JPH09503408A - 植え込まれた物体を除去するためのレーザー装置 - Google Patents
植え込まれた物体を除去するためのレーザー装置Info
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- JPH09503408A JPH09503408A JP7510933A JP51093395A JPH09503408A JP H09503408 A JPH09503408 A JP H09503408A JP 7510933 A JP7510933 A JP 7510933A JP 51093395 A JP51093395 A JP 51093395A JP H09503408 A JPH09503408 A JP H09503408A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/056—Transvascular endocardial electrode systems
- A61N1/057—Anchoring means; Means for fixing the head inside the heart
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
- A61B18/20—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser
- A61B18/22—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
- A61B18/24—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using laser the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor with a catheter
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/50—Instruments, other than pincettes or toothpicks, for removing foreign bodies from the human body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00681—Aspects not otherwise provided for
- A61B2017/00694—Aspects not otherwise provided for with means correcting for movement of or for synchronisation with the body
- A61B2017/00703—Aspects not otherwise provided for with means correcting for movement of or for synchronisation with the body correcting for movement of heart, e.g. ECG-triggered
-
- 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
- A61B2017/22072—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with an instrument channel, e.g. for replacing one instrument by the other
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/04—Electrodes
- A61N1/05—Electrodes for implantation or insertion into the body, e.g. heart electrode
- A61N1/056—Transvascular endocardial electrode systems
- A61N1/057—Anchoring means; Means for fixing the head inside the heart
- A61N2001/0578—Anchoring means; Means for fixing the head inside the heart having means for removal or extraction
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- Physics & Mathematics (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Surgery (AREA)
- Engineering & Computer Science (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Cardiology (AREA)
- Optics & Photonics (AREA)
- Vascular Medicine (AREA)
- Electromagnetism (AREA)
- Otolaryngology (AREA)
- Radiology & Medical Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Laser Surgery Devices (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Crystals, And After-Treatments Of Crystals (AREA)
- Semiconductor Lasers (AREA)
- Lasers (AREA)
Abstract
Description
Claims (1)
