|Publication number||USRE43300 E1|
|Application number||US 10/126,295|
|Publication date||Apr 3, 2012|
|Filing date||Apr 18, 2002|
|Priority date||Dec 2, 1996|
|Also published as||US6051008|
|Publication number||10126295, 126295, US RE43300 E1, US RE43300E1, US-E1-RE43300, USRE43300 E1, USRE43300E1|
|Inventors||Vahid Saadat, John H. Ream|
|Original Assignee||Abbott Cardiovascular Systems Inc.|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (223), Non-Patent Citations (41), Referenced by (30), Classifications (51), Legal Events (1)|
|External Links: USPTO, USPTO Assignment, Espacenet|
The present application is a continuation-in-part application of commonly assigned U.S. patent application Ser. No. 08/863,877, filed May 27, 1997, now U.S. Pat. No. 5,910,150 which claims the benefit of the filing date of U.S. provisional patent application Ser. No. 60/032,196, filed Dec. 2, 1996.
The present invention relates to apparatus and methods for performing surgery on an interior wall of a hollow-body organ such as the heart, or within the brain cavities and the like. More particularly, the present invention provides a device that enables a clinician to perform surgery on an interior wall of an organ or vessel using apparatus for stabilizing an end effector during the surgery.
A leading cause of death in the United States today is coronary artery disease, in which atherosclerotic plaque causes blockages in the coronary arteries, resulting in ischemia of the heart (i.e., inadequate blood flow to the myocardium). The disease manifests itself as chest pain or angina. In 1996, approximately 7 million people suffered from angina in the United States.
Coronary artery bypass grafting (CABG), in which the patient's chest is surgically opened and an obstructed artery replaced with a native artery harvested elsewhere, has been the conventional treatment for coronary artery disease for the last thirty years. Such surgery creates significant trauma to the patient, requires long recuperation times, and causes a great deal of morbidity and mortality. In addition, experience has shown that the graft becomes obstructed with time, requiring further surgery.
More recently, catheter-based therapies such as percutaneous transluminal coronary angioplasty (PTCA) and atherectomy have been developed. In PTCA, a mechanical dilatation device is disposed across an obstruction in the patient's artery and then dilated to compress the plaque lining the artery to restore patency to the vessel. Atherectomy involves using an end effector, such as a mechanical cutting device (or laser) to cut (or ablate) a passage through the blockage. Such methods have drawbacks, however, ranging from re-blockage of dilated vessels with angioplasty to catastrophic rupture or dissection of the vessel during atherectomy. Moreover, these methods may only be used for that fraction of the patient population where the blockages are few and are easily accessible. Neither technique is suitable for the treatment of diffuse atherosclerosis.
A more recent technique, which holds promise of treating a larger percentage of the patient population, including those patients suffering from diffuse atherosclerosis, is referred to as transmyocardial revascularization (TMR). In this method, a series of channels are formed in the left ventricular wall of the heart. Typically, between 15 and 30 channels about 1 mm in diameter and up to 3.0 cm deep are formed with a laser in the wall of the left ventricle to perfuse the heart muscle with blood coming directly from the inside of the left ventricle, rather than traveling through the coronary arteries. Apparatus and methods have been proposed to create those channels both percutaneously and intraoperatively (i.e., with the chest opened).
U.S. Pat. No. 5,389,096 to Aita et al. describes a catheter-based laser apparatus for percutaneously forming channels extending from the endocardium into the myocardium. U.S. Pat. No. 5,380,316 to Aita et al. describes an intraoperative laser-based system for performing TMR. U.S. Pat. No. 5,591,159 to Taheri describes a mechanical apparatus for performing TMR involving a catheter having an end effector formed from a plurality of spring-loaded needles.
Neither the Aita nor Taheri devices describe apparatus wherein the laser-tip or spring-loaded needles are stabilized during the channel-forming process. Because the end effector of such devices may shift position while in use, such previously known devices may not provide the ability to reliably determine the depth of the channels, nor the relative positions between channels if multiple channels are formed.
In view of the shortcomings of previously known TMR devices, it would be desirable to provide apparatus and methods for performing percutaneous surgery, such as TMR, that permit precise control of the end region of the device carrying the end effector.
It also would be desirable to control the location of the end region of the device within the ventricle both with respect to features of the ventricular walls and in relation to other channels formed by the device, and to stabilize the end region of the device within the organ, for example, to counteract reaction forces created by the actuation of the end effector during treatment.
A number of devices are known in the medical arts that provide certain aspects of the desired functionality. For example, U.S. Pat. Nos. 5,389,073 and 5,330,466 to Imran describe steerable catheters; U.S. Pat. No. 5,415,166 to Imran describes a device for endocardial mapping; U.S. Pat. No. 4,813,930 to Elliott describes a radially extendable member for stabilizing an angioplasty catheter within a vessel; U.S. Pat. No. 5,354,310 describes an expandable wire mesh and graft for stabilizing an aneurysm; and U.S. Pat. Nos. 5,358,472 and 5,358,485 to Vance et al. describe atherectomy cutters that provide for aspiration of severed material.
None of the foregoing references overcomes problems associated with locating an end region of a catheter against a position on the inside wall of a heart chamber. Moreover, the prior art is devoid of a comprehensive solution to the above-noted shortcomings of previously-known apparatus for percutaneously performing surgery, and especially for performing TMR.
In view of the foregoing, it is an object of this invention to provide apparatus and methods for performing surgery, such as TMR, that permit precise control of an end effector disposed in an end region of the apparatus.
It is another object of this invention to provide apparatus and methods, suitable for use in performing TMR and surgery of other hollow-body organs, that include the capability to stabilize within the organ an end region of the device carrying an end effector, for example, to counteract reaction forces created by the end effector during treatment.
These and other objects of the present invention are accomplished by providing apparatus having a directable end region carrying an end effector for performing surgery. Apparatus constructed in accordance with the present invention comprises a catheter having a longitudinal axis and an end region movable to a series of positions along the longitudinal axis. The end region may be selectively moved to a position at an angle relative to the longitudinal axis of the catheter, including a substantially orthogonal position. The catheter includes means for stabilizing a distal region of the apparatus within a hollow-body organ, and for counter-acting reaction forces developed during actuation of an end effector.
In a preferred embodiment of the apparatus of the invention, the catheter includes a catheter shaft and a guide member disposed for longitudinal sliding movement within a groove of the catheter shaft. The guide member includes an end region including an end effector maneuverable between a transit position wherein the end region lies parallel to a longitudinal axis of the catheter to a working position wherein the end region and end effector are oriented at an angle relative to the longitudinal axis, including a substantially orthogonal position. The catheter shaft preferably may include adjustable outwardly projecting stabilization members to provide a stable platform to counteract reaction forces generated when the end effector contacts the wall of the hollow-body organ.
Methods of using the apparatus of the present invention to perform surgery, such as transmyocardial revascularization, are also provided.
Further features of the invention, its nature and various advantages will be more apparent from the accompanying drawings and the following detailed description of the preferred embodiments, in which:
The present invention relates generally to apparatus and methods for percutaneously performing surgery within an organ or vessel. The apparatus of the present invention comprises a catheter including a stabilizing catheter shaft which percutaneously may be disposed within an organ. A guide member engaged with the catheter shaft includes an end region that may be selectively articulated to a position at an angle to a longitudinal axis of the catheter, including a position substantially orthogonal to the longitudinal axis. The end region carries an end effector (e.g., an ablative or mechanical cutting device) for treating tissue. Severed or ablated tissue may be aspirated through the catheter to its proximal end for disposal. The catheter shaft, either alone or in conjunction with stabilizing members, and the guide member, provides precise control over the location of the end region, and thus, the end effector.
The present invention therefore offers a device having a directable end region and end effector for performing surgery that provides a degree of control heretofore unattainable. While the invention is described hereinafter as particularly useful in the emerging field of transmyocardial revascularization, apparatus constructed in accordance with the present invention may be advantageously used in performing surgery on other organs or vessels, such as the intestines, blood vessels or the brain cavities. In addition, while the present invention is described herein in the context of a mechanical cutting system, the control and stabilization apparatus of the present invention may be advantageously used with other types of cutting elements, such as lasers, cryogenic cutters or radio-frequency ablation devices.
End region 25 of guide member 22 may be positioned longitudinally with respect to catheter shaft 21 by imparting relative movement between guide member 22 and catheter shaft 21 using handle assembly 26. Catheter shaft 21 preferably includes a plurality of stabilizing members 27 to support and stabilize distal region 23 of the apparatus within the hollow-body organ.
