WO1997019644A1 - Apparatus and methods for ultrasonically enhanced intraluminal therapy - Google Patents
Apparatus and methods for ultrasonically enhanced intraluminal therapy Download PDFInfo
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- WO1997019644A1 WO1997019644A1 PCT/US1996/019007 US9619007W WO9719644A1 WO 1997019644 A1 WO1997019644 A1 WO 1997019644A1 US 9619007 W US9619007 W US 9619007W WO 9719644 A1 WO9719644 A1 WO 9719644A1
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
- A61B17/2202—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
- A61B17/2202—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter
- A61B2017/22021—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter electric leads passing through the catheter
-
- 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
- A61B2017/22082—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 after introduction of a substance
- A61B2017/22084—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 after introduction of a substance stone- or thrombus-dissolving
Definitions
- the present invention relates generally to medical devices and methods More particularly, the present invention relates to apparatus and methods for the localized delivery of therapeutic ultrasound energy within the vasculature and other body lumens .
- vascular diseases such as acute myocardial infarction (heart attack) and peripheral arterial thrombosis (blood clots m leg arteries)
- acute myocardial infarction heart attack
- peripheral arterial thrombosis blood clots m leg arteries
- the core of the problem is that diseased sites within the blood vessels narrow and eventually become completely blocked as a result of the deposition of fatty materials, cellular debris, calcium, and/or blood clots, thereby blocking the vital flow of blood
- Current treatments include drugs, interventional devices, and/or bypass surgery
- High doses of thrombolytics clot-dissolving drugs
- thrombolytics fail to restore blood flow m the affected vessel m about 30% of patients
- these drugs can also dissolve beneficial clots or injure healthy tissue causing potentially fatal bleeding complications
- interventional devices including angioulasty, atherectomy, and laser ablation catheters
- the use of such devices to remove obstructing deposits may leave behind a wound that heals by forming a scar.
- the scar itself may eventually become a serious obstruction in the blood vessel (a process known as restenosis) .
- diseased blood vessels being treated with interventional devices sometimes develop vasoconstriction (elastic recoil), a process by which spasms or abrupt reclosures of the vessel occur, thereby restricting the flow of blood and necessitating further intervention.
- vasoconstriction elastic recoil
- bypass surgery can redirect blood around the obstructed artery resulting in improved blood flow.
- the resulting bypass grafts can themselves develop scar tissue and new blood clots in five to ten years resulting in blockage and the need for further treatment.
- all current therapies have limited long term success.
- ultrasonic energy has been proposed both to mechanically disrupt clot and to enhance the intravascular delivery of drugs to dissolve clot and inhibit restenosis.
- Ultrasonic energy may be delivered intravascularly using specialized catheters having an ultrasonically vibrating surface at or near their distal ends .
- One type of ultrasonic catheter employs a wire or other axial transmission element to deliver energy from an ultrasonic energy vibration source located outside the patient, through the catheter, and to the ultrasonically vibrating surf ce. While such systems can deliver relatively large amounts of energy, the need to transmit that energy through the entire length of the catheter presents a substantial risk to the patient.
- catheters are typically rigid and cannot easily traverse narrow, tortuous arteries, such as the coronary arteries which frequently need to be treated. Because of their rigidity and inability to follow the vascular lumen, these catheters present a serious risk of vascular wall perforation.
- the catheters of the '309 patent have relatively long, rigid transducers and are not amenable to receiving guidewires, both of which features make it difficult to position the catheters within the vasculature, particularly the coronary vasculature.
- it would be desirable to provide improved ultrasonic catheter designs overcoming at least some of the problems discussed above.
- transducer and driver designs which are highly efficient and which minimize the production of heat within the vascular or other luminal environment.
- ultrasonic energy is useful for a variety of purposes, including the direct mechanical disruption of clot, the enhancement of thrombolytic activity of agents to dissolve clot, and the enhancement of pharmacologic agents to prevent restenosis of vascular sites previously treated by angioplasty or other interventional methods .
- An electrosurgical angioplasty catheter having ultrasonic enhancement is described in U.S. Patent No. 4,936,281.
- An infusion and drainage catheter having an ultrasonic cleaning mechanism is described in U.S. Patent No. 4,698,058.
- a drug delivery catheter having a pair of spaced-apart balloons to produce an isolated region around arterial plaque is described in U.S. Patent No. 4,636,195.
- a catheter for the intraluminal delivery of ultrasonic energy comprises a catheter body having a proximal end and a distal end.
- a tail mass is attached to the catheter body, typically at its distal end, and a longitudinally oscillating driver engages and extends distally from the tail mass.
- An interface member is disposed to engage a distally forward surface of the oscillating driver, and the mass of the interface member is much less than that of the tail mass.
- the tail mass and interface member are connected to each other by a spring element so that a resonant system is formed for driving the interface member.
- the resonant frequency of the interface member, spring element, and oscillating driver is independent of the tail mass and defined primarily by the mass of the interface member and the elastic modulus of the spring element, and the oscillating driver.
- the resonant system defined by the interface member, the spring element, and the oscillating driver can be resonantly driven to enhance both the displacement amplitude of an interface surface on the interface member and increase the efficiency of operation, i.e., the conversion of electrical energy to mechanical energy.
- the longitudinally oscillating member may take any conventional form for an ultrasonic transducer, typically being a tubular piezoelectric transducer, a piezoelectric stack, or the like.
- An exemplary tubular piezoelectric transducer comprises a hollow piezoelectric cylinder having an inner cylindrical electrode and an outer cylindrical electrode.
- Application of a driving current to the electrodes causes axial and radial expansion and contraction of the piezoelectric transducer.
- the axial expansion and contraction allow the piezoelectric cylinder to resonantly drive the interface member m the longitudinal direction.
- An exemplary piezoelectric stack comprises a plurality of ceramic disks having electrodes therebetween.
- the spring element will comprise an axial member capable of mechanically coupling the interface member to the tail mass with sufficient space therebetween to receive the longitudinal driver.
- the spring element will comprise at least one rod secured at a proximal end to the tail mass and at a distal end to the interface member.
- the rod may optionally be tubular to provide the path for a guidewire, infusion of therapeutic agent, or the like.
- a single rod will usually be disposed coaxially within the catheter. Multiple rods may be disposed symmetrically about the axis of the catheter body
- the spring element may comprise a thin-walled cylindrical member secured to the tail mass and the interface member and enclosing the longitudinally oscillating member in a concentric manner.
- the interface member will usually include a distally disposed interface surface which forwardly transmits longitudinal oscillations into the environment surrounding the distal end of the catheter.
- the interface surface will typically be convex, although it could be flat, concave, or irregular.
- a method according to the present invention for treating intraluminal lesions comprises providing a catheter having an interface member at its distal end.
- a forwardly disposed surface of the interface member is advanced to a region near the intraluminal lesion, typically to a region of vascular stenosis within a patient's vasculature, and the interface member is resonantly driven relative to a tail mass mounted proximally of the interface member. In this way, ultrasonic energy is efficiently delivered into the regions surrounding the distal end of the catheter.
- the interface member will usually have a mass in the range from 0.005 gm to 1 gm, preferably from 0.01 gm to 0.3 gm, and is typically driven at a frequency in the range from 10 kHz to 300 kHz, and will have a longitudinal amplitude in the range from about 0.05 ⁇ m to 40 ⁇ m, preferably from 10 ⁇ m to 25 ⁇ m, under typical mass loading conditions of a vascular lumen.
- the forwardly disposed surface of the interface member will typically have an area in the range from 0.5 mm 2 to 20 mm 2 , preferably from 1 mm 2 to 12 mm 2 , and the catheter may be used in a variety of specific therapeutic protocols.
- the interface member will be engaged directly against a vascular obstruction and used to ablate the structure or optionally to dissolve the structure with the simultaneous delivery of a thrombolytic or fibrinolytic agent.
- the catheter can be used to deliver ultrasonic energy into an environment where a thrombolytic or fibrinolytic agent has been delivered, where the catheter need not be directly engaged against clot or other stenoses. In such cases, the ultrasonic energy will enhance the activity of the therapeutic agent, typically by improving penetration of the agent into the clot.
