Systems for ultrasound treatment

Description

BACKGROUND

Embodiments of the present invention generally relate to ultrasound treatment and imaging devices and more specifically relate to ultrasound devices having a transducer probe operable to emit and receive ultrasound energy for cosmetic treatment and imaging.

In general, a popular cosmetic procedure for reducing wrinkles on the brow region of a patient's face is a brow lift, during which portions of muscle, fat, fascia and other tissues in the brow region are invasively cut, removed, and/or paralyzed to help reduce or eliminate wrinkles from the brow. Traditionally, the brow lift requires an incision beginning at one ear and continuing around the forehead at the hair line to the other ear. A less invasive brow lift procedure is known as an endoscopic lift during which smaller incisions are made along the forehead and an endoscope and surgical cutting tools are inserted within the incisions to cut, remove, manipulate, or paralyze tissue to reduce or eliminate wrinkles from the brow.

Even less invasive cosmetic treatments are designed to inject a neurotoxin in the brow. This procedure paralyzes muscles within the brow which can assist in reducing wrinkles. However, such procedures are temporary, can require chronic usage to sustain the intended effects, and can have deleterious effects.

SUMMARY

There is a need for non-invasive cosmetic procedures for reducing wrinkles in the head and neck, such as in a brow region, and in other regions. In addition, there is a need for non-invasive cosmetic procedures that result in a tightening of skin in the head and neck, including the brow region, and other regions. Further, there is a need to effectively and efficiently image the region of the skin that is targeted for treatment. In several of the embodiments described herein, the procedure is entirely cosmetic and not a medical act.

Accordingly, several embodiments of the present invention provide a system and method for cosmetic treatment and imaging. In various embodiments the treatment system includes a hand wand with at least one finger activated control, or controller, and a removable transducer module having at least one ultrasound transducer. In one embodiment, the system includes a control module that is coupled to the hand wand and has a graphic user interface for controlling the removable transducer module that has an interface coupling the hand wand to the control module. In an aspect of the embodiment, the interface provides power to the hand wand and/or transfers a signal from the hand wand to the control module. In various embodiments of the present invention, the cosmetic treatment and imaging system is used in aesthetic procedures on a portion of a head of patient, including the face, scalp, neck and/or ears of a patient.

In accordance with one embodiment of an aesthetic imaging system, the aesthetic imaging system includes a hand wand, a removable transducer module, a control module, and an interface coupling the hand wand and the control module. The hand wand includes at least one finger activated controller. The removable transducer module includes an ultrasound transducer and at least one interface coupleable to the hand wand. The control module is coupled to the hand wand and includes a graphical user interface for controlling the removable transducer module. In one embodiment, the interface couples the hand wand to the control module, and provides at least power to the hand wand. In one embodiment, the interface transfers one or more signals between the hand wand and the control module. In one embodiment, at least one signal (e.g., 1, 2, 3, 4, 5 or more signals) is communicated from the wand to the control module. In another embodiment, at least one signal (e.g., 1, 2, 3, 4, 5 or more signals) is communicated from the control module to the wand. In several embodiments, at least one signal (e.g., 1, 2, 3, 4, 5 or more signals) is communicated to, from, or between the wand and control module. In one embodiment, the aesthetic imaging system also includes a printer coupled to the control module and the control module provides an output signal and power to the printer. In one embodiment, the aesthetic imaging system also includes a key operable to unlock the control module for controlling the removable transducer module. In one embodiment of an aesthetic imaging system, the hand wand includes a movement mechanism, operable to move the ultrasound transducer within the transducer module. In one embodiment, the aesthetic imaging system also includes at least one sensor coupled to the hand wand and/or the removable transducer module.

In accordance with one embodiment of a hand wand for use in cosmetic treatment, the wand includes a first controlling device operably controlling an imaging function, a second controlling device operably controlling a treatment function, a status indicator, an input for power, an output for at least one signal, a movement mechanism and a removable transducer module operably coupled to at least one of the first controlling device, the second controlling device and the movement mechanism. In one embodiment, the hand wand includes a latch mechanism removably holding the transducer module in the wand. In one embodiment, the hand wand includes a cable for communicating at least one of the input and the output. In one embodiment, the hand wand includes a controller operably interfacing with a cable, where the controller has a graphical user interface for controlling the removable transducer module. In one embodiment, the hand wand includes a first transducer module coupled to the first controlling device and a second transducer module coupled to the second controlling device.

In accordance with one embodiment of a device for cosmetic imaging and treatment, the device includes a removable transducer module and a controller. In one embodiment, the transducer module is not removable. In one embodiment, the transducer module is integrated, or permanently attached. The removable transducer module is interfaced to a hand enclosure having at least one controller button such that the transducer module and button is operable using one hand. The transducer module provides ultrasound energy for at least one of an imaging function and a treatment function. The controller is coupled to the hand enclosure and is interfaced to the transducer module. The controller controls the ultrasound energy and receives at least one signal from the transducer module. The controller has a power supply operably providing power for at least the ultrasound energy. In one embodiment, the device also includes a graphical user interface for controlling the transducer module and for viewing the at least one signal from the transducer module. In one embodiment, the device has a hand enclosure that also includes a movement mechanism operably moving a transducer in the transducer module, where the movement mechanism is controlled by the controller. In one embodiment, the device has at least one controller button as a first controller button controlling the imaging function and a second controlling button controlling the treatment function. In various embodiments, the device has a treatment function that is one of face lift, a brow lift, a chin lift, a wrinkle reduction, a scar reduction, a tattoo removal, a vein removal, sun spot removal, and pimple removal. In another embodiment the device may be used on adipose tissue.

In accordance with one embodiment of a method of performing cosmetic treatment on a facial (or other) area of a subject, the method includes inserting a transducer module into a hand controller, coupling the transducer module to the subject, activating a first switch on the hand controller operably initiating an imaging sequence of a portion of tissue below the dermal layer, collecting data from the imaging sequence, calculating a treatment sequence from the data, and activating a second switch on the hand controller operably initiating the treatment sequence. In one embodiment, the method also includes emitting a first ultrasound energy from a first transducer in the transducer module operably providing a source for the imaging sequence. In one embodiment, the method also includes emitting a second ultrasound energy from a second transducer in the transducer module operably providing a source for the treatment sequence. In one embodiment, the method also includes tightening a portion of the dermal layer on a facial area of a subject. In one embodiment, the method provides for the transducer module to permit the treatment sequence at a fixed depth below the dermal layer.

In accordance with one embodiment of a hand wand for use in cosmetic treatment, the wand includes a first controlling device operably controlling an ultrasonic imaging function, a second controlling device operably controlling an ultrasonic treatment function, a movement mechanism configured for travel through a liquid-tight seal, and a fluid-filled transducer module. In one embodiment, the fluid-filled transducer module is operably coupled to at least one of the first controlling, the second controlling device and the movement mechanism. In one embodiment, the fluid-filled transducer module is mechanically and electrically separable from at least one of the first controlling, the second controlling device and the movement mechanism. In one embodiment, the fluid-filled transducer module includes an acoustic liquid. In one embodiment, the fluid-filled transducer module includes a gel adapted to enhance transmission of an ultrasonic signal. In one embodiment, a gel adapted to enhance transmission of an ultrasonic signal is placed between the transducer and the patient's skin.

In accordance with one embodiment of a hand wand for use in cosmetic treatment, the wand includes a first controlling device operably controlling an ultrasonic imaging function, a second controlling device operably controlling an ultrasonic treatment function, and a movement mechanism configured to create a linear sequence of individual thermal lesions with the second controlling device. In one embodiment, the movement mechanism is configured to be automated and programmable by a user. In one embodiment, the wand includes a transducer module operably coupled to at least one of the first controlling device, the second controlling device and the movement mechanism. In one embodiment, the linear sequence of individual thermal lesions has a treatment spacing in a range from about 0.01 mm to about 25 mm. In one embodiment, the movement mechanism is configured to be programmed to provide variable spacing between the individual thermal lesions. In one embodiment the individual thermal lesions are discrete. In one embodiment the individual thermal lesions are overlapping.

In accordance with one embodiment of a variable ultrasonic parameter ultrasonic system for use in cosmetic treatment, the system includes a first controlling device, a second controlling device, a movement mechanism, and one or more removable transducer modules. In various embodiments, the one or more removable transducer modules includes two, three, four, five, six, or more removable transducer modules. In various embodiments, the different numbers of removable transducer modules can be configured for different or variable ultrasonic parameters. For example, in various non-limiting embodiments, the ultrasonic parameter can relate to transducer geometry, size, timing, spatial configuration, frequency, variations in spatial parameters, variations in temporal parameters, coagulation formation, depth, width, absorption coefficient, refraction coefficient, tissue depths, and/or other tissue characteristics. In various embodiments, a variable ultrasonic parameter may be altered, or varied, in order to effect the formation of a lesion for the desired cosmetic approach. In various embodiments, a variable ultrasonic parameter may be altered, or varied, in order to effect the formation of a lesion for the desired clinical approach. By way of example, one variable ultrasonic parameter relates to aspects of configurations associated with tissue depth. For example, some non-limiting embodiments of removable transducer modules can be configured for a tissue depth of 3 mm, 4.5 mm, 6 mm, less than 3 mm, between 3 mm and 4.5 mm, more than more than 4.5 mm, more than 6 mm, and anywhere in the ranges of 0-3 mm, 0-4.5 mm, 0-25 mm, 0-100 mm, and any depths therein. In one embodiment, an ultrasonic system is provided with two transducer modules, in which the first module applies treatment at a depth of about 4.5 mm and the second module applies treatment at a depth of about 3 mm. An optional third module that applies treatment at a depth of about 1.5-2 mm is also provided. A combination of two or more treatment modules is particularly advantageous because it permits treatment of a patient at varied tissue depths, thus providing synergistic results and maximizing the clinical results of a single treatment session. For example, treatment at multiple depths under a single surface region permits a larger overall volume of tissue treatment, which results in enhanced collagen formation and tightening. Additionally, treatment at different depths affects different types of tissue, thereby producing different clinical effects that together provide an enhanced overall cosmetic result. For example, superficial treatment may reduce the visibility of wrinkles and deeper treatment may induce formation of more collagen growth.

Although treatment of a subject at different depths in one session may be advantageous in some embodiments, sequential treatment over time may be beneficial in other embodiments. For example, a subject may be treated under the same surface region at one depth in week 1, a second depth in week 2, etc. The new collagen produced by the first treatment may be more sensitive to subsequent treatments, which may be desired for some indications. Alternatively, multiple depth treatment under the same surface region in a single session may be advantageous because treatment at one depth may synergistically enhance or supplement treatment at another depth (due to, for example, enhanced blood flow, stimulation of growth factors, hormonal stimulation, etc.).

In several embodiments, different transducer modules provide treatment at different depths. In several embodiments, a system comprising different transducers, each having a different depth, is particularly advantageous because it reduces the risk that a user will inadvertently select an incorrect depth. In one embodiment, a single transducer module can be adjusted or controlled for varied depths. Safety features to minimize the risk that an incorrect depth will be selected can be used in conjunction with the single module system.

In several embodiments, a method of treating the lower face and neck area (e.g., the submental area) is provided. In several embodiments, a method of treating (e.g., softening) mentolabial folds is provided. In other embodiments, a method of treating the eye region is provided. Upper lid laxity improvement and periorbital lines and texture improvement will be achieved by several embodiments by treating at variable depths. In one embodiment, a subject is treated with about 40-50 lines at depths of 4.5 and 3 mm. The subject is optionally treated with about 40-50 lines at a depth of about 1.5-2 mm. The subject is optionally treated with about 40-50 lines at a depth of about 6 mm. By treating at varied depths in a single treatment session, optimal clinical effects (e.g., softening, tightening) can be achieved.

In several embodiments, the treatment methods described herein are non-invasive cosmetic procedures. In some embodiments, the methods can be used in conjunction with invasive procedures, such as surgical facelifts or liposuction, where skin tightening is desired.

In accordance with one embodiment of a variable ultrasonic parameter system for use in cosmetic treatment, the system includes a first controlling device, a second controlling device, a movement mechanism, a first removable transducer module and a second removable transducer module. The first controlling device operably controls an ultrasonic imaging function. The second controlling device operably controls an ultrasonic treatment function. The movement mechanism is configured to create a linear sequence of individual thermal lesions for treatment purposes. The first removable transducer module is configured to treat tissue at a first tissue depth. The second removable transducer module is configured to treat tissue at a second tissue depth. The first and second transducer modules are interchangeably coupled to a hand wand. The first and second transducer modules are operably coupled to at least one of the first controlling device, the second controlling device and the movement mechanism. Rapid interchangeability and exchange of multiple modules on a single unit facilitates treatment in several embodiments. In one embodiment the individual thermal lesions are discrete. In one embodiment the individual thermal lesions are overlapping, merged, etc.

In accordance with one embodiment of an aesthetic imaging and treatment system includes a hand wand, a removable transducer module, a control module and an interface coupling the hand wand to the control module. The hand wand includes at least one finger activated controller. The removable transducer module includes an ultrasound transducer and at least one interface coupleable to the hand wand. The control module is coupled to the hand wand and includes a graphical user interface for controlling the removable transducer module. The interface coupling the hand wand to the control module transfers at least a signal between the hand wand and the control module. In one embodiment, the system also includes a printer coupled to the control module, with the control module providing an output signal and power to the printer. In one embodiment, the system also includes a key operable to unlock the control module for controlling the removable transducer module. In one embodiment, the hand wand also includes a movement mechanism, the movement mechanism operable to move the ultrasound transducer within the transducer module. In one embodiment, the system also includes at least one sensor coupled to one of the hand wand and the removable transducer module.

In accordance with one embodiment of a hand wand for use in cosmetic treatment, the wand includes a first controlling device operably controlling an imaging function, a second controlling device operably controlling a treatment function, a status indicator, an input for power, an output for at least one signal, a movement mechanism, and a removable transducer module operably coupled to at least one of the first controlling device, the second controlling device and the movement mechanism. In one embodiment, the system also includes a latch mechanism removably holding the transducer module in the wand. In one embodiment, the system also includes a cable for communicating at least one of the input and the output. In one embodiment, the system also includes a controller operably interfacing with the cable, the controller having a graphical user interface for controlling the removable transducer module. In one embodiment, the transducer module has a first transducer coupled to the first controlling device and a second transducer coupled to the second controlling device.

In accordance with one embodiment of a device for cosmetic treatment, the device includes a removable transducer module interfaced to a hand enclosure and a controller coupled to the hand enclosure and interfaced to the transducer module. The removable transducer module has at least one controller button such that the transducer module and button are operable using one hand. The transducer module provides ultrasound energy for a treatment function. The controller controls the ultrasound energy and receives at least one signal from the transducer module. The controller has a power supply operably providing power for at least the ultrasound energy. In one embodiment, the controller also includes a graphical user interface for controlling the transducer module and for viewing the at least one signal from the transducer. In one embodiment, the hand enclosure also includes a movement mechanism operably moving a transducer in the transducer module, the movement mechanism being controlled by the controller. In one embodiment, the at least one controller button includes a first controller button controlling the imaging function and a second controlling button controlling the treatment function. In one embodiment, the treatment function is at least one of face lift, a brow lift, a chin lift, a wrinkle reduction, a scar reduction, a tattoo removal, a vein removal, sun spot removal, and acne treatment

In accordance with one embodiment of a method of performing cosmetic treatment a facial area of a subject, the method includes inserting a transducer module into a hand controller, coupling the transducer module to the facial area of the subject, activating a first switch on the hand controller operably initiating an imaging sequence of a portion of tissue below the dermal layer, collecting data from the imaging sequence, calculating a treatment sequence from the data, and activating a second switch on the hand controller operably initiating the treatment sequence. In one embodiment, the method also includes emitting a first ultrasound energy from a first transducer in the transducer module operably providing a source for the imaging sequence. In one embodiment, the method also includes emitting a second ultrasound energy from a second transducer in the transducer module operably providing a source for the treatment sequence. In one embodiment, the method also includes tightening a portion of the dermal layer on a facial area of a subject. In one embodiment, the transducer module permits the treatment sequence at a fixed depth below the dermal layer.

In several embodiments, the invention comprises a hand wand for use in cosmetic treatment. In one embodiment, the wand comprises a first controlling device operably controlling an ultrasonic imaging function for providing ultrasonic imaging and a second controlling device operably controlling an ultrasonic treatment function for providing ultrasonic treatment. The controlling devices, in some embodiments, are finger/thumb operated buttons or keys that communicate with a computer processor. The wand also comprises a movement mechanism configured to direct ultrasonic treatment in a linear sequence of individual thermal lesions. In one embodiment, the linear sequence of individual thermal lesions has a treatment spacing in a range from about 0.01 mm to about 25 mm. In one embodiment the individual thermal lesions are discrete. In one embodiment the individual thermal lesions are overlapping. The movement mechanism is configured to be programmed to provide variable spacing between the individual thermal lesions. First and second removable transducer modules are also provided. Each of the first and second transducer modules are configured for both ultrasonic imaging and ultrasonic treatment. The first and second transducer modules are configured for interchangeable coupling to the hand wand. The first transducer module is configured to apply ultrasonic therapy to a first layer of tissue, while the second transducer module is configured to apply ultrasonic therapy to a second layer of tissue. The second layer of tissue is at a different depth than the first layer of tissue. The first and second transducer modules are configured to be operably coupled to at least one of the first controlling device, the second controlling device and the movement mechanism.

In one embodiment, a third transducer module is provided. The third transducer module is configured to apply ultrasonic therapy to a third layer of tissue, wherein the third layer of tissue is at a different depth than the first or second layers of tissue. Fourth and fifth modules are provided in additional embodiments. The transducer modules are configured to provide variable depth treatment and the movement mechanism is configured to provide variable treatment along a single depth level.

In one embodiment, at least one of the first controlling device and the second controlling device is activated by a control. The control module comprises a processor and a graphical user interface for controlling the first and second transducer modules.

A method of performing a cosmetic procedure on a subject using a hand wand as described herein is provided in several embodiments. In one embodiment, the method comprises ultrasonically imaging a first target region on the subject with the first transducer module and ultrasonically treating the first target region on the subject with the first transducer module at the first tissue depth. The treatment comprises multiple treatment lines across the first target region that are automatically selected (e.g., programmed, pre-set, etc.) by the movement mechanism. In one embodiment, the method further comprises exchanging the first transducer module with the second transducer module; ultrasonically imaging a second target region on the subject with the second transducer module; and ultrasonically treating the second target region on the subject with the second transducer module at the second tissue depth. The treatment comprises multiple treatment lines across the second target region that are automatically selected (e.g., programmed, pre-set, etc.) by the movement mechanism. In one embodiment, the first and second target regions are located under a single surface of the subject.

In several embodiments, the invention comprises a hand wand for use in cosmetic treatment. In accordance with one embodiment, the hand wand comprises a first controlling device, a second controlling device, a movement mechanism, and a transducer module. The first controlling device operably controls an ultrasonic imaging function for providing ultrasonic imaging. The second controlling device operably controls an ultrasonic treatment function for providing ultrasonic treatment. The movement mechanism is configured to direct ultrasonic treatment in a sequence of individual thermal lesions. The removable transducer module is configured for both ultrasonic imaging and ultrasonic treatment. The removable transducer module is configured for interchangeable coupling to the hand wand. The removable transducer module is configured to be operably coupled to at least one of said first controlling device, said second controlling device and said movement mechanism. The removable transducer module is configured to apply ultrasonic therapy to at a first variable ultrasonic parameter to tissue.

In one embodiment, the hand wand is configured to apply ultrasonic therapy to at a second variable ultrasonic parameter to tissue. In one embodiment, the removable transducer module is configured to apply ultrasonic therapy to at a second variable ultrasonic parameter to tissue. In one embodiment, the hand wand further comprises a second removable transducer module, wherein the second removable transducer module is configured to apply ultrasonic therapy to at the second variable ultrasonic parameter to tissue. In one embodiment, the variable ultrasonic parameter is tissue depth. In one embodiment, the variable ultrasonic parameter is frequency. In one embodiment, the variable ultrasonic parameter is timing. In one embodiment, the variable ultrasonic parameter is geometry.

In several embodiments, the invention comprises a hand wand for use in cosmetic treatment. In one embodiment, the wand comprises at least one controlling device, movement mechanism and transducer module. In one embodiment, the wand comprises at least one controlling device operably controlling an ultrasonic imaging function for providing ultrasonic imaging and operably controlling an ultrasonic treatment function for providing ultrasonic treatment. One, two or more controlling devices may be used. A movement mechanism configured to direct ultrasonic treatment in a sequence of individual thermal lesions is provided. The transducer module is configured for both ultrasonic imaging and ultrasonic treatment and is operably coupled to at least one controlling device and a movement mechanism. The transducer module is configured to apply ultrasonic therapy at a first ultrasonic parameter and a second ultrasonic parameter. In various embodiments, the first and second ultrasonic parameters are selected from the group consisting of: variable depth, variable frequency, and variable geometry. For example, in one embodiment, a single transducer module delivers ultrasonic therapy at two or more depths. In another embodiment, two or more interchangeable transducer modules each provide a different depth (e.g., one module treats at 3 mm depth while the other treats at a 4.5 mm depth). In yet another embodiment, a single transducer module delivers ultrasonic therapy at two or more frequencies, geometries, amplitudes, velocities, wave types, and/or wavelengths. In other embodiments, two or more interchangeable transducer modules each provide a different parameter value. In one embodiment, a single transducer may provide at least two different depths and at least two different frequencies (or other parameter). Variable parameter options are particularly advantageous in certain embodiments because they offer enhanced control of tissue treatment and optimize lesion formation, tissue coagulation, treatment volume, etc.

Further areas of applicability will become apparent from the description provided herein. It should be understood that the description and specific examples are intended for purposes of illustration only and are not intended to limit the scope of the embodiments disclosed herein.

BRIEF DESCRIPTION OF THE DRAWINGS

The drawings described herein are for illustration purposes only and are not intended to limit the scope of the present disclosure in any way. Embodiments of the present invention will become more fully understood from the detailed description and the accompanying drawings wherein:

FIG. 1 is an illustration depicting a cosmetic treatment system according to various embodiments of the present invention;

FIG. 2 is a top view illustrating a hand wand according to various embodiments of the present invention;

FIG. 3 is a side view illustrating a hand wand according to various embodiments of the present invention;

FIG. 4 is a side view illustrating an emitter-receiver module according to various embodiments of the present invention;

FIG. 5 is another side view illustrating an emitter-receiver module according to various embodiments of the present invention;

FIG. 6 is a block diagram illustrating an emitter-receiver module according to various embodiments of the present invention;

FIG. 7 is an illustration depicting a movement mechanism according to various embodiments of the present invention;

FIG. 8 is a block diagram illustrating a cosmetic treatment system according to various embodiments of the present invention;

FIG. 9 is an electronic block diagram illustrating a cosmetic treatment system according to various embodiments of the present invention;

FIG. 10 is a schematic illustration of a hand wand and an emitter-receiver module according to various embodiments of the present invention;

FIG. 11 is an illustration depicting one possible area of interest of a subject according to various embodiments of the present invention;

FIG. 12 is an illustration depicting one possible area of interest of a subject according to various embodiments of the present invention;

FIG. 13 is an illustration depicting an area of interest of a subject according to various embodiments of the present invention;

FIG. 14 is a cross-sectional illustration of a portion of an area of interest according to various embodiments of the present invention;

FIG. 15 is a cross-sectional illustration depicting an apparatus and a method according to one embodiment of the present invention;

FIG. 16 is a cross-sectional illustration depicting a treatment region according to various embodiments of the present invention;

FIG. 17 is an illustration depicting the cosmetic treatment system coupled to the region of interest according to various embodiments of the present invention;

FIG. 18 is a flow chart depicting a method according to various embodiments of the present invention;

FIG. 19 is a flow chart depicting another method according to various embodiments of the present invention.

FIG. 20 is a front view illustrating a controller according to various embodiments of the present invention;

FIG. 21 is a side view illustrating a controller according to various embodiments of the present invention;

FIG. 22 is a representation of an interactive graphical display on a controller according one embodiment of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT

The following description sets forth examples of embodiments, and is not intended to limit the present invention or its teachings, applications, or uses thereof. It should be understood that throughout the drawings, corresponding reference numerals indicate like or corresponding parts and features. The description of specific examples indicated in various embodiments of the present invention are intended for purposes of illustration only and are not intended to limit the scope of the invention disclosed herein. Moreover, recitation of multiple embodiments having stated features is not intended to exclude other embodiments having additional features or other embodiments incorporating different combinations of the stated features. Further, features in one embodiment (such as in one figure) may be combined with descriptions (and figures) of other embodiments.

In accordance with on embodiment of the present invention, methods and systems for ultrasound treatment of tissue are configured to provide cosmetic treatment. In various embodiments of the present invention, tissue below or even at a skin surface such as epidermis, dermis, fascia, and superficial muscular aponeurotic system (“SMAS”), are treated non-invasively with ultrasound energy. The ultrasound energy can be focused, unfocused or defocused and applied to a region of interest containing at least one of epidermis, dermis, hypodermis, fascia, and SMAS to achieve a therapeutic effect. In one embodiment, the present invention provides non-invasive dermatological treatment to produce eyebrow lift through tissue coagulation and tightening. In one embodiment, the present invention provides imaging of skin and sub-dermal tissue. Ultrasound energy can be focused, unfocused or defocused, and applied to any desired region of interest, including adipose tissue. In one embodiment, adipose tissue is specifically targeted.

In various embodiments of the present invention, certain cosmetic procedures that are traditionally performed through invasive techniques are accomplished by targeting energy, such as ultrasound energy, at specific subcutaneous tissues. In several embodiments, methods and systems for non-invasively treating subcutaneous tissues to perform a brow lift are provided; however, various other cosmetic treatment applications, such as face lifts, acne treatment and/or any other cosmetic treatment application, can also be performed with the cosmetic treatment system. In one embodiment, a system integrates the capabilities of high resolution ultrasound imaging with that of ultrasound therapy, providing an imaging feature that allows the user to visualize the skin and sub-dermal regions of interest before treatment. In one embodiment, the system allows the user to place a transducer module at optimal locations on the skin and provides feedback information to assure proper skin contact. In one embodiment, the therapeutic system provides an ultrasonic transducer module that directs acoustic waves to the treatment area. This acoustic energy heats tissue as a result of frictional losses during energy absorption, producing a discrete zone of coagulation.

In various embodiments, the device includes a removable transducer module interfaced to a hand enclosure having at least one controller button such that the transducer module and the controller button is operable using only one hand. In an aspect of the embodiments, the transducer module provides ultrasound energy for an imaging function and/or a treatment function. In another aspect of the embodiments, the device includes a controller coupled to the hand-held enclosure and interfaced to the transducer module. In a further aspect of the embodiments, the controller controls the ultrasound energy and receives a signal from the transducer module. The controller can have a power supply and driver circuits providing power for the ultrasound energy. In still another aspect of the embodiments, the device is used in cosmetic imaging and treatment of a patient, or simply treatment of the patient, such as on a brow of a patient.

