Surgery – Instruments
Patent
1998-01-26
1999-12-28
Buiz, Michael
Surgery
Instruments
604 22, A61B 1700, A61M 514
Patent
active
060075309
DESCRIPTION:
BRIEF SUMMARY
The invention relates to an angioplasty catheter for expanding and/or opening up morbidly constricted or obstructed blood vessels.
The invention also relates to a method of generating sound waves, particularly ultrasonic waves, within an angioplasty catheter.
The techniques, as known in medical technology, for expanding or recanalizing morbidly changed arteries are usually extremely invasive, e.g. balloon-tipped catheters, rotablators and Kensey catheters, or they are only used for the narrow-lumen recanalization of occlusions and have to be applied in combination with subsequent balloon dilation. The resultant trauma is the origin of renewed occlusion. A high relapse rate results therefrom.
For this reason, medical technology has switched over to the application of so-called ultrasonic recanalization techniques by means of which this risk of trauma can be minimized and hence the relapse rate significantly reduced. Ultrasonic recanalization is consequently a gentle technique for treating morbid arterial changes, with minimal traumatization of the vascular wall as a result of the selective ultrasonic effect. This is proved in the literature by in vivo and in vitro experiments.
A system in which the exogenously generated ultrasound is intra-arterially supplied to the stenosis or occlusion via a wire probe sheathed by a protective catheter is known from U.S. Pat. No. 4,870,953. The relatively inflexible wire probe which is difficult to control can be used only in a few vascular areas. A controlled release of energy is not possible either as a result of the long transmission distance encountered in intra-arterial applications.
An injection instrument in which a piezoceramic ultrasonic transducer is located at the distal end of the catheter is known from U.S. Pat. No. 5,197,946. The acoustic power of this ultrasonic transducer is, however, sufficient only to distribute injected medication and to boost and accelerate the effect of lysis medication. The released acoustic power is, nevertheless, too low for an effective ablation of for example the material of a vasoconstriction.
A rotating dilation catheter in which a stylet is inserted as a support and control element inside the inner lumen of a tubular wire coil with at least one pressure body is known from DE-OS 40 12 649 A1. This instrument is intended to be used to compact tissue in the stenosis in a radially outward manner and to smooth the inner vascular wall. To ensure a gentle application, the instrument can be used only in a slowly rotating manner, perhaps up to several thousand revolutions per minute. Technically speaking, this dilation catheter therefore cannot be used to generate ultrasound and this application is not envisaged either. The treatment principle also aims at displacement rather than the separation or disintegration of occlusive material.
A catheter in which a rotating removal instrument, i.e. a rotating miniature tool such as a cutter, drill etc., is used for therapeutic purposes is known from DE 33 20 076 C2. The rotational forces needed to drive these tools are generated by a probe tip designed as a fluid turbine and having tangential nozzles. The use of these tools causes the system to exhibit extremely invasive action, thus involving the aforementioned risks of embolization as a result of separating fairly large connected particles as well as the risk of damaging healthy tissue and a high re-occlusion rate conditioned thereby.
The invention is consequently based on the object of providing a simple and effective angioplasty catheter that is in turn based on the sound wave principle and designed for treatment of morbidly changed blood vessels; application of this catheter causes as little traumatization of the vascular walls as possible and hence permits maximum long-term treatment success rates. Another object of the invention is to provide a suitable and effective method of generating sound waves, particularly ultrasonic waves, in an angioplasty catheter 1.
This object is solved by an angioplasty catheter according to the invention a
REFERENCES:
patent: 4870953 (1989-10-01), Donmichael
patent: 5197946 (1993-03-01), Tachibana
patent: 5209719 (1993-05-01), Baruch et al.
patent: 5375602 (1994-12-01), Lancee et al.
patent: 5423797 (1995-06-01), Adrian et al.
patent: 5569179 (1996-10-01), Adrian
Dornhofer Thomas
Husslein Burkhard
Meyer Christian
Starck Erhard
Zscheeg Harry
Buiz Michael
C.R. Bard Inc.
Trinh Vikki
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