BRPI0806090A2 - sistema de força de impulso de radiação acústica baseada em catéter - Google Patents

sistema de força de impulso de radiação acústica baseada em catéter

Info

Publication number
BRPI0806090A2
BRPI0806090A2 BRPI0806090-8A BRPI0806090A BRPI0806090A2 BR PI0806090 A2 BRPI0806090 A2 BR PI0806090A2 BR PI0806090 A BRPI0806090 A BR PI0806090A BR PI0806090 A2 BRPI0806090 A2 BR PI0806090A2
Authority
BR
Brazil
Prior art keywords
acoustic radiation
catheter
radiation pulse
based acoustic
force system
Prior art date
Application number
BRPI0806090-8A
Other languages
English (en)
Inventor
Assaf Govari
Andres Claudio Altmann
Gilad Adler
Original Assignee
Biosense Webster 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 Biosense Webster Inc filed Critical Biosense Webster Inc
Publication of BRPI0806090A2 publication Critical patent/BRPI0806090A2/pt

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
    • 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
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/42—Details of probe positioning or probe attachment to the patient
    • A61B8/4245—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
    • A61B8/4254—Details of probe positioning or probe attachment to the patient involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient using sensors mounted on the probe
    • 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
    • A61B17/22004—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 using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • A61B17/2202—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 using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
    • A61B2018/0212—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument inserted into a body lumen, e.g. catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/36—Image-producing devices or illumination devices not otherwise provided for
    • A61B90/37—Surgical systems with images on a monitor during operation
    • A61B2090/378—Surgical systems with images on a monitor during operation using ultrasound
    • A61B2090/3782—Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument
    • A61B2090/3784—Surgical systems with images on a monitor during operation using ultrasound transmitter or receiver in catheter or minimal invasive instrument both receiver and transmitter being in the instrument or receiver being also transmitter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/20—Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis

Landscapes

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

Abstract

SISTEMA DE FORçA DE IMPULSO DE RADIAçãO ACúSTICA BASEADA EM CATéTER. A presente invenção refere-se a uma sonda, que inclui um elemento de ablação, o qual é configurado para realizar a ablação de tecido. A sonda também inclui um transdutor ultrassónico, localizado nas proximidades do elemento de ablação, o qual é configurado para transmitir impulsos de força de radiação acústicos (ARFIs) para o tecido, e para medir um deslocamento do tecido em resposta aos ARFIs, de modo a monitorar a ablação do tecido.
BRPI0806090-8A 2007-12-05 2008-12-05 sistema de força de impulso de radiação acústica baseada em catéter BRPI0806090A2 (pt)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US11/950,946 US10492854B2 (en) 2007-12-05 2007-12-05 Catheter-based acoustic radiation force impulse system

Publications (1)

Publication Number Publication Date
BRPI0806090A2 true BRPI0806090A2 (pt) 2009-11-17

Family

ID=40451134

Family Applications (1)

Application Number Title Priority Date Filing Date
BRPI0806090-8A BRPI0806090A2 (pt) 2007-12-05 2008-12-05 sistema de força de impulso de radiação acústica baseada em catéter

Country Status (10)

Country Link
US (1) US10492854B2 (pt)
EP (1) EP2067446A1 (pt)
JP (1) JP5627847B2 (pt)
KR (1) KR20090059044A (pt)
CN (1) CN101450004B (pt)
AU (1) AU2008255133B2 (pt)
BR (1) BRPI0806090A2 (pt)
CA (1) CA2645386A1 (pt)
IL (1) IL195715A (pt)
MX (1) MX2008015681A (pt)