In accordance with one embodiment for a method of performing a brow lift on a patient, the method includes coupling a probe to a brow region of the patient and imaging at least a portion of subcutaneous tissue of the brow region to determine a target area in the subcutaneous tissue. In one embodiment, the method includes administering ultrasound energy into the target area in the subcutaneous tissue to ablate or coagulate the subcutaneous tissue in the target area, which causes tightening of a dermal layer above or below the subcutaneous tissue of the brow region.

Moreover, several embodiments of the present invention provide a method of tightening a portion of a dermal layer on a facial area of a patient. In various embodiments, the method includes inserting a transducer module into a hand controller and then coupling the transducer module to a facial area of the patient. In one embodiment, the method includes activating a first switch on the hand to initiate an imaging sequence of a portion of tissue below a dermal layer, then collecting data from the imaging sequence. In these embodiments, the method includes calculating a treatment sequence from the collected data, and then activating a second switch on the hand to initiate the treatment sequence. In an aspect of the embodiments, the method can be useful on a portion of a face, head, neck and/or other part of the body of a patient.

In some embodiments, the system includes a hand wand with at least one finger activated controller, and a removable transducer module having an ultrasound transducer. In one embodiment, the system includes a control module that is coupled to the hand wand and has a graphic user interface for controlling the removable transducer module with an interface coupling the hand wand to the control module. In one embodiment, the interface provides power to the hand wand. In one embodiment, the interface transfers at least one signal between the hand wand and the control module. In one embodiment, the aesthetic imaging system is used in cosmetic procedures on a portion of a face, head, neck and/or other part of the body of a patient.

In addition, several embodiments of the present invention provide a hand wand for use in aesthetic treatment. In some embodiments, the hand wand includes a first controlling device operably controlling an imaging function, a second controlling device operably controlling a treatment function, a status indicator, an input for power, an output for at least one signal, and a movement mechanism. A removable transducer module can be coupled to the hand wand. The removable transducer module can be interfaced with the first controlling device, the second controlling device and/or the movement mechanism. In one embodiment, the hand wand is used in cosmetic procedures on a face, head, neck and/or other part of the body of a patient.

Several embodiments of the present invention may be described herein in terms of various components and processing steps. It should be appreciated that such components and steps may be realized by any number of hardware components configured to perform the specified functions. For example, some embodiments of the present invention may employ various medical treatment devices, visual imaging and display devices, input terminals and the like, which may carry out a variety of functions under the control of one or more control systems or other control devices. Several embodiments of the present invention may be practiced in any number of medical contexts. For example, the principles, features and methods discussed may be applied to any medical application.

To further explain in more detail various aspects of embodiments of the present invention, several examples of a cosmetic treatment system as used with a control system and an ultrasonic probe system will be provided. However, it should be noted that the following embodiments are for illustrative purposes, and that embodiments of the present invention can comprise various other configurations for a cosmetic treatment. In addition, although not illustrated in the drawing figures, the cosmetic treatment system can further include components associated with imaging, diagnostic, and/or treatment systems, such as any required power sources, system control electronics, electronic connections, and/or additional memory locations.

With reference to the illustration in FIG. 1, an embodiment of the present invention is depicted as a cosmetic treatment system 20. In various embodiments of the present invention, the cosmetic treatment system 20 (hereinafter “CTS 20”) includes a hand wand 100, an emitter-receiver module 200, and a controller 300. The hand wand 100 can be coupled to the controller 300 by an interface 130. In one embodiment the interface is a cord. In one embodiment, the cord is a two way interface between the hand wand 100 and the controller 300. In various embodiments the interface 130 can be, for example, any multi-conductor cable or wireless interface. In one embodiment, the interface 130 is coupled to the hand wand 100 by a flexible connection 145. In one embodiment, the flexible connection 145 is a strain relief. The distal end of the interface 130 is connected to a controller connector on a flex circuit 345. In various embodiments the flexible connector 145 can be rigid or may be flexible, for example, including a device such as an elastomeric sleeve, a spring, a quick connect, a reinforced cord, a combination thereof, and the like. In one embodiment, the flexible connection 145 and the controller connection on the flex circuit 345 can include an antenna and receiver for communications wirelessly between the hand wand 100 and the controller 300. In one embodiment, the interface 130 can transmit controllable power from the controller 300 to the hand wand 100.

In various embodiments, the controller 300 can be configured for operation with the hand wand 100 and the emitter-receiver module 200, as well as the overall CTS 20 functionality. In various embodiments, multiple controllers 300, 300′, 300″, etc. can be configured for operation with multiple hand wands 100, 100′, 100″, etc. and or multiple emitter-receiver modules 200, 200′, 200″, etc. In various embodiments, a second embodiment of a reference can be indicated with a reference number with one or more primes ('). For example, in one embodiment a first module 200 may be used with or as an alternative to a second module 200′, third module 200″, fourth module 200″′, etc. Likewise, in various embodiments, any part with multiples can have a reference number with one or more primes attached to the reference number in order to indicate that embodiment. For example, in one embodiment a first transducer 280 can be indicated with the 280 reference number, and a second transducer 280′ uses the prime. In one embodiment, controller 300 houses an interactive graphical display 310, which can include a touch screen monitor and Graphic User Interface (GUI) that allows the user to interact with the CTS 20. In various embodiments, this display 310 sets and displays the operating conditions, including equipment activation status, treatment parameters, system messages and prompts and ultrasound images. In various embodiments, the controller 300 can be configured to include, for example, a microprocessor with software and input/output devices, systems and devices for controlling electronic and/or mechanical scanning and/or multiplexing of transducers and/or multiplexing of transducer modules, a system for power delivery, systems for monitoring, systems for sensing the spatial position of the probe and/or transducers and/or multiplexing of transducer modules, and/or systems for handling user input and recording treatment results, among others. In various embodiments, the controller 300 can comprise a system processor and various digital control logic, such as one or more of microcontrollers, microprocessors, field-programmable gate arrays, computer boards, and associated components, including firmware and control software, which may be capable of interfacing with user controls and interfacing circuits as well as input/output circuits and systems for communications, displays, interfacing, storage, documentation, and other useful functions. System software may be capable of controlling all initialization, timing, level setting, monitoring, safety monitoring, and all other system functions required to accomplish user-defined treatment objectives. Further, the controller 300 can include various control switches that may also be suitably configured to control operation of the CTS 20. In one embodiment, the controller 300 includes an interactive graphical display 310 for conveying information to user. In one embodiment, the controller 300 includes one or more data ports 390. In one embodiment, the data port 390 is a USB port, and can be located on the front, side, and/or back of the controller 300 for access to storage, a printer 391, devices, or be used for other purposes. In various embodiments the CTS 20 includes a lock 395, and in one embodiment the lock 395 can be connectable to the controller 300 via a USB port. In one embodiment, in order to operate CTS 20, lock 395 must be unlocked so that power switch 393 may be activated. In another embodiment lock 395 must be unlocked insertion of USB access key or hardware dongle and associated software so that the interactive graphical display 310 can execute. In one embodiment, an emergency stop button 392 is readily accessible for emergency de-activation.

In various embodiments, an aesthetic imaging system or CTS 20 includes a hand wand 100 with at least one finger activated controller (150 and/or 160), and a removable emitter-receiver module 200 having an ultrasound transducer. Other embodiments may include non-removable emitter-receiver modules, imaging-only emitter-receiver modules, treatment-only emitter-receiver modules, and imaging-and-treatment emitter-receiver modules. In one embodiment, the CTS 20 includes a control module 300 that is coupled to the hand wand 100 and has a graphic user interface 310 for controlling the removable transducer module 200 with an interface 130, such as in one embodiment, a cord coupling the hand wand 100 to the control module 300. In one embodiment, the interface 130 provides power to the hand wand 100. In one embodiment, the interface 130 transfers at least one signal between the hand wand 100 and the control module 300. In an aspect of this embodiment, the aesthetic imaging system of CTS 20 is used in aesthetic procedures on a portion of a head of a patient. In one embodiment, the CTS 20 is used in aesthetic procedures on a portion of a face, head, neck and/or other part of the body of a patient.

In addition, certain embodiments of the present invention provide a hand wand 100 for use in aesthetic treatment. In some embodiments, the hand wand 100 includes a first controlling device 150 operably controlling an imaging function, a second controlling device 160 operably controlling a treatment function, a status indicator 155, an input for power, an output for at least one signal (for example to a controller 300), a movement mechanism 400, and a removable transducer module 200 in communication with the first controlling device 150, the second controlling device 160 and/or the movement mechanism 400. In an aspect of the embodiments, the hand wand 100 is used in cosmetic procedures on a face, head, neck and/or other part of the body of a patient.

In accordance to various embodiments of the present invention, an emitter-receiver module 200 can be coupled to the hand wand 100. In some embodiments an emitter-receiver module 200 can emit and receive energy, such as ultrasonic energy. In one embodiment, an emitter-receiver module 200 can be configured to only emit energy, such as ultrasonic energy. In one embodiment, the emitter-receiver module 200 is permanently attachable to the hand wand 100. In one embodiment, the emitter-receiver module 200 is attachable to and detachable from the hand wand 100. The emitter-receiver module 200 can be mechanically coupled to the hand wand 100 using a latch or coupler 140. An interface guide 235 can be useful in assisting the coupling of the emitter-receiver module 200 to the hand wand 100. In addition, the emitter-receiver module 200 can be electronically coupled to the hand wand 100 and such coupling may include an interface which is in communication with the controller 300. In one embodiment, an electric coupler at the interface guide 235, located at a proximal end of an emitter-receiver module 200 provides for electronic communication between the emitter-receiver module 200 and the hand wand 100, which can both be in electric communication with a controller 300. The emitter-receiver module 200 can comprise various probe and/or transducer configurations. For example, the emitter-receiver module 200 can be configured for a combined dual-mode imaging/therapy transducer, coupled or co-housed imaging/therapy transducers, or simply a separate therapy probe and an imaging probe. In one embodiment, the hand wand 100 includes a handle with an integrated receptacle for insertion of an emitter-receiver module 200 containing at least a transducer on one end and an electrical cable for attachment to the controller 200 on the other end.

With additional reference to the illustrations in FIGS. 2 and 3, the hand wand 100 can be designed for ergonomic considerations to improve comfort, functionality and/or ease of use of the hand wand 100 by a user, such as, for example, a practitioner or medical professional. The hand wand 100 can be designed to be used ambidextrously. In one embodiment, the use of the hand wand 100 is not diminished by whether it is in a right hand or a left hand. In one embodiment, of the hand wand 100 includes an imaging button 150, a treatment button 160, and an indicator 155 on a top portion of the hand wand 100. Other arrangements of buttons and/or indicators are possible in various embodiments. In one embodiment the hand wand 100 includes a hand rest 148 on a bottom portion and a coupler 140 distal to the flexible connector 145. In one embodiment, the hand rest 148 includes a clearance pocket molded into the hand wand 100 housing which allows a magnet-tipped clutch rod (433 and 432 of FIG. 7) to move back and forth to drive the transducer module's rectilinear motion without hitting the hand wand's housing. According to these aspects, the hand wand 100 can be operated by the user either in a right hand or a left hand. Further to these aspects, the user can control the imaging button 150 and the treatment button 160 with a thumb or finger, such as an index finger. An interior portion of the hand wand 100 can include electronics as well as software, connections, and/or couplings for interfacing to and from the electronics. In one embodiment, the hand wand 100 contains an electronic interface 175 (not illustrated here, but see other figures) in communication with at least one of the imaging button 150 and the treatment button 160. In accordance with one embodiment, the electronic interface 175 can interface with an outside source such as, for example, the controller 300. In various embodiments, the indictor 145 can be an LED, a light, an audio signal, and combinations thereof. In one aspect of the embodiments, the indicator 155 is a LED which can change colors based on different states of the CTS 20. For example the indicator 155 can be one color (or off) in a standby mode, a second color in an imaging mode and a third color in a treatment mode.

In one embodiment, the emitter-receiver module 200 is configured to removably attach both electronically and mechanically with a hand wand 100. In one embodiment, a motion mechanism 400 (see FIG. 7) is configured to move an ultrasonic transducer 280 in an emitter-receiver module 200 such as is illustrated in various embodiments in FIGS. 4-6. A user can remove the indicated transducer module from its protective, resealable pouch, setting aside the pouch for storing the transducer module between procedures, if necessary. In one embodiment, a hand wand 100 and an emitter-receiver module 200 can be connected by pushing the coupler 140 upwards and sliding the emitter-receiver module 200 into the hand wand 100 as shown in FIG. 1. In one embodiment, when the emitter-receiver module 200 is inserted, the controller 300 automatically detects it and updates the interactive graphical display 310. In one embodiment, the emitter-receiver module 200 locked into the hand wand 100 once the emitter-receiver module 200 is fully inserted and the coupler 140 at the tip of the hand wand 100 is pushed down. To disconnect the emitter-receiver module 200, the user can lift the coupler 140 at the tip of the hand wand 100 and slide the emitter-receiver module 200 out of the hand wand 100.

FIGS. 4 and 5 illustrate two opposing side views of an embodiment of an emitter-receiver module 200 comprising a housing 220 and an acoustically transparent member 230. In one embodiment, the housing 220 may include a cap 222 that is removable or permanently attachable to the housing 220. In one embodiment, the emitter-receiver module 200 includes an interface guide 235 and/or one or more side guides 240 that can be useful in assisting the coupling of the emitter-receiver module 200 to the hand wand 100. The emitter-receiver module 200 can include a transducer 280 which can emit energy through an acoustically transparent member 230. The acoustically transparent member 230 can be a window, a filter and/or a lens. The acoustically transparent member 230 can be made of any material that is transparent to the energy that is that is emitted by the transducer 280. In one embodiment, the acoustically transparent member 230 is transparent to ultrasound energy.

In various embodiments, the transducer 280 is in communication with the controller 300. In one embodiment, the transducer 280 is electronically coupled to the hand wand 100 and/or the controller 300. In one embodiment, the housing 220 is sealed by the cap 222 and the structure of the combination of the housing 220 and the cap 222 can hold a liquid (not shown). As illustrated in FIG. 6, an embodiment of the emitter-receiver module 200 housing 220 can have a port 275 which allows interfacing from the hand wand 100 into the transducer module 200 without affecting the integrity of the sealed structure of the housing 220 and the cap 222. Further, the cap 222 can include one or more ports. For example, a first port 292, a second port 293 and a third port 294. The ports in the cap 222 can be useful for electronically coupling the transducer 280 to the hand wand 100 and/or the controller 300. In one embodiment, at least one of the ports in the cap 222 may be used to interface a sensor 201 that may be useful in the emitter-receiver module 200. The sensor 201 can be in communication with the controller 300. More than one sensor 201 is used in some embodiments.

In various embodiments, as illustrated in the block diagram of FIG. 6, the transducer 280 is movable within the emitter-receiver module 200. The transducer 280 is held by a transducer holder 289. In one embodiment, the transducer holder 289 includes a sleeve 287 which is moved along motion constraining bearings, such as linear bearings, namely, a bar (or shaft) 282 to ensure a repeatable linear movement of the transducer 280. In one embodiment, sleeve 287 is a spline bushing which prevents rotation about a spline shaft 282, but any guide to maintain the path of motion is appropriate. In one embodiment, the transducer holder 289 is driven by a motion mechanism 400, which may be located in the hand wand 100 or in the emitter-receiver module 200. The motion mechanism 400, as is discussed below in relation to FIG. 7, includes a scotch yoke 403 with a movement member 432 and a magnetic coupling 433 on a distal end of the movement member 432. The magnet coupling 433 helps move the transducer 280. One benefit of a motion mechanism such as motion mechanism 400 is that it provides for a more efficient, accurate and precise use of an ultrasound transducer 280, for both imaging and for therapy purposes. One advantage this type of motion mechanism has over conventional fixed arrays of multiple transducers fixed in space in a housing is that the fixed arrays are a fixed distance apart. By placing transducer 280 on a linear track under controller 300 control, embodiments of the system and device provide for adaptability and flexibility in addition to the previously mentioned efficiency, accuracy and precision. Real time and near real time adjustments can be made to imaging and treatment positioning along the controlled motion by the motion mechanism 400. In addition to the ability to select nearly any resolution based on the incremental adjustments made possible by the motion mechanism 400, adjustments can be made if imaging detects abnormalities or conditions meriting a change in treatment spacing and targeting.

In one embodiment, one or more sensors 201 may be included in the emitter-receiver module 200. In one embodiment, one or more sensors 201 may be included in the emitter-receiver module 200 to ensure that a mechanical coupling between the movement member 432 and the transducer holder 289 is indeed coupled. In one embodiment, an encoder 283 may be positioned on top of the transducer holder 289 and a sensor 201 may be located in a dry portion of the emitter-receiver module 200, or vice versa (swapped). In various embodiments the sensor 201 is a magnetic sensor, such as a giant magnetoresistive effect (GMR) or Hall Effect sensor, and the encoder a magnet, collection of magnets, or multi-pole magnetic strip. The sensor may be positioned as a transducer module home position. In one embodiment, the sensor 201 is a contact pressure sensor. In one embodiment, the sensor 201 is a contact pressure sensor on a surface of the device to sense the position of the device or the transducer on the patient. In various embodiments, the sensor 201 can be used to map the position of the device or a component in the device in one, two, or threes dimensions. In one embodiment the sensor 201 is configured to sense the position, angle, tilt, orientation, placement, elevation, or other relationship between the device (or a component therein) and the patient. In one embodiment, the sensor 201 comprises an optical sensor. In one embodiment, the sensor 201 comprises a roller ball sensor. In one embodiment, the sensor 201 is configured to map a position in one, two and/or three dimensions to compute a distance between areas or lines of treatment on the skin or tissue on a patient. Motion mechanism 400 can be any motion mechanism that may be found to be useful for movement of the transducer 280. Other embodiments of motion mechanisms useful herein can include worm gears and the like. In various embodiments of the present invention, the motion mechanism is located in the emitter-receiver module 200.

In various embodiments, the motion mechanism can provide for linear, rotational, multi-dimensional motion or actuation, and the motion can include any collection of points and/or orientations in space. Various embodiments for motion can be used in accordance with several embodiments, including but not limited to rectilinear, circular, elliptical, arc-like, spiral, a collection of one or more points in space, or any other 1-D, 2-D, or 3-D positional and attitudinal motional embodiments. The speed of the motion mechanism 400 may be fixed or may be adjustably controlled by a user. One embodiment, a speed of the motion mechanism 400 for an image sequence may be different than that for a treatment sequence. In one embodiment, the speed of the motion mechanism 400 is controllable by the controller 300.

Transducer 280 can have a travel distance 272 such that an emitted energy 50 is able to be emitted through the acoustically transparent member 230. In one embodiment, the travel 272 is described as end-to-end range of travel of the transducer 280. In one embodiment, the travel 272 of the transducer 280 can be between about 100 mm and about 1 mm. In one embodiment, the length of the travel 272 can be about 25 mm. In one embodiment, the length of the travel 272 can be about 15 mm. In one embodiment, the length of the travel 272 can be about 10 mm. In various embodiments the length of the travel 272 can be about between 0-25 mm, 0-15 mm, 0-10 mm.

The transducer 280 can have an offset distance 270, which is the distance between the transducer 280 and the acoustically transparent member 230. In various embodiments of the present invention, the transducer 280 can image and treat a region of interest of about 25 mm and can image a depth less than about 10 mm. In one embodiment, the emitter-receiver module 200 has an offset distance 270 for a treatment at a depth 278 of about 4.5 mm below the skin surface 501 (see FIG. 15).

In various embodiments, transducer modules 200 can be configured for different or variable ultrasonic parameters. For example, in various non-limiting embodiments, the ultrasonic parameter can relate to aspects of the transducer 280, such as geometry, size, timing, spatial configuration, frequency, variations in spatial parameters, variations in temporal parameters, coagulation formation, depth, width, absorption coefficient, refraction coefficient, tissue depths, and/or other tissue characteristics. In various embodiments, a variable ultrasonic parameter may be altered, or varied, in order to effect the formation of a lesion for the desired cosmetic approach. In various embodiments, a variable ultrasonic parameter may be altered, or varied, in order to effect the formation of a lesion for the desired clinical approach. By way of example, one variable ultrasonic parameter relates to configurations associated with tissue depth 278. In several embodiments, the transducer module 200 is configured for both ultrasonic imaging and ultrasonic treatment and is operably coupled to at least one controlling device 150, 160 and a movement mechanism 400. The transducer module 200 is configured to apply ultrasonic therapy at a first ultrasonic parameter and a second ultrasonic parameter. In various embodiments, the first and second ultrasonic parameters are selected from the group consisting of: variable depth, variable frequency, and variable geometry. For example, in one embodiment, a single transducer module 200 delivers ultrasonic therapy at two or more depths 278, 278′. In another embodiment, two or more interchangeable transducer modules 200 each provide a different depth 278 (e.g., one module treats at 3 mm depth while the other treats at a 4.5 mm depth). In yet another embodiment, a single transducer module 200 delivers ultrasonic therapy at two or more frequencies, geometries, amplitudes, velocities, wave types, and/or wavelengths. In other embodiments, two or more interchangeable transducer modules 200 each provide a different parameter value. In one embodiment, a single transducer module 200 may provide at least two different depths 278, 278′ and at least two different frequencies (or other parameter). Variable parameter options are particularly advantageous in certain embodiments because they offer enhanced control of tissue treatment and optimize lesion formation, tissue coagulation, treatment volume, etc.

FIG. 15 illustrates one embodiment of a depth 278 that corresponds to a muscle depth. In various embodiments, the depth 278 can correspond to any tissue, tissue layer, skin, dermis, fat, SMAS, muscle, or other tissue. In some embodiments, different types of tissue are treated to provide synergistic effects, thus optimizing clinical results. In another embodiment, the emitter-receiver module has an offset distance 270 for a treatment at a depth 278 of about 3.0 mm below the surface 501. In various embodiments, this offset distance may be varied such that the transducer 280 can emit energy to a desired depth 278 below a surface 501. In various embodiments, in a treatment mode, bursts of acoustic energy from the transducer 280 can create a linear sequence of individual thermal lesions 550. In one embodiment the individual thermal lesions 550 are discrete. In one embodiment the individual thermal lesions 550 are overlapping. In various embodiments, the transducer 280 can image to a depth roughly between 1 and 100 mm. In one embodiment, the transducer imaging depth can be approximately 20 mm. In one embodiment, the transducer 280 can treat to a depth of between about zero (0) to 25 mm. In one embodiment, the transducer treatment depth can be approximately 4.5 mm.

In any of the embodiments described herein, the transducer treatment depth can be approximately 0.5 mm, 1 mm, 1.5 mm, 2 mm, 3 mm, 4 mm, 4.5 mm, 5 mm, 6 mm, 10 mm 15 mm, 20 mm, 25 mm, or any other depth in the range of 0-100 mm. Varied depth treatment, including treatment of the same tissue at different depths or treatment of different tissues, can increase clinical results by providing synergistic effects.

In various embodiments of the present invention, a transducer 280 is capable of emitting ultrasound energy for imaging, diagnostics, or treating and combinations thereof. In one embodiment, the transducer 280 is configured to emit ultrasound energy at a specific depth in a region of interest to target a region of interest of a specific tissue such as a corrugator supercilii muscle as described below. In this embodiment, the transducer 280 may be capable of emitting unfocused or defocused ultrasound energy over a wide area of the region of interest 65 for treatment purposes (see FIGS. 12 and 22). In one embodiment, the emitter-receiver module 200 contains a transducer 280 that can image and treat a region of tissue up to 25 mm long and can image a depth of up to 8 millimeters. Treatment occurs along a line less than or equal to the transducer's active length, which is indicated in one embodiment by guide marks (not illustrated here) on the sides of the emitter-receiver module 200 near a acoustically transparent member 230 along the surface adjacent to the patient's skin. In one embodiment, a marked guide at the front tip of the transducer 280 represents the center of the treatment line. In one embodiment of a treatment mode, bursts of sound energy create a linear sequence of individual thermal coagulation zones. In one embodiment the individual thermal coagulation zones are discrete. In one embodiment the individual thermal coagulation zones are overlapping. A label (not illustrated here) may be applied or etched on a side or top surface of the emitter-receiver module 200 to provide the transducer 280 type, expiration date, and other information. In one embodiment, an emitter-receiver module 200 can be configured with a label for tracking the type transducer 280 used, treatment frequency and treatment depth, a unique serial number, a part number, and date of manufacture. In one embodiment, the emitter-receiver modules 200 are disposable. In one embodiment, the system tracks use of the emitter-receiver modules 200 in order to determine the remaining life of the emitter-receiver module 200 as transducer life diminishes over time and/or usage. Once a transducer 280 has diminished capacity, the emitter-receiver module 200 may work less effectively in performing its functions. In one embodiment, the emitter-receiver module 200 or controller 300 will track usage and prevent additional usage of an emitter-receiver module 200 beyond a recommended usage life in order to preserve the safety and effectiveness of the device. This safety feature can be configured based on test data.

In one embodiment, an emitter-receiver module 200 is configured with a treatment frequency of approximately 4 MHz, a treatment depth of approximately 4.5 mm and an imaging depth range of roughly 0-8 mm. In one embodiment, an emitter-receiver module 200 is configured with a treatment frequency of approximately 7 MHz, a treatment depth of approximately 3.0 mm and an imaging depth range of roughly 0-8 mm. In one embodiment, an emitter-receiver module 200 is configured with a treatment frequency of approximately 7 MHz, a treatment depth of approximately 4.5 mm and an imaging depth range of roughly 0-8 mm.

Transducer 280 may comprise one or more transducers for facilitating imaging and/or treatment. The transducer 280 may comprise a piezoelectrically active material, such as, for example, lead zirconante titanate, or other piezoelectrically active materials such as, but not limited to, a piezoelectric ceramic, crystal, plastic, and/or composite materials, as well as lithium niobate, lead titanate, barium titanate, and/or lead metaniobate, including piezoelectric, electrically conductive, and plastic film layers deposited on spherically focused backing material. In addition to, or instead of, a piezoelectrically active material, the transducer 280 may comprise any other materials configured for generating radiation and/or acoustical energy. The transducer 280 may also comprise one or more matching and/or backing layers coupled to the piezoelectrically active material. The transducer 280 may also be configured with single or multiple damping elements.

In one embodiment, the thickness of a transduction element of the transducer 280 may be configured to be uniform. That is, the transduction element may be configured to have a thickness that is generally substantially the same throughout. In another embodiment, the transduction element may also be configured with a variable thickness, and/or as a multiple damped device. For example, the transduction element of the transducer 280 may be configured to have a first thickness selected to provide a center operating frequency of a lower range, for example from about 1 MHz to about 10 MHz. The transduction element may also be configured with a second thickness selected to provide a center operating frequency of a higher range, for example from about 10 MHz to greater than 100 MHz.