Apparatus 20 is coupled via cable 28 to controller 29. In a preferred embodiment wherein the end effector comprises a rotating cutting head, controller 29 includes a motor and control logic for rotating the cutting head responsive to commands input at handle assembly 26 or a footpedal (not shown) and a vacuum source for aspirating severed tissue from the treatment site. Controller 29 optionally may further include RF circuitry (shown in dotted line) for energizing the cutting head to cauterize tissue as it is cut. Alternatively, controller 29 may include a laser source or radio frequency circuitry for causing laser or RF ablation, respectively, using a suitable end effector.
Referring now to
Guide member 22 includes end region 25 carrying an end effector and flanges 34 and 35 that slidingly engage grooves 31 and 32. End region 25 may be articulated in region 36 using control wires or a temperature actuated shape-memory alloy steering mechanism, such as described in the aforementioned patents to Imran. Guide member 22 may be constructed of a spring material (commonly called a Bowden) with spaces in-between the coils to allow it to bend when it is pulled by a control wire asymmetrically, as previously known in the art. Alternatively, guide member 22 may be constructed of a stiffer material such as polyimide coated over a braided steel tubular structure, such as employed in previously known neuro-navigational endoscope devices. In this case, slits are provided on the inside of the bend in region 36 so that the guide member bends in the direction of the slits. The slits allow a tight bend radius which may not otherwise be achievable.
Guide member 22 preferably includes a lumen, as described hereinafter, through which tissue may be evacuated from a treatment site by suction. Accordingly, guide member 22 may also be formed from a loosely wound spring reinforced with a soft elastomeric coating. The elastomeric coating advantageously serves the following functions: it provides sealing along the length of the guide member required to maintain adequate suction through the lumen; it prevents collapse of the lumen in the presence of applied suction; it resists kinking of the coils of the spring; and it also enables the guide member to be bent to relatively tight radii. Reinforced tubing suitable for use as guide member 22 is available from Adam Spence Corporation, Wall, N.J.
In the above-described embodiments, end region 25 of guide member 22 is movable from a transit position lying parallel to the longitudinal axis of catheter shaft 21 to a working position wherein end region 25 is articulated to a position substantially orthogonal to the longitudinal axis of the catheter shaft. In addition, end region 25 may be constructed to enable it to be locked in position at any angle a that may be desired for a given application.
With respect to
Accordingly, wires 27a-27d may be moved from a retracted position in which they are retracted against distal region 23 of catheter shaft 21 to an expanded position in which they engage a wall of the organ and urge end region 25 into engagement with an opposing wall of the organ, thereby stabilizing catheter shaft 21 against rotation.
Stabilization members 27 may be constructed of any suitable elastic material, including stainless steel, spring steel, nickel-titanium alloys, and a variety of plastics. A nickel-titanium alloy is preferred where wires 27a-27d comprise a continuous coil, as in
Where stabilization members 27 comprise a single coil, as in
The longitudinal position of end region 25 with respect to catheter shaft 21 may be adjusted by sliding guide member 22 in groove 30 of the catheter shaft. Handle assembly 26 preferably includes means, described hereinafter, for moving guide member with respect to catheter shaft 21 so that end region 25 may be positioned at a series of vertical locations. In addition, stabilization members 27 may be adjusted to provide some control over the lateral positioning of the catheter shaft and guide member with respect to the interior wall of the organ or vessel. Thus, apparatus 20 enables a matrix of treatment sites to be accessed without removing and repositioning the apparatus.
Referring now to
Orientation of end region 25 of guide member 22 is accomplished by control wire 46, which is slidingly disposed in lumen 47 of guide member 22. As described hereinabove, guide member 22 preferably comprises a spring material with spaces in-between the coils to allow it to bend when control wire 46 is retracted in a proximal direction. Alternatively, guide member 22 may be constructed of polyimide coated over a braided steel tube and includes slits on the inside of bend region 36 so that end region 25 bends in the direction of the slits when control wire 46 is retracted in a proximal direction.
Cutting head 41 is connected to the motor of controller 29 via drive rod 45. Drive rod 45 may be formed of a flexible tube such as a bowden or a covered coil or may be formed of a plastic having both high torquability and flexibility. Drive rod 45 is disposed in lumen 44 for a limited range of reciprocation, e.g., up to 3.0 cm, to permit extension of cutting head 41 beyond the end of guide member 22. When end region 25 is in its transit position, cutting head 41 is disposed just below distal endface 48 of guide member 22. Drive rod 45 is hollow and preferably includes a covering of a soft plastic or elastomeric material to allow the application of a negative pressure to aspirate the severed tissue.
Applicant expects that high speed rotation of cutting head 41 will generate frictional heating of the tissue surrounding the cutting head, thereby causing coagulation of the tissue with minimal thermal damage to the surrounding tissue. Alternatively, tubular member 42 of cutting head 41 may comprise an electrically conductive material and be electrically coupled to the optional radio-frequency generator circuitry in controller 29 to provide coagulation of the edges of a channel formed in the tissue by cutting head 41. In this embodiment, tubular element 42 serves as the electrode in a monopolar coagulation arrangement. In addition, a second electrode (not shown) may be formed on the working end spaced apart from the cutting head 41, so that tubular member 42 serves as one electrode of a bipolar coagulation arrangement. Applicant expects that the sealing action produced by RF coagulation, if provided, will simulate the lesions produced by a laser.
With respect to
Upper portion 52 includes indicator 57a that may be selectively aligned with indicators 57b, so that the channels formed by end effector 40 are positioned at a series of spaced-apart locations. Cable 28 extends from upper portion 52 and connects the working end of apparatus 20 to controller 29. Upper portion 52 also includes button 58 which may be moved in slot 59 to control the articulation of end region 25 of guide member 22, and depth control lever 60 disposed in slot 61. Depth control lever 60 is moved within slot 61 to control reciprocation of cutting head 41 from end region 25. Slot 61 has a length so that when button 60 is moved to fully extend cutting head 41 from guide member 22, a proximal portion of tubular member 42 remains within guide member 22. In addition, or alternatively, a user-adjustable limit bar (not shown) may be provided in slot 61 to select the maximum extension of cutting head 41 desired for a particular application.
RF button 62 also may be provided to control activation of the optional RF circuitry of controller 29 to coagulate tissue surrounding the channel formed by micromorcellator 40. RF button also could take the form of a microswitch located within slot 61 of handle assembly 50, so as to provide automatic activation of the RF coagulation feature for a short period of time when depth control lever 60 is advanced to contact the user-adjustable limit bar.
It will therefore be seen that handle assembly 50 provides for longitudinal movement of end region 25 with respect to catheter shaft 21 via relative movement between upper portion 52 and lower portion 51 (using knob 53); provides selective deployment of stabilization members 27 via button 55; selective orientation of end region 25 via button 58; control over the depth of the channels formed by end effector 40 via depth control lever 60; and, optionally, activation of an RF coagulation feature via button 62.
Referring now to
Insertion of apparatus 20 into the left ventricle is with guide member 22 in its distal-most position with stabilization members 27 fully retracted and end region 25 in its transit position. As barbs 33 of catheter shaft 21 engage apex 205 of the left ventricle, catheter shaft 21 (and guide member 22) preferentially bends in regions 65 and 66 to form a “dog-leg”, in which distal region 23 becomes urged against a lateral wall of the ventricle. Regions 65 and 66 where the bends take place may be made flexurally weaker than the remainder of the catheter shaft to aid in the bending of the catheter at these locations.
The motor and vacuum source of controller 29 are then actuated to cause cutting head 41 to rotate and to induce negative pressure in lumen 44 of micromorcellator 40. The clinician then pushes depth control lever 60 distally in slot 61, causing cutting head 41 to be advanced beyond distal endface 48 of guide member 22 and engage the endocardium. When micromorcellator 40 engages the endocardium, a reaction force is generated in catheter shaft 21 that tends both to push end region 25 away from the tissue and to cause the catheter shaft to want to rotate. The relatively flat configuration of catheter shaft 21, in conjunction with barbs 33, is expected to adequately counteract the torque induced by operation of the micromorcellator. In addition, stabilization members 27 function to counteract both these outward reaction and torque effects.