- the catheter may be used to deliver an anti-thrombotic agent to a previously treated vascular site to inhibit restenosis. Again, the ultrasonic energy will typically provide for enhanced delivery and penetration of the anti-thrombotic agent into the blood vessel wall.
- the catheter may be used to dissolve the clot, without the adjunct benefit of thrombolytic agents.
- Fig. 1 illustrates an exemplary catheter and ultrasonic energy source constructed in accordance with the principles of the present invention.
- Fig. 2 is a detailed view of the distal end of the catheter of Fig. 1, shown in partial section.
- Fig. 3 is a perspective view of the tubular piezoelectric transducer which is incorporated in the catheter of Fig. 1.
- Fig. 4 is a cross-sectional view taken along line 4-
- Fig. 5 is a detailed view of the distal end of the catheter of Fig. 1, with the extent of longitudinal oscillation being shown in broken line.
- Fig. 6 is an alternative detailed view of the distal end of the catheter of Fig. 1, shown in partial section.
- Fig. 7 is a perspective view of the piezoelectric stack ultrasonic transducer incorporated in the design of
- Fig. 8 illustrates use of the catheter of Fig. 1 in a first protocol for ultrasonically ablating clot by direct engagement with the clot.
- Fig. 9 illustrates use of the catheter of Fig. 1 in a second protocol for ultrasonically enhancing the activity of a therapeutic agent released from the distal end of the catheter.
- the present invention provides apparatus and methods for the treatment of luminal conditions, particularly for the treatment of diseases of the coronary and peripheral vasculature
- Specific conditions include coronary and peripheral arterial disease and thrombosis.
- the apparatus and methods are useful for primary treatment of such diseases, where the purpose is to ablate, dissolve, or otherwise disrupt the clot, plaque, or other stenotic lesions which are responsible for the disease.
- catheters constructed according to the principles of the present invention can be used to directly engage and transmit ultrasonic energy into the stenotic material in order to mechanically disrupt the material to open the associated blood vessel lumen. Such mechanical disruption can be accomplished with or without the simultaneous administration of pharmacologic and therapeutic agents.
- the apparatus and methods of the present invention are also useful to enhance the administration of therapeutic agents, where the therapeutic agents are primarily responsible for the disruption of the stenotic material
- the catheter may be engaged against the stenotic material, or alternatively may be maintained a short distance away from the stenotic material
- the ultrasonic energy will be relied on to agitate and promote the penetration of the therapeutic agent into the stenotic material
- Suitable therapeutic agents include known thrombolytic and fibrinolytic drugs, such as heparin, tissue plasminogen activator (tPA) , urokmase, streptokmase, and the like.
- the catheters and methods of the present invention are still further useful for the treatment of vascular sites which have been previously treated by other interventional technique ⁇ , such as angioplasty, atherectomy, laser ablation, and the like
- the catheters will be used to agitate and promote the penetration of anti- thrombogenic agents into the vascular or other luminal wall to inhibit restenosis.
- Suitable anti-thrombogenic agents include hirudin, hirulog, heparin, tPA, urokmase, streptokmase, and the like
- the present invention may also be used for systemic and localized delivery of drugs within other body lumens, such as the ureter, the urethra, fallopian tubes, and the like.
- the present invention may further be used for the systemic and localized delivery of drugs within the vascular system for treatment of non-vascular diseases, e.g., for the treatment of tumors by the localized delivery of drugs to the vasculature supporting the tumor.
- the catheter of the present invention will comprise a catheter body having a proximal end and distal end.
- the catheter body will have dimensions and physical characteristics selected for the particular use.
- the length of the catheter body will typically be from 50 cm to 200 cm, usually being from 75 cm to 150 cm, and the diameter will be from 1 mm to 5 mm, usually being from 2 mm to 4 mm.
- the diameter of the catheter body may vary over its length, and different portions of the length may be formed from different materials.
- the catheter body will comprise a single extrusion having at least one lumen therethrough.
- the lumen will usually be capable of receiving a guidewire, and may also be capable of delivering therapeutic agents and/or carrying electrical wires for connection from the proximal end of the catheter body to the distal end.
- the catheter body may include separate lumens for delivering therapeutic agent (s) , routing electrical wires for connection to the ultrasonic transducer, or other purposes.
- the catheter body may be reinforced over all or a portion of its length. Conventional reinforcement materials include wire braids, wire meshes, wire coils, and the like. When employed with a guidewire for placement within the vasculature, the catheter body may have an "over-the-wire" design or a "rapid exchange" design.
- the guidewire lumen will extend substantially through the entire length of the catheter body.
- the guidewire lumen will terminate in a proximal guidewire port located relatively near the distal end of the catheter body, usually within 50 cm, more usually within 30 cm, and often within 25 cm or less.
- a proximal housing will be secured to the proximal end of the catheter body, where the housing includes a guidewire port, a therapeutic agent infusion port, and the like.
- a resonantly vibrating assembly is secured at or near the distal end of the catheter body
- the assembly will include an interface member which is resonantly vibrated at the desired ultrasonic frequency and which includes at least one interface surface for transmitting the ultrasonic vibrations to the fluid environment surrounding the distal end of the catheter.
- the resonantly vibrating assembly will usually be attached directly to the distal end of the catheter body but also could be disposed partially or totally withm the distal end of the catheter body Usually, the resonantly vibrating assembly will have a relatively short length, usually being below 2 cm, preferably being below 1 cm, and typically being the range from about 0 4 cm to 1 5 cm, more usually m the range from about 0.6 cm to 1 cm.
- the assembly will preferably have a low profile to facilitate vascular or other intraluminal introductions, typically having a diameter below 6 mm, usually the range from 1 mm to 5 mm, more usually the range from 2 mm to 4 mm.
- the interface surface will be forwardly disposed so that the surface may engage intraluminal obstructions as the catheter is advanced through the body lumen, such as a blood vessel.
- Such forwardly disposed vibrating surfaces will also be useful for projecting ultrasonic energy forwardly to agitate and promote absorption of a liquid therapeutic agent, which agent is usually delivered by the same catheter.
- the interface surfaces may be laterally disposed to radiate ultrasonic energy radially outward from the catheter body.
- the resonantly vibrating assembly of the present invention will further comprise a tail mass, a spring element connecting the interface member to the tail mass, and a longitudinally oscillating driver disposed between the tail mass and the interface member.
- the mass of the tail mass will be substantially greater than that of the interface member, typically being at least four-fold greater, and usually being at least eight-fold greater.
- the mass of the tail mass will be in the range from about 0.1 gm to 10 gm, more usually in the range from about 0.2 gm to 4 gm.
- the mass of the interface member will be in the range from 0.005 gm to 1 gm, more usually in the range from 0.01 gm to 0.3 gm.
- the tail mass will remain substantially stationary or immobilized while the longitudinally oscillating driver imparts longitudinal (axial) movement to the interface member.
- the mass of the interface member and the spring constant of the spring element will be selected so that the resonantly vibrating assembly resonates at a particular ultrasonic frequency, typically in the range from 10 kHz to 300 kHz, preferably from 20 kHz to 80 kHz.
- the longitudinally oscillating driver will also be selected to operate (when electronically driven) at the same ultrasonic frequency. In this way, the longitudinally oscillating driver will drive the resonantly vibrating assembly at its resonant frequency, thus enhancing the efficiency of energy transfer and increasing the amplitude of vibration (displacement) of the interface member.
- the interface member will operate with a displacement (under loaded conditions) of at least about 0.5 ⁇ m, preferably in the range from 0.5 ⁇ m to 40 ⁇ m, and more preferably in the range from 10 ⁇ m to 20 ⁇ m.
- the tail mass will usually be formed separately from the catheter body and other components of the vibratory assembly, but optionally could be formed as part of the catheter body or alternatively as an integral unit with the ⁇ pring element and/or interface member.
- the dimension ⁇ and shape of the tail mass will usually be selected to conform to the dimensions of the catheter body, i.e., usually being a short cylinder having a diameter which is the same as or slightly smaller than that of the distal end of the catheter body.
- the interface member will usually form the distal- most tip of the catheter, and will usually have a forwardly disposed convex surface which defines the interface surface
- the interface surface need not be convex, and could alternatively be concave, flat, irregular, or have any other geometry capable of radiating ultrasonic energy forwardly as the interface member is vibrated.
