WO2003055133A1 - Intervention tool - Google Patents
Intervention tool Download PDFInfo
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- WO2003055133A1 WO2003055133A1 PCT/EP2002/014018 EP0214018W WO03055133A1 WO 2003055133 A1 WO2003055133 A1 WO 2003055133A1 EP 0214018 W EP0214018 W EP 0214018W WO 03055133 A1 WO03055133 A1 WO 03055133A1
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- catheter
- tip
- instrument according
- interventional instrument
- central channel
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
- A61B8/445—Details of catheter construction
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
- A61B8/0841—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
Definitions
- the invention relates to an interventional instrument for insertion into a lumen of the human body, in particular an instrument to be used intracardially for insertion into the cardiovascular system.
- Such interventional instruments are e.g. B. catheters for placing vascular prostheses, so-called stents, with which constrictions in veins or vessels can be widened.
- so-called balloon catheters are used, which are advanced in the patient's bloodstream to the constriction to be treated, after which the balloon, which is arranged at the tip of the catheter, is inflated, thereby expanding the constriction, so that again an essentially normal blood flow is reached through the blood vessel. Then or at the same time, a stent can be placed to keep the narrowed area open.
- stenoses in the area of the heart valves can also be removed, whereby this procedure is often monitored with the help of external echocardiography.
- the patient's chest is irradiated using an ultrasound transducer; the reflected waves are received, evaluated and z. B. displayed on a color monitor.
- Echocardiography is a special application of the pulse echo method in the time-motion or real-time method or the continuous sound Doppler method for cardiac diagnosis, with the transducer is positioned on the front wall of the chest.
- Heart valve or mitral stenoses can be recorded and assessed, as well as aortic valve insufficiency, etc.
- Interventional instruments are known, in particular for minimally invasive medicine, which enable intracorporeal treatment, for example laser treatment, with the treatment site being monitored optically at the same time. This is done e.g. B. with the help of an optical fiber that runs in the instrument and into which light from an external light source is radiated, w ei the reflected light is recorded via a further optical fiber and is imaged, for example, on a monitor.
- such instruments can generally not be used in the bloodstream of a patient, since blood is a poor light guide and the optical monitoring is additionally disrupted by turbulence within the blood in the event of an intervention.
- the invention has for its object to provide an interventional instrument, in particular an intracardially used instrument for the coronary vascular system, with which the diagnosis and any intervention can be simplified.
- the interventional instrument accordingly has the following features: a catheter with a flexible tube, e.g. B. made of PVC, and a central channel penetrating the tube in its longitudinal direction, which has a preferably central mouth in the region of the catheter tip;
- a catheter with a flexible tube e.g. B. made of PVC
- a central channel penetrating the tube in its longitudinal direction which has a preferably central mouth in the region of the catheter tip
- an ultrasound transducer in the area of the tip of the catheter, which is preferably integrated in the wall of the catheter and is connected to an echocardiography device provided there via electrical lines running in the wall of the catheter to its distal end; the ultrasound transducer preferably surrounds the central channel of the tip of the catheter.
- a hand-held device which surrounds the catheter and is located extracorporeally and which is connected to controlled bending of the tip of the catheter with guide wires which run in the wall of the catheter and lead to the tip thereof;
- a branching piece in the catheter between the handheld device and the echocardiography device which has at least one lockable channel leading into the central channel of the catheter;
- a branching piece can be inserted into the central channel of the catheter and can be pushed up to its mouth, in order to carry out a medical intervention.
- the catheter is z. B. by an operator in the heart of a patient up to the area to be operated on Heart valve inserted, this insertion being controlled by observation of the image provided by the echocardiography device.
- the surgical instrument is then inserted into the catheter and pushed to the treatment site.
- the treatment site is shown on the monitor of the echocardiography device so that the desired operation can be carried out there with the surgical instrument; this in turn takes place while monitoring the image of the echocardiography device.
- Possible operations include removing a stenosis, taking tissue samples, etc. B. scalpels, tweezers, pliers, scrapers, etc. into consideration.
- the ultrasound transducer is preferably a phase-controlled transducer which operates in the range from approximately 5 to 10 MHz, a color Doppler mode being preferably used.
- a phase-controlled transducer which operates in the range from approximately 5 to 10 MHz, a color Doppler mode being preferably used.
