 can be manufactured by the low cost process (such as micro-injection is molded) being suitable for medical part.In addition, housing 301 can by having the plastics compatible with the ceramic wafer of electrothermal module of low thermal coefficient of expansion to reduce thermal stress during operation.
Jet impulse module 300 comprises single-nozzle 303, and for preferably coolant fluid jet directly being impacted the hot side 136 of electrothermal module at impact site 304 place, the hot side 136 of electrothermal module forms shock surface.Nozzle 303 have nozzle inside diameter D and with the hot side 136 of electrothermal module shock height H apart.Nozzle there is nozzle inside diameter D within the scope of 0.3mm to about 0.7mm usually and from about 0.3mm to the scope of about 0.7mm in shock height H.
Figure 16 B shows that each coolant fluid jet causes the heat trnasfer on imaginary circular impact zone 306, and circular impact district 306 has impact zone radius R, but the shape in real impact district 306 is by housing 301 gauge.But each coolant fluid jet has effective imaginary circular impact zone 307, and its maximum impact district radius is the twice of the size of nozzle inside diameter D, exceedes this radius, and the heat trnasfer in the annular section between impact zone 306 and 307 can significantly reduce.Therefore, if R>3D, then it is thermodynamically worth for adding nozzle, preferably to remove any annular section exceeding impact zone 307.Therefore, jet impulse module 300 can comprise the array of the nozzle 303 of single-nozzle 303 or m × n, at least one >1 wherein in m and n, and this depends on size and the size of the hot side 136 of electrothermal module.
Jet impulse module 300 has heat transfer coefficient h, and it depends on following two ratios:
First, ratio H/D, when maximum volume flow be 35cc/min and concrete specific nozzle diameter, when the speed of the coolant fluid jet flowed out from nozzle 303 is when from about 1.5m/sec to the scope of about 7.0m/sec, ratio H/D is preferably in the scope of from about 0.5 to about 1.5.
The second, ratio R/D, it is preferably in the scope of 2≤R/D≤4, because nozzle is too close to manufacture can be allowed each other to become complicated, and its corresponding coolant fluid jet may be caused interfering with each other.
Aforementioned jet impulse paper has been set forth jet impulse module 300 and has been had heat transfer coefficient h according to equation:
Wherein Nu is so-called nusselt number, and k is the heat conductivity of jet impulse fluid, and D is the nozzle inside diameter in units of rice.For example, 0.9%NaCl normal saline has heat conductivity k ≈ 0.58w/m DEG C.
Aforementioned jet impulse paper also states and calculates nusselt number Nu according to equation (5):
(5)Nu＝0.75×Re
1/
2×Pr
1/
3
Wherein Re is Reynolds number, and Pr is Pulan top number.
Jet impulse module 300 according to the present invention has the Reynolds number in the scope of from about 400 to about 1400, the Pulan top number in the scope of from about 9 to about 11, and from about 35,000w/m
2dEG C to about 55,000w/m
2dEG C scope in heat transfer coefficient h, between these larger than the heat transfer coefficient of heat spreader module three times and six times.
Be different from heat spreader module 200, jet impulse module 300 has the single temperature difference between hot side temperature Thot and coolant fluid, i.e. convection current temperature difference t1 makes Thot=Tin+ Δ t1.Convection current temperature drop Δ t1 calculates according to equation (3), and wherein heat exchange area A equals hot side area occupied.
Figure 17 and Figure 18 shows the most advanced and sophisticated 132A of open irrigating catheter, it comprises jet impulse module 311, described jet impulse module 311 has 1 × 3 array 312 of nozzle 313, for carrying out heat trnasfer from the TECMicrosystemsGmbH dash number 1MD03-036-4 electrothermal module 314 identical with the heat spreader module 200 of Fig. 5.Each nozzle 313 has nozzle inside diameter D=0.40mm and shock height H=0.40mm, makes each nozzle 313 have ratio D/H=1 within the scope of 0.5<D/H<1.5.TECMicrosystemsGmbH dash number 1MD03-036-4 has 2.8mm width, 6.6mm length and close to 20mm
2hot side area occupied.
