A catheter for treating a stenosis in a body lumen includes an elongate tube; a member sealed to a distal end of the elongate tube that is fillable with a conductive fluid; a metallization layer comprising at least one trace forming at least one inner electrode, the metallization layer being connected to at least one wire; and at least one outer electrode extending radially outwardly of the metallization layer and separated from the at least one inner electrode by at least one gap such that, when a voltage pulse is applied to the inner and outer electrodes, current flows across the at least one gap to generate at least one shock wave.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
2.
SYSTEMS, DEVICES, AND METHODS FOR SHOCK WAVE GENERATION UTILIZING CATHETERS WITH MULTI-METAL JOINTS
An exemplary catheter includes a catheter body, a first conductive member comprising a first material positioned on the catheter body, a second conductive member comprising a second material different from the first material positioned on the catheter body, one or more electrical joints configured to electrically couple the first conductive member to the second conductive member, and one or more shock wave emitters. Each shock wave emitter is configured to generate a shock wave, and at least one shock wave emitter of the one or more shock wave emitters comprises electrodes separated by a spark gap, wherein at least one of the electrodes is formed from the second conductive member.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
3.
SHOCK WAVE CATHETER AND SHOCK WAVE CATHETER SYSTEM
A catheter for generating shock waves, the catheter comprising: a catheter body; an emitter support member configured to extend at least partially distally of a distal end of the catheter body, where the emitter support member comprises a pre-formed distal portion, where the pre-formed distal portion is configured to coil into an annular loop around at least a portion of a longitudinal axis of the catheter body; a plurality of shock wave emitters mounted to the emitter support member; and an enclosure enclosing the plurality of shock wave emitters.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A catheter for generating shock waves, the catheter comprising: a catheter body; an emitter support member configured to extend at least partially distally of a distal end of the catheter body, where the emitter support member comprises a pre-formed distal portion, where the pre-formed distal portion is configured to coil into an annular loop around at least a portion of a longitudinal axis of the catheter body; a plurality of shock wave emitters mounted to the emitter support member; and an enclosure enclosing the plurality of shock wave emitters.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A catheter includes one or more shock wave generating or emitting sources mounted on or embedded in a main body lumen in positioned within an enclosure, where the enclosure has multiple regions or segments, and wherein one or more of the shock wave sources are located in one or more of the enclosure segments. In some aspects, the enclosure includes a narrowing between regions, in part defining the plurality of segments, the narrowing further functioning to keep the main body lumen centered along the length of the enclosure, thereby maintaining the shock wave sources an operational distance away from the material of the enclosure.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A catheter includes one or more shock wave generating or emitting sources mounted on or embedded in a main body lumen in positioned within an enclosure, where the enclosure has multiple regions or segments, and wherein one or more of the shock wave sources are located in one or more of the enclosure segments. In some aspects, the enclosure includes a narrowing between regions, in part defining the plurality of segments, the narrowing further functioning to keep the main body lumen centered along the length of the enclosure, thereby maintaining the shock wave sources an operational distance away from the material of the enclosure.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A catheter includes an elongate body, a rotatable shaft disposed within the elongate body, an impactor forming a distal end of the catheter and configured to translate relative to the elongate body for impacting an occlusion in the body lumen, and an actuator configured to translate the impactor. The actuator includes a cam and cam follower operatively coupled to the rotatable shaft such that rotation of the rotatable shaft causes relative rotation and translation between the cam and cam follower. The impactor is coupled to the cam or the cam follower such that the impactor translates in conjunction with the cam or the cam follower to impact the occlusion in the body lumen.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A catheter includes an elongate body, a rotatable shaft disposed within the elongate body, an impactor forming a distal end of the catheter and configured to translate relative to the elongate body for impacting an occlusion in the body lumen, and an actuator configured to translate the impactor. The actuator includes a cam and cam follower operatively coupled to the rotatable shaft such that rotation of the rotatable shaft causes relative rotation and translation between the cam and cam follower. The impactor is coupled to the cam or the cam follower such that the impactor translates in conjunction with the cam or the cam follower to impact the occlusion in the body lumen.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A shock wave catheter for treating a lesion in a body lumen includes a shock wave emitter assembly and a retractable enclosure. In a first configuration of the catheter, the retractable enclosure is sealed to a distal member of the catheter and the lesion is treated by shock waves propagating through the enclosure wall. In a second configuration of the catheter, the retractable enclosure is retracted from the distal member of the catheter and the lesion is treated directly by shock waves emitted from the shock wave emitter assembly.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
An exemplary catheter for generating shock waves includes a catheter body; an enclosure mounted to the catheter body; an emitter band positioned at least partially around the catheter body and within the enclosure; and at least three electrodes positioned adjacent to the emitter band and spaced apart from the emitter band by respective spark gaps, the at least three electrodes together with the emitter band forming electrode pairs of at least three shock wave emitters of the emitter band, wherein at least one of the at least three shock wave emitters can be driven separately from at least one other of the at least three shock wave emitters.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
11.
INTRAVASCULAR LITHOTRIPSY CATHETER WITH OMNI-DIRECTIONAL SHOCK WAVE EMITTERS
An exemplary catheter for generating shock waves includes a catheter body; an enclosure mounted to the catheter body; an emitter band positioned at least partially around the catheter body and within the enclosure; and at least three electrodes positioned adjacent to the emitter band and spaced apart from the emitter band by respective spark gaps, the at least three electrodes together with the emitter band forming electrode pairs of at least three shock wave emitters of the emitter band, wherein at least one of the at least three shock wave emitters can be driven separately from at least one other of the at least three shock wave emitters.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p. ex. des courants à haute fréquence
A61B 18/24 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet avec un cathéter
Described here are devices and methods for forming shock waves. The devices may comprise an axially extending elongate member. A first electrode pair may comprise a first electrode and a second electrode. The first electrode pair may be provided on the elongate member and positioned within a conductive fluid. A controller may be coupled to the first electrode pair. The controller may be configured to deliver a series of individual pulses to the first electrode pair, where each pulse creates a shock wave. The controller may cause current to flow through the electrode pair in a first direction for some of the pulses in the series and in a second direction opposite the first direction for the remaining pulses in the series.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
13.