- impulse mode i.e. M or 2D operation possible.
- FIG. 1 shows a schematic illustration of an interventional instrument according to the invention with a catheter receiving an operating instrument
- FIG. 2 shows a longitudinal section of the instrument according to FIG. 1 in the region of the catheter tip;
- Figure 3 is a schematic cross section along III-III in Figures 1 and 2;
- FIG. 4 shows a cross section through the instrument along IV-IV in FIG. 1.
- An interventional instrument 1 has a catheter 2 made of a thin PVC tube with a diameter of about 4 mm in this case, which is provided with a central channel 3 with a diameter of about 2 mm in this case, which is at the tip of the catheter Mouth 4 has.
- an ultrasound transducer 5 is incorporated in the wall of the tube, which can be of conventional design and z.
- B. consists of several segments 6, which are only indicated in Figure 2.
- the catheter 2 is guided to and passes through a hand-held device 7.
- the hand-held device 7 has two setting wheels 8 and 9, which can be rotated clockwise or counterclockwise by 180 ° about the longitudinal axis of the catheter.
- the handwheels 8 and 9 are connected in this case to four adjusting wires 10 which run from the adjusting wheels in the wall of the catheter 2 to the tip thereof.
- the tip of the catheter can be bent in all directions up to an angle non about 45 °; this enables a controlled advancement of the catheter 2 z. B. through the bloodstream around curves of the blood vessel.
- Control panel 16 which is connected to electronics, not shown here, with the
- Electrocardiography device 14 transmit signals in the
- Doppler operation in the range between 5 and 10 MHz is directed to the individual segments 6 of the transducer, the signals received by the transducer in turn via the
- Lines 11 are returned to the electrocardiography device 14. According to the Doppler principle, these signals can then be evaluated by the electronics and sent to the
- Blood vessel appears in the area of the catheter tip.
- the catheter 2 has between the hand-held device 7 and the connector 12 a branching piece 17 with two connecting channels 18 and 19 which open into the central channel 3 of the catheter and can be shut off at their distal ends by a valve 20 or 21.
- an only indicated surgical instrument 22 in this case a scalpel, is introduced into the central channel 3 with the aid of a guide wire 23 via the channel 18 of the branching piece 17 and advanced to the tip of the catheter, where it emerges from the mouth 4 there.
- this surgical instrument the desired medical intervention is carried out, for example by actuating an operating handle 24 at the end of the guide wire.
- Physiological parameters can be determined via the connecting channel 19 of the branching piece 17, eg. B. the pressure at the treatment site, for example in the heart chamber or in a blood vessel, blood samples are taken or contrast and medicinal products are injected.
Abstract
The invention relates to an intervention tool which comprises a catheter (2) at the tip of which an ultrasound transducer (5), preferably a phase-controlled Doppler ultrasound transducer, is provided with which an image of the surroundings of the catheter tip can be displayed on an echography device. The catheter (2) furthermore has a central channel (3) that extends through the catheter in the longitudinal direction and that leads to the open in the area of the tip of the catheter. Surgical tools (22) can be inserted via said channel for the purpose of a medical intervention in the area of the catheter tip.
Description
Interventionelles Instrument Interventional instrument
Die Erfindung bezieht sich auf ein interventionelles Instrument zum Einführen in ein Lumen des menschlichen Körpers, insbesondere ein intracardial zu verwendendes Instrument zum Einführen in das cardiovasculäre System.The invention relates to an interventional instrument for insertion into a lumen of the human body, in particular an instrument to be used intracardially for insertion into the cardiovascular system.
Derartige interventioneile Instrumente sind z. B. Katheter zum Platzieren von Gefäßprothesen, sogenannten Stents, mit denen Engstellen in Adern bzw. Gefäßen aufgeweitet werden können. Zu diesem Zweck werden sogenannte Ballonkatheter verwendet, die in der Blutbahn des Patienten an die zu behandelnde Engstelle vorgeschoben werden, wonach der Ballon, der an der Spitze des Katheters angeordnet ist, aufgeblasen und dadurch die Engstelle aufgeweitet wird, sodass wieder ein im wesentlichen normaler Blutfluss durch das Blutgefäß erreicht wird. Anschließend oder gleichzeitig kann zum Offenhalten der aufgewei eten Engstelle ein Stent platziert werden.Such interventional instruments are e.g. B. catheters for placing vascular prostheses, so-called stents, with which constrictions in veins or vessels can be widened. For this purpose, so-called balloon catheters are used, which are advanced in the patient's bloodstream to the constriction to be treated, after which the balloon, which is arranged at the tip of the catheter, is inflated, thereby expanding the constriction, so that again an essentially normal blood flow is reached through the blood vessel. Then or at the same time, a stent can be placed to keep the narrowed area open.
