CN1122680A - Laser balloon catheter apparatus - Google Patents
Laser balloon catheter apparatus Download PDFInfo
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- CN1122680A CN1122680A CN 94118135 CN94118135A CN1122680A CN 1122680 A CN1122680 A CN 1122680A CN 94118135 CN94118135 CN 94118135 CN 94118135 A CN94118135 A CN 94118135A CN 1122680 A CN1122680 A CN 1122680A
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Abstract
The laser ball shaped duct emits laser ray in a ball, the laser ray is conducted via optical fiber and irradiated on the tissue. It comprises laser emitter, cooling water supply channel, cooling water drain off channel and cooling water circulation device which supplies the cooling water and makes the ball expand and drain away the cooling water.
Description
The present invention relates to a kind of laser balloon catheter, it can insert body cavity, esophagus for example, and stomach is in the prostate, so that carry out laser therapy.
Laser balloon catheter is used to open the obstruction part of blood vessel.Carry out thermal therapeutical with laser balloon catheter with the laser irradiation cancerous tissue.
For example, at United States Patent (USP) NO.4, in 512,762, such laser balloon catheter structure is disclosed.In this patent, provide around fibre-optic lumen pipe, and provide a bulb to center on front end at fibre-optic front end.
At United States Patent (USP) NO.4, in 799,479, another kind of guide-tube structure is disclosed, wherein, there is an acoustic sensor in the bulb, with the vaporization of control tissue.
Yet when laser balloon catheter being inserted urethra heating prostate and treat, prostatic position is than the dark about 5-15mm of urethra inwall.When laser energy increases so that prostate is heated to a predetermined temperature, urethra inwall and near tissue are destroyed near the tissue the urethra by superheated.And be difficult to cure.
And in except prostatic treatment, the body cavity walls that laser balloon catheter inserts is maintained at low temperature, is subjected to the hot injury to prevent near the tissue the inwall.Otherwise, heated consumingly than darker the organizing possibly of inwall.
So far, water or air expand the bulb, but water does not circulate by the bulb.
So, an object of the present invention is to provide a kind of laser balloon catheter apparatus, can positively make laser-transmitting arrive darker position, can protect near the tissue of inwall that inserts laser balloon catheter simultaneously.
Another object of the present invention provides a kind of laser balloon catheter apparatus, can easily control the distribution of temperature at the inwall that depth direction inserts laser balloon catheter.
Another object of the present invention provides a kind of laser balloon catheter apparatus, has coolant circulation unit, can stablize the expansion in bulb.
For achieving the above object, the invention provides a kind of laser balloon catheter apparatus, can launch laser in the bulb, laser is by the optical fibers transmission, and use the laser irradiation tissue that transmits through the bulb, this device comprises laser beam emitting device, is arranged in the cooling fluid supply passage in bulb; Be used to discharge the liquid coolant passing away of liquid coolant; And coolant circulation unit, be used for making its expansion to the bulb supply cooling fluid by the cooling fluid supply passage, discharge liquid coolant by the liquid coolant passing away simultaneously.
After laser balloon catheter of the present invention for example inserts urethra, by to the bulb supply cooling fluid, cooling water preferably, and make its expansion.Laser by the optical fibers transmission is radiated on the target tissue from laser beam emitting device, for example on the prostate.This makes prostate be heated to a downright bad temperature, and recovers by the metabolism absorption relevant with necrosis.
Should distribute like this from the laser energy of urethra inwall, laser energy is progressively reduced with the transmission of laser at the inwall depth direction at the prostate depth direction.So,, just must make laser energy remain on a high level for deep tissue being heated to higher temperature.
Yet, because it is higher according to the laser energy of penetrating at the prostate middle part to be radiated at the laser energy of urethra inwall, so the inwall of urethra partly is heated to a higher temperature.So urethra may be subjected to the hot injury.
Yet, according to the present invention, liquid coolant, for example cooling water circulates by the bulb.So near the tissue the urethra inwall is cooled, and makes not organize to be subjected to the hot injury.Because near the hot injury of the tissue of urethra can not taken place, so can increase the output of laser.Prostatic deep tissue also can be heated.
If making by bulb of the present invention circulation, liquid coolant organize inwall partly to be cooled to for example 2-15 ℃, preferably about 3-7 ℃, and just organizing inwall that false narcotism partly takes place, the pain in the operation also can disappear or alleviate.
In laser balloon catheter apparatus of the present invention, temperature-detecting device is provided, be used for detecting directly or indirectly with the temperature of the tissue of laser irradiation with according to device from the Signal Regulation per unit time Laser emission rate of the expression tissue temperature of temperature-detecting device.
