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WO2001082778A2 - Systeme d'ablation a visualisation - Google Patents

Systeme d'ablation a visualisation Download PDF

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Publication number
WO2001082778A2
WO2001082778A2 PCT/US2001/013549 US0113549W WO0182778A2 WO 2001082778 A2 WO2001082778 A2 WO 2001082778A2 US 0113549 W US0113549 W US 0113549W WO 0182778 A2 WO0182778 A2 WO 0182778A2
Authority
WO
WIPO (PCT)
Prior art keywords
transducers
catheter
providing
adjacent
distal end
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/US2001/013549
Other languages
English (en)
Other versions
WO2001082778A3 (fr
Inventor
Narendra T. Sanghvi
Michael H. Phillips
Francis J. Fry
Ralf Seip
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.)
Focus Surgery Inc
Original Assignee
Focus Surgery Inc
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 Focus Surgery Inc filed Critical Focus Surgery Inc
Priority to AU2001257328A priority Critical patent/AU2001257328A1/en
Publication of WO2001082778A2 publication Critical patent/WO2001082778A2/fr
Publication of WO2001082778A3 publication Critical patent/WO2001082778A3/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
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4416—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to combined acquisition of different diagnostic modalities, e.g. combination of ultrasound and X-ray acquisitions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
    • A61B8/445—Details of catheter construction
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
    • A61B8/4483—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device characterised by features of the ultrasound transducer
    • A61B8/4488—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device characterised by features of the ultrasound transducer the transducer being a phased array
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N7/02—Localised ultrasound hyperthermia
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00163—Optical arrangements
    • A61B1/00165—Optical arrangements with light-conductive means, e.g. fibre optics
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/06—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements
    • A61B1/07—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor with illuminating arrangements using light-conductive means, e.g. optical fibres
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/307—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor for the urinary organs, e.g. urethroscopes, cystoscopes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00084—Temperature
    • A61B2017/00092—Temperature using thermocouples
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/10—Trunk
    • A61M2210/1078—Urinary tract
    • A61M2210/1085—Bladder
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/16—Male reproductive, genital organs
    • A61M2210/166—Prostate
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/02—Holding devices, e.g. on the body
    • A61M25/04—Holding devices, e.g. on the body in the body, e.g. expansible
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N2007/0078—Ultrasound therapy with multiple treatment transducers