As micromorcellator 40 is advanced to form channel 207 in the left ventricular wall, tissue severed by cutting head 41 is suctioned into lumen 44 and aspirated to the proximal end of apparatus 20 via the vacuum source of controller 29. The depth of channel 207, which is proportional to the movement of depth control lever 60 in slot 61, may be predetermined using conventional ultrasound techniques, MRI scanning, or other suitable methods. As channel 207 is formed, tissue severed from the ventricular wall is aspirated through lumen 44 of guide member 22, thereby reducing the risk of embolization of the severed material. In addition, applicant expects that the use of suction through lumen 44 will assist in stabilizing the micromorcellator, and tend to draw tissue into the cutting head.
Once micromorcellator 40 has achieved its maximum predetermined depth, cutting head 41 is withdrawn from channel 207 by retracting depth control lever 60 to its proximal-most position, thereby returning cutting head 41 to a position just below distal endface 48 of end region 25 of guide member 22. It is expected that rotation of cutting head 41 will generate sufficient frictional heat in the tissue contacting the exterior of cutting head 41 to coagulate the tissue defining the channel.
Optionally, RF button 62 may be depressed on handle assembly 50 to apply a burst of RF energy to the edges of channel 207 as micromorcellator 40 achieves its maximum predetermined depth, and while cutting head 41 is stationary, rotating or being withdrawn from the channel. If provided, this burst of RF energy is expected to further coagulate the tissue defining the walls of channel 207 and modify the surface properties of the tissue.
As shown in
The foregoing methods enable a matrix of channels to be formed illustratively in the left ventricular wall. It will of course be understood that the same steps may be performed in mirror image to stabilize the apparatus against the left ventricular wall while actuating the end effector to produce a series of channels in the septal region. In accordance with presently accepted theory, the formation of such channels in the endocardium or septal region enables oxygenated blood in the left ventricle to flow directly into the myocardium and thus nourish and oxygenate the muscle. It is believed that these channels may be drilled anywhere on the walls of the heart chamber, including the septum, apex and left ventricular wall, and the above-described apparatus provides this capability.
Referring now to
Dual-rail embodiment 70 may be used without stabilization members, or alternatively catheter shaft 73 may include the stabilization members of
Wires 71 and 72, in cooperation with a distally-directed axial force exerted on the handle assembly by the clinician, serve to anchor the catheter against a lateral wall of the left ventricle, while catheter shaft 74 and guide member 79 are advanced along the dual-rail. Like apparatus 20, apparatus 70 may include flexurally weaker locations along its length to aid in positioning distal region 74 within the left ventricle.
The dual-rail design of apparatus 70 also may be advantageously employed to determine the location of end region 75 and end effector 81 with respect to the interior of the hollow-body organ or vessel. In this embodiment, wires 71 and 72 are electrically connected within cushion 77 and have a uniform resistance per unit length. Electrodes 80 are positioned in distal end 82 of catheter shaft 73 to measure the resistance of wires 71 and 72 between the electrodes.
The resistance between electrodes 80 may be measured, for example, by ohmmeter circuitry, to determine the distance between the distal end 82 of the catheter shaft and the apex of the left ventricle. In conjunction with the displacement between the upper and lower portions of the handle assembly (see
Referring now to FIGS. 8 and 9A-9C, a first alternative embodiment of the stabilization members of the present invention are described. In
Accordingly, wires 91a-91d of the embodiment of
As illustrated in
Referring now to
As described hereinabove, guide member 102 moves relative to catheter shaft 101 to enable the clinician to form a series of vertically aligned channels in the myocardium. Once a line of channels has been formed, the catheter must be moved laterally to a new location and the procedure repeated until the desired number of channels has been achieved. One expedient for doing so, for example, applicable to the apparatus of
Specifically, when inflated, stabilization members 103 provide a degree of hoop strength that ensures proper contact of the distal face of end region 106 with the wall of the hollow-body organ or vessel at all times. Once a vertical row of channels has been formed, stabilization members 103 are deflated by the clinician and end region 106 is moved to a new lateral position. The stabilization members are fully re-inflated and another vertical row of channels is formed, as discussed hereinabove.
With respect to FIGS. 11 and 12A-12C, another embodiment of the apparatus of the present invention is described in which the stabilization members comprise longitudinally-oriented balloons. Apparatus 110 is otherwise similar to the apparatus of
Referring now to
End region 125 of guide member 122 may be positioned longitudinally with respect to catheter shaft 121 by imparting relative movement between guide member 122 and catheter shaft 121 using handle assembly 126. Catheter shaft 121 includes stabilizing assembly 127 to support and stabilize distal region 123 of the apparatus within an organ or vessel.
Apparatus 120 is coupled via cable 128 to controller 129. In a preferred embodiment, wherein the end effector comprises a flexible wire having a sharpened tip, controller 129 includes a hydraulic or pneumatic piston, valve assembly and control logic for extending and retracting the end effector beyond the distal endface of end region 125 responsive to commands input at handle assembly 126 or a footpedal (not shown). Controller 129 optionally may further contain RF generator circuitry for energizing electrodes disposed on the end effector to cause a controlled degree of necrosis at the treatment site.
Referring now to
End region 125 of guide member 122 is movable from a transit position lying parallel to longitudinal axis 124 of catheter shaft 121 to a working position wherein end region 125 is articulated to a position substantially orthogonal to the longitudinal axis of the catheter shaft. In addition, end region 125 may be constructed to enable it to be locked in position at any angle a that may be desired for a given application.
Stabilization assembly 127 comprises flat band 137 of resilient material, such as stainless steel, that projects outwardly from catheter shaft 121 in distal region 123. Illustratively, stabilization assembly 127 comprises multiple loops 127a-127c of band 137. Band 137 has its distal end affixed to the distal end of catheter shaft 121, and its proximal end connected to handle assembly 126. Band 137 passes through an interior lumen of catheter shaft 121 (see
In the position shown in
The longitudinal position of end region 125 with respect to catheter shaft 121 may be adjusted by sliding guide member 122 in track 130 of the catheter shaft. Handle assembly 126 preferably includes means, described hereinafter, for moving guide member 122 with respect to catheter shaft 121 so that end region 125 may be positioned at a series of longitudinal locations In addition, stabilization assembly 127 may be adjusted to provide some control over the lateral positioning of the catheter shaft and guide member with respect to the interior wall of the organ or vessel. Thus, apparatus 120 enables a matrix of treatment sites to be accessed without removing and repositioning the apparatus.
With respect to
Threaded post 145 is coupled to the proximal end of band 137, and slides in a slot (not visible in
Upper portion 141 includes indicator 147a that may be selectively aligned with indicators 147b, so that the treatment sites are positioned at a series of spaced-apart locations. Cable 128 extends from upper portion 141 and connects the end effector of apparatus 120 to controller 129. Button 148 disposed on the top surface of upper portion 141 may be depressed to command the control logic of controller 129 to reciprocate the end effector from end region 125, and optionally, cause necrosis at the treatment site. Button 149, disposed in a slot in the upper surface of the proximal end of guide tube 122 (not visible in
Handle assembly 126 therefore provides for longitudinal movement of end region 125 with respect to catheter shaft 121 via relative movement between upper portion 141 and lower portion 140 (using knob 142); provides selective deployment of stabilization assembly 127 (using post 145 and thumbwheel 146); selective orientation of end region 125 (using button 149); and control over operation of the end effector (using button 148).
Referring now to
With respect to
Apparatus 170 includes distal region 173 within which guide member 172 has end region 175 that is selectively movable between a transit position parallel to longitudinal axis 174 of catheter shaft 171 and a working position (as shown), substantially orthogonal to longitudinal axis 174. Distal region 173 preferably includes an end effector, as described in detail hereinabove. End region 175 of guide member 172 may be positioned longitudinally with respect to catheter shaft 171 by imparting relative movement between guide member 172 and catheter shaft 171 using handle assembly 176. Catheter shaft 121 includes stabilizing element 177 to support and stabilize distal region 173 of the apparatus within an organ or vessel.
