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1. 发明授权

US07758521B2 Methods and systems for accessing the pericardial space 有权
标题翻译：用于获取心包空间的方法和系统
公开(公告)号：US07758521B2
公开(公告)日：2010-07-20
申请号：US11000539
申请日：2004-12-01
申请人： Mary M Morris , Kenneth C. Gardeski , Michael R. Ujhelyi , Michael E. Leckrone
发明人： Mary M Morris , Kenneth C. Gardeski , Michael R. Ujhelyi , Michael E. Leckrone
IPC分类号： A61M25/00 , A61M25/01
CPC分类号： A61B17/3478 , A61B17/00234 , A61B17/3417 , A61B18/1492 , A61B2017/00247 , A61B2017/003 , A61B2017/22077 , A61B2017/3484 , A61B2017/3488 , A61B2017/349 , A61B2018/00291 , A61B2018/00357 , A61B2018/00392 , A61M25/0084 , A61M2025/0037
摘要： Methods and systems for transvenously accessing the pericardial space via the vascular system and atrial wall, particularly through the superior vena cava and right atrial wall, to deliver treatment in the pericardial space are disclosed. A steerable instrument is advanced transvenously into the right atrium of the heart, and a distal segment is deflected into the right atrial appendage. A fixation catheter is advanced employing the steerable instrument to affix a distal fixation mechanism to the atrial wall. A distal segment of an elongated medical device, e.g., a therapeutic catheter or an electrical medical lead, is advanced through the fixation catheter lumen, through the atrial wall, and into the pericardial space. The steerable guide catheter is removed, and the elongated medical device is coupled to an implantable medical device subcutaneously implanted in the thoracic region. The fixation catheter may be left in place.
摘要翻译：公开了通过血管系统和心房壁，特别是通过上腔静脉和右心房壁经心脏进入心包空间的方法和系统，以在心包空间中递送治疗。一个可操纵的器械被递送到心脏的右心房，远端部分被偏转到右心耳。使用可操纵的器械来前进固定导管，以将远端固定机构固定在心房壁上。细长医疗装置（例如治疗性导管或电气医用引线）的远端部分通过固定导管内腔前进通过心房壁并进入心包空间。可移动的导向导管被移除，并且细长的医疗装置被联接到皮下植入胸部区域的可植入医疗装置。固定导管可以留在原位。

2. 发明授权

US08000807B2 Methods and systems for accessing the pericardial space 有权
标题翻译：用于获取心包空间的方法和系统
公开(公告)号：US08000807B2
公开(公告)日：2011-08-16
申请号：US12815624
申请日：2010-06-15
申请人： Mary M Morris , Kenneth C. Gardeski , Michael R. Ujhelyi , Michael E. Leckrone
发明人： Mary M Morris , Kenneth C. Gardeski , Michael R. Ujhelyi , Michael E. Leckrone
IPC分类号： A61N1/05 , A61B18/00
CPC分类号： A61B17/3478 , A61B17/00234 , A61B17/3417 , A61B18/1492 , A61B2017/00247 , A61B2017/003 , A61B2017/22077 , A61B2017/3484 , A61B2017/3488 , A61B2017/349 , A61B2018/00291 , A61B2018/00357 , A61B2018/00392 , A61M25/0084 , A61M2025/0037
摘要： Methods and systems for transvenously accessing the pericardial space via the vascular system and atrial wall, particularly through the superior vena cava and right atrial wall, to deliver treatment in the pericardial space are disclosed. A steerable instrument is advanced transvenously into the right atrium of the heart, and a distal segment is deflected into the right atrial appendage. A fixation catheter is advanced employing the steerable instrument to affix a distal fixation mechanism to the atrial wall. A distal segment of an elongated medical device, e.g., a therapeutic catheter or an electrical medical lead, is advanced through the fixation catheter lumen, through the atrial wall, and into the pericardial space. The steerable guide catheter is removed, and the elongated medical device is coupled to an implantable medical device subcutaneously implanted in the thoracic region. The fixation catheter may be left in place.
摘要翻译：公开了通过血管系统和心房壁，特别是通过上腔静脉和右心房壁经心脏进入心包空间的方法和系统，以在心包空间中递送治疗。一个可操纵的器械被递送到心脏的右心房，远端部分被偏转到右心耳。使用可操纵的器械来前进固定导管，以将远端固定机构固定在心房壁上。细长医疗装置（例如治疗性导管或电气医用引线）的远端部分通过固定导管内腔前进通过心房壁并进入心包空间。可移动的导向导管被移除，并且细长的医疗装置被联接到皮下植入胸部区域的可植入医疗装置。固定导管可以留在原位。