Mit speziellen Ballonkathetern können auch Stenosen im Bereich der Herzklappen beseitigt werden, wobei dieses Verfahren häufig mit Hilfe der externen Echokardiographie überwacht wird. Hierbei wird der Brustkorb des Patienten mit Hilfe eines Ultraschallwandlers durchstrahlt; die reflektierten Wellen werden empfangen, ausgewertet und z. B. auf einem Farbmonitor dargestellt. Die Echokardiograhpie ist eine spezielle Anwendung des Impuls-Echoverfahrens im Time-Motion- oder Real-Time-Verfahren oder des Dauerschall- Doppler-Verfahrens zur Herzdiagnostik, wobei der Schallkopf
auf der Thorax-Vorderwand positioniert wird. Hiermit können Herzklappen- bzw. Mitralstenosen erfasst und beurteilt werden, ebenso Aortenklappeninsuffizienz etc.With special balloon catheters, stenoses in the area of the heart valves can also be removed, whereby this procedure is often monitored with the help of external echocardiography. The patient's chest is irradiated using an ultrasound transducer; the reflected waves are received, evaluated and z. B. displayed on a color monitor. Echocardiography is a special application of the pulse echo method in the time-motion or real-time method or the continuous sound Doppler method for cardiac diagnosis, with the transducer is positioned on the front wall of the chest. Heart valve or mitral stenoses can be recorded and assessed, as well as aortic valve insufficiency, etc.
Es wäre wünschenswert, die Diagnose derartiger Krankheiten zu vereinfachen und gegebenenfalls auch einen Eingriff an der befallenen Stelle vornehmen zu können.It would be desirable to simplify the diagnosis of such diseases and, if necessary, to be able to intervene in the affected area.
Es sind interventioneile Instrumente bekannt, insbesondere für die minimalinvasive Medizin, die eine intrakorporale Behandlung, z, B. eine Laserbehandlung ermöglichen, wobei gleichzeitig der Behandlungsort optisch überwacht wird. Dies erfolgt z. B. mit Hilfe einer Lichtleitfaser, die in dem Instrument verläuft und in die Licht von einer externen Lichtquelle eingestrahlt wird, w ei das reflektierte Licht über eine weitere Lichtleitfaser aufgenommen und etwa auf einem Monitor abgebildet wird. Derartige Instrumente können jedoch in aller Regel nicht in der Blutbahn eines Patienten angewendet werden, da Blut ein schlechter Lichtleiter ist und die optische Überwachung bei einem etwaigen Eingriff durch Turbulenzen innerhalb des Blutes zusätzlich gestört wird.Interventional instruments are known, in particular for minimally invasive medicine, which enable intracorporeal treatment, for example laser treatment, with the treatment site being monitored optically at the same time. This is done e.g. B. with the help of an optical fiber that runs in the instrument and into which light from an external light source is radiated, w ei the reflected light is recorded via a further optical fiber and is imaged, for example, on a monitor. However, such instruments can generally not be used in the bloodstream of a patient, since blood is a poor light guide and the optical monitoring is additionally disrupted by turbulence within the blood in the event of an intervention.
Der Erfindung liegt die Aufgabe zugrunde, ein interventionelles Instrument insbesondere ein intracardial zu verwendendes Instrument für das Coronar-Gefäßsystem anzugeben, mit dem die Diagnose und ein etwaiger Eingriff vereinfacht werden können.The invention has for its object to provide an interventional instrument, in particular an intracardially used instrument for the coronary vascular system, with which the diagnosis and any intervention can be simplified.
Diese Aufgabe ist gemäß der Erfindung durch die Merkmale des Anspruches 1 gelöst.This object is achieved according to the invention by the features of claim 1.