Distal region 173 of apparatus 170 is described in greater detail with respect to
Stabilization element 177 comprises wire or band 186 of resilient material, such as stainless steel, that exits catheter shaft 171 through skive 187, and is fixed to catheter shaft 171 near distal end 188. When deployed within a hollow organ, such as a chamber of the heart, as depicted in
While preferred illustrative embodiments of the invention are described, it will be apparent to one skilled in the art that various changes and modifications may be made without departing from the invention, and the appended claims are intended to cover all such changes and modifications that fall within the true spirit and scope of the invention.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US1162901||Oct 8, 1915||Dec 7, 1915||Edward B Cantey||Instrument for cutting cores from solid substances.|
|US2710000||Feb 19, 1952||Jun 7, 1955||Cromer Jeremiah Keith||Cutting instrument|
|US2749909||Sep 21, 1954||Jun 12, 1956||Biopsy knife|
|US3120845||Feb 20, 1961||Feb 11, 1964||Horner David B||Self-powered surgical drill|
|US3470876||Sep 28, 1966||Oct 7, 1969||John Barchilon||Dirigible catheter|
|US3477423||Jan 9, 1967||Nov 11, 1969||Baxter Laboratories Inc||Biopsy instrument|
|US3557794||Jul 30, 1968||Jan 26, 1971||Us Air Force||Arterial dilation device|
|US3614953||Jan 21, 1969||Oct 26, 1971||Nat Res Dev||Drills for clearing obstructions in arteries|
|US3692020||Apr 29, 1971||Sep 19, 1972||Schied Robert J||Rotary punch for excising uniform diopsy specimens|
|US3780246||Aug 22, 1972||Dec 18, 1973||Black & Decker Mfg Co||Hand-operated tool with switch actuator having three-position lock-off assembly|
|US4207874||Mar 27, 1978||Jun 17, 1980||Choy Daniel S J||Laser tunnelling device|
|US4362161||Oct 27, 1980||Dec 7, 1982||Codman & Shurtleff, Inc.||Cranial drill|
|US4381037||Oct 28, 1980||Apr 26, 1983||Black & Decker Inc.||Portable electric tool|
|US4461305||Sep 4, 1981||Jul 24, 1984||Cibley Leonard J||Automated biopsy device|
|US4464738||Feb 23, 1981||Aug 7, 1984||Sonic Tape Public Limited Company||Sonar distance sensing apparatus|
|US4468224||Jan 28, 1982||Aug 28, 1984||Advanced Cardiovascular Systems, Inc.||System and method for catheter placement in blood vessels of a human patient|
|US4479896||Jul 8, 1983||Oct 30, 1984||Antoniades Harry N||Method for extraction localization and direct recovery of platelet derived growth factor|
|US4576162||Sep 17, 1984||Mar 18, 1986||Mccorkle Charles E||Apparatus and method for separation of scar tissue in venous pathway|
|US4578057||Aug 31, 1984||Mar 25, 1986||Cordis Corporation||Ventricular right angle connector and system|
|US4582056||Sep 17, 1984||Apr 15, 1986||Mccorkle Jr Charles E||Endocardial lead extraction apparatus and method|
|US4600014||Feb 10, 1984||Jul 15, 1986||Dan Beraha||Transrectal prostate biopsy device and method|
|US4640296||Dec 10, 1985||Feb 3, 1987||Schnepp Pesch Wolfram||Biopsy cannula|
|US4646738||Dec 5, 1985||Mar 3, 1987||Concept, Inc.||Rotary surgical tool|
|US4702261||Jul 3, 1985||Oct 27, 1987||Sherwood Medical Company||Biopsy device and method|
|US4729763||Jun 6, 1986||Mar 8, 1988||Henrie Rodney A||Catheter for removing occlusive material|
|US4788975||Nov 5, 1987||Dec 6, 1988||Medilase, Inc.||Control system and method for improved laser angioplasty|
|US4790812||Nov 15, 1985||Dec 13, 1988||Hawkins Jr Irvin F||Apparatus and method for removing a target object from a body passsageway|
|US4792327||Oct 16, 1987||Dec 20, 1988||Barry Swartz||Lipectomy cannula|
|US4813930||Oct 13, 1987||Mar 21, 1989||Dimed, Inc.||Angioplasty guiding catheters and methods for performing angioplasty|
|US4850354||Aug 13, 1987||Jul 25, 1989||Baxter Travenol Laboratories, Inc.||Surgical cutting instrument|
|US4856529||Feb 6, 1987||Aug 15, 1989||Cardiometrics, Inc.||Ultrasonic pulmonary artery catheter and method|
|US4895156||Jul 2, 1986||Jan 23, 1990||Schulze John E||Sensor system using fluorometric decay measurements|
|US4895166||Nov 23, 1987||Jan 23, 1990||Interventional Technologies, Inc.||Rotatable cutter for the lumen of a blood vesel|
|US4898577||Sep 28, 1988||Feb 6, 1990||Advanced Cardiovascular Systems, Inc.||Guiding cathether with controllable distal tip|
|US4917102 *||Sep 14, 1988||Apr 17, 1990||Advanced Cardiovascular Systems, Inc.||Guidewire assembly with steerable adjustable tip|
|US4923462||Aug 15, 1988||May 8, 1990||Cordis Corporation||Catheter system having a small diameter rotatable drive member|
|US4957742||Jan 10, 1989||Sep 18, 1990||Regents Of The University Of Minnesota||Method for promoting hair growth|
|US4964854||Jan 23, 1989||Oct 23, 1990||Luther Medical Products, Inc.||Intravascular catheter assembly incorporating needle tip shielding cap|
|US4976710||Nov 15, 1988||Dec 11, 1990||Mackin Robert A||Working well balloon method|
|US4985028||Aug 30, 1989||Jan 15, 1991||Angeion Corporation||Catheter|
|US5030201||Nov 24, 1989||Jul 9, 1991||Aubrey Palestrant||Expandable atherectomy catheter device|
|US5087265 *||Jul 24, 1989||Feb 11, 1992||American Biomed, Inc.||Distal atherectomy catheter|
|US5093877||Oct 30, 1990||Mar 3, 1992||Advanced Cardiovascular Systems||Optical fiber lasing apparatus lens|
|US5104393||Nov 2, 1990||Apr 14, 1992||Angelase, Inc.||Catheter|
|US5106386||Nov 2, 1990||Apr 21, 1992||Angelase, Inc.||Catheter|
|US5123904||Dec 31, 1990||Jun 23, 1992||Olympus Optical Co., Ltd.||Surgical resecting instrument|
|US5125924||Sep 24, 1990||Jun 30, 1992||Laser Engineering, Inc.||Heart-synchronized vacuum-assisted pulsed laser system and method|
|US5125926||Sep 24, 1990||Jun 30, 1992||Laser Engineering, Inc.||Heart-synchronized pulsed laser system|
|US5133713||Mar 30, 1990||Jul 28, 1992||Huang Jong Khing||Apparatus of a spinning type of resectoscope for prostatectomy|
|US5135531||Mar 27, 1990||Aug 4, 1992||Surgical Systems & Instruments, Inc.||Guided atherectomy system|
|US5152744||Dec 27, 1990||Oct 6, 1992||Smith & Nephew Dyonics||Surgical instrument|
|US5195988||Nov 4, 1991||Mar 23, 1993||Haaga John R||Medical needle with removable sheath|
|US5197968||Aug 14, 1991||Mar 30, 1993||Mectra Labs, Inc.||Disposable tissue retrieval assembly|
|US5224951||Feb 19, 1991||Jul 6, 1993||Dexide, Inc.||Surgical trocar and spike assembly|
|US5242460||Oct 25, 1990||Sep 7, 1993||Devices For Vascular Intervention, Inc.||Atherectomy catheter having axially-disposed cutting edge|
|US5263959||Oct 21, 1991||Nov 23, 1993||Cathco, Inc.||Dottering auger catheter system and method|
|US5269785||Jun 28, 1990||Dec 14, 1993||Bonutti Peter M||Apparatus and method for tissue removal|
|US5273051||Mar 16, 1993||Dec 28, 1993||Wilk Peter J||Method and associated device for obtaining a biopsy of tissues of an internal organ|
|US5281218||Jun 5, 1992||Jan 25, 1994||Cardiac Pathways Corporation||Catheter having needle electrode for radiofrequency ablation|
|US5285795||Sep 12, 1991||Feb 15, 1994||Surgical Dynamics, Inc.||Percutaneous discectomy system having a bendable discectomy probe and a steerable cannula|
|US5287861||Oct 30, 1992||Feb 22, 1994||Wilk Peter J||Coronary artery by-pass method and associated catheter|
