Method and system for invasive skin treatment

Information

  • Patent Grant
  • 8906015
  • Patent Number
    8,906,015
  • Date Filed
    Tuesday, February 15, 2011
    13 years ago
  • Date Issued
    Tuesday, December 9, 2014
    10 years ago
Abstract
A system and method for simultaneously heating a plurality of discrete skin volumes to a coagulation temperature. The system comprises an applicator containing an electrode having a plurality of spaced apart protruding conducting elements configured to contact the skin surface at a plurality of discrete locations. A controller applies a voltage to the electrode so as to simultaneously heat a plurality of skin volumes to a coagulation temperature when the applicator is applied to the skin surface.
Description
FIELD OF THE INVENTION

The invention relates to methods and systems for skin treatment.


BACKGROUND OF THE INVENTION

Directed damage of the skin is used to stimulate regrowth of collagen and to improve skin appearance. A well known method of directed damage is ablating the epidermis using laser radiation having wavelengths strongly absorbed by water so as to heat the water to above boiling temperature. Typical lasers used for epidermis ablation are CO.sub.2 and Er:YAG lasers. Ablating the epidermis using RF (radiofrequency) current is described in U.S. Pat. No. 6,309,387. This treatment significantly reduces wrinkles and improves the skin appearance. The main disadvantages of skin resurfacing are the long healing period that can be over a month long and the high risk of dischromia. These disadvantages have reduced the popularity of ablative skin resurfacing in recent years.


Non-ablative skin resurfacing is based on heating of the dermis to a sub-necrotic temperature with simultaneous cooling of the skin surface. U.S. Pat. No. 5,810,801 describes penetrating the dermis with infrared laser radiation with dynamic cooling of the skin surface using a cryogen spray.


Wrinkles are created in skin due to the breakage of collagen fibers and to the penetration of fat into the dermal structure. Thus, destroying adipose cells and structure, can improve the surface structure. However, most wrinkle treatment methods target the collagen and do not have a significant effect on deep wrinkles. Radio frequency (RF) energy has been used for the treatment of the epidermal and dermal layers of the skin. For example, U.S. Pat. No. 6,749,626 describes use of RF for collagen formation in dermis. This patent describes a method for collagen scar formation. U.S. Pat. Nos. 6,470,216, 6,438,424, 6,430,446, and 6,461,378 disclose methods and apparatuses for affecting the collagen matrix using RF with special electrode structures together with cooling and smoothing of the skin surface. U.S. Pat. Nos. 6,453,202, 6,405,090, 6,381,497, 6,311,090, 5,871,524, and 6,452,912 describe methods and apparatuses for delivering RF energy to the skin using a membrane structure. U.S. Pat. Nos. 6,453,202 and 6,425,912 describe methods and apparatuses for delivering RF energy and creating a reverse temperature gradient on the skin surface. Although a non-ablative treatment is much safer and does not scar the skin tissue, the results of non-ablative treatments are less satisfactory.


A method described in U.S. patent application No. 20030216719 attempts to maintain the efficiency of ablative treatment with a shorter healing time and a lower risk of adverse effects. The device described in that patent coagulates discrete regions of the skin where the regions have a diameter of tens of micrometers and the distance between the regions is larger than the regions themselves. This treatment provides skin healing within a few days but the results are very superficial and less spectacular than with CO.sub.2 laser treatment, even after multiple treatments.


U.S. Pat. No. 6,277,116 describes a method of applying electromagnetic energy to the skin through an array of electrodes and delivery electrolyte using a microporous pad.


A device for ablation of the skin stratum corneum using RF electrodes is described in U.S. Pat. Nos. 6,711,435, 6,708,060, 6,611,706, and 6,597,946. However, the parameters of this device are optimized for the ablation of the stratum corneum so as to enhance drug penetration into the skin, and not for thermal collagen remodeling.


SUMMARY OF THE INVENTION

The present invention provides a system and method for simultaneously heating skin at a plurality of discrete regions of the skin. The invention may be used for collagen remodeling. In accordance with the invention RF energy is applied to the skin at a plurality of discrete locations on the skin. The RF energy is applied using an electrode having a plurality of spaced apart protruding conducting pins. When the electrode is applied to the skin surface, each protruding conducting pin contacts the skin surface at a different location, so that the plurality of pins contacts the skin at a plurality of discrete locations. An RF voltage is then applied to the electrode so as to generate an electric current in the skin that heats the skin to a coagulation temperature simultaneously at a plurality of discrete regions of the skin. Coagulation temperatures are typically in the range of about 60.degree. C. to about 70.degree. C.


The protruding pins may have blunt tips which do not penetrate into the skin when the electrode is applied to the skin. In this case, the discrete regions of treated skin are located at the skin surface in the epidermis. Alternatively, the pins may have sharp tips that allow the protruding pin to penetrate the skin into the dermis. In this way, the discrete regions of treated skin are located in the dermis.


