Apparatus and method for sealing vascular punctures
원문보기
IPC분류정보
국가/구분
United States(US) Patent
등록
국제특허분류(IPC7판)
A61B-018/18
A61B-017/00
A61B-017/34
A61B-018/04
A61B-018/14
A61B-018/08
A61B-019/00
출원번호
UP-0150878
(1993-10-22)
등록번호
US-RE40863
(2009-07-29)
국제출원번호
PCT/US93/010202
(1993-10-22)
§371/§102 date
19951023
(19951023)
국제공개번호
WO94/024948
(1994-11-10)
발명자
/ 주소
Tay, Sew Wah
Schankereli, Kemal
Holman, Thomas
Mische, Hans
출원인 / 주소
Boston Scientific Scimed, Inc.
대리인 / 주소
Crompton, Seager & Tufte LLC
인용정보
피인용 횟수 :
78인용 특허 :
162
초록▼
An apparatus for closing and sealing a vascular puncture is connected to an energy supply such that heat is generated in, or thermally conducted to, the tissue, thereby thermally fusing the vascular tissue together. The method for closing and sealing a vascular puncture comprises applying radio freq
An apparatus for closing and sealing a vascular puncture is connected to an energy supply such that heat is generated in, or thermally conducted to, the tissue, thereby thermally fusing the vascular tissue together. The method for closing and sealing a vascular puncture comprises applying radio frequency or other energy to the tissue, the energy being sufficient to thermally fuse the tissue together, thus sealing the puncture. Embodiments of depth finding and guiding devices, as well as blood vessel occluders, are also disclosed.
대표청구항▼
We claim: 1. A method of sealing a vascular opening comprising the steps of: a) percutaneously inserting a probe adjacent to the vascular opening over a guiding element extending from the vessel through the vascular opening; b) conducting energy from said probe directly to tissue adjacent the prob
We claim: 1. A method of sealing a vascular opening comprising the steps of: a) percutaneously inserting a probe adjacent to the vascular opening over a guiding element extending from the vessel through the vascular opening; b) conducting energy from said probe directly to tissue adjacent the probe in an amount sufficient to cauterize said tissue to thereby close said vascular opening; and c) removing said probe. 2. The method of claim 1 wherein the step of conducting energy comprises conducting thermal energy from said probe tip to the tissue. 3. The method of claim 1 wherein the step of conducting energy comprises conducting electrical energy to the tissue. 4. The method of claim 3 wherein the step of conducting electrical energy comprises conducting alternating current electrical energy to the tissue. 5. The method of claim 4 wherein the step of conducting alternating current electrical energy to the tissue comprises conducting radio frequency energy. 6. The method of claim 4 wherein the step of conducting alternating current electrical energy to the tissue comprises conducting an alternating current having a frequency between 25 kHz and 1,000 kHz. 7. The method of claim 4 wherein the step of conducting alternating current electrical energy comprises conducting microwave energy to cauterize the tissue. 8. The method of claim 3 wherein the step of conducting electrical energy comprises conducting direct current electrical energy to the tissue. 9. The method of claim 8 wherein the step of conducting direct current electrical energy comprises conducting direct current electrical energy in pulsed form. 10. The method of claim 3 wherein the step of conducting electrical energy comprises conducting electrical energy through bipolar electrodes. 11. The method of claim 3 wherein the step of conducting electrical energy comprises conducting electrical energy through a monopolar electrode. 12. The method of claim 1 wherein the probe includes a lumen from a distal end of the probe to a point that will be outside of the body when the probe is in place to seal the vascular opening, and blood flows through the lumen during the sealing process, cessation of flowing blood being indicative of completion of the sealing process. 13. The method of claim 1 further comprising the step of spreading subcutaneous tissue adjacent the vascular opening away from the vascular opening. 14. The method of claim 1 further comprising conducting energy from the probe to the tissue while the guiding element extends through the vascular opening. 15. The method of claim 14, wherein after the steps of conducting energy and removing the probe, the method further comprises the step of removing the guiding element from the vessel, leaving a small hole that clots over to finish closing the vascular opening. 16. The method of claim 14, wherein after the steps of conducting energy and removing the probe, the method further comprises removing the guiding element from the vessel, and the vessel tissue further constricting to finish closing the vascular opening. 