|US5292309||Jan 22, 1993||Mar 8, 1994||Schneider (Usa) Inc.||Surgical depth measuring instrument and method|
|US5313949 *||Feb 1, 1993||May 24, 1994||Cardiovascular Imaging Systems Incorporated||Method and apparatus for intravascular two-dimensional ultrasonography|
|US5323781||May 19, 1993||Jun 28, 1994||Duke University||Methods for the diagnosis and ablation treatment of ventricular tachycardia|
|US5324284||Jun 5, 1992||Jun 28, 1994||Cardiac Pathways, Inc.||Endocardial mapping and ablation system utilizing a separately controlled ablation catheter and method|
|US5330466||Dec 1, 1992||Jul 19, 1994||Cardiac Pathways Corporation||Control mechanism and system and method for steering distal extremity of a flexible elongate member|
|US5336237||Aug 25, 1993||Aug 9, 1994||Devices For Vascular Intervention, Inc.||Removal of tissue from within a body cavity|
|US5339799||Apr 17, 1992||Aug 23, 1994||Olympus Optical Co., Ltd.||Medical system for reproducing a state of contact of the treatment section in the operation unit|
|US5342300||Mar 12, 1993||Aug 30, 1994||Stefanadis Christodoulos I||Steerable stent catheter|
|US5342393||Aug 27, 1992||Aug 30, 1994||Duke University||Method and device for vascular repair|
|US5354310||Mar 22, 1993||Oct 11, 1994||Cordis Corporation||Expandable temporary graft|
|US5358472||Sep 9, 1993||Oct 25, 1994||Schneider (Usa) Inc.||Guidewire atherectomy catheter and method of using the same|
|US5358485||Aug 16, 1993||Oct 25, 1994||Schneider (Usa) Inc.||Cutter for atherectomy catheter|
|US5366468||Nov 9, 1993||Nov 22, 1994||Linvatec Corporation||Double bladed surgical router having aspiration ports within flutes|
|US5366490 *||Dec 22, 1993||Nov 22, 1994||Vidamed, Inc.||Medical probe device and method|
|US5370675 *||Feb 2, 1993||Dec 6, 1994||Vidamed, Inc.||Medical probe device and method|
|US5379772||Sep 14, 1993||Jan 10, 1995||Intelliwire, Inc.||Flexible elongate device having forward looking ultrasonic imaging|
|US5380316||Jun 16, 1993||Jan 10, 1995||Advanced Cardiovascular Systems, Inc.||Method for intra-operative myocardial device revascularization|
|US5383884||Dec 4, 1992||Jan 24, 1995||American Biomed, Inc.||Spinal disc surgical instrument|
|US5389073||Oct 12, 1993||Feb 14, 1995||Cardiac Pathways Corporation||Steerable catheter with adjustable bend location|
|US5389096||Feb 25, 1993||Feb 14, 1995||Advanced Cardiovascular Systems||System and method for percutaneous myocardial revascularization|
|US5392917||Aug 3, 1993||Feb 28, 1995||Ethicon, Inc.||Easy open 1-2-3 instrumentation package|
|US5396897||May 3, 1993||Mar 14, 1995||The General Hospital Corporation||Method for locating tumors prior to needle biopsy|
|US5403334||Oct 1, 1993||Apr 4, 1995||Devices For Vascular Intervention, Inc.||Atherectomy device having helical blade and blade guide|
|US5409000||Sep 14, 1993||Apr 25, 1995||Cardiac Pathways Corporation||Endocardial mapping and ablation system utilizing separately controlled steerable ablation catheter with ultrasonic imaging capabilities and method|
|US5415166||Sep 28, 1993||May 16, 1995||Cardiac Pathways Corporation||Endocardial mapping apparatus and cylindrical semiconductor device mounting structure for use therewith and method|
|US5419777||May 2, 1994||May 30, 1995||Bavaria Medizin Technologie Gmbh||Catheter for injecting a fluid or medicine|
|US5425376||Sep 8, 1993||Jun 20, 1995||Sofamor Danek Properties, Inc.||Method and apparatus for obtaining a biopsy sample|
|US5429144||Apr 5, 1994||Jul 4, 1995||Wilk; Peter J.||Coronary artery by-pass method|
|US5439474||Oct 8, 1993||Aug 8, 1995||Li Medical Technologies, Inc.||Morcellator system|
|US5443443||Aug 17, 1993||Aug 22, 1995||Surgical Systems & Instruments, Inc.||Atherectomy system|
|US5456689||Oct 13, 1993||Oct 10, 1995||Arnold J. Kresch||Method and device for tissue resection|
|US5464395 *||Apr 5, 1994||Nov 7, 1995||Faxon; David P.||Catheter for delivering therapeutic and/or diagnostic agents to the tissue surrounding a bodily passageway|
|US5465717||Aug 15, 1994||Nov 14, 1995||Cardiac Pathways Corporation||Apparatus and Method for ventricular mapping and ablation|
|US5488958||Nov 7, 1994||Feb 6, 1996||Vance Products Incorporated||Surgical cutting instrument for coring tissue affixed thereto|
|US5492119||Dec 22, 1993||Feb 20, 1996||Heart Rhythm Technologies, Inc.||Catheter tip stabilizing apparatus|
|US5497784||Jun 30, 1994||Mar 12, 1996||Intelliwire, Inc.||Flexible elongate device having steerable distal extremity|
|US5505725||Jan 27, 1995||Apr 9, 1996||Cardiogenesis Corporation||Shapeable optical fiber apparatus|
|US5507802||Oct 7, 1994||Apr 16, 1996||Cardiac Pathways Corporation||Method of mapping and/or ablation using a catheter having a tip with fixation means|
|US5520634||Jul 12, 1994||May 28, 1996||Ethicon, Inc.||Mechanical morcellator|
|US5527279||May 12, 1994||Jun 18, 1996||Cardiac Pathways Corporation||Control mechanism and system and method for steering distal extremity of a flexible elongate member|
|US5531780||Jun 30, 1994||Jul 2, 1996||Pacesetter, Inc.||Implantable stimulation lead having an advanceable therapeutic drug delivery system|
|US5551427||Feb 13, 1995||Sep 3, 1996||Altman; Peter A.||Implantable device for the effective elimination of cardiac arrhythmogenic sites|
|US5554152||Dec 20, 1994||Sep 10, 1996||Cardiogenesis Corporation||Method for intra-operative myocardial revascularization|
|US5562694||Oct 11, 1994||Oct 8, 1996||Lasersurge, Inc.||Morcellator|
|US5569178||Oct 20, 1995||Oct 29, 1996||Henley; Julian L.||Power assisted suction lipectomy device|
|US5569254||Apr 12, 1995||Oct 29, 1996||Midas Rex Pneumatic Tools, Inc.||Surgical resection tool having an irrigation, lighting, suction and vision attachment|
|US5569284||Sep 23, 1994||Oct 29, 1996||United States Surgical Corporation||Morcellator|
|US5575293||Feb 6, 1995||Nov 19, 1996||Promex, Inc.||Apparatus for collecting and staging tissue|
|US5575772||Feb 15, 1996||Nov 19, 1996||Boston Scientific Corporation||Albation catheters|
|US5575787||Feb 27, 1995||Nov 19, 1996||Abela Laser Systems, Inc.||Cardiac ablation catheters and method|
|US5575810||Sep 15, 1995||Nov 19, 1996||Ep Technologies, Inc.||Composite structures and methods for ablating tissue to form complex lesion patterns in the treatment of cardiac conditions and the like|
|US5578067||Apr 4, 1995||Nov 26, 1996||Pacesetter Ab||Medical electrode system having a sleeve body and control element therefor for selectively positioning an exposed conductor area|
|US5584842 *||Jun 30, 1994||Dec 17, 1996||Intramed Laboratories, Inc.||Valvulotome and method of using|
|US5588432||Jul 10, 1995||Dec 31, 1996||Boston Scientific Corporation||Catheters for imaging, sensing electrical potentials, and ablating tissue|
|US5591159||Nov 9, 1994||Jan 7, 1997||Taheri; Syde A.||Transcavitary myocardial perfusion apparatus|
|US5593405 *||Jan 9, 1995||Jan 14, 1997||Osypka; Peter||Fiber optic endoscope|
|US5601573||Mar 15, 1995||Feb 11, 1997||Ethicon Endo-Surgery, Inc.||Sterile occlusion fasteners and instruments and method for their placement|
