US20030078570A1 - Cryoablation catheter for long lesion ablations - Google Patents
Cryoablation catheter for long lesion ablationsDownload PDFInfo
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- US20030078570A1 US20030078570A1US10/001,360US136001AUS2003078570A1US 20030078570 A1US20030078570 A1US 20030078570A1US 136001 AUS136001 AUS 136001AUS 2003078570 A1US2003078570 A1US 2003078570A1
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- tubular member
- outer tubular
- passageway
- distal end
- inner tubular
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Classifications
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00184—Moving parts
- A61B2018/00196—Moving parts reciprocating lengthwise
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
- A61B2018/0212—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques using an instrument inserted into a body lumen, e.g. catheter
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/02—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by cooling, e.g. cryogenic techniques
- A61B2018/0231—Characteristics of handpieces or probes
- A61B2018/0262—Characteristics of handpieces or probes using a circulating cryogenic fluid
Definitions
- the present inventionrelates to a cryoablation catheter, and more particularly to a cryoablation catheter for creating long lesions.
- the surgical implementmay include a rigid or flexible structure having an ablation device at or near its distal end that is placed adjacent to the tissue to be ablated. Radio frequency energy, microwave energy, laser energy, extreme heat, and extreme cold may be provided by the ablation device to destroy the tissue.
- cardiac arrhythmiamay be treated through selective ablation of cardiac tissue to eliminate the source of the arrhythmia.
- a popular minimally invasive procedure, radio frequency (RF) catheter ablationincludes a preliminary step of conventional mapping followed by the creation of one or more ablated regions (lesions) in the cardiac tissue using RF energy. Multiple lesions are frequently required. Often, five lesions, and sometimes as many as twenty lesions may be required before a successful result is attained. Sometimes only one of the lesions is actually effective.
- RFradio frequency
- cryogenic mapping and ablationDeficiencies of radio frequency ablation devices and techniques have been to some extent overcome by cryogenic mapping and ablation.
- cryogenic mapping techniquesare in U.S. Pat. Nos. 5,423,807; 5,281,213 and 5,281,215.
- both cryogenic and RF ablation devicesare usually configured for spot or circular tissue ablation.
- a cryoablation catheter systemfor creating linear lesions which includes an outer tubular member capable of insertion into the vessels of the body, a ceiling cap disposed at the distal end of the outer tubular member for forming a cooling chamber at the distal end of the tubular member, an inner tubular member slidably disposed within the outer tubular member.
- the proximal end of the inner tubular memberis adapted to receive a fluid, such as nitrous oxide.
- a fluid expansion nozzlesuch as a Joule-Thompson nozzle, is disposed on the distal end of the inner tubular member.
- the catheter systemalso includes a nozzle control system which is comprised of an inner ring member formed of a magnetic material which is mounted on the proximal end of the inner tubular member, and an outer ring member formed of magnetic material which is slidably mounted on the outer tubular member. Because of the magnetic attraction between these two magnetic members, when the outer ring member is moved along the outer tubular member it “pulls” or draws the inner magnetic ring member along with the outer magnetic ring member to thereby cause the inner tubular member to be moved longitudinally which in turn causes the fluid expansion nozzle to be moved longitudinally within the cooling chamber.
- the inner tubular memberis disposed coaxially within the outer tubular member so as to define a passageway between the inner tubular member and the outer tubular member, and a cylindrical support member is disposed between the inner tubular member and the outer tubular member for supporting the inner tubular member for movement within the cooling chamber.
- the cylindrical support memberincludes at least one passageway which extends through the support member to permit fluid, such as, nitrous oxide, to be returned through the passageway for removal from the catheter system.
- the inner magnetic ring memberis disposed coaxially within the outer tubular member and extends in the passageway between the inner tubular member and the outer tubular member, and includes at least one passageway which extends through the inner magnetic ring member to permit fluid to be returned through the passageway for removal from the catheter.
- the fluid expansion nozzletakes the form of a Joule-Thompson nozzle which is disposed on the distal end of the inner tubular member.
- nozzle control system of the present inventionit is possible to provide a cryoablation catheter system for creating linear lesions by moving the fluid expansion nozzle in a longitudinal direction along the interior of the cooling chamber while maintaining an entirely sealed catheter system.
- a cryoablation catheter systemfor creating linear lesions by moving the fluid expansion nozzle in a longitudinal direction along the interior of the cooling chamber while maintaining an entirely sealed catheter system.
