WO2017047543A1 - Cathéter d'ablation - Google Patents

Cathéter d'ablation Download PDF

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Publication number
WO2017047543A1
WO2017047543A1 PCT/JP2016/076779 JP2016076779W WO2017047543A1 WO 2017047543 A1 WO2017047543 A1 WO 2017047543A1 JP 2016076779 W JP2016076779 W JP 2016076779W WO 2017047543 A1 WO2017047543 A1 WO 2017047543A1
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WO
WIPO (PCT)
Prior art keywords
balloon
heat insulating
cooling
ablation catheter
cooling balloon
Prior art date
Application number
PCT/JP2016/076779
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English (en)
Japanese (ja)
Inventor
大久保　到
繁 大森
中川　雄司
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テルモ株式会社
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Publication of WO2017047543A1 publication Critical patent/WO2017047543A1/fr

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    • 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
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters

Definitions

  • the present invention relates to an ablation catheter.
  • catheter ablation is known as a treatment method for arrhythmias such as atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, atrial tachycardia, ventricular tachycardia, and premature ventricular contraction.
  • catheter ablation “catheter myocardial cauterization” that prevents abnormal electrical signals from being transmitted to the entire heart by cauterizing myocardial tissue causing arrhythmia and myocardial tissue causing arrhythmia”
  • Catheter myocardial freezing cauterization freezing coagulation ablation
  • Patent Document 1 describes an ablation catheter used for cryocoagulation ablation.
  • the ablation catheter of Patent Document 1 includes a double-structured balloon including an inner balloon and an outer balloon. By forming a hole in the inner balloon by a cutting means, the coolant in the inner balloon is used as the outer balloon. It can be exhausted through. If such an ablation catheter is used, the target region can be obtained by introducing a coolant into the inner balloon while the expanded balloon is in contact with the myocardial tissue (target region) causing arrhythmia. Can be frozen and solidified.
  • An object of the present invention is to provide an ablation catheter excellent in ablation efficiency.
  • Such an object is achieved by the present inventions (1) to (7) below.
  • the heat insulating balloon has a distal end portion located on the distal end side of the shaft, and a proximal end portion located closer to the proximal end side than the distal end portion,
  • the maximum diameter of the distal end portion is the ablation catheter according to (2), which is smaller than the maximum diameter of the proximal end portion.
  • the above-mentioned heat insulation balloon has the 1st heat insulation balloon located in the tip end side of the shaft rather than the cooling balloon, and the 2nd heat insulation balloon located in the base end side of the shaft rather than the cooling balloon.
  • the ablation catheter according to (1) has the 1st heat insulation balloon located in the tip end side of the shaft rather than the cooling balloon, and the 2nd heat insulation balloon located in the base end side of the shaft rather than the cooling balloon.
  • the maximum diameter of the first heat insulation balloon is smaller than the maximum diameter of the cooling balloon, and the maximum diameter of the second heat insulation balloon is larger than the maximum diameter of the cooling balloon (4) Or the ablation catheter in any one of (6).
  • the cooling balloon since at least a part of the cooling balloon is covered by the heat insulating balloon to which the heat insulating agent is supplied, when the myocardial tissue causing arrhythmia is frozen and solidified by the cooling balloon, It becomes difficult for the cooling balloon to come into contact with surrounding blood. Therefore, heat such as blood is easily transmitted to the cooling balloon, and the temperature in the cooling balloon can be efficiently reduced. Therefore, excellent ablation efficiency can be exhibited.
  • FIG. 1 is a plan view showing an ablation catheter according to the first embodiment of the present invention.
  • FIG. 2 is a view showing a state during operation of the ablation catheter shown in FIG.
  • FIG. 3 is a longitudinal sectional view showing an expanded state of the ablation catheter shown in FIG. 4 is a cross-sectional view of a shaft of the ablation catheter shown in FIG.
  • FIG. 5 is a cross-sectional view of the ablation catheter shown in FIG.
  • FIG. 6 is a cross-sectional view of the ablation catheter shown in FIG.
  • FIG. 7 is a cross-sectional view of the ablation catheter shown in FIG.