|US5601586||Jan 17, 1995||Feb 11, 1997||Linvatec Corporation||Variable angle rotating shaver|
|US5601588||Sep 27, 1995||Feb 11, 1997||Olympus Optical Co., Ltd.||Endoscopic puncture needle|
|US5606974||May 2, 1995||Mar 4, 1997||Heart Rhythm Technologies, Inc.||Catheter having ultrasonic device|
|US5607421||May 25, 1994||Mar 4, 1997||The Trustees Of Columbia University In The City Of New York||Myocardial revascularization through the endocardial surface using a laser|
|US5609591||Mar 9, 1995||Mar 11, 1997||S.L.T. Japan Co., Ltd.||Laser balloon catheter apparatus|
|US5609621||Aug 4, 1995||Mar 11, 1997||Medtronic, Inc.||Right ventricular outflow tract defibrillation lead|
|US5611803||Dec 22, 1994||Mar 18, 1997||Urohealth Systems, Inc.||Tissue segmentation device|
|US5613972||Sep 13, 1994||Mar 25, 1997||The University Of Miami||Surgical cutting heads with curled cutting wings|
|US5640955 *||Feb 14, 1995||Jun 24, 1997||Daig Corporation||Guiding introducers for use in the treatment of accessory pathways around the mitral valve using a retrograde approach|
|US5643253||Jun 6, 1995||Jul 1, 1997||Rare Earth Medical, Inc.||Phototherapy apparatus with integral stopper device|
|US5651781||Apr 20, 1995||Jul 29, 1997||Grace-Wells Technology Partners No. 1, L.P.||Surgical cutting instrument|
|US5658263||May 18, 1995||Aug 19, 1997||Cordis Corporation||Multisegmented guiding catheter for use in medical catheter systems|
|US5662124||Jun 19, 1996||Sep 2, 1997||Wilk Patent Development Corp.||Coronary artery by-pass method|
|US5662671||Jul 17, 1996||Sep 2, 1997||Embol-X, Inc.||Atherectomy device having trapping and excising means for removal of plaque from the aorta and other arteries|
|US5665062 *||Jan 23, 1995||Sep 9, 1997||Houser; Russell A.||Atherectomy catheter and RF cutting method|
|US5669920||Mar 20, 1996||Sep 23, 1997||Devices For Vascular Intervention, Inc.||Atherectomy catheter|
|US5680860||Oct 31, 1995||Oct 28, 1997||Cardiac Pathways Corporation||Mapping and/or ablation catheter with coilable distal extremity and method for using same|
|US5683362||May 14, 1996||Nov 4, 1997||Rowland; Christopher A.||Apparatus for performing diagnostic and therapeutic modalities in the biliary tree|
|US5688234||Jan 26, 1996||Nov 18, 1997||Cardiometrics Inc.||Apparatus and method for the treatment of thrombotic occlusions in vessels|
|US5702412||Oct 3, 1995||Dec 30, 1997||Cedars-Sinai Medical Center||Method and devices for performing vascular anastomosis|
|US5709697||Nov 22, 1995||Jan 20, 1998||United States Surgical Corporation||Apparatus and method for removing tissue|
|US5722400 *||Feb 16, 1995||Mar 3, 1998||Daig Corporation||Guiding introducers for use in the treatment of left ventricular tachycardia|
|US5724975||Dec 12, 1996||Mar 10, 1998||Plc Medical Systems, Inc.||Ultrasonic detection system for transmyocardial revascularization|
|US5725521 *||Mar 29, 1996||Mar 10, 1998||Eclipse Surgical Technologies, Inc.||Depth stop apparatus and method for laser-assisted transmyocardial revascularization and other surgical applications|
|US5730741 *||Feb 7, 1997||Mar 24, 1998||Eclipse Surgical Technologies, Inc.||Guided spiral catheter|
|US5743870||May 6, 1996||Apr 28, 1998||Somnus Medical Technologies, Inc.||Ablation apparatus and system for removal of soft palate tissue|
|US5755714 *||Sep 17, 1996||May 26, 1998||Eclipse Surgical Technologies, Inc.||Shaped catheter for transmyocardial revascularization|
|US5766163 *||Jul 3, 1996||Jun 16, 1998||Eclipse Surgical Technologies, Inc.||Controllable trocar for transmyocardial revascularization (TMR) via endocardium method and apparatus|
|US5776092||Mar 22, 1995||Jul 7, 1998||Erbe Elektromedizin Gmbh||Multifunctional surgical instrument|
|US5782823||Apr 5, 1996||Jul 21, 1998||Eclipse Surgical Technologies, Inc.||Laser device for transmyocardial revascularization procedures including means for enabling a formation of a pilot hole in the epicardium|
|US5797870||Jun 7, 1995||Aug 25, 1998||Indiana University Foundation||Pericardial delivery of therapeutic and diagnostic agents|
|US5807384||Dec 20, 1996||Sep 15, 1998||Eclipse Surgical Technologies, Inc.||Transmyocardial revascularization (TMR) enhanced treatment for coronary artery disease|
|US5807401||Nov 2, 1995||Sep 15, 1998||Grieshaber & Co. Ag Schaffhausen||Ophthalmic surgical apparatus for pulverizing and removing the lens nucleus from the eye of a living being|
|US5814028||Oct 23, 1996||Sep 29, 1998||Daig Corporation||Curved guiding introducers for cardiac access|
|US5830210||Oct 21, 1996||Nov 3, 1998||Plc Medical Systems, Inc.||Catheter navigation apparatus|
|US5830222||Oct 11, 1996||Nov 3, 1998||Transvascular, Inc.||Device, system and method for intersititial transvascular intervention|
|US5833715||Jun 27, 1995||Nov 10, 1998||Pacesetter, Inc.||Implantable stimulation lead having an advanceable therapeutic drug delivery system|
|US5834418||Mar 20, 1996||Nov 10, 1998||Theratechnologies, Inc.||Process for the preparation of platelet growth factors extract|
|US5840059||Jun 7, 1995||Nov 24, 1998||Cardiogenesis Corporation||Therapeutic and diagnostic agent delivery|
|US5846225||Feb 19, 1997||Dec 8, 1998||Cornell Research Foundation, Inc.||Gene transfer therapy delivery device and method|
|US5851171 *||Nov 4, 1997||Dec 22, 1998||Advanced Cardiovascular Systems, Inc.||Catheter assembly for centering a radiation source within a body lumen|
|US5857995||Jul 7, 1997||Jan 12, 1999||Surgical Dynamics, Inc.||Multiple bladed surgical cutting device removably connected to a rotary drive element|
|US5871495||Sep 13, 1996||Feb 16, 1999||Eclipse Surgical Technologies, Inc.||Method and apparatus for mechanical transmyocardial revascularization of the heart|
|US5873366||Nov 7, 1996||Feb 23, 1999||Chim; Nicholas||Method for transmyocardial revascularization|
|US5876373||Apr 4, 1997||Mar 2, 1999||Eclipse Surgical Technologies, Inc.||Steerable catheter|
|US5878751||Oct 20, 1997||Mar 9, 1999||Myocardial Stents, Inc.||Method for trans myocardial revascularization (TMR)|
|US5885272||Nov 21, 1995||Mar 23, 1999||Aita; Michael||System and method for percutaneous myocardial revascularization|
|US5885276||Dec 2, 1997||Mar 23, 1999||Galil Medical Ltd.||Method and device for transmyocardial cryo revascularization|
|US5893848||Oct 24, 1996||Apr 13, 1999||Plc Medical Systems, Inc.||Gauging system for monitoring channel depth in percutaneous endocardial revascularization|
|US5899874||Apr 30, 1993||May 4, 1999||Stiftelsen For Medicinsk-Teknisk Utveckling||Preparation and method for production of platelet concentrates with significantly prolonged viabilty during storage|
|US5906594||Jan 8, 1997||May 25, 1999||Symbiosis Corporation||Endoscopic infusion needle having dual distal stops|
|US5910150 *||May 27, 1997||Jun 8, 1999||Angiotrax, Inc.||Apparatus for performing surgery|
|US5916214||Mar 28, 1997||Jun 29, 1999||Medtronic Cardiorhythm||Dual curve ablation catheter|
|US5921982 *||Apr 30, 1997||Jul 13, 1999||Lesh; Michael D.||Systems and methods for ablating body tissue|
|US5925012||Dec 27, 1996||Jul 20, 1999||Eclipse Surgical Technologies, Inc.||Laser assisted drug delivery|
