The present invention relates to a radio frequency ablation device, and in particular, to a radio frequency ablation device comprising a balloon blocking guide catheter, and a radio frequency ablation method implemented by using the radio frequency ablation device, and belongs to the field of nerve ablation technologies.
Abnormalities of a vegetative nerve play a very important role in occurrence, evolution, and development of many diseases. Recently, with the development of minimally invasive techniques, the nerve ablation technique gradually has been applied to the clinic to give treatments for symptoms such as hypertension, diabetes, heart diseases, and cancerous tumors, and has achieved good effects.
A radio frequency ablation catheter is an important device for conducting radio frequency ablation. A guide catheter is a tube disposed outside the radio frequency ablation catheter. The radio frequency ablation catheter usually needs assistance of the guide catheter to establish a path from the in vitro to the heart or the renal artery. During the ablation operation, most parts of the ablation catheter is kept inside the guide catheter.
In the existing technology, the radio frequency ablation device includes a radio frequency ablation instrument provided with a radio frequency generator, a radio frequency ablation catheter, and a radio frequency electrode that connected to an output terminal of the radio frequency generator by using a wire disposed inside the radio frequency ablation catheter, and further includes a loop electrode connected to a loop terminal of the radio frequency generator. In the existing nerve ablation operation for a peripheral nerve of a lumen, the loop electrode of the radio frequency ablation device is usually disposed as a peripheral patch electrode, and is disposed in vitro. For a specific structure of the radio frequency ablation device, refer to the Chinese patent (Patent application number: CN200880126859.X) entitled “SYSTEM AND METHOD FOR MEASUREMENT OF IMPEDANCE USING CATHETER SUCH AS ABLATION CATHETER”. As shown in
In addition, in the existing technology, there is a device in which a radio frequency electrode and a loop electrode are disposed on a same support to ablate pathological tissues, for example, a scissor radio frequency ablation device provided in the Chinese patent (Patent application number: CN201210128849.8) entitled “MULTIFUNCTIONAL RADIO FREQUENCY COOLING KNIFE”. As shown in
The primary technical problem to be resolved in the present invention is to provide a radio frequency ablation device comprising a balloon blocking guide catheter.
Another technical problem to be resolved by the present invention is to provide a radio frequency ablation method implemented by using the radio frequency ablation device.
To achieve the foregoing invention objective, the following technical solutions are used in the present invention.
A radio frequency ablation device includes a balloon blocking guide catheter, wherein the balloon blocking guide catheter comprises a dual-chamber or multi-chamber catheter, an inflatable closed balloon used to block local blood flow inside a blood vessel is disposed on an outer wall of a far end of the guide catheter, a first catheter branch communicating with a first lumen inside the guide catheter is disposed on a near end of the guide catheter, the inside of the closed balloon communicates with the first lumen inside the guide catheter, the first catheter branch is used to provide an inflation material for the closed balloon through the first lumen, a second catheter branch communicating with a second lumen inside the guide catheter is disposed on the near end of the guide catheter, an infusion port is disposed on a far end of the second lumen, and the second catheter branch is used to infuse liquid/gas into a blood vessel on a to-be-ablated portion through the infusion port;
the radio frequency ablation device further comprises a radio frequency ablation catheter disposed in a particular lumen inside the balloon blocking guide catheter, wherein an electrode support is disposed on a far end of the radio frequency ablation catheter, at least two electrodes are disposed on the electrode support, at least one of the electrodes is connected to an output terminal of a radio frequency generator, to form a radio frequency electrode, and at least one of the electrodes is connected to a loop terminal of the radio frequency generator, to form a loop electrode; and
during a radio frequency ablation process, the closed balloon disposed on the far end of the balloon blocking guide catheter is inflated to block local blood flow inside the blood vessel, liquid/gas is infused into the blood vessel on the to-be-ablated portion through the second catheter branch, and a loop is formed between the radio frequency electrode and the loop electrode.
Preferably, the electrode support can expand and contract.
Preferably, the radio frequency ablation catheter is disposed in the second lumen inside the balloon blocking guide catheter.
Preferably, one or more through-wall electrodes are disposed on the far end of the radio frequency ablation catheter, and the through-wall electrode is hollow and communicates with a path inside the radio frequency ablation catheter, and is used to inject liquid/gas into a blood vessel wall.
Preferably, the through-wall electrode is disposed at an adherent location in the middle of a segment-shaped electrode support, or the through-wall electrode is disposed at a front segment of a strip-shaped puncture needle.