In another embodiment, the protruding elements are provided with sharp tips that allow the elements to penetrate into the skin. After application of the RF current in the skin, the protruding elements are pressed into the skin and an electrical current is then generated that coagulates tissue in the vicinity of the tip of each protruding element. The mechanical properties of the skin are changed after coagulation and the protruding elements may penetrate inside the skin without excessive pressure. A pre-pulse of RF energy can be applied to the skin in order to soften the skin tissue so as to facilitate penetration of the protruding elements into the skin.


The surface of the skin may be pre-cooled and/or cooled during the treatment to avoid damage to the skin in the area between protruding elements. Skin cooling may be provided by contact cooling or by applying a pre-cooled liquid or cryogen spray.


The invention may be used in wrinkle treatment, collagen remodeling, skin tightening, loose skin treatment, sub-cutaneous fat treatment or skin resurfacing.


Thus in its first aspect, the invention provides a system for simultaneously heating a plurality of discrete skin volumes to a coagulation temperature, comprising:

    • (a) an applicator comprising an electrode having a plurality of spaced apart protruding conducting elements configured to contact the skin surface at a plurality of discrete locations; and
    • (b) a controller configured to apply a voltage to the electrode so as to simultaneously heat a plurality of skin volumes to a coagulation temperature when the applicator is applied to the skin surface.


In its second aspect, the invention provides a method for simultaneously heating a plurality of discrete skin volumes to a coagulation temperature, comprising:

    • (a) applying an applicator to the skin surface, the applicator comprising an electrode having a plurality of spaced apart protruding conducting elements configured to contact the skin surface at a plurality of discrete locations; and
    • (b) applying a voltage to the electrode so as to simultaneously heat a plurality of skin volumes to a coagulation temperature.


In the case when protruding part of the electrode penetrates within the skin the size of protruding elements should be small enough to avoid significant damage of the skin surface. Preferable size of protruding elements is from 10 to 200 microns and coagulation depth can be varied from 100 microns up to 2 mm for invasive electrodes.





BRIEF DESCRIPTION OF THE DRAWINGS

In order to understand the invention and to see how it may be carried out in practice, preferred embodiments will now be described, by way of non-limiting examples only, with reference to the accompanying drawings, in which:



FIG. 1 shows a system for treating skin simultaneously at a plurality of discrete regions of skin, in accordance with the invention;



FIG. 2 shows an applicator for use in the system of FIG. 1;



FIG. 3 shows a second applicator for use in the system of FIG. 1; and



FIG. 4 shows a third applicator for use in the system of FIG. 1.





DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS


FIG. 1 shows a system for applying RF energy to a plurality of discrete regions of skin in accordance with the invention. The system includes an applicator 13, to be described in detail below, configured to apply RF energy simultaneously to a plurality of discrete regions of skin of an individual 22. The applicator 13 is connected to a control unit 11 via a cable 12. The control unit 11 includes a power source 18. The power source 18 is connected to an RF generator 15 that is connected to electrodes in the applicator 13 via wires in the cable 12. The control unit 11 has an input device such as a keypad 10 that allows an operator to input selected values of parameters of the treatment, such as the frequency, pulse duration and intensity of the RF energy. The control unit 11 optionally contains a processor 9 for monitoring and controlling various functions of the device.



FIG. 2 shows an applicator 13a that may be used for the applicator 13 in accordance with one embodiment of the invention. The applicator 13a comprises an electrode 1 from which a plurality of protruding conducting elements 5 extend. Each protruding element 5 (referred to herein as a “pin”) terminates in a tip 7 having a high curvature. The electrical current from the tips is much higher than from flat parts 6 of the electrode. Skin volumes 4 around the tips 7 are therefore heated to a much higher temperature than the surrounding dermis 3 and epidermis 2, so that the skin volumes 4 may be heated to a coagulation temperature, while the skin temperature in the outside the volumes 4 are not heated to a coagulation temperature. The electrical energy is adjusted to selectively damage skin adjacent to tips so that the treatment of the skin occurs simultaneously at a plurality of discrete volumes 4. The pulse duration is preferably short enough to prevent significant heat diffusion far from the tips. In order to limit significant heat transfer from the tips, the pulse duration should preferably not exceed 200 ms. The selectivity of the treatment can be improved by electrode cooling of the skin surface. Cooling also causes a more uniform heat distribution at the tips. This can be achieved by circulating a cooling fluid through tubes 8 in the flat regions 6 between the pins 5. The electrode 1 is contained in a housing 10 connected to the cable 12. The cable 12 electrically connects the electrode 1 with a terminal of the power source 18. A second terminal of the power supply 18 may be connected to a ground electrode 20 via a cable 23 (See FIG. 1).