- magnetic attractionwhich exists from an external ring magnet and an internal ring magnet it is possible to “pull” the fluid expansion nozzle along a longitudinal path within the sealed cooling chamber while maintaining a hermetically sealed catheter system.
- FIG. 1is a schematic view of a system for cryoablation with a catheter according to the present invention placed within a human heart;
- FIG. 2illustrates in detail the distal tip of the cryoablation catheter according to the present invention placed within a human heart
- FIG. 3illustrates in detail the proximal end of the cryoablation catheter, the control handle and the coolant system including the cooling nozzle control system in more detail;
- FIG. 3Aillustrates in more detail a cross sectional view of the cooling nozzle control system.
- FIG. 1a cryoablation catheter system 1 according to the present invention has been illustrated with a catheter 2 .
- the catheter 2comprises an outer body 3 , an inner body 6 , a handle 4 and a deflection knob 5 .
- the deflection knob 5is connected with the inner body 6 and the handle 4 with the outer body 3 , whereby the deflection knob 5 is movable in the axial direction of the catheter 2 in relation to the handle 4 in such a way that the distal tip of the inner body 6 , where the inner body 6 opens out into the lumen of the outer body 3 , is movable in an axial direction with respect to the distal tip of the catheter 2 .
- the deflection knob 5is connected via a heat exchanger 25 , a connecting tube 27 through a control unit 24 and a valve 8 with a gas cylinder 7 , containing N 2 O.
- a gas cylinder 7containing N 2 O.
- other substances than N 2 Omay be used.
- a fluidis used of which the cooling effect only occurs on expansion when it is ejected via the inner body 6 close to the distal end of the catheter 2 into the lumen of the outer body 3 . This fluid will expand, as a result of which the cooling effect will be achieved.
- N 2 Omeets this requirement with satisfactory results.
- the valve 8constitutes the control means with which the flow of N 2 O through the inner body 6 , and the pressure inside this inner body 6 is regulated.
- the pressuredepends on the intended effect of the cryoablation at the distal tip of the catheter 2 .
- the catheter 2has been provided near to the distal end with measuring equipment, such as a thermocouple, which also forms part of the control means, in which case the valve 8 is activated on the basis of the measuring results obtained at the thermocouple. In that case the measurement of the temperature is set to a target value established in advance, in order to effect the required degree of cryoablation.
- the tip at the distal end of the catheter 2may also be provided with other measurement equipment to determine the position of the nozzle 12 for instance.
- Examples of such measuring equipmentare marking rings which are recognizable when using imaging techniques like MRI or when using x-ray radiation.
- Equipment to determine whether the surrounding tissue also needs to be ablatedmay be included here as well.
- the distal end of the catheter 2has been introduced into a chamber of the heart 10 and advanced to a position where tissue 14 is located which is suitable for ablation. It could however also concern here applications in a vein or at any other location. The only thing which is important, is that in the body cavity there is tissue, like the tissue 14 illustrated here, which qualifies for ablation.
- FIG. 2is a detailed and partly cross-sectional view of the distal end of the catheter 2 in a position for use.
- the inner body 6opens out into the internal lumen 16 of the outer body 3 close to the distal end of the catheter.
- a flow of N 2 O coolantis supplied, which is ejected via a nozzle 12 , which preferably takes the form of a Joule-Thompson nozzle, so that a cold zone 13 is created.
- the coldness created on the outside of the outer body 3is such that ice 15 is formed and the tissue 14 is ablated.
- the deflection knob 5which is connected with the inner body 6 , is movable in relation to the handle 4 , which is connected with the outer body 3 .
- the nozzle 12 at the distal end of the inner body 6is moved in relation to the outer body 3 .
- the outer body 3on the other hand has in the meantime become stuck in the ice 15 , and is consequently no longer movable.
- the inner body 6 and, in particular in the proximity of the nozzle 12 hereof, a sliding block 11has been arranged around the inner body 6 close to the nozzle 12 , which functions as a distancing body.
- the dimensions of the sliding block 11correspond to those of the internal lumen 16 of the outer body 3 , so that it can move freely up and down in the outer body 3 in the direction indicated by arrow “A,” in which changes can be made in the position of the nozzle 20 12 .
- the sliding block 11also includes passageways 11 a which extend through the sliding block. The sliding block 11 is provided with the passageways 11 a to allow the coolant fluid to flow back from the cooling chamber.