- the interface surface will have an area in the range from 0.5 mm 2 to 20 mm 2 , preferably from 1 mm 2 to 12 mm 2 .
- the spring element may comprise a smgle rod or tube extending distally from the tail mass and attached to the proximal surface of the interface member.
- the smgle spring element will be disposed coaxially withm the catheter.
- the spring element may comprise multiple rods or shafts, in which case they will usually be disposed symmetrically about the axis of the catheter.
- One or more axial passages may be formed through the resonantly vibrating assembly, typically for passage of a guidewire, delivery of therapeutic agents, or the like. To provide such lumens, it will be necessary to form holes through both the tail mass and the interface member. Such holes can be aligned and joined by one or more axial components of the spring element, typically the form of hollow tubes to provide a continuous lumen through the assembly.
- the longitudinally oscillating driver can take any conventional form of ultrasonic transducer capable of converting electrical energy to mechanical ultrasonic vibrations.
- Exemplary transducers include piezoelectric elements, such as hollow piezoelectric cylinders, piezoelectric stacks, and the like Suitable piezoelectric cylinders will be composed of a suitable piezoelectric material, such as a lead zirconate titmate (e.g., PZT-8) , have a length m the range from 2 mm to 2 cm, an outer diameter m the range from 1 mm to 4 mm, and a wall thickness in the range from 0.1 mm to 0.5 mm.
- a lead zirconate titmate e.g., PZT-8
- Piezoelectric stacks will comprise a plurality of ceramic disks, typically from 10 to 60 disk ⁇ , having electrodes of alternate polarity disposed between the disks
- Other suitable ultrasonic transducers include magnetostrictive elements, such as those described m copending application serial no. 08/566,740, the full disclosure of which is incorporated herein by reference.
- the spring element which joins the interface member to the tail mass may comprise a single component, e.g., a single solid rod or hollow tube disposed along the longitudinal axis of the catheter or a cylindrical shell either withm or external to the longitudinally oscillating driver.
- the spring element may comprise a plurality of components, such as a plurality of rods or tubes disposed symmetrically about the longitudinal axis of the catheter.
- the spring element may be composed of any of a wide variety of materials, most typically being a stainless steel, such as a hardened stainless steel having a Rockwell stiffness of at least about 35. Other suitable materials include superelastic alloys, such as nickel-titanium alloys known as nitmols.
- the cross-sectional area of the spring element (s) shall be sufficient to provide a maximum tension of approximately 20% of the tensile strength of the material, typically about 25,000 PSI, at the time when the spring experiences its maximum deformation, i.e., the time of maximum forward displacement of the interface member.
- the assembly of the tail mass, interface member, and longitudinally oscillating driver is compressed by the spring mass with a static force sufficient to present continuing compressive forces at the time when the assembly shrinks to its minimum longitudinal displacement.
- the interface member and spring element shall have a mass and stiffness which together assure that the spring element retains compressive force on the interface member at the time of maximum reverse acceleration m order to prevent the interface member from separating from the oscillating driver.
- the time of maximum reverse acceleration occurs at the time of maximum forward displacement.
- the catheter 12 includes a catheter body 16 having a distal end 18 and a proximal end 20, a proximal housing 22 having a fluid infusion port 24 , and a guidewire port 26.
- the catheter 12 includes at least a single lumen 28 extending from the proximal end 20 to the distal end 18 and connected to both the fluid infusion port 24 and the guidewire port 26.
- a cable 30 extends from the proximal end 20 of the catheter body 16 (typically through the lumen 28) and includes a connector 32 which may be removably attached to the power supply 14.
- the power supply 14 may be selected to drive the ultrasonic transducer (described below) at about a preselected frequency.
- the power supply 14 will typically comprise a conventional signal generator, such as those that are commercially available from suppliers such as Hewlett- Packard, Palo Alto, California, and Tektronic ⁇ , Portland, Oregon, and a power amplifier, such as those commercially available from suppliers such as ENI, Rochester, New York, and Krohn-Hite, Avon, Massachusetts.
- the power supply may comprise custom signal generator and power amplifier circuits with tracking circuits to keep the driving frequency at the resonant frequency of the ultrasonic driver in the catheter tip as this resonant frequency drifts due to thermally induced material variations.
- the longitudinally oscillating driver 50 will be energized by a continuous wave signal generator operating at a fixed frequency selected to resonantly drive the assembly 40 under the expected operating load.
- a tracking generator may be used which monitors the output current and voltage of the driver 50 and adjusts its own operating frequency to match any thermal or other drift in the system.
- the driver 50 may be energized by a function generator which sweeps within a resonant energization band in order to control the duty cycle, with a more narrow bandwidth providing a higher duty cycle.
- a function generator may also be configured or programmed to operate in an on-off or burst mode, with a duty cycle just sufficient to achieve the biological effect. By employing such discontinuous operation, heating of the resonantly vibrating assembly 40 can be minimized. Referring now to Figs.
- a resonantly vibrating assembly 40 is mounted withm the distal end of the catheter body 16
- the resonantly vibrating assembly 40 comprises a tail mass 42, an interface member 44, and a spring element 46 m the form of a tube having a lumen 48 therethrough
- the tubular spring element 46 is connected at its distal end to the interface member 44 and at its proximal end to the tail mass 42. Attachment of these components can be achieved n conventional ways, such as threaded attachment joints, the use of adhesives such as epoxy, solder joints, welded joints, and the like.
- a longitudinally oscillating driver 50 is mounted between the tail mass 42 and the interface member 44
- the driver 50 is a tubular piezoelectric transducer, as best illustrated Figs. 3 and 4.
- the tubular transducer includes a piezoelectric tube 52 formed from a suitable material , as described above, sandwiched between an outer electrode 54 and mner electrode 56.
- a suitable driving voltage to the electrodes 54 and 56 will cause the tubular transducer to oscillate both longitudinally and radially.
- a suitable continuous or variable (time dependent) wave driving voltage will be from 10 V to 200 V. The resulting axial displacement is best observed in Fig. 5, where displacements m the ranges set forth above may be achieved.
- a lumen 60 is formed through the tail mass and a second lumen 62 is formed through the interface member.
- the lumens 60 and 62 are aligned with the lumen 48 through the driver 50. In this way, a continuous lumen is provided from the lumen 28 of the catheter body through the distal tip of the catheter. This lumen is suitable for introducing the catheter over the guidewire and/or delivering therapeutic agents through the catheter and releasing said agents from the distal tip.
- FIG. 6 An alternative resonantly vibrating assembly 70 is illustrated Figs 6 and 7
- Catheter body 12, tail mass 42, and interface member 44 may all be identical to those described in connection with Figs. 1-5.
- the spring element comprises a pair of radially offset shafts 72 which are disposed symmetrically about the axis of the catheter.
- a longitudinally oscillating driver 74 comprises a stack of piezoelectric disks 76 which are sandwiched between electrode plates 78, as best illustrated in Fig. 7.
- the electrodes 78 will be connected to positive and negative terminals of the power supply 14 in order to induce longitudinal vibrations in the piezoelectric stack.
- the stack may be machined to include opposed channels 80 to accommodate the rods 72 as well as a central lumen 82 for accommodating a guidewire and/or the delivery of fluids.
- a catheter 12 for directly engaging a region of thrombus T in a diseased blood vessel BV having a region of plaque P is illustrated.
- the forwardly disposed interface surface of interface member 44 is advanced through the lumen of the blood vessel in a conventional manner until it engages the thrombus T.
- the resonantly vibrating assembly will then be activated to cause ultrasonic vibration of the interface member 44.
- the interface surface of the interface member in turn, will transmit the ultrasonic vibrations directly into the thrombus T, resulting in mechanical disruption of the thrombus and clot.
- a thrombolytic or fibrinolytic agent may be delivered through the catheter 12 and released into a region proximal to the thrombus T, either before, during or after the mechanical disruption.
- the ultrasonic energy will be transmitted while the treatment agent is being released to enhance penetration of the agent into the thrombus T.
- FIG. 9 An alternative treatment method is illustrated in Fig. 9.
