Meadox Medicals, Inc.

Cryocor, Inc.

Boston Scientific Scimed, Inc.

Warner-Lambert Company

Scimed Life Systems, Inc.

Critikon, Inc

Medtronic Ave, Inc.

Extracorporeal Medical Specialties Inc.

Vascor, Inc.

Deseret Medical, Inc.

David J Lentz

Richard J Zdrahala

Edward J Dormier

Peter J Schmitt

Jamie Henderson

Richard J Koerner

Gary L Loomis

Eric Ryba

Kevin S Weadock

Nick Popadiuk

Mohammad A Khan

Ronald Rakos

Krzysztof Sowinski

Joseph A O'Donnell

Birendra K Patnaik

Jillian K Allen

Ravikumar Kudaravalli

Richard B Houghton

Horng-Ban Lin

Elisabeth M Pollock

Alvin B Salinas

Jack Tant

Mark L Stiger

Steven W Kovalcheck

Charles W Daugherty

Ellen M Golds

Jean-Pierre Sachetto

Stephen L Thoresen

Antonio Moroni

Robert F Stepto

Markus Thoma

Victor L Bartholomew

Phillip A Estepa

Jakob Silbiger

Michael A Mohn, Jr

Nicholas Popadiuk

Matt M Riordan

Rey O Cruz

Johannes Rehm

Gustav Lay

Gerald Kalin

Jennifer DePreker

Hong Li

A configuration for a cryo-catheter which optimizes both the catheter's outer diameter and the size of the catheter's internal refrigerant flow path is described. Specifically, the inner dimensions of the cryo-catheter are configured to accommodate a pre-selected flow of refrigerant into the catheter's distal tip, and a return flow of refrigerant from the distal tip. The return flow is established in the void spaces between a refrigerant supply line and the inner wall of the catheter body. The available void space varies along the catheter length and depends on the presence/absence of various catheter accessories (i.e. pull wires, pressure tubes, etc.) which typically only extend through a portion of the catheter length. The disclosed configuration ensures that the cryo-catheter does not operate in a refrigerant limited condition, maintains the refrigerant as a liquid in the supply tube, and maintains the return line pressure at about 1 atmosphere.

Cryo-applicator cross-section configuration

An applicator for cryoablating tissue to form linear (i.e. straight line and curvilinear) lesions in targeted tissue includes a fluid refrigerant delivery system having a source of a fluid refrigerant and a tubular cryoablation segment. Structurally, the segment has an open proximal end and a distal end, and is formed with a lumen. Also, the segment is formed with at least one distal port and at least one proximal port, with each port connected in fluid communication with the segment's lumen. The proximal end of the tubular segment is operably connected in fluid communication with the source of fluid refrigerant. For the system, the ports can be selectively sized to outflow liquid refrigerant through the distal and proximal ports at a substantially same mass flow rate.

Cryoablation segment for creating linear lesions

An articulation segment for a catheter includes a tube formed with a first plurality of axially aligned slits that are respectively oriented in planes perpendicular to the axis, with each slit extending azimuthally in an arc partway around the axis. The tube is also formed with a second plurality of similarly formed slits that are axially offset and diametrically opposed relative to the slits of the first plurality to allow for a bending of the catheter in a plurality of different planes. In a particular embodiment, the slits are arranged to allow the articulation segment to be reconfigured from a straight, substantially cylindrically shaped tube to a configuration in which a portion of the articulation segment is formed in the shape of a ring.

Catheter articulation segment with alternating cuts

An implantable intraluminal device includes a multilayer composite tubular device supporting one or more stents between the layer thereof. A first porous elongate tube includes an exterior surface and an interior luminal surface. A radially expandable member is disposed about the exterior surface of the first tube. A second porous elongate tube is disposed concentrically over the first tube and is secured thereto so that the radially expandable member is longitudinally immobilized therebetween.

ePTFE graft-stent composite device

A catheter-based system for performing a cryoablation procedure uses a precooler to lower the temperature of a fluid refrigerant to a sub-cool temperature (&#x2212;40&#xb0; C.) at a working pressure (400 psi). The sub-cooled fluid is then introduced into a supply line of the catheter. Upon outflow of the primary fluid from the supply line, and into a tip section of the catheter, the fluid refrigerant boils at an outflow pressure of approximately one atmosphere, at a temperature of about &#x2212;88&#xb0; C. In operation, the working pressure is computer controlled to obtain an appropriate outflow pressure for the coldest possible temperature in the tip section.

