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WO2013157208A1 - Dispositif de traitement de type à insertion vasculaire - Google Patents

Dispositif de traitement de type à insertion vasculaire Download PDF

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Publication number
WO2013157208A1
WO2013157208A1 PCT/JP2013/002286 JP2013002286W WO2013157208A1 WO 2013157208 A1 WO2013157208 A1 WO 2013157208A1 JP 2013002286 W JP2013002286 W JP 2013002286W WO 2013157208 A1 WO2013157208 A1 WO 2013157208A1
Authority
WO
WIPO (PCT)
Prior art keywords
blood vessel
treatment device
balloon
type treatment
insertion type
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/JP2013/002286
Other languages
English (en)
Japanese (ja)
Inventor
吏悟 小林
小林　淳一
杉本　良太
平原　一郎
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.)
Terumo Corp
Original Assignee
Terumo Corp
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 Terumo Corp filed Critical Terumo Corp
Publication of WO2013157208A1 publication Critical patent/WO2013157208A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • 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
    • A61N7/022—Localised ultrasound hyperthermia intracavitary
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22051—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • A61B2017/22055—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation with three or more balloons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/22—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22051—Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation
    • A61B2017/22065—Functions of balloons
    • A61B2017/22071—Steering
    • 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
    • A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
    • A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00214—Expandable means emitting energy, e.g. by elements carried thereon
    • A61B2018/0022—Balloons
    • 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
    • A61B2018/00434—Neural system
    • 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
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/00595—Cauterization
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N2007/0004—Applications of ultrasound therapy
    • A61N2007/0021—Neural system treatment
    • A61N2007/003—Destruction of nerve tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N2007/0056—Beam shaping elements
    • A61N2007/006—Lenses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N2007/0056—Beam shaping elements
    • A61N2007/0069—Reflectors

Definitions

  • the present invention relates to a blood vessel insertion type treatment device, and particularly to a blood vessel insertion type treatment device that can be inserted into a blood vessel and cauterize a living tissue around the blood vessel from inside the blood vessel.
  • a blood vessel insertion type treatment device capable of cauterizing a living tissue around a blood vessel such as a renal artery sympathetic nerve around the renal artery while suppressing damage to the blood vessel.
  • a blood vessel insertion type treatment device includes: An elongated insertion tube having a proximal end and an insertion end at both ends; A first ultrasonic transducer that is provided near the insertion end in the insertion tube and emits ultrasonic waves for cauterization in a specific direction; An acoustic mirror is provided in a specific direction from the first ultrasonic transducer in the insertion tube and reflects the ablation ultrasonic waves in a direction different from the longitudinal direction of the insertion body.
  • the ultrasonic waves for cauterization generated by the first ultrasonic transducer are reflected by the acoustic mirror in a direction different from the longitudinal direction. Therefore, it is possible to cauterize living tissue in the direction of reflection by the acoustic mirror. Since ultrasonic waves are used for cauterization of a living tissue, it is possible to suppress damage to blood vessels or the like interposed between the first ultrasonic transducer and the ablation target tissue.
  • the blood vessel insertion type treatment device configured as described above, it is possible to suppress damage to blood vessels when removing living tissue around the blood vessels.
  • FIG. 2 is an enlarged view of the vicinity of a renal artery in which a guiding catheter is inserted in FIG. 1. It is sectional drawing along the longitudinal direction of the insertion end vicinity of the blood vessel insertion type treatment device of 1st Embodiment. It is a perspective view of the acoustic balloon lens for demonstrating the structure of an acoustic balloon lens. It is sectional drawing along the longitudinal direction of the insertion end vicinity of the blood vessel insertion type treatment device of 2nd Embodiment.
  • FIG. 6 is an enlarged view of the vicinity of a renal artery in which a guiding catheter is inserted in FIG.
  • FIG. 5 It is sectional drawing along the longitudinal direction of the insertion end vicinity of the blood vessel insertion type treatment device of 3rd Embodiment. It is a figure which shows the 1st modification of a mesh balloon.
