An acoustic imaging system for use within a heart has a catheter, an ultrasound device incorporated into the catheter, and an electrode mounted on the catheter. The ultrasound device directs ultrasonic signals toward an internal structure in the heart to create an ultrasonic image, and the electrode is arranged for electrical contact with the internal structure. A chemical ablation device mounted on the catheter ablates at least a portion of the internal structure by delivery of fluid to the internal structure. The ablation device includes a material that vibrates in response to electrical excitation, the ablation being at least assisted by vibration of the material. The ablation device may alternatively be a transducer incorporated into the catheter, arranged to convert electrical signals into radiation and to direct the radiation toward the internal structure. The electrode may be a sonolucent structure incorporated into the catheter, through which the ultrasound device is arranged to direct signals. An acoustic marker mounted on the catheter emits a sonic wave when electrically excited. A central processing unit creates a graphical representation of the internal structure, and super-imposes items of data onto the graphical representation at locations that represent the respective plurality of locations within the internal structure corresponding to the plurality of items of data. A display system displays the graphical representation onto which the plurality of items of data are super-imposed.

Catheters for imaging, sensing electrical potentials and ablating tissue

Surgical devices for treating tissue are provided. Also provided are systems for treating tissue and methods of treating tissue. An exemplary surgical device has a handle, a fluid passage connectable to a fluid source, a tip portion and a distal end. The tip portion can simultaneously provide RF power and conductive fluid to tissue. The tip portion includes an electrode having a domed portion having a domed surface and a cylindrical portion having a cylindrical surface. The domed portion is located distal to the cylindrical portion and occupies at least a portion of the distal end of the surgical device. The device includes a fluid outlet opening in fluid communication with the fluid passage, the fluid outlet opening configured to provide the conductive fluid to a surface of the electrode proximal to the distal end surface of the surgical device.

Fluid-assisted medical devices, systems and methods

A device for ultrasonic imaging, and methods for the use an manufacture thereof, particularly of small coronary vessels. The device comprises an elongate member with a distal end that can be positioned within a small vessel of a patient's body while a proximal end is located outside the body, a transducer located at a distal end of the elongate member and operable to scan the distal coronary vessels with ultrasonic pulses, and a signal processor connected to a proximal end of the elongate member and to the transducer for generating and receiving pulses to and from the transducer. A motor may be also connected to the proximal end of the elongate member for rotating the transducer.

Intravascular imaging apparatus and methods for use and manufacture

This invention is a circumferential ablation device assembly which is adapted to forming a circumferential conduction block in a pulmonary vein. The assembly includes a circumferential ablation element which is adapted to ablate a circumferential region of tissue along a pulmonary vein wall which circumscribes the pulmonary vein lumen, thereby transecting the electrical conductivity of the pulmonary vein against conduction along its longitudinal axis and into the left atrium. The circumferential ablation element includes an expandable member with a working length that is adjustable from a radially collapsed position to a radially expanded position. An equatorial band circumscribes the outer surface of the working length and is adapted to ablate tissue adjacent thereto when actuated by an ablation actuator. The equatorial band has a length relative to the longitudinal axis of the expandable member that is narrow relative to the working length, and is also substantially shorter than its circumference when the working length is in the radially expanded position. A pattern of insulators may be included over an ablation element which otherwise spans the working length in order to form the equatorial band described. The expandable member is also adapted to conform to the pulmonary vein in the region of its ostium, such as by providing a great deal of radial compliance or by providing a taper along the working length which has a distally reducing outer diameter. A linear ablation element is provided adjacent to the circumferential ablation element in a combination assembly which is adapted for use in a less-invasive “maze”-type procedure in the region of the pulmonary vein ostia in the left ventricle.

Circumferential ablation device assembly

An ablation apparatus including a maneuvering mechanism, a conductive element attached to the apparatus, a sensor attached to the apparatus and an output device in communication with the sensor is provided. The sensor senses vibration during the ablation procedure and sends a signal to the output device to reduce power to the conductive element.

Vibration sensitive ablation device and method

Acoustic imaging balloon catheters formed by a disposable liquid-confining sheath supporting a high fidelity, flexible drive shaft which carries on its end an ultrasound transducer and includes an inflatable dilatation balloon. The shaft and transducer rotate with sufficient speed and fidelity to produce real time images on a T.V. screen. In preferred embodiments, special features that contribute to the high fidelity of the drive shaft include the particular multi-filar construction of concentric, oppositely wound, interfering coils, a pre-loaded torque condition on the coils enhancing their interfering contact, and dynamic loading of the distal end of the probe, preferably with viscous drag. The coil rotating in the presence of liquid in the sheath is used to produce a desirable pressure in the region of the transducer. Numerous selectable catheter sheaths are shown including a sheath with an integral acoustically-transparent window, sheaths with end extensions that aid in positioning, a liquid injection-producing sheath, a sheath having its window section under tension employing an axially loaded bearing, a sheath carrying a dilatation or positioning balloon over the transducer, a sheath carrying a distal rotating surgical tool and a sheath used in conjunction with a side-viewing trocar.

Acoustic imaging catheter and the like

An elongated, rigid implement (200) having a sharp distal end (202) is insertable into a solid mass within the body of a living being through a puncture site in the solid mass created by the sharp distal end. An elongated sleeve, which engages the elongated, rigid implement, is insertable into the solid mass. Fluid is provided to an expandable chamber (8) located in the vicinity of a distal end of the elongated sleeve through at least one channel (26) located within the elongated sleeve, to inflate the chamber while the chamber is positioned interstitially within the solid mass. A heating device (22, 24) located within the expandable chamber is powered, through at least one elongated conductor located within the elongated sleeve, to heat fluid within the chamber while the chamber is filled with the fluid and is positioned interstitially within the solid mass.

Interstitial heating of tissue

An acoustic imaging system for use within a heart has a catheter (6), an ultrasound device (10) incorporated into the catheter (6), and an electrode (300, 304, 334, 394) mounted on the catheter (6). The ultrasound device (10) directs ultrasonic signals toward an internal structure in the heart to create an ultrasonic image, and the electrode (300, 304, 334, 394) is arranged for electrical contact with the internal structure. A chemical ablation device (55, 86, 314, 396) mounted on the catheter (6) ablates at least a portion of the internal structure by delivery of fluid to the internal structure. The ablation device (55) may include a material that vibrates in response to electrical excitation, the ablation being at least assisted by vibration of the material. The ablation device may alternatively be a transducer (414) incorporated into the catheter (6), arranged to convert electrical signals into radiation and to direct the radiation toward the internal structure. The electrode may be a sonolucent structure (304, 334) incorporated into the catheter (6).

Imaging, electrical potential sensing, and ablation catheters

An apparatus and method for treating an aneurysm (23) in a vessel (20) that isolates a volume around the aneurysm, evacuates that volume and heats the aneurysmal wall (24). A catheter (31) includes one or more inflatable balloons (34, 35) for defining the isolated volume and occluding and preventing any blood flow through the volume. Suction applied through the catheter (31, 55) to the isolated volume withdraws any blood in the isolated volume and displaces the tissue for contact with a thermal source (50) that heats the aneurysmal wall. When the treatment is completed, the balloons are deflated and the catheter is removed from the vessel.

Charles D Lennox

Papers

Acoustic imaging catheter and the like

Interstitial heating of tissue

Imaging, electrical potential sensing, and ablation catheters

Device for treating aneurysms