In yet another embodiment, the transducer 280 is configured as a single broadband transducer excited with two or more frequencies to provide an adequate output for raising a temperature within a treatment area of the region of interest to the desired level as discussed herein. The transducer 280 may be configured as two or more individual transducers, such that each transducer 280 may comprise a transduction element. The thickness of the transduction elements may be configured to provide center-operating frequencies in a desired treatment range. For example, in one embodiment, the transducer 280 may comprise a first transducer configured with a first transduction element having a thickness corresponding to a center frequency range of about 1 MHz to about 10 MHz, and a second transducer configured with a second transduction element having a thickness corresponding to a center frequency range of about 10 MHz to greater than 100 MHz. Various other combinations and ranges of thickness for a first and/or second transduction element can be designed to focus at specific depths below a surface 501, for specific frequency ranges, and/or specific energy emissions.

The transduction elements of the transducer 280 can be configured to be concave, convex, and/or planar. In one embodiment, the transduction elements are configured to be concave in order to provide focused energy for treatment of the region of interest. Additional embodiments of transducers are disclosed in U.S. patent application Ser. No. 10/944,500, entitled “System and Method for Variable Depth Ultrasound Treatment,” incorporated in its entirety herein by reference.

Moreover, the transducer 280 can be any distance from the surface 501. In that regard, it can be far away from the surface 501 disposed within a long transducer or it can be just a few millimeters from the surface 501. This distance can be determined by design using the offset distance 270 as described herein. In certain embodiments, positioning the transducer 280 closer to the surface 501 is better for emitting ultrasound at higher frequencies. Moreover, both two and three dimensional arrays of elements can be used in the present invention. Furthermore, the transducer 280 may comprise a reflective surface, tip, or area at the end of the transducer 280 that emits ultrasound energy. This reflective surface may enhance, magnify, or otherwise change ultrasound energy emitted from the CTS 20.

In various embodiments any set of one or more transducers 280 can be used for various functions, such as separate treat/image or dual-mode (both treat/image) transducers or a treat-only version. In various embodiments the imaging element(s) can be on the side (adjacent to) or at any relative position, attitude, and/or height, or even within the therapy element(s). One or more therapy depths and frequencies can be used and one or more imaging elements or one or more dual-mode elements. In various embodiments any controllable means of moving the active transduction element(s) within the emitter-receiver module 200 housing constitute viable embodiments.

In various embodiments, the emitter-receiver module 200 can also be configured in various manners and comprise a number of reusable and/or disposable components and parts in various embodiments to facilitate its operation. For example, the emitter-receiver module 200 can be configured within any type of transducer probe housing or arrangement for facilitating the coupling of the transducer 280 to a tissue interface, with such housing comprising various shapes, contours and configurations. The emitter-receiver module 200 can comprise any type of matching, such as for example, electric matching, which may be electrically switchable, multiplexer circuits and/or aperture/element selection circuits, and/or probe identification devices, to certify probe handle, electric matching, transducer usage history and calibration, such as one or more serial EEPROM (memories).

In various embodiments, the emitter-receiver module 200 may also comprise cables and connectors, motion mechanisms, motion sensors and encoders, thermal monitoring sensors, and/or user control and status related switches, and indicators such as LEDs. In one embodiment, a motion mechanism similar to the motion mechanism 400 described in the hand wand 100 may be used to drive the emitter-receiver module 200 from within the emitter-receiver module 200. In one embodiment, a hand wand 100 is electrically connectable to the emitter-receiver module 200 to drive the emitter-receiver module 200 from within itself. In various embodiments, a motion mechanism (in any of the embodiments described herein) may be used to controllably create multiple lesions, or sensing of probe motion itself may be used to controllably create multiple lesions and/or stop creation of lesions 550, as discussed herein. For example in one embodiment, for safety reasons if the emitter-receiver module 200 is suddenly jerked or is dropped, a sensor can relay this action to the controller 300 to initiate a corrective action or shut down the emitter-receiver module 200. In addition, an external motion encoder arm may be used to hold the probe during use, whereby the spatial position and attitude of the emitter-receiver module 200 is sent to the controller 300 to help controllably create lesions 550. Furthermore, other sensing functionality such as profilometers or other imaging modalities may be integrated into the emitter-receiver module 200 in accordance with various embodiments. In one embodiment, pulse-echo signals to and from the emitter/receiver module 200 are utilized for tissue parameter monitoring of the treatment region 550.

Coupling components can comprise various devices to facilitate coupling of the emitter-receiver module 200 to a region of interest. For example, coupling components can comprise cooling and acoustic coupling system configured for acoustic coupling of ultrasound energy and signals. Acoustic cooling/coupling system with possible connections such as manifolds may be utilized to couple sound into the region-of-interest, control temperature at the interface and deeper into tissue, provide liquid-filled lens focusing, and/or to remove transducer waste heat. The coupling system may facilitate such coupling through use of one or more coupling mediums, including air, gases, water, liquids, fluids, gels, solids, and/or any combination thereof, or any other medium that allows for signals to be transmitted between the transducer 280 and a region of interest. In one embodiment one or more coupling media is provided inside a transducer. In one embodiment a fluid-filled emitter-receiver module 200 contains one or more coupling media inside a housing. In one embodiment a fluid-filled emitter-receiver module 200 contains one or more coupling media inside a sealed housing, which is separable from a dry portion of an ultrasonic device.

In addition to providing a coupling function, in accordance with one embodiment, the coupling system can also be configured for providing temperature control during the treatment application. For example, the coupling system can be configured for controlled cooling of an interface surface or region between the emitter-receiver module 200 and a region of interest and beyond by suitably controlling the temperature of the coupling medium. The suitable temperature for such coupling medium can be achieved in various manners, and utilize various feedback systems, such as thermocouples, thermistors or any other device or system configured for temperature measurement of a coupling medium. Such controlled cooling can be configured to further facilitate spatial and/or thermal energy control of the emitter-receiver module 200.

In one embodiment, the emitter-receiver module 200 is connected to a motion mechanism 400 in the hand wand 100. In one embodiment, the motion mechanism 400 may be in the emitter-receiver module 200. One embodiment of a motion mechanism 400 is illustrated in FIG. 7, which depicts a two phase stepper motor 402 and a scotch yoke 403 to produce a linear motion. The stepper motor 402 rotates as indicated by arrow 405 which moves a pin 404 in a circular path. The pin 404 slides in a slot 406 of the scotch yoke 403. This causes the scotch yoke 403 to move in a linear fashion. The scotch yoke 403 is held by guides 410 and glide members 412 may be between the scotch yoke 403 and guide 410. In one embodiment, a guide 410 is a shoulder screw. Embodiments of the glide member 412 may include any material or mechanical device that lowers a coefficient of friction between the guide 410 and the scotch yoke 403, or any linear bearings. For example, in various embodiments the glide member 412 can be at least one of an elastomeric material, a lubricant, ball bearings, a polished surface, a magnetic device, pressurized gas, or any other material or device useful for gliding.

A sensor 425 operates as one embodiment of a position sensor by reading an encoder 430 which is mounted on the scotch yoke 403. In one embodiment, the encoder strip 430 is an optical encoder which has a pitch in a range from about 1.0 mm to about 0.01 mm. In one embodiment, the pitch may be about 0.1 mm. The encoder strip 430 can include index marks at each end of its travel. The direction of travel of the encoder strip 430 can be determined by comparing phases of two separate channels in the optical sensor 425. In one embodiment, the encoder strip 430 has one, two or more home positions which may be useful in calibrating for a position and travel of the scotch yoke 403.

In one embodiment, the movement of the scotch yoke 403 is transferred through the movement mechanism 432 such that the transducer 280 moves in a linear fashion inside of the emitter-receiver module 200. In one embodiment, the scotch yoke 403 includes a movement member 432 and a magnetic coupling 433 on a distal end of the movement member 432. The movement member 432 can be sized to travel through or within a liquid-tight seal.

Transducer 280 can have a travel distance 272 The coupling system may facilitate such coupling With reference to FIG. 8, a block diagram illustrates various embodiments of the CTS 20. In one embodiment, the controller 300 includes a controller subsystem 340, a therapy subsystem 320, an imaging subsystem 350, an embedded host 330 (with software) and an interactive graphical display 310. In one embodiment, the therapy subsystem 320, the controller subsystem 340, and/or the imaging subsystem 350 is interfaced with the hand wand 100 and/or the emitter-receiver module 200. In various embodiments, the CTS 20 has built into the controller 300 limits as to an amount of energy 50 that can be emitted from the emitter-receiver module 200. These limits can be determined by time of emission, frequency of the energy emitted, power of energy, a temperature, and/or combinations thereof. The temperature may be from monitoring the surface 501 and/or monitoring the emitter-receiver module 200. According to one embodiment the limits may be preset and cannot be changed by the user.

According to various embodiments, when the emitter-receiver module 200 is coupled to the surface 501, which may be a skin surface of the subject, the CTS 20 can image and/or treat a treatment area 272. In some aspects of these embodiments, the imaging by the CTS 20 can be over essentially the entire treatment area 272 at specified depths 278 below the surface 501. In some aspects of these embodiments, the treatment can include discrete energy emissions 50 to create lesion 550 at intervals along the treatment area 272 and at specified depths 278. In one embodiment the intervals are discrete. In one embodiment the intervals are overlapping.

In various embodiments the imaging subsystem 350 may be operated in a B-mode. The imaging subsystem 350 can provide support to the emitter-receiver module 200 such that the emitter-receiver module 200 can have emission energy 50 from a frequency of about 10 MHz to greater than 100 MHz. In one embodiment, the frequency is about 18 MHz. In one embodiment, the frequency is about 25 MHz. The imaging subsystem 350 can support any frame rate that may be useful for the applications. In some embodiments, the frame rate may be in a range from about 1 frames per second (hereinafter “FPS”) to about 100 FPS, or from about 5 FPS to about 50 FPS or from about 5 FPS to about 20 FPS nominal. An image field of view may be controlled by the image area of the transducer 280 in a focus of the transducer 280 at a specific depth 278 below the surface 501 as discussed herein. In various embodiments, the field of view can be less than 20 mm in depth and 100 mm in width or less than 10 mm in depth and less than 50 mm in width. In one embodiment, a particularly useful image field of view is about 8 mm in depth by about 25 mm in width.

A resolution of the field of view can be controlled by the graduation of the movement mechanism 400. As such, any pitch may be useful based on the graduation of the motion mechanism 400. In one embodiment, the resolution of the field of view may be controlled by the resolution of an encoder 430 and sensor 425. In one embodiment the image field of view can have a pitch in the range of 0.01 mm to 0.5 mm or from about 0.05 mm to about 0.2 mm. In one embodiment, a particularly useful line pitch for the image field of view is about 0.1 mm.

According to various embodiments, the imaging subsystem 350 can include one or more functions. In one embodiment, the one or more functions can include any of the following B-mode, scan image, freeze image, image brightness, distance calipers, text annotation for image, save image, print image, and/or combinations thereof. In various embodiments of the present invention, the imaging subsystem 350 contains pulse echo imaging electronics.

Various embodiments of the therapy subsystem 320 comprise a radio frequency (hereinafter “RF”) driver circuit which can deliver and/or monitor power going to the transducer 280. In one embodiment, the therapy subsystem 320 can control an acoustic power of the transducer 280. In one embodiment, the acoustic power can be from a range of 1 watt (hereinafter “W”) to about 100 W in a frequency range from about 1 MHz to about 10 MHz, or from about 10 W to about 50 W at a frequency range from about 3 MHz to about 8 MHz. In one embodiment, the acoustic power and frequencies are about 40 W at about 4.3 MHz and about 30 W at about 7.5 MHz. An acoustic energy produced by this acoustic power can be between about 0.01 joule (hereinafter “J”) to about 10 J or about 2 J to about 5 J. In one embodiment, the acoustic energy is in a range less than about 3 J.

In various embodiments the therapy subsystem 320 can control a time on for the transducer 280. In one embodiment, the time on can be from about 1 millisecond (hereinafter “ms”) to about 100 ms or about 10 ms to about 50 ms. In one embodiment, time on periods can be about 30 ms for a 4.3 MHz emission and about 30 ms for a 7.5 MHz emission.

In various embodiments, the therapy subsystem 320 can control the drive frequency of the transducer 280 moving across the travel 272. In various embodiments, the frequency of the transducer 280 is based on the emitter/receiver 200 connected to the hand wand 100. According to some embodiments, the frequency of this movement may be in a range from about 1 MHz to about 10 MHz, or about 4 MHz to about 8 MHz. In one embodiment, the frequencies of this movement are about 4.3 MHz or about 7.5 MHz. As discussed herein, the length of the travel 272 can be varied, and in one embodiment, the travel 272 has a length of about 25 mm.

According to various embodiments, the therapy subsystem 320 can control the line scan along the travel 272 and this line scan can range from 0 to the length of the distal of the travel 272. In one embodiment, the line scan can be in a range from about 0 to about 25 mm. According to one embodiment, the line scan can have incremental energy emissions 50 having a treatment spacing 295 and this treatment spacing can range from about 0.01 mm to about 25 mm or from 0.2 mm to about 2.0 mm. In one embodiment, treatment spacing 295 is about 1.5 mm. In various embodiments, the treatment spacing 295 can be predetermined, constant, variable, programmable, and/or changed at any point before, during or after a treatment line. The resolution of the line scan is proportional to the resolution of the motion mechanism 400. In various embodiments, the resolution that is controllable by the therapy subsystem 320 is equivalent to the resolution controllable by the imaging subsystem 350 and, as such, can be in the same range as discussed for the imaging subsystem 350.

In various embodiments, the therapy subsystem 320 can have one or more functions. In one embodiment, the one or more functions can include any of the following: emission energy control, treatment spacing, travel length, treatment ready, treatment, treatment stop, save record, print record, display treatment, and/or combinations thereof.

In various embodiments, the control subsystem 340 includes electronic hardware which mechanically scans the transducer 280 for one or more functions. In one embodiment, one or more functions that can be scanned by the controller subsystem 340 can include scanning the transducer 280 for imaging, a position of the transducer 280 for imaging, scan slip positions of the transducer 280 at locations for therapy, controls therapy hardware settings, provides other control functions, interfacing with the embedded host 330, and/or combinations thereof. In one embodiment the locations are discrete. In one embodiment the locations are overlapping.

In various embodiments, an embedded host 330 is in two-way communication with the controller 340 and the graphical interface 310. In one embodiment, data from the controller 340 can be converted to a graphical format by the embedded host 330 and then transferred to the graphical interface 310 for displaying imaging and/or treatment data.

In one embodiment, commands can be entered by a user employing the graphical interface 310. The commands entered by use of the graphical interface 310 can be communicated to embedded host 330 and then communicated to controller 340 for control and operation of the therapy subsystem 320, the imaging subsystem 350, the hand wand 100, and/or the emitter-receiver module 200. In various embodiments, the embedded host 330 can include a processing unit, memory, and/or software.

In various embodiments, when the imaging button 150 is pressed the CTS 20 enters an imaging sequence in which the imaging subsystem 350 acquires scan lines which are transferred to the embedded host 330 for data conversion and/or graphical conversion which is then communicated to the graphical interface 310. While the system is operating in the imaging sequence, the imaging button 150 may be pressed again which puts the CTS 20 into a ready state. In an aspect of this embodiment, an audio warning or visual display such as the indicator 155 may be initiated to alert the user that the CTS 20 is in the ready state. In the ready state, the controller subsystem 340 communicates with the embedded host 330 to acquire users entered treatment settings. These treatment settings can be checked and can be verified and converted to hardware parameter in the controller subsystem 340. In one embodiment, such set hardware parameters can include treatment timing, cadence, time on, time off, RF driver power, voltage levels, acoustic power output, oscillator frequency, therapy transducer frequency, treatment spacing, travel, motion mechanism speed, and/or combinations thereof. The CTS 20 may remain in the ready state indefinitely or may be timed out after a set time period.

In various embodiments of the present invention, when the CTS 20 is in the ready state, the treatment button 160 may be activated. This activation of the treatment button 160 commences a treatment sequence. The treatment sequence is controllable by the therapy subsystem 320 which executes the treatment sequence along with the controller subsystem 340 and independently of the embedded host 330. The treatment sequence is delivered in real time and last one of the length of the activating of the treatment button 160 or a programmed time downloaded from the embedded host 330 into the controller subsystem 340 and/or the therapy subsystem 320.

In various embodiments, safety features can be designed in the CTS 20 to ensure safe use, imaging, and treatment. In various embodiments, the embedded host 330 is in communication with data port 390 which can comprise either one-way or two-way communication between the data port 390 and the embedded host 330. The data port 390 can interface any electronic storage device, for example, the data port 390 can be interfaced for one or more of a USB drive, a compact flash drive, a secured digital card, a compact disc, and the like. In one embodiment, a storage device through data port 390 to the embedded host 330 can download treatment records or software updates. In another aspect of these embodiments, the storage device can be a two-way communication through data port 390 to the embedded host 330 such that a treatment protocol can be downloaded to the embedded host 330 and CTS 20. A treatment protocol can include parameters, imaging data, treatment data, date/time, treatment duration, subject information, treatment location, and combinations thereof, and the like which can be uploaded by and/or downloaded from the embedded host 330 to the storage device via the data port 390. In one embodiment, a second data port (not shown) may be located on the back of the controller. The second data port may provide power and/or data to a printer.

In various embodiments, the CTS 20 includes a lock 395. In one embodiment, in order to operate CTS 20, lock 395 must be unlocked so that power switch 393 may be activated. In one embodiment, the power may remain on as the lock 395 is unlocked and locked successively and different parameters are entered. A key 396 (not illustrated) may be needed to unlock the lock 395. Examples of keys 396 useful herein include a standard metal tooth and groove key, or an electronic key. In some embodiments, an electronic key 396 may be digitally encoded to include user information and collect data and/or time usage of CTS 20. In one embodiment, an electronic key is particularly useful with CTS 20 may be a USB drive with encryption such that inserting the USB drive key into lock 395 the CTS 20 may be activated. In various embodiments, a software key can be configured to indicate a condition or status to the user, lock the system, interrupt the system, or other feature.

With reference to FIG. 9, a CTS 20 layout block diagram is illustrated according to various embodiments of the present invention. In accordance with the aspects of these embodiments, the controller 300 can include several electronic sections. Included in these electronic sections can be a power supply 350 which provides power to CTS 20 including the controller 300, the hand wand 100, and/or the emitter-receiver module 200. In one embodiment, the power supply 350 can supply power to a printer or other data output device. The controller 300 can include the controller subsystem 340 as described herein, the host 330, a graphical interface 310, an RF driver 352 and a front panel flex circuit 345. The RF driver 352 can provide power to the transducer 280. The embedded host 330 can be a host computer which may be used collecting user input, transferring it to the controller subsystem 340 and for displaying images and system statuses on the graphical interface 310. The power supply 350 can be convertible for use internationally based on different voltage inputs and typically is a medical grade power supply. The power supply may be plugged into a standard wall socket to draw power or may draw power from a battery or any other alternative source that may be available.

The graphical interface 310 displays images and systems status as well as facilitates the user interface for entering commands to control the CTS 20. The controller subsystem 340 can control the imaging subsystem 350, the therapy subsystem 320, as well as interfacing and communicating treatment protocol to the hand wand 100 and the emitter-receiver module 200, as described herein. In one embodiment, the controller subsystem 340 not only sets treatment parameters but also monitors the status of such treatment and transfers such status to the host 330 for display on display/touch screen 310. The front panel flex circuit 345 can be a printed circuit cable that connects the controller 300 to the interface cable 130. In one embodiment, the cable 130 can include a quick connect or release, multi-pin connector plug which interfaces to the front panel flex circuit 345 as described herein.

The cable 130 allows for interfacing of the controller 300 with the hand wand 100 and the emitter-receiver module 200 as described herein.

Now with reference to FIG. 10, the hand wand 100 includes the hand piece imaging sub-circuits 110, encoder 420, sensor 425, image 150 and treat 160 switches, motor 402, status light 155, and interconnect and flex interconnect 420. The hand wand 100 interfaces with spring pin flex 106 and spring pin connector 422 which can be used for hardware, software and/or power interface from the hand wand 100 to the emitter-receiver module 200.

In various embodiments of the present invention, the emitter-receiver module 200 can include a probe ID and connector PCB 224. The probe ID and connector PCB can include a secure EEPROM. The probe ID and connector PCB 224 can be interfaced with a PCB located in a dry portion of the emitter-receiver module 200 and interfaced with the transducer 280 The transducer 280 is typically located in the liquid portion of the emitter-receiver module 200. In one embodiment, the emitter-receiver module 200 can be connected to the hand wand 100 via the spring pin flex 106 and spring pin connector 422 which can be a twelve contact spring pin connector that is recessed in the hand wand 100. The spring pin flex 106 with its twelve contact spring pin connector can be connected to the probe ID and connector PCB 224 which can include gold plated contacts. In one embodiment, the probe ID and connector PCB 224 can include a usage counter that disables the emitter-receiver module 200 after a pre-set usage. In various embodiments, the pre-set usage can range from a single treatment sequence to multiple treatment sequences. In one embodiment, the pre-set usage is determined by a pre-set time on of the transducer 280. In one embodiment, the pre-set usage is a single cycle of treatment sequences. In this aspect, essentially the emitter-receiver module 200 is disposable after each use. In one embodiment, the system automatically shuts off or otherwise indicates to a user that the emitter-receiver module 200 should be replaced. The system may be programmed to shut off or otherwise indicate replacement based on at least one of usage time, energy delivered, shelf time, or a combination thereof.

With further reference to FIG. 10, a block diagram illustrates an interconnection of the hand wand 100 and the emitter-receiver module 200. The hand wand 100 can include a therapy protection switch which can provide a electric isolation between treat and image functions. A transducer pulse generated by the controller subsystem 340 can be received by matching network 173. In one embodiment, a single transducer 280 can be used for therapy without imaging. In another embodiment one dual-mode transducer can be used for therapy and imaging. In another embodiment, two transducers 280 can be used for therapy and imaging. In yet another embodiment, therapy is done at relatively low frequencies (such as, in one embodiment, nominally 4 and 7 MHz) with a first transducer 280, and a second higher frequency transducer for imaging (such as, in one embodiment, 18-40 MHz or more).

The imaging sub-circuits 110 can include a time gain control amplifier and tunable bypass filter which can receive echoes produced by the imaging portion of the transducer 280. The imaging can be controlled by imaging switch 150. Power can be transferred from the controller 300 via cable 130. Such power can be directed to the imaging sub-circuits 110, the image switch 150 and the treatment switch 160. Such power can also be provided to the stepper motor 402, the encoder 425, the probe IO switch 181, the hand wand temperature sensor 183, and a hand wand ID EEPROM 169. All of the electronics described in FIG. 10 for the hand wand 100 can be mounted on the circuit board with an interface to cable 130 and/or an interface to the emitter-receiver module 200.

The emitter-receiver module 200 includes an interface connectable to the hand wand 100 as described in FIG. 9. The emitter-receiver module 200 can include any type of storage device 249. In one embodiment, the storage device 249 is part of the electric interface mating circuit board 224 and electric matching 243 circuit board. In one embodiment, the storage device 249 is a permanent storage device. In one embodiment, the storage device 249 is a non-volatile member. In one embodiment, the storage device 249 is an EEPROM. In one embodiment, the storage device 249 is a secure EEPROM. In one embodiment, a transducer PCB can contain calibration data and information storage in the secure EEPROM. Further in this aspect, the emitter-receiver module 200 includes a sensor which measures a fluid temperature of the fluid portion of the emitter-receiver module 200, a matching network 243 interfaced to the treatment portion of the transducer 280. In various embodiments, the storage device 249 can contain digital security information, build date, transducer focus depth, transducer power requirements, and the like. In one embodiment, the storage device 249 can include a timer which inactivates the emitter-receiver module 200 for use with CTS 20 after a predetermined shelf life has expired. The emitter-receiver module 200 can include a position encoder 283, such as a magnet, connected to the transducer 280 and a sensor 241, such as a Hall sensor, connected to the stationary emitter/receiver housing 220 via circuit board. The position encoder 283 and the position sensor 241 can act as a sensor for determining a transducer 280 home position and/or movement as described herein. The imaging portion of the transducer 280 can receive a transducer RF signal from the controller 300.

Since it is possible for a user to potentially touch the spring pin flex contacts 422 when an emitter-receiver module 200 is not attached, the current must be able to be turned off in this situation to provide safety to the user. To provide such safety, contact pins 422 on opposite ends of the spring pin flex 106 can be used to detect an attachment of the emitter-receiver module 200 to the hand wand 100. As discussed above, motion mechanism 400 can be connected to the transducer 280 to provide linear movement of the transducer along the travel 272.

In various embodiments, the CTS 20 can include various safety features to provide a safe environment for the user and/or the subject that receives treatment. One embodiment, the CTS 20 can include at least one of calibration data, safe operating area, high mismatch detect, high current detect, RF driver supply voltage monitoring, forward and reverse electric power monitoring, acoustic coupling detection, acoustic coupling complete, treatment position sensing, and combinations thereof.

For example, calibration data can include certain characteristics for a given emitter-receiver module 200 that reside on the storage device 249. Such characteristics can include but are not limited to unique and traceable serial numbers, probe identification, frequency setting, acoustic power versus voltage lookup table, electric power versus voltage lookup table, maximum power levels, date codes, usage, other information, and/or combinations thereof. For example, a safe operating area safety feature limits energy output for a given emitter-receiver module 200 is limited to a safe operating area. Such a limitation may include for a given emitter-receiver module 200, the acoustic power level supplied by the power supply voltage and the time On may be limited in the hardware and/or software of the controller 300 and/or the emitter-receiver module 200.

An example of a high mismatch detect safety feature can include if a fault occurs in reflective power from the load of the emitter-receiver module 200 is large as compared a forward power such as the emitter-receiver module 200 failure, open circuit, or high reflective energy, then a system Stop state would automatically and indefinitely be invoked by comparator circuit latched in the hardware of the controller 300 and a notification of such fault would appear on the display/touch screen 310 to alert the user. An example of a high current detect safety feature can include if a driver fault or load fault occurs such that a large current draw is detected such as for example a short circuit or electrical component failure, then a Stop state would be automatically and immediately invoked as located in the hardware of the controller 300 and a notice would be displayed on the display/touch screen 310 to alert the user.

An example of RF driver supply voltage monitoring safety feature can include the CTS 20 measuring the RF driver power supply voltage setting before, during and after treatment to assure that the voltage is at the correct level. If it is determined that the voltage is outside the correct level, then a Stop state would be automatically and immediately invoked and a notice would be displayed on the display/touch screen 310 to alert the user. An example of a safety feature includes monitoring the stepper motor 402 during treatment and determining if it is in an acceptable range such that the transducer 280 is properly moving along the travel 272 at a predetermined rate or frequency. If it is determined that the stepper motor 402 is not at an expected position, a notification is issued to alert the user.

An example of an acoustic coupling safety feature includes an imaging sequence that indicates to the user that the emitter-receiver module 200 is acoustically coupled to the surface 501 before and after treatment. An image sequence confirms that the transducer 280 is scanning a treatment area.