3. 发明申请

US20100249729A1 Methods and Systems for Accessing the Pericardial Space 有权
标题翻译：用于获取心包空间的方法和系统
公开(公告)号：US20100249729A1
公开(公告)日：2010-09-30
申请号：US12815624
申请日：2010-06-15
申请人： Mary M. Morris , Kenneth C. Gardeski , Michael R. Ujhelyi , Michael E. Leckrone
发明人： Mary M. Morris , Kenneth C. Gardeski , Michael R. Ujhelyi , Michael E. Leckrone
IPC分类号： A61M5/32 , A61N1/00
CPC分类号： A61B17/3478 , A61B17/00234 , A61B17/3417 , A61B18/1492 , A61B2017/00247 , A61B2017/003 , A61B2017/22077 , A61B2017/3484 , A61B2017/3488 , A61B2017/349 , A61B2018/00291 , A61B2018/00357 , A61B2018/00392 , A61M25/0084 , A61M2025/0037
摘要： Methods and systems for transvenously accessing the pericardial space via the vascular system and atrial wall, particularly through the superior vena cava and right atrial wall, to deliver treatment in the pericardial space are disclosed. A steerable instrument is advanced transvenously into the right atrium of the heart, and a distal segment is deflected into the right atrial appendage. A fixation catheter is advanced employing the steerable instrument to affix a distal fixation mechanism to the atrial wall. A distal segment of an elongated medical device, e.g., a therapeutic catheter or an electrical medical lead, is advanced through the fixation catheter lumen, through the atrial wall, and into the pericardial space. The steerable guide catheter is removed, and the elongated medical device is coupled to an implantable medical device subcutaneously implanted in the thoracic region. The fixation catheter may be left in place.
摘要翻译：公开了通过血管系统和心房壁，特别是通过上腔静脉和右心房壁经心脏进入心包空间的方法和系统，以在心包空间中递送治疗。一个可操纵的器械被递送到心脏的右心房，远端部分被偏转到右心耳。使用可操纵的器械来前进固定导管，以将远端固定机构固定在心房壁上。细长医疗装置（例如治疗性导管或电气医用引线）的远端部分通过固定导管内腔前进通过心房壁并进入心包空间。可移动的导向导管被移除，并且细长的医疗装置被联接到皮下植入胸部区域的可植入医疗装置。固定导管可以留在原位。