FIG. 3 shows an applicator 13b that may be used for the applicator 13 in accordance with another embodiment of the invention. The applicator 13b comprises an electrode 100 consisting of a plurality of conducting pins 101 extending from a conducting plate 102. The pins 101 are separated by electrical insulating material 105. The applicator 13b is used similarly as the applicator 13a to deliver electrical current to discrete volumes of skin 4.


The pins 5 in the applicator 13a and the pins 101 in the applicator 13b are provided with blunt tips 7 and 107, respectively. This prevents the pins 5 and 101 from penetrating into the skin when the electrode 13a or 13b is applied t the skin surface. Thus, the applicators 13a and 13b provide simultaneous non-invasive coagulation of skin regions 4.



FIG. 4 shows an applicator 13c that may be used for the applicator 13 in accordance with another embodiment of the invention. The applicator 13c is configured to be used for invasive collagen remodeling. The applicator 13c includes an electrode 201 having a plurality of protruding conducting pins 205. The pins 205 have sharp tips 206 that are configured to penetrate through the epidermis 202 into the dermis 203 when pressed on the skin as shown in FIG. 4. The applicator 13c is used similarly to the applicators 13a and 13b so that the treatment of the skin occurs simultaneously in a plurality of discrete skin volumes 204. However, unlike the discrete volumes 4, which are located in the epidermis (see FIGS. 2 and 3), the volumes 204 are located below the surface in the dermis 203 (FIG. 4). This reduces skin redness that sometimes occurs when the treated regions are in the epidermis. A maximal current density is created at the tips of the pins 205. The sides of the protruding elements may be coated with insulating material to avoid skin heating around the pins 205 (not shown).


The present invention can be combined with other methods of skin treatment including laser treatment. For example non-ablative collagen remodeling by laser radiation may be combined with the invasive RF heating of the skin dermis in accordance with the invention.


The preferable parameters for non-invasive skin coagulation in accordance with the invention are as follows: Electrode size above 0.3 cm; Protruding element at contact with the skin up to 0.5 mm Protruding element height about 1 mm. Distance between protruding elements at least twice the element diameter; Current density: over 1 A/cm.sup.2; RF current pulse duration: not longer than 0.5 sec; The optimal parameters for invasive skin coagulation: Electrode size above 0.3 cm; Pin diameter at contact with the skin not larger than 0.3 mm Pin protruding height above 1 mm. Distance between pins at least 1 mm; Current density above 0.1 A/cm.sup.2; RF current pulse duration not longer than 0.5 sec.