LOCUS EMITTER SHOCK WAVE CATHETER DEVICES WITH INCREASED LONGEVITY AND HIGHER SONIC OUTPUT
An exemplary shock wave catheter system comprises: a catheter body comprising a lumen; an emitter wire configured to generate shock waves, wherein one or more gaps are formed between two or more portions of the emitter wire along a length of the catheter body, each of the one or more gaps forming a locus emitter; a carrier wire configured to conduct electricity to the emitter wire; and one or more electrical joints configured to electrically couple and join the emitter wire and the carrier wire.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
The present invention provides a system and method for treating tight, hard-to-cross calcified lesions in which an angioplasty balloon is used to dilate the lesions and provide shock waves to restore normal blood flow in a patient's artery. An exemplary device includes an elongated tube and a balloon wrapped circumferentially around the tube and sealed to a distal end of the tube. During treatment, the device is advanced into a patient's vasculature and the balloon is inflated with conductive fluid such that the balloon is fixed to walls of the vasculature proximal to the calcified lesion. The balloon includes at least one low-profile emitter positioned near the distal end of the balloon, which may be activated to generate shock waves to break loose calcifications in the lesion. After calcium in the tight lesion has been modified, the balloon can be deflated and advanced further into the lesion to continue treatment.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p. ex. des courants à haute fréquence
15.
INTRAVASCULAR LITHOTRIPSY CATHETER WITH OSCILLATING IMPACTOR
Catheter devices for treating occlusions in body lumen are described herein. The catheter devices may include a tubular body having a distal end, an distal portion elastically connected to the distal end of the tubular body, an impactor connected to the distal portion and separated by a space from the distal end of the tubular body, a distal shock wave emitter located adjacent to the space and connected to a power source, and an enclosure at least partially surrounding each of the distal end of the tubular body, the elastic distal portion, the impactor, and the distal shock wave emitter. The impactor may be configured to move in response to shock waves generated from the distal shock wave emitter, such that a length of the space in the proximal-distal direction increases by between 0.05 mm and 0.6 mm.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
16.
SYSTEMS, DEVICES, AND METHODS FOR SHOCK WAVE GENERATION UTILIZING CATHETERS WITH MULTI-METAL JOINTS
An exemplary catheter includes a catheter body, a first conductive member comprising a first material positioned on the catheter body, a second conductive member comprising a second material different from the first material positioned on the catheter body, one or more electrical joints configured to electrically couple the first conductive member to the second conductive member, and one or more shock wave emitters. Each shock wave emitter is configured to generate a shock wave, and at least one shock wave emitter of the one or more shock wave emitters comprises electrodes separated by a spark gap, wherein at least one of the electrodes is formed from the second conductive member.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
17.
Systems, devices, and methods for shock wave generation utilizing catheters with multi-metal joints
An exemplary catheter includes a catheter body, a first conductive member comprising a first material positioned on the catheter body, a second conductive member comprising a second material different from the first material positioned on the catheter body, one or more electrical joints configured to electrically couple the first conductive member to the second conductive member, and one or more shock wave emitters. Each shock wave emitter is configured to generate a shock wave, and at least one shock wave emitter of the one or more shock wave emitters comprises electrodes separated by a spark gap, wherein at least one of the electrodes is formed from the second conductive member.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
18.
LASER INTRAVASULAR LITHOTRIPSY DEVICE FOR STENOSIS CALCIFIED LESIONS
Laser IVL systems and methods are disclosed. A laser IVL system can include at least one light energy source and a catheter. The catheter can include an elongate sheath, an enclosure sealed to a distal end of the elongate sheath, and at least one optical fiber contained within the elongate sheath. The enclosure may have a fill volume less than 10 mL and may be fillable with a fluid. The at least one optical fiber can be optically coupled to receive light from the at least one light energy source and configured to transmit the received light at a light emitting region of the at least one optical fiber into a distal region of the catheter that is enclosed by the enclosure to generate shock waves in the fluid.
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
19.
LASER INTRAVASULAR LITHOTRIPSY DEVICE FOR STENOSIS CALCIFIED LESIONS
Laser IVL systems and methods are disclosed. A laser IVL system can include at least one light energy source and a catheter. The catheter can include an elongate sheath, an enclosure sealed to a distal end of the elongate sheath, and at least one optical fiber contained within the elongate sheath. The enclosure may have a fill volume less than 10 mL and may be fillable with a fluid. The at least one optical fiber can be optically coupled to receive light from the at least one light energy source and configured to transmit the received light at a light emitting region of the at least one optical fiber into a distal region of the catheter that is enclosed by the enclosure to generate shock waves in the fluid.
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
A61B 18/22 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet
The present disclosure relates generally to thrombectomy devices. An exemplary catheter comprises: an emitter assembly comprising at least one emitter; wherein each emitter comprises an electrode pair, and wherein each emitter is configured to generate a plurality of cavitation bubbles when a voltage is applied to the pair of electrodes; an infusion lumen formed by at least a portion of an outer wall of the catheter, the infusion lumen configured to receive a conductive fluid, wherein the emitter assembly is housed within the infusion lumen, wherein a distal segment of the infusion lumen includes a plurality of holes on the portion of the outer wall of the catheter, and wherein the plurality of holes are configured to release the conductive fluid and the plurality of cavitation bubbles out of the catheter to treat thrombus at a treatment site; an aspiration lumen including aspiration ports at the distal segment thereof.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
Catheters, medical systems and devices comprised of
catheters, medical probes, and pulse generator for the
treatment of cardiovascular diseases and disorders.
Various shock wave catheters and methods of use thereof that do not utilize a guidewire are described herein. The shock wave catheters include at least one shock wave emitter disposed within a distal portion of the shock wave catheter and configured to generate shock waves. The ends of conductive wires extending within an elongate tube can form the shock wave emitter(s). The shock wave emitter(s) can be surrounded by an enclosure fillable with a conductive fluid delivered by the lumen of the elongate tube. The elongate tube can include a coil or slits therein that enable flexibility of the shock wave catheter, which, in combination with the narrow profile of the shock wave catheters described herein, enable their use in navigating and treating small, tortuous vessels.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
An exemplary catheter for use in a body lumen comprises: a catheter body; and a plurality of shock wave emitters disposed at a distal end of the catheter body, each shock wave emitter configured to generate a shock wave that propagates distally of the catheter body, wherein the plurality of shock wave emitters are arrayed about a longitudinal axis of the catheter body such that shock waves emitted from the plurality of shock wave emitters can constructively interfere distally of the catheter body, and wherein each shock wave emitter comprises electrodes separated by a spark gap and at least one electrical connector that connects at least one of the electrodes to an electrode of another shock wave emitter of the plurality of shock wave emitters.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
24.
A SYSTEM AND METHOD FOR APPLYING ACOUSTIC WAVE THERAPY THROUGH EPITHELIA
This disclosure provides methods, devices, and systems for treating biological tissue. The present implementations more specifically relate to techniques for applying acoustic wave therapy through an epithelium. In some aspects, an ophthalmic treatment apparatus may include an interface and an acoustic wave emitter. The interface is configured to provide fluid to an epithelium and the acoustic wave emitter is configured to generate acoustic waves in the fluid that radiate toward tissue for treatment under the epithelium. Example suitable acoustic waves include shock waves and/or cavitation waves. In some implementations, the acoustic wave emitter may generate the acoustic waves in the fluid using laser generation techniques. In some other implementations, the acoustic wave emitter may generate the acoustic waves in the fluid using electrohydraulic generation techniques.