4. 发明授权

US07207988B2 Method and apparatus for providing intra-pericardial access 有权
标题翻译：用于提供心包内通路的方法和装置
公开(公告)号：US07207988B2
公开(公告)日：2007-04-24
申请号：US10606908
申请日：2003-06-26
申请人： Michael E. Leckrone , Timothy G. Laske , Michael Ujhelyi
发明人： Michael E. Leckrone , Timothy G. Laske , Michael Ujhelyi
IPC分类号： A61B18/14
CPC分类号： A61B17/3478 , A61B17/3417 , A61B18/1492 , A61B2017/00247 , A61B2017/22077 , A61B2017/3443 , A61B2017/3484 , A61B2017/3488 , A61B2017/349 , A61B2018/00291 , A61B2018/00357 , A61B2018/00392
摘要： A method and apparatus for accessing the pericardial space which provides for stable short term or long term placement of a delivery catheter or cannula having its distal most end located in the pericardial space. The catheter or cannula may be introduced into the pericardial space either transvenously through the wall of a heart chamber or transthoracically by penetrating the chest wall and the pericardium. Some embodiments are provided with a mechanism for stabilizing the distal end of the catheter or cannula, which mechanism may employ an extensible elastic, generally tubular member located at the distal end of the catheter or cannula. The device may be provided with a mechanism for extending the tubular member longitudinally, causing its diameter to diminish substantially. The tubular member may be passed through the wall of the heart or the pericardium in its extended configuration and thereafter, the distal-most portion of the tubular member may be moved proximally, causing its diameter enlarge, anchoring the distal end of the catheter or cannula to the pericardium or to the wall of a heart chamber. In these embodiments, the device is preferably provided with a shoulder or flange located proximal to the extendible tubular member, for location on the opposite side of the heart wall or pericardium from the distal end of the catheter or cannula.
摘要翻译：一种用于进入心包空间的方法和装置，其提供其最远端位于心包空间中的输送导管或插管的稳定的短期或长期放置。导管或插管可以通过穿透胸壁和心包而经心脏穿过心室的壁或经胸腔引入心包空间。一些实施例设置有用于稳定导管或插管的远端的机构，该机构可以使用位于导管或插管的远端处的可伸展的弹性大体管状构件。该装置可以设置有用于纵向延伸管状构件的机构，从而使其直径基本上减小。管状构件可以以其延伸构型穿过心脏壁或心包，此后，管状构件的最远端部分可以向近侧移动，导致其直径增大，将导管或套管的远端固定到心包室或心室的壁。在这些实施例中，装置优选地设置有位于可伸缩管状构件的近侧的肩部或凸缘，用于位于与导管或插管远端的心脏壁或心包相反的一侧。

5. 发明授权

US06613062B1 Method and apparatus for providing intra-pericardial access 有权
标题翻译：用于提供心包内通路的方法和装置
公开(公告)号：US06613062B1
公开(公告)日：2003-09-02
申请号：US09430096
申请日：1999-10-29
申请人： Michael E. Leckrone , Timothy G. Laske , Michael Ujhelyi
发明人： Michael E. Leckrone , Timothy G. Laske , Michael Ujhelyi
IPC分类号： A61B1732
CPC分类号： A61B17/3478 , A61B17/3417 , A61B18/1492 , A61B2017/00247 , A61B2017/22077 , A61B2017/3443 , A61B2017/3484 , A61B2017/3488 , A61B2017/349 , A61B2018/00291 , A61B2018/00357 , A61B2018/00392
摘要： A method and apparatus for accessing the pericardial space which provides for stable short term or long term placement of a delivery catheter or cannula having its distal most end located in the pericardial space. The catheter or cannula may be introduced into the pericardial space either transvenously through the wall of a heart chamber or transthoracically by penetrating the chest wall and the pericardium. Some embodiments are provided with a mechanism for stabilizing the distal end of the catheter or cannula, which mechanism may employ an extensible elastic, generally tubular member located at the distal end of the catheter or cannula. The device may be provided with a mechanism for extending the tubular member longitudinally, causing its diameter to diminish substantially. The tubular member may be passed through the wall of the heart or the pericardium in its extended configuration and thereafter, the distal-most portion of the tubular member may be moved proximally, causing its diameter enlarge, anchoring the distal end of the catheter or cannula to the pericardium or to the wall of a heart chamber. In these embodiments, the device is preferably provided with a shoulder or flange located proximal to the extendible tubular member, for location on the opposite side of the heart wall or pericardium from the distal end of the catheter or cannula.
摘要翻译：一种用于进入心包空间的方法和装置，其提供其最远端位于心包空间中的输送导管或插管的稳定的短期或长期放置。导管或插管可以通过穿透胸壁和心包而经心脏穿过心室的壁或经胸腔引入心包空间。一些实施例设置有用于稳定导管或插管的远端的机构，该机构可以使用位于导管或插管的远端处的可伸展的弹性大体管状构件。该装置可以设置有用于纵向延伸管状构件的机构，从而使其直径基本上减小。管状构件可以以其延伸构型穿过心脏壁或心包，此后，管状构件的最远端部分可向近侧移动，导致其直径增大，将导管或插管的远端固定到心包室或心室的壁。在这些实施例中，装置优选地设置有位于可伸缩管状构件的近侧的肩部或凸缘，用于位于与导管或插管远端的心脏壁或心包相反的一侧。