Still further, other safety features may be included such as thermal monitoring, use of a stop switch, a probe sensor, or a combination thereof. An example of thermal monitoring can include monitoring the temperature of the liquid portion of the emitter-receiver module 200, monitoring the temperature of the hand wand 100, monitoring the temperature of the controller 300, monitoring the temperature of the controller subsystem 340 and/or monitoring the temperature of the RF driver 352. Such temperature monitoring assures that the devices described operate within temperatures that are acceptable and will provide notification if a temperature is outside an acceptable range thus alerting the user.

A stop switch can be included in CTS 20 such that when a user hits the stop switch the system moves to a safe and inactive state upon activation of the stop switch. An example of a probe sense fail safe can include immediately stopping imaging and/or treatment if the emitter-receiver module 200 is disconnected from the hand wand 100 while in use. In one embodiment, the CTS 20 can include a system diagnostic which can include software checks for errors, unexpected events and usage. The system diagnostics may also include maintenance indicator that tracks the usage of the CTS 20 and notifies the user that maintenance is needed for the system. Other safety features may be included in the CTS 20 that are well known in the art such as fuses, system power supply over voltage and over current limiting, as well as standardized protections such as fire safety ratings, electrical safety ratings, ISO\EN 60601 compliance and the like.

In various embodiments, the CTS 20 includes a removable transducer module 200 interfaced to a hand enclosure 100 having at least one controller button (150 and/or 160) such that the transducer module 200 and the controller button (150 and/or 160) is operable using only one hand. In an aspect of the embodiments, the transducer module 200 provides ultrasound energy for an imaging function and/or a treatment function. In another aspect of the embodiments, the device includes a controller 300 coupled to the hand-held enclosure 100 and interfaced to the transducer module 200. In a further aspect of these embodiments, the controller 300 controls the ultrasound energy of and receives a signal from the transducer module 200. The controller 300 can have a power supply providing power for the ultrasound energy. In still another aspect of the embodiments, the device is used in aesthetic imaging and treatment on a brow of a patient.

FIG. 11 illustrates a schematic drawing of anatomical features of interest in the head and face region of a patient 500, including a trigeminal nerve 502, a facial nerve 504, a parotid gland 506 and a facial artery 508. In one embodiment, the anatomical features of interest are areas to be treated with care or to be noted, treated with care, or even avoided during treatment. FIGS. 12-14 illustrate one region of interest 65 (hereinafter “ROI 65”) and a cross-sectional tissue portion 10 along the line 23-23 of the ROI 65 on a subject 500, such as may be used for example when performing a brow lift. This cross-sectional tissue portion 10 can be located anywhere in the ROI 65 and can in any direction or of any length with in the ROI 65. Of course, the subject 500 can be a patient that may be treated with a brow lift. The cross-sectional portion tissue 10 includes a surface 501 in a dermal layer 503, a fat layer 505, a superficial muscular aponeurotic system 507 (hereinafter “SMAS 507”), and a facial muscle layer 509. The combination of these layers in total may be known as subcutaneous tissue 510. Also illustrated in FIG. 14 is a treatment zone 525 which is below the surface 501. In one embodiment, the surface 501 can be a surface of the skin of a subject 500. Although the term facial muscle may be used herein as an example, the inventors have contemplated application of the device to any tissue in the body. In various embodiments, the device and/or methods may be used on muscles (or other tissue) of the face, neck, head, arms, legs, or any other location in the body.

Facial muscle tissue is capable of contraction and expansion. Skeletal muscle is a fibrous tissue used to generate stress and strain. For example, skeletal muscles in the forehead region can produce frowning and wrinkles. There are several facial muscles within the brow or forehead including the epicranius muscle, the corrugator supercilii muscle, and the procerus muscle. These facial muscles are responsible for movement of the forehead and various facial expressions. Besides facial muscles, other tissues exist in the brow region that also can lead to wrinkles on the brow.

In accordance with one embodiment of the present invention, methods for ultrasound cosmetic treatment of tissue using one cosmetic treatment system are provided. The ultrasound energy can be focused, unfocused or defocused and is applied to a ROI 65 containing one of facial muscle tissue or dermal layers or fascia to achieve a therapeutic effect, such as a tighten of a brow of a subject 500.

In various embodiments, certain cosmetic procedures that are traditionally performed through invasive techniques are accomplished by targeting energy such as ultrasound energy at specific subcutaneous tissues 510. In one embodiment, methods for non-invasively treating subcutaneous tissues 510 to perform a brow life are provided. In one embodiment, a non-invasive brow lift is performed by applying ultrasound energy at specific depths 278 along the brow to ablatively cut, cause tissue to be reabsorbed into the body, coagulate, remove, manipulate, or paralyze subcutaneous tissue 510 such as the facial muscle 509, for example, the corrugator supercilii muscle, the epicranius muscle, and the procerus muscle within the brow to reduce wrinkles.

In some embodiments, ultrasound energy is applied at a ROI 65 along a patient's forehead. The ultrasound energy can be applied at specific depths and is capable of targeting certain subcutaneous tissues within the brow such as with reference to FIGS. 12-14, SMAS 507 and/or facial muscle 509. The ultrasound energy targets these tissues and cuts, ablates, coagulates, micro-ablates, manipulates and/or causes the subcutaneous tissue 510 to be reabsorbed into the subject's body which effectuates a brow lift non-invasively.

For example, the corrugator supercilii muscle in a target zone 525, can be targeted and treated by the application of ultrasound energy at specific depths 278. This facial muscle 509 or other subcutaneous facial muscles can be ablated, coagulated, micro-ablated, shaped or otherwise manipulated by the application of ultrasound energy in a non-invasive manner. Specifically, instead of cutting a corrugator supercilii muscle during a classic or endoscopic brow lift, the targeted muscle 509 such as the corrugator supercilii can be ablated, micro-ablated, or coagulated by applying ultrasound energy at the forehead without the need for traditional invasive techniques.

One method is configured for targeted treatment of subcutaneous tissue 510 in the forehead region 65 in various manners such as through the use of therapy only, therapy and monitoring, imaging and therapy, or therapy, imaging and monitoring. Targeted therapy of tissue can be provided through ultrasound energy delivered at desired depths 278 and locations via various spatial and temporal energy settings. In one embodiment, the tissues of interest are viewed in motion in real time by utilizing ultrasound imaging to clearly view the moving tissue to aid in targeting and treatment of a ROI 65 on the patient's forehead. Therefore, the practitioner or user performing the non-invasive brow lift can visually observe the movement and changes occurring to the subcutaneous tissue 510 during treatment.

FIGS. 15 - 17 illustrate an embodiment of a method of administering a brow lift. Other embodiments include multiple treatment depths, three dimensional (3-D) treatment, and use of multiple treatment sessions over time. The CTS 20 can be coupled to a tissue portion 10 of the ROI 65 that is to be treated. In one embodiment, a treatment zone 525 is first imaged and then treated. In one embodiment, a user activates the imaging button 150 to initiate the imaging sequence. Imaging can be displayed on the graphical interface 310. In one embodiment, the imaging sequence can be controlled on a touchscreen 315 that is part of the graphical interface 310. After the imaging sequence is started, the treatment sequence can be initiated at any time. The user can activate treatment button 160 at any time to initiate the treatment sequence. Treatment and imaging can occur simultaneously or occur sequentially. For example, a user can image, treat, image, treat, etc. As schematically illustrated in FIG. 15, the treatment sequence activates the treatment portion of the transducer 280 to create voids or lesions 550 below the surface 105. Note that FIG. 15 illustrates one embodiment of a depth 278 that corresponds to a muscle depth. In various embodiments, the depth 278 can correspond to any tissue, tissue layer, skin, dermis, fat, SMAS, muscle, or other tissue. Note that as illustrated, the energy 50 represented is for illustration purposes only. Certain figures including FIGS. 15-17 show energy 50 emanating from the entire length of the transducer housing (its entire opening such as corresponding to travel distance 272); however the actual energy is emitted from a sub-length of that, e.g., the actual transduction element of the transducer 280. In one embodiment, the transduction element of the transducer 280 is scanned in a linear motion to cover the region of interest, such that at any time the energy is not coming out of the entire transducer housing's length at once.

In one embodiment, CTS 20 generates ultrasound energy which is directed to and focused below the surface 501. This controlled and focused ultrasound energy creates the lesion 550 which may be a thermally coagulated zone or void in subcutaneous tissue 510. In one embodiment, the emitted energy 50 raises a temperature of the tissue at a specified depth 278 below the surface 501. The temperature of the tissue can be raised from about 1° C. to about 100° C. above an ambient temperature of the tissue, or about 5° C. to about 60° C. above an ambient temperature of the tissue or above 10° C. to about 50° C. above the ambient temperature of the tissue. In some embodiments, the emitted energy 50 targets the tissue below the surface 501 which cuts, ablates, coagulates, micro-ablates, manipulates, and/or causes a lesion 550 in the tissue portion 10 below the surface 501 at a specified depth 278. In one embodiment, during the treatment sequence, the transducer 280 moves in a direction denoted by the arrow marked 290 at specified intervals 295 to create a series of treatment zones 254 each of which receives an emitted energy 50 to create a lesion 550. For example, the emitted energy 50 creates a series of lesions 550 in the facial muscle layer 509 of tissue portion 10.

In various embodiments, delivery of emitted energy 50 at a suitable depth 278, distribution, timing, and energy level is provided by the emitter-receiver module 200 through controlled operation by the control system 300 to achieve the desired therapeutic effect of controlled thermal injury to treat at least one of the dermis layer 503, fat layer 505, the SMAS layer 507 and the facial muscle layer 509. During operation, the emitter-receiver module 200 and/or the transducer 280 can also be mechanically and/or electronically scanned along the surface 501 to treat an extended area. In addition, spatial control of a treatment depth 278 can be suitably adjusted in various ranges, such as between a wide range of about 0 mm to about 25 mm, suitably fixed to a few discrete depths, with an adjustment limited to a fine range, for example, approximately between about 3 mm to about 9 mm, and/or dynamically adjusted during treatment, to treat at least one of the dermis layer 503, fat layer 505, the SMAS layer 507 and the facial muscle layer 509. Before, during, and after the delivery of ultrasound energy 50 to at least one of the dermis layer 503, fat layer 505, the SMAS layer 507 and the facial muscle layer 509, monitoring of the treatment area and surrounding structures can be provided to plan and assess the results and/or provide feedback to the controller 300 and the user via the graphical interface 310.

As to the treatment of the SMAS layer 507 and similar fascia, connective tissue can be permanently tightened by thermal treatment to temperatures about 60° C. or higher. Upon ablating, collagen fibers shrink immediately by approximately 30% of their length. The shrunken fibers can produce tightening of the tissue, wherein the shrinkage should occur along the dominant direction of the collagen fibers. Throughout the body, collagen fibers are laid down in connective tissues along the lines of chronic stress (tension). On the aged face, the collagen fibers of the SMAS 507 region are predominantly oriented along the lines of gravitational tension. Shrinkage of these fibers results in tightening of the SMAS 507 in the direction desired for correction of laxity and sagging due to aging. The treatment includes the ablation of specific regions of the SMAS 507 region and similar suspensory connective tissues.

In addition, the SMAS layer 507 varies in depth and thickness at different locations, for example from about 0.5 mm to about 5 mm or more. On the face, important structures such as nerves, parotid gland, arteries and veins are present over, under or near the SMAS 507 region. Treating through localized heating of regions of the SMAS 507 layer or other suspensory subcutaneous tissue 510 to temperatures of about 60° C. to about 90° C., without significant damage to overlying or distal/underlying tissue, or proximal tissue, as well as the precise delivery of therapeutic energy to the SMAS layer 507, and obtaining feedback from the region of interest before, during, and after treatment can be suitably accomplished through the CTS 20.

In various embodiments, a method is provided for performing a brow lift on a patient. In some embodiments, the method includes coupling a probe 200 to a brow region 65 of the patient 60 and imaging at least a portion of subcutaneous tissue 510 of the brow region to determine a target area in the subcutaneous tissue 510. In an aspect of the embodiment, the method includes administering ultrasound energy 50 into the target area 525 in the subcutaneous tissue 510 to ablate the subcutaneous tissue 510 in the target area 525, which causes tightening of a dermal layer 503 above the subcutaneous tissue 510 of the brow region 65.

In various embodiments, a method is provided for tightening a portion of a dermal layer 503 on a facial area of a patient 60. In some embodiments, the method includes inserting a transducer module 200 into a hand controller 100 and then coupling the transducer module 200 to a facial area of the patient 60. In one embodiment, the method includes activating a first switch 150 on the hand controller 100 to initiate an imaging sequence of a portion of tissue 10 below the dermal layer 503, then collecting data from the imaging sequence. In this embodiment, the method includes calculating a treatment sequence from the collected data, and activating a second switch 160 on the hand controller 100 to initiate the treatment sequence. In an aspect of the embodiments, the method can be useful on a portion of a face, head, neck and/or other part of the body of a patient 60.

With reference to FIG. 16, after the emitted energy has created lesions 550, healing and/or tightening of the portion of tissue 10 begins. In one embodiment, the void or lesion 550 can dissipate in the facial muscle layer 509 of the portion of tissue 10. For example, the facial muscle layer 509 has movement 560 around the lesion 550 to shrink the lesion 550. Eventually, the body essentially eliminates the lesion 550 through resorption, and can enhance the growth of tissue. This movement 560 causes upper layers such as the SMAS 507 to have movement 570 above where the lesion 550 was located. This in turn causes movement 580 at the surface 501 which tightens surface 501. This surface movement 580 at the surface 501 is the goal of any brow lift. The surface movement 580 creates a tightening effect across the skin surface 501 which can provide a more youthful look for the subject 500. In various embodiments, a medicant can be applied during the coupling of the CTS 20 to the portion of tissue 10. This medicant can be activated in the target zone 525 by the emitted energy 50 and can assist, accelerate, and/or treat the void or lesion 550 during the dissipation and/or healing of the void or lesion 550. Medicants include, but are not limited to, hyaluronic acid, retinol, vitamins (e.g., vitamin c), minerals (e.g., copper) and other compounds or pharmaceuticals that can be activated by energy and/or would benefit from deeper penetration into the skin.

Turning to FIG. 18, a flow chart illustrates a method according to various embodiments of the present invention. A method 800 can include a first step 801 which is a coupling of a probe to a brow region. For example, step 801 can include the coupling of the emitter-receiver module 200 to a portion of tissue 10 in a ROI 65 of the subject 500. This step 801 can include a gel located between the emitter-receiver module 200 and the portion of tissue 10 that assists in the coupling of a probe to the brow region. Step 801 can move to step 802 which is imaging subcutaneous tissue 510 in the brow region. Step 802 can include imaging the portion of tissue 10 using the CTS 20 as discussed herein. Optionally, a step 810 can be included between steps 801 and 802. Step 810 is the applying a medicant to the brow region. The medicant can be any substance or material that has an active ingredient that may be helpful in the tightening of the surface 501 and/or in the healing and/or dissipation of the void or lesion 550 in a portion of tissue 10 below the surface 501. In one embodiment, the medicant can also act as a coupling gel useful in step 801. Step 802 moves to step 803 which is determining a target zone 525. Step 803 can include reviewing an image that was created in step 802 to help determine the target zone 525.

Step 803 moves to step 804 which is the administering of energy to the target zone 525. For example, step 804 can be illustrated in, for example, FIG. 15. Note that FIG. 15 illustrates one embodiment of a depth 278 that corresponds to a muscle depth. In various embodiments, the depth 278 can correspond to any tissue, tissue layer, skin, dermis, fat, SMAS, muscle, or other tissue. Step 804 moves to step 805 which is ablating the tissue in the target zone 525. In various embodiments, this “ablating” may be coagulation instead of ablation. Ablation is more or less instantaneous physical removal, analogous to sublimation or vaporization, while thermal coagulation is milder in that it is killing tissue but leaving it in place. Step 805 is illustrated in FIG. 15. Note that FIG. 15 illustrates one embodiment of a depth 278 that corresponds to a muscle depth. In various embodiments, the depth 278 can correspond to any tissue, tissue layer, skin, dermis, fat, SMAS, muscle, or other tissue. In step 805, the void or lesion 550 is created in a portion of tissue 10 below the surface 501. Step 805 moves to step 806 which is tightening a dermal layer 503 above or below the treated tissue. In the illustrated embodiment, step 806 is merely tightening a dermal layer above the tissue, but the broader step described is possible in various embodiments. Step 806 is illustrated in FIG. 17. For example, one of the surface 501 in the dermal layer 503 is tightened due to the void or lesion 505 being dissipated or healed. Between step 505 and 506, an optional step 812 may be used. Typically, for step 812 to be used, optional step 810 must also be used. In step 812, the medicant is activated in the target zone 525. This activation of the medicant can allow active ingredient to assist in tightening the dermal layer 503 above the ablate tissue. For example, the active ingredient may assist in the healing or dissipating of the void or lesion 550. In another example, the medicant may be activated at the surface 501 or in the dermal layer 503 to assist tightening.

With reference to FIG. 19 a method 900 is illustrated according to various embodiments of the present invention. Method 900 begins with inserting a transducer module to the hand controller. For example, method 900 can include the inserting of the emitter-receiver module 200 into the hand wand 100. Step 901 moves to step 902 which is the coupling of the module to a facial area of the subject. For example, step 902 can include coupling the emitter-receiver module 200 to a region of interest 65 of a subject 63. Step 902 moves to step 903 which is activating a first switch on the hand controller. For example, step 903 can include activating an imaging button 150 on the hand wand 100. Step 903 moves to step 904 which is initiating the imaging sequence. For example, step 904 can include imaging sequence that can be collected by the CTS 20 as discussed herein. Step 904 moves to step 905 which is collecting imaging data. Step 905 moves to step 906 which is calculating a treatment sequence. In various embodiments, “calculating” as used with respect to step 906 can be determining, selecting, selecting a predetermined treatment sequence, and/or selecting a desired treatment sequence. For example, step 906 can include the controller 300 downloading a treatment sequence to the hand wand 100 and the emitter-receiver module 200. Step 906 moves to step 907 which is the activating of a second switch on the hand controller. For example, step 907 can be the activating of the treatment button 160 on the hand wand 100. Step 907 moves to step 908 which is executing the treatment sequence. For example, step 908 can be any treatment sequence as discussed herein. In other embodiments, the illustrated method may be broader to include generalized activating of switches anywhere and anyhow, such as with foot switches or switches on the controller 300, in various non-limiting embodiments.

FIGS. 20-21 illustrate a front and side view of one embodiment of a controller 300 as previously described herein. FIG. 22 illustrates one embodiment of an interactive graphical display 310, which can include a touch screen monitor and Graphic User Interface (GUI) that allows the user to interact with the CTS 20. FIG. 22 illustrates a general example of an embodiment of an interactive graphical display 310, which may include system function tabs 1000, therapy controls 1010, imaging controls 1020, region control 1030, patient total line count 1040, treat zone line count 1050, system status 1060, probe information area 1070, header information 1080 and/or image-treat region 1090.

The system function tabs 1000 reflect aspects of the system function. In one embodiment, the interactive graphical display 310 has one or more general functions. In various embodiments the interactive graphical display 310 has two, three, four or more general functions. In one embodiment, an interactive graphical display 310 has three general functions: a planning function, a imaging/treatment function, and a settings function. In one embodiment, the planning function contains the controls and information instrumental in planning a treatment, which can automatically set therapy controls. In one embodiment, the planning function can display an overview of the various treatment regions with recommended treatment parameters for each. For example, parameters for treating such regions as the forehead, left or right temple, left or right preauricular, left or right neck, submental, and left or right cheek can show a recommended emitter-receiver module 200 listing energy levels and recommended numbers of lines of treatment. Certain areas can include a protocol listing for selection of treatment protocols, a protocol allowed treat regions listing, and disallowed regions that can not be selected due to an incorrect transducer, which can be grayed out. In one embodiment, the imaging/treatment function contains the controls and protocol information needed for imaging soft tissue and for treating pertinent soft tissue. In various embodiments, a start up screen can include patient and/or facility data. In one embodiment the imaging/treatment function can include a main startup screen. In one embodiment a imaging/treatment function can be configured for a forehead. The settings function allows the user to input, track, store and/or print patient treatment information outside the scanning function, and can include such information as patient and facility information, end treatment, treatment records, images, help, volume, and system shutdown controls and dialogs.

The therapy controls 1010 can set acoustic energy level, spacing for setting the distance between micro-coagulative zones, and length which can set the maximum distance of the treatment line and similar information.

The imaging controls 1020 can include marker (not scanning), display (scanning), image and scan information. The marker can include a distance icon to show calipers and text for annotation. The display can increase or decrease brightness or other display related characteristics. The image icon can toggle a treat ruler, or save an image. The scan buttons can start or stop scanning for imaging purposes and similar information.

The region control 1030 launches a dialog below the image to select tissue region. The patient total line count 1040 keeps track of the cumulative number of treatment lines delivered and similar information. The treat zone line count 1050 indicates a zone of treatment, such as forehead or submental, etc. and can display the lines delivered to a zone or a protocol for recommended lines and similar information. The system status 1060 can display that the system is ready, treating, or other mode-dependent system messages and similar information. The probe information area 1070 can display the name of the attached transducer, the treatment depth of the transducer, and the number of lines spent/(vs.) total line capacity of transducer and similar information. The header information 1080 can include the facility, clinician, patient name and patient identification, date and time and similar information. The image-treat region 1090 can include an ultrasound image, horizontal and vertical (depth) rulers with 1 mm tick marks or other measuring dimensions, a treatment ruler indicating spacing, length and depth of treatment, and other similar information.

One benefit or advantage of using a treatment system that also allows imaging is that a user can verify that there sufficient coupling between the transducer and the skin (such as by applying coupling gel between the emitter-receiver module 200 and skin) by ensuring there are not dark, vertical bars, as indicative of air pockets between the face of the transducer and patient. A lack of coupling may result in a region that is improperly treated. Corrective action might include placing more coupling ultrasound gel to ensure proper contact and communication between the device and the patient.

Therapeutic treatment can be initiated by pressing the treatment button 160 on the hand wand 100. In one embodiment, an indicator 155 will display a yellow light to indicate the system is in the “treating” state. As the energy 50 is delivered a continuous tone is sounded and a yellow ‘treating’ line will advance over the green ‘ready’ treatment line on the screen. To deliver the next line of energy in the same treatment area, the user can advance the transducer roughly 1-6 mm, or roughly 2-3 mm (depending on the treatment, region, etc.) to adjacent tissue and press the treatment button 160 again. In various embodiments, a time period can elapse between delivering a previous line of energy 50. In various embodiments, the time period can be 1 second, 5 seconds, 10 seconds, or any other duration. In one embodiment, if five or ten seconds (or some other duration) have elapsed between delivering the previous line of energy 50, the user can press the imaging button 150 on the hand wand 100 to restore the “ready” state, and then press the treatment button 160 next to it. Treatment can continue in this fashion until the recommended number of lines (as shown on the bottom/center of the screen) has been delivered. In one embodiment, when the correct number of lines is delivered, the line count color turns from orange to white.

In one embodiment, the settings function allows a user to export images. Stored images are listed in the bottom dialog box and the most recently user-selected image is displayed above it. If an external storage device and/or printer is attached then image file export and/or printing is enabled, respectively. In one embodiment, the settings function allows a user to export records.

In certain embodiments, the interactive graphical display 310 can display error messages to direct appropriate user responses, such as in one embodiment of an error message.

The citation of references herein does not constitute admission that those references are prior art or have relevance to the patentability of the teachings disclosed herein. All references cited in the Description section of the specification are hereby incorporated by reference in their entirety for all purposes. In the event that one or more of the incorporated references, literature, and similar materials differs from or contradicts this application, including, but not limited to, defined terms, term usage, described techniques, or the like, this application controls.

Some embodiments and the examples described herein are examples and not intended to be limiting in describing the full scope of compositions and methods of these invention. Equivalent changes, modifications and variations of some embodiments, materials, compositions and methods can be made within the scope of the present invention, with substantially similar results.

