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1. 发明授权

US10576246B2 Intravascular fluid catheter with minimal internal fluid volume 有权
公开(公告)号：US10576246B2
公开(公告)日：2020-03-03
申请号：US13643065
申请日：2012-08-22
申请人： David R. Fischell , Tim A. Fischell
发明人： David R. Fischell , Tim A. Fischell
IPC分类号： A61M25/00 , A61M25/06 , A61M25/01 , A61B5/00
摘要： A catheter-based/intravascular ablation (denervation) system includes a multiplicity of needles which expand open around a central axis to engage the wall of a blood vessel, or the wall of the left atrium, allowing the injection of a cytotoxic or/or neurotoxic solution for ablating conducting tissue, or nerve fibers around the ostium of the pulmonary vein, or circumferentially in or just beyond the outer layer of the renal artery. The expandable needle delivery system is formed with self-expanding materials and include structures, near the end portion of the needles, or using separate guide tubes. The system also includes means to limit and/or adjust the depth of penetration of the ablative fluid into the tissue of the wall of the targeted blood vessel. The preferred embodiment of the catheter delivered through the vascular system of a patient includes a multiplicity of expandable guide tubes that engage the wall of a blood vessel. Injection needles having injection egress at or near their sharpened distal end are then advanced through the guide tubes to penetrate the wall of the blood vessel to a prescribed depth. The ability to provide PeriVascular injection so as to only affect the outer layer(s) of a blood vessel without affecting the media has particular application for PeriVascular Renal Denervation (PVRD) of the sympathetic nerves which lie in the adventitia or outside the adventitia of the renal artery.

2. 发明授权

US09278196B2 Expandable catheter system for vessel wall injection and muscle and nerve fiber ablation 有权
标题翻译：用于血管壁注射和肌肉和神经纤维消融的可扩展导管系统
公开(公告)号：US09278196B2
公开(公告)日：2016-03-08
申请号：US13216495
申请日：2011-08-24
申请人： David R. Fischell , Tim A. Fischell
发明人： David R. Fischell , Tim A. Fischell
IPC分类号： A61M25/06 , A61M25/00 , A61B5/00
CPC分类号： A61M25/0662 , A61B5/6848 , A61M25/0084 , A61M25/0097 , A61M2025/0086 , A61M2025/0681
摘要： A vascular nerve ablation (denervation) system includes a multiplicity of expandable needles which open around a central axis to engage the wall of a blood vessel allowing the injection of a cytotoxic or neurotoxic solution for ablating conducting tissue in and near the vessel wall of a renal artery or pulmonary vein. The expandable needles are formed of self-expanding materials and include structures which limit the distance of penetration of the injection needles into the tissue of the wall of the blood vessel.
摘要翻译：血管神经消融（去神经支配）系统包括多个可展开的针，其围绕中心轴线开放以接合血管壁，允许注射细胞毒性或神经毒性溶液以消除肾脏血管壁内和附近的传导组织动脉或肺静脉。可膨胀针由自膨胀材料形成，并且包括限制注射针穿入血管壁组织的距离的结构。

3. 发明授权

US08591495B2 Introducer sheath with thin-walled shaft 有权
标题翻译：导管护套带薄壁轴
公开(公告)号：US08591495B2
公开(公告)日：2013-11-26
申请号：US13431526
申请日：2012-03-27
申请人： Robert E. Fischell , Tim A. Fischell , David R. Fischell
发明人： Robert E. Fischell , Tim A. Fischell , David R. Fischell
IPC分类号： A61M25/00
CPC分类号： A61M25/01 , A61M25/0012 , A61M25/005 , A61M25/0108 , A61M25/02 , A61M25/0662 , A61M39/0606 , A61M2025/0266 , A61M2025/028 , A61M2025/0286 , B21C37/042
摘要： A thin-walled introducer sheath is described. In some embodiments, the introducer sheath includes structural support components, such as wires, used in connection with a polymeric inner coating, a polymeric outer coating, or both. Further, in some embodiments, the wire components are annealed to reduce cold-work-related stresses and hardness. Use of annealed components may enable a reduction in the thickness of the polymeric outer coating in some applications.
摘要翻译：描述了薄壁导引鞘。在一些实施例中，引入器护套包括与聚合物内涂层，聚合物外涂层或两者结合使用的结构支撑部件，例如导线。此外，在一些实施例中，将线材部件退火以减少与冷加工有关的应力和硬度。在一些应用中，退火组分的使用可以使聚合物外涂层的厚度减小。

