JP6552824B2 - 制御された交感神経切除並びに顕微焼灼システム及び方法 - Google Patents
制御された交感神経切除並びに顕微焼灼システム及び方法 Download PDFInfo
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Description
本出願は、Landy Toth et al.によって2012年1月26日付で出願された米国仮出願第61/590,812号、発明の名称「制御された交感神経切除並びに顕微焼灼システム及び方法」、及びLandy Toth et al.によって2012年3月20日付で出願された米国仮出願第61/613,097号、発明の名称「制御された交感神経切除並びに顕微焼灼システム及び方法」の利益及びこれらに対する優先権を主張する国際出願であり、これらの内容全体が全ての目的のもと引用することにより本明細書中の一部となる。
と、管腔付近内の治療部位にエネルギーを印加する工程と、管腔付近内の1又は複数の部位で電気生理学的活動をモニタリングして、第2の活動レベルを得る工程と、第1の活動レベル及び第2の活動レベルを比較して、エネルギー印加が電気生理学的活動に影響を与えたかどうか、十分なエネルギーが印加されたかどうか、又は更にエネルギーを印加すべきかどうかそれらの組合せ等を決定する工程と、を含む、方法が提供される。
Claims (24)
- 管腔付近内の電気生理学的活動をモニタリングする顕微手術具であって、
管腔内におけるデリバリーカテーテルからの展開のために伸長される構造を有するマイクロフィンガーと、
電気的かつ機械的に前記マイクロフィンガーに連結され、前記デリバリーカテーテルからの前記マイクロフィンガーの展開時に管腔壁と干渉するように構成される検知チップであって、
前記管腔付近内の前記電気生理学的活動を測定し、
前記管腔付近内の測定された前記電気生理学的活動に関連する1又は複数の電気生理学的信号を体外システムに伝達するために構成される、前記検知チップと、
前記検知チップと電気的に連結され、前記体外システムに前記電気生理学的信号を伝達する前に、前記検知チップで検知された前記電気生理学的信号の調整を行うように配置された微小回路であって、
前記検知チップで検知された前記電気生理学的信号の調整が、前記電気生理学的信号をデジタル形式に変換すること、および、前記電気生理学的信号を増幅すること、の少なくとも一方を含み、
前記マイクロフィンガーに埋め込まれた前記微小回路
を含む、顕微手術具。 - 前記電気生理学的信号が、水分濃度、緊張、誘発電位、神経活動の遠隔刺激、筋電図信号[EMG]、筋音図信号[MMG]、局所電場電位、電気音響学的事象、血管拡張、血管壁の硬化度、筋交感神経活動[MSNA]、中枢交感神経ドライブ、組織緊張、及び神経連絡の1又は複数に関連する、請求項1に記載の顕微手術具。
- 前記検知チップが1又は複数の電極を含む、請求項1に記載の顕微手術具。
- 前記マイクロフィンガーが、前記検知チップと前記管腔壁との間の接触力を変更するために構成される活性材料要素を含む、請求項1に記載の顕微手術具。
- 前記検知チップが前記接触力の変化を測定するために構成される力検知要素を含む、請求項4に記載の顕微手術具。
- 1又は複数の電極の少なくとも1つが、前記マイクロフィンガーのコアフレクシャの先端又は末端の少なくとも一方に成形された露出した電極領域を含み、前記露出した電極領域が前記検知チップを前記管腔壁中に実質的に埋め込むように構成される、請求項3に記載の顕微手術具。
- 前記マイクロフィンガーが、前記管腔の長手方向及び/又は前記管腔の円周方向に掃過される間、前記管腔壁との接触を実質的に維持するために、前記活性材料要素の前記接触力の測定された変化に応じて前記活性材料要素の前記接触力を変更するように構成される、請求項5に記載の顕微手術具。
- 少なくとも1又は複数の電極が前記マイクロフィンガーのコアフレクシャの中立軸の片側に対して配向される露出した電極領域を含む、請求項1に記載の顕微手術具。
- 前記マイクロフィンガーの1又は複数の領域が、前記管腔の空洞から前記検知チップを実質的に電気的に隔離するように構成される絶縁層で選択的に被覆された、請求項1に記載の顕微手術具。
- 前記マイクロフィンガーが150um未満、100um未満、75um未満、50um未満、25um未満、10um未満、5um未満の特徴的な幅を有する、請求項1に記載の顕微手術具。
- 複数の前記マイクロフィンガーを含み、展開に際して、前記マイクロフィンガーのそれぞれが前記管腔壁に対して実質的に独立してバイアスするように構成される、請求項1に記載の顕微手術具。
- 複数の前記マイクロフィンガーがケージ、メッシュ、又はステント型の構造を形成するために構成される、請求項11に記載の顕微手術具。
- 前記検知チップが針電極を含み、前記マイクロフィンガーが展開に際して前記管腔壁へと該針電極を刺し込むために構成される、請求項1に記載の顕微手術具。
- 前記マイクロフィンガーが、前記デリバリーカテーテルから展開されるように構成される、請求項1に記載の顕微手術具。
- 前記デリバリーカテーテルの少なくとも一部が、3mm未満の直径を有する、請求項14に記載の顕微手術具。
- 前記デリバリーカテーテルの少なくとも一部が、0.75mm未満の直径を有する、請求項14に記載の顕微手術具。
- 前記マイクロフィンガーと前記管腔壁の間の相対運動の間、前記マイクロフィンガーのそれぞれが前記管腔壁との接触を独立して維持するために構成される、請求項11に記載の顕微手術具。
- 前記マイクロフィンガーの1又は複数が前記相対運動の存在下で信号を伝達するために構成される、請求項17に記載の顕微手術具。
- 前記検知チップが、前記検知チップに運動を適用する間に歪み計測及び力計測を組み合わせることにより組織の緊張を測定するように構成される、請求項1に記載の顕微手術具。
- 前記管腔が、血管、動脈、静脈、腎動脈の1つを含む、請求項1に記載の顕微手術具。
- 前記マイクロフィンガーが、前記管腔を通る流体の流れを妨げることなく前記管腔壁との接触を維持するために構成された長手方向のワイヤーケージを形成する複数のマイクロフィンガーの一部である、請求項1に記載の顕微手術具。
- 前記管腔内の標的部位へ前記長手方向のワイヤーケージの誘導を補助するために構成されたガイドワイヤをさらに含む、請求項21に記載の顕微手術具。
- 前記長手方向のワイヤーケージを通る前記ガイドワイヤの通路を調整するために構成された遠位小環をさらに含む、請求項22に記載の顕微手術具。
- 前記マイクロフィンガーが、放射状にバイアスされた屈曲バネを含む、請求項1に記載の顕微手術具。
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