Claims

1. A detachable and interchangeable transducer module for use in ultrasound treatment, comprising: a sealed housing comprising an acoustic fluid and an acoustically transparent window,a circuit board configured for electrical connection to a spring pin connector operably coupled to a hand wand at an interface,an ultrasonic treatment piezoelectric element configured to focus ultrasound energy at a depth in a range between 3 mm and 9 mm below a skin surface with a treatment frequency in a range of 1 MHz to 10 MHz at an acoustic power in a range of 1 watt to 100 watts,wherein the ultrasonic treatment piezoelectric element is acoustically coupled to the acoustically transparent window via the acoustic fluid in the sealed housing, anda movement mechanism comprising a shaft, the movement mechanism configured to attach to an encoder and a stepper motor configured to move the ultrasonic treatment piezoelectric element at a position along the shaft to direct an ultrasonic treatment in a sequence of spaced thermal lesions,wherein the encoder is configured for measuring the position of the ultrasonic treatment piezoelectric element along the shaft in the sealed housing,wherein the ultrasonic treatment piezoelectric element is configured to focus the ultrasound energy at the depth for treatment in at least one of the group consisting of: a dermis tissue, a fascia tissue, a muscle tissue, and a fat tissue,wherein the shaft of the movement mechanism moves the ultrasonic treatment piezoelectric element within the sealed housing;wherein the transducer module is configured to detach from the hand wand via the interface, which thereby permits a second transducer module to interchangeably attach to the hand wand after detachment from the transducer module.
2. The transducer module of claim 1, wherein the movement mechanism further comprises any one or more of the group consisting of: a scotch yoke, a magnetic coupling, and a screw attached to the stepper motor to linearly move the ultrasonic treatment piezoelectric element.
3. The transducer module of claim 1, further comprising an ultrasound imaging piezoelectric element configured for attachment to a display for providing an ultrasonic image.
4. The transducer module of claim 1, wherein the ultrasonic treatment piezoelectric element and the movement mechanism are configured for operation via electrical communication with an electronic key.
5. The transducer module of claim 1, wherein an integrated receptacle of the hand wand is configured for removable insertion and detachment of the transducer module.
6. The transducer module of claim 5, wherein the second transducer module comprising: a second sealed housing comprising a second acoustic fluid and a second acoustically transparent window,a second ultrasonic treatment piezoelectric element configured to focus ultrasound energy at a second depth in a range of 3 mm to 4.5 mm below the skin surface with a second treatment frequency in a range of 1 MHz to 10 MHz at a second acoustic power in a range of 1 watt to 100 watts,wherein the second ultrasonic treatment piezoelectric element is acoustically coupled to the second acoustically transparent window via the second acoustic fluid in the second sealed housing.
7. The transducer module of claim 5, wherein the second transducer module comprising: a second sealed housing comprising a second acoustic fluid and a second acoustically transparent window,a second ultrasonic treatment piezoelectric element configured to focus ultrasound at a second depth in a range of 1.5 mm to 3 mm below the skin surface with a second treatment frequency in a range of 1 MHz to 10 MHz at a second acoustic power in a range of 1 watt to 100 watts, andwherein the second ultrasonic treatment piezoelectric element is acoustically coupled to the second acoustically transparent window via the second acoustic fluid in the second sealed housing,wherein the transducer module and second transducer module are configured to provide treatment at different depths below the skin surface.
8. An interchangeable transducer module for use in ultrasound treatment, comprising: a sealed housing comprising an ultrasonic treatment piezoelectric element, an acoustic fluid, and a circuit board,wherein the circuit board is configured for electrical connection to a spring pin connector operably coupled to a hand wand at an interface,the ultrasonic treatment piezoelectric element configured to focus ultrasound at a depth in a range between 3 mm and 9 mm below a skin surface with a treatment frequency in a range of 1 MHz to 10 MHz at an acoustic power in a range of 1 watt to 100 watts,a storage device configured for containing calibration data or storage data, anda movement mechanism comprising a shaft, the movement mechanism configured to attach to an encoder and a stepper motor configured to move the ultrasonic treatment piezoelectric element at a position along the shaft to direct an ultrasonic treatment in a linear sequence of spaced thermal lesions,wherein the encoder is configured for measuring the position of the ultrasonic treatment piezoelectric element along the shaft in the sealed housing,wherein the ultrasonic treatment piezoelectric element is configured to provide the ultrasonic treatment at the depth for treatment in at least one of the group consisting of: a skin tissue, a fascia tissue, a muscle tissue, and a fat tissue,wherein the transducer module is configured to detach from the hand wand via the interface, which thereby permits a second transducer module to interchangeably attach to the hand wand.
9. The transducer module of claim 8, wherein the ultrasonic treatment piezoelectric element is connected to a microprocessor for controlling the ultrasonic treatment.
10. The transducer module of claim 8, wherein the movement mechanism comprises a screw attached to the stepper motor to linearly move the ultrasonic treatment piezoelectric element when the screw is rotated.
11. The transducer module of claim 8, wherein the movement mechanism comprises a magnetic coupling and a scotch yoke comprising a slot to interface with a pin attached to the stepper motor as the pin moves in a circular path to linearly move the ultrasonic treatment piezoelectric element.
12. The transducer module of claim 8, further comprising an ultrasound imaging piezoelectric element configured for providing an ultrasonic image on a display of the at least one of the group consisting of: the skin tissue, the fascia tissue, the muscle tissue, and the fat tissue.
13. A removable transducer module for use in ultrasound treatment, comprising: a sealed housing comprising an ultrasonic treatment piezoelectric element and an acoustically transparent window,the ultrasonic treatment piezoelectric element being configured for acoustic coupling to the acoustically transparent window to focus ultrasound in a linear sequence of individual thermal lesions at a depth in a range between 3 mm and 9 mm below a skin surface with a treatment frequency in a range of 1 MHz to 10 MHz at an acoustic power in a range of 1 watt to 100 watts,a circuit board configured for electrical connection to a spring pin connector operably coupled to a hand wand at an interface,wherein the transducer module comprises a movement mechanism, and a treatment button of the hand wand is configured for operably controlling the ultrasonic treatment piezoelectric element via the movement mechanism when the sealed housing is coupled to the hand wand,wherein the movement mechanism is configured for connection to a stepper motor and an encoder, the stepper motor configured to move the ultrasonic treatment piezoelectric element inside the removable transducer module at a position along a shaft, the encoder being configured to measure the position of the ultrasonic treatment piezoelectric element along the shaft in the sealed housing,wherein the transducer module is configured to detach from the hand wand via the interface, which thereby permits a second transducer module to removably attach to the hand wand.
14. The transducer module according to claim 13, further comprising a latch mechanism configured for removably holding the transducer module to the hand wand.
15. The transducer module according to claim 13, wherein the movement mechanism comprises a screw configured to move the ultrasonic treatment piezoelectric element to create a series of separated ablative lesions under the skin surface.
16. The transducer module according to claim 13, configured for connection to a graphical user interface for controlling the ultrasound treatment.
17. The transducer module according to claim 13, wherein the ultrasound treatment is at least one of face lift, a wrinkle reduction, a skin tightening, and a scar reduction.
18. The transducer module according to claim 13, wherein the ultrasonic treatment piezoelectric element in the transducer module is electronically coupled to the treatment button of the hand wand, the treatment button configured for operably controlling the ultrasonic treatment piezoelectric element when the sealed housing is coupled to an integrated receptacle at the interface.
19. The transducer module of claim 13, wherein the interface is configured for interchangeable coupling to the hand wand at the interface via at least one spring pin at the spring pin connector, the interface configured for removable insertion of the transducer module from the interface.
20. The transducer module according to claim 13, further comprising an ultrasound imaging piezoelectric element configured for providing an ultrasonic image on a display.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No. 16/703,019, filed Dec. 4, 2019 and issued as U.S. Pat. No. 11,123,039, which is a continuation of U.S. patent application Ser. No. 12/996,616, filed Jan. 12, 2011 and issued as U.S. Pat. No. 10,537,304, which is a U.S. National Phase under 35 U.S.C. 371 of International Application No. PCT/US2009/046475, filed Jun. 5, 2009 and published in English on Dec. 10, 2009, which claims the benefit of priority from U.S. Provisional No. 61/059,477 filed Jun. 6, 2008, each of which is incorporated in its entirety by reference, herein. Any and all priority claims identified in the Application Data Sheet, or any correction thereto, are hereby incorporated by reference under 37 CFR 1.57.

US Referenced Citations (1235)