Demgemäss weist das interventioneile Instrument folgende Merkmale auf:
einen Katheter mit einem flexiblen Schlauch, z. B. aus PVC, und einem den Schlauch in dessen Längsrichtung durchsetzenden zentralen Kanal, der im Bereich der Katheterspitze eine vorzugsweise mittige Mündung aufweist;The interventional instrument accordingly has the following features: a catheter with a flexible tube, e.g. B. made of PVC, and a central channel penetrating the tube in its longitudinal direction, which has a preferably central mouth in the region of the catheter tip;
einen Ultraschallwandler im Bereich der Spitze des Katheters, der vorzugsweise in der Wand des Katheters integriert ist und über in der Wand des Katheters zu dessen distalem Ende verlaufende elektrische Leitungen mit einem dort vorgesehenen Echokardiographiegerät verbunden ist; der Ultraschallwandler umgibt im Bereich der Spitze des Katheters vorzugsweise dessen zentralen Kanal.an ultrasound transducer in the area of the tip of the catheter, which is preferably integrated in the wall of the catheter and is connected to an echocardiography device provided there via electrical lines running in the wall of the catheter to its distal end; the ultrasound transducer preferably surrounds the central channel of the tip of the catheter.
ein den Katheter umgebendes und extrakorporal gelegenes Handgerät, das zum gesteuerten Abbiegen der Spitze des Katheters mit Stelldrähten verbunden ist, die in der Wand des Katheters verlaufen und bis zu dessen Spitze führen;a hand-held device which surrounds the catheter and is located extracorporeally and which is connected to controlled bending of the tip of the catheter with guide wires which run in the wall of the catheter and lead to the tip thereof;
ein Verzweigungsstück im Katheter zwischen Handgerät und Echokardiographiegerät, welches zumindest einen in den zentralen Kanal des Katheters führenden absperrbaren Kanal aufeist; unda branching piece in the catheter between the handheld device and the echocardiography device, which has at least one lockable channel leading into the central channel of the catheter; and
ein Operationsinstrument, das über dasa surgical tool that is about the
Verzweigungsstück in den zentralen Kanal des Katheters einführbar und bis zu dessen Mündung vorschiebbar ist, zur Durchführung einer medizinischen Intervention.A branching piece can be inserted into the central channel of the catheter and can be pushed up to its mouth, in order to carry out a medical intervention.
Der Katheter wird z. B. durch einen Operateur in das Herz eines Patienten bis in die Nähe einer zu operierenden
Herzklappe eingeführt, wobei dieses Einführen durch Beobachtung des durch das Echokardiographiegerät gelieferten Bildes gesteuert wird. Anschließend wird das Operationsinstrument in den Katheter eingeführt und an den Behandlungsort geschoben. Der Behandlungsort wird auf dem Monitor des Echokardiographiegerätes dargestellt, sodass dort mit dem Operationsinstrument die gewünschte Operation durchgeführt werden kann; dieses erfolgt wiederum unter Überwachung des Bildes des Echokardiographiegerätes. Mögliche Operation sind etwa, Beseitigen einer Stenose, Entnehemsn von Gewebeproben etc. Als Operationsinstrumente zur medizinischen Intervention kommen z. B. Skalpelle, Pinzetten, Zangen, Schabegeräte, etc. in Betracht.The catheter is z. B. by an operator in the heart of a patient up to the area to be operated on Heart valve inserted, this insertion being controlled by observation of the image provided by the echocardiography device. The surgical instrument is then inserted into the catheter and pushed to the treatment site. The treatment site is shown on the monitor of the echocardiography device so that the desired operation can be carried out there with the surgical instrument; this in turn takes place while monitoring the image of the echocardiography device. Possible operations include removing a stenosis, taking tissue samples, etc. B. scalpels, tweezers, pliers, scrapers, etc. into consideration.
Vorzugsweise ist der Ultraschallwandler ein phasengesteuerter Transducer, der im Bereich von etwa 5 bis 10 MHz arbeitet, wobei bevorzugt ein Farb-Dopplerbetrieb verwendet wird. Selbstverständlich sind auch die o. a. anderen Arbeitsweisen im Impulsbetrieb, das heißt M- oder 2D-Betrieb möglich.The ultrasound transducer is preferably a phase-controlled transducer which operates in the range from approximately 5 to 10 MHz, a color Doppler mode being preferably used. Of course, the above. other ways of working in impulse mode, i.e. M or 2D operation possible.