- 【特許請求の範囲】 1.基端及び先端を持つカテーテルであって、中央内腔を備えた管状部分を有 し、かつ、先端には細長い前記カテーテルの外面に亘って位置決めされた保護バ ンドと前記カテーテルの内面に亘って位置決めされた保護リングとを設けた、前 記カテーテルと、 先端が保護バンドと保護リングとの間を延び、かつ、管状部分によって支持さ れた、少なくとも一つの光ファイバと、 前記カテーテルの内面と前記カテーテルの外面との間にある組織除去領域だけ に、レーザーエネルギを光ファイバを通して、かつ、光ファイバの先端を越えて 伝達する、光ファイバと連通したレーザーエネルギ源と、 を有する、物体を静脈系から取り出すためのシステム。 2.前記カテーテルには、スタイレットを前記カテーテルに入れることができ るスタイレットポートが設けられている、請求項1に記載のシステム。 3.前記カテーテルの先端の直前の領域まで前記カテーテルに対して第1方向 に延びる前記光ファイバを更に有する、請求項1に記載のシステム。 4.第1方向は、前記カテーテルの内腔に向かう方向である、請求項3に記載 のシステム。 5.前記カテーテルの先端は放射先端不透過性材料である、請求項1に記載の システム。 6.前記光ファイバの先端は前記保護リングの先端から基端方向に間隔を隔て られている、請求項1に記載のシステム。 7.前記カテーテルは心臓信号を検出するための手段を更に有する、請求項1 に記載のシステム。 8.前記心臓信号を検出するための手段は心臓に電気的に接続するための手段 を含む、請求項7に記載のシステム。 9.心臓信号を検出するための手段、及び、レーザーエネルギの伝達を検出し た心臓信号と同期させるための手段を更に有する、請求項1に記載のシステム。 10.レーザーエネルギの伝達を検出した心臓信号と同期させるための前記手段 は、検出した心臓信号に応じてレーザー用のトリガーパルスを発生する手段を更 に有する、請求項9に記載のシステム。 11.レーザーエネルギの伝達を検出した心臓信号と同期させるための前記手段 は、トリガーパルスの前縁を特定の時間に位置決めするための手段、トリガーパ ルスの幅を決定するための手段、及びレーザーの発射をトリガーパルスに応じて 及び決定された幅に亘って制御するための手段を更に有する、請求項9に記載の システム。 12.前記保護リングの先端及び前記保護バンドの先端は前記カテーテルの先端 に位置決めされている、請求項1に記載のシステム。 13.前記保護リングの先端はテーパ形状をなしている、請求項1に記載のシス テム。 14.前記保護バンドの先端はテーパ形状をなしている、請求項1に記載のシス テム。 15.前記光ファイバは所定の半径方向厚さを有し、前記保護リングは、前記光 ファイバの半径方向厚さと同じか或いはそれ以下の半径方向厚さを有する、請求 項1に記載のシステム。 16.前記レーザーエネルギは、前記光ファイバの先端を越えて前記静脈系の流 体内の前記組織除去領域内に伝達される、請求項1に記載のシステム。 17.基端及び先端を有するカテーテルであって、中央内腔を備えた管状部分を 有し、先端には細長いカテーテルの外面に亘って位置決めされた保護バンドが設 けられ、前記保護バンドは先端を有し、前記カテーテルの先端には細長い前記カ テーテルの内面に亘って位置決めされた保護リングが設けられ、前記保護リング は先端を有する、前記カテーテルと、 前記管状部分によって支持された少なくとも一つの光ファイバであって、前記 光ファイバは先端を有し、前記光ファイバの先端は前記保護バンドと前記保護リ ングとの間に延在し、前記光ファイバの先端が前記保護バンドの先端から基端方 向に間隔を隔てられている、前記光ファイバと、 光エネルギが前記カテーテルの先端の直前の領域に伝達されるように前記光フ ァイバと連通した、レーザーエネルギ源と、 を有する、静脈系から物体を取り出すためのシステム。 18.前記レーザーエネルギ源は、前記カテーテルの内面と前記カテーテルの外 面との間にある組織除去領域のみに、前記レーザーエネルギを前記光ファイバを 通して、かつ、前記光ファイバの先端を越えて伝達する、請求項17に記載のシ ステム。 19.前記先端の直前の領域まで前記カテーテルの内腔に向かう方向に延びる光 ファイバを更に有する、請求項17に記載のシステム。 20.前記光ファイバの先端は前記保護リングの先端から基端方向に間隔を隔て られている、請求項17に記載のシステム。 21.前記カテーテルは前記心臓信号を検出するための手段を更に有する、請求 項17に記載のシステム。 22.前記心臓信号を検出するための手段は心臓に電気的に接続するための手段 を有する、請求項21に記載のシステム。 23.前記心臓信号を検出するための手段と、前記レーザーエネルギの伝達を検 出した心臓信号と同期させるための手段とを更に有する、請求項17に記載のシ ステム。 24.レーザーエネルギの伝達を検出した心臓信号と同期させるための前記手段 は、検出した心臓信号に応じてレーザー用のトリガーパルスを発生する手段を更 に有する、請求項23に記載のシステム。 25.レーザーエネルギの伝達を検出した心臓信号と同期させるための前記手段 は、トリガーパルスの前縁を特定の時間に位置決めするための手段、トリガーパ ルスの幅を決定するための手段、及び、レーザーの発射をトリガーパルスに応じ て、かつ、決定された幅に亘って制御するための手段を更に有する、請求項24 に記載のシステム。 26.前記光ファイバは所定の半径方向厚さを有し、前記保護リングは前記光フ ァイバの半径方向厚さと同じか或いはそれ以下の半径方向厚さを有する、請求項 17に記載のシステム。 27.内腔と、少なくとも一つの光ファイバとを備え、更に、外面に亘って位置 決めされた保護バンドと、内面に亘って位置決めされた保護リングとからなる、 保護アッセンブリを備えた先端を有し、前記光ファイバは前記保護バンドと前記 保護リングとの間に延在するように構成されたカテーテルを、静脈系に導入する 工程と、 植え込まれた物体を前記カテーテルの内腔内に位置決めする工程と、 前記カテーテルの先端を線維質の瘢痕組織の直前に位置決めする工程と、 前記カテーテルの内面と前記カテーテルの外面との間にある組織除去領域のみ に、レーザーエネルギを前記光ファイバを通して、かつ、前記光ファイバの先端 を越えて前記組織除去領域に伝達する工程と、 線維質の瘢痕組織が植え込まれた物体を解放するに従って、カテーテルを植え 込まれた物体に沿って移動させる工程と、 前記静脈組織から前記物体を取り除く工程と、 を有する、線維質の瘢痕組織で身体に付着した植え込まれた物体を取り出すた めの方法。 