- All components of the catheter illustrated herehave preferably been made of materials which do not shrink together due to expansion or contraction of the materials.
- the outer body 3has been closed off by means of a closure 17 .
- the catheter system illustrated in FIG. 3includes a catheter 2 .
- the proximal end of the catheter 2carries a handle 4 , with which the catheter has been received in the deflection knob 5 .
- a pressure line 23extends from the proximal end of the catheter 2 to the distal end. The pressure line 23 supplies high pressure refrigerant to the distal end of the catheter.
- FIGS. 3 and 3Aalso illustrate in more detail the nozzle positioning mechanism 5 a which is comprised of an outer ring 40 formed of a magnetic material which is slidably mounted on a cylindrical piston 42 .
- the outer magnetic ringis hermetically sealed within a polymer layer 44 .
- An inner ring 46extends around and is fixedly attached to the inner body 6 .
- the inner ring 46is also formed of a magnetic material.
- the inner magnetic ringincludes multiple passageways 47 which serve to permit the cooled fluid to be removed from the catheter system 2 .
- the cooling nozzle 12is mounted on the distal end of the inner body 6 .
- the outer magnetic ring 40As the outer magnetic ring 40 is moved along the cylindrical piston 42 , it causes the inner magnetic ring 46 to be pulled along through magnetic attraction. As the inner ring 46 is pulled along, it causes the inner body to be moved which in turn draws the cooling nozzle 12 along a longitudinal path through the cooling chamber. Accordingly, the wall of the cooling chamber is cooled along the path of travel of the cooling nozzle 12 . This path of travel creates a linear lesion along the line of contact between the cooling chamber and adjacent tissue.
- the expanded gaseous fluidflows, via the discharge channel formed by the internal lumen 16 in the catheter body and through the passageways 11 a back to the proximal end of the catheter.
- the discharge channel of the catheter bodyis connected in a suitably sealed-off manner with the line 32 in the deflection knob 5 .
- the refrigerantis pre-cooled in the heat exchanger 25 , before it is introduced into the catheter.
- the cooling means illustrated schematically in FIG. 3comprises an insulated cooling chamber 26 , through which a connecting pressure tube 27 extends in a helical pattern.
- the pressure line 23is connected with this connection tube 27 .
- the fluid under pressureis supplied to the connection tube 27 from a refrigerant source illustrated here as a gas cylinder 7 .
- the required quantityis regulated by means of the adjustable valve 29 .
- a linebranches off from the refrigerant line which, via a restriction 34 , opens out into the cooling chamber 26 .
- the quantity of fluid supplied to the cooling chamber 26is regulated by the size and the dimensions of the restriction 34 and the control valve 30 .
- the restriction 34On passing the restriction 34 the refrigerant expands in the chamber 26 and removes heat from the surroundings, that is to say from the refrigerant flowing through the connecting tube 27 which is cooled as a result.
- the expanded fluidis extracted from the chamber 26 through the line 31 , so that a sufficient pressure difference is maintained across the restriction.
- a temperature sensor 22has been arranged at the proximal end of the pressure line, which is connected via a signal line 21 with a temperature measuring device. In this way it is possible to check the temperature of the refrigerant supplied to the proximal end of the pressure line 23 .
- the control valve 30may be regulated on the basis of the temperature measured. In another embodiment, the control valve 30 may be regulated by a control means on the basis of the temperature measured with the sensor 22 .
- a temperature sensor(not shown) may also be placed at the tip of the catheter 2 .
- this temperature sensorthe temperature at the tip of the catheter 2 may be monitored.
- the value measured by this sensormay be used to adjust the adjustable valve 29 .
- the adjustable valve 29may be regulated automatically in response to the temperature measured at the tip.
- the catheter device according to the inventionis for instance used to ablate surface tissue inside the heart, when treating certain cardiac arrhythmias.
- the pre-cooled fluidwill at the most absorb only little heat from the surroundings.
- the pressure line 23 forming the inner body 6extends through the central lumen.
- the expanded gas which is being removed from the tipflows through this lumen.
- This expanded gashas initially a very low temperature and is only heated to limited degree in the tip.
- the gas flowing through the lumen 16 forming the discharge channelconsequently still has a low temperature, so that as a result none or only little heating of the refrigerant supplied under pressure will take place.
- the heat exchanger 25for instance may be integrated into the deflection knob 5 .