  • FIG. 9 is a cross-sectional view taken along line IX-IX in FIG. It is a figure which shows the 2nd modification of a mesh balloon.
  • FIG. 11 is a cross-sectional view taken along line XI-XI in FIG. 10.
  • FIG. 1 is a diagram for explaining a technique for removing a renal artery sympathetic nerve using the blood vessel insertion type treatment device according to the first embodiment of the present invention.
  • the operator inserts the guiding catheter 200 from the patient's thigh into the femoral artery FA in advance and allows the distal end of the guiding catheter 200 to reach the renal artery RA.
  • a guide wire (not shown) is used for reaching the guiding artery 200 to the renal artery RA.
  • the guiding catheter 200 is tubular, and a device for diagnosis and treatment can be inserted.
  • the blood vessel insertion type treatment device 100 is generally string-shaped, has an insertion end and a proximal end, and can be inserted into the lumen of the guiding catheter 200 from the insertion end.
  • the surgeon inserts the blood vessel insertion type treatment device 100 into the guiding catheter 200 and causes the insertion end to protrude from the guiding catheter 200 (see FIG. 2).
  • the acoustic balloon lens 101 provided in the vicinity of the insertion end of the blood vessel insertion type treatment device 100 is expanded to fix the blood vessel insertion type treatment device 100 in the renal artery RA.
  • the blood vessel insertion type treatment device 100 has an imaging function and an ablation function.
  • the blood vessel insertion type treatment device 100 can emit imaging ultrasound IUS. The surgeon executes an imaging function of the inserted blood vessel insertion type treatment device 100 to acquire an image around the renal artery from the renal artery RA.
  • the surgeon discriminates the sympathetic nerve SN to be cauterized based on the acquired image, and adjusts the position of the blood vessel insertion type treatment device 100 so that the cauterized ultrasound CUS is irradiated to the discriminated sympathetic nerve SN. . After the position adjustment, the surgeon performs the cauterization function of the blood vessel insertion type treatment device 100 to cauterize the desired sympathetic nerve SN.
  • the blood vessel insertion type treatment device 100 includes an insertion tube 102, a first ultrasonic transducer 103, an acoustic mirror 104, a torque transmission body 105, an image acquisition unit 106, an acoustic balloon lens 101 (see FIG. 2), and the like. Is done.
  • the insertion tube 102 is formed of a member having acoustic properties and flexibility.
  • the end of the insertion tube 102 on the insertion end side is open.
  • the inside of the insertion tube 102 is filled with a medium having acoustic transmission properties from the base end side.
  • the first ultrasonic transducer 103 is provided in the vicinity of the insertion end in the insertion tube 102.
  • the first ultrasonic transducer 103 has a disk shape and emits an ablation ultrasonic wave CUS in a direction perpendicular to the plate surface.
  • the first ultrasonic transducer 103 is fixed in the insertion tube 102 such that the ultrasonic wave CUS for cauterization is emitted toward the proximal end and the plate surface is perpendicular to the longitudinal direction of the insertion tube 102.
  • the distance for transmitting ultrasonic waves and the amount of heat generated at the position where the ultrasonic waves converge are determined by the frequency. Therefore, the frequency of the ultrasound CUS for cauterization is determined in advance based on the approximate interval from the inside of the renal artery RA to the renal artery sympathetic nerve SN and the amount of heat generated for cauterization of the sympathetic nerve SN.
  • a signal line extending from the first ultrasonic transducer 103 to the proximal end is connected to an ablation control unit (not shown).
  • the ablation control unit supplies a drive signal to the first ultrasonic transducer 103 so as to generate the ablation ultrasonic wave CUS at the above-described frequency.
  • the acoustic mirror 104 is provided in the insertion tube 102 on the proximal side with respect to the first ultrasonic transducer 103.
  • the acoustic mirror 104 has a conical shape and has a reflecting surface on the side surface.
  • the acoustic mirror 104 is fixed in the insertion tube 102 so that the bottom surface of the acoustic mirror 104 is perpendicular to the longitudinal direction of the insertion tube 102 and the apex faces the insertion end side.
