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WO1999011185A1 - Appareil pour traiter des lesions vasculaires, notamment des varices - Google Patents

Appareil pour traiter des lesions vasculaires, notamment des varices Download PDF

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Publication number
WO1999011185A1
WO1999011185A1 PCT/DE1998/002443 DE9802443W WO9911185A1 WO 1999011185 A1 WO1999011185 A1 WO 1999011185A1 DE 9802443 W DE9802443 W DE 9802443W WO 9911185 A1 WO9911185 A1 WO 9911185A1
Authority
WO
WIPO (PCT)
Prior art keywords
probe
vessel
probe body
varices
probe head
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/DE1998/002443
Other languages
German (de)
English (en)
Inventor
Steffen Hoffmann
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to EP98952505A priority Critical patent/EP1009305A1/fr
Publication of WO1999011185A1 publication Critical patent/WO1999011185A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1402—Probes for open surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A61B2018/00392—Transmyocardial revascularisation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/0091—Handpieces of the surgical instrument or device

Definitions

  • the present invention relates to a device for the treatment of vascular defects, in particular varices (i.e. varicose veins) using high-frequency energy according to the preamble of claim 1. Furthermore, the invention relates to a device for the treatment of varices according to the preamble of claim 22.
  • varices have been surgically removed, especially if they are varices of larger diameter, in such a way that the treating physician places incisions along the varices and the diseased vessel is removed in sections over the incisions.
  • the problem here is that such a treatment is very stressful for the patient on the one hand, and on the other hand there is a risk that scars due to the cuts remain.
  • a rigid needle is used, for example, to prick the skin and to treat a comparatively short section of a varice.
  • the treatment is carried out under local anesthesia, which means that the blood vessels in the area of local anesthesia can contract reflexively.
  • the problem here is that when the needle is inserted again, it becomes very difficult to properly pierce the vessel.
  • the object of the present invention is to provide a novel device for the treatment of vascular defects, in particular varices, with which a On the one hand, a patient-friendly and, on the other hand, efficient, ie time-saving treatment can be carried out without the need for cuts.
  • a probe to be inserted into the vessel is provided as the treatment instrument, which comprises an elongated flexible probe body and a probe head located at one end thereof for applying high-frequency energy to the vessel.
  • the probe is fully inserted into the diseased vessel and slowly pulled out of the vessel under high-frequency exposure, causing the vessel walls to coagulate (weld together).
  • This makes it possible to treat vessels over long distances in a simple manner, without having to be stabbed again and again. Apart from the puncture point at the insertion area of the probe, no stitches or cuts are necessary.
  • the invention ensures that the cost of an operative intervention is completely eliminated.
  • the flexibility of the probe body is expediently set in such a way that the probe can be inserted following the course of the vessel when it is inserted into the vessel.
  • a guide (in particular a so-called “vein indwelling cannula”) is advantageously provided for placing the probe, which can preferably be carried out with a puncture position check, ie a check to check whether the vessel has been pierced.
  • a guide is not always necessary
  • the probe can be placed during an operation (e.g. in the case of a crossectomy of Venasaphenamagna).
  • the guide expediently has a needle which is surrounded by a sheath.
  • the needle can be pulled out of the sheath after the guide has been placed, ie it can be removed.
  • the needle is expediently provided as a hollow needle, preferably with a cavity provided at the end facing away from the tip. When the needle is inserted into the vessel, some blood flows into the cavity and thus indicates to the treating doctor that he has placed the needle correctly.
  • the diameter of the probe body is dimensioned such that it seals the vessel together with the casing.
  • the diameter of the probe body expediently corresponds essentially to the diameter of the probe head.
  • the probe body comprises a metal wire and a plastic sheath surrounding the metal wire.
  • This can expediently also consist of Teflon.
  • the probe body is provided with a scale, which in the front area, i.e. the area facing the probe head can advantageously be made finer.
  • the doctor to be treated can precisely monitor the respective position of the probe head with respect to the guidance while the probe is gradually being pulled out of the varicose vein.
  • the temperature in the region of the probe head can be detected according to a further embodiment of the present invention.
  • the probe body consists of temperature-conductive material, but at least it includes such.
  • the probe body can also have a temperature-conductive coating.
  • the device can have a temperature display and / or a warning tone generator that can be activated via the temperature. It is also expedient to provide a control circuit with automatic shutdown of the probe when a working temperature or a working temperature range is exceeded.
  • the metal wire is made of steel or tungsten.
  • the probe head is made of a highly conductive metal, e.g. made of Au, Pt or Ag or a corresponding metal alloy. It is also conceivable that the metal wire and probe head, in particular in the case of very thin probes, consist of one and the same material, the metal wire being exposed only in the region of the probe head, i.e. there is no insulation.
  • the probe head can be elongated, in particular, with a rounded front. This prevents premature perforation of the vein wall and thus an uncontrolled exit from the vein by the probe. This also leads to better management, i.e. ensures easier advancement of the probe within the vein.
  • probe bodies with different diameters and / or lengths, which can be used on the device according to the invention as required.
  • an additional guide sleeve can be expedient, which is introduced into the vessel to be treated beforehand.
  • the insertion of the guide sleeve can be carried out together with the probe in increments or increments.
  • Claim 22 describes a device for the treatment of varices, in which the probe body for self-adaptation to the course of the varices is inflexible over its entire length with respect to pressure and tensile loading and flexible with respect to loading across to its longitudinal direction when the probe body is inserted or withdrawn into or out of the varices to be treated.