6. 发明授权

US4432362A Atrial-based, atrial-ventricular sequential cardiac pacer 失效
标题翻译：基于心房的心房心室顺序心脏起搏器
公开(公告)号：US4432362A
公开(公告)日：1984-02-21
申请号：US355367
申请日：1982-03-08
申请人： Michael E. Leckrone , James P. Martucci
发明人： Michael E. Leckrone , James P. Martucci
IPC分类号： A61N1/368 , A61N1/36
CPC分类号： A61N1/368
摘要： Atrial refractory and ventricular inhibit functions are independently implemented in an atrial-synchronized pacer. Spontaneous signals on the ventricular lead inhibit ventricular stimulation for a predetermined interval independent of the atria, except when there is noise on the ventricular lead. The atrial-based pacing logic establishes the usual refractory period following spontaneous P-waves, and when noise is detected on the atrial lead, the pacing logic reverts to a fixed atrial rate. The ventricular-inhibited logic includes a retriggerable noise timing circuit and a non-retriggerable inhibit timing circuit both triggered by the output of the ventricular sense amplifier. The output of the inhibit circuit disables the ventricular stimulation output circuit. However, if the output of the noise circuit stays high for an interval indicative of electromagnetic interference, the trigger input to the inhibit timing circuit is disabled to permit ventricular stimulation. Meanwhile, the pacing logic institutes fixed rate pacing due to atrial noise. In AV synchronous and atrial-synchronized AV sequential pacer embodiments, the digital pacing logic uses existing circuitry while the ventricular-inhibited logic is implemented by an add-on RC-timed circuit. In the AV sequential pacer, the AV delay circuit is separate from the pacing logic, and its input is provided by the atrial sense amplifier normally and by the output of the pacing logic during ventricular noise.
摘要翻译：房性难治性和心室抑制功能是独立实施的心房同步起搏器。心室引线上的自发信号可以独立于心房，以预定的间隔抑制心室刺激，除非在心室导线上有噪音。基于心房的起搏逻辑建立了自发性P波之后的常见难治期，并且当在心房线上检测到噪声时，起搏逻辑恢复到固定的心房率。心室抑制逻辑包括可再触发噪声定时电路和不可再触发禁止定时电路，两者均由心室感知放大器的输出触发。抑制电路的输出禁用心室刺激输出电路。然而，如果噪声电路的输出在指示电磁干扰的间隔处保持高电平，则禁止定时电路的触发输入被禁止以允许心室刺激。同时，起搏逻辑机构由于心房噪声而产生固定的起搏速度。在AV同步和心房同步AV序列跟踪器实施例中，数字起搏逻辑使用现有电路，而通过附加RC定时电路实现心室禁止逻辑。在AV顺序起搏器中，AV延迟电路与起搏逻辑分开，其输入由心律感受放大器正常提供，并由心室噪声中的起搏逻辑的输出提供。