28.前記カテーテル本体にスタイレット内腔を形成する工程を更に有する、請 求項27に記載の方法。 29.前記カテーテル本体を植え込まれた物体に沿って操作する工程を更に有す る、請求項27に記載の方法。 30.植え込まれた物体から遠ざかる方向に前記レーザーエネルギを放出する前 記光ファイバを提供する工程を更に有する、請求項27に記載の方法。 31.前記光ファイバの先端を前記保護リングの先端近くに位置決めする工程を 更に有する、請求項27に記載の方法。 32.植え込まれた物体は前記ペースメーカーのリード線である、請求項27に 記載の方法。 33.心臓信号を検出し、前記光ファイバに連結されたレーザーを検出した心臓 信号に合わせて賦勢し、前記線維質の瘢痕組織に前記レーザーエネルギを放出す る、請求項27に記載の方法。 34.内腔と先端と基端とを持ち、かつ、外面に亘って位置決めされた保護バン ドと内面に亘って位置決めされた保護リングとからなる保護アッセンブリを先端 に備えた、カテーテルと、 前記カテーテルによって支持された少なくとも一つの光ファイバであって、前 記カテーテルの先端の直前の領域まで延在し、前記保護バンドと前記保護リング との間に延在し、所定の半径方向厚さを有し、前記保護リングの半径方向厚さは 前記光ファイバの半径方向厚さと等しいか、或いは、それ以下であるように構成 された、前記光ファイバと、 光エネルギが前記カテーテルの先端の直前の領域に伝達されるように前記光フ ァイバと連通した、レーザーエネルギ源と、 を有する、静脈系から物体を取り出すための装置。 35.前記カテーテルは、更に、心臓信号を検出するための手段を有する、請求 項34に記載のシステム。 36.心臓信号を検出するための前記手段は、心臓に電気的に接続するための手 段を含む、請求項35に記載のシステム。 37.更に、心臓信号を検出するための手段と、レーザーエネルギの伝達を検出 した前記心臓信号に同期させるための手段とを有する、請求項36に記載のシス テム。 38.レーザーエネルギの伝達を検出した心臓信号と同期させるための前記手段 は、検出した心臓信号に応じてレーザー用のトリガーパルスを発生する手段を更 に有する、請求項37に記載のシステム。 39.前記保護リングの先端及び前記保護バンドの先端は、前記カテーテルの先 端に位置決めされている、請求項34に記載のシステム。 40.前記保護リングの先端はテーパ形状をなす、請求項34に記載のシステム 。 41.前記光ファイバの先端は前記保護リングの先端から基端方向に間隔を隔て られている、請求項34に記載のシステム。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/131,055 | 1993-10-01 | ||
US08/131,055 US5423806A (en) | 1993-10-01 | 1993-10-01 | Laser extractor for an implanted object |
PCT/US1994/011146 WO1995009575A1 (en) | 1993-10-01 | 1994-10-03 | Laser extractor for an implanted object |
Publications (2)
Publication Number | Publication Date |
---|---|
JPH09503408A true JPH09503408A (ja) | 1997-04-08 |
JP3450010B2 JP3450010B2 (ja) | 2003-09-22 |
Family
ID=22447646
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP51093395A Expired - Fee Related JP3450010B2 (ja) | 1993-10-01 | 1994-10-03 | 植え込まれた物体を除去するためのレーザー装置 |
Country Status (7)
Country | Link |
---|---|
US (2) | US5423806A (ja) |
EP (1) | EP0721317B1 (ja) |
JP (1) | JP3450010B2 (ja) |
AU (1) | AU683502B2 (ja) |
CA (1) | CA2172051C (ja) |
DE (1) | DE69430311T2 (ja) |
WO (1) | WO1995009575A1 (ja) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
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WO2016035218A1 (ja) * | 2014-09-02 | 2016-03-10 | 嗣允 藤原 | ペースメーカーリード癒着剥離用シース |
JP2023523412A (ja) * | 2020-04-21 | 2023-06-05 | ボストン サイエンティフィック サイムド,インコーポレイテッド | アブレーションシステムにおける適応的ecgトリガ |
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US5423806A (en) * | 1993-10-01 | 1995-06-13 | Medtronic, Inc. | Laser extractor for an implanted object |
US20050187599A1 (en) * | 1994-05-06 | 2005-08-25 | Hugh Sharkey | Method and apparatus for controlled contraction of soft tissue |