  • FIG. 8 is a diagram for explaining a technique of cryocoagulation ablation using the ablation catheter shown in FIG. FIG.
  • FIG. 9 is a diagram for explaining a technique of cryocoagulation ablation using the ablation catheter shown in FIG.
  • FIG. 10 is a diagram for explaining a technique of cryocoagulation ablation using the ablation catheter shown in FIG.
  • FIG. 11 is a diagram for explaining a technique of cryocoagulation ablation using the ablation catheter shown in FIG.
  • FIG. 12 is a diagram illustrating a technique for cryocoagulation ablation using the ablation catheter shown in FIG.
  • FIG. 13 is a longitudinal sectional view of an ablation catheter according to the second embodiment of the present invention.
  • FIG. 14 is a view showing a state during the operation of the ablation catheter shown in FIG.
  • FIG. 1 is a plan view showing an ablation catheter according to the first embodiment of the present invention.
  • FIG. 2 is a view showing a state during operation of the ablation catheter shown in FIG.
  • FIG. 3 is a longitudinal sectional view showing an expanded state of the ablation catheter shown in FIG. 4 is a cross-sectional view of a shaft of the ablation catheter shown in FIG. 5 to 7 are cross-sectional views of the ablation catheter shown in FIG.
  • FIG. 8 to FIG. 12 are diagrams for explaining a technique of cryocoagulation ablation using the ablation catheter shown in FIG.
  • the right side in FIG. 1 is also referred to as “tip”, and the left side is also referred to as “base end”.
  • An ablation catheter system 100 shown in FIG. 1 is a medical device used for “frozen coagulation ablation (catheter myocardial cryoablation)” which is a treatment method for atrial fibrillation which is a kind of arrhythmia.
  • frozen coagulation ablation a frozen cautery line (frostbite) is formed at the junction between the pulmonary vein and the left atrium, and the abnormal signal is confined in the pulmonary vein so that the abnormal signal is not transmitted to the atrium.
  • frostbite frozen cautery line
  • Such freezing and coagulation ablation is said to be effective in that electrical disconnection is possible while maintaining the physical strength of the myocardial tissue.
  • Catheter myocardial cauterization which is another treatment method for atrial fibrillation, it requires less skill of the operator, and the operation time tends to be shorter. It can be said that this is a treatment with less burden.
  • frozen coagulation ablation is not limited to the treatment of atrial fibrillation, but for the treatment of other arrhythmias (atrial flutter, paroxysmal supraventricular tachycardia, atrial tachycardia, ventricular tachycardia, ventricular extrasystole, etc.) Can also be applied.
  • arrhythmias atrial flutter, paroxysmal supraventricular tachycardia, atrial tachycardia, ventricular tachycardia, ventricular extrasystole, etc.
  • the ablation catheter system 100 includes an ablation catheter 200, a coolant supply device 300, and a heat insulating agent supply device 400, as shown in FIG.
  • the ablation catheter 200 is connected to the coolant supply device 300 and the heat insulating agent supply device 400, whereby the coolant C is supplied from the coolant supply device 300 to the ablation catheter 200 and the heat insulating agent.
  • Thermal insulation I can be supplied from the supply device 400 to the ablation catheter 200.
  • the ablation catheter 200 includes a long shaft 210 having flexibility and a balloon 250 provided at the tip of the shaft 210.
  • the balloon 250 includes a cooling balloon 260, a distal-side heat insulating balloon (first heat-insulating balloon) 270 located on the distal side of the cooling balloon 260, and a proximal-side heat-insulated balloon (first surface) located on the proximal side of the cooling balloon 260. 2 heat insulation balloon) 280. That is, the distal end side heat insulation balloon 270 and the proximal end side heat insulation balloon 280 are arranged with the cooling balloon 260 interposed therebetween. Each of these three balloons 260, 270, 280 is expandable / contractable.
  • a state where the balloon is expanded is also referred to as an “expanded state”
  • a state where the balloon is deflated is also referred to as a “deflated state”.
  • the cooling balloon 260 is in contact with the joint 940 between the left atrium 920 and the pulmonary vein 930 in the expanded state, and the distal side heat insulating balloon 270 is expanded in the pulmonary vein 930.
  • the proximal adiabatic balloon 280 is positioned in the left atrium 920 in an expanded state.