Weitere Ausgestaltungen der Erfindung ergeben sich aus den Unteransprüchen .Further embodiments of the invention result from the subclaims.
Die Erfindung ist ein einem Ausführungsbeispiel anhand der Zeichnung näher erläutert. In dieser stellen dar:The invention is explained in more detail in one embodiment using the drawing. In this represent:
Figur 1 eine schematische Darstellung eines interventioneilen Istrumentes gemäß der Erfindung mit einem ein Operationsinstrument aufnehmenden Katheter;FIG. 1 shows a schematic illustration of an interventional instrument according to the invention with a catheter receiving an operating instrument;
Figur 2 einen Längsschnitt des Instrumentes gemäß Figur 1 im Bereich der Katheterspitze;
Figur 3 einen schematischen Querschnitt längs III-III in den Figuren 1 und 2; undFIG. 2 shows a longitudinal section of the instrument according to FIG. 1 in the region of the catheter tip; Figure 3 is a schematic cross section along III-III in Figures 1 and 2; and
Figur 4 einen Querschnitt durch das Instrument längs IV-IV in Figur 1.FIG. 4 shows a cross section through the instrument along IV-IV in FIG. 1.
Ein interventionelles Instrument 1 weist einen Katheter 2 aus einem dünnen PVC-Schlauch mit einem Durchmesser von in diesem Fall etwa 4 mm auf, der mit einem zentralen Kanal 3 mit einem Durchmesser von in diesem Falle etwa 2 mm versehen ist, der an der Katheterspitze eine Mündung 4 aufweist. Im Bereich der Katheterspitze ist in der Wand des Schlauches ein Ultraschall-Transducer 5 eingearbeitet, der herkömmlicher Bauart sein kann und z. B. aus mehreren Segmenten 6 besteht, die in Figur 2 nur angedeutet sind. Der Katheter 2 ist zu einem Handgerät 7 geführt und durchsetzt dieses. Das Handgerät 7 weist zwei Stellräder 8 und 9 auf, die jeweils im bzw. gegen den Uhrzeigersinn um 180° um die Längsachse des Katheters drehbar sind. Die Handräder 8 und 9 sind mit in diesem Falle vier Stelldrähten 10 verbunden, die von den Stellrädern in der Wand des Katheters 2 bis zu dessen Spitze verlaufen. Durch Verdrehen der Stellräder kann die Spitze des Katheters in alle Richtungen bis zu einem Winkel non etwa 45° abgebogen werden; dieses ermöglicht ein gesteuertes Vorschieben des KAtheters 2 z. B. durch die Blutbahn um Kurven des Blutgefässes herum.An interventional instrument 1 has a catheter 2 made of a thin PVC tube with a diameter of about 4 mm in this case, which is provided with a central channel 3 with a diameter of about 2 mm in this case, which is at the tip of the catheter Mouth 4 has. In the area of the catheter tip, an ultrasound transducer 5 is incorporated in the wall of the tube, which can be of conventional design and z. B. consists of several segments 6, which are only indicated in Figure 2. The catheter 2 is guided to and passes through a hand-held device 7. The hand-held device 7 has two setting wheels 8 and 9, which can be rotated clockwise or counterclockwise by 180 ° about the longitudinal axis of the catheter. The handwheels 8 and 9 are connected in this case to four adjusting wires 10 which run from the adjusting wheels in the wall of the catheter 2 to the tip thereof. By turning the setting wheels, the tip of the catheter can be bent in all directions up to an angle non about 45 °; this enables a controlled advancement of the catheter 2 z. B. through the bloodstream around curves of the blood vessel.