Temperature-detecting device can have a detection head that is positioned at the surface, bulb.
According to tissue temperature signal,, can positively control the temperature of the target tissue that will shine by regulating the Laser emission cycle of each unit interval from temperature-detecting device.
According to the present invention, a kind of laser balloon catheter is provided, can in a bulb, launch laser, laser conducts by optical fibers, and with the laser irradiation tissue of passing the bulb.Conduit comprises laser beam emitting device; One first conduit, optical fibers pass it and extend, and a front end that is positioned at the bulb is arranged, and have an intercommunicating pore to make that conduit is inboard to communicate with the inboard, bulb at front end; The optical fibers front end is fixed on the fixture of first conduit; Coaxial and around second conduit of first conduit, it has a front end that communicates with the inboard, bulb; And coolant circulation unit, comprise a cooling fluid supply passage, it is one of in space in first conduit and the space between first and second conduit, with a liquid coolant passing away, it is other space, be used for by cooling fluid supply passage supply cooling fluid with the expansion bulb, simultaneously by liquid coolant passing away discharge liquid coolant; Pass fixture or between the fixture and first conduit, form the liquid coolant intercommunicating pore.
Make its fracture probably because on optical fibers, apply an excessive power, so it is effective providing one first conduit also to provide one second conduit around first conduit with the protection optical fibers around optical fibers.Liquid coolant can circulate by the space between the space in first conduit and first and second conduit.
Cooling water circulating device can comprise the cooling water tank of a sealing, one force (forcing) pump is used for supplying with compressed air to cooling water tank, one cooling water tube has a cooling water circulating pump, be used for by cooled water supply channel water being pumped into the bulb from described cooling water tank, with a cooling water recurrent canal, the cooling water that is used for making the bulb returns cooling water tank under the horizontal plane by the cooling water passing away.Can control the flow of recirculated cooling water by driving cooling water circulating pump.
Can have the output adjusting device, to regulate laser beam emitting device emitted laser output.According to tissue temperature signal,, can control circulating water flow and emitted laser amount respectively by driving circulating water flow amount control device and output adjusting device from temperature-detecting device.
Fig. 1 is the diagrammatic sketch of the whole laser irradiation device of the present invention;
Fig. 2 has shown the embodiment with different bulbs;
Fig. 3 has shown that another has the embodiment in different bulbs;
Fig. 4 has shown the whole LASER Illuminator System of the present invention;
Fig. 5 is the sectional side elevation of laser balloon catheter front-end architecture;
Fig. 6 is the sectional side elevation that amplifies, and has shown the main part of catheter proximal end;
Fig. 7 is the sketch map of holder;
Fig. 8 is the prostatic sketch map of treatment;
Fig. 9 is a curve chart, shown carry out and when not forcing to cool off the urethra inwall in the Temperature Distribution of depth direction;
Figure 10 is a sectional side elevation, has shown to use the embodiment of thin slice as the Laser emission end;
Figure 11 is a sketch map, has shown the narrow of laser balloon catheter being inserted blood vessel;
Figure 12 is a sketch map, has shown the narrow with the laser irradiation blood vessel;
Figure 13 is a sectional side elevation, has shown the structure of another laser balloon catheter;
Figure 14 is a sketch map, has shown cooling water circulation pipeline;
Present invention is described below by embodiment and with reference to accompanying drawing.
Fig. 1 has shown whole laser balloon catheter apparatus.One optical fibers 2 inserts first conduit 4.First conduit, 4 front ends have a tube head 6.The minor diameter part 6A that is arranged in tube head 6 rear ends inserts first conduit 4.First conduit 4 is by flexible material manufacturings such as for example polyethylene tubes, and laser can be by wherein transmitting.Second conduit 8 is equally by flexible material manufacturings such as polyethylene tubes, and it is coaxially around first conduit 4.
One bulb 10 and is fixed on second conduit, 8 front end outer surfaces and tube head 6 outer surfaces with binding agent or line on second conduit, 8 front ends and tube head 6.Bulb 10 is by inflatable and for example latex rubber manufacturing of material that can pass laser.
Liquid coolant, preferably cooling water W is by bulb 10 circulations.First conduit, 4 front ends that are arranged in bulb 10 have an intercommunicating pore 4A.The part of holder 12 also has a through hole (not shown), and circulating pump 30 is extracted cooling water W out from cooling water tank 28, and infeeds bulb 10 by the gap in first and second conduits 4 and 8.The cooling water W that infeeds bulb 10 flows into first conduit 4, and through holder 12, returns cooling water tank 28 again and be used for recirculation.