- a sleeve catheter 90 is disposed over the catheter 12 of the present invention.
- An anti-thrombogenic treatment agent is delivered through the sleeve catheter 90 to a target site TS within a blood vessel BV.
- the interface member 44 is ultrasonically vibrated, as described previously. The ultrasonic vibration will enhance penetration of the agent into the wall of the blood vessel BV.
- This method would be equally suitable for delivering drugs into other body lumens.
- Use of the sleeve catheter 90 for delivering drugs is illustrated as an alternative to delivering the drugs through the lumen of the catheter 12 itself. It will be appreciated that the sleeve catheter 90 could have been used in the method of Fig. 8. Conversely, the lumen of catheter 12 could have been used to deliver the anti-thrombogenic agent in the method of Fig. 9.
Abstract
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP96942821A EP0955910A4 (en) | 1995-11-30 | 1996-11-27 | Apparatus and methods for ultrasonically enhanced intraluminal therapy |
AU11421/97A AU1142197A (en) | 1995-11-30 | 1996-11-27 | Apparatus and methods for ultrasonically enhanced intraluminal therapy |
JP9520664A JP2000502264A (en) | 1995-11-30 | 1996-11-27 | Apparatus and method for enhancing endoluminal treatment with ultrasound |
BR9611786-9A BR9611786A (en) | 1995-11-30 | 1996-11-27 | Catheter and process for the treatment of intraluminal lesions. |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/565,575 | 1995-11-30 | ||
US08/565,575 US5725494A (en) | 1995-11-30 | 1995-11-30 | Apparatus and methods for ultrasonically enhanced intraluminal therapy |
Publications (1)
Publication Number | Publication Date |
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WO1997019644A1 true WO1997019644A1 (en) | 1997-06-05 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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PCT/US1996/019007 WO1997019644A1 (en) | 1995-11-30 | 1996-11-27 | Apparatus and methods for ultrasonically enhanced intraluminal therapy |
Country Status (7)
Country | Link |
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US (1) | US5725494A (en) |
EP (1) | EP0955910A4 (en) |
JP (1) | JP2000502264A (en) |
AU (1) | AU1142197A (en) |
BR (1) | BR9611786A (en) |
CA (1) | CA2239116A1 (en) |
WO (1) | WO1997019644A1 (en) |
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Families Citing this family (186)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6210356B1 (en) * | 1998-08-05 | 2001-04-03 | Ekos Corporation | Ultrasound assembly for use with a catheter |
US6176842B1 (en) * | 1995-03-08 | 2001-01-23 | Ekos Corporation | Ultrasound assembly for use with light activated drugs |
NL1002274C2 (en) * | 1996-02-07 | 1997-08-08 | Cordis Europ | High-frequency thrombectomy catheter. |
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US6676626B1 (en) * | 1998-05-01 | 2004-01-13 | Ekos Corporation | Ultrasound assembly with increased efficacy |
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US6012457A (en) * | 1997-07-08 | 2000-01-11 | The Regents Of The University Of California | Device and method for forming a circumferential conduction block in a pulmonary vein |
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US6652515B1 (en) | 1997-07-08 | 2003-11-25 | Atrionix, Inc. | Tissue ablation device assembly and method for electrically isolating a pulmonary vein ostium from an atrial wall |
US6997925B2 (en) * | 1997-07-08 | 2006-02-14 | Atrionx, Inc. | Tissue ablation device assembly and method for electrically isolating a pulmonary vein ostium from an atrial wall |
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US6500174B1 (en) * | 1997-07-08 | 2002-12-31 | Atrionix, Inc. | Circumferential ablation device assembly and methods of use and manufacture providing an ablative circumferential band along an expandable member |
US6514249B1 (en) | 1997-07-08 | 2003-02-04 | Atrionix, Inc. | Positioning system and method for orienting an ablation element within a pulmonary vein ostium |
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US6794369B2 (en) | 1997-12-31 | 2004-09-21 | Pharmasonics | Methods, systems, and kits for intravascular nucleic acid delivery |
US6503231B1 (en) * | 1998-06-10 | 2003-01-07 | Georgia Tech Research Corporation | Microneedle device for transport of molecules across tissue |
US6312402B1 (en) * | 1998-09-24 | 2001-11-06 | Ekos Corporation | Ultrasound catheter for improving blood flow to the heart |
AU1128600A (en) | 1998-11-20 | 2000-06-13 | Joie P. Jones | Methods for selectively dissolving and removing materials using ultra-high frequency ultrasound |
US6607502B1 (en) * | 1998-11-25 | 2003-08-19 | Atrionix, Inc. | Apparatus and method incorporating an ultrasound transducer onto a delivery member |
US6758830B1 (en) | 1999-05-11 | 2004-07-06 | Atrionix, Inc. | Catheter positioning system |
EP1769759B1 (en) * | 1999-05-11 | 2008-08-13 | Atrionix, Inc. | Apparatus for ultrasound ablation |
ATE353001T1 (en) | 1999-05-11 | 2007-02-15 | Atrionix Inc | BALLOON ANCHORING WIRE |
US6611707B1 (en) | 1999-06-04 | 2003-08-26 | Georgia Tech Research Corporation | Microneedle drug delivery device |
US6743211B1 (en) * | 1999-11-23 | 2004-06-01 | Georgia Tech Research Corporation | Devices and methods for enhanced microneedle penetration of biological barriers |
US6852097B1 (en) * | 1999-06-24 | 2005-02-08 | Fulton, Iii Richard E. | Mechanically active infusion catheter |
IL131623A0 (en) * | 1999-08-27 | 2001-01-28 | Dan Weiss | Apparatus to couple ultrasonic energy to catheters and other transdermal medical devices |
US20040249401A1 (en) * | 1999-10-05 | 2004-12-09 | Omnisonics Medical Technologies, Inc. | Apparatus and method for an ultrasonic medical device with a non-compliant balloon |
US20050096669A1 (en) * | 1999-10-05 | 2005-05-05 | Omnisonics Medical Technologies, Inc. | Apparatus and method for an ultrasonic medical device to treat coronary thrombus bearing lesions |
US20030065263A1 (en) * | 1999-10-05 | 2003-04-03 | Omnisonics Medical Technologies, Inc. | Ultrasonic probe device with rapid attachment and detachment means having a line contact collet |
US20040158150A1 (en) * | 1999-10-05 | 2004-08-12 | Omnisonics Medical Technologies, Inc. | Apparatus and method for an ultrasonic medical device for tissue remodeling |
US6660013B2 (en) * | 1999-10-05 | 2003-12-09 | Omnisonics Medical Technologies, Inc. | Apparatus for removing plaque from blood vessels using ultrasonic energy |
US6733451B2 (en) | 1999-10-05 | 2004-05-11 | Omnisonics Medical Technologies, Inc. | Apparatus and method for an ultrasonic probe used with a pharmacological agent |
US6551337B1 (en) * | 1999-10-05 | 2003-04-22 | Omnisonics Medical Technologies, Inc. | Ultrasonic medical device operating in a transverse mode |
US20050043629A1 (en) * | 1999-10-05 | 2005-02-24 | Omnisonics Medical Technologies, Inc. | Apparatus and method for an ultrasonic medical device having a probe with a small proximal end |
US6695782B2 (en) * | 1999-10-05 | 2004-02-24 | Omnisonics Medical Technologies, Inc. | Ultrasonic probe device with rapid attachment and detachment means |