Preferably, the through-wall electrode also serves as a radio frequency electrode or a loop electrode.
A radio frequency ablation method is used to ablate a peripheral nerve of a lumen by using the radio frequency ablation device. A closed balloon disposed on a far end of a balloon blocking guide catheter is inflated, to block local blood flow inside a blood vessel on a to-be-ablated portion; liquid/gas is infused into the blood vessel on the to-be-ablated portion by using the balloon blocking guide catheter, to change a conductivity environment and/or a temperature environment inside the blood vessel on the to-be-ablated portion; and different electrodes of a radio frequency ablation catheter are controlled to form a loop between a radio frequency electrode and a loop electrode through a blood vessel wall, to conduct radio frequency ablation.
Preferably, the liquid/gas is used to reduce conductivity inside the blood vessel on the to-be-ablated portion.
Preferably, liquid/gas used to change resistance of the blood vessel wall is injected into the blood vessel wall before radio frequency ablation.
Preferably, the liquid/gas is used to reduce resistance of the blood vessel wall.
The radio frequency ablation device provided in the present invention includes a balloon blocking guide catheter. The closed balloon disposed on the far end of the guide catheter is inflated for blocking, so that local blood flow during radio frequency ablation can be blocked. Liquid/gas is infused into the blood vessel, so that the temperature environment and/or conductivity environment inside the blood vessel can be changed. In the radio frequency ablation device, no peripheral electrode needs to be used, and the loop passing through the blood vessel wall can be formed between the radio frequency electrode and the loop electrode disposed on the electrode support, to conduct radio frequency ablation. Because the blood vessel wall is close to the nerve, and no conductivity is implemented in the lumen, a radio frequency loss is small, and an optimal radio frequency ablation effect is achieved. In addition, liquid/gas used to reduce local resistance may be further injected into the blood vessel wall through the hollow through-wall electrode, to increase a conductivity degree and a conductivity probability when the electrodes pass through the blood vessel wall, and reduce a degree and probability of conductivity between the electrodes inside the blood vessel lumen during radio frequency ablation. In addition, liquid is infused into the blood vessel lumen and the blood vessel wall, so that a local temperature can be reduced, and a local blood vessel can be protected.
The following gives a detailed description with reference to the accompanying drawings and specific embodiments. For the convenience of description, an end close to a manipulator (away from a to-be-ablated portion) is referred to as a near end, and an end away from the manipulator (close to the to-be-ablated portion) is referred to as a far end.
To change an ablation mode in the existing technology that when a peripheral nerve of a lumen is ablated, a peripheral patch electrode needs to be disposed in vitro as a loop electrode, and the peripheral patch electrode and the radio frequency electrode form a human body loop to conduct radio frequency ablation. The present invention provides a radio frequency ablation device 300 shown in
As shown in
As shown in
One or more through-wall electrodes may further be disposed on the far end of the radio frequency ablation catheter 320. The through-wall electrode may be disposed on the electrode support, or the through-wall electrode may be directly disposed on a strip-shaped connection catheter of the radio frequency ablation catheter. The through-wall electrode is hollow and communicates with a path inside the radio frequency ablation catheter, and is used to inject liquid/gas into the blood vessel wall. For example, when the electrode support is segment-shaped, the through-wall electrode may be disposed at an adherent location in the middle of the segment-shaped electrode support. For another example, when a shape of the electrode support is a strip-shaped puncture needle, the through-wall electrode may be directly disposed at a front segment of the strip-shaped puncture needle. When the through-wall electrode is disposed on the electrode support, the through-wall electrode may be independently disposed, and the through-wall electrode may also serve as a radio frequency electrode or a loop electrode.
The following describes the radio frequency ablation device provided in the present invention and a radio frequency ablation principle thereof with reference to
As shown in
As shown in
In this case, because the contrast agent is a poor conductor, and has high resistance, an environment inside the lumen is a non-conductive environment, and is in a non-conducted state. In this case, a peripheral electrode needs to be used, and mutual electron motion can be implemented between electrodes through the blood vessel wall, to implement radio frequency. A radio frequency emission direction between electrodes can be controlled by controlling a radio frequency sequence of the electrodes, to implement radio frequency ablation on nerve tissues on different ports of the outside of the blood vessel wall. When the foregoing solution is used, the blood vessel wall is a conductor, and because the blood vessel wall is close to the nerve, there is a small radio frequency loss, and the ideal radio frequency ablation effect of the nerve is achieved. Therefore, it is appropriate to infuse liquid used to reduce conductivity in the lumen, for example, non-conductive liquid, into the blood vessel in which blood flow is blocked, and good nerve ablation effect can be achieved. In addition, the non-conductive liquid infused into the lumen of the blood vessel can further reduce the temperature of the local lumen, and protect the local blood vessel. Certainly, gas may be alternatively infused into the blood vessel in which blood flow is blocked, to achieve a same objective.
