Boston Scientific Scimed, Inc.

Scimed Life Systems, Inc.

Aesculap Ag

Terumo Kabushiki Kaisha

Eclipse Surgical Technologies, Inc.

Cibiem, Inc.

Covidien LP

Boston Scientific Corporation

Miriam H Taimisto

Mark Gelfand

Tim Koss

Roseanne Varner

Erik T Engelson

Uday N Kumar

Dan Francis

Dominique Filloux

Steven Ha

Hanson Gifford

Mark E Deem

David S Utley

David E Haines

Josef Vincent Koblish

William W Malecki

Brent C Gerberding

Kenneth N Horne

Steven D Yee

Richard Lardner

Jose D Alejandro

Robert F Bencini

Christopher J Danek

Joseph Charles Eder

Veijo T Suorsa

Katie L Krueger

Doug Sutton

Michael Aita

Zoar Jacob Engelman

Martin Maitre Grasse

Yegor D Sinelnikov

Kenneth M Martin

Winnie Chung

Andy Uchida

Daniel Burkhoff

Jon Wohlgemuth

Kevin Gertner

Venkata Vegesna

Kenneth P Aron

Jason Michael Miller

Michael Brick Markham

Noriyoshi Yamamoto

John Valenti

Tyler Baughman

Burt Uebelhoer

Stephen Van Lue

Lucia Kim

Jennifer D Marler

Viorica Filimon

Martin M Grasse

Timothy A Koss

Xian Wei

In a method of controlling electrosurgical power delivery based on a comparison of sensed tissue impedance to various impedance threshold values, energy is delivered to tissue in a sealing cycle as a series of pulses. An initial pulse has a profile with a preset energy starting value that increases at a ramping rate to a preset end value. Sensed impedance data are monitored throughout each pulse and compared to an impedance threshold value for RF setpoint, an impedance threshold value for cumulative time, and an impedance threshold value for energy cutback. Based on sensed impedance during a pulse, the profile of a subsequent pulse can be modified. In a high impedance event that reflects low tissue presence, energy may be cutback. A sealing cycle is stopped when a cumulative amount of time with an impedance value over the impedance cumulative time threshold value reaches a sealing cycle duration limit.

Impedance mediated control of power delivery for electrosurgery

Methods and devices for assessing, and treating patients having sympathetically mediated disease, involving augmented peripheral chemoreflex and heightened sympathetic tone by reducing chemosensor input to the nervous system via carotid body ablation.

Carotid body ablation with a transvenous ultrasound imaging and ablation catheter

A method of controlling electrosurgical power delivery is based on a comparison of sensed tissue impedance to various impedance threshold values. Energy is delivered to tissue in a sealing cycle as a series of pulses. A pulse has a profile with a preset energy starting value that increases at a ramping rate to a preset end value. Sensed impedance data are monitored throughout each pulse and compared to each of an impedance threshold value for RF setpoint, an impedance threshold value for cumulative time, and an impedance threshold value for energy cutback. Based on sensed impedance during a pulse, the profile of a subsequent pulse can be modified. In the event of a high impedance event that reflects low tissue presence, energy may be cutback. A sealing cycle is stopped when a cumulative amount of time with an impedance value over the impedance cumulative time threshold value reaches a limit.

Embodiments of the disclosed technology provide systems, devices, and methods of creating an electrosurgical tissue seal that is augmented with a seal-enhancing composition. One embodiment of a device includes a set of opposing electrosurgical jaws configured to be able to close on a targeted tissue-sealing site; the jaws have a reservoir configured to hold a tissue seal-enhancing composition. The reservoir is in communication with a surface of the tissue-sealing site when the jaws are closed on the site, and the electrosurgical device is configured to deliver the tissue seal-enhancing composition to the site during an electrosurgical procedure. The device is further configured to deliver sufficient radiofrequency energy to the site such that the targeted tissue and the tissue seal-enhancing composition at the tissue-sealing site are processed to form a high integrity sealed tissue site.

Electrosurgical tissue sealing augmented with a seal-enhancing composition

A method of controlling electrosurgical power delivery based on a comparison of sensed tissue impedance to various impedance threshold values is provided. Energy is delivered to tissue in a sealing cycle as a series of pulses. An initial pulse has a profile with a preset energy starting value that increases at a ramping rate to a preset end value. Sensed impedance data are monitored throughout each pulse and compared to each of an impedance threshold value for RF setpoint, an impedance threshold value for cumulative time, and an impedance threshold value for energy cutback. Based on sensed impedance during a pulse, the profile of a subsequent pulse can be modified. In the event of a high impedance event that reflects low tissue presence, energy may be cutback. A sealing cycle is stopped when a cumulative amount of time with an impedance value over the impedance cumulative time threshold value reaches a sealing cycle duration limit.

