Claims
- 1. A method for recanalizing an anastomotic junction of a vascular fistula or graft, said method comprising:
recanalizing an anastomotic junction that has become occluded; and exposing the recanalized junction to vibrational energy at a mechanical index and for a time sufficient to inhibit hyperplasia.
- 2. A method as in claim 1, wherein recanalizing of the anastomotic junction comprises angioplasty or atherectomy.
- 3. A method as in claim 1, wherein the vibrational energy does not cause significant cavitation in a wall of the blood vessel.
- 4. A method as in claim 1, wherein the vibrational energy causes a temperature rise below 10° C. in the wall of the blood vessel.
- 5. A method as in claim 1, wherein vascular smooth muscle cells at least mostly remain viable but in a quiescent state in the neointimal layer after exposure to the vibrational energy.
- 6. A method as in claim 1, wherein migration of vascular smooth muscle cells into the neointimal layer is not substantially inhibited.
- 7. A method as in claim 1, wherein viability of vascular smooth muscle cells in a medial layer of the blood vessel is not significantly inhibited.
- 8. A method as in claim 1, wherein the vibrational energy has a frequency in the range from 20 kHz to 5 MHz.
- 9. A method as in claim 8, wherein the intensity is in the range from 0.01 W/cm2 to 100 W/cm2.
- 10. A method as in claim 9, wherein the frequency and intensity are selected to produce a mechanical index at the neointimal wall in the range from 0.1 to 50.
- 11. A method as in claim 1, wherein the vibrational energy is directed against the anastomotic junction with a pulse repetition frequency (PRF) in the range from 10 Hz to 10 kHz.
- 12. A method as in claim 1, wherein the energy is directed against the anastomotic junction with a duty cycle in the range from 0.1 to 100 percent.
- 13. A method as in claim 1, wherein the anastomotic junction is between an artery and a vein in an arterio-venous fistula.
- 14. A method as in claim 1, wherein the anastomotic junction is between a graft and a vein in an arterio-venous graft.
- 15. A method as in claim 1, wherein the anastomotic junction is between a graft and a coronary artery in a coronary artery bypass graft.
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] This application is a continuation of application Ser. No. 09/345,661, filed on Jun. 30, 1999, the full disclosure of which is incorporated herein by reference. The subject matter of the present invention is related to the disclosure of copending application Ser. No. 09/223,230, the full disclosure of which is incorporated herein by reference.
Continuations (1)
|
Number |
Date |
Country |
Parent |
09345661 |
Jun 1999 |
US |
Child |
10010411 |
Dec 2001 |
US |