Definitions

  • This invention relates to medical treatment with ultrasound. It is disclosed in the context of a system for the treatment of prostate disease, but is believed to be useful in other applications as well.
  • the region of a catheter, such as a urological catheter, adjacent the remote end of the catheter is provided with one or more small ultrasound transducers capable of transmitting sufficient power at appropriate frequencies in one or more modes of operation for ultrasound visualization and high intensity focused ultrasound (HL U) therapy.
  • a catheter such as a urological catheter
  • HL U high intensity focused ultrasound
  • the therapeutic ultrasound is at frequencies and powers capable of achieving treatment by one or the other or both of HIFU-induced tissue ablation and cavitation.
  • treated tissue is reabsorbed by the body over a relatively longer period of time.
  • treated tissue is mechanically destroyed.
  • a mechanism such as a flushing fluid flow or irrigation with or without a continuous vacuum assist, is provided to remove the debris occasioned by the cavitation debridement.
  • a flushing fluid flow may be directed into the body of the patient undergoing treatment, for example, toward the bladder of a patient undergoing treatment of the prostate, for example, to flush debris into the bladder.
  • the tissue debris may, for example, then be removed during treatment with or without the application of a vacuum, or after treatment when the patient's bladder is voided.
  • the visualization may be optical, for example, by providing an optical fiber in the catheter and providing a light source adjacent the distal end of the optical fiber, that is, the end inside the urethra.
  • the light source may be, for example, a second optical fiber provided with light from a source at the proximal end of the catheter, or may be a light emitting diode (LED) adjacent the distal end of the catheter powered by an electrical source at the proximal end of the catheter via conductors which extend along the length of the catheter from its proximal end to its distal end.
  • LED light emitting diode
  • the visualization may be by means of one or more of the ultrasound transducers driven in, for example, a pulse-echo mode to provide (an) ultrasound image(s) of the progress of the treatment.
  • the ultrasound image(s) can be converted by known techniques into (a) video image(s).
  • Such visualization mechanisms permit the progress of the treatment to be monitored, regardless of the mechanism of treatment.
  • the catheter can be of any of a number of suitable types, including catheters with stiffening members, braided catheters and catheters with braided sheaths to permit the transmission of torque down the length of the catheter. This aids in the manipulation of the remote end of the catheter, including the transducer(s) into various orientations necessary for effective visualization and therapy.
  • a device is provided adjacent the or each transducer for monitoring the temperature adjacent the or each transducer.
  • the temperature monitoring device includes a thermocouple oriented adjacent the or each transducer.
  • Fig. 1 illustrates a partly fragmentary sectional side elevational, partly block and partly schematic diagram of a detail of a system constructed according to the invention in place for HIFU and/or cavitation-inducing treatment of a prostate;
  • Fig. 2 illustrates a partly fragmentary view of a detail of another system constructed according to the invention;
  • Fig. 3 illustrates a block diagram of a detail of a system constructed according to the invention
  • Fig. 4 illustrates a partly block and partly schematic diagram of a detail of another system constructed according to the invention
  • Fig. 5 illustrates a partly block and partly schematic diagram of a detail of another system constructed according to the invention
  • Fig. 6 illustrates a partly block and partly schematic diagram of a cross-section taken along lines 6-6 of Fig. 4
  • Fig. 7 illustrates a partly block and partly schematic diagram of a cross-section of a detail of another system constructed according to the invention
  • Fig. 8 illustrates a detail of another system constructed according to the invention.
  • Fig. 9 illustrates a detail of another system constructed according to the invention. Detailed Descriptions of Illustrative Embodiments
  • transurethral catheters 10 are provided for use in patients suffering from benign prostate hyperplasia (BPH) or prostate cancer.
  • Fig. 1 illustrates a lower portion of a bladder 12, a bladder neck 14, and an upper portion of a urethra 16 of such a patient.
  • the patient's diseased prostate tissue 18 can grow into the bladder 12.
  • the catheters 10 can be constructed from, for example, live or synthetic rubber or other materials from which urological catheters are customarily constructed.
  • Catheter 10 includes a proximal end 20 and a distal end 22. As illustrated in Fig.
  • catheter 10 may include a balloon 24 located at the distal end 22 to aid in positioning the catheter 10 relative to the prostate tissue 18.
  • Catheter 10 further includes one or more lumens, as best illustrated in Figs. 6-7, for the various services which are delivered in any given catheter 10 to its distal end 22, and for any signals, material, and so on, which is returned to its proximal end 20.
  • a number, illustratively three or four, of small ultrasound transducers 30 are provided adjacent the distal end 22 of catheter 10.
  • Catheter 10 is sufficiently ruggedly constructed to permit manipulation of the transducers 30 into the orientations necessary to treat the prostate 18 in the manner which will be described. Once properly positioned, the transducers 30 are excited through appropriate electrical conductors which extend through a lumen 26.