Claims
  • 1. A system for selectively treating a plurality of discrete skin volumes, the system comprising: a plurality of protruding conducting elements configured to contact a plurality of discrete skin locations, wherein the plurality of protruding conducting elements are further configured for connection to an RF voltage source for applying a voltage to the plurality of protruding conducting elements to energize the plurality of protruding conducting elements, and wherein the plurality of protruding conducting elements are further configured such that, when the plurality of protruding conducting elements are in contact with the discrete skin locations and energized, the plurality of protruding conducting elements cause selective heating of the plurality of discrete skin volumes adjacent to the plurality of discrete skin locations; anda cooling element configured to maintain the plurality of discrete skin locations below a coagulation temperature when the plurality of protruding conducting elements are in contact with the plurality of discrete skin locations, the cooling element comprising at least one tube between protruding conducting elements and at least a coolant circulating therethrough.
  • 2. The system according to claim 1 additionally comprising a second cooling element configured to apply at least one of a group consisting of a pre-cooled fluid and a cryogen fluid to the plurality of discrete skin locations when the plurality of protruding conducting elements are in contact with the plurality of discrete skin locations.
  • 3. The system according to claim 1, wherein the RF voltage source is configured to apply voltage pulses to the electrodes.
  • 4. The system according to claim 3, wherein the pulses have duration of less than 0.5 sec.
  • 5. The system according to claim 1, wherein each of the plurality of conducting elements has a diameter less than 0.5 mm at a portion configured to contact the skin surface.
  • 6. The system according to claim 1, wherein the plurality of conducting elements are spaced apart from one another at a distance greater than twice a diameter of each of the plurality of conducting elements.
  • 7. The system according to claim 1, wherein the voltage source is configured to apply a current density of at least 1 A/cm2 at the tip.
  • 8. A method of selectively treating a plurality of discrete skin volumes, the method comprising: contacting a plurality of discrete skin locations with a plurality of protruding conducting elements;applying a RF voltage to the plurality of protruding conducting elements to energize the plurality of conducting elements;causing selective heating of the plurality of discrete skin volumes adjacent to the plurality of discrete locations by generating electrical current through the plurality of conducting elements when the plurality of conducting elements contact the plurality of discrete skin locations; andcirculating a coolant through at least one tube running between protruding conducting elements such that the temperature of the plurality of discrete skin locations is below the coagulation temperature when the plurality of protruding conducting elements contact the plurality of discrete skin locations.
  • 9. The method according to claim 8, wherein applying the RF voltage comprises applying the RF voltage in pulses having duration of less than 0.5 sec.
  • 10. The method according to claim 9, wherein each of the plurality of conducting elements has a diameter less than 0.5 mm at a portion that contacts the skin surface.
  • 11. The method according to claim 8, wherein the plurality of conducting elements are spaced apart from one another at a distance greater than twice a diameter of each of the plurality of conducting elements.
  • 12. The method according to claim 8, wherein applying the RF voltage includes applying the RF voltage to generate a current density of at least 1 A/cm2 at the tip.
  • 13. The method according to claim 8, wherein applying the RF voltage comprises applying the RF voltage at a level sufficient to heat the plurality of discrete skin volumes to a coagulation temperature to stimulate generation of new collagen.
  • 14. A skin treatment apparatus for selectively heating a plurality of discrete skin volumes to a coagulation temperature to stimulate generation of collagen at the plurality of discrete skin volumes, the apparatus comprising: a plurality of protruding conducting elements configured to contact a plurality of discrete skin locations, wherein the plurality of protruding conducting elements are further configured for connection to an RF voltage source configured to apply a voltage to the plurality of protruding conducting elements to energize the plurality of protruding conducting elements, and wherein the plurality of protruding conducting elements are further configured such that, when the plurality of protruding conducting elements are in contact with the discrete skin locations and energized, the plurality of protruding conducting elements cause selective heating of the plurality of discrete skin volumes adjacent to the plurality of discrete skin locations at least up to a coagulation temperate so as to stimulate generation of collagen at the plurality of discrete skin volumes; anda cooling element configured to maintain the plurality of discrete skin locations below the coagulation temperature when the plurality of protruding conducting elements are in contact with the plurality of discrete skin locations, the cooling element comprising at least one tube between protruding conducting elements and at least a coolant circulating therethrough.
  • 15. The apparatus according to claim 14, additionally comprising a second cooling element configured to apply at least one of a group consisting of a pre-cooled fluid and a cryogen fluid to the plurality of discrete skin locations when the plurality of protruding conducting elements are in contact with the plurality of discrete skin locations.
  • 16. The apparatus according to claim 14, wherein each of the plurality of conducting elements has a diameter less than 0.5 mm at a portion that contacts the skin surface.
  • 17. The apparatus according to claim 14, wherein the RF voltage source is configured to apply voltage pulses to the electrodes.
  • 18. The apparatus according to claim 17, wherein the pulses have duration of less than 0.5 sec.
  • 19. The apparatus according to claim 14, wherein the plurality of conducting elements are spaced apart from one another at a distance greater than twice a diameter of each of the plurality of conducting elements.
  • 20. The apparatus according to claim 14, wherein the voltage source is configured to apply a current density of at least 1 A/cm2 at the tip.
CROSS-REFERENCE TO RELATED APPLICATIONS

This application is being filed under 35 USC 111 and 37 CFR 1.53 and is a continuation of U.S. patent application Ser. No. 12/876,765 filed Sep. 7, 2010, now U.S Pat. No. 8,579,896, which is a continuation of U.S. patent application Ser. No. 12/702,723, filed Feb. 9, 2010 and of U.S. patent application Ser. No. 12/702,647 filed on Feb. 9, 2010, both of these applications are continuations of and claim priority to U.S patent application Ser. No. 10/931,271, filed Sep. 1, 2004 and bears the title of METHOD AND SYSTEM FOR INVASIVE SKIN TREATMENT and which has now been abandoned.