A61F 9/008 - Procédés ou dispositifs pour la chirurgie de l'œil utilisant un laser
A61N 5/06 - Thérapie par radiations utilisant un rayonnement lumineux
A61N 5/067 - Thérapie par radiations utilisant un rayonnement lumineux utilisant un rayonnement laser
A61N 1/36 - Application de courants électriques par électrodes de contact courants alternatifs ou intermittents pour stimuler, p. ex. stimulateurs cardiaques
Various shock wave catheters and methods of use thereof that do not utilize a guidewire are described herein. The shock wave catheters include at least one shock wave emitter disposed within a distal portion of the shock wave catheter and configured to generate shock waves. The ends of conductive wires extending within an elongate tube can form the shock wave emitter(s). The shock wave emitter(s) can be surrounded by an enclosure Tillable with a conductive fluid delivered by the lumen of the elongate tube. The elongate tube can include a coil or slits therein that enable flexibility of the shock wave catheter, which, in combination with the narrow profile of the shock wave catheters described herein, enable their use in navigating and treating small, tortuous vessels.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
26.
INTRAVASCULAR LITHOTRIPSY CATHETER WITH OSCILLATING TIP
Described herein are shock wave catheters and methods of use thereof for treating occlusions in a body lumen, the catheter comprising: a catheter enclosure; one or more shock wave emitters enclosed within the catheter enclosure; and an elongated body that extends to at least a distal end of the catheter enclosure, wherein a distal end of the elongated body is configured to vibrate from shock waves produced by the shock wave emitters to deliver mechanical forces to an occlusion in the body lumen.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
27.
INTRAVASCULAR LITHOTRIPSY CATHETER WITH OSCILLATING TIP
Described herein are shock wave catheters and methods of use thereof for treating occlusions in a body lumen, the catheter comprising: a catheter enclosure; one or more shock wave emitters enclosed within the catheter enclosure; and an elongated body that extends to at least a distal end of the catheter enclosure, wherein a distal end of the elongated body is configured to vibrate from shock waves produced by the shock wave emitters to deliver mechanical forces to an occlusion in the body lumen.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
28.
Shock wave catheters and methods of use thereof for treating, imaging, and characterizing body lumens
Shock wave catheters and methods of use thereof are disclosed herein for intravascular lithotripsy (IVL) and intravascular imaging of a body lumen. The shock wave catheter can include an elongate tube; at least one shock wave emitter disposed at a distal portion of the elongate tube and configured to emit shock waves for treating an occlusion in a body lumen; at least one sensor for imaging the body lumen, the at least imaging sensor disposed at the distal portion of the elongate tube; and at least one enclosure enclosing the at least one shock wave emitter and the at least one sensor. The at least one sensor may be an ultrasound transducer for intravascular ultrasound (IVUS) imaging of the body lumen. Alternatively, the at least one sensor may be an optical coherence tomography (OCT) sensor for OCT imaging of the body lumen.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A61B 90/30 - Dispositifs pour éclairer une zone chirurgicale, les dispositifs ayant une corrélation avec d’autres dispositifs chirurgicaux ou avec une intervention chirurgicale
A laser lithotripsy system may include a light energy source and a catheter. The catheter may comprise an optical fiber comprising a core and a cladding that encases the core. The optical fiber may be configured to be optically coupled to receive laser light from the light energy source. The optical fiber may include at least one evanescent portion and at least one non-evanescent portion. When light propagates through the core, an evanescent field may be transmitted out of the optical fiber in the evanescent portion and may not transmitted out of the optical fiber in the non-evanescent portion.
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 18/22 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet
31.
DRUG DELIVERY BEYOND THE BLOOD-BRAIN BARRIER USING SHOCK WAVES
Described herein are shock wave catheters and methods of use thereof for delivering an active agent of a drug to the CNS via a body lumen or cavity, such as sinonasal cavity, which can bypass the blood-brain barrier (BBB). The catheters described herein can be advanced through an intranasal passage to the nasal cavity such that at least a portion of the enclosure is disposed in the nasal cavity. The enclosure can be coated with a drug coating. The method can include filling the enclosure with a conductive fluid. At least one shock wave can be generated at a shock wave emitter of the catheter disposed within the enclosure. The at least one shock wave can cause a therapeutically effective amount of the active agent of the drug coating to be delivered to the CNS via tissue of the nasal cavity, in turn, treating central nervous system diseases.
A61B 1/233 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p. ex. endoscopesDispositions pour l'éclairage dans ces instruments pour le nez, c.-à-d. nasoscopes
A61M 27/00 - Appareillage pour drainage des blessures
Surgical implants comprised of artificial material; medical
systems and devices comprised of delivery catheters and
implantable scaffolds comprising artificial materials for
the treatment of cardiovascular diseases and disorders;
catheters; medical systems and devices comprised of
catheters, medical probes, pulse generators for the
treatment of cardiovascular diseases and disorders; medical
systems and devices comprised of catheters, medical probes,
pulse generators for use in intravascular lithotripsy
medical procedures; medical systems and devices comprised of
catheters, medical probes, pulse generators for use in
coronary vasculature and peripheral vasculature medical
procedures; balloon catheters; angioplasty catheters;
intracardiac catheters; intravenous catheters; medical and
surgical catheters.
33.
DRUG DELIVERY BEYOND THE BLOOD-BRAIN BARRIER USING SHOCK WAVES
Described herein are shock wave catheters and methods of use thereof for delivering an active agent of a drug to the CNS via a body lumen or cavity, such as sinonasal cavity, which can bypass the blood-brain barrier (BBB). The catheters described herein can be advanced through an intranasal passage to the nasal cavity such that at least a portion of the enclosure is disposed in the nasal cavity. The enclosure can be coated with a drug coating. The method can include filling the enclosure with a conductive fluid. At least one shock wave can be generated at a shock wave emitter of the catheter disposed within the enclosure. The at least one shock wave can cause a therapeutically effective amount of the active agent of the drug coating to be delivered to the CNS via tissue of the nasal cavity, in turn, treating central nervous system diseases.
A61M 37/00 - Autres appareils pour introduire des agents dans le corpsPercutanisation, c.-à-d. introduction de médicaments dans le corps par diffusion à travers la peau
A laser lithotripsy system may include a light energy source and a catheter. The catheter may comprise an optical fiber comprising a core and a cladding that encases the core. The optical fiber may be configured to be optically coupled to receive laser light from the light energy source. The optical fiber may include at least one evanescent portion and at least one non-evanescent portion. When light propagates through the core, an evanescent field may be transmitted out of the optical fiber in the evanescent portion and may not transmitted out of the optical fiber in the non-evanescent portion.