  • the ablation ultrasonic wave CUS1 emitted from the first ultrasonic transducer 103 is surrounded by the acoustic mirror 104 in the longitudinal direction of the insertion tube 102. (Refer to reference sign “CUS2”).
  • the torque transmission body 105 is formed by a flexible member so as to extend from the vicinity of the proximal end of the insertion tube 102 to the insertion end. With the insertion end of the torque transmission body 105 reaching the bottom surface of the acoustic mirror 104 of the insertion tube 102, the proximal end of the torque transmission body 105 protrudes from the proximal end of the insertion tube 102.
  • the outer diameter of the torque transmission body 105 is determined to be smaller than the inner diameter of the insertion tube 102, and the torque transmission body 105 is rotatable within the insertion tube 102 about the longitudinal direction. Therefore, when torque that rotates about the longitudinal direction is supplied to the proximal end of the torque transmission body 105, the supplied torque is transmitted to the insertion end of the torque transmission body 105, and the entire torque transmission body 105 is transferred into the insertion tube 102. Rotate. Further, the torque transmission body 105 is freely displaceable along the longitudinal direction in the insertion tube 102.
  • the image acquisition unit 106 is provided in the vicinity of the insertion end of the torque transmission body 105.
  • the image acquisition unit 106 has a single imaging ultrasonic transducer 107.
  • the imaging ultrasonic transducer 107 is arranged so as to emit ultrasonic waves in a direction inclined by a predetermined angle from the direction perpendicular to the longitudinal direction of the torque transmitting body 105 to the insertion end side.
  • the imaging ultrasonic transducer 107 From the imaging ultrasonic transducer 107, it is possible to generate imaging ultrasonic IUS suitable for image acquisition.
  • the imaging ultrasonic transducer 107 generates a pixel signal corresponding to the reflected wave of the imaging ultrasonic IUS.
  • the resolution due to the reflected wave of the ultrasonic wave varies depending on the frequency.
  • the frequency of the imaging ultrasound IUS is determined in advance based on the resolution necessary for confirmation and diagnosis of the position of a specific sympathetic nerve.
  • a signal line extending from the imaging ultrasonic transducer 107 to the base end is connected to an imaging control unit (not shown).
  • the imaging control unit supplies a drive signal to the imaging ultrasonic transducer 107 so as to generate the imaging ultrasonic IUS at the above-described frequency.
  • the imaging control unit receives a pixel signal generated by the imaging ultrasonic transducer 107.
  • the imaging control unit creates an image based on pixel signals corresponding to a number of locations irradiated with imaging ultrasonic waves.
  • the irradiation position of the imaging ultrasonic waves can be determined by detecting the rotational position of the torque transmission body 105 and the displacement position along the longitudinal direction using an encoder or a position sensor, and is used for creating an image.
  • the acoustic balloon lens 101 is provided in the insertion tube 102 in the vicinity of the position where the acoustic mirror 104 is disposed.
  • the blood vessel insertion type treatment device 100 can be fixed in the blood vessel.
  • the acoustic balloon lens 101 has a double structure having an inner balloon 108 and an outer balloon 109. Different media are used to inflate the inner balloon 108 and the outer balloon 109, respectively. As the medium of the inner balloon 108, an object having an ultrasonic transmission speed smaller than that of the medium of the outer balloon 109 is used.
  • the ultrasonic wave CUS for cauterization reflected by the acoustic mirror 104 has the passage distance of the inner balloon 108 and the passage distance of the outer balloon 109 depending on the reflection position from the top side to the bottom side of the acoustic mirror 104. change. Therefore, the inner balloon 108 and the outer balloon 109 are formed so as to be able to converge the ultrasonic wave at a convergence position separated from the insertion tube 102 by a predetermined distance. The approximate distance from the renal artery to the renal artery sympathetic nerve is determined as a predetermined distance.