One thermocouple 14A is bonded on 10 inner surfacies of bulb, and its lead 14 is connected in a temperature control equipment 24.The temperature of bulb 10 inner surfacies roughly is to organize the temperature of M inwall detected, and the signal of an expression temperature is sent to temperature control equipment 24.According to the temperature signal of output, temperature control equipment 24 control laser generators 26 are regulated the laser emission time cycle of each unit interval, and regulate the flow by circulating pump 30 circulation cooling water W.So that organize the inner wall temperature of M to become the temperature of target.
This makes the temperature of organizing inwall become the temperature of target, and can be by the temperature of control laser irradiation at the rate controlled heat tissue of organizing M inside.If the temperature of deep tissue is adjusted to the temperature of target, can be by pre-determining the temperature of organizing the M inwall and the temperature of deep tissue, the temperature of deep tissue is adjusted into the temperature of target, and the temperature of M inwall is organized in monitoring.
Fig. 2 has shown the embodiment that does not have the coaxial pipe device.One optical fibers 2 is fixed on the holder 16, and its front end is arranged in bulb 10.One cooling water tube 18 and a cooling water discharge pipe 20 extend through holder 16 in parallel to each other.Spheroid 10 cross-over connections are between holder 16 and tube head 6.18 effusive cooling water W infeed bulb 10 from cooling water tube, discharge by cooling water discharge pipe 20 then.
Because conduit does not have guiding device.So it is difficult that conduit is inserted tissue forcibly.Conduit can cooperate with an endoscope and insert effectively.
Fig. 3 has shown another embodiment, and wherein, the bulb 24A that centers on second conduit 24 of first conduit 22 is fixed in the front end of first conduit 22.Make second conduit 24 be configured as a bulb 24A by the vinylacetate resin and plastic pipe of blowing a front end heating with dilated diameter.Cooling water W expands bulb 24A, as shown in phantom in FIG..Because in deformation of guide tube, reduced diameter, so will can not hinder it to insert tissue.
By the gap in first conduit 22, the through hole 12A of holder 12 and intercommunicating pore 22A infeed bulb 24A with cooling water W, make bulb 24A expand and be pressed in and organize on the inwall, shown in solid line among the figure.
Laser balloon catheter of the present invention and cooling water circulating device can be applied among Fig. 4-7.
Front end in intubate 110 has first and second bulbs 101 and 102.Intubate 110 has first inner catheter 112 and second conduit 114 around first conduit.Between first and second conduits 112 and 114, be useful on lead 116, one evacuating catheters 118 and the one second bulb expansion cooling fluid supply pipe 120 of temperature sensor.The lead 116 that is used for temperature sensor is connected in a joint 112.The signal of expression temperature is delivered to temperature controller 24 to drive a laser generator 26 by joint 122.When in the treatment urine being arranged, urine is discharged by urinary catheter 118.For example, water W2 is fed to the second bulb expansion cooling fluid supply pipe 120.
When the liquid that is used in first bulb 101 of expanding by circulating pump 30, for example water W1 is after cooling water tank 28 is fed to pipe 32, it is by the Clearance Flow between first and second conduits 112 and 114, and be used to make first ball 101 to expand, afterwards, flow into first conduit 112 and return cooling water tank 28 again.Water in the cooling water tank is adjusted to one and gives fixed temperature.
From the laser of laser generator 26, preferably Nd-YAG laser transmits by joint 36 and optical fibers 38.
The front-end architecture of laser balloon catheter is shown in Fig. 5.Optical fibers 38 is arranged in first conduit 112, and this conduit comprises the pipe of system such as a polyethylene.The thermal protection pipe 40 that one high rigidity is arranged in the front end of first conduit 112.One metal holder 42 is arranged, with the fixing front end of optical fibers 38 in protecting tube 40.
Fig. 6 and 7 has shown the fixing means of optical fibers 38.Holder 42 front have partly 42A of a garden shape, and in rear end side one flat fixed part 42B are arranged.Garden shape partly has through hole 42C in 42 both sides.Holder 42 is plated with reflective metals, and is for example golden, in order to reflector laser.Optical fibers 38 passes fixed part 42B and garden shape part 42A.The optical fibers 38 of stretching in outside the shape part 42A front end of garden does not have coating, so that its core 38A exposes.So laser is launched from core 38A.In this case, laser is with the front end emission of higher percentage ratio from core 38.For laser is launched with higher ratio from the side of core, core is processed as a rough surface.On the regional Z of Fig. 6 coated with the thin film that comprises diffusion material, or coated with comprising for example thin film of carbon of extinction powder, so that luminous energy is become heat energy.