17. The method of claim 14, wherein after the step of conducting energy and prior to removing the probe, the method further comprises removing the guiding element from the vessel and conducting additional energy from the probe to the tissue surrounding the probe to finish closing the vascular opening. 18. The method of claim 1 further comprising the step of using an ultrasound system to verify that the probe is adjacent the vascular opening. 19. The method of claim 1 wherein the vascular opening comprises an opening remaining after a catheterization procedure. 20. The method of claim 1 wherein the guiding element extends through the vascular opening in a manner such that the depth of the vascular opening in relationship to the extending portion of the guiding element is known and the method comprises guiding the cautery device to a depth so as to be properly located with respect to the vascular opening by reference to the known relationship between the depth of the vascular opening and the guiding element. 21. A method of using radio frequency energy to close a vascular puncture surrounded by vascular tissue comprising the steps of: a) guiding a cautery device to the vascular puncture, said cautery device comprising at least one electrode connected to a radio frequency energy source, said electrode being guided into direct contact with the vascular tissue; and b) supplying radio frequency energy to the electrode while the electrode is in contact with the vascular tissue, thereby delivering radio frequency energy to the vascular tissue, thereby causing the vascular tissue surrounding the puncture to fuse together to close the opening without blocking flow through the vessel. 22. The method of claim 21, wherein the cautery device includes a lumen therein and is guided to the site of the vascular puncture by passing the lumen over a guiding element extending from the vascular puncture. 23. The method of claim 21, further comprising guiding the cautery device to the vascular puncture using a Doppler flow detection system. 24. The method of claim 23, wherein the step of guiding the cautery devices comprises using a cautery device equipped with the Doppler flow detection system on a distal portion thereof. 25. The method of claim 23, wherein the method comprises first guiding a guiding element equipped with a Doppler flow detection system to the vascular puncture aided by the Doppler flow detection system and then guiding the cautery device to the site of the vascular puncture using said guiding element. 26. A method of determining the depth of a percutaneous vascular wall having a puncture therein comprising the steps of: a) providing an elongated member having i) a lumen therein, ii) a port in the side thereof in fluid communication with the lumen, and iii) an exit opening of the lumen proximal of the port; b) advancing said elongated member through the puncture and into the vessel; c) monitoring the exit opening for blood flow, indicative of whether the side port is within the vessel or at or outside of the vascular wall; and d) thus ascertaining the depth of the vascular wall. 27. The method of claim 26, wherein the step of providing an elongated member having a lumen therein comprises providing an elongated member having a lumen extending to the distal end of the elongated member and a guide wire threaded through the lumen. 28. The method of claim 27, wherein the guide wire has an enlarged cross-section at its distal end which is larger in diameter than the distal end of said lumen and the method includes the step of blocking flow into the distal end of the lumen by use of the enlarged cross-section at the distal end of the guide wire. 29. The method of claim 27, wherein the lumen has a cross-section from the location of the side port to the exit opening of the lumen larger than the cross-section at the distal end of the lumen and the method comprises using the guide wire to plug the distal end of the lumen and blood entering the port and flowing out of the exit opening. 30. The method of claim 27, wherein the proximal end of the elongated member is attached to the distal end of a dilating member and the method comprises percutaneously inserting the dilating member to the depth of the vessel to spread subcutaneous tissue above the puncture site. 31. The method of claim 30, further comprising sliding a cautery sheath over the dilating member and withdrawing the dilating member from the tissue, leaving the elongated member extending into the vessel through the puncture and the cautery sheath spreading the tissue away from the elongated member. 