Jet impulse module 311 needs three nozzles 313 to carry out heat trnasfer with the length in fact along electrothermal module 314, as referring to now following calculate explain:
Jet impulse module 311 has the nozzle 313 of three spaced at equal intervals along its length, makes each impact zone radius R=1.15, the spaced apart 2.3mm of adjacent nozzles 313, and two end nozzle 313 separately and the spaced apart 1.15mm of opposite ends of electrothermal module 314.Therefore, ratio R/D will be 1.15/0.40=2.75, and therefore this be acceptable within the scope of the optimal value of R/D.
Jet impulse module 311 may utilize single-nozzle 313 effectively to carry out heat trnasfer along the width of electrothermal module 314, as now below second calculate in explain:
Jet impulse module 311 has single central nozzle 313 along its width, and make its impact zone radius R=2.8mm/2=1.4mm, and ratio R/D is 1.4/0.40=3.5, this is within the scope of acceptable R/D.
When jet impulse module 311, Reynolds number has 410 values, and Pulan top number has all values, makes according to equation (5) Nu=34 and according to equation (4), its heat transfer coefficient h=34 × 0.58/0.4 × 10
-3=49000w/m
2dEG C.As limited, at jet impulse cooling Ah=Af and therefore according to equation (3), jet impulse module 314 has convection current temperature difference t1:
The hot side of electrothermal module 136 has hot side temperature Thot=Tin+ Δ t1=5 DEG C+8 DEG C=13 DEG C, makes electrothermal module cold side 137 have cold-side temperature Tcold=Thot-35 DEG C=13 DEG C-35 DEG C=-22 DEG C, and this is within the scope of the cryogenic temperature of expection.
Figure 19 shows the most advanced and sophisticated 132B of circulation conduit, its jet impulse module 300 having horizontal electrothermal module 134 and have single-nozzle 303.
cryoablation catheter designs
Figure 20 to Figure 27 illustrates the different characteristic according to cryoablation catheter of the present invention.Described feature is not mutually repel, and cryoablation catheter can comprise the combination of one or more feature.In addition, cryoablation catheter can comprise longitudinal electrothermal module or horizontal electrothermal module.Further, cryoablation catheter can comprise heat spreader module or jet impulse module.
Figure 20 is that hangover portion of district is deployed in after its guide catheter dome 133 for the portion of hangover district of the most advanced and sophisticated 132B of cryoablation catheter to form the longitudinal section of the circulating frozen conduit 130B of ice hockey IB.Cryoablation catheter 130B comprises metallic plate 160, itself and the high thermal conductive contact of electrothermal module cold side 137.Metallic plate 160 has peripheral cylindrical surface 160A, for the freezing tissue be in contact with it.The length extending to the catheter tip 132B of conduit dome 133 from metallic plate 160 is preferably made up of the non-high conductivity material of such as polyamide.For the clinical practice needing electric conductivity, conduit dome 133 can be made of metal.
Figure 21 is the open longitudinal section rinsing cryoablation catheter 130A, the open cryoablation catheter 130A that rinses has catheter tip 132A, it comprises longitudinal electrothermal module 134A and horizontal electrothermal module 134B and heat exchange arranges 138, for carrying out heat trnasfer from these two electrothermal module 134A and 134B simultaneously.Electrothermal module 134A and 134B can be considered as having single hot side, and its hot side area occupied equals the summation of its each hot side area occupied.
Figure 22 and Figure 23 illustrates open flushing cryoablation catheter system 100A, and it comprises open cryoablation catheter 130A and RF that rinse and melts device 114, and melt for performing RF in treatment site, RF melts device 114 wire 150 and is connected to dome 133.