  • the blood vessel insertion type treatment device 100 of the first embodiment configured as described above, it is possible to maximize the heat generation energy at the convergence position of the ablation ultrasonic waves. Therefore, while it is possible to cauterize living tissue distributed from the inside of the blood vessel to the outside of the blood vessel, it is possible to suppress damage to the blood vessel interposed between the living tissue.
  • the blood vessel insertion type treatment device 100 of the first embodiment by using the conical acoustic mirror 104, an ultrasonic wave for ablation emitted from the first ultrasonic transducer 103 in a specific direction is inserted into the insertion tube. 102 can be reflected to the surroundings. Therefore, it is possible to easily cauterize an object extending in an annular shape or an arc shape outside the blood vessel without rotating the insertion tube 102.
  • the acoustic balloon lens 101 is used to fix the blood vessel insertion type treatment device 100 in the blood vessel and converge the ablation ultrasonic wave at a predetermined distance. Is feasible. Therefore, it is possible to reduce the number of components compared to the case where separate balloons and acoustic lenses are used.
  • the image acquisition unit 106 is provided in the vicinity of the first ultrasonic transducer 103, confirmation of a living tissue to be ablated, and ablation status Confirmation is easy.
  • the second embodiment is different from the first embodiment in that a cylindrical acoustic lens and a mesh balloon are used without using the acoustic balloon lens 101.
  • the second embodiment will be described below with a focus on differences from the first embodiment.
  • symbol is attached
  • the blood vessel insertion type treatment device 1000 includes an insertion tube 102, a first ultrasonic transducer 103, an acoustic mirror 104, a torque transmission body 105, an image acquisition unit 106, and a cylindrical acoustic device.
  • a lens 1100 and a mesh balloon 1110 are included.
  • the configurations and functions of the insertion tube 102, the first ultrasonic transducer 103, the acoustic mirror 104, the torque transmission body 105, and the image acquisition unit 106 are the same as those in the first embodiment.
  • the cylindrical acoustic lens 1100 has a cylindrical side surface on the inner surface and a concave surface in the cylinder height direction on the outer surface. Therefore, the cylindrical acoustic lens 1100 has a function of converging ultrasonic waves along the cylinder height direction.
  • the cylindrical acoustic lens 1100 is formed so that the length in the height direction of the cylindrical acoustic lens 1100 is longer than the length from the top to the bottom of the acoustic mirror 104.
  • the cylindrical acoustic lens 1100 is disposed in the insertion tube 102 so that the entire acoustic mirror 104 is accommodated inside the cylinder.
  • the mesh balloon 1110 is provided in the insertion tube 102.
  • the mesh balloon 1110 is provided on the base end side with respect to the image acquisition unit 106 in a state where the torque transmission body 105 reaches the bottom surface of the acoustic mirror 104.
  • the blood vessel insertion type treatment device 1000 of the second embodiment configured as described above can cauterize living tissue distributed from the inside of the blood vessel to the outside of the blood vessel. It is possible to suppress damage to blood vessels intervening between tissues. Further, similarly to the first embodiment, an object extending in an annular shape or an arc shape can be easily cauterized outside the blood vessel without rotating the insertion tube 102. In addition, as in the first embodiment, it is easy to confirm a living tissue to be ablated, a condition of ablation, and the like.
  • the vicinity of the insertion end of the blood vessel insertion type treatment device 1000 can be temporarily fixed in the blood vessel using the mesh balloon 1110. Further, since the mesh balloon 1110 is used, blood flow can be secured, and overheating of the inner wall of the blood vessel that irradiates the ultrasound CUS for cauterization while fixing the blood vessel insertion type treatment device 1000 in the blood vessel can be prevented. It is.
  • a blood vessel insertion type treatment device according to a third embodiment of the present invention will be described.
  • the configuration of the acoustic mirror is different from that of the first embodiment.
  • the third embodiment will be described below with a focus on differences from the first embodiment.
  • symbol is attached
  • the blood vessel insertion type treatment device 1001 of the third embodiment includes an insertion tube 102, a first ultrasonic transducer 1031, an acoustic mirror 1041, a torque transmission body 1051, an image acquisition unit 106, and a mesh.