32. The method of claim 26, wherein the step of providing an elongated member having a lumen comprises providing an elongated member having a lumen closed at the distal end of the elongated member. 33. The method of claim 26, wherein the elongated member further includes indicia on the side thereof proximal of the port and the method further comprises the step of using the indicia to indicate the depth of the vascular wall. 34. The method of claim 26, wherein the step of providing an elongated member having a lumen with an exit opening proximal of the port comprises providing an elongated member having a lumen with the exit opening formed in the side of the elongated member. 35. The method of claim 26, wherein the step of ascertaining the depth of the vascular wall includes noting the relative position of the elongated member and the skin surface when the blood just stops flowing through the lumen during removal of the elongated member from the vessel. 36. The method of claim 1 wherein the probe comprises a balloon. 37. The method of claim 21 wherein the cautery device comprises a balloon. 38. The method of claim 26 wherein the elongated member comprises a balloon. 39. A method of sealing a vascular opening in a vessel, the method comprising: a) percutaneously inserting a probe adjacent to the vascular opening over a guiding element extending from the vessel through the vascular opening; b) conducting energy from the probe directly to tissue adjacent the probe in an amount sufficient to cauterize the tissue to thereby close the vascular opening; and c) removing the probe. 40. The method of claim 39, wherein the sealing of the opening is performed without blocking flow through the vessel. 41. The method of claim 39, further including verifying the position of the probe in relation to the vascular opening using ultrasound. 42. The method of claim 39 wherein the probe comprises a balloon. 43. A method of sealing a vascular opening comprising: a) percutaneously guiding a cautery device over a guiding element extending through the vascular opening to a position adjacent the vascular opening; b) delivering energy from the cautery device to tissue adjacent the vascular opening in an amount sufficient to cauterize the tissue to thereby close the vascular opening; and c) removing the cautery device from the position near the vascular opening. 44. The method of claim 43, wherein the guiding step includes using ultrasound to verify a spatial relationship between the cautery device and the vascular opening. 45. The method of claim 43, further including verifying the position of the cautery device in relation to the vascular opening using ultrasound. 46. The method of claim 43, wherein the sealing of the opening is performed without blocking flow through the vessel. 47. The method of claim 43 wherein the cautery device comprises a balloon. 48. A method of sealing a vascular opening, the method comprising: a) percutaneously positioning a cautery device in a position adjacent the vascular opening by guiding the cautery device over a guiding element extending through the vascular opening; b) delivering energy from the cautery device to tissue adjacent the vascular opening in an amount sufficient to thereby cause tissue adjacent the vascular opening to fuse together to close the opening; and c) removing the cautery device from the position near the vascular opening. 49. The method of claim 48, wherein the guiding step includes using ultrasound to verify a spatial relationship between the cautery device and the vascular opening. 50. The method of claim 48, further including determining the position of the vascular opening in relation to the cautery device using ultrasound. 51. The method of claim 50, wherein the position of the vascular opening in relation to the cautery device is determined prior to delivering energy. 52. The method of claim 48, further including verifying a spatial relationship between the vascular opening and the cautery device using ultrasound during the step of delivering energy. 53. The method of claim 48, wherein the sealing of the opening is performed without blocking flow through the vessel. 54. The method of claim 48, further including verifying a spatial relationship between the vascular opening and the cautery device using ultrasound. 55. The method of claim 48 wherein the cautery device comprises a balloon. 56. A method of sealing a vascular opening, the method comprising: a) percutaneously positioning a cautery device over a guiding element passing through the vascular opening in a position adjacent the vascular opening using a position indicating mechanism; b) delivering energy from the cautery device to bodily material adjacent to the vascular opening, resulting in local heating of the bodily material adjacent to the vascular opening to achieve hemostasis; c) removing the cautery device from near the vascular opening. 