  • the coolant C is supplied to the cooling balloon 260, and the joint 940 can be frozen and solidified by the cooling balloon 260.
  • the heat insulating agent I is supplied to the distal side heat insulating balloon 270 and the proximal side heat insulating balloon 280, and the freezing and coagulation of blood by the cooling balloon 260 can be suppressed by these balloons 270 and 280.
  • the distal side heat insulating balloon 270 is disposed away from the cooling balloon 260 in the contracted state. Therefore, it becomes easy to position the distal side heat insulating balloon 270 in the pulmonary vein 930.
  • the base end side heat insulating balloon 280 is disposed in contact with the cooling balloon 260 in the contracted state.
  • the distal end side portion of the proximal end side heat insulating balloon 280 is formed integrally with the proximal end side portion of the cooling balloon 260. Therefore, the configuration of the balloon 250 is simplified.
  • the distal side heat insulating balloon 270 covers the distal end portion 261 of the cooling balloon 260.
  • the proximal heat insulating balloon 280 covers the proximal end portion 262 of the cooling balloon 260.
  • the central portion (the portion between the distal end portion 261 and the proximal end portion 262) 263 of the cooling balloon 260 is not covered with the distal end side thermal insulation balloon 270 and the proximal end thermal insulation balloon 280, and is exposed to the outside. .
  • the joint portion 940 can be efficiently frozen and solidified. Further, since the distal end portion 261 and the proximal end portion 262 of the cooling balloon 260 are covered with the distal end side heat insulating balloon 270 and the proximal end heat insulating balloon 280, it is difficult for blood to contact the cooling balloon 260. Therefore, the freezing and coagulation of blood by the cooling balloon 260 can be suppressed. On the other hand, since the heat of blood is difficult to be transmitted to the cooling balloon 260, the temperature rise of the cooling balloon 260 can be suppressed. Therefore, the joint part 940 can be efficiently frozen and solidified.
  • the distal side heat insulating balloon 270 is disposed in the pulmonary vein 930 narrower than the joint portion 940. Therefore, in the expanded state, the maximum diameter R2 of the distal side heat insulating balloon 270 is configured to be smaller than the maximum diameter R1 of the cooling balloon 260. In this way, by satisfying the relationship of R2 ⁇ R1, the burden on the pulmonary vein 930 when the distal side heat insulating balloon 270 is expanded can be reduced.
  • the proximal-side heat insulating balloon 280 is disposed in the left atrium 920 wider than the joint portion 940. Therefore, in the expanded state, the maximum diameter R3 of the proximal heat insulating balloon 280 is configured to be larger than the maximum diameter R1 of the cooling balloon 260. Thus, by satisfying the relationship of R3> R1, the base end side heat insulating balloon 280 can cover a wider range of the base end portion 262 of the cooling balloon 260.
  • the constituent materials of the balloons 260, 270, and 280 are not particularly limited.
  • thermoplastic resins such as polyester such as polyolefin and polyethylene terephthalate, polyvinyl chloride, polyurethane, polyurethane elastomer, and nylon elastomer (polyamide elastomer). Silicone rubber, latex rubber (natural rubber) or the like can be used.
  • nylon elastomer is preferable as the constituent material of the distal side heat insulating balloon 270.
  • the distal-side heat insulating balloon 270 is difficult to expand rapidly, and damage to the pulmonary vein 930 can be suppressed.
  • the base end side heat insulating balloon 280 among these, polyurethane elastomer and latex rubber are preferable. By using such a material, it becomes the base end side heat insulating balloon 280 which is flexible and easily stretched.
  • the balloon 250 has been described above.
  • the configuration of the balloon 250 is not limited to the configuration described above as long as the same effect can be exhibited.
  • the proximal heat insulating balloon 280 may be separated from the cooling balloon 260.
  • the distal side heat insulation balloon 270 may be in contact with the cooling balloon 260, and the proximal end side portion of the distal end side thermal insulation balloon 270 may be formed integrally with the distal side portion of the cooling balloon 260.
  • the coolant C supplied to the cooling balloon 260 is not particularly limited.