  • a balloon 1110 (see FIG. 6) and the like are included.
  • the configurations and functions of the insertion tube 102 and the image acquisition unit 106 are the same as those in the first embodiment.
  • the configuration and function of the mesh balloon 1110 are the same as those in the second embodiment.
  • the function of the first ultrasonic transducer 1031 is the same as that of the first embodiment. Unlike the first embodiment, the first ultrasonic transducer 1031 is provided in the torque transmission body 1051. A hollow h is formed in the torque transmission body 1051 in the vicinity of the insertion end, and the first ultrasonic transducer 1031 is provided in the hollow h.
  • the first ultrasonic transducer has a disk shape, emits the cauterization ultrasonic wave CUS on the base end side, and the plate surface is perpendicular to the longitudinal direction of the torque transmitting body 1051. So that it is fixed in the hollow h.
  • the acoustic mirror 1041 is provided closer to the base end side than the first ultrasonic transducer 1031 in the hollow h.
  • the acoustic mirror 1041 is a concave acoustic mirror whose reflecting surface is concave.
  • the acoustic mirror 1041 is fixed in the hollow h so that the ultrasonic waves for cauterization emitted from the first ultrasonic transducer 1031 in the proximal direction are reflected in a direction perpendicular to the longitudinal direction.
  • the torque transmission body 1051 has a hollow h in the vicinity of the insertion end.
  • the first ultrasonic transducer 1031 and the acoustic mirror 1041 are provided in the hollow h.
  • the hollow h is filled with the ultrasonic transmission substance in a state where the first ultrasonic transducer 1031 and the acoustic mirror 1041 are fixed.
  • the ultrasonic transmission material is a material that can reduce propagation loss compared to air and can reduce reflection at the interface with the insertion tube 102, and examples thereof include saline and resin.
  • the function and configuration of the torque transmission body 1051 other than the hollow h formed and filled with the ultrasonic transmission material are the same as those in the first embodiment.
  • the blood vessel insertion type treatment device 1001 of the third embodiment configured as described above can cauterize living tissue distributed from the inside of the blood vessel to the outside of the blood vessel. It is possible to suppress damage to blood vessels intervening between tissues. In addition, as in the first embodiment, it is easy to confirm a living tissue to be ablated, a condition of ablation, and the like.
  • the vicinity of the insertion end of the blood vessel insertion type treatment device 1001 is temporarily fixed in the blood vessel using the mesh balloon 1110 as in the second embodiment. Is possible. Further, since the mesh balloon 1110 is used, it is possible to prevent overheating of the inner wall portion of the blood vessel that irradiates the ultrasound CUS for cauterization while fixing the blood vessel insertion type treatment device 1001 in the blood vessel.
  • the blood vessel insertion type treatment device 1001 of the third embodiment it is possible to change the irradiation position of the ultrasonic CUS for cauterization using the torque transmission body 1051.
  • the ultrasonic wave In ablation of a living tissue using an ultrasonic transducer, the ultrasonic wave is converged to the focal point, so that the region that can be cauterized is only near the focal point.
  • it is possible to rotate the blood vessel insertion type treatment device 1001 as a whole it is necessary to release the fixation by the mesh balloon 1110, which requires a complicated procedure.
  • the torque transmission body 1051 can be rotated manually or automatically.
  • the conical acoustic mirror 104 is provided in the first and second embodiments, it may be a cone-shaped acoustic mirror.
  • the mesh balloon 1110 is provided, but the blood vessel insertion type treatment devices 1000 and 1001 are temporarily fixed in the blood vessel using other balloons.
  • a possible configuration may be used.
  • a balloon that prevents overheating of the inner wall of the blood vessel is preferable.
  • the same overheating prevention effect as that of the mesh balloon 1110 can be obtained by a configuration having a plurality of balloons 112 that can be expanded in different directions around the insertion tube 102.
  • the mesh balloon 1110 may be configured to include a balloon 113 that is inflatable around the insertion tube 102 and has a hole OH that penetrates in the longitudinal direction. It is possible to obtain the same effect of preventing overheating.