  • the probe body When the probe body is inserted, it is subjected to pressure without being compressed, and when the probe body is pulled out, there is no elongation in the longitudinal direction despite the tensile stress. At the same time, the probe body readily follows the curves and windings of the course of the varices when inserting / removing the probe body due to its flexibility in relation to the load transverse to its longitudinal direction. This means that a long and tortuous varice can be treated in a patient-friendly manner via a single puncture site. In the prior art, a rigid varicose needle had to be used to treat short sections of the varice at several puncture sites.
  • the device according to claim 22 can be supplemented by all the features of claims 1 to 21 in order to be adapted to the desired treatment requirements.
  • Figure 1 is a highly simplified, schematic representation of the device according to the invention in its entirety in use.
  • FIG. 2 shows a representation of the guide to be used for the use of the device
  • FIG 3 shows a section of the probe body in longitudinal section a) in plan view b) and in cross section c);
  • FIG. 4 shows sectional views (a) and (b) of configurations of the probe according to FIG. 1 in the head region;
  • Fig. 5 is a sectional view of the probe of FIG. 1 in the head area with the additional use of a guide sleeve.
  • Reference number 1 in FIG. 1 shows the device according to the invention in its entirety. It comprises a flexible, elongated probe 2 consisting of a handle 17, an example made of tungsten probe body 3 and a probe head 4 arranged at the end of the probe body 3 for the emission of high-frequency energy.
  • the probe body 3 is inserted into the diseased vessel 10 via a guide 5.
  • Reference numeral 11 in Fig. 1 denotes the various skin layers of the human body.
  • the probe is connected via a cable 14 to the high-frequency source 14 or the housing 13 of the same.
  • the high-frequency source 14 also has a display 20 and an adjusting device 15 for delivering the high-frequency energy.
  • the guide comprises a hollow needle 6 with a cavity 8, which serves as a stitch position control.
  • the cavity 8 fills with blood.
  • the guide 5 is designed in such a way that after the sheath 7 has been placed in the skin, the needle is removed and the probe body can be inserted.
  • the probe body 3 has an internal metal wire 12, a plastic, in particular Teflon coating 9 surrounding the metal wire and a temperature-conductive coating 19.
  • the temperature-conductive coating extends only over part of the initial region of the probe body.
  • the temperature at the probe head 4 can be “felt” and displayed on the display 20 in a simple manner via the temperature-conductive layer 19. It is also possible to activate a warning signal (not shown) when a certain temperature is exceeded.
  • a control circuit (not shown in the figures) is expediently provided, which ensures automatic shutdown when a working temperature or a working temperature range is exceeded.
  • the probe head 4 is provided with a cylindrical shape on the front, with the casing 7 and the probe head 4 forming a uniform surface according to FIG. 4 (a) or according to FIG. 4 (b) to form the probe. denkopfes 4 the foremost piece of the metal wire is not surrounded by the coating 9. After inserting the probe body 3 into the guide 5, this ensures that no blood can escape during the treatment through an intermediate space between the guide 5 and the probe body 3.
  • the metal wire from the same material as the probe head, i.e. to make these two parts available in one part.
  • the probe head is formed by the zone of the metal wire that is not covered by the coated zone.
  • the probe body 3 can additionally be surrounded by a guide sleeve 21, the guide sleeve 21 serving the purpose of somewhat stabilizing the interior of the vessel to facilitate the insertion of the probe.
  • the guide sleeve is more flexible than the probe 2.
  • the guide is inserted through the skin 11 into the vessel 10 to be treated and the needle 6 is then removed. Via the cavity 8 it can be seen that the vessel to be treated has actually been hit.
  • the probe is then inserted through the guide 5 into the treatment vessel over the entire treatment length. The dimensions of the probe head 4 and probe body 3 including the guide 5 automatically seal the guide 5.
  • a local anesthetic can then be injected along the varices. If several varices are to be treated, it is advantageous to place several probes in parallel under anesthesia and not to exceed the maximum dose of local anesthetic. Since the patient is anesthetized before the probe is inserted, it is expedient to simultaneously insert a plurality of probes for the treatment of a plurality of vessels during a treatment. Once the probes have been placed, the respective vessel is made as bloodless as possible (for example, by putting it up, putting on a tourniquet or by compressing wrap).
  • the vessel in question is then treated under the influence of high-frequency energy (for example in the megahertz range), the vessel walls welding together, ie coagulating.
  • high-frequency energy for example in the megahertz range
  • the probe is gradually pulled out of the vessel from the most distant to the puncture point in the vessel, as a result of which the vessel walls are welded continuously.
  • the high-frequency energy can be changed using a setting button 15 (see FIG. 1).
  • probe bodies 3 of different lengths or strengths can be used for each device.
  • the probe head 4 At the front of the probe body 3 is the probe head 4 in the form of a flattened ball.
  • the probe body 4 is e.g. made of metal wire or tungsten. However, other materials for this are also conceivable.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un appareil pour traiter des lésions vasculaires, notamment des varices, à l'aide d'énergie haute fréquence. Cet appareil comprend un boîtier (13), un générateur de haute fréquence (14) et un instrument de traitement, relié au générateur de haute fréquence et qui permet de traiter les vaisseaux (10) altérés. Il est prévu au niveau de l'instrument de traitement, une sonde (2) à introduire dans le vaisseau (10). Cette sonde comprend un corps (3) souple étiré et une tête (4) située à une de ses extrémités, qui est destinée à appliquer de l'énergie haute fréquence au vaisseau (10).
PCT/DE1998/002443 1997-08-30 1998-08-21 Appareil pour traiter des lesions vasculaires, notamment des varices Ceased WO1999011185A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP98952505A EP1009305A1 (fr) 1997-08-30 1998-08-21 Appareil pour traiter des lesions vasculaires, notamment des varices