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
A61B 18/22 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet
Disclosed herein shock wave catheters comprising one or more shock wave electrodes for cracking calcifications located within blood vessels. In some variations, a shock wave catheter has first and second shock wave electrodes each circumferentially disposed over the outer surface of the catheter. In certain variations, the first electrode has a recess and the second electrode has a protrusion that is received by the recess and a spark gap is located along the separation between the recess and the protrusion. The second electrode can also have a recess that receives a protrusion from a third shock wave electrode, where the separation between the second and third electrodes along the separation between the recess and the protrusion forms a second spark gap. A shock wave can be initiated across these spark gaps when a voltage is applied over the electrodes.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A shock wave catheter for treating a lesion in a body lumen includes a shock wave emitter assembly and a retractable enclosure. In a first configuration of the catheter, the retractable enclosure is sealed to a distal member of the catheter and the lesion is treated by shock waves propagating through the enclosure wall. In a second configuration of the catheter, the retractable enclosure is retracted from the distal member of the catheter and the lesion is treated directly by shock waves emitted from the shock wave emitter assembly.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A shock wave catheter for treating a lesion in a body lumen includes a shock wave emitter assembly and a retractable enclosure. In a first configuration of the catheter, the retractable enclosure is sealed to a distal member of the catheter and the lesion is treated by shock waves propagating through the enclosure wall. In a second configuration of the catheter, the retractable enclosure is retracted from the distal member of the catheter and the lesion is treated directly by shock waves emitted from the shock wave emitter assembly.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
40.
BURST MODE OPERATION OF INTRAVASCULAR LITHOTRIPSY (IVL)
Disclosed herein are systems and methods for applying voltage(s) across electrodes of a shock wave catheter system. The electrodes in the shock wave catheter may be activated by using at least one packet comprising a plurality of sub-pulses. The plurality of sub-pulses within a packet may be delivered in rapid succession (e.g., with a frequency of 100 Hz - 10 kHz, pulse width duration of 1 ps or shorter, and/or peak power of 250 kW or higher). The packets may be delivered in bursts with, e.g., a frequency of 1 - 4 Hz). The time between adjacent sub-pulses may be less than the time between adjacent packets. The sub-pulses may be delivered with a higher peak power (lower energy) compared to non-burst pulses. The voltages of the sub-pulses may be applied using a single- or multi-stage generator circuit. The shock wave catheter may be operated in burst mode operation and/or non-burst mode operation.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
(1) Surgical implants comprised of artificial material; medical systems and devices comprised of delivery catheters and implantable scaffolds comprising artificial materials for the treatment of cardiovascular diseases and disorders; catheters; medical systems and devices comprised of catheters, medical probes, pulse generators for the treatment of cardiovascular diseases and disorders; medical systems and devices comprised of catheters, medical probes, pulse generators for use in intravascular lithotripsy medical procedures; medical systems and devices comprised of catheters, medical probes, pulse generators for use in coronary vasculature and peripheral vasculature medical procedures; balloon catheters; angioplasty catheters; intracardiac catheters; intravenous catheters; medical and surgical catheters.
42.
BURST MODE OPERATION OF INTRAVASCULAR LITHOTRIPSY (IVL)
Disclosed herein are systems and methods for applying voltage(s) across electrodes of a shock wave catheter system. The electrodes in the shock wave catheter may be activated by using at least one packet comprising a plurality of sub-pulses. The plurality of sub-pulses within a packet may be delivered in rapid succession (e.g., with a frequency of 100 Hz-10 kHz, pulse width duration of 1 μs or shorter, and/or peak power of 250 kW or higher). The packets may be delivered in bursts with, e.g., a frequency of 1-4 Hz). The time between adjacent sub-pulses may be less than the time between adjacent packets. The sub-pulses may be delivered with a higher peak power (lower energy) compared to non-burst pulses. The voltages of the sub-pulses may be applied using a single- or multi-stage generator circuit. The shock wave catheter may be operated in burst mode operation and/or non-burst mode operation.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
Described herein are shock wave devices and methods for the treatment of calcified heart valves. One variation of a shock wave device includes three balloons that are each sized and shaped to fit within a concave portion of a valve cusp when inflated with a liquid and a shock wave source within each of the three balloons. Each balloon is separately and/or independently inflatable, and each shock wave source is separately and/or independently controllable. Methods of treating calcified heart valves using a shock wave device can include advancing a shock wave device having one or more balloons and a shock wave source in each of the balloons to contact a heart valve, inflating the one or more balloons with a liquid such that the balloon is seated within a concave portion of a valve cusp, and activating the shock wave source.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
Surgical implants comprised of artificial material; medical systems and devices comprised of delivery catheters and implantable scaffolds comprising artificial materials for the treatment of cardiovascular diseases and disorders; Catheters; Medical systems and devices comprised of catheters, medical probes, pulse generators for the treatment of cardiovascular diseases and disorders; Medical systems and devices comprised of catheters, medical probes, pulse generators for use in intravascular lithotripsy medical procedures; Medical systems and devices comprised of catheters, medical probes, pulse generators for use in coronary vasculature and peripheral vasculature medical procedures; Balloon catheters; Angioplasty catheters; Intracardiac catheters; Intravenous catheters; Medical and surgical catheters
Surgical implants comprised of artificial material; medical
systems and devices comprised of delivery catheters and
implantable scaffolds comprising artificial materials for
the treatment of cardiovascular diseases and disorders.
46.
Locus emitter shock wave catheter devices with increased longevity and higher sonic output
An exemplary shock wave catheter system comprises: a catheter body comprising a lumen; an emitter wire configured to generate shock waves, wherein one or more gaps are formed between two or more portions of the emitter wire along a length of the catheter body, each of the one or more gaps forming a locus emitter; a carrier wire configured to conduct electricity to the emitter wire; and one or more electrical joints configured to electrically couple and join the emitter wire and the carrier wire.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
47.
LOCUS EMITTER SHOCK WAVE CATHETER DEVICES WITH INCREASED LONGEVITY AND HIGHER SONIC OUTPUT
An exemplary shock wave catheter system comprises: a catheter body comprising a lumen; an emitter wire configured to generate shock waves, wherein one or more gaps are formed between two or more portions of the emitter wire along a length of the catheter body, each of the one or more gaps forming a locus emitter; a carrier wire configured to conduct electricity to the emitter wire; and one or more electrical joints configured to electrically couple and join the emitter wire and the carrier wire.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
(1) Surgical implants comprised of artificial material; medical systems and devices comprised of delivery catheters and implantable scaffolds comprising artificial materials for the treatment of cardiovascular diseases and disorders.
Described herein is a device for treating a narrowed region of a lumen in the ear or nose of a patient, the device comprising: an elongated tube; at least one shock wave emitter, the at least one shock wave emitter configured to generate at least one shock wave along a working direction; at least one imaging sensor oriented to capture images along the working direction; and a fillable member sealed to a distal end of the elongated tube and surrounding the at least one shock wave emitter and the at least one imaging sensor, the fillable member fillable with a conductive fluid.