- the pressure line 23may in that case be surrounded along more or less its entire length by expanded fluid which is being discharged, so that the temperature of the pressure fluid may be controlled accurately.
- the nozzle configurationmay be radially placed inside the distal end of the pressure tube, or in other possible configurations.
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Abstract
Description
- 1. Field of the Invention[0001]
- The present invention relates to a cryoablation catheter, and more particularly to a cryoablation catheter for creating long lesions.[0002]
- 2. Description of the Prior Art[0003]
- Many medical procedures are performed using minimally invasive surgical techniques wherein one or more slender implements are inserted through one or more small incisions into a patient's body. With respect to ablation, the surgical implement may include a rigid or flexible structure having an ablation device at or near its distal end that is placed adjacent to the tissue to be ablated. Radio frequency energy, microwave energy, laser energy, extreme heat, and extreme cold may be provided by the ablation device to destroy the tissue.[0004]
- With respect to cardiac procedures, cardiac arrhythmia may be treated through selective ablation of cardiac tissue to eliminate the source of the arrhythmia. A popular minimally invasive procedure, radio frequency (RF) catheter ablation, includes a preliminary step of conventional mapping followed by the creation of one or more ablated regions (lesions) in the cardiac tissue using RF energy. Multiple lesions are frequently required. Often, five lesions, and sometimes as many as twenty lesions may be required before a successful result is attained. Sometimes only one of the lesions is actually effective.[0005]
- Deficiencies of radio frequency ablation devices and techniques have been to some extent overcome by cryogenic mapping and ablation. Such cryogenic mapping techniques are in U.S. Pat. Nos. 5,423,807; 5,281,213 and 5,281,215. However, even though combined cryogenic mapping and ablation devices often times permit greater certainty and less tissue damage than RF devices and techniques, both cryogenic and RF ablation devices are usually configured for spot or circular tissue ablation.[0006]
- Spot tissue ablation is acceptable for certain procedures. However, other procedures may be more therapeutically effective if multiple spot lesions are made along a predetermined line, or a single elongate or linear lesion is created in a single ablative step. Radio frequency ablation devices are known to be able to create linear lesions by dragging the ablation tip along a line while the ablation electrode is energized. U.S. patent application Ser. No. 09/518,044 entitled, “Cryoablation Catheter For Long Lesion Ablations,” assigned to the same assignee as the present invention disclosing the concept of “dragging” the ablation tip, or the cooling tip, of a cryoablation catheter along a line in order to create a long lesion. In order to accomplish this function, the cryogenic cooling nozzle is moved longitudinally along the inside of a cooling chamber to thereby cause the outer surface of the cooling chamber to be cooled along a linear path which in turn creates a linear lesion along the path.[0007]
- In accordance with one aspect of the present invention there is provided a cryoablation catheter system for creating linear lesions which includes an outer tubular member capable of insertion into the vessels of the body, a ceiling cap disposed at the distal end of the outer tubular member for forming a cooling chamber at the distal end of the tubular member, an inner tubular member slidably disposed within the outer tubular member. The proximal end of the inner tubular member is adapted to receive a fluid, such as nitrous oxide. A fluid expansion nozzle, such as a Joule-Thompson nozzle, is disposed on the distal end of the inner tubular member. The catheter system also includes a nozzle control system which is comprised of an inner ring member formed of a magnetic material which is mounted on the proximal end of the inner tubular member, and an outer ring member formed of magnetic material which is slidably mounted on the outer tubular member. Because of the magnetic attraction between these two magnetic members, when the outer ring member is moved along the outer tubular member it “pulls” or draws the inner magnetic ring member along with the outer magnetic ring member to thereby cause the inner tubular member to be moved longitudinally which in turn causes the fluid expansion nozzle to be moved longitudinally within the cooling chamber.[0008]
- In accordance with another aspect of the present invention, the inner tubular member is disposed coaxially within the outer tubular member so as to define a passageway between the inner tubular member and the outer tubular member, and a cylindrical support member is disposed between the inner tubular member and the outer tubular member for supporting the inner tubular member for movement within the cooling chamber. The cylindrical support member includes at least one passageway which extends through the support member to permit fluid, such as, nitrous oxide, to be returned through the passageway for removal from the catheter system. In accordance with still another aspect of the present invention, the inner magnetic ring member is disposed coaxially within the outer tubular member and extends in the passageway between the inner tubular member and the outer tubular member, and includes at least one passageway which extends through the inner magnetic ring member to permit fluid to be returned through the passageway for removal from the catheter. In accordance with still another aspect of the present invention, the fluid expansion nozzle takes the form of a Joule-Thompson nozzle which is disposed on the distal end of the inner tubular member.[0009]