US Referenced Citations (380)
Number Name Date Kind
1430354 Burdick Sep 1922 A
2088780 Follese Aug 1937 A
2183726 Sommer et al. Feb 1939 A
2231095 Sommer et al. Feb 1941 A
2727132 Hills Dec 1955 A
2824308 Duncan Feb 1958 A
2888927 Fozard Jun 1959 A
3088205 Ellis May 1963 A
D196532 Facci Oct 1963 S
4016886 Doss et al. Apr 1977 A
4174713 Mehl Nov 1979 A
4182329 Smit et al. Jan 1980 A
4185632 Shaw Jan 1980 A
4200104 Harris Apr 1980 A
4211230 Woltosz Jul 1980 A
4228931 Ruscitti et al. Oct 1980 A
4321926 Roge Mar 1982 A
D269294 Rakocy et al. Jun 1983 S
D271015 Geraets Oct 1983 S
D271199 Geraets Nov 1983 S
4444190 Mutzhas Apr 1984 A
D274462 Rakocy et al. Jun 1984 S
4532924 Auth et al. Aug 1985 A
4550728 Runyon et al. Nov 1985 A
4553936 Wang Nov 1985 A
4566454 Mehl et al. Jan 1986 A
4686986 Fenyo et al. Aug 1987 A
4753958 Weinstein et al. Jun 1988 A
4784135 Blum et al. Nov 1988 A
4844063 Clark Jul 1989 A
4867682 Hammesfahr et al. Sep 1989 A
4869584 Dion Sep 1989 A
5016999 Williams May 1991 A
5071418 Rosenbaum Dec 1991 A
5125928 Parins et al. Jun 1992 A
5169384 Bosniak et al. Dec 1992 A
5286479 Garlich et al. Feb 1994 A
5316473 Hare May 1994 A
5319363 Welch et al. Jun 1994 A
5348554 Imran et al. Sep 1994 A
5353798 Sieben Oct 1994 A
5383874 Jackson et al. Jan 1995 A
5402697 Brooks Apr 1995 A
5406340 Hoff Apr 1995 A
5418130 Platz et al. May 1995 A
5449378 Schouenborg Sep 1995 A
5487662 Kipke et al. Jan 1996 A
5509916 Taylor Apr 1996 A
5520684 Imran May 1996 A
5521392 Kennedy et al. May 1996 A
5564851 Connely et al. Oct 1996 A
5582476 Hansen Dec 1996 A
5611793 Wilson et al. Mar 1997 A
5628771 Mizukawa et al. May 1997 A
5642997 Gregg et al. Jul 1997 A
5658148 Neuberger et al. Aug 1997 A
5674267 Mir et al. Oct 1997 A
5681282 Eggers et al. Oct 1997 A
5683380 Eckhouse et al. Nov 1997 A
5693052 Weaver Dec 1997 A
5698866 Doiron et al. Dec 1997 A
5704935 Pahl et al. Jan 1998 A
5707403 Grove et al. Jan 1998 A
5718702 Edwards Feb 1998 A
5722411 Suzuki et al. Mar 1998 A
5731582 West Mar 1998 A
5735844 Anderson et al. Apr 1998 A
5755753 Knowlton May 1998 A
5769880 Truckai et al. Jun 1998 A
5810801 Anderson et al. Sep 1998 A
5814008 Chen et al. Sep 1998 A
5824023 Anderson Oct 1998 A
5836999 Eckhouse et al. Nov 1998 A
5843143 Whitehurst Dec 1998 A
5846252 Mehl, Sr. Dec 1998 A
5868744 Willmen Feb 1999 A
5871469 Eggers et al. Feb 1999 A
5871524 Knowlton Feb 1999 A
5873855 Eggers et al. Feb 1999 A
5888198 Eggers et al. Mar 1999 A
5919219 Knowlton Jul 1999 A
5935143 Hood Aug 1999 A
5949514 Wargon Sep 1999 A
5954710 Paolini et al. Sep 1999 A
5961543 Waldmann Oct 1999 A
5984915 Loeb et al. Nov 1999 A
5993180 Westerhof et al. Nov 1999 A
6024733 Eggers et al. Feb 2000 A
6030384 Nezhat Feb 2000 A
6053172 Hovda et al. Apr 2000 A
6056548 Neuberger et al. May 2000 A
6063108 Salansky et al. May 2000 A
6066134 Eggers et al. May 2000 A
6080127 Li et al. Jun 2000 A
6080391 Tsuchiya et al. Jun 2000 A
6081934 Stefanovsky et al. Jul 2000 A
6107326 Jori Aug 2000 A
6132701 Perez et al. Oct 2000 A
6148232 Avrahami Nov 2000 A
6159222 Yiu Dec 2000 A
6186960 Tripp et al. Feb 2001 B1
6187001 Azar et al. Feb 2001 B1
6188407 Smith et al. Feb 2001 B1
6190609 Chapman et al. Feb 2001 B1
6191110 Jaynes et al. Feb 2001 B1
6210402 Olsen et al. Apr 2001 B1
6221095 Van Zuylen et al. Apr 2001 B1
6228078 Eggers et al. May 2001 B1
6231571 Ellman et al. May 2001 B1
6231593 Meserol May 2001 B1