A61B 17/16 - Instruments pour réaliser une ostéoclasieForets ou ciseaux pour osTrépans
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
Surgical implants comprised of artificial material; medical systems and devices comprised of delivery catheters and implantable scaffolds comprising artificial materials for the treatment of cardiovascular diseases and disorders
51.
LOW PROFILE ELECTRODES FOR AN ANGIOPLASTY SHOCK WAVE CATHETER
Described herein are low-profile electrodes for use with an angioplasty shockwave catheter. A low-profile electrode assembly may have an inner electrode, an insulating layer disposed over the inner electrode such that an opening in the insulating layer is aligned with the inner electrode, and an outer electrode sheath disposed over the insulating layer such that an opening in the outer electrode sheath is coaxially aligned with the opening in the insulating layer. This layered configuration allows for the generation of shockwaves that propagate outward from the side of the catheter. In some variations, the electrode assembly has a second inner electrode, and the insulating layer and outer electrode may each have a second opening that are coaxially aligned with the second inner electrode. An angioplasty shockwave catheter may have a plurality of such low-profile electrode assemblies along its length to break up calcified plaques along a length of a vessel.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
The invention provides a device for generating shock waves. The device may comprise an elongated tube and a conductive sheath circumferentially mounted around the elongated tube. The device may further comprise first and second insulated wires extending along the outer surface of the elongated tube. A portion of the first insulated wire is removed to form a first inner electrode, which is adjacent to a first side edge of the conductive sheath. A portion of the second insulated wire is removed to form a second inner electrode, which is adjacent to a second side edge of the conductive sheath. Responsive to a high voltage being applied across the first inner electrode and the second inner electrode, a first shock wave is created across the first side edge and the first inner electrode, and a second shock wave is created across the second side edge and the second inner electrode.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
The present invention provides a catheter for treating occlusions in blood vessels. An exemplary catheter for treating occlusions in blood vessels comprises a tubular inner member including a base segment with a first lumen defining a fluid inlet port, and a second lumen defining a fluid outlet port. An extension segment is distal to the base segment. The extension segment has a reduced cross-section. An emitter assembly includes a first insulated wire extending through the second lumen and a second insulated wire, and a conductive sheath wrapped circumferentially around the first insulated wire, the second insulated wire, and the extension segment. A cap or balloon is sealably attached to the distal end of the catheter and surrounds the emitter assembly, said cap or balloon being fillable with conductive fluid.
A61B 17/225 - Instruments, dispositifs ou procédés chirurgicaux pour la lithotritie extracorporelle par onde de choc [ESWL], p. ex. utilisant des ondes ultrasonores
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
The present disclosure provides a catheter for treating lesions in a body lumen, such as calcified lesions and occlusions in vasculature. When a voltage is applied across the conductive elements, current flows across an arcing region, from one electrode element to another, to produce shock waves and cavitation bubbles. As a treatment continues, the conductive elements slowly erode at the arcing region where current flows between the electrodes. To increase the lifespan of the electrode assembly, the distal edges of the conductive elements may be shaped to promote erosion of the sheaths in a predetermined or semi-controlled pattern.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
58.
SYSTEMS, DEVICES, AND METHODS FOR GENERATING SHOCK WAVES IN A FORWARD DIRECTION
An exemplary catheter for use in a body lumen comprises: a catheter body; and a plurality of shock wave emitters disposed at a distal end of the catheter body, each shock wave emitter configured to generate a shock wave that propagates distally of the catheter body, wherein the plurality of shock wave emitters are arrayed about a longitudinal axis of the catheter body such that shock waves emitted from the plurality of shock wave emitters can constructively interfere distally of the catheter body, and wherein each shock wave emitter comprises electrodes separated by a spark gap and at least one electrical connector that connects at least one of the electrodes to an electrode of another shock wave emitter of the plurality of shock wave emitters.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A shock wave catheter includes an elongate member and a shock wave emitter assembly located at a distal region of the elongate member. The shock wave emitter assembly includes a shock absorber made of a low durometer material. A shock wave catheter system includes a shock wave catheter with a shock absorber and a high voltage power supply configured to generate high voltage pulses. A method for treating a lesion in a body lumen includes generating shock waves with a shock wave catheter system that includes a shock wave catheter with a shock absorber.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
60.
SYSTEMS, DEVICES, AND METHODS FOR TREATMENT OF TARGET MATERIAL IN A BODY LUMEN WITH SHOCK WAVES
A catheter includes a catheter body; at least one shock wave emitter disposed on the catheter body; and a moveable shield extending at least partially around the catheter body and configured for translating along the catheter body. Exemplary catheters are configured to modify lesions, including fibrotic and calcified tissue buildup within the body.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
61.
Systems, devices, and methods for generating shock waves in a forward direction
An exemplary catheter for use in a body lumen comprises: a catheter body; and a plurality of shock wave emitters disposed at a distal end of the catheter body, each shock wave emitter configured to generate a shock wave that propagates distally of the catheter body, wherein the plurality of shock wave emitters are arrayed about a longitudinal axis of the catheter body such that shock waves emitted from the plurality of shock wave emitters can constructively interfere distally of the catheter body, and wherein each shock wave emitter comprises electrodes separated by a spark gap and at least one electrical connector that connects at least one of the electrodes to an electrode of another shock wave emitter of the plurality of shock wave emitters.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61M 5/00 - Dispositifs pour faire pénétrer des agents dans le corps par introduction sous-cutanée, intravasculaire ou intramusculaireAccessoires à cet effet, p. ex. dispositifs de remplissage ou de nettoyage, appuis-bras
A catheter includes a catheter body; at least one shock wave emitter disposed on the catheter body; and a moveable shield extending at least partially around the catheter body and configured for translating along the catheter body. Exemplary catheters are configured to modify lesions, including fibrotic and calcified tissue buildup within the body.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A shock wave catheter includes an elongate member and a shock wave emitter assembly located at a distal region of the elongate member. The shock wave emitter assembly includes a shock absorber made of a low durometer material. A shock wave catheter system includes a shock wave catheter with a shock absorber and a high voltage power supply configured to generate high voltage pulses. A method for treating a lesion in a body lumen includes generating shock waves with a shock wave catheter system that includes a shock wave catheter with a shock absorber.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
64.
ELECTRODE AND CATHETER DESIGN FOR DIRECTIONAL LITHOTRIPSY CATHETERS
The present disclosure provides a catheter for treating lesions in a body lumen, such as calcified lesions and occlusions in vasculature. When a voltage is applied across the conductive elements, current flows across an arcing region, from one electrode element to another, to produce shock waves and cavitation bubbles. As a treatment continues, the conductive elements slowly erode at the arcing region where current flows between the electrodes. To increase the lifespan of the electrode assembly, the distal edges of the conductive elements may be shaped to promote erosion of the sheaths in a predetermined or semi-controlled pattern.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
65.