An adaptive algorithm monitors the rate of tissue impedance change during an electrosurgical procedure. Impedance levels are examined to determine an impedance ramp and/or slope rate, which indicates the rate at which a target tissue is undergoing a phase or state change. The level of electrosurgical energy applied to the target tissue is adjusted in real time. Energy is applied to the target tissue at levels that allow tissue phase or state change to occur in an optimum fashion. Undesired results such as thermal damage and defective sealing are mitigated. Another embodiment determines impedance achieved within a specific interval and adjusts the electrosurgical energy applied to the tissue after a threshold impedance has been maintained or exceeded for a predetermined interval. A further aspect of the invention provides mitigation during processing for partial tissue coverage of device electrodes or thin tissue.

Impedance mediated power delivery for electrosurgery

Methods for treating anatomic tissue defects such as a patent foramen ovale generally involve positioning a distal end of a catheter device at the site of the defect, exposing a housing and energy transmission member from the distal end of the catheter, engaging the housing with tissues at the site of the defect, applying suction or other approximating tool to the tissue via the housing to bring the tissue together, and applying energy to the tissue with the energy transmission member or to deliver a clip or fixation device to substantially close the defect. Apparatus generally include a catheter body, a housing extending from a distal end of the catheter body for engaging tissue at the site of the defect, and further adapted to house a fusing or fixation device such as an energy transmission member adjacent a distal end of the housing, or a clip or fixation delivery element.

Methods and electrode apparatus to achieve a closure of a layered tissue defect

A single transducer element that is capable of oscillation at a plurality of natural resonant frequencies may be used in an ultrasonic imaging catheter assembly including a catheter body configured to be inserted and guided through the vascular system of a living being, a lumen and a rotatable imaging core adapted to pass through the lumen, the imaging core including a flexible drive-shaft. Because the transducer element is capable of oscillation at a plurality of natural resonant frequencies, a user can switch from one frequency to another in order to improve the depth of field or resolution without having to switch out the catheter or imaging core.

Transducer with multiple resonant frequencies for an imaging catheter

Methods and apparatus for treatment of layered tissue defects having a majority of the surfaces of the defect layers in contact generally involve use of a catheter having at least one energy transmission member at its distal end. The distal end of the apparatus also typically has a force applying member which can apply a force to the tissue defect. Often this force is a lateral force or vacuum which helps the tissue to appose itself. An exemplary method of closing a patent foramen ovale (PFO) involves positioning a closure device between layers of the PFO. Energy is then applied to the layered tissue defect with the closure device so as to substantially close the tissue defect. The energy is often monopolar or bipolar radiofrequency energy. A force may also be applied by the closure device to the layered tissue defect so as to bring the layered tissue defect together.

Methods and apparatus for closing a layered tissue defect

Methods and apparatus for treatment of layered tissue defects such as a patent foramen ovale provide for applying energy to tissues adjacent to the PFO with a closure device that substantially closes the PFO. Apparatus generally includes an elongate flexible member having a proximal end and a distal end and an energy transmission member deployable from the elongate flexible member. The energy transmission member applies energy to the layered tissue defect at a first position and a second position adjacent to the first position so as to substantially close the layered tissue defect along at least a portion of the defect. Applied energy may be monopolar or bipolar radiofrequency energy or any other suitable energy, such as laser, microwave, ultrasound, resistive heating, direct heat energy, cryogenic or the like. PFO closure via energy-based approaches of the invention may help prevent stroke, treat migraine headache, and possibly treat or prevent other medical conditions.

The present inventions provide assemblies, probes, and methods for creating circumferential lesions in tissue, e.g., the tissue within or around the ostium of a vessel. An ablation probe with an ablative structure can be placed in contact within or around the ostium of the vessel. A diagnostic probe can be introduced through a lumen within the ablation probe and inserted into the vessel. The energy can be provided to the ablative structure to create a circumferential lesion within or around the ostium of the vessel, and the diagnostic structure can be used to diagnose the tissue to determine whether the circumferential lesion can be properly created.

Medical probes for creating and diagnosing circumferential lesions within or around the ostium of a vessel

A medical probe for mapping is provided. The medical probe includes an elongated member, a first mapping ring electrode mounted to the elongated member, and a second mapping ring electrode mounted to the elongated member. The first and second mapping ring electrodes are electrically insulated from each other. The second mapping ring electrode is located substantially concentric to the first mapping ring electrode, and is coaxially surrounding the first mapping ring electrode.

La placian electrode

A medical device for use by an operator to perform a medical procedure in a body includes a handle to be held by the operator, a shaft attached to the handle and an actuating assembly to control functions associated with the medical procedure. The shaft includes an operative distal portion to perform a medical procedure in the body. The medical device may be part of an ablation catheter system that is programmed to correlate one or more functions with the actuation of the actuating assembly. Multiple actuating assemblies may be provided. Each actuating assembly may be a button. Other types of actuating assemblies may also be used, such as switches or a trackball. The actuating assembly may also be provided on a sleeve that may be selectively attached to the handle of the catheter or the physician operating the catheter, for example.

Medical device control systems

Growing community of inventors

San Jose, CA, United States of America

Miriam H Taimisto