Number	Name	Date	Kind
2427348	Bond et al.	Sep 1947	A
2792829	Calosi	Feb 1952	A
3913386	Saglio	Oct 1975	A
3965455	Hurwitz	Jun 1976	A
3992925	Perilhou	Nov 1976	A
4039312	Patru	Aug 1977	A
4059098	Murdock	Nov 1977	A
4101795	Fukumoto	Jul 1978	A
4151834	Sato et al.	May 1979	A
4166967	Benes et al.	Sep 1979	A
4211948	Smith et al.	Jul 1980	A
4211949	Brisken et al.	Jul 1980	A
4213344	Rose	Jul 1980	A
4276491	Daniel	Jun 1981	A
4315514	Drewes et al.	Feb 1982	A
4325381	Glenn	Apr 1982	A
4343301	Indech	Aug 1982	A
4372296	Fahim	Feb 1983	A
4379145	Masuho et al.	Apr 1983	A
4381007	Doss	Apr 1983	A
4381787	Hottinger	May 1983	A
4397314	Vaguine	Aug 1983	A
4409839	Taenzer	Oct 1983	A
4417170	Benisncasa	Nov 1983	A
4431008	Wanner et al.	Feb 1984	A
4441486	Pounds	Apr 1984	A
4452084	Taenzer	Jun 1984	A
4484569	Driller	Nov 1984	A
4507582	Glenn	Mar 1985	A
4513749	Kino	Apr 1985	A
4513750	Heyman et al.	Apr 1985	A
4527550	Ruggera et al.	Jul 1985	A
4528979	Marchenko	Jul 1985	A
4534221	Fife et al.	Aug 1985	A
4566459	Umemura et al.	Jan 1986	A
4567895	Putzke	Feb 1986	A
4586512	Do-Huu	May 1986	A
4587971	Stolfi	May 1986	A
4601296	Yerushalmi	Jul 1986	A
4620546	Aida et al.	Nov 1986	A
4637256	Sugiyama et al.	Jan 1987	A
4646756	Watmough	Mar 1987	A
4663358	Hyon	May 1987	A
4668516	Duraffourd et al.	May 1987	A
4672591	Breimesser et al.	Jun 1987	A
4680499	Umemura et al.	Jul 1987	A
4697588	Reichenberger	Oct 1987	A
4754760	Fukukita et al.	Jul 1988	A
4757820	Itoh	Jul 1988	A
4771205	Mequio	Sep 1988	A
4801459	Liburdy	Jan 1989	A
4803625	Fu et al.	Feb 1989	A
4807633	Fry	Feb 1989	A
4817615	Fukukita et al.	Apr 1989	A
4858613	Fry	Aug 1989	A
4860732	Hasegawa et al.	Aug 1989	A
4865041	Hassler	Sep 1989	A
4865042	Umemura	Sep 1989	A
4867169	Machida	Sep 1989	A
4874562	Hyon	Oct 1989	A
4875487	Seppi	Oct 1989	A
4881212	Takeuchi	Nov 1989	A
4891043	Zeimer et al.	Jan 1990	A
4893624	Lele	Jan 1990	A
4896673	Rose	Jan 1990	A
4900540	Ryan et al.	Feb 1990	A
4901729	Saitoh	Feb 1990	A
4917096	Englehart	Apr 1990	A
4932414	Coleman et al.	Jun 1990	A
4938216	Lele	Jul 1990	A
4938217	Lele	Jul 1990	A
4947046	Kawabata et al.	Aug 1990	A
4951653	Fry	Aug 1990	A
4955365	Fry	Sep 1990	A
4958626	Nambu	Sep 1990	A
4976709	Sand	Dec 1990	A
4979501	Valchanov	Dec 1990	A
4992989	Watanabe et al.	Feb 1991	A
5012797	Liang	May 1991	A
5018508	Fry et al.	May 1991	A
5030874	Saito et al.	Jul 1991	A
5036855	Fry	Aug 1991	A
5040537	Katakura	Aug 1991	A
5054310	Flynn	Oct 1991	A
5054470	Fry	Oct 1991	A
5054491	Saito et al.	Oct 1991	A
5070879	Herres	Dec 1991	A
5088495	Miyagawa	Feb 1992	A
5115814	Griffith	May 1992	A
5117832	Sanghvi	Jun 1992	A
5123418	Saurel	Jun 1992	A
5142511	Kanai et al.	Aug 1992	A
5143063	Fellner	Sep 1992	A
5143074	Dory	Sep 1992	A
5149319	Unger	Sep 1992	A
5150711	Dory	Sep 1992	A
5150714	Green	Sep 1992	A
5152294	Mochizuki et al.	Oct 1992	A
5156144	Iwasaki	Oct 1992	A
5158536	Sekins	Oct 1992	A
5159931	Pini	Nov 1992	A
5163421	Bernstein	Nov 1992	A
5163436	Saitoh et al.	Nov 1992	A
5178135	Uchiyama et al.	Jan 1993	A
5190518	Takasu	Mar 1993	A
5190766	Ishihara	Mar 1993	A
5191880	McLeod	Mar 1993	A
5205287	Erbel et al.	Apr 1993	A
5209720	Unger	May 1993	A
5212671	Fujii et al.	May 1993	A
5215680	D'Arrigo	Jun 1993	A
5224467	Oku	Jul 1993	A
5230334	Klopotek	Jul 1993	A
5230338	Allen et al.	Jul 1993	A
5247924	Suzuki et al.	Sep 1993	A
5255681	Ishimura et al.	Oct 1993	A
5257970	Dougherty	Nov 1993	A
5265614	Hayakawa	Nov 1993	A
5267985	Shimada	Dec 1993	A
5269297	Weng	Dec 1993	A
5282797	Chess	Feb 1994	A
5295484	Marcus	Mar 1994	A
5295486	Wollschlager et al.	Mar 1994	A
5304169	Sand	Apr 1994	A
5305756	Entrekin et al.	Apr 1994	A
5321520	Inga et al.	Jun 1994	A
5323779	Hardy et al.	Jun 1994	A
5327895	Hashimoto et al.	Jul 1994	A
5329202	Garlick et al.	Jul 1994	A
5348016	Unger et al.	Sep 1994	A
5358466	Aida et al.	Oct 1994	A
5360268	Hayashi	Nov 1994	A
5370121	Reichenberger	Dec 1994	A
5370122	Kunig	Dec 1994	A
5371483	Bhardwaj	Dec 1994	A
5375602	Lancee et al.	Dec 1994	A
5379773	Hornsby	Jan 1995	A
5380280	Peterson	Jan 1995	A
5380519	Schneider et al.	Jan 1995	A
5383917	Desai et al.	Jan 1995	A
5391140	Schaetzle	Feb 1995	A
5391197	Burdette et al.	Feb 1995	A
5392259	Bolorforosh	Feb 1995	A
5396143	Seyed-Bolorforosh et al.	Mar 1995	A
5398689	Connor et al.	Mar 1995	A
5406503	Williams	Apr 1995	A
5413550	Castel	May 1995	A
5417216	Tanaka	May 1995	A
5423220	Finsterwald et al.	Jun 1995	A
5435311	Umemura	Jul 1995	A
5438998	Hanafy	Aug 1995	A
5443068	Cline et al.	Aug 1995	A
5445611	Eppstein et al.	Aug 1995	A
5458596	Lax	Oct 1995	A
5460179	Okunuki et al.	Oct 1995	A
5460595	Hall et al.	Oct 1995	A
5419327	Rohwedder	Nov 1995	A
5469854	Unger et al.	Nov 1995	A
5471488	Fujio	Dec 1995	A
5472405	Buchholtz et al.	Dec 1995	A
5487388	Rello et al.	Jan 1996	A
5492126	Hennige	Feb 1996	A
5496256	Bock	Mar 1996	A
5501655	Rolt	Mar 1996	A
5503152	Oakley et al.	Apr 1996	A
5503320	Webster et al.	Apr 1996	A
5507790	Weiss	Apr 1996	A
5511296	Dias et al.	Apr 1996	A
5520188	Hennige	May 1996	A
5522869	Burdette	Jun 1996	A
5523058	Umemura et al.	Jun 1996	A
5524620	Rosenchein	Jun 1996	A
5524624	Tepper	Jun 1996	A
5524625	Okazaki	Jun 1996	A
5526624	Berg	Jun 1996	A
5526812	Dumoulin et al.	Jun 1996	A
5526814	Cline et al.	Jun 1996	A
5526815	Granz	Jun 1996	A
5529070	Augustine et al.	Jun 1996	A
5540235	Wilson	Jul 1996	A
5558092	Unger	Sep 1996	A
5560362	Sliwa et al.	Oct 1996	A
5573497	Chapelon	Nov 1996	A
5575291	Hayakawa	Nov 1996	A
5575807	Faller	Nov 1996	A
5577502	Darrow et al.	Nov 1996	A
5577507	Snyder et al.	Nov 1996	A
5577991	Akui et al.	Nov 1996	A
5580575	Unger et al.	Dec 1996	A
5643179	Fujimoto	Jan 1997	A
5601526	Chapelon	Feb 1997	A
5603323	Pflugrath et al.	Feb 1997	A
5605154	Ries et al.	Feb 1997	A
5609562	Kaali	Mar 1997	A
5615091	Palatnik	Mar 1997	A
5618275	Bock	Apr 1997	A
5620479	Diederich	Apr 1997	A
5622175	Sudol et al.	Apr 1997	A
5617858	Taverna et al.	May 1997	A
5638819	Manwaring et al.	Jun 1997	A
5644085	Lorraine et al.	Jul 1997	A
5647373	Paltieli	Jul 1997	A
5655535	Frlemel et al.	Aug 1997	A
5655538	Lorraine	Aug 1997	A
5657760	Ying	Aug 1997	A
5658328	Johnson	Aug 1997	A
5660836	Knowlton	Aug 1997	A
5662116	Kondo	Sep 1997	A
5665053	Jacobs	Sep 1997	A
5665141	Vago	Sep 1997	A
5671746	Dreschel et al.	Sep 1997	A
5673699	Trahey et al.	Oct 1997	A
5676692	Sanghvi	Oct 1997	A
5685820	Riek et al.	Nov 1997	A
5690608	Watanabe	Nov 1997	A
5694936	Fujimoto	Dec 1997	A
5697897	Buchholtz	Dec 1997	A
5701900	Shehada et al.	Dec 1997	A
5704361	Seward et al.	Jan 1998	A
5706252	Le Verrier et al.	Jan 1998	A
5706564	Rhyne	Jan 1998	A
5715823	Wood et al.	Feb 1998	A
5720287	Chapelon et al.	Feb 1998	A
5722411	Suzuki	Mar 1998	A
5727554	Kalend et al.	Mar 1998	A
5735280	Sherman et al.	Apr 1998	A
5740804	Cerofolini	Apr 1998	A
5743863	Chapelon	Apr 1998	A
5746005	Steinberg	May 1998	A
5746762	Bass	May 1998	A
5748767	Raab	May 1998	A
5749364	Sliwa et al.	May 1998	A
5755228	Wilson et al.	May 1998	A
5755753	Knowlton	May 1998	A
5762066	Law	Jun 1998	A
5763886	Schulte	Jun 1998	A
5769790	Watkins	Jun 1998	A
5779644	Eberle et al.	Jul 1998	A
5792058	Lee	Aug 1998	A
5795297	Daigle	Aug 1998	A
5795311	Wess	Aug 1998	A
5810009	Mine et al.	Sep 1998	A
5810888	Fenn	Sep 1998	A
5814599	Mitragotri et al.	Sep 1998	A
5817013	Ginn et al.	Oct 1998	A
5817021	Reichenberger	Oct 1998	A
5820564	Slayton	Oct 1998	A
5823962	Schaetzle	Oct 1998	A
5827204	Grandia et al.	Oct 1998	A
5840032	Hatfield et al.	Nov 1998	A
5844140	Seale	Dec 1998	A
5853367	Chalek et al.	Dec 1998	A
5866024	de Villeneuve	Feb 1999	A
5869751	Bonin	Feb 1999	A
5871524	Knowlton	Feb 1999	A
5873902	Sanghvi	Feb 1999	A
5876341	Wang et al.	Mar 1999	A
5879303	Averkiou et al.	Mar 1999	A
5882557	Hayakawa	Mar 1999	A
5891034	Bucholz	Apr 1999	A
5895356	Andrus et al.	Apr 1999	A
5899861	Friemel et al.	May 1999	A
5904659	Duarte	May 1999	A
5919219	Knowlton	Jul 1999	A
5923099	Bilir	Jul 1999	A
5924989	Polz	Jul 1999	A
5928169	Schatzle et al.	Jul 1999	A
5931805	Brisken	Aug 1999	A
5938606	Bonnefous	Aug 1999	A
5938612	Kline-Schoder	Aug 1999	A
5948011	Knowlton	Sep 1999	A
5957844	Dekel	Sep 1999	A
5957882	Nita et al.	Sep 1999	A
5957941	Ream	Sep 1999	A
5964707	Fenster et al.	Oct 1999	A
5967980	Ferre et al.	Oct 1999	A
5968034	Fullmer	Oct 1999	A
5971949	Levin	Oct 1999	A
5977538	Unger et al.	Nov 1999	A
5984881	Ishibashi et al.	Nov 1999	A
5984882	Rosenchein	Nov 1999	A
5990598	Sudol et al.	Nov 1999	A
5997471	Gumb et al.	Dec 1999	A
5997497	Nita et al.	Dec 1999	A
5999843	Anbar	Dec 1999	A
6004262	Putz et al.	Dec 1999	A
6007499	Martin et al.	Dec 1999	A
6013032	Savord	Jan 2000	A
6014473	Hossack et al.	Jan 2000	A
6016255	Bolan et al.	Jan 2000	A
6019724	Gronningsaeter et al.	Feb 2000	A
6022308	Williams	Feb 2000	A
6022317	Cruanas et al.	Feb 2000	A
6022327	Chang	Feb 2000	A
6030374	McDaniel	Feb 2000	A
6036646	Barthe	Mar 2000	A
6039048	Silberg	Mar 2000	A
6039689	Lizzi	Mar 2000	A
6042556	Beach	Mar 2000	A
6049159	Barthe	Apr 2000	A
6050943	Slayton	Apr 2000	A
6059727	Fowlkes	May 2000	A
6071239	Cribbs	Jun 2000	A
6080108	Dunham	Jun 2000	A
6083148	Williams	Jul 2000	A
6086535	Ishibashi	Jul 2000	A
6086580	Mordon et al.	Jul 2000	A
6090054	Tagishi	Jul 2000	A
6093148	Fujimoto	Jul 2000	A
6093883	Sanghvi	Jul 2000	A
6100626	Frey et al.	Aug 2000	A
6101407	Groezinger	Aug 2000	A
6106469	Suzuki et al.	Aug 2000	A
6113558	Rosenchein	Sep 2000	A
6113559	Klopotek	Sep 2000	A
6120452	Barthe	Sep 2000	A
6123081	Durette	Sep 2000	A
6126619	Peterson et al.	Oct 2000	A
6135971	Hutchinson	Oct 2000	A
6139499	Wilk	Oct 2000	A
6159150	Yale et al.	Dec 2000	A
6171244	Finger et al.	Jan 2001	B1
6176840	Nishimura	Jan 2001	B1
6183426	Akisada	Feb 2001	B1
6183502	Takeuchi	Feb 2001	B1
6183773	Anderson	Feb 2001	B1
6190323	Dias	Feb 2001	B1
6190336	Duarte	Feb 2001	B1
6193658	Wendelken	Feb 2001	B1
6198956	Dunne	Mar 2001	B1
6210327	Brackett et al.	Apr 2001	B1
6213948	Barthe	Apr 2001	B1
6216029	Paltieli	Apr 2001	B1
6233476	Strommer et al.	May 2001	B1
6234990	Rowe et al.	May 2001	B1
6241753	Knowlton	Jun 2001	B1
6246898	Vesely et al.	Jun 2001	B1
6251074	Averkiou et al.	Jun 2001	B1
6251088	Kaufman et al.	Jun 2001	B1
6268405	Yao	Jul 2001	B1
6273864	Duarte	Aug 2001	B1
6280402	Ishibashi et al.	Aug 2001	B1
6287257	Matichuk	Sep 2001	B1
6287304	Eggers et al.	Sep 2001	B1
6296619	Brisken	Oct 2001	B1
6301989	Brown et al.	Oct 2001	B1
6307302	Toda	Oct 2001	B1
6309355	Cain et al.	Oct 2001	B1
6311090	Knowlton	Oct 2001	B1
6315741	Martin	Nov 2001	B1
6322509	Pan et al.	Nov 2001	B1
6322532	D'Sa	Nov 2001	B1
6325540	Lounsberry et al.	Dec 2001	B1
6325758	Carol et al.	Dec 2001	B1
6325769	Klopotek	Dec 2001	B1
6325798	Edwards et al.	Dec 2001	B1
6338716	Hossack et al.	Jan 2002	B1
6350276	Knowlton	Feb 2002	B1
6356780	Licato et al.	Mar 2002	B1
6361531	Hissong	Mar 2002	B1
6370411	Osadchy et al.	Apr 2002	B1
6375672	Aksan	Apr 2002	B1
6377854	Knowlton	Apr 2002	B1
6377855	Knowlton	Apr 2002	B1
6381497	Knowlton	Apr 2002	B1
6381498	Knowlton	Apr 2002	B1
6387380	Knowlton	May 2002	B1
6390982	Bova et al.	May 2002	B1
6405090	Knowlton	Jun 2002	B1
6409720	Hissong	Jun 2002	B1
6413216	Cain et al.	Jul 2002	B1
6413253	Koop	Jul 2002	B1
6413254	Hissong	Jul 2002	B1
6419648	Vitek	Jul 2002	B1
6423007	Lizzi et al.	Jul 2002	B2
6425865	Salcudean	Jul 2002	B1
6425867	Vaezy	Jul 2002	B1
6425912	Knowlton	Jul 2002	B1
6428477	Mason	Aug 2002	B1
6428532	Doukas	Aug 2002	B1
6430446	Knowlton	Aug 2002	B1
6432057	Mazess et al.	Aug 2002	B1
6432067	Martin	Aug 2002	B1
6432101	Weber	Aug 2002	B1
6436061	Costantino	Aug 2002	B1
6438424	Knowlton	Aug 2002	B1
6440071	Slayton	Aug 2002	B1
6440121	Weber	Aug 2002	B1
6443914	Costantino	Sep 2002	B1
6447443	Keogh et al.	Sep 2002	B1
6450979	Miwa et al.	Sep 2002	B1
6451013	Bays et al.	Sep 2002	B1
6453202	Knowlton	Sep 2002	B1
6461304	Tanaka et al.	Oct 2002	B1
6461378	Knowlton	Oct 2002	B1
6470216	Knowlton	Oct 2002	B1
6485420	Bullis	Nov 2002	B1
6488626	Lizzi	Dec 2002	B1
6491657	Rowe	Dec 2002	B2
6500121	Slayton	Dec 2002	B1
6500141	Irion	Dec 2002	B1
6506171	Vitek et al.	Jan 2003	B1
6508774	Acker	Jan 2003	B1
6511427	Sliwa, Jr. et al.	Jan 2003	B1
6511428	Azuma	Jan 2003	B1
6514244	Pope	Feb 2003	B2
6517484	Wilk	Feb 2003	B1
6524250	Weber	Feb 2003	B1
6666835	Martin	Mar 2003	B2
6540679	Slayton	Apr 2003	B2
6540685	Rhoads	Apr 2003	B1
6540700	Fujimoto et al.	Apr 2003	B1
6547788	Maguire et al.	Apr 2003	B1
6554771	Buil et al.	Apr 2003	B1
6569099	Babaev	May 2003	B1
6569108	Sarvazyan et al.	May 2003	B2
6572552	Fukukita	Jun 2003	B2
6575956	Brisken et al.	Jun 2003	B1
6595934	Hissong	Jul 2003	B1
6599256	Acker	Jul 2003	B1
6605043	Dreschel	Aug 2003	B1
6605080	Altshuler et al.	Aug 2003	B1
6607498	Eshel	Aug 2003	B2
6618620	Freundlich et al.	Sep 2003	B1
6623430	Slayton	Sep 2003	B1
6626854	Friedman	Sep 2003	B2
6626855	Weng	Sep 2003	B1
6638226	He et al.	Oct 2003	B2
6645145	Dreschel et al.	Nov 2003	B1
6645150	Angelsen et al.	Nov 2003	B2
6645162	Friedman	Nov 2003	B2
6662054	Kreindel	Dec 2003	B2
6663627	Francischelli	Dec 2003	B2
6665806	Shimizu	Dec 2003	B1
6669638	Miller	Dec 2003	B1
6673017	Jackson	Jan 2004	B1
6685639	Wang et al.	Feb 2004	B1
6685640	Fry	Feb 2004	B1
6692450	Coleman	Feb 2004	B1
6699237	Weber	Mar 2004	B2
6716184	Vaezy et al.	Apr 2004	B2
6719449	Laughlin	Apr 2004	B1
6719694	Weng	Apr 2004	B2
6726627	Lizzi et al.	Apr 2004	B1
6733449	Krishnamurthy et al.	May 2004	B1
6749624	Knowlton	Jun 2004	B2
6772490	Toda	Aug 2004	B2
6773409	Truckai et al.	Aug 2004	B2
6775404	Pagoulatos et al.	Aug 2004	B1
6790187	Thompson et al.	Sep 2004	B2
6824516	Batten et al.	Nov 2004	B2
6825176	White et al.	Nov 2004	B2
6835940	Morikawa et al.	Dec 2004	B2
6846290	Lizzi et al.	Jan 2005	B2
6875176	Mourad et al.	Apr 2005	B2
6882884	Mosk et al.	Apr 2005	B1
6887239	Elstrom	May 2005	B2
6887260	McDaniel	May 2005	B1
6889089	Behl	May 2005	B2
6896657	Willis	May 2005	B2
6902536	Manna	Jun 2005	B2
6905466	Saigo	Jun 2005	B2
6918907	Kelly	Jul 2005	B2
6920883	Bessette	Jul 2005	B2
6921371	Wilson	Jul 2005	B2
6932771	Whitmore	Aug 2005	B2
6932814	Wood	Aug 2005	B2
6936044	McDaniel	Aug 2005	B2
6936046	Hissong	Aug 2005	B2
6945937	Culp et al.	Sep 2005	B2
6948843	Laugharn et al.	Sep 2005	B2
6953941	Nakano et al.	Oct 2005	B2
6958043	Hissong	Oct 2005	B2
6971994	Young et al.	Dec 2005	B1
6974417	Lockwood	Dec 2005	B2
6976492	Ingle	Dec 2005	B2
6992305	Maezawa et al.	Jan 2006	B2
6997923	Anderson	Feb 2006	B2
7006874	Knowlton	Feb 2006	B2
7020528	Neev	Mar 2006	B2
7022089	Ooba	Apr 2006	B2
7058440	Heuscher et al.	Jun 2006	B2
7063666	Weng	Jun 2006	B2
7070565	Vaezy et al.	Jul 2006	B2
7074218	Washington et al.	Jul 2006	B2
7094252	Koop	Aug 2006	B2
7108663	Talish et al.	Sep 2006	B2
7115123	Knowlton	Oct 2006	B2
7122029	Koop et al.	Oct 2006	B2
7142905	Slayton	Nov 2006	B2
7165451	Brooks et al.	Jan 2007	B1
7179238	Hissong	Feb 2007	B2
7189230	Knowlton	Mar 2007	B2
7229411	Slayton	Jun 2007	B2
7235592	Muratoglu	Jun 2007	B2
7258674	Cribbs	Aug 2007	B2
7273459	Desilets	Sep 2007	B2
7294125	Phalen et al.	Nov 2007	B2
7297117	Trucco	Nov 2007	B2
7303555	Makin et al.	Dec 2007	B2
7311679	Desilets et al.	Dec 2007	B2
7327071	Nishiyama et al.	Feb 2008	B2
7331951	Eshel et al.	Feb 2008	B2
7332985	Larson et al.	Feb 2008	B2
7338434	Haarstad et al.	Mar 2008	B1
7347855	Eshel	Mar 2008	B2
RE40403	Cho et al.	Jun 2008	E
7393325	Barthe	Jul 2008	B2
7398116	Edwards	Jul 2008	B2
7399279	Abend et al.	Jul 2008	B2
7491171	Barthe et al.	Feb 2009	B2
7507235	Keogh et al.	Mar 2009	B2
7510536	Foley et al.	Mar 2009	B2
7517315	Willis	Apr 2009	B2
7530356	Slayton	May 2009	B2
7530958	Slayton	May 2009	B2
7532201	Quistgaard et al.	May 2009	B2
7571336	Barthe	Aug 2009	B2
7601120	Moilanen et al.	Oct 2009	B2
7615015	Coleman	Nov 2009	B2
7615016	Barthe	Nov 2009	B2
7652411	Crunkilton et al.	Jan 2010	B2
7662114	Seip et al.	Feb 2010	B2
7674257	Pless et al.	Mar 2010	B2
7686763	Vaezy et al.	Mar 2010	B2
7713203	Lacoste et al.	Mar 2010	B2
7694406	Wildes et al.	Apr 2010	B2
7695437	Quistgaard et al.	Apr 2010	B2
7727156	Angelsen et al.	Jun 2010	B2
7758524	Barthe	Jul 2010	B2
7766848	Desilets et al.	Aug 2010	B2
7789841	Huckle et al.	Sep 2010	B2
7806839	Mast et al.	Oct 2010	B2
7815570	Eshel et al.	Oct 2010	B2
7819826	Diederich et al.	Oct 2010	B2
7828734	Azhari et al.	Oct 2010	B2
7824348	Barthe	Nov 2010	B2
7833162	Hasegawa et al.	Nov 2010	B2
7841984	Cribbs et al.	Nov 2010	B2
7846096	Mast et al.	Dec 2010	B2
7857773	Desilets et al.	Dec 2010	B2
7875023	Eshel et al.	Jan 2011	B2
7901359	Mandrusov et al.	Mar 2011	B2
7905007	Calisti et al.	Mar 2011	B2
7905844	Desilets et al.	Mar 2011	B2
7914453	Slayton et al.	Mar 2011	B2
7914469	Torbati	Mar 2011	B2
7955281	Pedersen et al.	Jun 2011	B2
7967764	Lidgren et al.	Jun 2011	B2
7967839	Flock et al.	Jun 2011	B2
7955262	Rosenberg	Jul 2011	B2
7993289	Quistgaard et al.	Aug 2011	B2
8057465	Sliwa, Jr. et al.	Sep 2011	B2
8057389	Barthe et al.	Nov 2011	B2
8066641	Barthe et al.	Nov 2011	B2
8123707	Huckle et al.	Feb 2012	B2
8128618	Gliklich et al.	Mar 2012	B2
8133180	Slayton et al.	Mar 2012	B2
8133191	Rosenberg et al.	Mar 2012	B2
8142200	Crunkilton et al.	Mar 2012	B2
8152904	Slobodzian et al.	Apr 2012	B2
8162858	Manna et al.	Apr 2012	B2
8166332	Barthe et al.	Apr 2012	B2
8182428	Angelsen et al.	May 2012	B2
8197409	Foley et al.	Jun 2012	B2
8206299	Foley et al.	Jun 2012	B2
8208346	Crunkilton	Jun 2012	B2
8211017	Foley et al.	Jul 2012	B2
8262591	Pedersen et al.	Sep 2012	B2
8262650	Zanelli et al.	Sep 2012	B2
8264126	Toda et al.	Sep 2012	B2
8273037	Kreindel et al.	Sep 2012	B2
8282554	Makin et al.	Oct 2012	B2
8292835	Cimino	Oct 2012	B1
8298163	Cimino	Oct 2012	B1
8333700	Barthe et al.	Dec 2012	B1
8334637	Crunkilton et al.	Dec 2012	B2
8337407	Quistgaard et al.	Dec 2012	B2
8343051	Desilets et al.	Jan 2013	B2
8454540	Eshel et al.	Jan 2013	B2
8366622	Slayton et al.	Feb 2013	B2
8398549	Palmeri et al.	Mar 2013	B2
8409097	Slayton et al.	Apr 2013	B2
8425435	Wing et al.	Apr 2013	B2
8388535	Weng et al.	May 2013	B2
8444562	Barthe et al.	May 2013	B2
8460193	Barthe et al.	Jun 2013	B2
8480585	Slayton et al.	Jul 2013	B2
8486001	Weyant	Jul 2013	B2
8506486	Slayton et al.	Aug 2013	B2
8512250	Quistgaard et al.	Aug 2013	B2
8523775	Barthe et al.	Sep 2013	B2
8523849	Liu et al.	Sep 2013	B2
8535228	Slayton et al.	Sep 2013	B2
8570837	Toda et al.	Oct 2013	B2
8573392	Bennett et al.	Nov 2013	B2
8583211	Salomir et al.	Nov 2013	B2
8585618	Hunziker et al.	Nov 2013	B2
8604672	Toda et al.	Dec 2013	B2
8622937	Weng et al.	Jan 2014	B2
8636665	Slayton et al.	Jan 2014	B2
8641622	Barthe et al.	Feb 2014	B2
8663112	Slayton et al.	Mar 2014	B2
8672848	Slayton et al.	Mar 2014	B2
8690778	Slayton et al.	Apr 2014	B2
8690779	Slayton et al.	Apr 2014	B2
8690780	Slayton et al.	Apr 2014	B2
8708935	Barthe et al.	Apr 2014	B2
8715186	Slayton et al.	May 2014	B2
8726781	Eckhoff et al.	May 2014	B2
8728071	Lischinsky et al.	May 2014	B2
8753295	Thierman	Jun 2014	B2
8758253	Sano et al.	Jun 2014	B2
8836203	Nobles et al.	Sep 2014	B2
8857438	Barthe et al.	Oct 2014	B2
8858471	Barthe et al.	Oct 2014	B2
8915853	Barthe et al.	Dec 2014	B2
8915854	Slayton et al.	Dec 2014	B2
8915870	Barthe et al.	Dec 2014	B2
8920320	Stecco et al.	Dec 2014	B2
8920324	Slayton et al.	Dec 2014	B2
8926533	Bockenstedt et al.	Jan 2015	B2
8932224	Barthe et al.	Jan 2015	B2
8932238	Wing et al.	Jan 2015	B2
8968205	Zeng et al.	Mar 2015	B2
9011336	Slayton et al.	Apr 2015	B2
9039617	Slayton et al.	May 2015	B2
9039619	Barthe et al.	May 2015	B2
9050116	Homer	Jun 2015	B2
9095697	Barthe et al.	Aug 2015	B2
9107798	Azhari et al.	Aug 2015	B2
9114247	Barthe et al.	Aug 2015	B2
9180314	Desilets et al.	Nov 2015	B2
9216276	Slayton et al.	Dec 2015	B2
9220915	Liu et al.	Dec 2015	B2
9272162	Slayton et al.	Mar 2016	B2
9283409	Slayton et al.	Mar 2016	B2
9283410	Slayton et al.	Mar 2016	B2
9295607	Rosenberg	Mar 2016	B2
9308390	Youngquist	Apr 2016	B2
9308391	Liu et al.	Apr 2016	B2
9314650	Rosenberg et al.	Apr 2016	B2
9320537	Slayton et al.	Apr 2016	B2
9345910	Slayton et al.	May 2016	B2
9421029	Barthe et al.	Aug 2016	B2
9427600	Barthe et al.	Aug 2016	B2
9427601	Barthe et al.	Aug 2016	B2
9433803	Lin et al.	Sep 2016	B2
9440093	Homer	Sep 2016	B2
9440096	Barthe et al.	Sep 2016	B2
9492645	Zhou et al.	Nov 2016	B2
9492686	Da Silva	Nov 2016	B2
9498651	Sapozhnikov et al.	Nov 2016	B2
9510802	Barthe et al.	Dec 2016	B2
9522290	Slayton et al.	Dec 2016	B2
9532832	Ron Edoute et al.	Jan 2017	B2
9533174	Barthe et al.	Jan 2017	B2
9533175	Slayton et al.	Jan 2017	B2
9545529	Britva et al.	Jan 2017	B2
9566454	Barthe et al.	Feb 2017	B2
9623267	Ulric et al.	Apr 2017	B2
9694211	Barthe et al.	Jul 2017	B2
9694212	Barthe et al.	Jul 2017	B2
9700340	Barthe et al.	Jul 2017	B2
9707412	Slayton et al.	Jul 2017	B2
9710607	Ramdas et al.	Jul 2017	B2
9713731	Slayton et al.	Jul 2017	B2
9802063	Barthe et al.	Oct 2017	B2
9827449	Barthe et al.	Nov 2017	B2
9827450	Slayton et al.	Nov 2017	B2
9833639	Slayton et al.	Dec 2017	B2
9833640	Barthe et al.	Dec 2017	B2
9895560	Barthe et al.	Feb 2018	B2
9907535	Barthe et al.	Mar 2018	B2
9919167	Domankevitz	Mar 2018	B2
9974982	Slayton et al.	May 2018	B2
9993664	Aviad et al.	Jun 2018	B2
10010721	Slayton et al.	Jul 2018	B2
10010724	Barthe et al.	Jul 2018	B2
10010725	Slayton et al.	Jul 2018	B2
10010726	Barthe et al.	Jul 2018	B2
10016626	Zovrin et al.	Jul 2018	B2
10046181	Barthe et al.	Aug 2018	B2
10046182	Barthe et al.	Aug 2018	B2
10070883	Barthe et al.	Sep 2018	B2
10183183	Burdette	Jan 2019	B2
10226645	Barthe	Mar 2019	B2
10238894	Slayton et al.	Mar 2019	B2
10245450	Slayton et al.	Apr 2019	B2
10252086	Barthe et al.	Apr 2019	B2
10265550	Barthe et al.	Apr 2019	B2
10272272	Lee et al.	Apr 2019	B2
10300308	Seip et al.	May 2019	B2
10328289	Barthe et al.	Jun 2019	B2
10406383	Luebcke	Sep 2019	B2
10420960	Emery	Sep 2019	B2
10420961	Lacoste	Sep 2019	B2
10485573	Clark, III et al.	Nov 2019	B2
10492862	Domankevitz	Dec 2019	B2
10525288	Slayton et al.	Jan 2020	B2
10532230	Barthe et al.	Jan 2020	B2
10537304	Barthe et al.	Jan 2020	B2
10556123	Altshuler et al.	Feb 2020	B2
10583287	Schwarz	Mar 2020	B2
10603519	Slayton et al.	Mar 2020	B2
10603521	Emery et al.	Mar 2020	B2
10603523	Slayton et al.	Mar 2020	B2
10610705	Barthe et al.	Apr 2020	B2
10610706	Barthe et al.	Apr 2020	B2
10639006	Choi et al.	May 2020	B2
10639504	Kim	May 2020	B2
10751246	Kaila	Aug 2020	B2
10772646	Lu et al.	Sep 2020	B2
10780298	Cain et al.	Sep 2020	B2
10888716	Slayton et al.	Jan 2021	B2
10888717	Slayton et al.	Jan 2021	B2
10888718	Barthe et al.	Jan 2021	B2
10960235	Barthe et al.	Mar 2021	B2
10960236	Slayton et al.	Mar 2021	B2
11123039	Barthe et al.	Sep 2021	B2
11167155	Barthe et al.	Nov 2021	B2
11179580	Slayton et al.	Nov 2021	B2
11207547	Slayton et al.	Dec 2021	B2
11207548	Barthe et al.	Dec 2021	B2
11224895	Brown et al.	Jan 2022	B2
11235179	Barthe et al.	Feb 2022	B2
11235180	Slayton et al.	Feb 2022	B2
11241218	Emery et al.	Feb 2022	B2
20010009997	Pope	Jul 2001	A1
20010009999	Kaufman et al.	Jul 2001	A1
20010014780	Martin	Aug 2001	A1
20010014819	Ingle	Aug 2001	A1
20010031922	Weng	Oct 2001	A1
20010039380	Larson et al.	Nov 2001	A1
20010041880	Brisken	Nov 2001	A1
20020000763	Jones	Jan 2002	A1
20020002345	Marlinghaus	Jan 2002	A1
20020040199	Klopotek	Apr 2002	A1
20020040442	Ishidera	Apr 2002	A1
20020055702	Atala	May 2002	A1
20020062077	Emmenegger	May 2002	A1
20020062142	Knowlton	May 2002	A1
20020072691	Thompson et al.	Jun 2002	A1
20020082528	Friedman	Jun 2002	A1
20020082529	Suorsa et al.	Jun 2002	A1
20020082589	Friedman	Jun 2002	A1
20020087080	Slayton	Jul 2002	A1
20020095143	Key	Jul 2002	A1
20020099094	Anderson	Jul 2002	A1
20020111569	Rosenschien et al.	Aug 2002	A1
20020115917	Honda et al.	Aug 2002	A1
20020128639	Pless et al.	Aug 2002	A1
20020128648	Weber	Sep 2002	A1
20020143252	Dunne et al.	Oct 2002	A1
20020156400	Babaev	Oct 2002	A1
20020161357	Anderson	Oct 2002	A1
20020165529	Danek	Nov 2002	A1
20020168049	Schriever	Nov 2002	A1
20020169394	Eppstein et al.	Nov 2002	A1
20020169442	Neev	Nov 2002	A1
20020173721	Grunwald et al.	Nov 2002	A1
20020193784	McHale et al.	Dec 2002	A1
20020193831	Smith	Dec 2002	A1
20030009153	Brisken et al.	Jan 2003	A1
20030014039	Barzell et al.	Jan 2003	A1
20030018255	Martin	Jan 2003	A1
20030018270	Makin et al.	Jan 2003	A1
20030023283	McDaniel	Jan 2003	A1
20030028111	Vaezy et al.	Feb 2003	A1
20030028113	Gilbert et al.	Feb 2003	A1
20030032900	Ella	Feb 2003	A1
20030036706	Slayton et al.	Feb 2003	A1
20030040739	Koop	Feb 2003	A1
20030050678	Sierra	Mar 2003	A1
20030055308	Friemel et al.	Mar 2003	A1
20030055417	Truckai et al.	Mar 2003	A1
20030060736	Martin et al.	Mar 2003	A1
20030065313	Koop	Apr 2003	A1
20030066708	Allison et al.	Apr 2003	A1
20030073907	Taylor	Apr 2003	A1
20030074023	Kaplan	Apr 2003	A1
20030083536	Eshel	May 2003	A1
20030092988	Makin	May 2003	A1
20030097071	Halmann et al.	May 2003	A1
20030099383	Lefebvre	May 2003	A1
20030125629	Ustuner	Jul 2003	A1
20030135135	Miwa et al.	Jul 2003	A1
20030139790	Ingle et al.	Jul 2003	A1
20030149366	Stringer et al.	Aug 2003	A1
20030153961	Babaev	Aug 2003	A1
20030171678	Batten et al.	Sep 2003	A1
20030171701	Babaev	Sep 2003	A1
20030176790	Slayton	Sep 2003	A1
20030191396	Sanghvi	Oct 2003	A1
20030199794	Sakurai et al.	Oct 2003	A1
20030200481	Stanley	Oct 2003	A1
20030212129	Liu et al.	Nov 2003	A1
20030212351	Hissong	Nov 2003	A1
20030212393	Knowlton	Nov 2003	A1
20030216648	Lizzi et al.	Nov 2003	A1
20030216795	Harth	Nov 2003	A1
20030220536	Hissong	Nov 2003	A1
20030220585	Hissong	Nov 2003	A1
20030229331	Brisken et al.	Dec 2003	A1
20030233085	Giammarusti	Dec 2003	A1
20030236487	Knowlton	Dec 2003	A1
20040000316	Knowlton	Jan 2004	A1
20040001809	Brisken	Jan 2004	A1
20040002658	Marian, Jr.	Jan 2004	A1
20040002705	Knowlton	Jan 2004	A1
20040010222	Nunomura et al.	Jan 2004	A1
20040015079	Berger et al.	Jan 2004	A1
20040015106	Coleman	Jan 2004	A1
20040030227	Littrup	Feb 2004	A1
20040030268	Weng et al.	Feb 2004	A1
20040039312	Hillstead	Feb 2004	A1
20040039418	Elstrom	Feb 2004	A1
20040041563	Lewin et al.	Mar 2004	A1
20040041880	Ikeda et al.	Mar 2004	A1
20040042168	Yang et al.	Mar 2004	A1
20040044375	Diederich et al.	Mar 2004	A1
20040049134	Tosaya et al.	Mar 2004	A1
20040049734	Tosaya et al.	Mar 2004	A1
20040059266	Fry	Mar 2004	A1
20040068186	Ishida et al.	Apr 2004	A1
20040073079	Altshuler et al.	Apr 2004	A1
20040073113	Salgo	Apr 2004	A1
20040073115	Horzewski et al.	Apr 2004	A1
20040073116	Smith	Apr 2004	A1
20040073204	Ryan et al.	Apr 2004	A1
20040077977	Ella et al.	Apr 2004	A1
20040082857	Schonenberger	Apr 2004	A1
20040082859	Schaer	Apr 2004	A1
20040102697	Evron	May 2004	A1
20040105559	Aylward et al.	Jun 2004	A1
20040106867	Eshel et al.	Jun 2004	A1
20040122323	Vortman et al.	Jun 2004	A1
20040122493	Ishibashi et al.	Jun 2004	A1
20040143297	Ramsey	Jul 2004	A1
20040152982	Hwang et al.	Aug 2004	A1
20040158150	Rabiner et al.	Aug 2004	A1
20040186535	Knowlton	Sep 2004	A1
20040189155	Funakubo	Sep 2004	A1
20040206365	Knowlton	Oct 2004	A1
20040210214	Knowlton	Oct 2004	A1
20040217675	Desilets	Nov 2004	A1
20040249318	Tanaka	Dec 2004	A1
20040254620	Lacoste	Dec 2004	A1
20040267252	Washington et al.	Dec 2004	A1
20050007879	Nishida	Jan 2005	A1
20050033201	Takahashi	Feb 2005	A1
20050033316	Kertz	Feb 2005	A1
20050038340	Vaezy et al.	Feb 2005	A1
20050055018	Kreindel	Mar 2005	A1
20050055073	Weber	Mar 2005	A1
20050061834	Garcia et al.	Mar 2005	A1
20050070961	Maki	Mar 2005	A1
20050074407	Smith	Apr 2005	A1
20050080469	Larson	Apr 2005	A1
20050085731	Miller et al.	Apr 2005	A1
20050091770	Mourad et al.	May 2005	A1
20050096542	Weng	May 2005	A1
20050104690	Larson et al.	May 2005	A1
20050113689	Gritzky	May 2005	A1
20050131302	Poland	Jun 2005	A1
20050137656	Malak	Jun 2005	A1
20050143677	Young et al.	Jun 2005	A1
20050154313	Desilets	Jul 2005	A1
20050154314	Quistgaard	Jul 2005	A1
20050154332	Zanelli	Jul 2005	A1
20050154431	Quistgaard	Jul 2005	A1
20050187495	Quistgaard	Aug 2005	A1
20050191252	Mitsui	Sep 2005	A1
20050193451	Quistgaard	Sep 2005	A1
20050193820	Sheljaskow	Sep 2005	A1
20050197681	Barolet et al.	Sep 2005	A1
20050228281	Nefos	Oct 2005	A1
20050240127	Seip et al.	Oct 2005	A1
20050240170	Zhang et al.	Oct 2005	A1
20050251120	Anderson et al.	Nov 2005	A1
20050251125	Pless et al.	Nov 2005	A1
20050256406	Barthe	Nov 2005	A1
20050261584	Eshel	Nov 2005	A1
20050261585	Makin et al.	Nov 2005	A1
20050267454	Hissong	Dec 2005	A1
20050288748	Li et al.	Dec 2005	A1
20060004306	Altshuler	Jan 2006	A1
20060020260	Dover et al.	Jan 2006	A1
20060025756	Francischelli	Feb 2006	A1
20060042201	Curry	Mar 2006	A1
20060058664	Barthe	Mar 2006	A1
20060058671	Vitek et al.	Mar 2006	A1
20060058707	Barthe	Mar 2006	A1
20060058712	Altshuler et al.	Mar 2006	A1
20060074309	Bonnefous	Apr 2006	A1
20060074313	Slayton et al.	Apr 2006	A1
20060074314	Slayton	Apr 2006	A1
20060074355	Slayton	Apr 2006	A1
20060079816	Barthe	Apr 2006	A1
20060079868	Makin	Apr 2006	A1
20060084891	Barthe	Apr 2006	A1
20060089632	Barthe	Apr 2006	A1
20060089688	Panescu	Apr 2006	A1
20060094988	Tosaya	May 2006	A1
20060106325	Perrier	May 2006	A1
20060111744	Makin	May 2006	A1
20060116583	Ogasawara et al.	Jun 2006	A1
20060116671	Slayton	Jun 2006	A1
20060122508	Slayton	Jun 2006	A1
20060122509	Desilets	Jun 2006	A1
20060161062	Arditi et al.	Jul 2006	A1
20060184069	Vaitekunas	Aug 2006	A1
20060184071	Klopotek	Aug 2006	A1
20060189972	Grossman	Aug 2006	A1
20060206105	Chopra	Sep 2006	A1
20060224090	Ostrovsky et al.	Oct 2006	A1
20060229514	Wiener	Oct 2006	A1
20060238068	May et al.	Oct 2006	A1
20060241440	Eshel	Oct 2006	A1
20060241442	Barthe	Oct 2006	A1
20060241470	Novak et al.	Oct 2006	A1
20060241576	Diederich et al.	Oct 2006	A1
20060250046	Koizumi et al.	Nov 2006	A1
20060282691	Barthe	Dec 2006	A1
20060291710	Wang et al.	Dec 2006	A1
20070016039	Vortman et al.	Jan 2007	A1
20070032784	Gliklich	Feb 2007	A1
20070035201	Desilets	Feb 2007	A1
20070055154	Torbati	Mar 2007	A1
20070055155	Owen et al.	Mar 2007	A1
20070055156	Desilets et al.	Mar 2007	A1
20070065420	Johnson	Mar 2007	A1
20070083120	Cain et al.	Apr 2007	A1
20070087060	Dietrich	Apr 2007	A1
20070088245	Babaev et al.	Apr 2007	A1
20070088346	Mirizzi et al.	Apr 2007	A1
20070161902	Dan	Jul 2007	A1
20070166357	Shaffer et al.	Jul 2007	A1
20070167709	Slayton	Jul 2007	A1
20070018553	Kennedy	Aug 2007	A1
20070208253	Slayton	Sep 2007	A1
20070219448	Seip et al.	Sep 2007	A1
20070219604	Yaroslavsky et al.	Sep 2007	A1
20070219605	Yaroslavsky et al.	Sep 2007	A1
20070238994	Stecco et al.	Oct 2007	A1
20070239075	Rosenberg	Oct 2007	A1
20070239077	Azhari et al.	Oct 2007	A1
20070239079	Manstein et al.	Oct 2007	A1
20070239142	Altshuler	Oct 2007	A1
20080015435	Cribbs et al.	Jan 2008	A1
20080027328	Klopotek	Jan 2008	A1
20080033458	McLean	Feb 2008	A1
20080039724	Seip et al.	Feb 2008	A1
20080071255	Barthe	Mar 2008	A1
20080086054	Slayton	Apr 2008	A1
20080086056	Chang et al.	Apr 2008	A1
20080097214	Meyers	Apr 2008	A1
20080097253	Pedersen et al.	Apr 2008	A1
20080114251	Weymer et al.	May 2008	A1
20080139943	Deng et al.	Jun 2008	A1
20080139974	Da Silva	Jun 2008	A1
20080146970	Litman et al.	Jun 2008	A1
20080167556	Thompson	Jul 2008	A1
20080183077	Moreau-Gobard et al.	Jul 2008	A1
20080183110	Davenport et al.	Jul 2008	A1
20080188745	Chen et al.	Aug 2008	A1
20080194964	Randall et al.	Aug 2008	A1
20080195000	Spooner et al.	Aug 2008	A1
20080200810	Buchalter	Aug 2008	A1
20080200813	Quistgaard	Aug 2008	A1
20080214966	Slayton	Sep 2008	A1
20080214988	Altshuler et al.	Sep 2008	A1
20080221491	Slayton	Sep 2008	A1
20080223379	Stuker et al.	Sep 2008	A1
20080242991	Moon et al.	Oct 2008	A1
20080243035	Crunkilton	Oct 2008	A1
20080269608	Anderson et al.	Oct 2008	A1
20080275342	Barthe	Nov 2008	A1
20080281206	Bartlett et al.	Nov 2008	A1
20080281236	Eshel et al.	Nov 2008	A1
20080281237	Slayton	Nov 2008	A1
20080281255	Slayton	Nov 2008	A1
20080294072	Crutchfield, III	Nov 2008	A1
20080294073	Barthe	Nov 2008	A1
20080319356	Cain	Dec 2008	A1
20090005680	Jones et al.	Jan 2009	A1
20090012394	Hobelsberger et al.	Jan 2009	A1
20090043198	Milner et al.	Feb 2009	A1
20090043293	Pankratov et al.	Feb 2009	A1
20090048514	Azhari et al.	Feb 2009	A1
20090069677	Chen et al.	Mar 2009	A1
20090093737	Chomas et al.	Apr 2009	A1
20090156969	Santangelo	Jun 2009	A1
20090163807	Sliwa	Jun 2009	A1
20090171252	Bockenstedt et al.	Jul 2009	A1
20090171266	Harris	Jul 2009	A1
20090177122	Peterson	Jul 2009	A1
20090177123	Peterson	Jul 2009	A1
20090182231	Barthe et al.	Jul 2009	A1
20090198157	Babaev et al.	Aug 2009	A1
20090216159	Slayton et al.	Aug 2009	A1
20090226424	Hsu	Sep 2009	A1
20090227910	Pedersen et al.	Sep 2009	A1
20090230823	Kushculey et al.	Sep 2009	A1
20090253988	Slayton et al.	Oct 2009	A1
20090281463	Chapelon et al.	Nov 2009	A1
20090312693	Thapliyal et al.	Dec 2009	A1
20090318909	Debenedictis et al.	Dec 2009	A1
20090326420	Moonen et al.	Dec 2009	A1
20100011236	Barthe et al.	Jan 2010	A1
20100022919	Peterson	Jan 2010	A1
20100022921	Seip et al.	Jan 2010	A1
20100022922	Barthe et al.	Jan 2010	A1
20100030076	Vortman et al.	Feb 2010	A1
20100042020	Ben-Ezra	Feb 2010	A1
20100049178	Deem et al.	Feb 2010	A1
20100056925	Zhang et al.	Mar 2010	A1
20100056962	Vortman et al.	Mar 2010	A1
20100100014	Eshel et al.	Apr 2010	A1
20100113983	Heckerman et al.	May 2010	A1
20100130891	Taggart et al.	May 2010	A1
20100160782	Slayton et al.	Jun 2010	A1
20100160837	Hunziker et al.	Jun 2010	A1
20100168576	Poland et al.	Jul 2010	A1
20100191120	Kraus et al.	Jul 2010	A1
20100241035	Barthe et al.	Sep 2010	A1
20100249602	Buckley et al.	Sep 2010	A1
20100249669	Ulric et al.	Sep 2010	A1
20100256489	Pedersen et al.	Oct 2010	A1
20100274161	Azhari et al.	Oct 2010	A1
20100280420	Barthe et al.	Nov 2010	A1
20100286518	Lee et al.	Nov 2010	A1
20100312150	Douglas et al.	Dec 2010	A1
20110040171	Foley et al.	Feb 2011	A1
20110040190	Jahnke et al.	Feb 2011	A1
20110040213	Dietz et al.	Feb 2011	A1
20110040214	Foley et al.	Feb 2011	A1
20110066084	Desilets et al.	Mar 2011	A1
20110072970	Slobodzian et al.	Mar 2011	A1
20110077514	Ulric et al.	Mar 2011	A1
20110079083	Yoo et al.	Apr 2011	A1
20110087099	Eshel et al.	Apr 2011	A1
20110087255	McCormack et al.	Apr 2011	A1
20110112405	Barthe et al.	May 2011	A1
20110144490	Davis et al.	Jun 2011	A1
20110178444	Slayton et al.	Jul 2011	A1
20110178541	Azhari	Jul 2011	A1
20110190745	Uebelhoer et al.	Aug 2011	A1
20110201976	Sanghvi et al.	Aug 2011	A1
20110251524	Azhari et al.	Oct 2011	A1
20110251527	Kushculey et al.	Oct 2011	A1
20110270137	Goren et al.	Nov 2011	A1
20110319793	Henrik et al.	Dec 2011	A1
20110319794	Gertner	Dec 2011	A1
20120004549	Barthe et al.	Jan 2012	A1
20120016239	Barthe et al.	Jan 2012	A1
20120029353	Slayton et al.	Feb 2012	A1
20120035473	Sanghvi et al.	Feb 2012	A1
20120035475	Barthe et al.	Feb 2012	A1
20120035476	Barthe et al.	Feb 2012	A1
20120046547	Barthe et al.	Feb 2012	A1
20120053458	Barthe et al.	Mar 2012	A1
20120059288	Barthe et al.	Mar 2012	A1
20120111339	Barthe et al.	May 2012	A1
20120123304	Rybyanets et al.	May 2012	A1
20120136280	Rosenberg et al.	May 2012	A1
20120136282	Rosenberg et al.	May 2012	A1
20120143056	Slayton et al.	Jun 2012	A1
20120143100	Jeong et al.	Jun 2012	A1
20120165668	Slayton et al.	Jun 2012	A1
20120165848	Slayton et al.	Jun 2012	A1
20120191019	Desilets et al.	Jul 2012	A1
20120191020	Vitek et al.	Jul 2012	A1
20120197120	Makin et al.	Aug 2012	A1
20120197121	Slayton et al.	Aug 2012	A1
20120209150	Zeng et al.	Aug 2012	A1
20120215105	Slayton et al.	Aug 2012	A1
20120271202	Wisdom	Oct 2012	A1
20120271294	Barthe et al.	Oct 2012	A1
20120277639	Pollock et al.	Nov 2012	A1
20120296240	Azhari et al.	Nov 2012	A1
20120302883	Kong et al.	Nov 2012	A1
20120316426	Foley et al.	Dec 2012	A1
20120330197	Makin et al.	Dec 2012	A1
20120330222	Makin et al.	Dec 2012	A1
20120330223	Makin et al.	Dec 2012	A1
20120330283	Hyde et al.	Dec 2012	A1
20120330284	Hyde et al.	Dec 2012	A1
20130012755	Slayton	Jan 2013	A1
20130012816	Slayton et al.	Jan 2013	A1
20130012838	Jaeger et al.	Jan 2013	A1
20130012842	Barthe	Jan 2013	A1
20130018285	Park et al.	Jan 2013	A1
20130018286	Slayton et al.	Jan 2013	A1
20130046209	Slayton et al.	Feb 2013	A1
20130051178	Rybyanets	Feb 2013	A1
20130060170	Lee et al.	Mar 2013	A1
20130066208	Barthe et al.	Mar 2013	A1
20130066237	Smotrich et al.	Mar 2013	A1
20130072826	Slayton et al.	Mar 2013	A1
20130073001	Campbell	Mar 2013	A1
20130096471	Slayton et al.	Apr 2013	A1
20130096596	Schafer	Apr 2013	A1
20130190659	Slayton et al.	Jul 2013	A1
20130211293	Auboiroux et al.	Aug 2013	A1
20130225994	Hsu et al.	Aug 2013	A1
20130268032	Neev	Oct 2013	A1
20130274603	Barthe et al.	Oct 2013	A1
20130278111	Sammoura	Oct 2013	A1
20130281853	Slayton et al.	Oct 2013	A1
20130281891	Slayton et al.	Oct 2013	A1
20130296697	Slayton et al.	Nov 2013	A1
20130296700	Slayton et al.	Nov 2013	A1
20130296743	Lee et al.	Nov 2013	A1
20130303904	Barthe et al.	Nov 2013	A1
20130303905	Barthe et al.	Nov 2013	A1
20130310714	Eshel et al.	Nov 2013	A1
20130310863	Makin et al.	Nov 2013	A1
20130345562	Barthe et al.	Dec 2013	A1
20140024974	Slayton et al.	Jan 2014	A1
20140050054	Toda et al.	Feb 2014	A1
20140081300	Melodelima et al.	Mar 2014	A1
20140082907	Barthe et al.	Mar 2014	A1
20140117814	Toda et al.	May 2014	A1
20140142430	Slayton et al.	May 2014	A1
20140148834	Barthe et al.	May 2014	A1
20140155747	Bennett	Jun 2014	A1
20140180174	Slayton et al.	Jun 2014	A1
20140187944	Slayton et al.	Jul 2014	A1
20140188015	Slayton et al.	Jul 2014	A1
20140188145	Slayton et al.	Jul 2014	A1
20140194723	Herzog et al.	Jul 2014	A1
20140208856	Schmid	Jul 2014	A1
20140221823	Keogh et al.	Aug 2014	A1
20140236049	Barthe et al.	Aug 2014	A1
20140236061	Lee et al.	Aug 2014	A1
20140243713	Slayton et al.	Aug 2014	A1
20140257145	Emery	Sep 2014	A1
20140276055	Barthe et al.	Sep 2014	A1
20140316269	Zhang et al.	Oct 2014	A1
20150000674	Barthe et al.	Jan 2015	A1
20150025420	Slayton et al.	Jan 2015	A1
20150064165	Perry et al.	Mar 2015	A1
20150080723	Barthe et al.	Mar 2015	A1
20150080771	Barthe et al.	Mar 2015	A1
20150080874	Slayton et al.	Mar 2015	A1
20150088182	Slayton et al.	Mar 2015	A1
20150141734	Chapelon et al.	May 2015	A1
20150164734	Slayton et al.	Jun 2015	A1
20150165238	Slayton et al.	Jun 2015	A1
20150165243	Slayton et al.	Jun 2015	A1
20150174388	Slayton	Jun 2015	A1
20150202468	Slayton et al.	Jul 2015	A1
20150217141	Barthe et al.	Aug 2015	A1
20150238258	Palero et al.	Aug 2015	A1
20150297188	Konofagou	Oct 2015	A1
20150321026	Branson et al.	Nov 2015	A1
20150360058	Barthe et al.	Dec 2015	A1
20150374333	Barthe et al.	Dec 2015	A1
20150375014	Slayton et al.	Dec 2015	A1
20160001097	Cho et al.	Jan 2016	A1
20160016015	Slayton et al.	Jan 2016	A1
20160027994	Toda et al.	Jan 2016	A1
20160151618	Powers et al.	Jun 2016	A1
20160158580	Slayton et al.	Jun 2016	A1
20160175619	Lee et al.	Jun 2016	A1
20160206335	Slayton	Jul 2016	A1
20160206341	Slayton	Jul 2016	A1
20160256675	Slayton	Sep 2016	A1
20160296769	Barthe et al.	Oct 2016	A1
20160310444	Dobak, III	Oct 2016	A1
20160361571	Bernabei	Dec 2016	A1
20160361572	Slayton	Dec 2016	A1
20170028227	Emery et al.	Feb 2017	A1
20170043190	Barthe et al.	Feb 2017	A1
20170050019	Ron Edoute et al.	Feb 2017	A1
20170080257	Paunescu et al.	Mar 2017	A1
20170090507	Weiner et al.	Mar 2017	A1
20170100585	Hall et al.	Apr 2017	A1
20170119345	Levien et al.	May 2017	A1
20170136263	Reil	May 2017	A1
20170209201	Slayton et al.	Jul 2017	A1
20170209202	Friedrichs et al.	Jul 2017	A1
20170304654	Blanche et al.	Oct 2017	A1
20170368574	Sammoura	Dec 2017	A1
20180001113	Streeter	Jan 2018	A1
20180015308	Reed et al.	Jan 2018	A1
20180043147	Slayton	Feb 2018	A1
20180099162	Bernabei	Apr 2018	A1
20180099163	Bernabei	Apr 2018	A1
20180126190	Aviad et al.	May 2018	A1
20180154184	Kong et al.	Jun 2018	A1
20180207450	Sanchez et al.	Jul 2018	A1
20180272156	Slayton et al.	Sep 2018	A1
20180272157	Barthe et al.	Sep 2018	A1
20180272158	Barthe et al.	Sep 2018	A1
20180272159	Slayton et al.	Sep 2018	A1
20180317884	Chapelon et al.	Nov 2018	A1
20180333595	Barthe et al.	Nov 2018	A1
20180360420	Vortman et al.	Dec 2018	A1
20190000498	Barthe et al.	Jan 2019	A1
20190009110	Gross et al.	Jan 2019	A1
20190009111	Myhr et al.	Jan 2019	A1
20190022405	Greenbaum et al.	Jan 2019	A1
20190038921	Domankevitz	Feb 2019	A1
20190060675	Krone et al.	Feb 2019	A1
20190091490	Alexander et al.	Mar 2019	A1
20190142380	Emery et al.	May 2019	A1
20190143148	Slayton	May 2019	A1
20190184202	Zereshkian et al.	Jun 2019	A1
20190184203	Slayton et al.	Jun 2019	A1
20190184205	Slayton et al.	Jun 2019	A1
20190184207	Barthe et al.	Jun 2019	A1
20190184208	Barthe et al.	Jun 2019	A1
20190224501	Burdette	Jul 2019	A1
20190262634	Barthe et al.	Aug 2019	A1
20190282834	Zawada et al.	Sep 2019	A1
20190290939	Watson et al.	Sep 2019	A1
20190350562	Slayton et al.	Nov 2019	A1
20190366126	Pahk et al.	Dec 2019	A1
20190366127	Emery	Dec 2019	A1
20190366128	Slayton et al.	Dec 2019	A1
20200094083	Slayton et al.	Mar 2020	A1
20200100762	Barthe et al.	Apr 2020	A1
20200129759	Schwarz	Apr 2020	A1
20200171330	Barthe et al.	Jun 2020	A1
20200179727	Slayton et al.	Jun 2020	A1
20200179729	Slayton et al.	Jun 2020	A1
20200188703	Barthe et al.	Jun 2020	A1
20200188704	Barthe et al.	Jun 2020	A1
20200188705	Emery et al.	Jun 2020	A1
20200206072	Capelli et al.	Jul 2020	A1
20200222728	Khokhlova et al.	Jul 2020	A1
20210038925	Emery	Feb 2021	A1
20210378630	Slayton et al.	Dec 2021	A1