Families Citing this family (48)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040082859A1 (en) 2002-07-01 2004-04-29 Alan Schaer Method and apparatus employing ultrasound energy to treat body sphincters
WO2007136566A2 (en) 2006-05-19 2007-11-29 Prorhythm, Inc. Ablation device with optimized input power profile and method of using the same
US10492854B2 (en) 2007-12-05 2019-12-03 Biosense Webster, Inc. Catheter-based acoustic radiation force impulse system
KR101060345B1 (ko) * 2008-08-22 2011-08-29 삼성메디슨 주식회사 Ａｒｆｉ를 이용하여 탄성영상을 형성하는 초음파 시스템 및 방법
US9364194B2 (en) 2008-09-18 2016-06-14 General Electric Company Systems and methods for detecting regions of altered stiffness
EP2186481A1 (en) * 2008-11-17 2010-05-19 Medison Co., Ltd. Ultrasonic probe capable of probing curved surface
US20100168568A1 (en) * 2008-12-30 2010-07-01 St. Jude Medical, Atrial Fibrillation Division Inc. Combined Diagnostic and Therapeutic Device Using Aligned Energy Beams
WO2010093603A1 (en) 2009-02-11 2010-08-19 Boston Scientific Scimed, Inc. Insulated ablation catheter devices and methods of use
JP5490235B2 (ja) 2009-06-30 2014-05-14 ボストン サイエンティフィック サイムド，インコーポレイテッド マップ及び切除のための開放洗浄ハイブリッドカテーテル
JP5690343B2 (ja) * 2009-09-15 2015-03-25 コーニンクレッカ フィリップス エヌ ヴェ 超音波診断装置、システム及び作動方法
EP3117776B1 (en) 2009-09-17 2019-01-23 Koninklijke Philips N.V. Ultrasound catheter with temperature detection at distal end
CN102596320B (zh) 2009-10-30 2016-09-07 瑞蔻医药有限公司 通过经皮超声波去肾神经治疗高血压的方法和装置
CN102958565B (zh) * 2010-06-24 2016-01-20 皇家飞利浦电子股份有限公司 在多个维度上的hifu治疗的实时监测和控制
US8727995B2 (en) * 2010-09-09 2014-05-20 Siemens Medical Solutions Usa, Inc. Reduction of motion artifacts in ultrasound imaging with a flexible ultrasound transducer
US8545409B2 (en) * 2011-04-14 2013-10-01 St. Jude Medical, Inc. Arrangement and interface for RF ablation system with acoustic feedback
WO2012166239A1 (en) 2011-06-01 2012-12-06 Boston Scientific Scimed, Inc. Ablation probe with ultrasonic imaging capabilities
US20140163372A1 (en) * 2011-07-22 2014-06-12 Koninklijke Philips N.V. Ablation apparatus
WO2013040297A1 (en) 2011-09-14 2013-03-21 Boston Scientific Scimed, Inc. Ablation device with ionically conductive balloon
WO2013040201A2 (en) 2011-09-14 2013-03-21 Boston Scientific Scimed, Inc. Ablation device with multiple ablation modes
JP2013090809A (ja) * 2011-10-26 2013-05-16 Olympus Corp 脂肪除去装置
US9241761B2 (en) 2011-12-28 2016-01-26 Koninklijke Philips N.V. Ablation probe with ultrasonic imaging capability
CA2860636A1 (en) 2012-01-10 2013-07-18 Boston Scientific Scimed, Inc. Electrophysiology system
US8814796B2 (en) * 2012-01-10 2014-08-26 Hologic, Inc. System and method for tissue ablation in a body cavity
US8945015B2 (en) 2012-01-31 2015-02-03 Koninklijke Philips N.V. Ablation probe with fluid-based acoustic coupling for ultrasonic tissue imaging and treatment
US9332962B2 (en) * 2013-03-13 2016-05-10 Siemens Medical Solutions Usa, Inc. Ultrasound ARFI displacement imaging using an adaptive time instance
WO2014159273A1 (en) 2013-03-14 2014-10-02 Recor Medical, Inc. Methods of plating or coating ultrasound transducers
CN105188848B (zh) 2013-03-14 2019-12-10 瑞蔻医药有限公司 基于超声波的神经调制系统
US10098566B2 (en) 2013-09-06 2018-10-16 Covidien Lp System and method for lung visualization using ultrasound
US10201265B2 (en) 2013-09-06 2019-02-12 Covidien Lp Microwave ablation catheter, handle, and system
CN105658164B (zh) 2013-09-06 2018-08-21 柯惠有限合伙公司 微波消融导管、手柄、及系统
US10448861B2 (en) 2013-09-06 2019-10-22 Covidien Lp System and method for light based lung visualization
JP6599885B2 (ja) * 2014-03-27 2019-10-30 コーニンクレッカ フィリップス エヌ ヴェ 正規化された変位差に基づく熱的破壊痕サイズ制御のための手法
EP3206612B1 (en) 2014-10-13 2022-06-29 Boston Scientific Scimed Inc. Tissue diagnosis and treatment using mini-electrodes
CN106604675B (zh) 2014-10-24 2020-01-10 波士顿科学医学有限公司 具有耦接到消融尖头的柔性电极组件的医疗设备
US9743854B2 (en) 2014-12-18 2017-08-29 Boston Scientific Scimed, Inc. Real-time morphology analysis for lesion assessment
CN107427280B (zh) * 2015-02-27 2021-05-11 皇家飞利浦有限公司 用于基于弹性成像监测的自适应消融和治疗的系统和方法
US11010983B2 (en) 2016-11-16 2021-05-18 Navix International Limited Tissue model dynamic visual rendering
US10709507B2 (en) * 2016-11-16 2020-07-14 Navix International Limited Real-time display of treatment-related tissue changes using virtual material
US20180168615A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
US11006854B2 (en) * 2017-02-24 2021-05-18 Teleflex Medical Incorporated Intravascular sensing devices having flexible tip structure
US11583249B2 (en) * 2017-09-08 2023-02-21 Biosense Webster (Israel) Ltd. Method and apparatus for performing non-fluoroscopic transseptal procedure
US11707320B2 (en) * 2019-12-24 2023-07-25 Biosense Webster (Israel) Ltd. Irreversible electroporation (IRE) based on field, contact force and time
CN111773567A (zh) * 2020-08-17 2020-10-16 杭州福嵩科技有限责任公司 一种高强度聚焦超声-穿刺消融的融合治疗设备
CN114209419B (zh) * 2021-12-14 2024-07-05 上海交通大学医学院附属瑞金医院 一种消融治疗设备
CN114533251B (zh) * 2022-02-21 2023-11-03 深圳市赛禾医疗技术有限公司 消融导管、导管消融系统、方法、装置以及存储介质
CN114601556B (zh) * 2022-04-19 2022-09-20 天津市鹰泰利安康医疗科技有限责任公司 脉冲场消融刺激用电极、使用方法及电压调节方法
US20240065755A1 (en) 2022-08-23 2024-02-29 Biosense Webster (Israel) Ltd. Planar multi-electrode catheters
USD1090847S1 (en) 2023-08-07 2025-08-26 Biosense Webster (Israel) Ltd. Distal portion of catheter