The Laser emission end has a joint 44, and transmitting terminal is the front portion that extends outside the optical fibers front end.The part 44A that joint 44 rear ends have a diameter to reduce.First connecting leg, 46 cross-over connections that can conduct laser of one plastics are between reduced diameter portion part 44A periphery and protecting tube 40.First connecting leg 46 is positioned at protecting tube 40 outer surfaces, with first conduit, 11 2 front end adjacency.There is an intercommunicating pore 46A appropriate location of first connecting leg 46.In first connecting leg 46, between reduced diameter portion part 44A rear end and protecting tube 40 front ends, a helical spring 48 is arranged.The plating of helical spring 48 outer surfaces is with laser reflective film, and is for example golden.Reduced diameter portion part 44A rear end face is coated with laser reflective film, for example gold plating 44B.In most preferred embodiment of the present invention, laser scattering on first connecting leg 46 and protecting tube 40 inner surfacies.Make the method for laser light scattering can comprise that the inner surface with first connecting leg 46 and protecting tube 40 is processed into rough surface, and by drying aluminum or silica flour attached on the inner surface.
On the other hand, in joint 44 front portions for example metal tube head 52 is arranged.Second connection tube 54 of formation second connecting device by a flexiplast makes tube head 52 link to each other with joint 44.By tying up of line 56 two ends of second connection tube 54 are fixed on tube head 52 and the joint 44.Form a through hole 54A on the connecting leg 54.
In this embodiment, the pipe that constitutes first ball 101 extends through joint 44 to tube head 52 provides second ball 102.In another embodiment of the present invention, first ball 101 can separate with second ball 102.Tying up of clamp device by for example line 58, the front end of second ball 102 can be fixed on the tube head 52.First and second balls 101 and 102 constitute by having flexibility and elastic expansible material.In the present embodiment, it is made by latex rubber, also can be made by silicone rubber.
Joint 52 front ends comprise half bulb part 52A, and the garden post part at middle part and the minor diameter of rear end are partly.Hemisphere partly 52A partly has main urine mouth 52B and pays urine mouthful 52C in middle and both sides, and communicates with a shared urine mouthful 52D who opens in minor diameter part rear end.
The urinary catheter 118 that is inserted on the tube head 52 minor diameters part extends through joint 44, and passes first conduit 114, and outwards opens, as shown in Figure 1.So when surgical operation had urine, urine flowed into any one urine mouth, and discharged by urinary catheter 52D and 18.In operation on prostate, because prostatic heating has promoted to urinate, so this urination apparatus is effectively.The reason that the urine mouth is opened in hemisphere part 52A middle part and both sides is if any one opening has been stopped up by bladder, can both urinate reposefully by opening.
On the other hand, the second ball expansion cooling fluid supply pipe 120 extends into first conduit 14, and extends through joint and enter second connecting leg 54.From the cooling water W2 of the outside supply second ball expansion cooling fluid supply pipe 20 of flowing through, and infeed second connecting leg 54, import second ball 102 through intercommunicating pore 54A then, be used for the expansion of second ball 102.Extracting cooling water W2 out by the second ball expansion cooling fluid supply pipe 20 shrinks second ball.
As shown in Figure 5, the lead 16 of temperature sensor extends through the gap between first and second conduits 12 and 14, and centers on the periphery of joint 44, and through second conduit 114, contacts with first ball, 102 inner surfacies at medium position along length.Lead 116 front ends are clipped in and contain between reflective two aluminium foils and the reflector plate of plastic sheet system with white pigments.Reflector plate 116A is bonded on first ball, 101 inner surfacies with binding agent.
Laser balloon catheter is preferably used in the treatment prostate, and not have compression pump fashionable as cooling water W1 and W2, and first and second balls 101 and 102 contractilitys because of self shrink.At this moment, the inflatable part 114A of second conduit 114 also correspondingly shrinks because of the contraction of first ball 101.
In this case, laser balloon catheter is inserted urethra 60, and second ball 102 is positioned in the bladder 62, as shown in Figure 8.Then, by circulating pump 30 cooling water W1 is made its expansion from the inflatable part 114A of cooling water tank 28 through managing gap between 32 and first and second conduits 112 and 114 and infeeding second conduit 114.This also expands first ball 101, shown in Fig. 5 and 8.Be used for expansible cooling water W1 and flow into first conduit 112, and return cooling water tank 28 through communicating pipe 46 through discharge pipe 34.
Cooling water W2 also infeeds second ball 102 through second ball expansion cooling fluid supply pipe 120, the second connecting legs 54 and intercommunicating pore 54A, so that 102 expansions of second ball, shown in Fig. 5 and 8.