In der Wand des Schlauches 2 sind elektrische Leitungen 11 eingearbeitet, die zu den einzelnen Segmenten 6 des Transducers 5 führen. Die Leitungen werden in der Wand des Schlauches 2 auch jenseits des Handgerätes 7 bis zu einem Stecker 12 am distalen Ende des Katheters 1 weitergeführt. Dieser Stecker wird mit einem korrespondierenden Stecker 13
eines Echokardiographiegerätes 14 verbunden, das, wie schematisch angedeutet, einen Farbmonitor 15 und einIn the wall of the hose 2, electrical lines 11 are incorporated, which lead to the individual segments 6 of the transducer 5. The lines are continued in the wall of the tube 2 beyond the handheld device 7 up to a plug 12 at the distal end of the catheter 1. This connector is connected to a corresponding connector 13 an echocardiography device 14 connected, which, as indicated schematically, a color monitor 15 and a
Bedienfeld 16 aufweist, welches mit einer hier nicht dargestellten Elektronik verbunden ist, die mit denControl panel 16, which is connected to electronics, not shown here, with the
Leitungen des Steckers 13 kommuniziert. Von demLines of the plug 13 communicates. Of the
Elektrokardiographiegerät 14 werden Sendesignale imElectrocardiography device 14 transmit signals in the
Dopplerbetrieb im Bereich zwischen 5 und 10 MHz an die einzelnen Segmente 6 des Transducers geleitet, wobei die von dem Transducer empfangenen Signale wiederum über dieDoppler operation in the range between 5 and 10 MHz is directed to the individual segments 6 of the transducer, the signals received by the transducer in turn via the
Leitungen 11 zum Elektrokardiographiegerät 14 zurückgeleitet werden. Nach dem Dopplerprinzip können dann diese Signale durch die Elektronik ausgewertet und an denLines 11 are returned to the electrocardiography device 14. According to the Doppler principle, these signals can then be evaluated by the electronics and sent to the
Monitor 15 weitergeleitet werden, auf dem dann das Bild desMonitor 15 are forwarded, on which then the image of the
Blutgefässes im Bereich der Katheterspitze erscheint.Blood vessel appears in the area of the catheter tip.
Der Katheter 2 weist zwischen dem Handgerät 7 und dem Stecker 12 ein Verzweigungsstück 17 mit zwei Anschlusskanälen 18 und 19 auf, die in den zentralen Kanal 3 des Katheters münden und an ihren distalen Enden jeweils durch ein Ventil 20 bzw. 21 absperrbar sind. Über den Kanal 18 des Verzweigungsstückes 17 wird, sobald die Spitze des Katheters den gewünschten und mit Hilfe des Echokardiographiegerätes definierten Behandlungsort erreicht hat, ein nur angedeutetes Operationsinstrument 22, in diesem Falle etwa ein Skalpell, in den zentralen Kanal 3 mit Hilfe eines Führungsdrahtes 23 eingebracht und bis zu der Katheterspitze vorgeschoben, wo es aus der dortigen Mündung 4 austritt. Mit diesem Operationsinstrument wird, etwa durch Betätigen eines Bediengriffes 24 am Ende des Führungsdrahtes, die gewünschte medizinische Intervention vorgenommen. Ein Beispiel hierfür ist etwa die Entfernung einer Stenose an einer Herzklappe. Gesteuert wird diese Intervention von einem Operateur anhand des auf dem Monitor 15 erscheinenden Bildes.
Über den Anschlusskanal 19 des Verzweigungsstückes 17 können physiologische Parameter bestimmt werden, z. B. der Druck am Behandlungsort etwa in der Herzkammer oder in einem Blutgefäß, Blutproben entnommen werden oder Kontrastund Arzneimittel injiziert werden.
The catheter 2 has between the hand-held device 7 and the connector 12 a branching piece 17 with two connecting channels 18 and 19 which open into the central channel 3 of the catheter and can be shut off at their distal ends by a valve 20 or 21. As soon as the tip of the catheter has reached the desired treatment location, which is defined with the aid of the echocardiography device, an only indicated surgical instrument 22, in this case a scalpel, is introduced into the central channel 3 with the aid of a guide wire 23 via the channel 18 of the branching piece 17 and advanced to the tip of the catheter, where it emerges from the mouth 4 there. With this surgical instrument, the desired medical intervention is carried out, for example by actuating an operating handle 24 at the end of the guide wire. An example of this is the removal of a stenosis from a heart valve. This intervention is controlled by an operator on the basis of the image appearing on the monitor 15. Physiological parameters can be determined via the connecting channel 19 of the branching piece 17, eg. B. the pressure at the treatment site, for example in the heart chamber or in a blood vessel, blood samples are taken or contrast and medicinal products are injected.