Family Cites Families (23)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2645386A (en) 1950-06-05 1953-07-14 Bobrick Mfg Corp Dispenser for thick and viscous liquids
NL9001755A (nl) * 1990-08-02 1992-03-02 Optische Ind De Oude Delft Nv Endoscopische aftastinrichting.
JPH05228150A (ja) 1992-02-25 1993-09-07 Fujitsu Ltd 超音波探触子及び超音波診断装置
US5471988A (en) * 1993-12-24 1995-12-05 Olympus Optical Co., Ltd. Ultrasonic diagnosis and therapy system in which focusing point of therapeutic ultrasonic wave is locked at predetermined position within observation ultrasonic scanning range
JPH07227395A (ja) * 1993-12-24 1995-08-29 Olympus Optical Co Ltd 超音波診断治療システム
US6690963B2 (en) * 1995-01-24 2004-02-10 Biosense, Inc. System for determining the location and orientation of an invasive medical instrument
WO1997029685A1 (en) * 1996-02-15 1997-08-21 Biosense, Inc. Independently positionable transducers for location system
WO1997029709A1 (en) * 1996-02-15 1997-08-21 Biosense, Inc. Medical procedures and apparatus using intrabody probes
US5893848A (en) 1996-10-24 1999-04-13 Plc Medical Systems, Inc. Gauging system for monitoring channel depth in percutaneous endocardial revascularization
US5904651A (en) * 1996-10-28 1999-05-18 Ep Technologies, Inc. Systems and methods for visualizing tissue during diagnostic or therapeutic procedures
EP0989822A4 (en) 1997-06-23 2004-07-28 Focus Surgery Inc METHODS AND DEVICES FOR CREATING ACOUSTIC HEMOSTASIS
US20030130657A1 (en) * 1999-08-05 2003-07-10 Tom Curtis P. Devices for applying energy to tissue
US6371912B1 (en) * 2000-04-05 2002-04-16 Duke University Method and apparatus for the identification and characterization of regions of altered stiffness
US20060079773A1 (en) * 2000-11-28 2006-04-13 Allez Physionix Limited Systems and methods for making non-invasive physiological assessments by detecting induced acoustic emissions
WO2004002305A2 (en) 2002-07-01 2004-01-08 Allez Physionix Systems and methods for making noninvasive assessments of cardiac tissue and parameters
US20040068178A1 (en) * 2002-09-17 2004-04-08 Assaf Govari High-gradient recursive locating system
US7306593B2 (en) 2002-10-21 2007-12-11 Biosense, Inc. Prediction and assessment of ablation of cardiac tissue
US20050215899A1 (en) * 2004-01-15 2005-09-29 Trahey Gregg E Methods, systems, and computer program products for acoustic radiation force impulse (ARFI) imaging of ablated tissue
US20070073135A1 (en) 2005-09-13 2007-03-29 Warren Lee Integrated ultrasound imaging and ablation probe
US7766833B2 (en) 2005-11-23 2010-08-03 General Electric Company Ablation array having independently activated ablation elements
WO2008112005A1 (en) 2006-08-04 2008-09-18 Abla-Tx, Inc. Methods and systems for planning, performing and monitoring thermal ablation
JP4966718B2 (ja) 2007-04-10 2012-07-04 宇部興産株式会社 二次電池用非水電解液
US10492854B2 (en) 2007-12-05 2019-12-03 Biosense Webster, Inc. Catheter-based acoustic radiation force impulse system

Also Published As

Publication number Publication date
CN101450004B (zh) 2012-11-14
JP2009142653A (ja) 2009-07-02
CA2645386A1 (en) 2009-06-05
US20090149753A1 (en) 2009-06-11
EP2067446A1 (en) 2009-06-10
CN101450004A (zh) 2009-06-10
AU2008255133A1 (en) 2009-06-25
IL195715A (en) 2013-05-30
MX2008015681A (es) 2009-06-17
IL195715A0 (en) 2009-09-01
AU2008255133B2 (en) 2013-03-28
JP5627847B2 (ja) 2014-11-19
US10492854B2 (en) 2019-12-03
KR20090059044A (ko) 2009-06-10

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B03A Publication of a patent application or of a certificate of addition of invention [chapter 3.1 patent gazette]
B08F Application dismissed because of non-payment of annual fees [chapter 8.6 patent gazette]

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B08K Patent lapsed as no evidence of payment of the annual fee has been furnished to inpi [chapter 8.11 patent gazette]

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