Figure 24 and Figure 25 illustrates and open rinses cryoablation catheter system 100A, and it comprises and openly rinses cryoablation catheter 130A, and it has catheter tip 132A, catheter tip 132A with harvester 161, for gathering patient information in treatment site.Exemplary harvester 161 especially comprises sensor, camera and analog thereof for sensing physiological parameter.Exemplary sensor especially comprises ultrasonic sensor, Pressure gauge and analog thereof.Controller 103 is connected to harvester 161 by holding wire 162.
Figure 26 and Figure 27 illustrates circulating frozen conduit system 100B, and it comprises blank pipe chamber 163, for introducing operation tool at therapentic part.This type of operation tool can be such as the biopsy syringe needle 165 being connected to external suction pump.
Although describe the present invention relative to a limited number of embodiment, should be appreciated that, many changes of the present invention, amendment and other application can be carried out within the scope of the appended claims.
Claims (13)
1. for a cryoablation catheter for cryoablation catheter system, it comprises external coolant fluid source, and for transmitting downstream coolant fluid stream, described cryoablation catheter comprises:
(a) elongated flexible parts of vessels, it is most advanced and sophisticated that it has short rigid conduit, for introduction into therapentic part;
(b) at least one electrothermal module, it has the hot side of electrothermal module and electrothermal module cold side, the high-termal conductivity outer surface height thermal conductive contact of described electrothermal module cold side and described catheter tip;
(c) coolant fluid supply pipe, it is connected with described external coolant fluid source stream, for described downstream coolant fluid stream is delivered to described catheter tip; And
D the heat exchange at () described catheter tip place is arranged, for receiving the downstream coolant fluid stream imported into from described coolant fluid supply pipe, to cool the hot side of described electrothermal module, and the coolant fluid stream spread out of,
Described heat exchange arranges to have heat transfer coefficient h and heat exchange area Ah, and can form convection current temperature difference t1 according to lower relation of plane through its coolant fluid stream and the hot side of described electrothermal module
Wherein Q carries out the required total heat energy of heat trnasfer from the hot side of described electrothermal module to described coolant fluid stream, and Δ t1 is from the scope of about 4 DEG C to about 10 DEG C, described heat exchange is made to arrange the cryogenic temperature that the described outer surface of described catheter tip can be chilled to from approximately-15 DEG C to about-30 DEG C, so that in the freezing tissue of described therapentic part.
2. cryoablation catheter according to claim 1, wherein said heat exchange is arranged and is made up of the heat spreader module with the hot side thermo-contact of described electrothermal module, and described heat spreader module has from about 5000w/m
2dEG C to about 10,000w/m
2dEG C scope in heat transfer coefficient h, and the hot side of described electrothermal module has hot side area occupied Af, and described heat spreader module has heat exchange area Ah, and it is than large at least four times of described hot side area occupied Af.
3. cryoablation catheter according to claim 2, wherein said heat exchange is arranged and is comprised finned radiator.
4. cryoablation catheter according to claim 2, wherein said heat exchange is arranged and is comprised coiled radiator.
5. cryoablation catheter according to claim 2, wherein said heat exchange arranges that the radiator comprising traverse net parts is stacking.
6. cryoablation catheter according to claim 2, wherein said heat exchange is arranged and is comprised porous radiator.
7. cryoablation catheter according to claim 1, wherein said heat exchange is arranged and is comprised jet impulse module, described jet impulse module comprises at least one nozzle, for impacting coolant fluid jet on shock surface, described shock surface and the hot side thermo-contact of described electrothermal module, to carry out heat trnasfer from the hot side of described electrothermal module
At least one nozzle at least one nozzle wherein said has nozzle inside diameter D and the shock height H from described shock surface, for limiting from about 0.5 to the ratio D/H in about 1.5 scopes.