Refrigeration source for a cryoblation catheter

A bi-directional system for actively deflecting the distal tip of a catheter includes a reconfigurable tube that is positioned proximal to the catheter's distal tip. The tube is formed with slits that are arranged to allow the tube to be transformed from a relaxed, cylindrical configuration to a plurality of deflected configurations. First and second pull wires are provided, with each wire having a respective distal end that is attached to the distal end of the tube. Each wire extends to a catheter handle where it is attached to a respective reel. The reels can be rotated, back and forth, to selectively deflect or relax the tube. To ensure a smooth recovery after a relatively large deflection, a mechanism is disclosed for delaying an application of tension on one of the pull wires until at least a portion of any tension on the other pull wire is released.

System for bi-directionally controlling the cryo-tip of a cryoablation catheter

An active system for deflecting a distal portion of a catheter into a hoop configuration includes an elongated catheter body having a proximal portion and a distal portion that is formed with a lumen. A thin-walled tube, which is typically made of a metallic material, is positioned in the lumen. The tube includes a cylindrical wall and includes a plurality of lateral slits that are typically formed in the tube wall and arranged such that the tube can be transformed between a relaxed, cylindrical configuration and a deflected configuration wherein the tube is substantially hoop shaped. One end of a deflection wire is attached to the tube and the other wire end is attached to a reel that is rotationally mounted onto a catheter handle housing. In use, the reel is rotated to axially retract the wire and transform the tube into a hoop configuration.

Active system for deflecting a distal portion of a catheter into a hoop configuration

An implantable microporous ePTFE tubular vascular graft exhibits long term patency, superior radial tensile strength and suture hole elongation resistance. The graft includes a first ePTFE tube and a second ePTFE tube circumferentially disposed over the first tube. The first ePTFE tube exhibits a porosity sufficient to promote cell endothelization, tissue ingrowth and healing. The second ePTFE tube exhibits enhanced radial strength in excess of the radial tensile strength of the first tube.

Self-sealing PTFE vascular graft and manufacturing methods

A system for cryoablating target tissue at a treatment site includes a cryo-element that is attached to the distal end of a cryo-catheter. An annular shaped balloon is attached to a cylindrical shaped sleeve and the sleeve is slideably mounted over the cryo-catheter. The distal end of a fill tube is attached to the sleeve to place the lumen of the fill tube in fluid communication with the balloon. In use, the cryo-element is first positioned at the treatment site using the cryo-catheter. Next, the fill tube is used to advance the balloon and sleeve over the cryo-catheter until the balloon is interposed between the cryo-element and the target tissue. Saline solution is then pumped through the fill tube to expand the balloon between the cryo-element and target tissue. A refrigerant is then expanded in the cryo-element which freezes the saline solution and cryoablates the target tissue.

Catheter system for performing a single step cryoablation

A cryoablation device having a pressure monitoring system includes an elongated catheter tube that has a central lumen and is formed with a closed distal end. The distal end of a refrigerant supply line is positioned in the central lumen and distanced from the catheter tube's distal end to establish an expansion chamber therebetween. A return line, which can be established between the supply line and the catheter tube or can include a return tube, is provided to exhaust expanded refrigerant from the chamber. First and second pressure sensors are respectively positioned in the supply line upstream from the expansion chamber and in the return line. Typically, both sensors are positioned to remain at extracorporeal locations throughout a cryoablation procedure. Measured pressures are used together with the supply and return line dimensions to analytically estimate the chamber pressure and allow the expansion of refrigerant in the chamber to be monitored.

Pressure monitor for cryoablation catheter

Refrigeration source for a cryoablation catheter

A device for steering a cardiac cryoablation catheter through the vasculature of a patient includes separate first and second deflection members that connect a tip member to the distal end of a catheter tube. Importantly, the first deflection member has a first flexural modulus, and the second deflection member has a second flexural modulus that is greater than the first flexural modulus. Also included is a control wire for pulling the tip member toward the catheter tube. In response, the first and second deflection members differentially deflect, according to their respective flexural moduli, to move the tip member for steering the catheter through the vasculature.

Wire reinforced articulation segment

A system and method for transferring heat requires a supply tube connected in fluid communication with a capillary tube. A tip member is positioned to surround the distal end of the capillary tube to create a cryo-chamber. In operation, a liquid refrigerant is introduced into the supply tube at a working pressure (e.g. 450 psia). The pressure is then significantly reduced on the liquid refrigerant as it transits through the capillary tube. The refrigerant then exits the distal end of the capillary tube, still in its liquid state. Inside the cryo-chamber, at a pressure of less than about one atmosphere, the refrigerant transitions into its gaseous state. The resultant refrigeration causes heat to transfer into the cryo-chamber.

Distal end for cryoablation catheters

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La Jolla, CA, United States of America

David J Lentz