Foreign Referenced Citations (200)

Number	Date	Country
2460061	Nov 2001	CN
1734284	Dec 2009	CN
104027893	Sep 2014	CN
4029175	Mar 1992	DE
10140064	Mar 2003	DE
10219297	Nov 2003	DE
10219217	Dec 2004	DE
20314479	Dec 2004	DE
0142215	May 1984	EP
0344773	Dec 1989	EP
1479412	Nov 1991	EP
0473553	Apr 1992	EP
670147	Feb 1995	EP
0661029	Jul 1995	EP
724894	Feb 1996	EP
763371	Nov 1996	EP
1044038	Oct 2000	EP
1050322	Nov 2000	EP
1234566	Aug 2002	EP
1262160	Dec 2002	EP
0659387	Apr 2003	EP
1374944	Jan 2004	EP
1028660	Jan 2008	EP
1874241	Jan 2008	EP
1362223	May 2008	EP
1750804	Jul 2008	EP
1283690	Nov 2008	EP
1811901	Apr 2009	EP
1785164	Aug 2009	EP
2230904	Sep 2010	EP
1501331	Jun 2011	EP
2066405	Nov 2011	EP
2474050	Jul 2012	EP
2527828	Nov 2012	EP
2709726	Nov 2015	EP
1538980	Jan 2017	EP
3124047	Jan 2017	EP
2897547	Nov 2017	EP
2173261	Aug 2018	EP
3417911	Dec 2018	EP
2532851	Sep 1983	FR
2685872	Jan 1992	FR
2672486	Aug 1992	FR
2703254	Mar 1994	FR
2113099	Aug 1983	GB
102516	Jan 1996	IL
112369	Aug 1999	IL
120079	Mar 2001	IL
63036171	Feb 1988	JP
03048299	Mar 1991	JP
3123559	May 1991	JP
03136642	Jun 1991	JP
4089058	Mar 1992	JP
04150847	May 1992	JP
7080087	Mar 1995	JP
07505793	Jun 1995	JP
7184907	Jul 1995	JP
7222782	Aug 1995	JP
09047458	Feb 1997	JP
9108288	Apr 1997	JP
9503926	Apr 1997	JP
3053069	Oct 1998	JP
11123226	May 1999	JP
11505440	May 1999	JP
11506636	Jun 1999	JP
10248850	Sep 1999	JP
2000126310	May 2000	JP
2000166940	Jun 2000	JP
2000233009	Aug 2000	JP
2001-46387	Feb 2001	JP
2001136599	May 2001	JP
2001170068	Jun 2001	JP
2002505596	Feb 2002	JP
2002078764	Mar 2002	JP
2002515786	May 2002	JP
2002537013	May 2002	JP
2002521118	Jul 2002	JP
2002537939	Nov 2002	JP
2003050298	Jul 2003	JP
2003204982	Jul 2003	JP
2004-504898	Feb 2004	JP
2004-507280	Mar 2004	JP
2004154256	Mar 2004	JP
2004-509671	Apr 2004	JP
2004-512856	Apr 2004	JP
2004130145	Apr 2004	JP
2004147719	May 2004	JP
2005503388	Feb 2005	JP
2005527336	Sep 2005	JP
2005323213	Nov 2005	JP
2006520247	Sep 2006	JP
2008515559	May 2008	JP
2009518126	May 2009	JP
2010517695	May 2010	JP
2001-0019317	Mar 2001	KR
1020010024871	Mar 2001	KR
2002-0038547	May 2002	KR
100400870	Oct 2003	KR
20060121267	Nov 2006	KR
1020060113930	Nov 2006	KR
1020070065332	Jun 2007	KR
1020070070161	Jul 2007	KR
1020070098856	Oct 2007	KR
1020070104878	Oct 2007	KR
1020070114105	Nov 2007	KR
1020000059516	Apr 2012	KR
10-2013-0124598	Nov 2013	KR
10-1365946	Feb 2014	KR
386883	Sep 2000	TW
201208734	Mar 2012	TW
WO9312742	Jul 1993	WO
WO9524159	Sep 1995	WO
WO9625888	Aug 1996	WO
WO9634568	Nov 1996	WO
WO9639079	Dec 1996	WO
WO9735518	Oct 1997	WO
WO9832379	Jul 1998	WO
WO9852465	Nov 1998	WO
WO9933520	Jul 1999	WO
WO9939677	Aug 1999	WO
WO9949788	Oct 1999	WO
WO200006032	Feb 2000	WO
WO0015300	Mar 2000	WO
WO0021612	Apr 2000	WO
WO0048518	Aug 2000	WO
WO0053113	Sep 2000	WO
WO200071021	Nov 2000	WO
WO0128623	Apr 2001	WO
WO01045550	Jun 2001	WO
WO0182777	Nov 2001	WO
WO0182778	Nov 2001	WO
WO0187161	Nov 2001	WO
WO01080709	Nov 2001	WO
WO2001087161	Nov 2001	WO
WO0209812	Feb 2002	WO
WO0209813	Feb 2002	WO
WO02015768	Feb 2002	WO
WO0224050	Mar 2002	WO
WO200149194	Jul 2002	WO
WO2002054018	Jul 2002	WO
WO02092168	Nov 2002	WO
WO03053266	Jul 2003	WO
WO03065347	Aug 2003	WO
WO03070105	Aug 2003	WO
WO03077833	Sep 2003	WO
WO03086215	Oct 2003	WO
WO03096883	Nov 2003	WO
WO03099177	Dec 2003	WO
WO03099382	Dec 2003	WO
WO03101530	Dec 2003	WO
WO2004000116	Dec 2003	WO
WO2004080147	Sep 2004	WO
WO2004110558	Dec 2004	WO
WO2005011804	Feb 2005	WO
WO2005065408	Jul 2005	WO
WO2005065409	Jul 2005	WO
WO2005090978	Sep 2005	WO
WO2005113068	Dec 2005	WO
WO2006042163	Apr 2006	WO
WO2006036870	Apr 2006	WO
WO2006042168	Apr 2006	WO
WO2006042201	Apr 2006	WO
WO2006065671	Jun 2006	WO
WO2006082573	Aug 2006	WO
WO2006104568	Oct 2006	WO
WO2006110388	Oct 2006	WO
WO2007067563	Jun 2007	WO
WO2008036479	Mar 2008	WO
WO2008036622	Mar 2008	WO
WO2008144274	Nov 2008	WO
WO2009013729	Jan 2009	WO
WO2009149390	Oct 2009	WO
WO2010006293	Jan 2010	WO
WO2010102128	Sep 2010	WO
WO2012134645	Oct 2012	WO
WO2013048912	Apr 2013	WO
WO2013178830	Dec 2013	WO
WO2014043206	Mar 2014	WO
WO2014045216	Mar 2014	WO
WO2014055708	Apr 2014	WO
WO2014057388	Apr 2014	WO
WO2014127091	Aug 2014	WO
WO2015160708	Oct 2015	WO
WO2016054155	Apr 2016	WO
WO2016115363	Jul 2016	WO
WO2017127328	Jul 2017	WO
WO2017149506	Sep 2017	WO
WO2017165595	Sep 2017	WO
WO 2017212489	Dec 2017	WO
WO2017212489	Dec 2017	WO
WO2017223312	Dec 2017	WO
WO2018035012	Feb 2018	WO
WO2018158355	Sep 2018	WO
WO2019008573	Jan 2019	WO
WO 2019147596	Aug 2019	WO
WO2019164836	Aug 2019	WO
WO2020009324	Jan 2020	WO
WO2020075906	Apr 2020	WO
WO2020080730	Apr 2020	WO
WO2020121307	Jun 2020	WO

Non-Patent Literature Citations (380)