CATHETER SYSTEM WITH INDEPENDENTLY CONTROLLABLE BUBBLE AND ARC GENERATION
Described herein are systems and methods for implementing a power source for a shock wave catheter system, the power source including two separate voltage sources: a bubble generation voltage source and an arc generation voltage source. In one or more examples, the power source can be configured such that the bubble generation voltage source provides a lower voltage to a pair of electrodes of the shock wave catheter system. The lower voltage can be configured to induce electrolysis of a fluid that surrounds the pair of electrodes of the shock wave catheter system for generating and growing a bubble. Once a bubble has formed, the arc generation voltage source can then be engaged to provide a high-voltage electrical pulse to the electrodes of the shock wave catheter system, thereby generating an arc (i.e., spark) across the electrodes.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
66.
Intravascular lithotripsy catheter with oscillating impactor
Catheter devices for treating occlusions in body lumen are described herein. The catheter devices may include a tubular body having a distal end, an distal portion elastically connected to the distal end of the tubular body, an impactor connected to the distal portion and separated by a space from the distal end of the tubular body, a distal shock wave emitter located adjacent to the space and connected to a power source, and an enclosure at least partially surrounding each of the distal end of the tubular body, the elastic distal portion, the impactor, and the distal shock wave emitter. The impactor may be configured to move in response to shock waves generated from the distal shock wave emitter, such that a length of the space in the proximal-distal direction increases by between 0.05 mm and 0.6 mm.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
Described herein are shock wave catheters having discontinuous emitter bands. The catheters may be used for treating occlusions in a body lumen. In some examples, the catheters include an elongated tube, a shock wave electrode assembly at least partially embedded within the elongated tube, and an enclosure surrounding the shock wave electrode assembly. In some examples, the electrode assembly includes an emitter band at least partially encircling the elongated tube, the emitter band forming a first electrode of an electrode pair, and one wire having a distal end forming a second electrode of the electrode pair. The shock wave electrode assembly is configured to emit a shock wave when a voltage pulse is applied across the electrode pair. In some examples, the at least one emitter band is compressible to reduce a diameter of the emitter band.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
Described herein are shock wave catheters having discontinuous emitter bands. The catheters may be used for treating occlusions in a body lumen. In some examples, the catheters include an elongated tube, a shock wave electrode assembly at least partially embedded within the elongated tube, and an enclosure surrounding the shock wave electrode assembly. In some examples, the electrode assembly includes an emitter band at least partially encircling the elongated tube, the emitter band forming a first electrode of an electrode pair, and one wire having a distal end forming a second electrode of the electrode pair. The shock wave electrode assembly is configured to emit a shock wave when a voltage pulse is applied across the electrode pair. In some examples, the at least one emitter band is compressible to reduce a diameter of the emitter band.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
Catheter devices for treating occlusions in body lumen are described herein. The catheter devices may include a tubular body having a distal end, an distal portion elastically connected to the distal end of the tubular body, an impactor connected to the distal portion and separated by a space from the distal end of the tubular body, a distal shock wave emitter located adjacent to the space and connected to a power source, and an enclosure at least partially surrounding each of the distal end of the tubular body, the elastic distal portion, the impactor, and the distal shock wave emitter. The impactor may be configured to move in response to shock waves generated from the distal shock wave emitter, such that a length of the space in the proximal-distal direction increases by between 0.05 mm and 0.6 mm.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
70.
DEVICE AND METHOD FOR GENERATING FORWARD DIRECTED SHOCK WAVES
Described herein is a shock wave device for the treatment of vascular occlusions. The shock wave device includes an outer covering and an inner member inner connected at a distal end of the device. First and second conductive wires extend along the length of the device within the volume between the outer covering and the inner member. A conductive emitter band circumscribes the ends of the first and second wires to form a first spark gap between the end of the first wire and the emitter band and a second spark gap between the end of the second wire and the emitter band. When the volume is filled with conductive fluid and a high voltage pulse is applied across the first and second wires, first and second shock waves can be initiated from the first and second spark gaps.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61M 5/00 - Dispositifs pour faire pénétrer des agents dans le corps par introduction sous-cutanée, intravasculaire ou intramusculaireAccessoires à cet effet, p. ex. dispositifs de remplissage ou de nettoyage, appuis-bras
A catheter for treating a lesion in a body lumen includes an elongate member, an enclosure, and shock wave emitters enclosed by the enclosure. At least one of the shock wave emitters has a different size than at least one of the other emitters. Providing a smaller shock wave emitter at a distal end of the catheter can help make the catheter more navigable through the body lumen.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
72.
SHOCK WAVE CATHETER WITH DIFFERENTLY SIZED SHOCK WAVE EMITTERS
A catheter for treating a lesion in a body lumen includes an elongate member, an enclosure, and shock wave emitters enclosed by the enclosure. At least one of the shock wave emitters has a different size than at least one of the other emitters. Providing a smaller shock wave emitter at a distal end of the catheter can help make the catheter more navigable through the body lumen.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
An apparatus includes a balloon adapted to be placed adjacent a calcified region of a body. The balloon is inflatable with a liquid. The apparatus further includes a shock wave generator within the balloon that produces shock waves that propagate through the liquid for impinging upon the calcified region adjacent the balloon. The shock wave generator includes a plurality of shock wave sources distributed within the balloon.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/225 - Instruments, dispositifs ou procédés chirurgicaux pour la lithotritie extracorporelle par onde de choc [ESWL], p. ex. utilisant des ondes ultrasonores
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A catheter for delivering shockwaves to a calcified lesion includes an elongated carrier, a pair of electrodes carried by the carrier, said electrodes being immersed in a conductive liquid, and a power source with a circuit coupled to the electrodes for supplying voltage pulses to the electrodes. The power source includes a capacitor and a switch. Each voltage pulse is between 1,000 volts and 10,000 volts. Each voltage pulse is generated by closing the switch that causes a charge stored on the capacitor to be delivered to the electrode pair. Each voltage pulse has sufficient energy to generate an arc in the liquid, allowing current to flow across the pair of electrodes to produce a shock wave associated with the expansion of a steam bubble. The catheter also includes a temperature sensor configured to sense the temperature of the conductive fluid proximate to the pair of electrodes.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A catheter system for treating stenosis in a body lumen includes a first energy source, a second energy source, and a catheter. The catheter includes an elongate member that is navigable through the body lumen, a first acoustic energy emitter connected to the first energy source and configured to emit acoustic energy when energy is received from the first energy source, and a second acoustic energy emitter connected to the second energy source and configured to emit acoustic energy when energy is received from the second energy source.
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
77.