  • the proximal end 20 of catheter 10 is provided for attachment through a coupler 32 (illustrated diagrammatically) to one or more of the various services, such as a light source 34 (illustrated diagrammatically), an electric power source 36 (illustrated diagrammatically), and a cooling and irrigating fluid source 38 (illustrated diagrammatically), and a monitor 46 (illustrated diagrammatically), which may be necessary or desirable for conducting and monitoring the progress of a treatment using the catheter 10.
  • the light source 34 may be, for example, a lamp (not shown).
  • the lamp is adapted to provide light to a fiber optic waveguide 40 (see, for example, Figs.
  • the monitor 46 converts the returned image into a display for use by the treating physician in monitoring the progress of the treatment.
  • the light source 34 can also be a power supply coupled by electrical conductors through, for example, lumen 26 of the catheter 10 to an LED positioned, for example, where lens 48 is positioned in Fig. 2, adjacent the distal end 22 of the catheter 10, to illuminate the treatment field and provide sufficient reflections to be transmitted via lens 44 and waveguide 42 to monitor 46.
  • the monitor system 44, 42, 46 could also be, for example, a solid state imaging device, such as a charge coupled device, or the like, or any other suitable mechanism for producing on the monitor 46 a suitably high resolution image of the progress of treatment.
  • a region 50 of the catheter 10 adjacent the distal end 22 of the catheter 10 is provided with a number, illustratively three or four, of small ultrasound transducers 30 capable of transmitting sufficient power at appropriate frequencies for ultrasound visualization and therapy.
  • the transducers 30 are best illustrated in Figs. 2, 4, 6 and 7.
  • the transducers 30 lie adjacent each other in an array extending along the longitudinal extent of the catheter 10.
  • conductors 54 through which each transducer 30 can be separately controlled extend through lumen 26.
  • the transducers) 30 may be of the types illustrated and described in U.S. Patent No. 5,117,832 or WO 99/49788, or any other suitable type.
  • the therapeutic ultrasound is at frequencies and powers capable of achieving treatment by one or both of cavitation-induced tissue destruction and high intensity focused ultrasound hyperthermia (HIFU).
  • HIFU high intensity focused ultrasound hyperthermia
  • Treatment of, for example, diseased prostate tissue 18, with HLFU results in necrosis of the treated prostate tissue 18 with the ultimate result that the treated tissue 18 is reabsorbed and/or discarded by the body over a period of several weeks to several months.
  • Focal points 58 are the geometric foci of the transducers 30 illustrated in Fig. 2. By movement of the catheter 10, the focal points 58 of each transducer 30 may be moved for treatment of other areas of the diseased prostate tissue 18.
  • the drive signals to the transducers 30 can be phased in known manner to vary the effective focus of the array of transducers 30. Further, if segmented transducers 30 of the type illustrated in, for example, WO 99/49788 are used in some one or more of the illustrated positions, the effective focus of each such segmented transducer 30 can be altered by appropriately phasing the drive signals to the various segments of that respective transducer, and the composite focus of the array of transducers 30 can be altered as well.
  • the net effect of effective HIFU treatment of diseased prostate tissue 18 is that the patient experiences progressively better and better urine flow over the period while reabsorption of the necrosed tissue progresses until all of the necrosed prostate tissue 18 has finally been reabsorbed and recovery is complete.
  • thermocouple(s) 60 illustrated in Fig. 4 can be provided adjacent the transducer(s) 30 for monitoring the temperatures adjacent the transducer(s) 30. This feedback can be helpful in treatment, but is also helpful to prevent damage to the transducer(s) 30 due to overheating.
  • the conductors for coupling the thermocouples 60 to the control system for the transducers 30 can be provided along with conductors 54 in lumen 26. Different ultrasound transducer excitation frequencies and powers can be employed which promote cavitation as the treatment modality, rather than HIFU.
  • Cavitation is ordinarily conducted at somewhat lower excitation powers and frequencies, with frequencies typically ranging in the hundreds of kilohertz and powers in the watts per square centimeter to tens of watts per square centimeter range, as opposed to HIFU which is ordinarily conducted at frequencies ranging in the megahertz and powers in the hundreds of watts to kilowatts per square centimeter over short duty cycles.
  • the treated prostate tissue 18 is mechanically debrided by the formation and bursting of gas, for example, oxygen, nitrogen and the like, bubbles which fo ⁇ n in the liquids, for example, blood and water, present in the tissue 18.
  • Cavitation can also be promoted by "seeding," for example, by irrigating the treatment site with, for example, carbonated water instead of degassed water, or mixed with degassed water.
  • the resulting tissue debris may remain at the debridement site. However, leaving the tissue debris there may result in further complications, and so, the catheter 10 may be provided with a mechanism for removal of the debris.
  • One such mechanism is a lumen 62 in the catheter 10 coupled at its proximal end 20 to the cooling and irrigating fluid source 38.
  • This source 38 may be, for example, a source of degassed water maintained at a temperature that permits its use not only as an irrigation medium for the treatment site, but also as a cooling medium for the transducer(s) 30.
  • the catheter 10 can be so configured that the medium flows over the transducer(s) 30, cooling it (them).
  • the irrigation cooling medium also picks up debris and flushes the debris away, for example, through another lumen 66 provided in the catheter 10, or via the urethra 16 to the bladder 12, from which the debris may contemporaneously or later be evacuated, for example, by the application of a vacuum at the proximal end of a lumen 68, or by the patient emptying his bladder 12.