6251127 Biel Jun 2001 B1
6258319 Hearst et al. Jul 2001 B1
6273884 Altshuler et al. Aug 2001 B1
6277116 Utely et al. Aug 2001 B1
6280438 Eckhouse et al. Aug 2001 B1
6288498 Cheng Sep 2001 B1
6308413 Westerhof et al. Oct 2001 B1
6309387 Eggers et al. Oct 2001 B1
6311090 Knowlton Oct 2001 B1
6325797 Stewart et al. Dec 2001 B1
6343400 Massholder et al. Feb 2002 B1
6343933 Montgomery et al. Feb 2002 B1
6352535 Lewis et al. Mar 2002 B1
6353763 George et al. Mar 2002 B1
6360116 Jackson et al. Mar 2002 B1
6381497 Knowlton Apr 2002 B1
6405090 Knowlton Jun 2002 B1
6406157 Audet Jun 2002 B1
6413255 Stern Jul 2002 B1
6413268 Hartman Jul 2002 B1
6416514 Ein-Gal Jul 2002 B1
6419674 Bowser et al. Jul 2002 B1
6425912 Knowlton Jul 2002 B1
6430446 Knowlton Aug 2002 B1
6433343 Cimino et al. Aug 2002 B1
6436051 Morris et al. Aug 2002 B1
6438424 Knowlton Aug 2002 B1
6440121 Weber et al. Aug 2002 B1
6452912 Leemjun Sep 2002 B1
6453202 Knowlton Sep 2002 B1
6461354 Olsen et al. Oct 2002 B1
6461378 Knowlton Oct 2002 B1
6461567 Hearst et al. Oct 2002 B1
6462070 Hasan et al. Oct 2002 B1
6470216 Knowlton Oct 2002 B1
6471716 Pecukonis Oct 2002 B1
6482201 Olsen et al. Nov 2002 B1
6482204 Lax et al. Nov 2002 B1
6487447 Weimann et al. Nov 2002 B1
6493940 Westerhof et al. Dec 2002 B2
6494900 Salansky et al. Dec 2002 B1
6497702 Bernaz Dec 2002 B1
6508813 Althshuler Jan 2003 B1
6511475 Altshuler et al. Jan 2003 B1
6514243 Eckhouse et al. Feb 2003 B1
6514248 Eggers et al. Feb 2003 B1
6517532 Altshuler et al. Feb 2003 B1
6533775 Rizoiu et al. Mar 2003 B1
6544259 Tsaliovich Apr 2003 B1
6544261 Ellsberry et al. Apr 2003 B2
6558653 Andersen et al. May 2003 B2
6572637 Yamazaki et al. Jun 2003 B1
6582429 Krishnan et al. Jun 2003 B2
6594905 Furst et al. Jul 2003 B2
6595990 Weinstein et al. Jul 2003 B1
6597946 Avrahami Jul 2003 B2
6602245 Thiberg Aug 2003 B1
6611706 Avrahami Aug 2003 B2
6612819 Furst et al. Sep 2003 B1
6618620 Freundlich et al. Sep 2003 B1
6620158 Ronci Sep 2003 B2
6629974 Penny et al. Oct 2003 B2
6632002 Chubb et al. Oct 2003 B1
6632220 Eggers et al. Oct 2003 B1
6637877 Hartley et al. Oct 2003 B1
6662054 Kreindel et al. Dec 2003 B2
6663620 Altshuler et al. Dec 2003 B2
6676655 McDaniel Jan 2004 B2
6702808 Kreindel Mar 2004 B1
6708060 Avrahami et al. Mar 2004 B1
6711435 Avrahami Mar 2004 B2
6719754 Underwood et al. Apr 2004 B2
6723092 Brown et al. Apr 2004 B2
D490156 Fischer et al. May 2004 S
D490526 Jonsen May 2004 S
6740079 Eggers et al. May 2004 B1
6743211 Prausnitz et al. Jun 2004 B1
6749626 Bhatvinayak et al. Jun 2004 B1
6758845 Weckwerth et al. Jul 2004 B1
6761729 Babaev Jul 2004 B2
6770069 Hobart et al. Aug 2004 B1
6773431 Eggers et al. Aug 2004 B2
6780838 Lipton et al. Aug 2004 B2
6795728 Chornenky et al. Sep 2004 B2
RE38643 Sugaya et al. Nov 2004 E
6887260 McDaniel May 2005 B1
6889090 Kreindel May 2005 B2
6905496 Ellman et al. Jun 2005 B1
6918907 Kelly et al. Jul 2005 B2
6974450 Weber et al. Dec 2005 B2
6997923 Anderson et al. Feb 2006 B2
7006874 Knowlton et al. Feb 2006 B2
7013179 Carter et al. Mar 2006 B2
7022121 Stern et al. Apr 2006 B2
7077840 Altshuler et al. Jul 2006 B2
7115123 Knowlton et al. Oct 2006 B2
7115124 Xiao Oct 2006 B1
7118563 Weckwerth et al. Oct 2006 B2
7141049 Stern et al. Nov 2006 B2
7153298 Cohen Dec 2006 B1
7164942 Avrahami et al. Jan 2007 B2
7204832 Altshuler et al. Apr 2007 B2
7234239 Saito et al. Jun 2007 B2
7238183 Kreindel Jul 2007 B2