7. 发明授权

US5026366A Angioplasty catheter and method of use thereof 失效
标题翻译：血管成形术导管及其使用方法
公开(公告)号：US5026366A
公开(公告)日：1991-06-25
申请号：US321621
申请日：1988-07-26
申请人： Michael E. Leckrone
发明人： Michael E. Leckrone
IPC分类号： A61B17/00 , A61B17/22 , A61B18/20 , A61B18/24 , A61B18/28 , A61B19/00 , A61M1/00
CPC分类号： A61B18/28 , A61B18/20 , A61B18/245 , A61B2017/00154 , A61B2017/00172 , A61B2017/22038 , A61B2017/22052 , A61B2018/00636 , A61B90/39
摘要： The disclosure relates to a device for use in removing undesired material, e.g., occlusion or plaque, from a duct or blood vessel within a patient's body. The device comprises a catheter adapted to be disposed within a duct and an element disposed adjacent to the distal end portion of the catheter such as a fiber optic emitting laser energy, a heated element or a knife for intersecting and releasing the undesired material. An inflatable bladder is provided for positioning the distal end portion of the catheter adjacent the inner surface of the duct to maintain the element for intersecting and releasing the undesired material adjacent thereto. The device can also include a pair of abutments disposed adjacent the distal end portion of the catheter to form a chamber adjacent the inner surface of the blood vessle afor receiving the undesired material and for preventing the escape of laser energy after it has been applied to the undesired material. One of the abutments may have reflecting or fluorescing material for relecting back laser energy through an optical receiving fiber that athe undesired material has been removed. The catheter also includes an occluding balloon to impede the flow of blood. Another embodiment comprises a housing having two lumens, one passing a translational and rotational filament and a second containing a fiber optic. Yet another embodiment of the invention comprises a catheter for boring a hole in a total occlusion of a blood vessel. In other embodiments of the invention, the catheter device may have a conically shaped nose to avoid trauma to blood vessels.
摘要翻译： PCT No.PCT / US86 / 02617 Sec。 371日期：1988年7月26日 102（e）日期1988年7月26日PCT Filted 1986年12月2日PCT公布。出版物WO88 / 04157 日期1988年6月16日。本公开涉及一种用于从患者体内的管道或血管中除去不想要的物质，例如闭塞或斑块的装置。该装置包括适于布置在管道内的导管和邻近导管的远端部分设置的元件，例如发射激光能量的光纤，加热元件或用于交叉和释放不需要的材料的刀。提供了一种可膨胀囊，用于将导管的远端部分定位在管道的内表面附近，以保持该元件用于与其相邻的相互不相关的材料相交和释放。该装置还可以包括邻近导管的远端部分设置的一对邻接部，以形成邻近血液容器的内表面的腔室，用于接收不期望的材料并防止激光能量在其被施加到不需要的材料。基台中的一个可以具有反射或荧光材料，用于通过光学接收光纤反射激光能量，使得不希望的材料已被去除。导管还包括阻塞血液的阻塞气囊。另一个实施例包括具有两个流明的壳体，一个通过平移和旋转细丝的壳体，以及包含光纤的第二腔室。本发明的另一个实施例包括用于在血管的完全闭塞中钻孔的导管。在本发明的其它实施例中，导管装置可以具有锥形鼻部，以避免对血管的创伤。

8. 发明授权

US4627436A Angioplasty catheter and method for use thereof 失效
公开(公告)号：US4627436A
公开(公告)日：1986-12-09
申请号：US585112
申请日：1984-03-01
申请人： Michael E. Leckrone
发明人： Michael E. Leckrone
IPC分类号： A61B17/00 , A61B17/22 , A61B18/20 , A61B18/24 , A61B18/28 , A61B19/00 , A61M1/00 , A61B17/36
CPC分类号： A61B18/28 , A61B18/20 , A61B18/245 , A61B2017/00154 , A61B2017/00172 , A61B2017/22038 , A61B2017/22052 , A61B2018/00636 , A61B90/39
摘要： The disclosure relates to a device for use in removing undesired material from a duct within a patient's body. The device comprises a catheter adapted to be disposed within a duct and an element disposed adjacent to the distal end portion of the catheter such as a fiber optic emitting laser energy, a heated element or a knife for intersecting and releasing the undesired material. The undesired material may be an occlusion or an accumulation of plaque within a blood vessel. An inflatable bladder is provided for positioning the distal end portion of the catheter adjacent the inner surface of the duct to maintain the element for intersecting and releasing the undesired material adjacent thereto. The device can also include a pair of abutments disposed adjacent the distal end portion of the catheter to form a chamber adjacent the inner surface of the blood vessel and prevent the escape of laser energy after it has been applied to the undesired material.