  • a gas such as nitrous oxide (N 2 O), argon (Ar), or krypton (Kr), liquid nitrogen, or liquefied nitrous oxide. Etc. can be used.
  • the heat insulating agent I supplied to the distal end side heat insulating balloon 270 and the proximal end side heat insulating balloon 280 heat exchange between the cooling balloon 260 and blood is suppressed as compared with the case where the cooling balloon 260 and blood directly touch each other. If it can do, it will not specifically limit, For example, a saline (physiological saline), a carbon dioxide, a silica airgel etc. can be used.
  • the temperature of the heat insulating agent I (the temperature in the balloons 270 and 280) is preferably not less than the blood freezing point and not more than the blood temperature, specifically about 10 ° C. to 30 ° C. Thereby, the freezing and coagulation of blood can be more effectively suppressed.
  • the shaft 210 has a double tube structure having an outer tube 220 and an inner tube 230 disposed inside the outer tube 220.
  • the lumen 231 formed in the inner tube 230 is used to insert a guide wire or an electrode catheter used during the operation.
  • the outer diameter of the inner tube 230 is smaller than the inner diameter of the outer tube 220, and a lumen 240 is formed between the inner tube 230 and the outer tube 220. This lumen 240 is used, for example, as a flow path for a contrast agent used during surgery.
  • the outer tube 220 has eight flow paths 221 to 228 formed independently along the circumferential direction.
  • the flow paths 221, 223, 225, and 227 are connected to the inside of the cooling balloon 260 as shown in FIG. Among these, the flow paths 221 and 225 are coolant supply flow paths for supplying the coolant C to the cooling balloon 260 from the coolant supply apparatus 300, and the flow paths 223 and 227 are the coolant supplied to the cooling balloon 260. This is a coolant recovery flow path for recovering C to the coolant supply device 300.
  • the coolant supply ports 221 a and 225 a of the flow paths 221 and 225 are located on the opposite side across the central axis J of the shaft 210, and the coolant C from the coolant supply ports 221 a and 225 a is in the cooling balloon 260. Supplied to the other side.
  • the coolant supply ports 221a and 225a are located at the center of the cooling balloon 260 in the length direction, and the coolant C is injected from the coolant supply ports 221a and 225a toward the radial direction of the cooling balloon 260. With such a configuration, the coolant C can be supplied into the cooling balloon 260 in a short time without unevenness.
  • the coolant recovery ports 223a and 227a of the flow paths 223 and 227 are located on the opposite side across the central axis J of the shaft 210, and the coolant C is recovered from the coolant recovery ports 223a and 227a.
  • the coolant recovery ports 223a and 227a are located at the center of the cooling balloon 260 in the length direction. That is, the coolant recovery ports 223 a and 227 a are arranged side by side in the circumferential direction of the coolant supply ports 221 a and 225 a and the shaft 210.
  • the number and arrangement of the coolant supply ports are not limited to the present embodiment as long as the coolant C can be supplied into the cooling balloon 260.
  • the number and arrangement of the coolant recovery ports are not limited to the present embodiment as long as the coolant C in the cooling balloon 260 can be recovered.
  • the flow paths 222 and 226 are connected to the inside of the distal side heat insulating balloon 270.
  • the flow path 222 is a heat insulating agent supply flow path for supplying the heat insulating agent I from the heat insulating agent supply device 400 to the front end side heat insulating balloon 270
  • the flow path 226 is the heat insulating agent I supplied to the front end side heat insulating balloon 270.
  • It is a heat insulation agent collection
  • the heat insulating agent supply device 400 collects the heat insulating agent I in the front end side heat insulating balloon 270 from the flow path 226 while supplying the heat insulating agent I from the flow path 222 to the front end side heat insulating balloon 270, and thereby the front end side heat insulating balloon 270.
  • the heat insulating agent I can be circulated inside. Therefore, the heat insulation effect by the front end side heat insulation balloon 270 can be maintained over time.
  • the heat-insulating agent supply port 222a of the flow path 222 and the heat-insulating agent recovery port 226a of the flow path 226 are located on opposite sides of the central axis J of the shaft 210.