Laser from laser generator 26 is radiated on the optical fibers 38 by joint 36, and launches from core 38A at optical fibers 38 front ends.The laser that is incident upon on the protecting tube 40 or first connecting leg 46 directly transmits by pipe 40 and 46, or is passing through its transmission after reflection and the scattering repeatedly, and at transverse scattering, and is incident upon on the prostate 64 by second conduit 114 and first ball 101.If some laser that forward are incident upon on the gold-plated helical spring 48 simultaneously, it is reflected by helical spring 48, and at transverse scattering, and is incident upon on the prostate 64 by first connecting leg, 46, the second conduits 14 and first ball 101.
Forward not the laser of interfering and on Gold plated Layer 44B, reflect, and when they transmitted rearward or interfere with helical spring 48, some in them were in horizontal reflection with helical spring 48.The reflected light that transmits rearward reflects on the gold-plated front surface of holder 42 garden shapes part 42A, forwards then.Like this, after reflecting repeatedly, laser is at transverse scattering.So laser is launched to prostate in ball 101 both sides from first ball, 101 whole surfaces with low dosage with high dose at the middle part along ball length.
The laser that is incident upon on the prostate 64 is absorbed to produce heat by its tissue.So prostate 64 is heated.Keep a preset time cycle with LASER HEATING.Prostate 64 having diseased tissues to be exposed to laser and being heated and downright bad, prostatic other will restore after being organized in operation soon.
Also available ultrasound wave heating prostate.Though many ultrasound wave are absorbed by the moisture content in the prostata tissue, the laser rate that tissue absorbs is lower, and therapeutical effect is also low.In contrast, the laser rate of laser rate, particularly Nd-YAG that moisture content absorbs approximately is 10%, and remaining laser is by the protein adsorption in the tissue.Even cooling water flows in ball.Most laser also can transmit by cooling water.
In an embodiment of the present invention, the inside of cooling off first ball 101 by the cooling water W1 by second conduit, 114 forced circulation is to hold it in a predetermined temperature.When not forcing to cool off, laser energy reduces from the transmission of urethra inwall to the prostate deep with it.When the prostate deep was heated to a lower temperature, the urethra inwall was heated to a higher temperature, shown in the temperature distribution history among Fig. 9.
If laser energy increases, to the prostate middle part heat tissue than its dark about 6-12mm, urethra inwall and near tissue are by superheated and may be damaged from the urethra inwall.It is more difficult curing damaged tissue.
When cooling off the inflatable part 114A of first ball 101 and second conduit 114 with cooling water W1, near the urethra tissue is cooled, shown in the temperature distribution history X among Fig. 9, with when laser makes it organize heating reliably with enough energy exposure prostate middle part, can prevent the urethral tissue damage.In this case, by circulating load or the temperature of control laser energy and cooling water W1, the distribution of energy attemperation is shown in temperature distribution history X1 or X2 among Fig. 9.According to prostatic symptom, can strengthen therapeutical effect by the attemperation distribution.
For prostatitis, by pressure cooling the prostate inboard is heated to and is no more than 43 ℃ temperature with cooling water W1.For prostate hyperplasia, the prostate inboard is heated to 45 ℃ or higher, makes it downright bad, simultaneously by forcing cooling with cooling water W1, make the urethra inwall and near do not organize and can be subjected to the hot injury.Downright bad tissue is absorbed by metabolism ground, reduces prostatic size, makes urethra open-minded.
The front position of the length of the inflatable part 114A of the ball 101 and second conduit 114 or optical fibers 38 is adjusted, to prevent laser infringement sphincter 66.The length of ball is that about 2-4cm can treat prostate effectively.
In operation, second ball 102 makes earlier the laser balloon catheters location effectively, prevents that again laser balloon catheter from deviating from from bladder 62.Both, made after second ball 102 is positioned in the bladder 62 laser balloon catheter being inserted, to have expanded, and to have drawn back laser catheter then and lean against the cervical region 62A of bladder 62, and first ball 101 is located with respect to prostate up to second ball 102 by making second ball 102.After finishing the location, first ball 101 is expanded.In operation, even the laser balloon catheter displacement because second ball 102 leans against the cervical region 62A of bladder 62, is deviate from from bladder 62 so can prevent laser balloon catheter.
Detect the temperature of urethra inwall by a thermocouple at lead 116 front ends.By lead 116 and joint 122 signal of representation temperature is delivered to temperature control equipment 24.Poor according to the detected temperatures of urethra inwall and target temperature adjusted the laser generator interval of 26 switch times, and adjusts the temperature of urethra inwall.By pre-determining the mutual relation between prostate middle part temperature and the urethra inner wall temperature, and can control the temperature in the middle part of the prostate.