57. The method of claim 56, wherein the position indicating mechanism comprises an ultrasound device. 58. The method of claim 56, wherein the position indicating mechanism comprises a Doppler flow detection system. 59. The method of claim 56, wherein the position indicating mechanism comprises a flow anemometer. 60. The method of claim 56, wherein the vascular wall includes an intima layer, and the local heating of bodily material adjacent to the vascular opening to achieve hemostasis occurs without substantially heating the intima layer of the vascular wall. 61. The method of claim 56 wherein the cautery device comprises a balloon. 62. A method of sealing a vascular opening, the method comprising: a) guiding a cautery device to a position near the vascular opening using an ultrasound device to verify a spatial relationship between the opening and the device; and b) delivering energy from the cautery device to tissue adjacent the vascular opening in an amount sufficient to thereby cause tissue adjacent the vascular opening to fuse together to close the opening. 63. The method of claim 62 wherein the cautery device comprises a balloon. 64. A method of sealing a vascular opening in a vascular wall, the method comprising: a) positioning a cautery device in a position near the vascular opening using ultrasound to verify a spatial relationship between the device and the opening; b) delivering energy from the cautery device to tissue adjacent the vascular opening in an amount sufficient to thereby cause the vascular tissue to fuse together to close the opening; and c) removing the energy delivering means from the position near the vascular opening. 65. The method of claim 64 wherein the cautery device comprises a balloon. 66. A method of sealing a vascular opening in a vascular wall, the method comprising: a) verifying a spatial relationship between the vascular opening and a cautery device using ultrasound; b) positioning a cautery device in a position near the vascular opening using ultrasound; c) delivering energy from the cautery device to tissue adjacent the vascular opening in an amount sufficient to thereby cause the vascular tissue to fuse together to close the opening; and d) removing the cautery device from the position near the vascular opening. 67. The method of claim 66 wherein the cautery device comprises a balloon. 68. A method of sealing a vascular opening, the method comprising: a) positioning an energy delivering device in a position adjacent the vascular opening by guiding the energy delivering device over a guiding element extending through the vascular opening; b) delivering energy from the energy delivering device to tissue adjacent the vascular opening in an amount sufficient to thereby cause the vascular tissue to fuse together to close the opening; and c) removing the energy delivering device from the position near the vascular opening. 69. The method of claim 68 wherein the cautery device comprises a balloon.
연구과제 타임라인
LOADING...
LOADING...
LOADING...
LOADING...
LOADING...
이 특허에 인용된 특허 (162)
Marks Lloyd A. (Bryn Mawr PA), Aperture occlusion device.
Jackson Anthony (13 Cayuse Lane Rancho Palos Verdes CA 90274), Apparatus and method for detecting probe penetration of human epidural space and injecting a therapeutic substance there.
Tay Sew-Wah (Plymouth MN) Schankereli Kemal (Stillwater MN) Holman Thomas (Minneapolis MN) Mische Hans (St. Cloud MN), Apparatus and method for sealing vascular punctures.
Zeiher Andreas (Klarastrasse 55 D-7800 Freiburg DEX), Balloon catheter for rechanneling stenoses in body passages, in particular of coronary and peripheral arterial vessels.
Degler ; Jr. Howard E. (St. Petersburg FL) Clark David E. (Gainesville FL) Hren John J. (Gainesville FL) Jenkins David A. (Gainesville FL) Johnson ; III Paul F. (Gainesville FL), Bipolar electrosurgical knife.
Parins David J. (White Bear Lake MN) Szczech Gerald S. (Minnetonka MN) Nicoloff Demitre M. (Edina MN) Berhow Steven W. (Brooklyn Center MN), Bipolar scalpel for harvesting internal mammary artery.
LeVeen Harry H. (321 Confederate Cir. Charleston SC 29407) LeVeen Robert F. (312 Lombard St. Philadelphia PA 19147) LeVeen Eric G. (358 Summit Ave. Mount Vernon NY 10552), Catheter with separable balloons.
Neuwirth Robert S. (Englewood NJ) Bolduc Lee R. (Raleigh NC), Cauterizing apparatus and method for laparoscopic cholecystostomy, gallbladder ablation and treatment of benign prostate.