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE19737965.6 1997-08-30
DE19737965A DE19737965C1 (de) 1997-08-30 1997-08-30 Gerät zur Behandlung von Varizen

Publications (1)

Publication Number Publication Date
WO1999011185A1 true WO1999011185A1 (fr) 1999-03-11

Family

ID=7840721

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE1998/002443 Ceased WO1999011185A1 (fr) 1997-08-30 1998-08-21 Appareil pour traiter des lesions vasculaires, notamment des varices

Country Status (3)

Country Link
EP (1) EP1009305A1 (fr)
DE (1) DE19737965C1 (fr)
WO (1) WO1999011185A1 (fr)

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2333964A (en) * 1999-03-04 1999-08-11 Falah Hasan Ali Intravenous coagulation catheter for treatment of varicose veins
FR2816217A1 (fr) * 2000-11-07 2002-05-10 Formes Et Performances Traitement cosmetologique des varicosites et dispositif pour sa mise en oeuvre
WO2002098310A1 (fr) * 2001-06-05 2002-12-12 E-Globe Technologies Ltd. Tire-veine electrochirurgical
RU2301044C2 (ru) * 2001-06-05 2007-06-20 Е-Глоуб Текнолоджиз Лтд. Электрохирургический венозный стриппер (варианты)
WO2010057934A1 (fr) * 2008-11-18 2010-05-27 F Care Systems Cathéter flexible
WO2007014063A3 (fr) * 2005-07-21 2010-06-17 Vnus Medical Technologies, Inc. Systemes et methodes pour traiter une structure anatomique creuse
US7789876B2 (en) 2000-08-14 2010-09-07 Tyco Healthcare Group, Lp Method and apparatus for positioning a catheter relative to an anatomical junction
US7842076B2 (en) 2004-12-20 2010-11-30 Tyco Healthcare Group, Lp Systems and methods for treating a hollow anatomical structure
US7955369B2 (en) 2004-09-27 2011-06-07 Tyco Healthcare Group Lp Systems and methods for treating a hollow anatomical structure

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE19956764C2 (de) 1999-11-25 2002-01-03 Steffen Hoffmann Gerät zur Behandlung von Gefäßdefekten
DE10254668A1 (de) * 2002-11-22 2004-06-09 Großpointner, Martina Gerät zur Behandlung von Gefäßdefekten