Claims
1. Katheter zum Einführen in ein Lumen des menschlichen Körpers, gekennzeichnet durch folgende Merkmale:1. Catheter for insertion into a lumen of the human body, characterized by the following features:
einen Katheter (2) mit einem flexiblen Schlauch und einem den Schlauch in dessen Längsrichtung durchsetzenden zentralen Kanal (3) , der im Bereich der Spitze des Katheters eine Mündung (4) aufweist;a catheter (2) with a flexible tube and a central channel (3) penetrating the tube in its longitudinal direction and having a mouth (4) in the area of the tip of the catheter;
einen Ultraschallwandler (5) im Bereich der Spitze des Katheters (2), der über in der Wand des Katheters (2) zu dessen distalem Ende verlaufende elektrische Leitungen (11) mit einem dort vorgesehenen Echokardiographiegerät (14) verbindbar ist;an ultrasound transducer (5) in the area of the tip of the catheter (2), which can be connected to an echocardiography device (14) provided there via electrical lines (11) running in the wall of the catheter (2) to its distal end;
ein den Katheter umgebendes und extrakorporal gelegenes Handgerät (7), das zum gesteuerten Abbiegen der Spitze des Katheters (2) mit Stelldrähten (10) verbunden ist, die in der Wand des Katheters (2) verlaufen und bis zu dessen Spitze führen;a hand-held device (7) which surrounds the catheter and is located extracorporeally and which, for the controlled bending of the tip of the catheter (2), is connected to adjusting wires (10) which run in the wall of the catheter (2) and lead to the tip thereof;
ein Verzweigungsstück (17) im Katheter (2) zwischen Handgerät (7) und Echokardiographiegerät (14), welches zumindest einen in den zentralen Kanal (3) des Katheters (2) führenden absperrbaren Kanal 18, 19) aufeist; unda branching piece (17) in the catheter (2) between the handheld device (7) and the echocardiography device (14), which has at least one lockable channel 18, 19) leading into the central channel (3) of the catheter (2); and
ein Operationsinstrument (22) , das über das Verzweigungsstück (17) in den zentralen Kanal (3) des Katheters einführbar und bis zu dessen Mündung (4) vorschiebbar ist, zur Durchführung einer medizinischen Intervention.an operating instrument (22) which via the branching piece (17) into the central channel (3) of the Catheter insertable and can be pushed up to its mouth (4) for performing a medical intervention.
2. Interventionelles Instrument nach Anspruch 1, dadurch gekennzeichnet, dass der Ultraschallwandler (5) ein phasengesteuerter Transducer ist.2. Interventional instrument according to claim 1, characterized in that the ultrasonic transducer (5) is a phase-controlled transducer.
3. Interventionelles Instrument nach Anspruch 1 oder 2, dadurch gekennzeichnet, dass der Ultraschallwandler (14) im Bereich von 5 bis 10 MHz arbeitet.3. Interventional instrument according to claim 1 or 2, characterized in that the ultrasonic transducer (14) operates in the range from 5 to 10 MHz.
. Interventionelles Instrument nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass der Ultraschallwandler (5) im Dopplerbetrieb arbeitet., Interventional instrument according to one of the preceding claims, characterized in that the ultrasonic transducer (5) operates in Doppler mode.
5. Interventionelles Instrument nach Anspruch 4, dadurch gekennzeichnet, dass das Echographiegerät (14) ein Doppler-Echographiegerät , insbesondere ein Doppler- Echokardiographiegerät ist.5. Interventional instrument according to claim 4, characterized in that the echography device (14) is a Doppler echography device, in particular a Doppler echocardiography device.
6. Interventionelles Instrument nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass der zentrale Kanal (3) an der Spitze des Katheters (2) zentral ins Freie mündet und im Bereich der Spitze des Katheters von dem Ultraschaiiwandler (5) umgeben ist.6. Interventional instrument according to one of the preceding claims, characterized in that the central channel (3) opens out centrally at the tip of the catheter (2) and is surrounded by the ultrasound transducer (5) in the area of the tip of the catheter.
7. Interventionelles Instrument nach einem der vorhergehenden Ansprüche, dadurch gekennzeichnet, dass der Katheter (2) ein Handgerät (7) aufweist, das mit Stelldrähten (10) verbunden ist, die in der Wand des Katheters (2) eingearbeitet sind und zur Spitze des Katheters (2) führen. Interventionelles Instrument nach Anspruch 7, dadurch gekennzeichnet, dass das Handgerät (2) mit den Stelldrähten (10) verbundene Stellräder (8, 9) aufweist. 7. Interventional instrument according to one of the preceding claims, characterized in that the catheter (2) has a hand-held device (7) which is connected to control wires (10) which are incorporated in the wall of the catheter (2) and to the tip of the Guide the catheter (2). Interventional instrument according to claim 7, characterized in that the hand-held device (2) has adjusting wheels (8, 9) connected to the adjusting wires (10).