As shown in
In this embodiment, a structure of the radio frequency ablation device is basically the same as that in Embodiment 1, and includes the balloon blocking guide catheter, a radio frequency ablation catheter, and a radio frequency ablation instrument connected to the radio frequency ablation catheter. A difference between Embodiment 2 and Embodiment 1 lies in that a hollow through-wall electrode is further disposed on a far end of the radio frequency ablation catheter. The through-wall electrode is hollow and communicates with an internal path of the radio frequency ablation catheter, and is used to inject liquid used to change resistance of a blood vessel wall into the blood vessel wall. For example, normal saline used to reduce the resistance may be infused. The through-wall electrode may be a radio frequency electrode or a loop electrode disposed on an electrode support, or may be a separately disposed electrode dedicated for injection.
An outlet is disposed on a far end of the through-wall electrode, an inlet is disposed on a near end of the through-wall electrode, and the inlet communicates with the internal path of the radio frequency ablation catheter. An infusion tube communicating with the internal path is disposed on a rear end of the radio frequency ablation catheter, and the infusion tube is connected to an infusion device. The infusion device may inject, through the hollow through-wall electrode and the infusion tube, a material used to reduce local resistance of a blood vessel wall, for example, normal saline, into a wall tissue near a radio frequency ablation point, to increase a conductivity degree and a conductivity probability when the electrodes pass through the blood vessel wall, and reduce a degree and probability of conductivity between the electrodes inside the blood vessel lumen during radio frequency ablation.
Therefore, during the radio frequency ablation process, the closed balloon disposed on the far end of the guide catheter is inflated to block local blood flow inside the blood vessel, liquid/gas used to reduce conductivity inside the lumen is infused into the blood vessel through the guide catheter, and at the same time, liquid used to reduce local resistance is injected into the wall tissue of the blood vessel through the hollow through-wall electrode, and then, a loop may be formed between the radio frequency electrode and the loop electrode through the blood vessel wall by controlling different electrodes of the radio frequency ablation catheter, to conduct radio frequency ablation. Therefore, the nerve ablation effect is better than that in Embodiment 1.
Specifically, the through-wall electrode disposed on the far end of the radio frequency ablation catheter 2 may be disposed at an adherent location in the middle of a segment-shaped radio frequency electrode, or may be disposed at a front segment of a strip-shaped puncture needle radio frequency electrode. In addition, a front end of the through-wall electrode is a sharp acute angle and may have an edge, a shape of the through-wall electrode is a cone, a rhombus, or the like, a length range of the through-wall electrode is preferably 0.01 to 20 mm, and a diameter range of the through-wall electrode is preferably 0.01 to 2.0 mm.
In this embodiment, to inject liquid used to reduce local resistance into a blood vessel wall on a to-be-ablated portion, a hollow puncture needle is disposed on a front end of the radio frequency ablation catheter, to replace an injection function of the hollow through-wall electrode in Embodiment 2. A through-wall electrode or a common electrode disposed in this embodiment only has a radio frequency ablation function, or may have a hollow structure and have an injection function. After the through-wall electrode penetrates or passes through the blood vessel wall, the through-wall electrode may directly release energy to a nerve plexus near the blood vessel wall, to reduce injury caused to the blood vessel wall during the radio frequency process. For introduction of the through-wall electrode, refer to the description made by the applicant in the prior patent application “CATHETER AND DEVICE FOR NERVE ABLATION IN CAVITY-PASSING AND WALL-PENETRATING MODE AND METHOD FOR NERVE ABLATION” (patent application number: CN201310049148.X). In this embodiment, the remaining structure of the radio frequency ablation device is basically the same as that in Embodiment 2, and includes the balloon blocking guide catheter, the radio frequency ablation catheter, and a radio frequency ablation instrument connected to the radio frequency ablation catheter.
A liquid cavity communicating with the puncture needle is disposed in the radio frequency ablation catheter provided in this embodiment, and is connected to an external infusion device through a catheter branch. The infusion device may inject, through the catheter branch and puncture needle, a material used to reduce local resistance of a blood vessel wall, for example, normal saline, into a wall tissue near a radio frequency ablation point, to increase a conductivity degree and a conductivity probability when the electrodes pass through the blood vessel wall, and reduce a degree and probability of conductivity between the electrodes inside the blood vessel lumen during radio frequency ablation.