US6652547B2 (en) | 1999-10-05 | 2003-11-25 | Omnisonics Medical Technologies, Inc. | Apparatus and method of removing occlusions using ultrasonic medical device operating in a transverse mode |
US6695781B2 (en) | 1999-10-05 | 2004-02-24 | Omnisonics Medical Technologies, Inc. | Ultrasonic medical device for tissue remodeling |
US20040097996A1 (en) * | 1999-10-05 | 2004-05-20 | Omnisonics Medical Technologies, Inc. | Apparatus and method of removing occlusions using an ultrasonic medical device operating in a transverse mode |
US20050119679A1 (en) * | 1999-10-05 | 2005-06-02 | Omnisonics Medical Technologies, Inc. | Apparatus and method for an ultrasonic medical device to treat chronic total occlusions |
US20030236539A1 (en) * | 1999-10-05 | 2003-12-25 | Omnisonics Medical Technologies, Inc. | Apparatus and method for using an ultrasonic probe to clear a vascular access device |
US20050043753A1 (en) * | 1999-10-05 | 2005-02-24 | Omnisonics Medical Technologies, Inc. | Apparatus and method for an ultrasonic medical device to treat peripheral artery disease |
US6461383B1 (en) | 1999-12-30 | 2002-10-08 | Advanced Cardiovascular Systems, Inc. | Ultrasonic catheter vascular stent system and method |
US7166098B1 (en) * | 1999-12-30 | 2007-01-23 | Advanced Cardiovascular Systems, Inc. | Medical assembly with transducer for local delivery of a therapeutic substance and method of using same |
US6698647B1 (en) | 2000-03-10 | 2004-03-02 | Honeywell International Inc. | Aluminum-comprising target/backing plate structures |
US6508775B2 (en) | 2000-03-20 | 2003-01-21 | Pharmasonics, Inc. | High output therapeutic ultrasound transducer |
WO2001070112A1 (en) * | 2000-03-20 | 2001-09-27 | Pharmasonics, Inc. | High output therapeutic ultrasound transducer |
US6432068B1 (en) * | 2000-03-20 | 2002-08-13 | Pharmasonics, Inc. | High output therapeutic ultrasound transducer |
US6913581B2 (en) | 2000-03-20 | 2005-07-05 | Paul D. Corl | High output therapeutic ultrasound transducer |
US6599288B2 (en) | 2000-05-16 | 2003-07-29 | Atrionix, Inc. | Apparatus and method incorporating an ultrasound transducer onto a delivery member |
DE60109444T2 (en) | 2000-06-13 | 2006-04-13 | Atrionix, Inc., Irwindale | SURGICAL ABLATION PROBE FOR FORMING A RINGED LESION |
US6638246B1 (en) | 2000-11-28 | 2003-10-28 | Scimed Life Systems, Inc. | Medical device for delivery of a biologically active material to a lumen |
US9302903B2 (en) * | 2000-12-14 | 2016-04-05 | Georgia Tech Research Corporation | Microneedle devices and production thereof |
US6471980B2 (en) | 2000-12-22 | 2002-10-29 | Avantec Vascular Corporation | Intravascular delivery of mycophenolic acid |
US20020082679A1 (en) * | 2000-12-22 | 2002-06-27 | Avantec Vascular Corporation | Delivery or therapeutic capable agents |
US20030050692A1 (en) * | 2000-12-22 | 2003-03-13 | Avantec Vascular Corporation | Delivery of therapeutic capable agents |
US20050203612A1 (en) * | 2000-12-22 | 2005-09-15 | Avantec Vascular Corporation | Devices delivering therapeutic agents and methods regarding the same |
US6939375B2 (en) | 2000-12-22 | 2005-09-06 | Avantac Vascular Corporation | Apparatus and methods for controlled substance delivery from implanted prostheses |
US7083642B2 (en) * | 2000-12-22 | 2006-08-01 | Avantec Vascular Corporation | Delivery of therapeutic capable agents |
US20030033007A1 (en) * | 2000-12-22 | 2003-02-13 | Avantec Vascular Corporation | Methods and devices for delivery of therapeutic capable agents with variable release profile |
US7077859B2 (en) | 2000-12-22 | 2006-07-18 | Avantec Vascular Corporation | Apparatus and methods for variably controlled substance delivery from implanted prostheses |
US8235919B2 (en) * | 2001-01-12 | 2012-08-07 | Celleration, Inc. | Ultrasonic method and device for wound treatment |
US7914470B2 (en) * | 2001-01-12 | 2011-03-29 | Celleration, Inc. | Ultrasonic method and device for wound treatment |
US6740040B1 (en) * | 2001-01-30 | 2004-05-25 | Advanced Cardiovascular Systems, Inc. | Ultrasound energy driven intraventricular catheter to treat ischemia |
WO2003009777A2 (en) * | 2001-07-26 | 2003-02-06 | Avantec Vascular Corporation | Delivery of therapeutic capable agents |
US6554846B2 (en) | 2001-09-28 | 2003-04-29 | Scimed Life Systems, Inc. | Sonic burr |
DE60213457T2 (en) * | 2001-12-03 | 2007-10-18 | Ekos Corp., Bothell | ULTRASONIC CATHETER FOR SMALL VESSELS |
AU2002357316A1 (en) * | 2001-12-14 | 2003-06-30 | Ekos Corporation | Blood flow reestablishment determination |
US6780191B2 (en) * | 2001-12-28 | 2004-08-24 | Yacmur Llc | Cannula system |
AU2003209287A1 (en) * | 2002-01-15 | 2003-07-30 | The Regents Of The University Of California | System and method providing directional ultrasound therapy to skeletal joints |
US20030135262A1 (en) * | 2002-01-15 | 2003-07-17 | Dretler Stephen P. | Apparatus for piezo-electric reduction of concretions |
US7819826B2 (en) * | 2002-01-23 | 2010-10-26 | The Regents Of The University Of California | Implantable thermal treatment method and apparatus |
IL162734A0 (en) | 2002-02-01 | 2005-11-20 | Ariad Gene Therapeutics Inc | Phosphorus-containing compounds & uses thereof |
ATE524146T1 (en) * | 2002-02-11 | 2011-09-15 | Gold T Tech Inc | IMPLANTABLE DEVICE FOR PREVENTING THROMBUS FORMATION |
AU2003212481A1 (en) * | 2002-02-28 | 2003-09-09 | Ekos Corporation | Ultrasound assembly for use with a catheter |
US7829029B2 (en) | 2002-05-29 | 2010-11-09 | NanoVibronix, Inv. | Acoustic add-on device for biofilm prevention in urinary catheter |
US7393501B2 (en) * | 2002-05-29 | 2008-07-01 | Nano Vibronix Inc | Method, apparatus and system for treating biofilms associated with catheters |
WO2004012599A1 (en) * | 2002-07-29 | 2004-02-12 | Omnisonics Medical Technologies, Inc. | Radiopaque coating for an ultrasonic medical device |
US9955994B2 (en) | 2002-08-02 | 2018-05-01 | Flowcardia, Inc. | Ultrasound catheter having protective feature against breakage |
US7335180B2 (en) | 2003-11-24 | 2008-02-26 | Flowcardia, Inc. | Steerable ultrasound catheter |
US6786202B2 (en) * | 2002-09-24 | 2004-09-07 | Caterpillar Inc | Hydraulic pump circuit |
US8361067B2 (en) | 2002-09-30 | 2013-01-29 | Relievant Medsystems, Inc. | Methods of therapeutically heating a vertebral body to treat back pain |
US8613744B2 (en) | 2002-09-30 | 2013-12-24 | Relievant Medsystems, Inc. | Systems and methods for navigating an instrument through bone |
US7258690B2 (en) | 2003-03-28 | 2007-08-21 | Relievant Medsystems, Inc. | Windowed thermal ablation probe |
US6907884B2 (en) | 2002-09-30 | 2005-06-21 | Depay Acromed, Inc. | Method of straddling an intraosseous nerve |
US8808284B2 (en) * | 2008-09-26 | 2014-08-19 | Relievant Medsystems, Inc. | Systems for navigating an instrument through bone |
US6921371B2 (en) * | 2002-10-14 | 2005-07-26 | Ekos Corporation | Ultrasound radiating members for catheter |
US20040176686A1 (en) * | 2002-12-23 | 2004-09-09 | Omnisonics Medical Technologies, Inc. | Apparatus and method for ultrasonic medical device with improved visibility in imaging procedures |