- With the nozzle control system of the present invention, it is possible to provide a cryoablation catheter system for creating linear lesions by moving the fluid expansion nozzle in a longitudinal direction along the interior of the cooling chamber while maintaining an entirely sealed catheter system. In other words, by use of magnetic attraction which exists from an external ring magnet and an internal ring magnet it is possible to “pull” the fluid expansion nozzle along a longitudinal path within the sealed cooling chamber while maintaining a hermetically sealed catheter system.[0010]
- These and other objects of the present invention will become more apparent when considered in view of the following description of a preferred embodiment of the present invention.[0011]
- Further properties, advantages and measures according to the present invention will be explained in greater detail in the description of a preferred embodiment, with reference to the attached figures in which:[0012]
- FIG. 1 is a schematic view of a system for cryoablation with a catheter according to the present invention placed within a human heart;[0013]
- FIG. 2 illustrates in detail the distal tip of the cryoablation catheter according to the present invention placed within a human heart;[0014]
- FIG. 3 illustrates in detail the proximal end of the cryoablation catheter, the control handle and the coolant system including the cooling nozzle control system in more detail; and[0015]
- FIG. 3A illustrates in more detail a cross sectional view of the cooling nozzle control system.[0016]
- In FIG. 1 a cryoablation catheter system[0017]1 according to the present invention has been illustrated with a
catheter 2. Thecatheter 2 comprises anouter body 3, aninner body 6, a handle4 and adeflection knob 5. Thedeflection knob 5 is connected with theinner body 6 and the handle4 with theouter body 3, whereby thedeflection knob 5 is movable in the axial direction of thecatheter 2 in relation to the handle4 in such a way that the distal tip of theinner body 6, where theinner body 6 opens out into the lumen of theouter body 3, is movable in an axial direction with respect to the distal tip of thecatheter 2. - The[0018]
deflection knob 5 is connected via aheat exchanger 25, aconnecting tube 27 through acontrol unit 24 and a valve8 with a gas cylinder7, containing N2O. By way of an alternative, or as an addition, also other substances than N2O may be used. Preferably, a fluid is used of which the cooling effect only occurs on expansion when it is ejected via theinner body 6 close to the distal end of thecatheter 2 into the lumen of theouter body 3. This fluid will expand, as a result of which the cooling effect will be achieved. N2O meets this requirement with satisfactory results. - As illustrated in FIG. 1 the valve[0019]8 constitutes the control means with which the flow of N2O through the
inner body 6, and the pressure inside thisinner body 6 is regulated. The pressure depends on the intended effect of the cryoablation at the distal tip of thecatheter 2. In an embodiment of the present invention not illustrated here, thecatheter 2 has been provided near to the distal end with measuring equipment, such as a thermocouple, which also forms part of the control means, in which case the valve8 is activated on the basis of the measuring results obtained at the thermocouple. In that case the measurement of the temperature is set to a target value established in advance, in order to effect the required degree of cryoablation. - The tip at the distal end of the[0020]
catheter 2 may also be provided with other measurement equipment to determine the position of thenozzle 12 for instance. Examples of such measuring equipment are marking rings which are recognizable when using imaging techniques like MRI or when using x-ray radiation. Equipment to determine whether the surrounding tissue also needs to be ablated may be included here as well. - In the situation illustrated in FIG. 1, the distal end of the[0021]
catheter 2 has been introduced into a chamber of theheart 10 and advanced to a position wheretissue 14 is located which is suitable for ablation. It could however also concern here applications in a vein or at any other location. The only thing which is important, is that in the body cavity there is tissue, like thetissue 14 illustrated here, which qualifies for ablation. - FIG. 2 is a detailed and partly cross-sectional view of the distal end of the[0022]
catheter 2 in a position for use. Theinner body 6 opens out into theinternal lumen 16 of theouter body 3 close to the distal end of the catheter. Through the inner body6 a flow of N2O coolant is supplied, which is ejected via anozzle 12, which preferably takes the form of a Joule-Thompson nozzle, so that acold zone 13 is created. In the immediate proximity of thiscold zone 13, at thenozzle 12 of theinner body 6, the coldness created on the outside of theouter body 3 is such thatice 15 is formed and thetissue 14 is ablated. - As has been described in connection with FIG. 1, the[0023]