LeVeen Harry H. (321 Confederate Cir. Charleston SC 29407) LeVeen Eric G. (3-3 Woodlike Rd. Albany NY 12203) LeVeen Robert F. (312 Lombard St. Philadelphia PA 19147), Dual balloon catheter.
Petruzzi Claude E. (Bronxville NY) Quint Robert H. (Jamaica NY) D\Amelio Frank D. (Naugatuck CT) Esposito Dominick G. (Mamaroneck NY), Electrosurgical device with treatment arc of less than 360 degrees.
Li Lehmann K. (Fairfield CT) Warren Russell F. (Greenwich CT) Arnoczky Steven P. (New York NY) Bedard Robert J. (Southbury CT), Fibrin clot delivery device and method.
Makower Joshua (Nanuet NY) Vidal Claude A. (Santa Barbara CA) LeMott Steven R. (East Lyme CT) Wells Rodney E. (East Lyme CT) Banks Thomas F. (Santa Barbara CA), Hemostatic implant introducer.
Makower Joshua (Nanuet NY) Vidal Claude A. (Santa Barbara CA) LeMott Steven R. (East Lyme CT) Wells Rodney E. (East Lyme CT) Banks Thomas F. (Santa Barbara CA), Hemostatic implant introducer.
Kensey Kenneth (Chester Springs PA) Nash John (Downingtown PA) Evans Douglas (King of Prussia PA), Hemostatic puncture closure system and method of use.
Nash John (Downingtown PA) Evans Douglas (Devon PA), Hemostatic vessel puncture closure system utilizing a plug located within the puncture tract spaced from the vessel, and.
Farin Gunter (Tubingen-Hirschau DEX) Haag Reiner (Rietheim DEX) Putz Peter (Tubingen DEX), High frequency electrosurgical apparatus for thermal coagulation of biologic tissues.
Parks Stephen K. (San Jose CA) Fishman Udi (San Jose CA) Nuckolls Damon M. (Sunnyvale CA), Method and apparatus for emplacement of a gastrostomy catheter.
Geddes Leslie A. (West Lafayette IN) Hinds Marvin H. (Marion IN) Bourland Joe D. (West Lafayette IN) Voorhees William D. (West Lafayette IN), Method and apparatus for thermally destroying a layer of an organ.
Dew Douglas K. (Maitland FL) Hsu Long S. (Orlando FL) Halpern Steven J. (Winter Park FL), Method for closing tissue wounds using radiative energy beams.
Landymore Roderick W. (R.R. #2 ; Spruce Court Three Fathom Harbour ; N.S. CAX B0J 1N0) Marble Allan E. (6366 South Street Halifax ; N.S. CAX B3H 1T9), Method for effecting closure of a perforation in the septum of the heart.
Mikalov Abraham (5700 Collins Ave. ; Apt. 8-H Miami Beach FL 33141) Barkin Jamie S. (9640 W. Broadview Dr. Bay Harbor FL 33154), Method of placing an esophageal voice prosthesis in a laryngectomized person.
Cage John M. (2316 Leavenworth St. Los Altos CA) Shaw Robert F. (2316 Leavenworth St. San Francisco CA 94100) Stoft Paul E. (Menlo Park CA), Method of using an electrically heated surgical cutting instrument.
O\Reilly Gerald V. (Swampscott MA), Optical fiber with detachable metallic tip for intravascular laser coagulation of arteries, veins, aneurysms, vascular m.
Kensey Kenneth (Chester Springs PA) Nash John (Downingtown PA) Evans Douglas (King of Prussia PA), Plug device with pulley for sealing punctures in tissue and methods of use.
Dorsey Denis P. (51 Rainlily Rd. Levittown PA 19056) Dorsey James D. (417 Glendale Rd. Wilbraham MA 01095), Tissue sampling device with visual and tactile indicator.