  • the heat insulating agent I becomes easy to flow in the front end side heat insulation balloon 270, and the heat insulating agent I can be circulated in the front end side heat insulation balloon 270 uniformly. Therefore, the heat insulation effect by the front end side heat insulation balloon 270 improves.
  • the heat insulating agent supply port 222a and the heat insulating agent recovery port 226a are arranged in the axial direction of the shaft 210.
  • the arrangement is not particularly limited, and for example, the shaft 210 It may be displaced in the axial direction.
  • the heat insulating agent supply port 222a may be disposed on the distal end side of the shaft 210, and the heat insulating agent recovery port 226a may be disposed on the proximal end side.
  • positioning the heat insulating agent I becomes easier to flow in the front end side heat insulating balloon 270.
  • the number of the heat insulating agent supply ports 222a and the heat insulating agent recovery ports 226a is not particularly limited, and two or more of them may be arranged.
  • the flow paths 224 and 228 are connected in the proximal heat insulating balloon 280.
  • the flow path 224 is a heat insulating agent supply flow path for supplying the heat insulating agent I from the heat insulating agent supply device 400 to the base end side heat insulating balloon 280
  • the flow path 228 is the heat insulating material supplied to the base end side heat insulating balloon 280. It is a heat insulating agent recovery flow path for recovering the agent I to the heat insulating agent supply device 400.
  • the heat insulating agent supply device 400 collects the heat insulating agent I in the base end side heat insulating balloon 280 from the flow path 228 while supplying the heat insulating agent I from the flow path 224 to the base end side heat insulating balloon 280, thereby The heat insulating agent I can be circulated in the heat insulating balloon 280. Therefore, the heat insulation effect by the base end side heat insulation balloon 280 can be maintained with time.
  • the heat-insulating agent supply port 224a of the flow channel 224 and the heat-insulating agent recovery port 228a of the flow channel 228 are located on the opposite sides of the central axis J of the shaft 210.
  • the heat insulating agent I becomes easy to flow in the base end side heat insulation balloon 280, and the heat insulating agent I can be circulated in the base end side heat insulation balloon 280 uniformly. Therefore, the heat insulation effect by the base end side heat insulation balloon 280 improves.
  • the heat insulating agent supply port 224a and the heat insulating agent recovery port 228a are arranged in the axial direction of the shaft 210.
  • the arrangement is not particularly limited, and for example, the shaft 210 It may be displaced in the axial direction. By setting it as such arrangement
  • the number of the heat insulating agent supply ports 224a and the heat insulating agent recovery ports 228a is not particularly limited, and two or more of them may be arranged.
  • the shaft 210 has been described in detail above.
  • the distal-side heat insulating balloon 270 and the proximal-side heat insulating balloon 280 supply and recover the heat insulating agent I one by one, whereas the cooling balloon 260 supplies the coolant C.
  • the cooling balloon 260 supplies the coolant C.
  • the constituent material of the shaft 210 is not particularly limited.
  • a fluorine-based resin such as polyamide, polyester, polyurethane, soft polyvinyl chloride, ABS resin, AS resin, or polytetrafluoroethylene.
  • Various thermoplastic materials such as styrene, polyolefin, polyurethane, polyester, polyamide, fluororubber, chlorinated polyethylene, etc., and also a combination of two or more of these (Polymer alloy, polymer blend, laminate, etc.).
  • the shaft 210 has been described above.
  • the configuration of the shaft 210 is not limited to the configuration of the present embodiment as long as the above-described function can be exhibited.
  • the shaft 210 may not have a double-pipe structure having an outer tube and an inner tube, and may have a configuration in which the above-described lumen or flow path is formed in a single solid shaft.
  • a hole is made from the right atrium 910 to the left atrium 920 by puncturing the septum portion of the atrium.
  • the ablation catheter 200 is introduced into the left atrium 920 from the right atrium 910 together with a steerable sheath (not shown) that can be bent.
  • the cooling balloon 260 is expanded, and the cooling balloon 260 (central part 263) is brought into contact with the joint 940 between the left atrium 920 and the pulmonary vein 930.
  • an electrode catheter (cardiac electrophysiology catheter) 800 is placed in the pulmonary vein 930 through the lumen 231 of the ablation catheter 200. Then, the potential of the pulmonary vein 930 is measured by the electrode catheter 800, or electrical stimulation is applied to the pulmonary vein 930 to induce atrial fibrillation, thereby elucidating the mechanism of atrial fibrillation.