US5458596A (en) | 1994-05-06 | 1995-10-17 | Dorsal Orthopedic Corporation | Method and apparatus for controlled contraction of soft tissue |
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US5769858A (en) * | 1995-10-20 | 1998-06-23 | Medtronic, Inc. | Locking stylet for extracting implantable lead or catheter |
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US6283960B1 (en) | 1995-10-24 | 2001-09-04 | Oratec Interventions, Inc. | Apparatus for delivery of energy to a surgical site |
US6095149A (en) * | 1996-08-13 | 2000-08-01 | Oratec Interventions, Inc. | Method for treating intervertebral disc degeneration |
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US6126682A (en) * | 1996-08-13 | 2000-10-03 | Oratec Interventions, Inc. | Method for treating annular fissures in intervertebral discs |
US6733496B2 (en) | 2001-06-06 | 2004-05-11 | Oratec Interventions, Inc. | Intervertebral disc device employing flexible probe |
US6832997B2 (en) | 2001-06-06 | 2004-12-21 | Oratec Interventions, Inc. | Electromagnetic energy delivery intervertebral disc treatment devices |
US7069087B2 (en) | 2000-02-25 | 2006-06-27 | Oratec Interventions, Inc. | Apparatus and method for accessing and performing a function within an intervertebral disc |
US6135999A (en) * | 1997-02-12 | 2000-10-24 | Oratec Internationals, Inc. | Concave probe for arthroscopic surgery |
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- 1994-10-03 DE DE69430311T patent/DE69430311T2/de not_active Expired - Lifetime
- 1994-10-03 CA CA002172051A patent/CA2172051C/en not_active Expired - Fee Related
- 1994-10-03 AU AU79629/94A patent/AU683502B2/en not_active Ceased
- 1994-10-03 WO PCT/US1994/011146 patent/WO1995009575A1/en active IP Right Grant
- 1994-10-03 JP JP51093395A patent/JP3450010B2/ja not_active Expired - Fee Related
- 1994-10-03 EP EP94930546A patent/EP0721317B1/en not_active Expired - Lifetime
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WO2016035218A1 (ja) * | 2014-09-02 | 2016-03-10 | 嗣允 藤原 | ペースメーカーリード癒着剥離用シース |
JP2023523412A (ja) * | 2020-04-21 | 2023-06-05 | ボストン サイエンティフィック サイムド,インコーポレイテッド | アブレーションシステムにおける適応的ecgトリガ |
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EP0721317A1 (en) | 1996-07-17 |
US5674217A (en) | 1997-10-07 |
US5423806A (en) | 1995-06-13 |
CA2172051C (en) | 2000-08-08 |
EP0721317B1 (en) | 2002-04-03 |
JP3450010B2 (ja) | 2003-09-22 |
DE69430311T2 (de) | 2002-11-28 |
AU683502B2 (en) | 1997-11-13 |
WO1995009575A1 (en) | 1995-04-13 |
CA2172051A1 (en) | 1995-04-13 |
AU7962994A (en) | 1995-05-01 |
DE69430311D1 (de) | 2002-05-08 |
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