9. 发明申请

US20120310269A1 VASCULAR OCCLUSION DEVICES AND METHODS 有权
标题翻译：血管造影装置及方法
公开(公告)号：US20120310269A1
公开(公告)日：2012-12-06
申请号：US13489970
申请日：2012-06-06
申请人： Neal E. Fearnot , Michael E. Leckrone
发明人： Neal E. Fearnot , Michael E. Leckrone
IPC分类号： A61M29/00
CPC分类号： A61B17/12022 , A61B17/12031 , A61B17/12109 , A61B17/12145 , A61B17/1215 , A61B17/12168 , A61B17/12172 , A61B17/12177 , A61B17/1219 , A61B2017/00004 , A61B2017/00778 , A61B2017/00853 , A61B2017/00871 , A61B2017/00889 , A61B2017/00893 , A61B2017/00898 , A61B2017/1205 , A61B2090/3966 , A61L31/005 , A61L31/146 , A61L31/16 , A61L31/18 , A61L2300/418 , A61L2430/36 , A61M2025/0681
摘要： The present invention provides, in certain embodiments, unique products and methods for occluding vascular vessels. Implantable devices useful in some inventive embodiments include at least two expandable occluding members, e.g., self-expandable sponge form devices, with an intermediate segment extending between the members. These devices are preferably compressible for placement in a delivery device lumen for delivery to a vascular vessel site. Upon deployment in the vessel, each of the members expands to occlude the vessel at a separate vessel location with the intermediate segment occupying space in the vessel between the two members. Optionally, the intermediate segment can be constructed to provide a hollow or other interior region for receiving one or more materials, for example, to receive an injectable fill material after one or both of the expandable members have been deployed.
摘要翻译：在某些实施方案中，本发明提供用于闭塞血管的唯一产品和方法。在一些本发明实施方式中有用的可植入装置包括至少两个可膨胀闭塞构件，例如自膨胀海绵形式装置，其中中间段在构件之间延伸。这些装置优选地是可压缩的，以便放置在输送装置内腔中以便输送到血管容器部位。在部署在容器中时，每个构件在单独的容器位置膨胀以封闭容器，中间段在容器中占据两个构件之间的空间。可选地，中间段可以被构造成提供用于接收一种或多种材料的中空或其它内部区域，例如在一个或两个可扩展构件展开之后接收可注射填充材料。

10. 发明授权

US5713934A Evoked and spontaneous cardiac activity detection in a dual-chamber electronic pacemaker and method 失效
标题翻译：诱发和自发心脏活动检测在双室电子起搏器和方法
公开(公告)号：US5713934A
公开(公告)日：1998-02-03
申请号：US542088
申请日：1995-10-12
申请人： Michael E. Leckrone
发明人： Michael E. Leckrone
IPC分类号： A61N1/368 , A61N1/37
CPC分类号： A61N1/3712
摘要： A method of operating a pacemaker and a pacemaker system that cuts short a pacemaker-defined refractory time period whenever capture is not achieved. The pacemaker generates a cardiac stimulation pulse, and in response thereto, initiates an evoked response detection time period and a refractory time period. If an evoked response occurs during the evoked response detection time period, capture is presumed. If an evoked response does not occur during the evoked response detection time period, then capture is not achieved and the refractory time period is terminated, or cut short, thereby lengthening the window during which natural cardiac activity may be sensed. In the event natural cardiac activity is not detected following the termination of the refractory time period, a backup stimulation pulse may be generated.
摘要翻译：一种操作起搏器和起搏器系统的方法，可以在无法实现捕获时缩短起搏器定义的难治性时间段。起搏器产生心脏刺激脉冲，响应于此，启动诱发反应检测时间段和难治时间段。如果在诱发响应检测时间段期间发生诱发反应，则假定捕获。如果在诱发反应检测时间段期间没有发生诱发反应，则不能获得捕获，并且不耐药时间段终止或切断短，从而延长可以感测自然心脏活动期间的窗口。在难治性时间期限结束后未检测到自然心脏活动的情况下，可产生备用刺激脉冲。

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