  • a contrast agent is introduced into the pulmonary vein 930 through the lumen 240, and it is confirmed that the cooling balloon 260 is in contact with the joint 940.
  • the heat insulating agent I is supplied to the distal end side thermal insulation balloon 270 and the proximal end side thermal insulation balloon 280 to expand them, and the distal side thermal insulation balloon 270 and the proximal end side thermal insulation balloon 280 are expanded. Circulate insulation I.
  • the distal end portion 261 of the cooling balloon 260 (site facing the pulmonary vein 930) is covered with the distal-side heat insulating balloon 270, and the proximal end portion 262 of the cooling balloon 260 (site facing the left atrium 920) is proximally insulated.
  • the state is covered with the balloon 280.
  • the coolant C is supplied to the cooling balloon 260.
  • the coolant C for example, nitrous oxide
  • the coolant C is supplied into the cooling balloon 260 in a compressed state, and the coolant C expands in the cooling balloon 260, so that the temperature in the cooling balloon 260 becomes ⁇ 70 ° C. or higher. It decreases to about -20 ° C. Therefore, the joint 940 in contact with the cooling balloon 260 is frozen and solidified, and a frozen cautery line 941 is formed at the joint 940 as shown in FIG.
  • the joint 940 is in contact with the central portion 263 that is not covered by either the distal-side heat insulation balloon 270 or the proximal-side heat insulation balloon 280 of the cooling balloon 260, so that the joint 940 can be efficiently frozen. Can solidify.
  • the contact between the cooling balloon 260 and the blood or contrast medium in the pulmonary vein 930 is suppressed by the distal-side heat insulating balloon 270, coagulation of the blood or contrast medium in the pulmonary vein 930 can be suppressed.
  • the heat of the blood in the pulmonary vein 930 and the heat of the contrast agent are not easily transmitted to the cooling balloon 260, the temperature rise of the cooling balloon 260 can be suppressed, and the joint portion 940 can be frozen and solidified more effectively.
  • the contact between the cooling balloon 260 and the blood in the left atrium 920 is suppressed by the proximal-side heat insulating balloon 280, blood coagulation in the left atrium 920 can be suppressed.
  • the heat of blood in the left atrium 920 is hardly transmitted to the cooling balloon 260, the temperature rise of the cooling balloon 260 can be suppressed, and the joint 940 can be frozen and solidified more effectively.
  • the electrode catheter 800 and the ablation catheter 200 are removed from the living body. Thereby, freezing solidification ablation is complete
  • the technique for one joint 940 out of the four joints 940 has been described, but the same technique may be performed for the remaining three joints 940.
  • FIG. 13 is a longitudinal sectional view of an ablation catheter according to the second embodiment of the present invention.
  • FIG. 14 is a view showing a state during the operation of the ablation catheter shown in FIG.
  • This embodiment is the same as the first embodiment described above except that the configuration of the balloon is mainly different.
  • the balloon 250 includes a cooling balloon 260 and a heat insulating balloon 290 that is located outside the cooling balloon 260 and covers the cooling balloon 260.
  • the cooling balloon 260 is supplied with the coolant C
  • the heat insulating balloon 290 is supplied with the heat insulating agent I.
  • the heat insulating balloon 290 includes a distal end portion 291 located on the distal end side from the cooling balloon 260, a proximal end portion 292 located on the proximal end side from the cooling balloon 260, and a central portion located so as to overlap the cooling balloon 260. 293.
  • the distal end portion 291 is a portion disposed in the pulmonary vein 930
  • the proximal end portion 292 is a portion disposed in the left atrium 920. Therefore, the maximum diameter of the distal end portion 261 is configured to be smaller than the maximum diameter of the proximal end portion 262 in the expanded state. As a result, the burden on the pulmonary vein 930 can be reduced when the heat insulating balloon 290 is expanded.
  • the central portion 293 of the heat insulating balloon 290 is a portion that contacts the joint portion 940 together with the cooling balloon 260.