4. 发明授权

US08483812B2 Cardiac event categorization system 有权
标题翻译：心脏事件分类系统
公开(公告)号：US08483812B2
公开(公告)日：2013-07-09
申请号：US12059146
申请日：2008-03-31
申请人： Robert E. Fischell , David R. Fischell , Tim A. Fischell , Scott J. S. Fischell
发明人： Robert E. Fischell , David R. Fischell , Tim A. Fischell , Scott J. S. Fischell
IPC分类号： A61B5/02 , A61N1/365
CPC分类号： A61L27/54 , A61L2300/236 , A61L2300/254 , A61L2300/42
摘要： Disclosed are methods for detecting an acute myocardial infarction (i.e., a heart attack) at the earliest possible time and promptly warning the patient that he should immediately seek medical care. The present invention includes an implantable electronic system that can sense a change in the patient's electrogram that is indicative of a heart attack. If a heart attack is sensed, the device would then cause an implantable and/or externally located alarm to be actuated to warn the patient of his condition and a medical practitioner at a remote diagnostic center would receive the patient's electrogram for analysis. The patient or a caretaker would then be informed to self-inject medication through a subcutaneous, pass-through drug port that can be a separate device or integrated into the implanted device that is designed for the early detection of a heart attack. The methods of the present invention include determining if a human patient is likely to have a heart attack and, if he is, then implanting within that patient a device that can sense when a heart attack occurs and alarm the patient to take appropriate actions if a heart attack does occur.
摘要翻译：公开了在早期检测急性心肌梗塞（即心脏病发作）的方法，并且及时警告患者他应该立即求医。本发明包括可以感测指示心脏病发作的患者电描记图变化的可植入电子系统。如果感测到心脏病发作，则该装置然后将致动可植入和/或外部定位的警报器，以警告患者其状况，并且远程诊断中心的医务人员将接收患者的电描记图以进行分析。然后将患者或看守者通知皮下，通过的药物口，自动注射药物，该药物口可以是单独的装置，也可以集成到设计用于早期发现心脏病发作的植入装置中。本发明的方法包括确定人类患者是否可能患有心脏病发作，并且如果他是，则在患者体内植入可以感测发生心脏病发作的装置，并且如果心脏病发作确实发生。

5. 发明申请

US20130053821A1 EXPANDABLE CATHETER SYSTEM FOR VESSEL WALL INJECTION AND MUSCLE AND NERVE FIBER ABLATION 有权
标题翻译：用于船舶注射和肌肉和神经纤维的膨胀导管系统
公开(公告)号：US20130053821A1
公开(公告)日：2013-02-28
申请号：US13216495
申请日：2011-08-24
申请人： DAVID R. FISCHELL , TIM A. FISCHELL
发明人： DAVID R. FISCHELL , TIM A. FISCHELL
IPC分类号： A61M25/10
CPC分类号： A61M25/0662 , A61B5/6848 , A61M25/0084 , A61M25/0097 , A61M2025/0086 , A61M2025/0681
摘要： A vascular nerve ablation (denervation) system includes a multiplicity of expandable needles which open around a central axis to engage the wall of a blood vessel allowing the injection of a cytotoxic or neurotoxic solution for ablating conducting tissue in and near the vessel wall of a renal artery or pulmonary vein. The expandable needles are formed of self-expanding materials and include structures which limit the distance of penetration of the injection needles into the tissue of the wall of the blood vessel.
摘要翻译：血管神经消融（去神经支配）系统包括多个可展开的针，其围绕中心轴线开放以接合血管壁，允许注射细胞毒性或神经毒性溶液以消除肾脏血管壁内和附近的传导组织动脉或肺静脉。可膨胀针由自膨胀材料形成，并且包括限制注射针穿入血管壁组织的距离的结构。

6. 发明申请

US20120271301A1 EXPANDABLE CATHETER SYSTEM FOR PERI-OSTIAL INJECTION AND MUSCLE AND NERVE FIBER ABLATION 有权
标题翻译：膀胱注射和肌肉和神经纤维的放大导管系统
公开(公告)号：US20120271301A1
公开(公告)日：2012-10-25
申请号：US13092363
申请日：2011-04-22
申请人： DAVID R. FISCHELL , TIM A. FISCHELL
发明人： DAVID R. FISCHELL , TIM A. FISCHELL
IPC分类号： A61B18/12
CPC分类号： A61B18/1492 , A61B2018/00214 , A61B2018/0022 , A61B2018/00375 , A61B2018/00404 , A61B2018/00434 , A61B2018/00511 , A61B2018/00577 , A61B2018/143 , A61M5/00
摘要： At the present time, physicians often treat patients with atrial fibrillation (AF) using radiofrequency (RF) catheter systems to ablate conducting tissue in the wall of the Left Atrium of the heart around the ostium of the pulmonary veins. These systems are expensive and take time consuming to use. The present invention circular ablation system CAS includes a multiplicity of expandable needles that can be expanded around a central axis and positioned to inject a fluid like ethanol to ablate conductive tissue in a ring around the ostium of a pulmonary vein quickly and without the need for expensive capital equipment. The expansion of the needles is accomplished by self-expanding or balloon expandable structures. The invention includes centering means so that the needles will be situated in a pattern surrounding the outside of the ostium of a vein. Also included are members that limit the distance of penetration of the needles into the wall of the left atrium. The present invention also has application to ablating tissue around the ostium of a renal artery for the treatment of hypertension.
摘要翻译：目前，医生经常使用射频（RF）导管系统治疗房颤患者，以消融肺静脉周围心脏左心房壁的导电组织。这些系统是昂贵的并且花费耗时的使用。本发明的圆形消融系统CAS包括多个可扩展的针，其可以围绕中心轴线扩张并且被定位成像乙醇一样注入流体，以便快速地在肺静脉的口周围环绕环中的导电组织，而不需要昂贵的资本设备。针的膨胀通过自膨胀或球囊可膨胀结构来实现。本发明包括定心装置，使得针头将位于围绕静脉口的外侧的图案中。还包括限制针头进入左心房壁的距离的成员。本发明还可用于消除肾动脉口周围的组织用于治疗高血压。