Because excessive laser penetration prostate can make its tissue sustain damage, so the most handy temperature probe 70 inserts rectum 68, as shown in Figure 8.Temperature probe 70 has a temperature sensor 74, and it has for example 5 thermocouples, is positioned at a side that the metal tube front end of high rigidity arranged, and makes the front end of thermocouple outside, makes pick off 74 biasings at the ball 76 of opposite side.The lead of temperature sensor 74 each thermocouple and an external device (ED) for example temperature control equipment 24 link to each other.After temperature probe 70 had inserted rectum 68, an external pressure source for example source of the gas expanded biases ball 76.Expansible biases ball 76 makes temperature probe to rectum 68 biasings, and closely contacts with the rectum inwall.To make its heating with laser irradiation prostate 64.A part of laser passes prostate 64 and arrives rectum 68 sides, makes to organize also near the rectum 68 to be heated.If temperature sensor 74 detected rectum 68 inner wall temperatures have surpassed predetermined temperature, the cycle of closing time of laser generator 26 will prolong, and perhaps laser energy reduces, to prevent the excessive heating of prostate 64.Also can prevent the hot injury of rectum 68.
The present invention has another embodiment, and as shown in figure 10, optical fibers is not as the device of launching laser.The chip 80 that one transmission laser is arranged at optical fibers 38 front ends.From the laser irradiation of optical fibers 38 front ends on chip 80.Make laser from chip 80 emissions.By a suitable connecting cylinder 82 optical fibers is linked to each other with chip.
In another embodiment, the expansion part 114A of second conduit 14 does not pass first ball 1 and extends to joint 44, and end at line 84 the place ahead slightly, be anchored on second conduit 14 with first ball 101, so that first ball 101 is expanded by pumping into cooling water W1 with Fig. 5.
The inflatable part 114A of second conduit 114 has many advantages by two membrane structures that first ball 101 extends to joint.If first ball 101 is by the latex rubber manufacturing, expandable first ball 101 will become hemispherical, and the vertical section is difficult to become ellipse garden shape.So, a plastic tube is provided earlier, and pressurizes and heat at its front end, blow processing, be formed with partly 11+A of identical and large diameter bulge.When the part 114A that expands is expanded, it will can not expand and exceed outside the ready-formed shape.So the shape of expansible first ball 101 will be followed the partly shape of 114A that expands.Second advantage is that lead 116 imports between first ball 101 and inflatable part 114A, and make the lead front end attached on the first ball inwall, when inflatable part 114A expands,, can prevent that also detected temperatures from making a mistake even the lead front end breaks away from from the first ball inner surface.The 3rd advantage is that even the one deck in the duplicature breaks, water can not leak yet.Extract out if will import the cooling water of inflatable part 114A, the contractility of first ball 101 will make the inflatable part 114A of second conduit 114 shrink automatically.
Though in the above embodiments, cooling water W1 passes through the Clearance Flow between first and second conduits 112 and 114, and flows into first conduit 112 by intercommunicating pore 46, and discharges by the space in first conduit 112, and the cooling-water flow direction can be opposite.
First connecting leg 46 is to be convenient to assembling with the reason that first conduit 112 separates, and for example holder 42 and protecting tube 40 are in the setting of first conduit, 12 front ends and the setting of first connecting leg, 46 medi-springs 48.So first connecting leg 46 can omit, and first conduit 112 can extend the partly 44A of minor diameter that packs into.In this case, first conduit 112 forms the intercommunicating pore of cooling water W1.
As mentioned above, though Nd-YAG laser is as best laser, also can use argon laser or diode laser etc.Because laser is absorbed by water at a low percentage ratio, they shine organizationally by the cooling water transmission and with a high ratio.
Though use cooling water with first and second balls 1 and 2 of expanding, also can use air, nitrogen and carbonoxide gas etc.The liquid coolant that also can use other is ethanol for example.
For laser balloon catheter of the present invention is inserted tissue reposefully, best first and second conduits 112 and 114 and first and second connecting legs 116 and 54 are flexible.If conduit can insert point-blank, at least one in these parts can be inflexibility.
Laser balloon catheter of the present invention also is effective for the treatment of other tissue.For example, conduit also is effectively for the narrow part N of blood vessel dilating V, as shown in figure 11.In this case, earlier lead 84 is inserted evacuating catheter 118.After lead 84 is inserted target vessel V or the while, laser balloon catheter is inserted blood vessel V.Then, second ball 102 is inflated, as shown in figure 11.Then, laser balloon catheter is extracted out.When second ball, 102 rear end shoulders leaned against narrow N, the surgeon can confirm the existence of second ball, 102 back narrow N according to feel.First ball 101 is when this position is inflated, and laser irradiation narrow N is with the blood vessel of vaporized expanding, as shown in figure 12.
