Surgery: kinesitherapy – Kinesitherapy – Ultrasonic
Patent
1994-09-16
1998-02-03
Smith, Ruth S.
Surgery: kinesitherapy
Kinesitherapy
Ultrasonic
606128, A61B 1722
Patent
active
057138311
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
The present invention relates to an apparatus for subjecting the coronary arteries of the heart to ultrasound for the purpose of accelerating reperfusion.
Today infarct of the heart is a very common disease in the civilized world. In Sweden each year in the range of 35,000 individuals are stricken with acute infarct of the heart, a fourth of which dies even before they reach the hospital. The disease has a course with various types of complications in the acute stage, together yielding a death rate during the stay at the hospital in the range of nearly 15 percent, varying primarily with age and the magnitude of the infarct of the heart. After discharge from the hospital there is a clear excessive mortality, the more pronounced the larger heart muscle injury the patient has experienced because of his infarct. If it is possible to reduce the magnitude of the infarct of the heart in the acute infarct stage it has been found that this results in lower mortality in the postage of the infarct. The method having most evidently being able to reduce the heart muscle injury has been early reperfusion of the heart muscle by thrombolytic treatment. Hitherto the thrombolytic treatment has been in form of intravenous medication resulting in enzymatic dissolution of the formation of the thrombus in a coronary artery constituting the immediate cause of the acute infarct of the heart. The earlier the treatment has been able to be performed, the heifer effect has been achieved with respect to reducing the heart muscle injury and survival rate after the infarct.
STATE OF THE ART
With the purpose of noninvasively providing reperfusion as fast as possible, hitherto infarct of the heart has been treated with pharmaceuticals initiating enzymatic thrombolysis. Intravenous thrombolytic treatment of patients with accute infarct of the heart results in reperfusion after 30-150 minutes, on the average after approximately 45 minutes. The potential gain in being able to reperfuse the myocardium immediately instead of having to wait 45 minutes is obvious. The possibility of accelerating thrombolysis under experimental conditions by subjecting the thrombus to ultrasound has been shown by the applicant. The present invention substantially reduces the time to reperfusion in that this experimentally confirmed principle using the claimed apparatus may be applied on patients having a suspected acute infarct of the heart.
A known apparatus closely related to the present invention is a diagnostic apparatus using ultrasound. The apparatus comprises an ultrasound transmitter and a receiver receiving the echo from the ultrasound when this is reflected against various organs of the body. The sound energy emitted is so low that no effect on the organ can be found.
Ultrasound apparatus may also be used for heating organs of the body, e.g. joints and muscles, for therapeutic reasons. In this case higher energy levels are used than in the present invention.
Another apparatus related to the present invention is renal calculus crushers, which are used to fragmentize renal calculi without surgical operation. The supplied energy, which may be sound energy, is focused such than the power is highly concentrated to the renal calculus itself, which in contrast to a thrombus is easily located using diagnostic ultrasound or X-rays. The difference in hardness between the renal calculus and the surrounding organs promotes the transmission of the destructive energy to the renal calculus.
SUMMARY OF THE INVENTION
The present invention provides a method and apparatus for reperfusion through accelerated thrombolysis. The method and apparatus utilizes ultrasound to influence a thrombus formed in a blood vessel. By means of the invention reperfusion may be obtained quicker than through enzymatic treatment only. The exact mechanism underlying the desired effect is not completely mapped out but it is believed to be some or more of the known physical effects provided by ultrasound energy in the present form.
According to the invention the appa
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patent: 4509525 (1985-04-01), Seo
patent: 5178135 (1993-01-01), Uchiyama et al.
patent: 5186162 (1993-02-01), Talish et al.
patent: 5207214 (1993-05-01), Romano
patent: 5269291 (1993-12-01), Carter
patent: 5323769 (1994-06-01), Bommannan et al.
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