deflection knob 5, which is connected with theinner body 6, is movable in relation to the handle4, which is connected with theouter body 3. In this manner thenozzle 12 at the distal end of theinner body 6 is moved in relation to theouter body 3. In the situation illustrated here, theouter body 3 on the other hand has in the meantime become stuck in theice 15, and is consequently no longer movable. Theinner body 6 and, in particular in the proximity of thenozzle 12 hereof, a sliding block11 has been arranged around theinner body 6 close to thenozzle 12, which functions as a distancing body. The dimensions of the sliding block11 correspond to those of theinternal lumen 16 of theouter body 3, so that it can move freely up and down in theouter body 3 in the direction indicated by arrow “A,” in which changes can be made in the position of the nozzle2012. The sliding block11 also includes passageways11awhich extend through the sliding block. The sliding block11 is provided with the passageways11ato allow the coolant fluid to flow back from the cooling chamber. - All components of the catheter illustrated here have preferably been made of materials which do not shrink together due to expansion or contraction of the materials.[0024]
- In the embodiment illustrated here, the[0025]
outer body 3 has been closed off by means of aclosure 17. - The catheter system illustrated in FIG. 3 includes a[0026]
catheter 2. The proximal end of thecatheter 2 carries a handle4, with which the catheter has been received in thedeflection knob 5. Apressure line 23 extends from the proximal end of thecatheter 2 to the distal end. Thepressure line 23 supplies high pressure refrigerant to the distal end of the catheter. - FIGS. 3 and 3A also illustrate in more detail the[0027]
nozzle positioning mechanism 5awhich is comprised of anouter ring 40 formed of a magnetic material which is slidably mounted on acylindrical piston 42. The outer magnetic ring is hermetically sealed within apolymer layer 44. Aninner ring 46 extends around and is fixedly attached to theinner body 6. Theinner ring 46 is also formed of a magnetic material. In addition, the inner magnetic ring includesmultiple passageways 47 which serve to permit the cooled fluid to be removed from thecatheter system 2. As previously described, the coolingnozzle 12 is mounted on the distal end of theinner body 6. Accordingly, as the outermagnetic ring 40 is moved along thecylindrical piston 42, it causes the innermagnetic ring 46 to be pulled along through magnetic attraction. As theinner ring 46 is pulled along, it causes the inner body to be moved which in turn draws the coolingnozzle 12 along a longitudinal path through the cooling chamber. Accordingly, the wall of the cooling chamber is cooled along the path of travel of the coolingnozzle 12. This path of travel creates a linear lesion along the line of contact between the cooling chamber and adjacent tissue. - The expanded gaseous fluid flows, via the discharge channel formed by the[0028]
internal lumen 16 in the catheter body and through the passageways11aback to the proximal end of the catheter. The discharge channel of the catheter body is connected in a suitably sealed-off manner with theline 32 in thedeflection knob 5. - To achieve sufficient cooling effect in the tip of the[0029]
catheter 2, the refrigerant is pre-cooled in theheat exchanger 25, before it is introduced into the catheter. The cooling means illustrated schematically in FIG. 3 comprises an insulatedcooling chamber 26, through which a connectingpressure tube 27 extends in a helical pattern. Thepressure line 23 is connected with thisconnection tube 27. The fluid under pressure is supplied to theconnection tube 27 from a refrigerant source illustrated here as a gas cylinder7. The required quantity is regulated by means of theadjustable valve 29. - Preceding the valve[0030]29 a line branches off from the refrigerant line which, via a
restriction 34, opens out into the coolingchamber 26. The quantity of fluid supplied to the coolingchamber 26 is regulated by the size and the dimensions of therestriction 34 and thecontrol valve 30. On passing therestriction 34 the refrigerant expands in thechamber 26 and removes heat from the surroundings, that is to say from the refrigerant flowing through the connectingtube 27 which is cooled as a result. The expanded fluid is extracted from thechamber 26 through theline 31, so that a sufficient pressure difference is maintained across the restriction. - As shown in FIG. 3, a[0031]
temperature sensor 22 has been arranged at the proximal end of the pressure line, which is connected via a signal line21 with a temperature measuring device. In this way it is possible to check the temperature of the refrigerant supplied to the proximal end of thepressure line 23. Thecontrol valve 30 may be regulated on the basis of the temperature measured. In another embodiment, thecontrol valve 30 may be regulated by a control means on the basis of the temperature measured with thesensor 22. - A temperature sensor (not shown) may also be placed at the tip of the[0032]