7266414 Cornelius et al. Sep 2007 B2
7275819 Bleau Oct 2007 B2
7278991 Morris et al. Oct 2007 B2
7278993 Kelly et al. Oct 2007 B2
7416550 Protsenko et al. Aug 2008 B2
7435247 Woloszko et al. Oct 2008 B2
7494488 Weber Feb 2009 B2
7517344 Van Hal et al. Apr 2009 B2
7601149 DiCarlo et al. Oct 2009 B2
7713266 Elkins et al. May 2010 B2
7771419 Carmel et al. Aug 2010 B2
7824394 Manstein Nov 2010 B2
7935107 Altshuler et al. May 2011 B2
7963985 Minamoto et al. Jun 2011 B2
8021360 Dunning et al. Sep 2011 B2
8034052 Podhajsky Oct 2011 B2
8109927 Kelly et al. Feb 2012 B2
8128622 Podhajsky et al. Mar 2012 B2
8133216 Knopp et al. Mar 2012 B2
8135475 Kreindel et al. Mar 2012 B2
8157807 Ferren et al. Apr 2012 B2
8202268 Wells et al. Jun 2012 B1
8206381 Lischinsky et al. Jun 2012 B2
8216215 Flyash et al. Jul 2012 B2
8235989 Palanker et al. Aug 2012 B2
8292882 Danek et al. Oct 2012 B2
8506564 Long et al. Aug 2013 B2
20010007068 Ota et al. Jul 2001 A1
20020035363 Edwards et al. Mar 2002 A1
20020058936 Avrahami et al. May 2002 A1
20020104543 Hollander et al. Aug 2002 A1
20020120256 Furuno et al. Aug 2002 A1
20020120260 Morris et al. Aug 2002 A1
20020120261 Morris et al. Aug 2002 A1
20020128641 Underwood et al. Sep 2002 A1
20020128648 Weber et al. Sep 2002 A1
20020143373 Courtnage et al. Oct 2002 A1
20020147384 Uchikubo Oct 2002 A1
20020173780 Altshuler et al. Nov 2002 A1
20020183245 Hasan et al. Dec 2002 A1
20020190337 House et al. Dec 2002 A1
20020198575 Sullivan Dec 2002 A1
20030004499 McDaniel Jan 2003 A1
20030032900 Ella Feb 2003 A1
20030032950 Altshuler et al. Feb 2003 A1
20030055413 Altshuler et al. Mar 2003 A1
20030055414 Altshuler et al. Mar 2003 A1
20030097162 Kreindel May 2003 A1
20030109871 Johnson et al. Jun 2003 A1
20030135250 Lauman et al. Jul 2003 A1
20030139790 Ingle et al. Jul 2003 A1
20030195494 Altshuler et al. Oct 2003 A1
20030199863 Swanson et al. Oct 2003 A1
20030199946 Gutwein Oct 2003 A1
20030216719 Debendictis et al. Nov 2003 A1
20040010250 Manna et al. Jan 2004 A1
20040010298 Altshuler et al. Jan 2004 A1
20040015161 Lovewell Jan 2004 A1
20040015162 McGaffigan Jan 2004 A1
20040064167 Berry et al. Apr 2004 A1
20040133251 Altshuler et al. Jul 2004 A1
20040143308 Lundahl et al. Jul 2004 A1
20040147984 Altshuler et al. Jul 2004 A1
20040167501 Island et al. Aug 2004 A1
20040181216 Kelly et al. Sep 2004 A1
20040186466 Chornenky Sep 2004 A1
20040193234 Butler Sep 2004 A1
20040210214 Knowlton Oct 2004 A1
20040236320 Protsenko et al. Nov 2004 A1
20040260210 Ella et al. Dec 2004 A1
20040267252 Washington et al. Dec 2004 A1
20050015042 Sun et al. Jan 2005 A1
20050033286 Eggers et al. Feb 2005 A1
20050043653 Trimmer et al. Feb 2005 A1
20050049543 Anderson et al. Mar 2005 A1
20050075573 Park et al. Apr 2005 A1
20050085804 McGaffigan Apr 2005 A1
20050096646 Wellman et al. May 2005 A1
20050137654 Hoenig et al. Jun 2005 A1
20050137655 MacFarland et al. Jun 2005 A1
20050143793 Korman et al. Jun 2005 A1
20050147137 Slatkine Jul 2005 A1
20050149012 Penny et al. Jul 2005 A1
20050177139 Yamazaki et al. Aug 2005 A1
20050288680 Ingle et al. Dec 2005 A1
20060036300 Kreindel Feb 2006 A1
20060095096 DeBenedictis et al. May 2006 A1
20060149343 Altshuler et al. Jul 2006 A1
20060184024 Da Silva et al. Aug 2006 A1
20060200213 McDaniel Sep 2006 A1
20060206173 Gertner et al. Sep 2006 A1
20060224217 Burgmann et al. Oct 2006 A1
20060231568 Lynn et al. Oct 2006 A1