8. the cryoablation catheter according to any one of claim 1 to 7, for portion of hangover district instead of its guide catheter dome of freezing described catheter tip.
9. the cryoablation catheter according to any one of claim 1 to 8, at least one electrothermal module wherein said comprises longitudinal electrothermal module and horizontal electrothermal module.
10. the cryoablation catheter according to any one of claim 1 to 9, wherein said catheter tip comprises RF electrode for melting purposes.
11. cryoablation catheters according to any one of claim 1 to 9, wherein said catheter tip comprises harvester, for gathering patient information in described treatment site.
12. cryoablation catheters according to any one of claim 1 to 9, wherein said parts of vessels comprises at least one blank pipe chamber, for operation tool is incorporated into described therapentic part.
13. 1 kinds of cryoablation catheter systems being applicable to the cryoablation catheter according to any one of claim 1 to 12.
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| PCT/IL2013/050363 WO2013164820A1 (en) | 2012-04-30 | 2013-04-30 | Cyrocatheter with coolant fluid cooled thermoelectric module |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN105377167A true CN105377167A (en) | 2016-03-02 |
| CN105377167B CN105377167B (en) | 2018-11-09 |
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| Application Number | Title | Priority Date | Filing Date |
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Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
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| CN109599972A (en) * | 2017-10-02 | 2019-04-09 | 通用电气航空系统有限责任公司 | Method for the rotor assembly of motor and for cooling down rotor assembly |
| CN110215275A (en) * | 2019-07-16 | 2019-09-10 | 孙悦 | A kind of freezer unit for treating preauricular flstula |
| CN110215276A (en) * | 2019-07-16 | 2019-09-10 | 孙悦 | A kind of refrigerating plant for treating preauricular flstula |
| CN111050709A (en) * | 2017-07-28 | 2020-04-21 | 凯希特许有限公司 | System and method for temperature contrast therapy |
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| US5139496A (en) * | 1990-12-20 | 1992-08-18 | Hed Aharon Z | Ultrasonic freeze ablation catheters and probes |
| CN1075248A (en) * | 1991-09-06 | 1993-08-18 | 低温医学科学公司 | The cryoinstrument of band discharge orifice and the using method of this apparatus |
| WO2012058430A2 (en) * | 2010-10-27 | 2012-05-03 | Cryomedix, Llc | Cryoablation apparatus with enhanced heat exchange area and related method |
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2013
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Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5139496A (en) * | 1990-12-20 | 1992-08-18 | Hed Aharon Z | Ultrasonic freeze ablation catheters and probes |
| CN1075248A (en) * | 1991-09-06 | 1993-08-18 | 低温医学科学公司 | The cryoinstrument of band discharge orifice and the using method of this apparatus |
| WO2012058430A2 (en) * | 2010-10-27 | 2012-05-03 | Cryomedix, Llc | Cryoablation apparatus with enhanced heat exchange area and related method |
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN111050709A (en) * | 2017-07-28 | 2020-04-21 | 凯希特许有限公司 | System and method for temperature contrast therapy |
| CN109599972A (en) * | 2017-10-02 | 2019-04-09 | 通用电气航空系统有限责任公司 | Method for the rotor assembly of motor and for cooling down rotor assembly |
| US10756598B2 (en) | 2017-10-02 | 2020-08-25 | Ge Aviation Systems Llc | Method and apparatus for cooling a rotor assembly |
| CN109599972B (en) * | 2017-10-02 | 2021-06-18 | 通用电气航空系统有限责任公司 | Rotor assembly for an electric machine and method for cooling a rotor assembly |
| CN110215275A (en) * | 2019-07-16 | 2019-09-10 | 孙悦 | A kind of freezer unit for treating preauricular flstula |
| CN110215276A (en) * | 2019-07-16 | 2019-09-10 | 孙悦 | A kind of refrigerating plant for treating preauricular flstula |
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|---|---|
| CN105377167B (en) | 2018-11-09 |
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