catheter 2. By means of this temperature sensor the temperature at the tip of thecatheter 2 may be monitored. The value measured by this sensor may be used to adjust theadjustable valve 29. Alternatively, theadjustable valve 29 may be regulated automatically in response to the temperature measured at the tip. - The catheter device according to the invention is for instance used to ablate surface tissue inside the heart, when treating certain cardiac arrhythmias.[0033]
- Because of the relatively high heat resistance coefficient of the material of which the[0034]
pressure line 23 has been made, the pre-cooled fluid will at the most absorb only little heat from the surroundings. Inside theouter body 3 of thecatheter 2 thepressure line 23 forming theinner body 6 extends through the central lumen. The expanded gas which is being removed from the tip flows through this lumen. This expanded gas has initially a very low temperature and is only heated to limited degree in the tip. The gas flowing through thelumen 16 forming the discharge channel consequently still has a low temperature, so that as a result none or only little heating of the refrigerant supplied under pressure will take place. - It should be noted that only a possible embodiment has been illustrated. Other embodiments are possible as well. The[0035]
heat exchanger 25 for instance may be integrated into thedeflection knob 5. Thepressure line 23 may in that case be surrounded along more or less its entire length by expanded fluid which is being discharged, so that the temperature of the pressure fluid may be controlled accurately. Alternatively, the nozzle configuration may be radially placed inside the distal end of the pressure tube, or in other possible configurations. - These modifications would be apparent to those having ordinary skill in the art to which this invention relates and are intended to be within the scope of the claims which follow.[0036]
Claims (9)
1. A cryoablation catheter system for creating linear lesions comprising:
an outer tubular member having a proximal end and a distal end and being capable of insertion into the vessels of the body;
a sealing cap disposed at the distal end of the outer tubular member for forming a cooling chamber at the distal end of the outer tubular member;
an inner tubular member slidably disposed within the outer tubular member and having a proximal end and a distal end, the proximal end of the inner tubular member being adapted to receive a fluid which cools when expanded;
a fluid expansion nozzle disposed on the distal end of the inner tubular member; and,
a nozzle control system comprising an inner ring member formed of a magnetic material fixedly mounted on the proximal end of the inner tubular member, and an outer ring member formed of a magnetic material slidably mounted on the outer tubular member which when moved along the outer tubular member causes the inner magnetic ring member to be pulled along with the outer magnetic ring member to thereby cause the inner tubular member to be moved longitudinally thereby causing the fluid expansion nozzle to be moved longitudinally within the cooling chamber.
2. A cryoablation catheter system as defined inclaim 1 , wherein the inner tubular member is disposed coaxially within the outer tubular member so as to define a passageway between the inner tubular member and the outer tubular member; and,
a cylindrical support member is disposed between the inner tubular member and the outer tubular member, said support member having at least one passageway which extends through the support member to permit fluid to be returned through the passageway for removal from the catheter system.
3. A cryoablation catheter system as defined inclaim 2 , wherein the inner magnetic ring member is disposed coaxially within the outer tubular member and extends in the passageway between the inner tubular member and the outer tubular member; and,
Said inner magnetic ring member has at least one passageway which extends through the inner magnetic ring member to permit fluid to be returned through the passageway for removal from the catheter system.
4. A cryoablation catheter system comprising a cryoablation catheter including:
an outer tubular member having a proximal end and a distal end and being capable of insertion into the vessels of the body;
a sealing cap disposed at the distal end of the outer tubular member for forming a cooling chamber at the distal end of the catheter;
an inner tubular member slidably disposed within the outer tubular member and having a proximal end and a distal end;
a Joule-Thompson nozzle disposed on the distal end of the inner tubular member;
a nozzle control system comprising an inner ring member formed of a magnetic material fixedly mounted on the proximal end of the inner tubular member, and an outer ring member formed of a magnetic material slidably mounted on the outer tubular member which when moved along the outer tubular member causes the inner magnetic ring member to be pulled along with the outer magnetic ring member to thereby cause the inner tubular member to be moved longitudinally thereby causing the Joule-Thompson nozzle to be moved longitudinally within the cooling chamber;
a source of a high pressure gas coupled to the proximal end of the inner tubular member; and,
a control valve for varying the pressure of a high pressure gas for varying the flow of gas to the Joule-Thompson nozzle.