Figure 13 shows another embodiment, and wherein, first ball 101 separates with second ball 102, and second conduit 114 does not extend forward, and first ball 101 is not a double membrane structure, but single structure, 112 extensions of first conduit cooperate with minor diameter part 44A.In this embodiment, first conduit 112 has constituted first connecting device.
In the present invention, preferably control the flow of cooling water according to the temperature signal of tissue.For this reason, adopt structure for example shown in Figure 14.According to from the temperature detecting head 14A signal of thermocouple for example, drive cooling water circulating pumps 30 by temperature control equipment 24, with the rate of circulating flow of control cooling water in ball 101.Simultaneously, laser generator 26 is actuated to control the laser irradiation rate of each unit interval.
Cooling water manages 32 by filter 80 from being pumped into by the isolated cooling water tank 28 of heat-barrier material.On the length of pipe 32, provide an effusion meter 81, detect flow by an amplifier 82.Determine the control flow of cooling water circulating pump 30 according to the deviation between present flow rate and the target flow.Effusion meter that is positioned on the discharge pipe 34 of label 83 expressions.Outlet at discharge pipe 34 has a water purifying column 84 that fills with ion exchange resin.
According to the signal of representative from the water temperature of temperature detector 85, drive chiller 87 by a cooling controller 86, make the cooling water in the cooling water tank 28 be controlled in a predetermined target temperature by cooling coil 88.In order to determine 30 cooling water circulation amounts of circulation of cooling water circulating pump,, and be sent to temperature control equipment 24 by the water temperature in the cooling-water temperature sensor 89 detection cooling water tanks 28.
Feed to ball 101 and poor between the cooling water flow of its discharge by providing, and ball 101 is expanded.Because the variation of cooling water flow is arranged, so the expansion rate of ball 101 is unsettled.So, preferably forced air is fed to one and is converted to the cooling water tank 28 of a seal box and ball 101 is expanded.An air pump 90 links to each other with cooling water tank 28 by a pressure air pipe 91 for this reason.The air pressure that air pump pumps into is controlled in expansion according to object ball 101.Label 94 and 95 is represented an oil mist filter and a relief valve respectively.
Because excessive pressure can make ball 101 break, so according to the pressure signal from the cooling water tank 28 of Pressure gauge 96, the aperture of first coarse adjustment eduction valve 92 is finely tuned the aperture of electromagnetic valve 93, again with the degrees of expansion of control ball 101.Water yield detector of label 99 expressions.
Under the situation that chiller 87 grades lost efficacy,, organize the danger that the hot injury is just arranged if cooling-water temperature sensor 89 detected coolant water temperatures are too high.Under the situation that piezometer 96 lost efficacy, if the hypertonia in the cooling water tank 28, ball 101 just has disruptive danger.So, in temperature control equipment 24, comprise that stops a laser generator 26, the interlock of cooling water circulation water tank 30 and air pump 90 all operations.Though diagram does not have a Pressure gauge 100A, to prevent that second ball 102 is owing to excessive expansion is broken in the cooling water tube that leads to second ball 102.One Pressure gauge 100B is arranged on evacuating catheter, be difficult to urinate owing to the obstruction of evacuating catheter preventing.When from the hypertonia of Pressure gauge 100A and 100B, interlock is also worked, to stop laser generator 26, all operations of cooling water circulating pump 30 and air pump 90.When from the internal rectum wall temperature of temperature detecting head 70 when too high, the work of laser generator 26 stops, and perhaps output reduces.
As mentioned above, according to the present invention, laser energy penetrates deep tissue reliably, prevents simultaneously Insert near the tissue in laser balloon catheter position and be subjected to fire damage. The invention provides one Individual advantage can easily be controlled temperature at the depth direction that inserts laser balloon catheter position inwall The distribution of degree.
The laser balloon catheter of invention is for the treatment prostate, and esophagus, stomach, 12 fingers Intestines, the tissue of blood vessel are effective. This conduit also can be used for the hyperthermia of cancerous tissue.
Claims (8)
1. a laser balloon catheter apparatus is used for launching laser at a ball, and laser is by the optical fibers transmission, and uses the laser irradiation tissue that transmits by ball, comprising:
Laser beam emitting device;
Be arranged in the cooling fluid supply passage of described ball;
Be used to discharge the liquid coolant passing away of liquid coolant;
Coolant circulation unit is used for liquid coolant is passed through described cooling fluid supply passage to the ball supply cooling fluid, and ball is expanded, and discharges liquid coolant by described liquid coolant passing away simultaneously.
2. laser balloon catheter apparatus as claimed in claim 1, it is characterized in that: also comprise temperature-detecting device, be used for detecting directly or indirectly by the temperature of the tissue of laser irradiation with according to device from Laser emission cycle of each unit interval of Signal Regulation of the expression tissue temperature of temperature-detecting device.