  • lumen 68 is provided in the catheter 10 for the evacuation of the debris-laden irrigation/cooling medium, this lumen 68 can be provided with a continuous vacuum 70 to assist in the removal of debris occasioned by the cavitation debridement.
  • the catheter 10's own visualization mechanism of the type described above, or a mechanism of the type described in, for example, the above referenced WO 99/49788, or X-ray or the like, may be used to determine the orientation of the transducer(s) 30 at the treatment site. Visualization can also be achieved by driving the ultrasound transducer(s) 30 in a pulse-echo mode to provide an ultrasound image of the progress of the treatment. The ultrasound image can be converted by l nown techniques into a video image on monitor 46. Such visualization mechanisms can permit the progress of the treatment to be monitored and controlled, regardless of the mechanism of treatment.
  • a switch 72 is provided to switch the power source, which may be, for example, a Focus Surgery, Inc., SonablateTM model 500TM ultrasound driver/receiver, for driving the transducer(s) 30 from a therapy power source 74, which may be either a cavitation inducing power and frequency power source or a HLFU therapy power source, as previously discussed, to a pulse-echo mode power supply 76 which sends out high frequency visualization pulses into the tissue 18 being treated, receives the echoes from the tissue 18, and then converts the received echoes into one or more images in one or more known formats, for example, A mode, B mode, M mode, and so on, of the tissue 18 under treatment for display on the monitor 46.
  • a therapy power source 74 which may be either a cavitation inducing power and frequency power source or a HLFU therapy power source, as previously discussed
  • a pulse-echo mode power supply 76 which sends out high frequency visualization pulses into the tissue 18 being treated, receives the echoes
  • a feedback loop incorporating, for example, a PC can also be employed to modulate the power supplied to the transducer(s) 30 as a result of the visualized progress of the treatment.
  • a PC (not shown)
  • standard beamforming techniques can be used to generate true two dimensional (2-D) images.
  • the transducer(s) 30 itself may be (a) non-segmented type, as shown in Figs. 2, 4, and 6, or a segmented type as illustrated in the above- identified WO 99/49788, or a segmented transducer 130, as shown, for example, in Fig. 5.
  • thermocouples 60 illustrated in Fig. 4 may also be provided for each segment, or for a group of segments, of the segmented transducer 130.
  • the catheter 10 can be of any of a number of suitable types.
  • One such type may include braided catheters and those with braided sheaths to permit the transmission of torque down the length of the catheter 10. This aids in the manipulation of the distal end 22 of the catheter 10 into various orientations necessary for effective visualization and therapy.
  • a stiffening member 80 such as, for example, a thin metal strip, can be provided to transmit torque from the proximal end 20 to the distal end 22 of the catheter 10. By driving member 80, transducer(s) 30, 130 can be reaimed in order to treat a different tissue 18 volume.
  • the transducer(s) can also serve as a ground conductor for the transducer(s) 30, 130, the light source 48 (if an LED at the distal end 22 is used as the light source), and so on.
  • a lumen 82 is also provided for inflating fluid for the balloon 24 if the catheter 10 is provided with a balloon 24.
  • the transducer(s) may also be (a) cylindrical, or part-cylindrical, type(s), which is (are) unfocused, for example, when the treatment modality is cavitation.
  • Transducer 140 illustrated in Fig. 8 is cylindrical in shape and is used with the catheter 10 in the cavitation mode.
  • Transducer 140 is cylindrical in shape, the wave which is produced by it propagates radially outward in all directions from its axis.
  • Transducer 142 illustrated in Fig. 9 can also be used for cavitation.
  • Transducer 142 has a part-circular, or sectoral, cross- section which can be used to propagate a cavitating ultrasound wave radially outward from its axis through a somewhat pie-shaped sector of tissue.
  • the ultrasound wave produced by transducer 142 is similarly unfocused.
  • the transducers 140, 142 will typically extend coaxially with the catheter 10, but that is not essential to practice the invention. Fig.
  • FIG. 7 illustrates another catheter cross sectional configuration, h this configuration, a catheter 10 is closed in the region 50 of the catheter 10 where the transducer(s) 30, 130, 140, 142 is (are) mounted.
  • a cavity 144 is thus provided for the transducer(s) 30, 130, 140, 142.
  • This mechanically isolates the transducer(s) 30, 130, 140, 142 somewhat from the tissue 18, providing some greater measure of protection for both the catheter 10 and tissue 18 from unintended damage by the other.
  • the covering over the transducer(s) 30, 130, 140, 142 in region 50 is of a type that permits propagation of the HIFU through it with minimal attenuation and minimal distortion of the ultrasound beam.
  • the cooling fluid flows from source 38 through a lumen as described above to the cavity 144. If the same cooling fluid is to be used for irrigation, of course, openings (not shown) can be provided for the flow of the fluid from the cavity 144 outward into the urethra 16 and/or the bladder 12.
  • the cooling fluid runs through cavity 144 over transducer(s) 30, 130, 140, 142, and, where it is (they are) present, thermocouple(s) 60 in order to maintain the temperature(s) of the transducer(s) 30, 130, 140, 142 at (an) appropriate level(s).
  • the cooling and irrigation fluid, or whatever portion of it is not exhausted into the tissue 18 to flush out debrided tissue, is then removed from the catheter 10 through lumen 66.
  • thermocouple(s) 60 where an LED 48 is employed as the light source
  • lumen 82 is provided to inflate and deflate balloon 24, where balloon 24 is present.