5. A cryoablation catheter system as defined inclaim 4 , wherein the inner tubular member is disposed coaxially within the outer tubular member so as to define a passageway between the inner tubular member and the outer tubular member; and,
a cylindrical support member is disposed between the inner tubular member and the outer tubular member, said support member having at least one passageway which extends through the support member to permit fluid to be returned through the passageway for removal from the catheter.
6. A cryoablation catheter system as defined inclaim 5 , wherein the inner magnetic ring member is disposed coaxially within the outer tubular member and extends in the passageway between the inner tubular member and the outer tubular member; and,
said inner magnetic ring member has at least one passageway which extends through the inner ring magnetic member to permit fluid to be returned through the passageway for removal from the catheter.
7. A cryoablation catheter system comprising:
an outer tubular member having a proximal end and a distal end and being capable of insertion into the vessels of the body;
a sealing cap disposed at the distal end of the outer tubular member for forming a cooling chamber at the distal end of the outer tubular member;
an inner tubular member slidably disposed within the outer tubular member and having a proximal end and a distal end, the proximal end of the inner tubular member being adapted to receive a fluid which when expanded cools to an extremely low temperature;
a Joule-Thompson nozzle disposed on the distal end of the inner tubular member; and,
a nozzle control system comprising an inner ring member formed of a magnetic material fixedly mounted on the proximal end of the inner tubular member, and an outer ring member formed of a magnetic material slidably mounted on the outer tubular member which when moved along the outer tubular member causes the inner magnetic ring member to be pulled along with the outer magnetic ring member to thereby cause the inner tubular member to be moved longitudinally thereby causing the Joule-Thompson nozzle to be moved longitudinally within the cooling chamber.
8. A cryoablation catheter system as defined inclaim 7 , wherein the inner tubular member is disposed coaxially within the outer tubular member so as to define a passageway between the inner tubular member and the outer tubular member; and,
a cylindrical support member is disposed between the inner tubular member and the outer tubular member, said support member having at least one passageway which extends through the support member to permit fluid to be returned through the passageway for removal from the catheter system.
9. A cryoablation catheter system as defined inclaim 8 , wherein the inner magnetic ring member is disposed coaxially within the outer tubular member and extends in the passageway between the inner tubular member and the outer tubular member; and,
said inner magnetic ring member has at least one passageway which extends through the inner ring member to permit fluid to be returned through the passageway for removal from the catheter system.
Priority Applications (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US10/001,360US6547785B1 (en) | 2001-10-23 | 2001-10-23 | Cryoablation catheter for long lesion ablations |
| EP02257265AEP1306059B1 (en) | 2001-10-23 | 2002-10-18 | Cryoablation catheter for long lesion ablations |
| DE60223774TDE60223774T2 (en) | 2001-10-23 | 2002-10-18 | Cryoablation catheter for oblong ablation |
| JP2002307368AJP2003169808A (en) | 2001-10-23 | 2002-10-22 | Low-temperature cauterization catheter for cauterization of long traumatic segment |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US10/001,360US6547785B1 (en) | 2001-10-23 | 2001-10-23 | Cryoablation catheter for long lesion ablations |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| US6547785B1 US6547785B1 (en) | 2003-04-15 |
| US20030078570A1true US20030078570A1 (en) | 2003-04-24 |
Family
ID=21695645
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| US10/001,360Expired - Fee RelatedUS6547785B1 (en) | 2001-10-23 | 2001-10-23 | Cryoablation catheter for long lesion ablations |
Country Status (4)
| Country | Link |
|---|---|
| US (1) | US6547785B1 (en) |
| EP (1) | EP1306059B1 (en) |
| JP (1) | JP2003169808A (en) |
| DE (1) | DE60223774T2 (en) |
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Also Published As
| Publication number | Publication date |
|---|---|
| EP1306059A2 (en) | 2003-05-02 |
| DE60223774D1 (en) | 2008-01-10 |
| DE60223774T2 (en) | 2008-04-10 |
| US6547785B1 (en) | 2003-04-15 |
| EP1306059A3 (en) | 2004-07-21 |
| EP1306059B1 (en) | 2007-11-28 |
| JP2003169808A (en) | 2003-06-17 |
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