WO2004058074A1 (en) | 2002-12-23 | 2004-07-15 | Omnisonics Medical Technologies, Inc. | Apparatus and method for ultrasonic medical device with improved visibility in imaging procedures |
EP1583569A4 (en) * | 2003-01-03 | 2009-05-06 | Ekos Corp | Ultrasonic catheter with axial energy field |
US7374551B2 (en) * | 2003-02-19 | 2008-05-20 | Pittsburgh Plastic Surgery Research Associates | Minimally invasive fat cavitation method |
US8142457B2 (en) * | 2003-03-26 | 2012-03-27 | Boston Scientific Scimed, Inc. | Percutaneous transluminal endarterectomy |
US20050119725A1 (en) * | 2003-04-08 | 2005-06-02 | Xingwu Wang | Energetically controlled delivery of biologically active material from an implanted medical device |
US8083707B2 (en) * | 2003-04-17 | 2011-12-27 | Tosaya Carol A | Non-contact damage-free ultrasonic cleaning of implanted or natural structures having moving parts and located in a living body |
EP1619995A2 (en) * | 2003-04-22 | 2006-02-01 | Ekos Corporation | Ultrasound enhanced central venous catheter |
US20040230116A1 (en) * | 2003-05-12 | 2004-11-18 | Pharmasonics, Inc. | Method and apparatus for detection of ultrasound transducer failure in catheter systems |
US8335555B2 (en) | 2003-05-30 | 2012-12-18 | Lawrence Livermore National Security, Llc | Radial reflection diffraction tomography |
US20040260182A1 (en) * | 2003-06-23 | 2004-12-23 | Zuluaga Andres F. | Intraluminal spectroscope with wall contacting probe |
US7670335B2 (en) * | 2003-07-21 | 2010-03-02 | Biosense Webster, Inc. | Ablation device with spiral array ultrasound transducer |
US20050059993A1 (en) * | 2003-09-17 | 2005-03-17 | Kamal Ramzipoor | Embolectomy device |
US7758510B2 (en) | 2003-09-19 | 2010-07-20 | Flowcardia, Inc. | Connector for securing ultrasound catheter to transducer |
US6949072B2 (en) * | 2003-09-22 | 2005-09-27 | Infraredx, Inc. | Devices for vulnerable plaque detection |
WO2005051229A2 (en) * | 2003-11-24 | 2005-06-09 | Avantec Vascular Corporation | Devices delivering therapeutic agents and methods regarding the same |
US20060058708A1 (en) * | 2003-12-24 | 2006-03-16 | Gill Heart | Method and apparatus for ultrasonically increasing the transportation of therapeutic substances through tissue |
US20050209578A1 (en) * | 2004-01-29 | 2005-09-22 | Christian Evans Edward A | Ultrasonic catheter with segmented fluid delivery |
CA2551831A1 (en) * | 2004-01-29 | 2005-08-11 | Ekos Corporation | Small vessel ultrasound catheter |
US9107590B2 (en) * | 2004-01-29 | 2015-08-18 | Ekos Corporation | Method and apparatus for detecting vascular conditions with a catheter |
US7201737B2 (en) * | 2004-01-29 | 2007-04-10 | Ekos Corporation | Treatment of vascular occlusions using elevated temperatures |
US7794414B2 (en) | 2004-02-09 | 2010-09-14 | Emigrant Bank, N.A. | Apparatus and method for an ultrasonic medical device operating in torsional and transverse modes |
MX2007002964A (en) * | 2004-09-13 | 2008-03-05 | Johnson & Johnson | Ablation device with phased array ultrasound transducer. |
WO2006063199A2 (en) * | 2004-12-09 | 2006-06-15 | The Foundry, Inc. | Aortic valve repair |
US20060173387A1 (en) * | 2004-12-10 | 2006-08-03 | Douglas Hansmann | Externally enhanced ultrasonic therapy |
US20070150051A1 (en) * | 2005-01-10 | 2007-06-28 | Duke Fiduciary, Llc | Vascular implants and methods of fabricating the same |
US8287583B2 (en) * | 2005-01-10 | 2012-10-16 | Taheri Laduca Llc | Apparatus and method for deploying an implantable device within the body |
JP4724827B2 (en) * | 2005-03-24 | 2011-07-13 | 国立大学法人山口大学 | Agitation treatment device and catheter |
US8932208B2 (en) * | 2005-05-26 | 2015-01-13 | Maquet Cardiovascular Llc | Apparatus and methods for performing minimally-invasive surgical procedures |
US20060270900A1 (en) * | 2005-05-26 | 2006-11-30 | Chin Albert K | Apparatus and methods for performing ablation |
US7431728B2 (en) * | 2005-09-06 | 2008-10-07 | Omnisonics Medical Technologies, Inc. | Ultrasound medical devices, systems and methods |
US7450241B2 (en) * | 2005-09-30 | 2008-11-11 | Infraredx, Inc. | Detecting vulnerable plaque |
US20070185479A1 (en) * | 2006-02-06 | 2007-08-09 | Liming Lau | Methods and devices for performing ablation and assessing efficacy thereof |
US20070225697A1 (en) * | 2006-03-23 | 2007-09-27 | Ketan Shroff | Apparatus and methods for cardiac ablation |
EP2015846A2 (en) | 2006-04-24 | 2009-01-21 | Ekos Corporation | Ultrasound therapy system |
US20070299346A1 (en) * | 2006-06-22 | 2007-12-27 | Paul Bigeleisen | Method, system, and apparatus for a doppler catheter |
US20080039879A1 (en) * | 2006-08-09 | 2008-02-14 | Chin Albert K | Devices and methods for atrial appendage exclusion |
US8192363B2 (en) * | 2006-10-27 | 2012-06-05 | Ekos Corporation | Catheter with multiple ultrasound radiating members |
US8246643B2 (en) | 2006-11-07 | 2012-08-21 | Flowcardia, Inc. | Ultrasound catheter having improved distal end |
US7842006B2 (en) * | 2006-11-17 | 2010-11-30 | Cfd Research Corporation | Thrombectomy microcatheter |
US8491521B2 (en) * | 2007-01-04 | 2013-07-23 | Celleration, Inc. | Removable multi-channel applicator nozzle |
EP2111261B1 (en) * | 2007-01-08 | 2015-04-15 | Ekos Corporation | Power parameters for ultrasonic catheter |
EP2114303A4 (en) * | 2007-02-09 | 2012-08-08 | Taheri Laduca Llc | Vascular implants and methods of fabricating the same |
EP2209517A4 (en) * | 2007-10-05 | 2011-03-30 | Maquet Cardiovascular Llc | Devices and methods for minimally-invasive surgical procedures |
US8262645B2 (en) * | 2007-11-21 | 2012-09-11 | Actuated Medical, Inc. | Devices for clearing blockages in in-situ artificial lumens |
EP2231024A4 (en) * | 2007-12-14 | 2015-03-18 | Ekos Corp | Ultrasound pulse shaping |
US8545440B2 (en) * | 2007-12-21 | 2013-10-01 | Carticept Medical, Inc. | Injection system for delivering multiple fluids within the anatomy |
US9044542B2 (en) | 2007-12-21 | 2015-06-02 | Carticept Medical, Inc. | Imaging-guided anesthesia injection systems and methods |
US8002736B2 (en) | 2007-12-21 | 2011-08-23 | Carticept Medical, Inc. | Injection systems for delivery of fluids to joints |
US20090177123A1 (en) * | 2007-12-28 | 2009-07-09 | Celleration, Inc. | Methods for treating inflammatory disorders |
US20090209986A1 (en) * | 2008-02-15 | 2009-08-20 | Stewart Michael C | Devices, Tools and Methods for Atrial Appendage Exclusion |
US20100022919A1 (en) * | 2008-07-22 | 2010-01-28 | Celleration, Inc. | Methods of Skin Grafting Using Ultrasound |
US10058716B2 (en) * | 2008-09-03 | 2018-08-28 | Nanyang Technological University | Micro-emulsifier for arterial thrombus removal |
EP3406210A1 (en) | 2008-09-26 | 2018-11-28 | Relievant Medsystems, Inc. | Systems and for navigating an instrument through bone |
US10028753B2 (en) | 2008-09-26 | 2018-07-24 | Relievant Medsystems, Inc. | Spine treatment kits |
DE102008054083A1 (en) * | 2008-10-31 | 2010-05-12 | Theuer, Axel E., Prof. Dr.-Ing. habil. | Medical device for the treatment of tumor tissue |
EP2448636B1 (en) * | 2009-07-03 | 2014-06-18 | Ekos Corporation | Power parameters for ultrasonic catheter |