Therefore, during the radio frequency ablation process, the closed balloon disposed on the far end of the guide catheter is inflated to block local blood flow inside the blood vessel, liquid/gas used to reduce conductivity inside the blood vessel is infused into the blood vessel through the guide catheter, and preferably, liquid/gas used to reduce conductivity is infused, to reduce a conductivity environment and a temperature environment inside the blood vessel on the to-be-ablated portion. At the same time, liquid used to reduce local resistance of the blood vessel wall is injected into a blood vessel wall tissue through the puncture needle. Then, a loop may be formed between the radio frequency electrode and the loop electrode through the blood vessel wall by controlling different electrodes of the radio frequency ablation catheter, to conduct radio frequency ablation. Therefore, the nerve ablation effect is better than that in Embodiment 1.
To sum up, in the radio frequency ablation device provided in the present invention and comprising the balloon blocking guide catheter, the closed balloon on the far end of the balloon blocking guide catheter is inflated, so that local blood flow inside the blood vessel on the to-be-ablated portion can be blocked. Liquid/gas used to change the conductivity environment or temperature environment is infused into the blood vessel on the to-be-ablated portion, and different electrodes of the radio frequency ablation catheter are controlled, so that a loop can be formed between the radio frequency electrode and the loop electrode through the blood vessel wall or the peripheral tissue thereof, to conduct radio frequency. In the radio frequency ablation device using the guide catheter, a radio frequency emission direction between electrodes can be controlled without a peripheral electrode, and the loop is formed between different electrodes through the blood vessel wall, to conduct radio frequency ablation. Compared with a loop passing through the entire human body, the loop formed between the radio frequency electrode and the loop electrode and passing through the blood vessel wall is a loop formed in a partial area, and needs to overcome small impedance of the human body. Because the blood vessel wall is close to the nerve, and no conductivity is implemented inside the chamber, a radio frequency loss is small, and an ideal nerve ablation effect is achieved.
In addition, liquid/gas used to reduce local resistance may be further infused into the blood vessel wall through the hollow through-wall electrode or the puncture needle, to increase a conductivity degree and a conductivity probability when the electrodes pass through the blood vessel wall, and reduce a degree and probability of conductivity between the electrodes inside the blood lumen during radio frequency ablation. In addition, liquid is injected into the blood vessel lumen and the blood vessel wall tissue, so that a local temperature can be reduced, and a local blood vessel can be protected.
The radio frequency ablation instrument in the present invention has a multi-channel radio frequency output function, and a loop can be formed between multiple electrodes and through the blood vessel wall. The radio frequency ablation instrument loads radio frequency energy to a blood vessel, muscle, and nerve attached to the ablation catheter through various electrodes of the ablation catheter, and a radio frequency current sequentially passes through the blood vessel wall and the loop electrode, and returns to the radio frequency ablation instrument, to form a radio frequency loading loop. The radio frequency current generates high-speed ion vibration in the attached tissues, and generates a temperature rise, to achieve an ablation objective.
In the technical solution provided in the present invention, by using the foregoing radio frequency ablation instrument, a partial radio frequency current loop can be formed between two electrodes through the blood vessel wall, and the radio frequency energy is released only between two electrodes forming the loop, and a temperature is generated, thereby greatly reducing much radio frequency energy consumed by human body impedance.
A working principle of the radio frequency ablation instrument has been described in detail in the two prior patent applications: “RADIO FREQUENCY ABLATION METHOD AND RADIO FREQUENCY ABLATION SYSTEM FOR NERVE ABLATION” (patent application number: CN201410035836.5) and “RADIO FREQUENCY ELECTRODE WITH TEMPERATURE MEASUREMENT FUNCTION AND IMPEDANCE MEASUREMENT FUNCTION AND ABLATION INSTRUMENT” (patent application number: CN201310530007.X), and details are not described herein again.
The foregoing has described in detail the radio frequency ablation device comprising a balloon blocking guide catheter, and the ablation method thereof in the present invention. Any obvious modification made by a person of ordinary skill in the art without departing from the spirit of the present invention is invasion of patent right of the present invention, and shall undertake the legal liability.
Number | Date | Country | Kind |
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201510689867.7 | Oct 2015 | CN | national |
201520821938.X | Oct 2015 | CN | national |
Filing Document | Filing Date | Country | Kind |
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PCT/CN2016/102980 | 10/22/2016 | WO | 00 |