|US5928943||Nov 21, 1995||Jul 27, 1999||Institut Fur Pflanzengenetik Und Kulturpflanzenforschung||Embryonal cardiac muscle cells, their preparation and their use|
|US5931848 *||May 27, 1997||Aug 3, 1999||Angiotrax, Inc.||Methods for transluminally performing surgery|
|US5938632||Mar 6, 1997||Aug 17, 1999||Scimed Life Systems, Inc.||Radiofrequency transmyocardial revascularization apparatus and method|
|US5941868||Nov 22, 1996||Aug 24, 1999||Localmed, Inc.||Localized intravascular delivery of growth factors for promotion of angiogenesis|
|US5941893 *||May 27, 1997||Aug 24, 1999||Angiotrax, Inc.||Apparatus for transluminally performing surgery|
|US5944716 *||Jan 31, 1997||Aug 31, 1999||Scimed Life Systems, Inc.||Radio frequency transmyocardial revascularization corer|
|US5951567||Jul 24, 1997||Sep 14, 1999||Cardiogenesis Corporation||Introducer for channel forming device|
|US5964754||May 23, 1997||Oct 12, 1999||Sulzer Osypka Gmbh||Device for perforating the heart wall|
|US5964757||Sep 5, 1997||Oct 12, 1999||Cordis Webster, Inc.||Steerable direct myocardial revascularization catheter|
|US5968059||Mar 6, 1997||Oct 19, 1999||Scimed Life Systems, Inc.||Transmyocardial revascularization catheter and method|
|US5971993||Dec 16, 1998||Oct 26, 1999||Myocardial Stents, Inc.||System for delivery of a trans myocardial device to a heart wall|
|US5980545||May 13, 1996||Nov 9, 1999||United States Surgical Corporation||Coring device and method|
|US5980548||Oct 29, 1997||Nov 9, 1999||Kensey Nash Corporation||Transmyocardial revascularization system|
|US5989278||Feb 13, 1998||Nov 23, 1999||Eclipse Surgical Technologies, Inc.||Method and apparatus for mechanical transmyocardial revascularization of the heart|
|US6030377||Oct 21, 1996||Feb 29, 2000||Plc Medical Systems, Inc.||Percutaneous transmyocardial revascularization marking system|
|US6036677||Jul 28, 1998||Mar 14, 2000||Cardiogenesis Corporation||Catheter with flexible intermediate section|
|US6045530||Oct 14, 1998||Apr 4, 2000||Heyer-Schulte Neurocare Inc.||Adjustable angle catheter|
|US6045565||Nov 2, 1998||Apr 4, 2000||Scimed Life Systems, Inc.||Percutaneous myocardial revascularization growth factor mediums and method|
|US6051008 *||Dec 15, 1998||Apr 18, 2000||Angiotrax, Inc.||Apparatus having stabilization members for percutaneously performing surgery and methods of use|
|US6056743 *||Mar 5, 1998||May 2, 2000||Scimed Life Systems, Inc.||Percutaneous myocardial revascularization device and method|
|US6056760||Jan 30, 1998||May 2, 2000||Nissho Corporation||Device for intracardiac suture|
|US6066126||Dec 18, 1997||May 23, 2000||Medtronic, Inc.||Precurved, dual curve cardiac introducer sheath|
|US6093177||Mar 7, 1997||Jul 25, 2000||Cardiogenesis Corporation||Catheter with flexible intermediate section|
|US6102887||Aug 11, 1998||Aug 15, 2000||Biocardia, Inc.||Catheter drug delivery system and method for use|
|US6106520||Sep 30, 1998||Aug 22, 2000||Hearten Medical, Inc.||Endocardial device for producing reversible damage to heart tissue|
|US6126654||Feb 24, 1999||Oct 3, 2000||Eclipse Surgical Technologies, Inc.||Method of forming revascularization channels in myocardium using a steerable catheter|
|US6165164||Mar 29, 1999||Dec 26, 2000||Cordis Corporation||Catheter for injecting therapeutic and diagnostic agents|
|US6179809 *||Sep 18, 1998||Jan 30, 2001||Eclipse Surgical Technologies, Inc.||Drug delivery catheter with tip alignment|
|US6197324||Jul 15, 1998||Mar 6, 2001||C. R. Bard, Inc.||System and methods for local delivery of an agent|
|US6224584||May 4, 1999||May 1, 2001||Eclipse Surgical Technologies, Inc.||Therapeutic and diagnostic agent delivery|
|US6238389||Sep 30, 1997||May 29, 2001||Boston Scientific Corporation||Deflectable interstitial ablation device|
|US6251104||Oct 31, 1997||Jun 26, 2001||Eclipse Surgical Technologies, Inc.||Guiding catheter system for ablating heart tissue|
|US6270496||Mar 1, 2000||Aug 7, 2001||Cardiac Pacemakers, Inc.||Steerable catheter with preformed distal shape and method for use|
|US6309370||Feb 5, 1998||Oct 30, 2001||Biosense, Inc.||Intracardiac drug delivery|
|US6322548||Mar 31, 1998||Nov 27, 2001||Eclipse Surgical Technologies||Delivery catheter system for heart chamber|
|US6589232||Apr 17, 2000||Jul 8, 2003||Richard L. Mueller||Selective treatment of endocardial/myocardial boundary|
|US6613062||Oct 29, 1999||Sep 2, 2003||Medtronic, Inc.||Method and apparatus for providing intra-pericardial access|
|US6620139||Nov 11, 1999||Sep 16, 2003||Tre Esse Progettazione Biomedica S.R.L.||Catheter system for performing intramyocardiac therapeutic treatment|
|US6638233 *||Aug 19, 1999||Oct 28, 2003||Fox Hollow Technologies, Inc.||Apparatus and methods for material capture and removal|
|US6905476||Jan 13, 2003||Jun 14, 2005||Biosense Webster, Inc.||Catheter with injection needle|
|US6994716||Sep 15, 2003||Feb 7, 2006||Kabushiki Kaisha Toshiba||Medical manipulator|
|US7094201||Aug 18, 1999||Aug 22, 2006||Medtronic, Inc.||System and method for genetically treating cardiac conduction disturbances|
|US20040010231||Jul 13, 2001||Jan 15, 2004||Leonhardt Howard J||Deployment system for myocardial cellular material|
|USRE33258||Nov 30, 1987||Jul 10, 1990||Surgical Dynamics Inc.||Irrigating, cutting and aspirating system for percutaneous surgery|
|EP0807412A1||May 13, 1997||Nov 19, 1997||United States Surgical Corporation||Coring device and method|
|EP0853921A2||Dec 23, 1997||Jul 22, 1998||Eclipse Surgical Technologies, Inc.||Laser assisted drug delivery|
|EP0868923A2||Mar 26, 1998||Oct 7, 1998||Eclipse Surgical Technologies, Inc.||Steerable catheter|
|EP0876796A2||May 7, 1998||Nov 11, 1998||Eclipse Surgical Technologies, Inc.||Device for use in the treatment of cardiovascular or other tissue|
|EP0895752A1||Aug 6, 1998||Feb 10, 1999||Eclipse Surgical Technologies, Inc.||Apparatus for sampling heart tissue and/or myocardial revascularization by mechanical cutting|
|WO1992010142A1 *||Nov 18, 1991||Jun 25, 1992||Howmedica Inc.||A device and method for interstitial laser energy delivery|
|1||A Collection of Abstracts, Society of Thoracic Surgeons, 1999.|
|2||Assmus, Transplantation of Progenitor Cells and Regeneration Enhancement in Acute Myocardial Infarction (TOPCARE-AMI), Clinical Investigation and Reports, Oct. 8, 2002, pp. 3009-3017, Department of Molecular Cardiology and Department of Hematology (H.M., D.H.) University of Frankfurt, Frankfurt, Germany, Circulation available at http://www.circulationha.org DOI: 10.1161/01.CIR.0000043246.74879CD.|
|3||Cooley, Denton A., M.D. et al., "Transmyocardial Laser Revascularization: Anatomic Evidence of Long-Term Channel Patency," Texas heart Institute Journal, vol. 21, No. 3 (1994), pp. 220-224.|
|4||Cooley, Denton A., M.D. et al., "Transmyocardial Laser Revascularization: Clinical Experience with Twelve-Month Follow-Up," The Journal of Thoracic and Cardiovascular Surgery, (Apr. 1996), pp. 791-799.|
|5||Fenton II, John W. et al. "Thrombin and Antithrombotics," Seminars in Thrombosis and Hemostasis, vol. 24, No. 2, 1998, pp. 1987-1991.|