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE10160594.3 | 2001-12-10 | ||
| DE2001160594 DE10160594A1 (en) | 2001-12-10 | 2001-12-10 | Instrument for introduction into a lumen of a human body comprises a catheter, an ultrasonic converter in the catheter end zone, a control handle, and an operation tool |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| WO2003055133A1 true WO2003055133A1 (en) | 2003-07-03 |
| WO2003055133A9 WO2003055133A9 (en) | 2004-12-29 |
Family
ID=7708661
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/EP2002/014018 WO2003055133A1 (en) | 2001-12-10 | 2002-12-10 | Intervention tool |
Country Status (2)
| Country | Link |
|---|---|
| DE (1) | DE10160594A1 (en) |
| WO (1) | WO2003055133A1 (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2008042423A2 (en) * | 2006-10-02 | 2008-04-10 | Hansen Medical, Inc. | Systems for three-dimensional ultrasound mapping |
Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP0616794A1 (en) * | 1993-03-12 | 1994-09-28 | Heart Rhythm Technologies, Inc. | Catheter for electrophysiological procedures |
| EP0904797A2 (en) * | 1997-09-24 | 1999-03-31 | Eclipse Surgical Technologies, Inc. | Steerable catheter with tip alignment and surface contact detector |
| US5935108A (en) * | 1997-11-14 | 1999-08-10 | Reflow, Inc. | Recanalization apparatus and devices for use therein and method |
| US6099475A (en) * | 1991-11-08 | 2000-08-08 | Mayo Foundation For Medical Education And Research | Volumetric image ultrasound transducer underfluid catheter system |
| WO2001070114A1 (en) * | 2000-03-17 | 2001-09-27 | Rita Medical Systems Inc. | Lung treatment apparatus |
| WO2001087174A1 (en) * | 2000-05-16 | 2001-11-22 | Atrionx, Inc. | Deflectable tip catheter with guidewire tracking mechanism |
-
2001
- 2001-12-10 DE DE2001160594 patent/DE10160594A1/en not_active Withdrawn
-
2002
- 2002-12-10 WO PCT/EP2002/014018 patent/WO2003055133A1/en not_active Application Discontinuation
Patent Citations (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6099475A (en) * | 1991-11-08 | 2000-08-08 | Mayo Foundation For Medical Education And Research | Volumetric image ultrasound transducer underfluid catheter system |
| EP0616794A1 (en) * | 1993-03-12 | 1994-09-28 | Heart Rhythm Technologies, Inc. | Catheter for electrophysiological procedures |
| EP0904797A2 (en) * | 1997-09-24 | 1999-03-31 | Eclipse Surgical Technologies, Inc. | Steerable catheter with tip alignment and surface contact detector |
| US5935108A (en) * | 1997-11-14 | 1999-08-10 | Reflow, Inc. | Recanalization apparatus and devices for use therein and method |
| WO2001070114A1 (en) * | 2000-03-17 | 2001-09-27 | Rita Medical Systems Inc. | Lung treatment apparatus |
| WO2001087174A1 (en) * | 2000-05-16 | 2001-11-22 | Atrionx, Inc. | Deflectable tip catheter with guidewire tracking mechanism |
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2008042423A2 (en) * | 2006-10-02 | 2008-04-10 | Hansen Medical, Inc. | Systems for three-dimensional ultrasound mapping |
| WO2008042423A3 (en) * | 2006-10-02 | 2008-07-24 | Hansen Medical Inc | Systems for three-dimensional ultrasound mapping |
| US8041413B2 (en) | 2006-10-02 | 2011-10-18 | Hansen Medical, Inc. | Systems and methods for three-dimensional ultrasound mapping |
| US8285364B2 (en) | 2006-10-02 | 2012-10-09 | Hansen Medical, Inc. | Systems and methods for three-dimensional ultrasound mapping |
Also Published As
| Publication number | Publication date |
|---|---|
| DE10160594A1 (en) | 2003-06-26 |
| WO2003055133A9 (en) | 2004-12-29 |
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