  • the cooling balloon 260 and the heat insulating balloon 290 are in close contact with each other, and the heat insulating agent I is not substantially present therebetween. Therefore, the freezing and solidification of the joint 940 by the cooling balloon 260 is not hindered by the heat insulating agent I.
  • the film thickness of the central portion 293 may be made thinner than the film thickness of the distal end portion 291 and the proximal end portion 292.
  • a heat insulating agent supply port and a heat insulating agent I for supplying the heat insulating agent I to each of the front end portion 291 and the base end portion 292 so that the heat insulating agent I can be circulated in each of the front end portion 291 and the base end portion 292.
  • a heat insulating agent recovery port for recovering.
  • the cooling balloon 260 that has been frozen and adhered to the joint 940 (tissue) must be peeled off immediately, but in that case, a warmed (higher temperature than normal use) heat insulating agent Adhesion can be efficiently released by refluxing I at a slightly high pressure (higher pressure than in normal use).
  • the ablation catheter of the present invention has been described based on the illustrated embodiment.
  • the present invention is not limited to this, and the configuration of each part may be replaced with an arbitrary configuration having the same function. Can do.
  • any other component may be added to the present invention. Moreover, you may combine each embodiment suitably.
  • the ablation catheter of the present invention has a long shaft, a cooling balloon provided on the shaft and expandable / shrinkable, and a heat insulating balloon provided on the shaft and covering at least a part of the cooling balloon.
  • a cooling agent is introduced into the cooling balloon, and a heat insulating agent is introduced into the heat insulating balloon.
  • the cooling balloon is used when the myocardial tissue causing arrhythmia is frozen and coagulated with the cooling balloon. Becomes difficult to contact with surrounding blood. Therefore, heat such as blood is easily transmitted to the cooling balloon, and the temperature in the cooling balloon can be efficiently reduced. Therefore, excellent ablation efficiency can be exhibited.
  • the ablation catheter of the present invention has industrial applicability.

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Abstract

La présente invention concerne un cathéter d'ablation 200 qui comprend : une tige 210 ; un ballonnet de refroidissement 260 disposé sur la tige 210 ; un ballonnet d'isolation thermique distal 270 qui est positionné vers le côté distal du ballonnet de refroidissement 260 et qui recouvre l'extrémité distale du ballonnet de refroidissement 260 lorsqu'il est dilaté ; et un ballonnet d'isolation thermique proximal 280 qui est positionné vers le côté proximal du ballonnet de refroidissement 260, et qui recouvre l'extrémité proximale du ballonnet de refroidissement 260 lorsqu'il est dilaté. Un réfrigérant C est introduit dans le ballonnet de refroidissement 260, et un agent d'isolation thermique I est introduit dans les ballonnets d'isolation thermique 270, 280.
PCT/JP2016/076779 2015-09-14 2016-09-12 Cathéter d'ablation WO2017047543A1 (fr)

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Cited By (9)

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US10028781B2 (en) 2013-09-30 2018-07-24 Arrinex, Inc. Apparatus and methods for treating rhinitis
CN108309432A (zh) * 2018-04-13 2018-07-24 山前（珠海）医疗科技有限公司 低温消融导管、低温消融操作装置及低温消融设备
US10159538B2 (en) 2014-07-25 2018-12-25 Arrinex, Inc. Apparatus and method for treating rhinitis
US10939965B1 (en) 2016-07-20 2021-03-09 Arrinex, Inc. Devices and methods for treating a nerve of the nasal cavity using image guidance
US11026738B2 (en) 2016-06-15 2021-06-08 Arrinex, Inc. Devices and methods for treating a lateral surface of a nasal cavity
JP2022506268A (ja) * 2018-11-01 2022-01-17 テラノバ，エルエルシー 前立腺を治療するための装置
US11253312B2 (en) 2016-10-17 2022-02-22 Arrinex, Inc. Integrated nasal nerve detector ablation-apparatus, nasal nerve locator, and methods of use
US11278356B2 (en) 2017-04-28 2022-03-22 Arrinex, Inc. Systems and methods for locating blood vessels in the treatment of rhinitis
US11602260B2 (en) 2016-02-11 2023-03-14 Arrinex, Inc. Method and device for image guided post-nasal nerve ablation

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