3. laser balloon catheter apparatus as claimed in claim 2 is characterized in that: temperature-detecting device has a detection head that is positioned at the ball surface.
4. a laser balloon catheter apparatus is used for launching laser at a ball, and laser is by the optical fibers transmission, and uses the laser irradiation tissue that transmits by ball, comprising:
Laser beam emitting device;
One first conduit, described optical fibers extends by it, and a front end that is arranged in ball is arranged, and at front end one intercommunicating pore is arranged, and is communicated with the ball inboard conduit is inboard;
Fixture is used for the optical fibers front end is fixed on first conduit;
One second conduit, it centers on first conduit coaxially, and a front end that communicates with the ball inboard is arranged;
Coolant circulation unit, comprise a cooling fluid supply passage, it is one of in the space of described first conduit and the gap between first and second conduits, with one be other spatial liquid coolant passing away, be used for ball being expanded, discharge liquid coolant through the liquid coolant passing away simultaneously through described cooling fluid supply passage supply cooling fluid;
One liquid coolant intercommunicating pore passes between described fixture or fixture and first conduit.
5. laser balloon catheter apparatus as claimed in claim 4 is characterized in that: ball chew the front end that is fixed in first conduit.
6. laser balloon catheter as claimed in claim 4 is characterized in that: described conduit is made of flexible material, and has a bulb, its front end to have a major diameter partly, is fixed in to the bulb forward end seal to be positioned on the forward tube head of described laser beam emitting device.
7. a laser balloon catheter apparatus is used for launching laser at a ball, and laser is by the optical fibers transmission, and uses the laser irradiation tissue that transmits by ball, comprising:
Laser beam emitting device,
Be arranged in the cooled water supply channel of described ball;
Be used to discharge the cooling water passing away of liquid coolant;
Cooling water circulating device is used for by described cooled water supply channel to the ball cooling water supply, so that the ball expansion is discharged cooling water through described liquid coolant passing away simultaneously;
Described cooling water circulating device comprises the cooling water tank of a sealing, one force (forcing) pump infeeds forced air to cooling water tank, one cooling water tube has a cooling water circulating pump to be used for that cooling water is infeeded ball and a cooling water recurrent canal through cooled water supply channel from cooling water tank to be used for making by the cooling water passing away cooling water of ball to turn back in the cooling water tank under the horizontal plane;
Described device also comprises temperature-detecting device, is used for detecting directly or indirectly the temperature by the target tissue of laser irradiation; With circulation cooling water flow amount control device, be used for by driving the flow of described cooling water circulating pump control circulation cooling water.
8. laser balloon catheter apparatus as claimed in claim 7, it is characterized in that: also comprise the adjusting device that is used to adjust from laser beam emitting device emitted laser amount, according to tissue temperature signal from temperature-detecting device, by driving described circulating water flow amount control device and described output adjusting device, can control the flow and the emitted laser amount of recirculated water respectively.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 94118135 CN1122680A (en) | 1994-11-08 | 1994-11-08 | Laser balloon catheter apparatus |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN 94118135 CN1122680A (en) | 1994-11-08 | 1994-11-08 | Laser balloon catheter apparatus |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN1122680A true CN1122680A (en) | 1996-05-22 |
Family
ID=5038679
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN 94118135 Pending CN1122680A (en) | 1994-11-08 | 1994-11-08 | Laser balloon catheter apparatus |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN1122680A (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN105616045A (en) * | 2016-03-03 | 2016-06-01 | 福建省立医院 | Interventional therapy device and method realizing steering and positioning fenestration through laser catheter |
| CN106255470A (en) * | 2014-01-10 | 2016-12-21 | 波士顿科学国际有限公司 | There is the medical apparatus and instruments of flexible circuit assembly |
-
1994
- 1994-11-08 CN CN 94118135 patent/CN1122680A/en active Pending
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106255470A (en) * | 2014-01-10 | 2016-12-21 | 波士顿科学国际有限公司 | There is the medical apparatus and instruments of flexible circuit assembly |
| CN106255470B (en) * | 2014-01-10 | 2020-04-28 | 波士顿科学国际有限公司 | Medical device with flexible circuit assembly |
| CN105616045A (en) * | 2016-03-03 | 2016-06-01 | 福建省立医院 | Interventional therapy device and method realizing steering and positioning fenestration through laser catheter |
| CN105616045B (en) * | 2016-03-03 | 2018-07-03 | 福建省立医院 | The interventional therapy device and application method of steering and positioning fenestration are realized by laser catheter |
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