INTRAVASCULAR LITHOTRIPSY CATHETERS WITH LATERALLY MOVABLE AND POSITIONABLE EMITTERS
A shock wave catheter for performing intravascular lithotripsy (IVL) is provided. The catheter includes an elongated tube having a central longitudinal axis, an enclosure sealed to the distal end of the elongated tube, and an adjustable emitter assembly disposed within the enclosure. The emitter assembly includes at least one laterally moveable or positionable shock wave generating emitter that, in a first configuration, is closer to the central longitudinal axis of the catheter, and, in a second configuration, is farther from the central longitudinal axis than in the first position. Various embodiments include support structures for the emitters, multiple balloons for positioning the emitters, helical ribbons, angled emitter ports, and other exemplary features for moving and/or positioning the emitters. Systems and methods for treating lesions in a body lumen are also provided herein.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p. ex. des courants à haute fréquence
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A catheter system for treating stenosis in a body lumen includes a first energy source, a second energy source, and a catheter. The catheter includes an elongate member that is navigable through the body lumen, a first acoustic energy emitter connected to the first energy source and configured to emit acoustic energy when energy is received from the first energy source, and a second acoustic energy emitter connected to the second energy source and configured to emit acoustic energy when energy is received from the second energy source.
A61B 18/24 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet avec un cathéter
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
Surgical implants comprised of artificial material;
catheters; medical systems and devices comprised of delivery
catheters and implantable scaffolds comprising artificial
materials for the treatment of cardiovascular diseases and
disorders; medical systems and devices comprised of
catheters, medical probes, pulse generators for the
treatment of cardiovascular diseases and disorders; medical
systems and devices comprised of catheters, medical probes,
pulse generators for use in intravascular lithotripsy
medical procedures and valvuloplasty medical procedures;
balloon catheters; intracardiac catheters; intravenous
catheters.
80.
INTRAVASCULAR LITHOTRIPSY CATHETERS WITH LATERALLY MOVABLE AND POSITIONABLE EMITTERS
A shock wave catheter for performing intravascular lithotripsy (IVL) is provided. The catheter includes an elongated tube having a central longitudinal axis, an enclosure sealed to the distal end of the elongated tube, and an adjustable emitter assembly disposed within the enclosure. The emitter assembly includes at least one laterally moveable or positionable shock wave generating emitter that, in a first configuration, is closer to the central longitudinal axis of the catheter, and, in a second configuration, is farther from the central longitudinal axis than in the first position. Various embodiments include support structures for the emitters, multiple balloons for positioning the emitters, helical ribbons, angled emitter ports, and other exemplary features for moving and/or positioning the emitters. Systems and methods for treating lesions in a body lumen are also provided herein.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
81.
LITHOTRIPSY CATHETERS HAVING ELECTRODES FORMED IN METALLIZATION LAYERS
A catheter for treating a stenosis in a body lumen includes an elongate tube; a member sealed to a distal end of the elongate tube that is fillable with a conductive fluid; a metallization layer comprising at least one trace forming at least one inner electrode, the metallization layer being connected to at least one wire; and at least one outer electrode extending radially outwardly of the metallization layer and separated from the at least one inner electrode by at least one gap such that, when a voltage pulse is applied to the inner and outer electrodes, current flows across the at least one gap to generate at least one shock wave.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
82.
Lithotripsy catheters having electrodes formed in metallization layers
A catheter for treating a stenosis in a body lumen includes an elongate tube; a member sealed to a distal end of the elongate tube that is fillable with a conductive fluid; a metallization layer comprising at least one trace forming at least one inner electrode, the metallization layer being connected to at least one wire; and at least one outer electrode extending radially outwardly of the metallization layer and separated from the at least one inner electrode by at least one gap such that, when a voltage pulse is applied to the inner and outer electrodes, current flows across the at least one gap to generate at least one shock wave.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
The invention provides a device for generating shock waves. The device may comprise an elongated tube and a conductive sheath circumferentially mounted around the elongated tube. The device may further comprise first and second insulated wires extending along the outer surface of the elongated tube. A portion of the first insulated wire is removed to form a first inner electrode, which is adjacent to a first side edge of the conductive sheath. A portion of the second insulated wire is removed to form a second inner electrode, which is adjacent to a second side edge of the conductive sheath. Responsive to a high voltage being applied across the first inner electrode and the second inner electrode, a first shock wave is created across the first side edge and the first inner electrode, and a second shock wave is created across the second side edge and the second inner electrode.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A system that breaks calcium in a liquid includes a catheter including first and second electrodes arranged to receive there-across a high electrical voltage at an initial low current. The high electrical voltage causes an electrical arc to form across the electrodes creating a gas bubble within the liquid, a high current to flow through the electrodes, and a mechanical shock wave. A power source provides the electrodes with the high electrical voltage at the initial current and terminates the high electrical voltage in response to the high current flow through the electrodes.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/225 - Instruments, dispositifs ou procédés chirurgicaux pour la lithotritie extracorporelle par onde de choc [ESWL], p. ex. utilisant des ondes ultrasonores
(1) Surgical implants comprised of artificial material; catheters; medical systems and devices comprised of delivery catheters and implantable scaffolds comprising artificial materials for the treatment of cardiovascular diseases and disorders; medical systems and devices comprised of catheters, medical probes, pulse generators for the treatment of cardiovascular diseases and disorders; medical systems and devices comprised of catheters, medical probes, pulse generators for use in intravascular lithotripsy medical procedures and valvuloplasty medical procedures; balloon catheters; intracardiac catheters; intravenous catheters.
Surgical implants comprised of artificial material; Catheters; Medical systems and devices comprised of delivery catheters and implantable scaffolds comprising artificial materials for the treatment of cardiovascular diseases and disorders; Medical systems and devices comprised of catheters, medical probes, pulse generators for the treatment of cardiovascular diseases and disorders; Medical systems and devices comprised of catheters, medical probes, pulse generators for use in intravascular lithotripsy medical procedures and valvuloplasty medical procedures; Balloon catheters; Intracardiac catheters; Intravenous catheters
87.
Catheter system with independently controllable bubble and arc generation
Described herein are systems and methods for implementing a power source for a shock wave catheter system, the power source including two separate voltage sources: a bubble generation voltage source and an arc generation voltage source. In one or more examples, the power source can be configured such that the bubble generation voltage source provides a lower voltage to a pair of electrodes of the shock wave catheter system. The lower voltage can be configured to induce electrolysis of a fluid that surrounds the pair of electrodes of the shock wave catheter system for generating and growing a bubble. Once a bubble has formed, the arc generation voltage source can then be engaged to provide a high-voltage electrical pulse to the electrodes of the shock wave catheter system, thereby generating an arc (i.e., spark) across the electrodes.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
88.