US9375223B2 (en) * | 2009-10-06 | 2016-06-28 | Cardioprolific Inc. | Methods and devices for endovascular therapy |
US11039845B2 (en) | 2009-10-06 | 2021-06-22 | Cardioprolific Inc. | Methods and devices for endovascular therapy |
US8740835B2 (en) * | 2010-02-17 | 2014-06-03 | Ekos Corporation | Treatment of vascular occlusions using ultrasonic energy and microbubbles |
JP6291253B2 (en) | 2010-08-27 | 2018-03-14 | イーコス・コーポレイシヨン | Ultrasound catheter |
EP2654624B1 (en) | 2010-12-23 | 2023-10-04 | Twelve, Inc. | System for mitral valve repair and replacement |
US11458290B2 (en) | 2011-05-11 | 2022-10-04 | Ekos Corporation | Ultrasound system |
CA2840084C (en) | 2011-06-21 | 2019-11-05 | Foundry Newco Xii, Inc. | Prosthetic heart valve devices and associated systems and methods |
WO2013013248A2 (en) * | 2011-07-20 | 2013-01-24 | Retrovascular, Inc. | Energy facilitated composition delivery |
EA201400478A1 (en) | 2011-10-19 | 2014-10-30 | Твелв, Инк. | DEVICES, SYSTEMS AND METHODS OF PROTESIZING THE HEART VALVE |
US9655722B2 (en) | 2011-10-19 | 2017-05-23 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
EA201400481A1 (en) | 2011-10-19 | 2014-10-30 | Твелв, Инк. | ARTIFICIAL HEART VALVE DEVICES, ARTIFICIAL MITRAL VALVES AND RELATED SYSTEMS AND METHODS |
US9763780B2 (en) | 2011-10-19 | 2017-09-19 | Twelve, Inc. | Devices, systems and methods for heart valve replacement |
US9039757B2 (en) | 2011-10-19 | 2015-05-26 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
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AU2012362524B2 (en) | 2011-12-30 | 2018-12-13 | Relievant Medsystems, Inc. | Systems and methods for treating back pain |
WO2013109269A1 (en) | 2012-01-18 | 2013-07-25 | Bard Peripheral Vascular, Inc. | Vascular re-entry device |
US9579198B2 (en) | 2012-03-01 | 2017-02-28 | Twelve, Inc. | Hydraulic delivery systems for prosthetic heart valve devices and associated methods |
RU2640564C2 (en) | 2012-08-02 | 2018-01-09 | Бард Периферэл Васкьюлар | Ultrasonic catheter system |
US10588691B2 (en) | 2012-09-12 | 2020-03-17 | Relievant Medsystems, Inc. | Radiofrequency ablation of tissue within a vertebral body |
EP2914186B1 (en) | 2012-11-05 | 2019-03-13 | Relievant Medsystems, Inc. | Systems for creating curved paths through bone and modulating nerves within the bone |
SG11201506154RA (en) | 2013-03-14 | 2015-09-29 | Ekos Corp | Method and apparatus for drug delivery to a target site |
US10111747B2 (en) | 2013-05-20 | 2018-10-30 | Twelve, Inc. | Implantable heart valve devices, mitral valve repair devices and associated systems and methods |
US9724151B2 (en) | 2013-08-08 | 2017-08-08 | Relievant Medsystems, Inc. | Modulating nerves within bone using bone fasteners |
EP3074089A4 (en) | 2013-11-26 | 2017-07-26 | Alliqua Biomedical, Inc. | Systems and methods for producing and delivering ultrasonic therapies for wound treatment and healing |
US10092742B2 (en) | 2014-09-22 | 2018-10-09 | Ekos Corporation | Catheter system |
CN111658234B (en) | 2015-08-21 | 2023-03-10 | 托尔福公司 | Implantable heart valve devices, mitral valve repair devices, and associated systems and methods |
WO2017189276A1 (en) | 2016-04-29 | 2017-11-02 | Medtronic Vascular Inc. | Prosthetic heart valve devices with tethered anchors and associated systems and methods |
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US20180140321A1 (en) | 2016-11-23 | 2018-05-24 | C. R. Bard, Inc. | Catheter With Retractable Sheath And Methods Thereof |
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US10582983B2 (en) | 2017-02-06 | 2020-03-10 | C. R. Bard, Inc. | Ultrasonic endovascular catheter with a controllable sheath |
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US10575950B2 (en) | 2017-04-18 | 2020-03-03 | Twelve, Inc. | Hydraulic systems for delivering prosthetic heart valve devices and associated methods |
US10702378B2 (en) | 2017-04-18 | 2020-07-07 | Twelve, Inc. | Prosthetic heart valve device and associated systems and methods |
US10792151B2 (en) | 2017-05-11 | 2020-10-06 | Twelve, Inc. | Delivery systems for delivering prosthetic heart valve devices and associated methods |
US10646338B2 (en) | 2017-06-02 | 2020-05-12 | Twelve, Inc. | Delivery systems with telescoping capsules for deploying prosthetic heart valve devices and associated methods |
US10709591B2 (en) | 2017-06-06 | 2020-07-14 | Twelve, Inc. | Crimping device and method for loading stents and prosthetic heart valves |
US10729541B2 (en) | 2017-07-06 | 2020-08-04 | Twelve, Inc. | Prosthetic heart valve devices and associated systems and methods |
US10786352B2 (en) | 2017-07-06 | 2020-09-29 | Twelve, Inc. | Prosthetic heart valve devices and associated systems and methods |
WO2021050767A1 (en) | 2019-09-12 | 2021-03-18 | Relievant Medsystems, Inc. | Systems and methods for tissue modulation |
Citations (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4838853A (en) * | 1987-02-05 | 1989-06-13 | Interventional Technologies Inc. | Apparatus for trimming meniscus |
US5197946A (en) | 1990-06-27 | 1993-03-30 | Shunro Tachibana | Injection instrument with ultrasonic oscillating element |
US5269291A (en) | 1990-12-10 | 1993-12-14 | Coraje, Inc. | Miniature ultrasonic transducer for plaque ablation |
US5279546A (en) * | 1990-06-27 | 1994-01-18 | Lake Region Manufacturing Company, Inc. | Thrombolysis catheter system |
US5315998A (en) | 1991-03-22 | 1994-05-31 | Katsuro Tachibana | Booster for therapy of diseases with ultrasound and pharmaceutical liquid composition containing the same |
US5318014A (en) | 1992-09-14 | 1994-06-07 | Coraje, Inc. | Ultrasonic ablation/dissolution transducer |
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 |
US5342292A (en) | 1991-11-04 | 1994-08-30 | Baxter International Inc. | Ultrasonic ablation device adapted for guidewire passage |
US5344395A (en) | 1989-11-13 | 1994-09-06 | Scimed Life Systems, Inc. | Apparatus for intravascular cavitation or delivery of low frequency mechanical energy |
US5362309A (en) | 1992-09-14 | 1994-11-08 | Coraje, Inc. | Apparatus and method for enhanced intravascular phonophoresis including dissolution of intravascular blockage and concomitant inhibition of restenosis |
US5380273A (en) | 1992-05-19 | 1995-01-10 | Dubrul; Will R. | Vibrating catheter |
US5397301A (en) | 1991-01-11 | 1995-03-14 | Baxter International Inc. | Ultrasonic angioplasty device incorporating an ultrasound transmission member made at least partially from a superelastic metal alloy |
Family Cites Families (30)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3433226A (en) * | 1965-07-21 | 1969-03-18 | Aeroprojects Inc | Vibratory catheterization apparatus and method of using |
US3565062A (en) * | 1968-06-13 | 1971-02-23 | Ultrasonic Systems | Ultrasonic method and apparatus for removing cholesterol and other deposits from blood vessels and the like |
US4636195A (en) * | 1982-04-02 | 1987-01-13 | Harvey Wolinsky | Method and apparatus for removing arterial constriction |
CA1237482A (en) * | 1984-03-09 | 1988-05-31 | Frank B. Stiles | Catheter for effecting removal of obstructions from a biological duct |