7. 发明申请

US20120271277A1 EXPANDABLE CATHETER SYSTEM FOR PERI-OSTIAL INJECTION AND MUSCLE AND NERVE FIBER ABLATION 有权
标题翻译：膀胱注射和肌肉和神经纤维的放大导管系统
公开(公告)号：US20120271277A1
公开(公告)日：2012-10-25
申请号：US13196104
申请日：2011-08-02
申请人： DAVID R. FISCHELL , TIM A. FISCHELL
发明人： DAVID R. FISCHELL , TIM A. FISCHELL
IPC分类号： A61M29/00
CPC分类号： A61B18/06 , A61B5/042 , A61B18/1477 , A61B18/1492 , A61B90/39 , A61B2017/22038 , A61B2017/22068 , A61B2018/0016 , A61B2018/00214 , A61B2018/0022 , A61B2018/00285 , A61B2018/00375 , A61B2018/00404 , A61B2018/00434 , A61B2018/00511 , A61B2018/00577 , A61B2018/00839 , A61B2018/143 , A61B2018/1475 , A61B2090/3966 , A61M2025/0087
摘要： At the present time, physicians often treat patients with atrial fibrillation (AF) using radiofrequency (RF) catheter systems to ablate conducting tissue in the wall of the Left Atrium of the heart around the ostium of the pulmonary veins. These systems are expensive and take time consuming to use. The present invention circular ablation system CAS includes a multiplicity of expandable needles that can be expanded around a central axis and positioned to inject a fluid like ethanol to ablate conductive tissue in a ring around the ostium of a pulmonary vein quickly and without the need for expensive capital equipment. The expansion of the needles is accomplished by self-expanding or balloon expandable structures. The invention includes centering means so that the needles will be situated in a pattern surrounding the outside of the ostium of a vein. Also included are members that limit the distance of penetration of the needles into the wall of the left atrium, or the aortic wall. The present invention also has an important application to ablate tissue around the ostium of one or both renal arteries, for the ablation of the sympathetic nerve fibers and/or other afferent or efferent nerves going to or from each kidney in order to treat hypertension.
摘要翻译：目前，医生经常使用射频（RF）导管系统治疗房颤患者，以消融肺静脉周围心脏左心房壁的导电组织。这些系统是昂贵的并且花费耗时的使用。本发明的圆形消融系统CAS包括多个可扩展的针，其可以围绕中心轴线扩张并且被定位成像乙醇一样注入流体，以便快速地在肺静脉的口周围环绕环中的导电组织，而不需要昂贵的资本设备。针的膨胀通过自膨胀或球囊可膨胀结构来实现。本发明包括定心装置，使得针头将位于围绕静脉口的外侧的图案中。还包括限制针穿入左心房壁或主动脉壁的距离的构件。本发明还具有重要的应用，用于消除一个或两个肾动脉周围的组织，用于消除去往或来自每个肾脏的交感神经纤维和/或其他传入或传出神经以治疗高血压。