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

Abstract

L'invention concerne un procédé de traitement des tissus, qui consiste à : (a) prévoir un cathéter (10) possédant des extrémités proximale (20) et distale (22), une lumière s'étendant entre lesdites extrémités distale et proximale, de multiples transducteurs à ultrasons (30) adjacents à l'extrémité distale (22), capables de transmettre suffisamment d'énergie pour permettre une thérapie à ultrasons concentrés de grande intensité, et un dispositif (60) conçu pour surveiller la température à proximité des transducteurs ; (b) orienter les transducteurs (30) adjacents à la zone de traitement ; (c) exciter les transducteurs (30) pour le traitement du tissu ; et (d) projeter un fluide au-dessus des transducteurs (30). L'appareil de traitement du tissu comporte le cathéter (10), le dispositif (60) de surveillance de la température à proximité des transducteurs (30), au moins un circuit d'attaque de transducteurs (74) conçu pour exciter les transducteurs (30), de manière que le tissu soit traité, et une source fournissant un flux de fluide dans la lumière et au-dessus des transducteurs (30).
PCT/US2001/013549 2000-04-28 2001-04-27 Systeme d'ablation a visualisation Ceased WO2001082778A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2001257328A AU2001257328A1 (en) 2000-04-28 2001-04-27 Ablation system with visualization

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US20031200P 2000-04-28 2000-04-28
US60/200,312 2000-04-28

Publications (2)

Publication Number Publication Date
WO2001082778A2 true WO2001082778A2 (fr) 2001-11-08
WO2001082778A3 WO2001082778A3 (fr) 2002-08-08

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WO (1) WO2001082778A2 (fr)

Cited By (58)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6719755B2 (en) 1996-10-22 2004-04-13 Epicor Medical, Inc. Methods and devices for ablation
EP1424100A1 (fr) * 2002-11-26 2004-06-02 Biosense, Inc. Dispositif pour isoler électriquement une chambre cardiaque par ultrasons
US6805129B1 (en) 1996-10-22 2004-10-19 Epicor Medical, Inc. Apparatus and method for ablating tissue
US6805128B1 (en) 1996-10-22 2004-10-19 Epicor Medical, Inc. Apparatus and method for ablating tissue
WO2005000097A2 (fr) 2003-06-10 2005-01-06 The Foundry, Inc. Procedes et appareil de traitement non invasif de la fibrillation auriculaire par des ultrasons focalises a haute intensite
US6840936B2 (en) 1996-10-22 2005-01-11 Epicor Medical, Inc. Methods and devices for ablation
US6949095B2 (en) 1996-10-22 2005-09-27 Epicor Medical, Inc. Apparatus and method for diagnosis and therapy of electrophysiological disease
US6997924B2 (en) 2002-09-17 2006-02-14 Biosense Inc. Laser pulmonary vein isolation
US7201749B2 (en) 2003-02-19 2007-04-10 Biosense, Inc. Externally-applied high intensity focused ultrasound (HIFU) for pulmonary vein isolation
US7387126B2 (en) 1996-10-22 2008-06-17 St. Jude Medical, Atrial Fibrillation Division, Inc. Surgical system and procedure for treatment of medically refractory atrial fibrillation
US7393325B2 (en) 2004-09-16 2008-07-01 Guided Therapy Systems, L.L.C. Method and system for ultrasound treatment with a multi-directional transducer
US7491171B2 (en) 2004-10-06 2009-02-17 Guided Therapy Systems, L.L.C. Method and system for treating acne and sebaceous glands
US7544163B2 (en) 2003-09-26 2009-06-09 Tidal Photonics, Inc. Apparatus and methods relating to expanded dynamic range imaging endoscope systems
US7559905B2 (en) 2006-09-21 2009-07-14 Focus Surgery, Inc. HIFU probe for treating tissue with in-line degassing of fluid
EP1874197A4 (fr) * 2005-04-12 2010-02-10 Ekos Corp Catheter ultrasonore a surface favorisant la cavitation
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