US4633119A (en) * | 1984-07-02 | 1986-12-30 | Gould Inc. | Broadband multi-resonant longitudinal vibrator transducer |
EP0189329A3 (en) * | 1985-01-25 | 1987-06-03 | Robert E. Fischell | A tunneling catheter system for transluminal arterial angioplasty |
US4698058A (en) * | 1985-10-15 | 1987-10-06 | Albert R. Greenfeld | Ultrasonic self-cleaning catheter system for indwelling drains and medication supply |
US4948587A (en) * | 1986-07-08 | 1990-08-14 | Massachusetts Institute Of Technology | Ultrasound enhancement of transbuccal drug delivery |
US4808153A (en) * | 1986-11-17 | 1989-02-28 | Ultramed Corporation | Device for removing plaque from arteries |
US4870953A (en) * | 1987-11-13 | 1989-10-03 | Donmicheal T Anthony | Intravascular ultrasonic catheter/probe and method for treating intravascular blockage |
US5163421A (en) * | 1988-01-22 | 1992-11-17 | Angiosonics, Inc. | In vivo ultrasonic system with angioplasty and ultrasonic contrast imaging |
US4920954A (en) * | 1988-08-05 | 1990-05-01 | Sonic Needle Corporation | Ultrasonic device for applying cavitation forces |
US5458631A (en) * | 1989-01-06 | 1995-10-17 | Xavier; Ravi | Implantable catheter with electrical pulse nerve stimulators and drug delivery system |
US4936281A (en) * | 1989-04-13 | 1990-06-26 | Everest Medical Corporation | Ultrasonically enhanced RF ablation catheter |
JPH0363041A (en) * | 1989-07-31 | 1991-03-19 | Olympus Optical Co Ltd | Ultrasonic therapeutic apparatus |
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 |
DE69110467T2 (en) * | 1990-06-15 | 1996-02-01 | Cortrak Medical Inc | DEVICE FOR DISPENSING MEDICINES. |
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 |
US5447509A (en) * | 1991-01-11 | 1995-09-05 | Baxter International Inc. | Ultrasound catheter system having modulated output with feedback control |
US5458568A (en) * | 1991-05-24 | 1995-10-17 | Cortrak Medical, Inc. | Porous balloon for selective dilatation and drug delivery |
GB2258364A (en) * | 1991-07-30 | 1993-02-03 | Intravascular Res Ltd | Ultrasonic tranducer |
US5269297A (en) * | 1992-02-27 | 1993-12-14 | Angiosonics Inc. | Ultrasonic transmission apparatus |
EP0582766A1 (en) * | 1992-08-13 | 1994-02-16 | Ministero Dell' Universita' E Della Ricerca Scientifica E Tecnologica | Ultrasonic recanalization system and transducer therefor |
AU3321293A (en) * | 1992-08-28 | 1994-03-29 | Cortrak Medical, Inc. | Polymer matrix drug delivery apparatus and method |
US5267985A (en) * | 1993-02-11 | 1993-12-07 | Trancell, Inc. | Drug delivery by multiple frequency phonophoresis |
US5462523A (en) * | 1993-05-18 | 1995-10-31 | Target Therapeutics, Inc. | Drug delivery system |
US5465725A (en) * | 1993-06-15 | 1995-11-14 | Hewlett Packard Company | Ultrasonic probe |
US5413107A (en) * | 1994-02-16 | 1995-05-09 | Tetrad Corporation | Ultrasonic probe having articulated structure and rotatable transducer head |
AU1889595A (en) * | 1994-03-07 | 1995-09-25 | Medisonic A/S | Apparatus for non-invasive tissue destruction by means of ultrasound |
-
1995
- 1995-11-30 US US08/565,575 patent/US5725494A/en not_active Expired - Fee Related
-
1996
- 1996-11-27 AU AU11421/97A patent/AU1142197A/en not_active Abandoned
- 1996-11-27 EP EP96942821A patent/EP0955910A4/en not_active Withdrawn
- 1996-11-27 JP JP9520664A patent/JP2000502264A/en not_active Ceased
- 1996-11-27 BR BR9611786-9A patent/BR9611786A/en not_active IP Right Cessation
- 1996-11-27 WO PCT/US1996/019007 patent/WO1997019644A1/en not_active Application Discontinuation
- 1996-11-27 CA CA002239116A patent/CA2239116A1/en not_active Abandoned
Patent Citations (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4838853A (en) * | 1987-02-05 | 1989-06-13 | Interventional Technologies Inc. | Apparatus for trimming meniscus |
US5344395A (en) | 1989-11-13 | 1994-09-06 | Scimed Life Systems, Inc. | Apparatus for intravascular cavitation or delivery of low frequency mechanical energy |
US5197946A (en) | 1990-06-27 | 1993-03-30 | Shunro Tachibana | Injection instrument with ultrasonic oscillating element |
US5279546A (en) * | 1990-06-27 | 1994-01-18 | Lake Region Manufacturing Company, Inc. | Thrombolysis catheter system |
US5269291A (en) | 1990-12-10 | 1993-12-14 | Coraje, Inc. | Miniature ultrasonic transducer for plaque ablation |
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 |
US5397301A (en) | 1991-01-11 | 1995-03-14 | Baxter International Inc. | Ultrasonic angioplasty device incorporating an ultrasound transmission member made at least partially from a superelastic metal alloy |
US5315998A (en) | 1991-03-22 | 1994-05-31 | Katsuro Tachibana | Booster for therapy of diseases with ultrasound and pharmaceutical liquid composition containing the same |
US5342292A (en) | 1991-11-04 | 1994-08-30 | Baxter International Inc. | Ultrasonic ablation device adapted for guidewire passage |
US5380273A (en) | 1992-05-19 | 1995-01-10 | Dubrul; Will R. | Vibrating catheter |
US5318014A (en) | 1992-09-14 | 1994-06-07 | Coraje, Inc. | Ultrasonic ablation/dissolution transducer |
US5362309A (en) | 1992-09-14 | 1994-11-08 | Coraje, Inc. | Apparatus and method for enhanced intravascular phonophoresis including dissolution of intravascular blockage and concomitant inhibition of restenosis |
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US8852166B1 (en) | 2002-04-01 | 2014-10-07 | Ekos Corporation | Ultrasonic catheter power control |
US9943675B1 (en) | 2002-04-01 | 2018-04-17 | Ekos Corporation | Ultrasonic catheter power control |
CN101616707B (en) * | 2006-03-29 | 2013-01-02 | 纳微振动技术公司 | An acoustic add-on device for biofilm prevention in urinary catheter |
US11925367B2 (en) | 2007-01-08 | 2024-03-12 | Ekos Corporation | Power parameters for ultrasonic catheter |
US11672553B2 (en) | 2007-06-22 | 2023-06-13 | Ekos Corporation | Method and apparatus for treatment of intracranial hemorrhages |
US9034004B2 (en) | 2010-02-09 | 2015-05-19 | Medinol Ltd. | Device for traversing vessel occlusions and method of use |
US10850065B2 (en) | 2010-02-09 | 2020-12-01 | Medinol Ltd. | Catheter tip assembled with a spring |
WO2011098913A1 (en) * | 2010-02-09 | 2011-08-18 | Oscillon Ltd. | Device for traversing vessel occlusions and method of use |
US10426923B2 (en) | 2014-02-03 | 2019-10-01 | Medinol Ltd. | Catheter tip assembled with a spring |
US11458284B2 (en) | 2014-02-03 | 2022-10-04 | Medinol Ltd. | Catheter tip assembled with a spring |
US10342570B2 (en) | 2014-02-03 | 2019-07-09 | Medinol Ltd. | Device for traversing vessel occlusions and method of use |
US10656025B2 (en) | 2015-06-10 | 2020-05-19 | Ekos Corporation | Ultrasound catheter |
US11740138B2 (en) | 2015-06-10 | 2023-08-29 | Ekos Corporation | Ultrasound catheter |
Also Published As
Publication number | Publication date |
---|---|
JP2000502264A (en) | 2000-02-29 |
US5725494A (en) | 1998-03-10 |
AU1142197A (en) | 1997-06-19 |
CA2239116A1 (en) | 1997-06-05 |
EP0955910A4 (en) | 2001-02-14 |
BR9611786A (en) | 1999-12-28 |
EP0955910A1 (en) | 1999-11-17 |
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