8. 发明申请

US20090240156A1 HIEARCHICAL COMMUNICATION SYSTEM FOR A CHRONICALLY IMPLANTED MEDICAL DEVICE 审中-公开
标题翻译：一种用于慢性植入式医疗器械的研究通讯系统
公开(公告)号：US20090240156A1
公开(公告)日：2009-09-24
申请号：US12437973
申请日：2009-05-08
申请人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson
发明人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson
IPC分类号： A61B5/0402
CPC分类号： A61B5/02455 , A61B5/0031 , A61B5/04012 , A61B5/0422 , A61B5/0452 , A61B5/0456 , A61B5/0468 , A61B5/0472 , A61B5/746 , A61B5/7465 , A61B2560/0209
摘要： A system for providing alerts with regard to a patient's heart. An implanted medical device includes a sensor as well as a processor configured to detect a cardiac event. An internal alarm is configured for producing an alarm signal. An internal transceiver acting in cooperation with an external transceiver within an external device is provided. The processor is configured to determine whether the external and internal transceivers are able to communicate with each other and send a command to the internal alarm if there is no communication.
摘要翻译：用于提供关于患者心脏的警报的系统。植入式医疗装置包括传感器以及配置成检测心脏事件的处理器。内部报警被配置为产生报警信号。提供了与外部设备内的外部收发器协同工作的内部收发器。处理器被配置为确定外部和内部收发器是否能够彼此通信，并且如果没有通信则将命令发送到内部警报。

9. 发明授权

US07558623B2 Means and method for the detection of cardiac events 有权
标题翻译：用于检测心脏事件的手段和方法
公开(公告)号：US07558623B2
公开(公告)日：2009-07-07
申请号：US10853058
申请日：2004-05-26
申请人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson
发明人： David R. Fischell , Tim A. Fischell , Jonathan Harwood , Robert E. Fischell , Steven R. Johnson
IPC分类号： A61B5/0452
CPC分类号： A61B5/0452 , A61B5/0006 , A61B5/0031 , A61B5/0456 , A61B5/046 , A61B5/0464 , A61B5/7465 , A61B2560/0209 , A61N1/3627 , A61N1/3702
摘要： Disclosed is a system for the detection of cardiac events that includes an implanted device called a cardiosaver, a physician's programmer and an external alarm system. The system is designed to provide early detection of cardiac events such as acute myocardial infarction or exercise induced myocardial ischemia caused by an increased heart rate or exertion. The system can also alert the patient with a less urgent alarm if a heart arrhythmia is detected. Using different algorithms, the cardiosaver can detect a change in the patient's electrogram that is indicative of a cardiac event within five minutes after it occurs and then automatically warn the patient that the event is occurring. To provide this warning, the system includes an internal alarm sub-system (internal alarm means) within the cardiosaver and/or an external alarm system (external alarm means) which are activated after the ST segment of the electrogram exceeds a preset threshold.
摘要翻译：公开了一种用于检测心脏事件的系统，其包括称为心脏切除器，医生程序员和外部警报系统的植入装置。该系统旨在提供心脏事件的早期检测，例如由心率增加或运动引起的急性心肌梗死或运动诱发的心肌缺血。如果检测到心律失常，该系统还可以警告患者不太紧急的警报。使用不同的算法，心脏检查器可以在发生后五分钟内检测到指示心脏事件的患者电描记图的变化，然后自动向患者发出事件发生。为了提供此警告，系统包括在心电图的ST段超过预设阈值之后激活的心律师内部的内部报警子系统（内部报警装置）和/或外部报警系统（外部报警装置）。

10. 发明申请

US20090105807A1 Stent having a multiplicity of undulating longitudinals 失效
标题翻译：支架有多个起伏的纵骨
公开(公告)号：US20090105807A1
公开(公告)日：2009-04-23
申请号：US12286558
申请日：2008-09-30
申请人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
发明人： Robert E. Fischell , David R. Fischell , Tim A. Fischell
IPC分类号： A61F2/06
CPC分类号： A61F2/844 , A61F2/90 , A61F2/91 , A61F2/915 , A61F2002/825 , A61F2002/91533 , A61F2002/9155 , A61F2210/0019
摘要： A method for implanting a balloon expandable stent at a site within a passageway of a curved coronary article. The stent includes at least two longitudinally spaced apart circumferential rings. At least one longitudinally extending connector extends between adjacent rings. The connector has at least one turn back portion that can expand or contract in length while being passed through a curved passageway. The stent is disposed on a stent delivery catheter having an inflatable balloon. The stent delivery catheter and the stent is delivered through the passageway to the site of implementation with the connector member expanding or contracting in length to facilitate delivery and placement of the stent. The stent is expanded at the site of implantation by inflating the balloon to force the stent radially outward against the wall of the coronary artery.
摘要翻译：一种用于将球囊可扩张支架植入弯曲冠状动脉制品通道内的部位的方法。支架包括至少两个纵向间隔开的周向环。至少一个纵向延伸的连接器在相邻的环之间延伸。连接器具有至少一个回转部分，其能够在穿过弯曲通道的同时膨胀或收缩。支架设置在具有可膨胀气囊的支架输送导管上。支架输送导管和支架通过通道被输送到实现位置，连接器构件的长度膨胀或收缩以便于支架的输送和放置。通过使气囊膨胀来使支架在植入部位扩张，以使支架径向向外抵靠冠状动脉壁。

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