|6||Folkman, Judah, "Angiogenic Therapy of the Human Heart," circulation, 1998, 97:628-629.|
|7||Frazier, O.H., M.D., "Myocardial Revascularization With Laser: Preliminary Findings," Supplement II Circulation, vol. 92, No. 9, (Nov. 1995), pp. II-58-II-65.|
|8||Hardy, Roger Ian, "A Histologic Study of Laser-Induced Transmyocardial Channels," Lasers in Surgery and Medicine, (1987), pp. 6:563-573.|
|9||Henry, Timothy D., Can We Really Grow New Blood Vessels, The Lancet, vol. 351, Jun 20, 1998, pp. 1926-1827.|
|10||Hershey, John E. et al., "Transmyocardial Puncture Revascularization: A Possible Emergency Adjunct to Arterial Implant Surgery," Geriatrics, (Mar. 1969), pp. 101-108.|
|11||Horvath, Keith A., M.D., et al., "Recovery and Viability of an Acute Myocardial Infarct After Transmyocardial Laser Revascularization," Journal of American College of Cardiology, vol. 25, No. 1 (Jan. 1995), pp. 258-263.|
|12||Horvath, Keith A., M.D., et al., "Transmyocardial Laser Revascularization: Operative Techniques and Clinical Results at Two Years," The Journal of Thoracic and Cardiovascular Surgery, (May 1996) pp. 1047-1053.|
|13||Khazei, Hassan A., "A New Method of Myocardial Revasularization," The Annals of Thoracic Surgery, vol. 6, No. 2, (Aug. 1968) pp. 163-171.|
|14||Knighton, David R., et al., "Role of Platelets and Fibrin in the Healing Sequence," Annals of Surgery, vol. 196, No. 4, Oct. 1982, pp. 379-388.|
|15||Kohmoto, Takushi, M.D., "Does Blood Flow Through Holmium: YAG Transmyocardial Laser Channels?," Ann. Thorac. Surg., (1996) pp. 61:861-868.|
|16||Kuzela, Ladislaw, "Experimental Evaluation of Direct Transventricular Revascularization," Journal ofThoracic and Cardiovasuclar Surger, vol. 57, No. 6, (Jun. 1969), pp. 770-773.|
|17||Lee, Garrett, M.D., "Effects of Laser Irradiation Delivered by Flexible Fiberoptic System on the Left Ventricular Internal Myocardium," American Heart Journal, (Sep. 1983), pp. 587-590.|
|18||Losordo, Douglas, W., et al., "Gene Therapy for Myocardial Angiogenesis Initial Clinical Results with Direct Myocardial Injection of phVEGF 165 as Sole Therapy Myocardial Ischemia," Circulation, 1998, 98:2800-2804.|
|19||Maloney, James P. et al., "In Vitro Release of Vascular Endothelial Growth Factor During Platelet Aggregation," American Physiological Society, H1054-H1061, 1998.|
|20||Mandrusov, Membrane-Based Cell Affinity Chromatography to Retrieve Viable Cells, Biotechnol, Prob. 1995, 11, 208-213, Artificial Organs Research Laboratory, Department of Chemical Engineering, Material Science and Metallurgy, Columbia University, New York, New York 10027, and Lousville, Lousville, Kentucky 40292.|
|21||Miyazono, Kohei et al, "Platelet-Derived Endothelial Cell Growth Factor, " Progress in Growth Factor Research, vol. 3, 1991, pp. 207-217.|
|22||NASA's Jet Propulsion Laboratory, "Swivel-Head Sampling Drill Bit," NASA Tech Briefs, Nov. 1998.|
|23||PCT Communication-Supplementary European Search Report, Aug. 3, 2001, 3 pages.|
|24||PCT Communication—Supplementary European Search Report, Aug. 3, 2001, 3 pages.|
|25||PCT International Search Report Mar. 18, 1998, 4 pages.|
|26||PCT Notification of Transmittal of International Preliminary Examination Report, Apr. 15, 1999, 13 pages.|
|27||PCT Written Opinion, Dec. 23, 1998, 4 pages.|
|28||Pipili-Synetos, E. et al., "Evidence That Platelets Promote Tube Formation By Endothelial Cells on Matrigel," British Journal of Pharmacology, vol. 125, 1998, pp. 1252-1257.|
|29||PMR Poduct, Axcis.TM. PMR.TM. System, http://www.cardiogenesis.com/percutaneous/product.html, Jan. 27, 1999.|
|30||PMR Product, Axcis tm PMR. System, http://www.cardiogenesis.com/percutaneous/product.html, Jan. 27, 1999.|
|31||Sen, P.K. et al., "Further Studies in Multiple Transmyocardial Acupuncture as a Method of Myocardial Revascularization," Surgery, vol. 64, No. 5, (Nov. 1968), pp. 861-870.|
|32||Simons, Michael et al. "Food for Starving Hearts," Nature Medicine, vol. 2, No. 5, pp. 519-520 (May 1996).|
|33||Thaning, Otto, "Transmyocardial Laser Revascularisation in South Africa," SAMJ, vol. 85, No. 8 (Aug. 1995) pp. 787-788.|
|34||The PMR.TM. Procedure, http://www.cardiogenesis.com/percutaneous/procedure.html, Jan. 27, 1999.|
|35||Tsopanoglou, Nikos E. et al., "Thrombin Promotes Angiogenesis By a Mechanism Independent of Fibrin Formation," American Physiological Society, 0363-6143/93, C1302-1307, 1993.|
|36||Verheul, Henk M. W., et al., "Platelet: Transporter of Vascular Endothelial Growth Factor," Clinical Cancer Research, vol. 3, Dec. 1997, pp. 2187-2190.|
|37||Von Oppell, Ulrich O., "Transmyocardial Laser Revascularisation," SAMJ, vol. 85, No. 9, (Sep. 1995), p. 930.|
|38||Wakabayashi, Akio, "Myocardial Boring For the Ischemic Heart,"Arch. Surgery, vol. 95, (Nov. 1967), pp. 743-752.|
|39||Wartiovaara, Ulla et al., Peripheral Blood Platelets Express VEGF-C and VEGF Which are Released During Platelet Activation, Thromb Haemost, 9198, 80:171-5, 1999.|
|40||Washington Adventist Hospital, "Washington Area Cardiologist Performs First State-of-the-Art Heart Procedure In U.S.," PR Newswire, Dec. 15, 1999, 2 pages.|
|41||White, Manuel et al., "Multiple Transmyocardial Puncture Revascularization in Refractory Ventricular Fibrillation due to Myocardial Ischemia," The Annals of Thoracic Surgery, vol. 6, No. 6, (Dec. 1968), pp. 557-563.|
|Citing Patent||Filing date||Publication date||Applicant||Title|
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|US9668765||Mar 15, 2013||Jun 6, 2017||The Spectranetics Corporation||Retractable blade for lead removal device|
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|US20100204684 *||Jan 12, 2010||Aug 12, 2010||Garrison Michi E||Methods and systems for performing neurointerventional procedures|
|US20110087147 *||Dec 13, 2010||Apr 14, 2011||Garrison Michi E||Methods and systems for treatment of acute ischemic stroke|
|US20110166496 *||Mar 17, 2011||Jul 7, 2011||Enrique Criado||Methods and systems for establishing retrograde carotid arterial blood flow|
|US20110166497 *||Mar 17, 2011||Jul 7, 2011||Enrique Criado||Methods and systems for establishing retrograde carotid arterial blood flow|
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|USD770616||Mar 3, 2015||Nov 1, 2016||The Spectranetics Corporation||Medical device handle|
|U.S. Classification||606/159, 606/170, 607/122, 606/15, 606/7|
|International Classification||A61B19/00, A61M1/00, A61B17/34, A61B18/14, A61B17/00, A61B17/22|
|Cooperative Classification||A61B18/00, A61B2017/003, A61B2017/00685, A61B2017/00039, A61B2018/1437, A61B2018/1435, A61B2018/00208, A61B2018/00738, A61B2018/1861, A61B2017/00026, A61B2018/00279, A61B2018/00916, A61B2017/22077, A61B2217/005, A61B2018/00761, A61B2218/002, A61B2017/3488, A61B2218/007, A61B2018/00196, A61B17/3207, A61B2017/00022, A61B2017/00398, A61B2018/00267, A61B18/1492, A61B17/320758, A61M25/0084, A61B2018/00392, A61B2017/00247, A61B2018/00839, A61B2017/306, A61B2018/00291, A61B34/20, A61B2090/034, A61B2090/3782, A61B90/37, A61B2090/0811|
|European Classification||A61B18/14V, A61B18/00, A61B17/3207, A61B17/3207R|