Nashef Basem (Geylinggasse 30 A-1130 Wien ATX) Urban Gerald (Rembrandstrasse 19 A-1020 Wien ATX) Kovac Werner (Mariahilferstrasse 127 A-1060 Wien ATX) Denck Helmuth (Kirchmayergasse 5-7 Haus C ; A-11, Tubular device for the treatment of hollow organs with electric current.
Weldon Thomas D. (Gainesville GA) Larsen Charles E. (Cumming GA) Rosen Jonathan J. (Alpharetta GA), Wound treating device and method for treating wounds.
Subramaniam, Raj; Tun, Zaya; Horn, Daniel J.; Sutermeister, Derek C.; Anderson, James M.; Lindquist, Jeffrey S.; Harrison, Kent D., Device and methods for nerve modulation using a novel ablation catheter with polymeric ablative elements.
Conley, Brian M.; Barry, Jonathan J.; Greeley, Roger D.; Greenlaw, Chad M.; Vaccarella, Lorenzo C.; Sylvester, Joseph, Electrosurgical devices and methods of use thereof.
Stone, Corbett W.; Hoey, Michael F.; Gustus, Rolfe Tyson; Perry, Mike; Blanck, Arthur G.; Kunstmanas, Linas R, Inducing desirable temperature effects on body tissue.
Stone, Corbett W.; Hoey, Michael F.; Gustus, Rolfe Tyson; Perry, Mike; Blanck, Arthur G.; Kunstmanas, Linas R., Inducing desirable temperature effects on body tissue.
Hanson, Cass A.; Cao, Hong; Chen, John Jianhua; Sutermeister, Derek C.; Quillin, Daniel T.; Pederson, Jr., Gary J., Medical devices for renal nerve ablation.
Mathur, Prabodh; Nassif, Rabih; Lee, Henry H.; Dandler, Andres; Espinosa, Joseluis, Methods and apparatuses for remodeling tissue of or adjacent to a body passage.
Herscher, Bret; Krawzsenek, David; LaBarge, Aaron; Espinosa, Joseluis; Perry, Michael, Power generating and control apparatus for the treatment of tissue.
Anderson, James M.; Sutermeister, Derek C.; Quillin, Daniel T.; Hanson, Cass A.; Royer, Adam J.; Jancaric, Thomas P.; Lindquist, Jeffrey S., Radio frequency (RF) balloon catheter having flushing and cooling capability.
Haverkost, Patrick A.; Groff, Joel N.; Willard, Martin R.; Ostroot, Timothy A.; Sutermeister, Derek C.; Hanson, Cass A.; Quillin, Daniel T.; Munsinger, Joel R., Renal denervation balloon catheter with ride along electrode support.
Steinke, Thomas A.; Stone, Corbett W.; Ross, Stephen O.; Kelleher, Brian S.; Michel, Raphael M.; Koenig, Donald H., Selectable eccentric remodeling and/or ablation.
Steinke, Tom A.; Stone, Corbett W.; Ross, Stephen O.; Kelleher, Brian S.; Michel, Raphael M.; Koenig, Donald H., Selectable eccentric remodeling and/or ablation.
Steinke, Tom A.; Stone, Corbett W.; Ross, Stephen O.; Kelleher, Brian S.; Michel, Raphael M.; Koenig, Donald H., Selectable eccentric remodeling and/or ablation of atherosclerotic material.
Stone, Corbett W.; Hoey, Michael F.; Blanck, Arthur G.; Briggs, Len; Perry, Mike; Gustus, Rolfe Tyson, System for inducing desirable temperature effects on body tissue.
Stone, Corbett W.; Hoey, Michael F.; Steinke, Tom A.; Michel, Raphael M.; Blanck, Arthur G.; Truesdale, Marlene Kay; Herscher, Bret, Tuned RF energy and electrical tissue characterization for selective treatment of target tissues.
※ AI-Helper는 부적절한 답변을 할 수 있습니다.