AORTIC LEAFLET REPAIR USING SHOCK WAVE APPLICATORS
Described herein are shock wave devices and methods for the treatment of calcified heart valves. One variation of a shock wave device may comprise an elongated flexible tube carried by a sheath. The tube may have a fluid input end, which may be located near a proximal end of the sheath. The tube may include a loop portion. The loop portion may be configured to be at least partially accommodated within a cusp of the heart valve. The tube may be fillable with a conductive fluid. In some variations, the shock wave device may include an array of electrode pairs associated with a plurality of wires positioned within the loop portion of a tube. The electrode pairs may be electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 18/22 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
The invention provides a system for treating an occlusion within a body lumen. The system may comprise an insulated outer sheath; an elongated conductive tube, wherein the insulated outer sheath is circumferentially mounted around the elongated conductive tube; and an insulated wire having a helically coiled portion at a distal end of the insulated wire. The coiled portion includes an exposed distal tip, and a distal portion of the elongated conductive tube is circumferentially mounted around the distal coiled portion of the insulated wire. When a voltage is applied across the insulated wire and the elongated conductive tube, a current is configured to flow from the exposed distal tip of the insulated wire to the elongated conductive tube to generate a plurality of cavitation bubbles. In an alternate embodiment, an elongated central electrode is used in place of the conductive tube.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
Described herein are systems and methods for implementing a power source for a shock wave catheter system, the power source including two separate voltage sources: a bubble generation voltage source and an arc generation voltage source. In one or more examples, the power source can be configured such that the bubble generation voltage source provides a lower voltage to a pair of electrodes of the shock wave catheter system. The lower voltage can be configured to induce electrolysis of a fluid that surrounds the pair of electrodes of the shock wave catheter system for generating and growing a bubble. Once a bubble has formed, the arc generation voltage source can then be engaged to provide a high-voltage electrical pulse to the electrodes of the shock wave catheter system, thereby generating an arc (i.e., spark) across the electrodes.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
Various shock wave catheters and methods of use thereof that do not utilize a guidewire are described herein. The shock wave catheters include at least one shock wave emitter disposed within a distal portion of the shock wave catheter and configured to generate shock waves. The ends of conductive wires extending within an elongate tube can form the shock wave emitter(s). The shock wave emitter(s) can be surrounded by an enclosure fillable with a conductive fluid delivered by the lumen of the elongate tube. The elongate tube can include a coil or slits therein that enable flexibility of the shock wave catheter, which, in combination with the narrow profile of the shock wave catheters described herein, enable their use in navigating and treating small, tortuous vessels.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
A valvuloplasty system comprises a balloon adapted to be placed adjacent leaflets of a valve. The balloon is inflatable with a liquid. The system further includes a shock wave generator within the balloon that produces shock waves. The shock waves propagate through the liquid and impinge upon the valve to decalcify and open the valve.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A catheter for treating an occlusion in a body lumen includes an elongate tube; a member sealed to a distal end of the elongate tube that is tillable with a conductive fluid; a cylindrical conductive sheath circumferentially mounted around the elongate tube within the member, the conductive sheath comprising a slot extending along a length of the conductive sheath; and a wire at least partially disposed in the slot, wherein a distal end of the wire is spaced apart from the conductive sheath by a gap in an arrangement such that when a voltage pulse is supplied to the insulated wire current flows across the gap to generate cavitation bubbles and/or shock waves.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
94.
INTRAVASCULAR LITHOTRIPSY CATHETER WITH SLOTTED EMITTER BANDS
A catheter for treating an occlusion in a body lumen includes an elongate tube; a member sealed to a distal end of the elongate tube that is fillable with a conductive fluid; a cylindrical conductive sheath circumferentially mounted around the elongate tube within the member, the conductive sheath comprising a slot extending along a length of the conductive sheath; and a wire at least partially disposed in the slot, wherein a distal end of the wire is spaced apart from the conductive sheath by a gap in an arrangement such that when a voltage pulse is supplied to the insulated wire current flows across the gap to generate cavitation bubbles and/or shock waves.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
Disclosed herein shock wave catheters comprising one or more shock wave electrodes for cracking calcifications located within blood vessels. In some variations, a shock wave catheter has first and second shock wave electrodes each circumferentially disposed over the outer surface of the catheter. In certain variations, the first electrode has a recess and the second electrode has a protrusion that is received by the recess and a spark gap is located along the separation between the recess and the protrusion. The second electrode can also have a recess that receives a protrusion from a third shock wave electrode, where the separation between the second and third electrodes along the separation between the recess and the protrusion forms a second spark gap. A shock wave can be initiated across these spark gaps when a voltage is applied over the electrodes.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
Described herein is a method for treating a narrowed region of a lumen in the ear or nose of a patient. The method includes advancing a catheter within the lumen such that a distal end of the catheter is positioned proximate to the narrowed region, filling a fillable member to expand the fillable member within the lumen, and generating at least one shock wave from at least one shock wave emitter. The at least one shock wave creates one or more fractures in a bony structure of the narrowed region of the lumen that dilate the narrowed region.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/16 - Instruments pour réaliser une ostéoclasieForets ou ciseaux pour osTrépans
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
Described herein is a method for treating a narrowed region of a lumen in the ear or nose of a patient. The method includes advancing a catheter within the lumen such that a distal end of the catheter is positioned proximate to the narrowed region, filling a Tillable member to expand the fillable member within the lumen, and generating at least one shock wave from at least one shock wave emitter. The at least one shock wave creates one or more fractures in a bony structure of the narrowed region of the lumen that dilate the narrowed region.
Catheters; medical systems and devices comprised of
catheters, medical probes, pulse generators for the
treatment of cardiovascular diseases and disorders; medical
systems and devices comprised of catheters, medical probes,
pulse generators for use in intravascular lithotripsy
medical procedures and valvuloplasty medical procedures;
balloon catheters; intracardiac catheters; intravenous
catheters; medical and surgical catheters.
The present invention provides a catheter for treating occlusions in body lumens. The catheter includes a catheter body that is fillable with fluid. An impactor is connected to the distal end of the catheter body and has a proximal end inside the catheter body and a distal end outside the catheter body. The catheter also includes a shock wave source configured to generate a shock wave, and a deflector coupled to the proximal end of the impactor in between the shock wave source and distal end of the catheter body. When the shock wave source generates a shock wave, the shock wave impinges on the deflector causing the deflector to advance in a forward direction in conjunction with the impactor such that the distal end of the impactor delivers a mechanical force to the occlusion to restore flow to the body lumen.
A61B 18/26 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet pour produire une onde de choc, p. ex. lithotritie par laser
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
The present disclosure provides a balloon catheter for treating a stenosis in a body lumen that incorporates at least one shock wave generator located within at least one balloon and at least one channel that permits blood to flow through the body lumen past the balloon while the balloon is inflated. The at least one channel acts as a bypass around the inflated balloon(s) of the catheter such that blood flow through the lumen is generally not fully blocked during a shock wave treatment.
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