20060247741 Hsu et al. Nov 2006 A1
20060253112 Suarez et al. Nov 2006 A1
20060259102 Slatkine Nov 2006 A1
20060271028 Altshuler et al. Nov 2006 A1
20070016117 Sliwa et al. Jan 2007 A1
20070038206 Altshuler et al. Feb 2007 A1
20070093798 Debenedictis et al. Apr 2007 A1
20070106349 Karni et al. May 2007 A1
20070129711 Altshuler et al. Jun 2007 A1
20070129771 Altschuler et al. Jun 2007 A1
20070142881 Hennings Jun 2007 A1
20070191821 Boxer Wachler Aug 2007 A1
20070191827 Lischinsky et al. Aug 2007 A1
20070197895 Nycz et al. Aug 2007 A1
20070198004 Altshuler et al. Aug 2007 A1
20070206275 Hemmer et al. Sep 2007 A1
20070213696 Altshuler et al. Sep 2007 A1
20070239142 Altshuler et al. Oct 2007 A1
20070239143 Altshuler et al. Oct 2007 A1
20070239152 Trezon Oct 2007 A1
20070271714 Adam et al. Nov 2007 A1
20080051680 Luebcke Feb 2008 A1
20080071334 Hoenig et al. Mar 2008 A1
20080082090 Manstein Apr 2008 A1
20080123238 Campos et al. May 2008 A1
20080125658 Lee et al. May 2008 A1
20080139901 Altshuler et al. Jun 2008 A1
20080154247 Dallarosa et al. Jun 2008 A1
20080183167 Britva et al. Jul 2008 A1
20080188846 Palanker et al. Aug 2008 A1
20080200910 Burger et al. Aug 2008 A1
20080214988 Altshuler et al. Sep 2008 A1
20080215124 Wagenaar et al. Sep 2008 A1
20080221504 Aghion Sep 2008 A1
20080294153 Allshuler et al. Nov 2008 A1
20080306476 Hennings et al. Dec 2008 A1
20090036953 Gustavsson Feb 2009 A1
20090043293 Pankratov et al. Feb 2009 A1
20090054743 Stewart Feb 2009 A1
20090105706 Livneh Apr 2009 A1
20090112205 McGill et al. Apr 2009 A1
20090119834 Kneale et al. May 2009 A1
20090171341 Pope et al. Jul 2009 A1
20090182315 Zigan et al. Jul 2009 A1
20090192503 Epshtein et al. Jul 2009 A1
20090222023 Boone et al. Sep 2009 A1
20090234341 Roth Sep 2009 A1
20090234342 Ely et al. Sep 2009 A1
20090240310 Kennedy Sep 2009 A1
20090299361 Flyash et al. Dec 2009 A1
20100010480 Mehta et al. Jan 2010 A1
20100063565 Beerwerth et al. Mar 2010 A1
20100145321 Altshuler et al. Jun 2010 A1
20100185193 Kreindel Jul 2010 A1
20100185194 Kreindel Jul 2010 A1
20100198134 Eckhouse Aug 2010 A1
20100211055 Eckhouse et al. Aug 2010 A1
20100249772 Mehta et al. Sep 2010 A1
20100274329 Bradley et al. Oct 2010 A1
20110112405 Barthe et al. May 2011 A1
20110137386 Kreindel Jun 2011 A1
20110166559 Eckhouse et al. Jul 2011 A1
20110196363 Kreindel Aug 2011 A1
20120016354 Epshtein et al. Jan 2012 A9
20120022512 Vaynberg Jan 2012 A1
20120022518 Levinson Jan 2012 A1
20120123397 Epshtein et al. May 2012 A1
20120143178 Mehta Jun 2012 A9
20120143270 Mehta Jun 2012 A1
20120197242 Rosenberg Aug 2012 A1
20120290023 Boyden et al. Nov 2012 A1
20130144280 Eckhouse et al. Jun 2013 A1
20130289679 Eckhouse et al. Oct 2013 A1
Foreign Referenced Citations (14)
Number Date Country
1078383 Nov 1993 CN
0528055 Feb 1993 EP
04299998 Oct 1992 JP
06113920 Apr 1994 JP
11132843 Dec 1999 JP
2003034630 Feb 2003 JP
WO-8302389 Jul 1983 WO
WO-9321992 Nov 1993 WO
WO-9909143 Feb 1999 WO
WO-9934867 Jul 1999 WO
WO-02078644 Oct 2002 WO
WO-02094116 Nov 2002 WO
WO-03039367 May 2003 WO
WO-2006128034 Nov 2006 WO
Related Publications (1)
Number Date Country
20110137386 A1 Jun 2011 US
Continuations (5)
Number Date Country
Parent 12876765 Sep 2010 US
Child 13028216 US
Parent 12702723 Feb 2010 US
Child 12876765 US
Parent 12702647 Feb 2010 US
Child 12702723 US
Parent 13028216 US
Child 12702723 US
Parent 10931271 Sep 2004 US
Child 13028216 US