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5163927A (en) * 1991-10-17 1992-11-17 Imagyn Medical, Inc. Linear eversion catheter system with position indicating indicia
US5236417A (en) * 1992-09-22 1993-08-17 Utah Pioneer Medical, Inc. Cholangiography catheter apparatus and method
WO1995001751A1 (fr) * 1993-07-01 1995-01-19 Boston Scientific Corporation Catheters de visualisation, detection de potentiels electriques, et ablation des tissus
WO1995019148A1 (fr) * 1994-01-18 1995-07-20 Endovascular, Inc. Appareil et procede de ligature veineuse
WO1995024160A1 (fr) * 1994-03-08 1995-09-14 Cardima, Inc. Catheter d'occlusion intravasculaire a h.f.
EP0737487A2 (fr) * 1992-04-10 1996-10-16 Cardiorhythm Cathéter dirigeable muni d'une électrode

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5366441A (en) * 1993-09-28 1994-11-22 Becton, Dickinson And Company Catheter introducer assembly with guidewire
US5437664A (en) * 1994-01-18 1995-08-01 Endovascular, Inc. Apparatus and method for venous ligation

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5163927A (en) * 1991-10-17 1992-11-17 Imagyn Medical, Inc. Linear eversion catheter system with position indicating indicia
EP0737487A2 (fr) * 1992-04-10 1996-10-16 Cardiorhythm Cathéter dirigeable muni d'une électrode
US5236417A (en) * 1992-09-22 1993-08-17 Utah Pioneer Medical, Inc. Cholangiography catheter apparatus and method
WO1995001751A1 (fr) * 1993-07-01 1995-01-19 Boston Scientific Corporation Catheters de visualisation, detection de potentiels electriques, et ablation des tissus
WO1995019148A1 (fr) * 1994-01-18 1995-07-20 Endovascular, Inc. Appareil et procede de ligature veineuse
WO1995024160A1 (fr) * 1994-03-08 1995-09-14 Cardima, Inc. Catheter d'occlusion intravasculaire a h.f.

Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2333964B (en) * 1999-03-04 1999-12-29 Falah Hasan Ali Intravenous coagulation catheter for treatment of varicose veins
GB2333964A (en) * 1999-03-04 1999-08-11 Falah Hasan Ali Intravenous coagulation catheter for treatment of varicose veins
US7789876B2 (en) 2000-08-14 2010-09-07 Tyco Healthcare Group, Lp Method and apparatus for positioning a catheter relative to an anatomical junction
FR2816217A1 (fr) * 2000-11-07 2002-05-10 Formes Et Performances Traitement cosmetologique des varicosites et dispositif pour sa mise en oeuvre
WO2002038218A1 (fr) * 2000-11-07 2002-05-16 Formes Et Performances Traitement cosmetologique des varicosites et dispositif pour sa mise en oeuvre
WO2002098310A1 (fr) * 2001-06-05 2002-12-12 E-Globe Technologies Ltd. Tire-veine electrochirurgical
EP1512378A1 (fr) * 2001-06-05 2005-03-09 E-Globe Technologies Ltd. Tire-veine électrochirurgical
RU2301044C2 (ru) * 2001-06-05 2007-06-20 Е-Глоуб Текнолоджиз Лтд. Электрохирургический венозный стриппер (варианты)
US7955369B2 (en) 2004-09-27 2011-06-07 Tyco Healthcare Group Lp Systems and methods for treating a hollow anatomical structure
US7842076B2 (en) 2004-12-20 2010-11-30 Tyco Healthcare Group, Lp Systems and methods for treating a hollow anatomical structure
WO2007014063A3 (fr) * 2005-07-21 2010-06-17 Vnus Medical Technologies, Inc. Systemes et methodes pour traiter une structure anatomique creuse
US8852178B2 (en) 2005-07-21 2014-10-07 Covidien Lp Systems for treating a hollow anatomical structure
EP2444018A3 (fr) * 2005-07-21 2016-01-06 Covidien LP Systèmes et méthodes pour traiter une structure anatomique creuse
US10722284B2 (en) 2005-07-21 2020-07-28 Covidien Lp Systems for treating a hollow anatomical structure
US11672587B2 (en) 2005-07-21 2023-06-13 Covidien Lp Systems for treating a hollow anatomical structure
WO2010057934A1 (fr) * 2008-11-18 2010-05-27 F Care Systems Cathéter flexible

Also Published As

Publication number Publication date
DE19737965C1 (de) 1999-05-12
EP1009305A1 (fr) 2000-06-21

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