  • the same overheating prevention effect as that of the mesh balloon 1110 can be obtained by the configuration having the balloon 114 formed so that the cross section along the plane perpendicular to the longitudinal direction has a star shape. Is possible.
  • the same overheating prevention effect as that of the mesh balloon 1110 can be obtained also by a configuration in which the balloon 116 is partially inflated using a plurality of wires 115.
  • a perfusion balloon or a cryoballoon that can cool the inner wall of the blood vessel using a refrigerant.
  • cauterization using ultrasonic waves it is possible to maximize the heat generation energy at the focal point, but the blood vessel walls including the inner wall of the blood vessel that propagates the ultrasonic waves before convergence can also generate heat due to the ultrasonic waves. Therefore, it is possible to further reduce the possibility of damage that can occur on the inner wall of the blood vessel by using a cooled balloon.
  • the image acquisition unit 106 is configured to acquire an image using ultrasonic waves, but acquires an image based on optical information such as TD-OCT and HUD-OCT. It may be a configuration.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
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PCT/JP2013/002286 2012-04-20 2013-04-02 Dispositif de traitement de type à insertion vasculaire Ceased WO2013157208A1 (fr)

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JP2012097101 2012-04-20
JP2012-097101 2012-04-20

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10293190B2 (en) 2002-04-08 2019-05-21 Medtronic Ardian Luxembourg S.A.R.L. Thermally-induced renal neuromodulation and associated systems and methods
US10335280B2 (en) 2000-01-19 2019-07-02 Medtronic, Inc. Method for ablating target tissue of a patient
US10589130B2 (en) 2006-05-25 2020-03-17 Medtronic, Inc. Methods of using high intensity focused ultrasound to form an ablated tissue area containing a plurality of lesions

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JP2001079016A (ja) * 1999-07-13 2001-03-27 Terumo Corp 加熱治療装置
JP2002017743A (ja) * 2000-07-03 2002-01-22 Olympus Optical Co Ltd 加熱治療装置
JP2003506132A (ja) * 1999-08-05 2003-02-18 ブロンカス テクノロジーズ， インコーポレイテッド 肺中に側副チャネルを作製するための方法およびデバイス
JP2004503324A (ja) * 2000-07-13 2004-02-05 トランサージカル，インコーポレイテッド 膨張性環状レンズによるエネルギー付与装置
JP2004290548A (ja) * 2003-03-28 2004-10-21 Toshiba Corp 画像診断装置、診断・治療装置及び診断・治療方法
JP2009536870A (ja) * 2006-05-12 2009-10-22 ビトロンユーエス， インコーポレイテッド 身体組織を切除するためのデバイス
JP2011528580A (ja) * 2008-07-18 2011-11-24 バイトロナス， インコーポレイテッド 組織にエネルギーを送達するシステムおよび方法

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH1085221A (ja) * 1996-05-31 1998-04-07 Hewlett Packard Co <Hp> 超音波プローブ
JP2001079016A (ja) * 1999-07-13 2001-03-27 Terumo Corp 加熱治療装置
JP2003506132A (ja) * 1999-08-05 2003-02-18 ブロンカス テクノロジーズ， インコーポレイテッド 肺中に側副チャネルを作製するための方法およびデバイス
JP2002017743A (ja) * 2000-07-03 2002-01-22 Olympus Optical Co Ltd 加熱治療装置
JP2004503324A (ja) * 2000-07-13 2004-02-05 トランサージカル，インコーポレイテッド 膨張性環状レンズによるエネルギー付与装置
JP2004290548A (ja) * 2003-03-28 2004-10-21 Toshiba Corp 画像診断装置、診断・治療装置及び診断・治療方法
JP2009536870A (ja) * 2006-05-12 2009-10-22 ビトロンユーエス， インコーポレイテッド 身体組織を切除するためのデバイス
JP2011528580A (ja) * 2008-07-18 2011-11-24 バイトロナス， インコーポレイテッド 組織にエネルギーを送達するシステムおよび方法

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