Entry
US 10,398,895 B2, 09/2019, Schwarz (withdrawn)
Adams et al., “High Intensity Focused Ultrasound Ablation of Rabbit Kidney Tumors” Sonablate High-Intensity Focused Ultrasound device; Journal of Endourology vol. 10, No. 1, (Feb. 1996).
Agren, Magnus S. et al., Collagenase in Wound Healing: Effect of Wound Age and Type. The Journal of Investigative Dermatology, vol. 99/No. 6, (Dec. 1992).
Alam, M., “The future of noninvasive procedural dermatology”. Semin Cutan Med Surg. Mar. 2013; 32(1):59-61.
Alam, M., et al., “Ultrasound tightening of facial and neck skin: a rater-blinded prospective cohort study”. J Am Acad Dermatol, 2010. 62(2): p. 262-9.
Alexiades-Armenakas, M., “Ultrasound Technologies for Dermatologic Techniques”. J Drugs Derm. 2014. 12 (11): p. 1305.
Alster, T.S., et al., “Noninvasive lifting of arm, thigh, and knee skin with transcutaneous intense focused ultrasound”. Dermatol Surg, 2012. 38(5): p. 754-9.
Alster, Tinas S., Tanzi, Elizabeth L., “Cellulite Treatment using a Novel Combination Radiofrequency, Infrared Light, and Mechanical Tissue Manipulation Device,” Journal of Cosmetic & Laser Therapy, Jun. 2005, vol. 7, Issue 2, pp. 81-85.
Arosarena, O., “Options and Challenges for Facial Rejuvenation in Patients With Higher Fitzpatrick Skin Phototypes”. JAMA Facial Plastic Surgery, 2015.
Arthur et al., “Non-invasive estimation of hyperthermia temperatures with ultrasound,” Int. J. Hyperthermia, Sep. 2005, 21(6), pp. 589-600.
Barthe et al., “Ultrasound therapy system and ablation results utilizing miniature imaging/therapy arrays,” Ultrasonics Symposium, 2004 IEEE, Aug. 23, 2004, pp. 1792-1795, vol. 3.
Bozec, Laurent et al., Thermal Denaturation Studies of Collagen by Microthermal Analysis and Atomic Force Microscopy, Biophysical Journal, vol. 101, pp. 228-236. (Jul. 2001).
Brobst, R.W., et. al., “Noninvasive Treatment of the Neck”. Facial Plast Surg Clin North Am, 2014. 22(2): p. 191-202.
Brobst, R.W., et., al., “Ulthera: initial and six month results”. Facial Plast Surg Clin North Am, 2012. 20(2): p. 163-76.
Brown J A et al: “Fabrication and performance of 40-60 MHz annular arrays”, 2003 IEEE Ultrasonics Symposium Proceedings. Honolulu, Hawaii, Oct. 5-8, 2003; [IEEE Ultrasonics Symposium Proceedings], New York, NY : IEEE, US, vol. 1, Oct. 5, 2003 (Oct. 5, 2003), pp. 869-872.
Calderhead et al., “One Mechanism Behind LED Photo-Therapy for Wound Healing and Skin Rejuvenation: Key Role of the Mast Cell” Laser Therapy 17.3: 141-148 (2008).
Carruthers et al., “Consensus Recommendations for Combined Aesthetic Interventions in the Face Using Botulinum Toxin, Fillers, and Energy-Based Devices” Dermatol Surg 2016 (pp. 1-12).
Casabona, G., et al., “Microfocused Ultrasound with Visualization and Calcium Hydroxylapatite for Improving Skin Laxity and Cellulite Appearance”; Plast Reconstr Surg Glob Open. Jul. 25, 2017;5(7):e1388, 8 pages.
Casabona, G., et al., “Microfocused Ultrasound With Visualization and Fillers for Increased Neocollagenesis: Clinical and Histological Evaluation”. Dermatol Surg 2014;40:S194-S198.
Chan, N.P., et al., “Safety study of transcutaneous focused ultrasound for non-invasive skin tightening in Asians”. Lasers Surg Med, 2011. 43(5): p. 366-75.
Chapelon et al., “Effects of Cavitation In The High Intensity Therapeutic Ultrasound”, Ultrasonics Symposium—1357 (1991).
Chapelon, et al., “Thresholds for Tissue Ablation by Focused Ultrasound” (1990).
Chen, L. et al., “Effect of Blood Perfusion on the ablation of liver parenchyma with high intensity focused ultrasound,” Phys. Med. Biol; 38:1661-1673; 1993b.
Coon, Joshua et al., “Protein identification using sequential ion/ion reactions and tandem mass spectrometry” Proceedings of the National Academy of Sciences of the USA, vol. 102, No. 27, Jul. 27, 2005, pp. 9463-9468.
Corry, Peter M., et al., “Human Cancer Treatment with Ultrasound”, IEEE Transactions on Sonics and Ultrasonics, vol. SU-31, No. 5, Sep. 1984, pp. 444, 456.
Damianou et al., “Application of the Thermal Dose Concept for Predicting the Necrosed Tissue Volume During Ultrasound Surgery,” 1993 IEEE Ultrasound Symposium, pp. 1199-1202.
Daum et al., Design and Evaluation of a Feedback Based Phased Array System for Ultrasound Surgery, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, vol. 45, No. 2, Mar. 1998, pp. 431-438.
Davis, Brian J., et al., “An Acoustic Phase Shift Technique for the Non-Invasive Measurement of Temperature Changes in Tissues”, 1985 Ultrasonics Symposium, pp. 921-924.
Dayan, S.H., et al., “Prospective, Multi-Center, Pivotal Trial Evaluating the Safety and Effectiveness of Micro-Focused Ultrasound with Visualization (MFU-V) for Improvement in Lines and Wrinkles of the Décolletage”. Plast Reconstr Surg. Oct. 2014; 134(4 Suppl 1):123-4.
Decision of the Korean Intellectual Property Tribunal dated Jun. 28, 2013 regarding Korean Patent No. 10-1142108, which is related to the pending application and/or an application identified in the Table on pp. 1-4 of the Information Disclosure Statement herein (English translation, English translation certification, and Korean decision included).
Delon Martin, C., et al, “Venous Thrombosis Generation By Means of High-Intensity Focused Ultrasound” Ultrasound in Med. & Biol., vol. 21, No. 1, pp. 113-119 (1995).
Dierickx, Christine C., “The Role of Deep Heating for Noninvasive Skin Rejuvenation” Lasers in Surgery and Medicine 38:799-807 (2006).
Dobke, M.K., et al., “Tissue restructuring by energy-based surgical tools”. Clin Plast Surg, 2012. 39(4): p. 399-408.
Dong, Yuan-Lin et al., “Effect of Ibuprofen on the Inflammatory Response To Surgical Wounds” The Journal of Trauma, vol. 35, No. 3. (1993).
Driller et al., “Therapeutic Applications of Ultrasound: A Review” IEEE Engineering in Medicine and Biology; (Dec. 1987) pp. 33-40.
Dvivedi, Sanjay, et al. “Effect of Ibuprofen and diclofenac sodium on experimental wound healing” Indian Journal of Experimental Biology, vol. 35, pp. 1243-1245. (Nov. 1997).
Fabi, S.G., “Microfocused Ultrasound With Visualization for Skin Tightening and Lifting: My Experience and a Review of the Literature”. Dermatol Surg. Dec. 2014; 40 Suppl 12:S164-7.
Fabi, S.G., “Noninvasive skin tightening: focus on new ultrasound techniques”. Clin Cosmet Investig Dermatol. Feb. 5, 2015; 8:47-52.
Fabi, S.G., et. al., “A prospective multicenter pilot study of the safety and efficacy of microfocused ultrasound with visualization for improving lines and wrinkles of the décolleté”. Dermatol Surg. Mar. 2015; 41(3):327-35.
Fabi, S.G., et. al., “Evaluation of microfocused ultrasound with visualization for lifting, tightening, and wrinkle reduction of the decolletage”. J Am Acad Dermatol, 2013. 69(6): p. 965-71.
Fabi, S.G., et. al., “Future directions in cutaneous laser surgery”. Dermatol Clin, 2014. 32(1): p. 61-9.
Fabi, S.G., et. al., “Retrospective Evaluation of Micro-focused Ultrasound for Lifting and Tightening the Face and Neck”. Dermatol Surg, 2014.
Friedmann D.P., “Comments on evaluation of microfocused ultrasound system for improving skin laxity and tightening in the lower face”. Aesthet Surg J. Mar. 2015;35(3):NP81-2.
Friedmann, D.P., et. al., “Combination of intense pulsed light, Sculptra, and Ultherapy for treatment of the aging face”. J Cosmet Dermatol, 2014. 13(2): p. 109-18.
Fry, W.J. et al., “Production of Focal Destructive Lesions in the Central Nervous System with Ultrasound,” J. Neurosurg., 11:471-478; 1954.
Fujimoto, et al., “A New Cavitation Suppression Technique for Local Ablation Using High-Intensity Focused Ultrasound” Ultrasonics Symposium—1629 (1995).
Gliklich et al., Clinical Pilot Study of Intense Ultrasound therapy to Deep Dermal Facial Skin and Subcutaneous Tissues, Arch Facial Plastic Surgery, Mar. 1, 2007, vol. 9, No. 1.
Gold, M.H., et. al., “Use of Micro-Focused Ultrasound with Visualization to Lift and Tighten Lax Knee Skin”. J Cosmet Laser Ther, 2014: p. 1-15.
Goldberg, D.J., et. al., “Safety and Efficacy of Microfocused Ultrasound to Lift, Tighten, and Smooth the Buttocks”. Dermatol Surg 2014; 40:1113-1117.
Greene, R.M., et al., “Skin tightening technologies”. Facial Plast Surg. Feb. 2014; 30(1):62-7.
Greenhalgh, David G., “Wound healing and diabetes mellitus” Clinics in Plastic Surgery 30; 37-45. (2003).
Guo, S. et al., “Factors Affecting Wound Healing” Critical Reviews in Oral Biology & Medicine, J Dent Res 89(3), pp. 219-229. (2010).
Haar, G.R. et al., “Tissue Destruction with Focused Ultrasound in Vivo,” Eur. Urol. 23 (suppl. 1):8-11; 1993.
Hantash, Basil M. et al., “Bipolar Fractional Radiofrequency Treatment Induces Neoelastogenesis and Neocollagenesis” Lasers in Surgery and Medicine 41:1-9 (2009).
Hantash, Basil M. et al., “In Vivo Histological Evaluation of a Novel Ablative Fractional Resurfacing Device” Lasers in Surgery and Medicine 39:96-107 (2007).
Harris, M.O., “Safety of Microfocused Ultrasound With Visualization in Patients With Fitzpatrick Skin Phototypes III to VI”. Jama Facial Plast. Surg, 2015.
Hart, et. al., “Current Concepts in the Use of PLLA: Clinical Synergy Noted with Combined Use of Microfocused Ultrasound and Poly-I-Lactic Acid on the Face, Neck, and Décolletage”. Amer. Soc. Plast. Surg. 2015. 136; 180-187S.
Hassan et al., “Structure and Applications of Poly(vinyl alcohol) Hydrogels Produced by Conventional Crosslinking or by Freezing/Thawing Methods,” advanced in Polymer Science, 2000, pp. 37-65, vol. 153.
Hassan et al., “Structure and Morphology of Freeze/Thawed PVA Hydrogels,” Macromolecules, Mar. 11, 2000, pp. 2472-2479, vol. 33, No. 7.
Hexsel et al., “A Validated Photonumeric Cellulite Severity Scale”; J Eur Acad Dermatol Venereol. May 2009; 23(5):523-8, 6 pages.
Hitchcock, T.M. et. al., “Review of the safety profile for microfocused ultrasound with Visualization”. Journal of Cosmetic Dermatology, 13, 329-335. (2014).
Husseini et al, “The Role of Cavitation in Acoustically Activated Drug Delivery,” J. Control Release, Oct. 3, 2005, pp. 253-261, vol. 107(2).
Husseini et al. “Investigating the mechanism of acoustically activated uptake of drugs from Pluronic micelles,” BMD Cancer 2002, 2:20k, Aug. 30, 2002, pp. 1-6.
Hynynen et al., Temperature Distributions During Local Ultrasound Induced Hyperthermia In Vivo, Ultrasonics Symposium—745 (1982).
Jeffers et al., “Evaluation of the Effect of Cavitation Activity on Drug-Ultrasound Synergisms,” 1993 IEEE Ultrasonics Symposium, pp. 925-928.
Jenne, J., et al., “Temperature Mapping for High Energy US-Therapy”, 1994 Ultrasonics Symposium, pp. 1879-1882.
Jeong, K.H., et al., “Neurologic complication associated with intense focused ultrasound”. J Cosmet Laser Ther, 2013.
Johnson, S.A., et al., “Non-lntrusive Measurement of Microwave and Ultrasound-Induced Hyperthermia by Acoustic Temperature Tomography”, Ultrasonics Symposium Proceedings, pp. 977-982. (1977).
Ketterling J. A. et al.: “Design and fabrication of a 40-MHz annular array transducer”, IEEE Transactions On Ultrasonics, Ferroelectrics And Frequency Control, IEEE, US, vol. 52, No. 4, Apr. 1, 2005 (Apr. 1, 2005), pp. 672-681.
Kim, H.J., et al., “Coagulation and ablation patterns of high-intensity focused ultrasound on a tissue mimicking phantom and cadaveric skin”. Laser Med Sci. Sep. 4, 2015.
Kornstein, A.N., “Ulthera for silicone lip correction”. Plast Reconstr Surg, 2012. 129(6): p. 1014e-1015e.
Kornstein, A.N., “Ultherapy shrinks nasal skin after rhinoplasty following failure of conservative measures”. Plast Reconstr Surg, 2013. 131(4): p. 664e-6e.
Krischak, G.D., et al., “The effects of non-steroidal anti-inflammatory drug application on incisional wound healing in rats” Journal of Wound Care, vol. 6, No. 2, (Feb. 2007).
Laubach, H.J., et. al., “Confined Thermal Damage with Intense Ultrasound (IUS)” [abstr.] American Society for Laser Medicine and Surgery Abstracts, p. 15 #43 (Apr. 2006).
Laubach, H.J., et. al., “Intense focused ultrasound: evaluation of a new treatment modality for precise microcoagulation within the skin”. Dermatol Surg, 2008. 34(5): p. 727-34.
Lee, H.J., et. al., “The efficacy and safety of intense focused ultrasound in the treatment of enlarged facial pores in Asian skin”. J Dermatolog Treat, 2014.
Lee, H.S., et. al., “Multiple Pass Ultrasound Tightening of Skin Laxity of the Lower Face and Neck”. Dermatol Surg, 2011.
Lin, Sung-Jan, et al., “Monitoring the thermally induced structural transitions of collagen by use of second-harmonic generation microscopy” Optics Letters, vol. 30, No. 6, (Mar. 15, 2005).
Macgregor J.L., et. al., “Microfocused Ultrasound for Skin Tightening”. Semin Cutan Med Surg 32:18-25. (2013).
Madersbacher, S. et al., “Tissue Ablation in Benign Prostatic Hyperplasia with High Intensity Focused Ultrasound,” Dur. Urol., 23 (suppl. 1):39-43; 1993.
Makin et al, “B-Scan Imaging and Thermal Lesion Monitoring Using Miniaturized Dual-Functionality Ultrasound Arrays,” Ultrasonics Symposium, 2004 IEEE, Aug. 23, 2004, pp. 1788-1791, vol. 3.
Makin et al, “Confirmed Bulk Ablation and Therapy Monitoring Using Intracorporeal Image-Treat Ultrasound Arrays,” 4th International Symposium on Therapeutic Ultrasound, Sep. 19, 2004.
Makin et al., “Miniaturized Ultrasound Arrays for Interstitial Ablation and Imaging,” UltraSound Med. Biol. 2005, Nov. 1, 2005, pp. 1539-1550, vol. 31(11).
Manohar et al, “Photoacoustic mammography laboratory prototype: imaging of breast tissue phantoms,” Journal of Biomedical Optics, Nov./Dec. 2004, pp. 1172-1181, vol. 9, No. 6.
Mast et al, “Bulk Ablation of Soft Tissue with Intense Ultrasound; Modeling and Experiments,” J. Acoust. Soc. Am., Oct. 1, 2005, pp. 2715-2724, vol. 118(4).
Meshkinpour, Azin, et al., “Treatment of Hypertrophic Scars and Keloids With a Radiofrequency Device: A Study of Collagen Effects” Lasers in Surgery and Medicine 37:343-349 (2005).
Microchip microID 125 kHz RFID System Design Guide, Microchip Technology Inc. (2004).
Minkis, K., et. al., “Ultrasound skin tightening”. Dermatol Clin, 2014. 32(1): p. 71-7.
Mitragotri, S., “Healing sound: the use of ultrasound in drug delivery and other therapeutic applications,” Nature Reviews; Drug Delivery, pp. 255-260, vol. 4 (Mar. 2005).
Mosser, David M. et al., “Exploring the full spectrum of macrophage activation” Nat Rev Immunol; 8(12): 958-969. (Dec. 2008).
Murota, Sei-Itsu, et al., “Stimulatory Effect of Prostaglandins on the Production of Hexosamine-Containing Substances by Cultured Fibroblasts (3) Induction of Hyaluronic Acid Synthetase by Prostaglandin” Department of Pharmacology, Tokyo Metropolitan Institute of Gerontology, Itabashiku, Tokyo-173, Japan. (Nov. 1977, vol. 14, No. 5).
Murota, Sei-Itsu, et al., “The Stimulatory Effect of Prostaglandins on Production of Hexosamine-Containing Substances by Cultured Fibroblasts” Department of Pharmacology, Tokyo Metropolitan Institute of Gerontology, Itabashiku, Tokyo-173, Japan. (Aug. 1976, vol. 12, No. 2).
Nestor, M.S. et. al., “Safety and Efficacy of Micro-focused Ultrasound Plus Visualization for the Treatment of Axillary Hyperhidrosis”. J Clin Aesthet Dermatol, 2014. 7(4): p. 14-21.
Oni, G., et. al. “Response to ‘comments on evaluation of microfocused ultrasound system for improving skin laxity and tightening in the lower face’”. Aesthet Surg J. Mar. 2015;35(3):NP83-4.
Oni, G., et. al., “Evaluation of a Microfocused Ultrasound System for Improving Skin Laxity and Tightening in the Lower Face”. Aesthet Surg J, 2014. 38:861-868.
Pak, C.S., et. al., “Safety and Efficacy of Ulthera in the Rejuvenation of Aging Lower Eyelids: A Pivotal Clinical Trial”. Aesthetic Plast Surg, 2014.
Paradossi et al., “Poly(vinyl alcohol) as versatile biomaterial for potential biomedical applications,” Journal of Materials Science: Materials in Medicine, 2003, pp. 687-691, vol. 14.
Pritzker, R.N., et. al, “Updates in noninvasive and minimally invasive skin tightening”. Semin Cutan Med Surg. Dec. 2014;33(4):182-7.
Pritzker, R.N., et. al., “Comparison of different technologies for noninvasive skin tightening”. Journal of Cosmetic Dermatology, 13, 315-323. (2014).
Rappolee, Daniel A., et al., “Wound Macrophages Express TGF and Other Growth Factors in Vivo: Analysis by mRNA Phenotyping” Science, vol. 241, No. 4866 (Aug. 1988).
Reid, Gavin, et al., “Tandem Mass spectrometry of ribonuclease A and B: N-linked glycosylation site analysis of whole protein ions,” Analytical Chemistry. Feb. 1, 2002, vol. 74, No. 3, pp. 577-583.
Righetti et al, “Elastographic Characterization of HIFU-Induced Lesions in Canine Livers,” 1999, Ultrasound in Med & Bio, vol. 25, No. 7, pp. 1099-1113.
Rokhsar, C., et. al., “Safety and efficacy of microfocused ultrasound in tightening of lax elbow skin”. Dermatol Surg. 2015; 41(7):821-6.
Rosenberg, Carol S. “Wound Healing in the Patient with Diabetes Mellitus” Nursing Clinics of North America, vol. 25, No. 1, (Mar. 1990).
Saad et al., “Ultrasound-Enhanced Effects of Adriamycin Against Murine Tumors,” Ultrasound in Med. & Biol. vol. 18, No. 8, pp. 715-723 (1992).
Sabet-Peyman, E.J. et. al., “Complications Using Intense Ultrasound Therapy to Treat Deep Dermal Facial Skin and Subcutaneous Tissues”. Dermatol Surg 2014; 40:1108-1112.
Sandulache, Vlad C. et al., “Prostaglandin E2 inhibition of keloid fibroblast migration, contraction, and transforming growth factor (TGF)-B1-induced collagen synthesis” Wound Rep Reg 15 122-133, 2007. (2007).
Sanghvi, N.T., et al., “Transrectal Ablation of Prostate Tissue Using Focused Ultrasound,” 1993 Ultrasonics Symposium, IEEE, pp. 1207-1210.
Sasaki, G.H. et. al., “Clinical Efficacy and Safety of Focused-Image Ultrasonography: A 2-Year Experience”. Aesthet Surg J, 2012.
Sasaki, G.H. et. al., “Microfocused Ultrasound for Nonablative Skin and Subdermal Tightening to the Periorbitum and Body Sites: Preliminary Report on Eighty-Two Patients”. Journal of Cosmetics, Dermatological Sciences and Applications, 2012, 2, 108-116.
Sassen, Sander, “ATI's R520 architecture, the new king of the hill?” http://www.hardwareanalysis.com/content/article/1813, Sep. 16, 2005, 2 pages.
Seip, Ralf, et al., “Noninvasive Detection of Thermal Effects Due to Highly Focused Ultrasonic Fields,” IEEE Symposium, pp. 1229-1232, vol. 2, Oct. 3-Nov. 1993.
Seip, Ralf, et al., “Noninvasive Estimation of Tissue Temperature Response to Heating Fields Using Diagnostic Ultrasound,” IEEE Transactions on Biomedical Engineering, vol. 42, No. 8, Aug. 1995, pp. 828-839.
Simon et al., “Applications of Lipid-Coated Microbubble Ultrasonic Contrast to Tumor Therapy,” Ultrasound in Med. & Biol. vol. 19, No. 2, pp. 123-125 (1993).
Sklar, L.R., et. al., “Use of transcutaneous ultrasound for lipolysis and skin tightening: a review”. Aesthetic Plast Surg, 2014. 38(2): p. 429-41.
Smith, Nadine Barrie, et al., “Non-invasive In Vivo Temperature Mapping of Ultrasound Heating Using Magnetic Resonance Techniques”, 1994 Ultrasonics Symposium, pp. 1829-1832, vol. 3.
Sonocare, Inc. Therapeutic Ultrasound System Model CST-100 Instruction Manual (1985).
Suh, D.H., et. al., “A intense-focused ultrasound tightening for the treatment of infraorbital laxity”. J Cosmet Laser Ther, 2012. 14(6): p. 290-5.
Suh, D.H., et. al., “Comparative histometric analysis of the effects of high-intensity focused ultrasound and radiofrequency on skin”. J Cosmet Laser Ther. Mar. 24, 2015:1-7.
Suh, D.H., et. al., “Intense Focused Ultrasound Tightening in Asian Skin: Clinical and Pathologic Results” American Society for Dermatologic Surgery, Inc.; 37:1595-1602. (2011).
Surry et al., “Poly(vinyl alcohol) cryogel phantoms for use in ultrasound and MR imaging,” Phys. Med. Biol., Dec. 6, 2004, pp. 5529-5546, vol. 49.
Syka J. E. P. et al., “Peptide and Protein Sequence Analysis by Electron Transfer Dissociation Mass Spectrometry,” Proceedings of the National Academy of Sciences of USA, National Academy of Science, Washington, DC, vol. 101, No. 26, Jun. 29, 2004, pp. 9528-9533.
Talbert, D. G., “An Add-On Modification for Linear Array Real-Time Ultrasound Scanners to Produce 3D Displays,” UTS Int'l 1977 Brighton, England (Jun. 28-30, 1977) pp. 57-67.
Tata et al., “Interaction of Ultrasound and Model Membrane Systems: Analyses and Predictions,” American Chemical Society, Phys. Chem. 1992, 96, pp. 3548-3555.
Ueno, S., et al., “Ultrasound Thermometry in Hyperthermia”, 1990 Ultrasonic Symposium, pp. 1645-1652.
Verhofstad, Michiel H.J. et al., “Collagen Synthesis in rat skin and ileum fibroblasts is affected differently by diabetes-related factors” Int. J. Exp. Path. (1998), 79, 321-328.
Wang, H., et al., “Limits on Focused Ultrasound for Deep Hyperthermia”, 1994 Ultrasonic Symposium, Nov. 1-4, 1994, pp. 1869-1872, vol. 3.
Wasson, Scott, “NVIDIA's GeForce 7800 GTX graphics processor Power MADD,” http://techreport.com/reviews/2005q2/geforce-7800gtx/index.x?pg=1, Jun. 22, 2005, 4 pages.
Webster et al. “The role of ultrasound-induced cavitation in the ‘in vitro’ stimulation of collagen synthesis in human fibroblasts”; Ultrasonics pp. 33-37(Jan. 1980).
Weiss, M., “Commentary: noninvasive skin tightening: ultrasound and other technologies: where are we in 2011?” Dermatol Surg, 2012. 38(1): p. 28-30.
White et al “Selective Creating of Thermal Injury Zones in the Superficial Musculoaponeurotic System Using Intense Ultrasound Therapy,” Arch Facial Plastic Surgery, Jan./Feb. 2007, vol. 9, No. 1 (pp. 22-29).
White, W. M., et al., “Selective Transcutaneous Delivery of Energy to Facial Subdermal Tissues Using the Ultrasound Therapy System” [abstr]. American Society for Laser Medicine and Surgery Abstracts, p. 37 #113 (Apr. 2006).
White, W. Matthew, et al., “Selective Transcutaneous Delivery of Energy to Porcine Soft Tissues Using Intense Ultrasound (IUS)” Lasers in Surgery and Medicine 40:67-75 (2008).
Woodward, J.A., et. al. “Safety and Efficacy of Combining Microfocused Ultrasound With Fractional CO2 Laser Resurfacing for Lifting and Tightening the Face and Neck”. Dermatol Surg, Dec. 2014 40:S190-S193.
Zelickson, Brian D. et al., “Histological and Ultrastructural Evaluation of the Effects of a Radiofrequency-Based Nonablative Dermal Remodeling Device, A Pilot Study” Arch Dermatol, vol. 140, (Feb. 2004).
Ulthera, Inc., Petition for Inter Partes Review filed Jul. 19, 2016 in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 63 pages (Filed Jul. 19, 2016).
Ulthera Exhibit 1001, U.S. Pat. No. 6,113,559 to Klopotek, filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1002, Patent file history of U.S. Pat. No. 6,113,559 Klopotek filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1003, Declaration of Expert Witness Mark E. Schafer, Ph.D. filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1004, Curriculum Vitae of Mark E. Schafer, Ph.D. filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1005, International PCT Publication WO96/34568 Knowlton filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1006, French Patent No. 2,672,486, Technomed patent filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1007, English translation of French Patent No. 2,672,486, Technomed filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1008, International PCT Publication WO93/12742, Technomed PCT filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1009, English translation of International PCT Publication WO93/12742, Technomed PCT filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1010, U.S. Pat. No. 5,601,526, which claims priority to Technomed PCT filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1011, Patent file history for European Patent Application No. 98964890.2, Klopotek filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1012, Translator Declaration filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1013, U.S. Pat. No. 5,230,334 to Klopotek filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1014, U.S. Pat. No. 5,755,753 to Knowlton filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1015, Excerpts from The American Medical Association Encyclopedia of Medicine (1989) filed Jul. 19, 2016 in re IPR2016-01459.
Ulthera Exhibit 1016, The Simultaneous Study of Light Emissions and Shock Waves Produced by Cavitation Bubbles, G. Gimenez, J. Acoust. Soc. Am. 71(4), Apr. 1982, pp. 839-847 (filed Jul. 19, 2016 in re IPR2016-01459).
Ulthera Exhibit 1017, Excerpts from Gray's Anatomy (1995) (filed Jul. 19, 2016 in re IPR2016-01459).
Ulthera Exhibit 1018, Anatomy of the Superficial Venous System, Comjen G.M., Dermatol. Surg., 1995; 21:35-45 (filed Jul. 19, 2016 in re IPR2016-01459).
Ulthera Exhibit 1019, Section 2.6 from Ultrasonics Theory and Application, by G.L. Gooberman (Hart Publishing Co., 1969) (filed Jul. 19, 2016 in re IPR2016-01459).
Ulthera Exhibit 1020, Deep Local Hyperthermia for Cancer Therapy: External Electromagnetic and Ultrasound Techniques, A.Y. Cheung and A. Neyzari, Cancer Research (Suppl.), vol. 44, pp. 4736-4744 (1984) (filed Jul. 19, 2016 in re IPR2016-01459).
Decision on Institution of Inter Partes Review in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 20 pages [011] (Dated Jan. 23, 2017).
Dermafocus Response to Institution of Inter Partes Review in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 73 pages [018] (Dated Apr. 26, 2017).
Dermafocus Exhibit List in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 5 pages [019] (Dated Apr. 26, 2017).
Dermafocus Exhibit 2002, Declaration of Mark Palmeri, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 136 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2003, Deposition of Dr. Mark Schafer, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 327 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2004, Amendment No. 4 to Ulthera Form S-1, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 308 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2005, Excerpt from Churchill Livingstone, Gray's Anatomy (38th ed. 1995), in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 7 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2006, Bo Eklof et al., “Revision of the CEAP Classification for Chronic Venous Disorders: Consensus Statement,” ACTA FAC MED NAISS, vol. 25, No. 1 (2008), 3-10 in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 7 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2007, WebMD, “Varicose Veins and Spider Veins” downloaded from http://www.webmd.com/skin-problems-andtreatments/guide/varicose-spider-veins#1 in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 3 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2008, John M. Porter et al, “Reporting Standards in Venous Disease: An Update,” Journal of Vascular Surgery, vol. 21, No. 4 (1995), 635-645 in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 11 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2009, Kullervo Hynynen, “Review of Ultrasound Therapy,” 1997 Ultrasonics Symposium (1997), 1305-1313, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 9 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2010, A.G. Visioli et al, “Preliminary Results of a Phase I Dose Escalation Clinical Trial Using Focused Ultrasound in the Treatment of Localised Tumours,” European Journal of Ultrasound, vol. 9 (1999), 11-18, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 8 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2011, U.S. Pat. No. 5,143,063, issued on Sep. 1, 1992, Fellner, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 6 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2012, Hugh G. Beebe et al, “Consensus Statement: Classification and Grading of Chronic Venous Disease in the Lower Limbs,” European Journal of Vascular and Endovascular Surgery, vol. 12 (1996), 487-492, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 6 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2013, Excerpt from Mosby's Medical Dictionary (3rd ed. 1990), in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 4 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2014, Excerpt from Miller-Keane Encyclopedia & Dictionary of Medicine, Nursing, & Allied Health (5th ed. 1992), in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 6 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2015, David J. Tibbs et al, Varicose Veins, Venous Disorders, and Lymphatic Problems in the Lower Limbs (1997), Chapter 4: Clinical Patterns of Venous Disorder I, 47-67, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 24 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2016, Mitchel P. Goldman et al, Varicose Veins and Telangiectasias (2nd ed. 1999), Chapter 22: Treatment of Leg Telangiectasias with Laser and High-Intensity Pulsed Light, 470-497, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 31 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2017, Email from Anderson to Klopotek dated May 25, 2004, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 1 page (Filed Apr. 26, 2017).
Dermafocus Exhibit 2018, List of Klopotek Patents, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 411 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2019, Declaration of Peter Klopotek Civil Action 15-cv-654-SLR, dated Nov. 2, 2016, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 1 page (Filed Apr. 26, 2017).
Dermafocus Exhibit 2020, “Our Technology,” downloaded from http://jobs.ulthera.com/about on Apr. 10, 2017, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 4 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2021, C. Damianou and K. Hynynen, “Focal Spacing and Near-Field Heating During Pulsed High Temperature Ultrasound Therapy,” Ultrasound in Medicine & Biology, vol. 19, No. 9 (1993), 777-787, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 11 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2022, Excerpt from Mosby's Medical Dictionary (5th ed. 1997), in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 5 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2023, Excerpt from Miller-Keane Encyclopedia & Dictionary of Medicine, Nursing, & Allied Health (6th ed. 1997), in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 7 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2024, Excerpt from Stedman's Concise Medical Dictionary (3 rd ed. 1997), in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 4 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2025, Excerpt from Taber's Cyclopedic Medical Dictionary (18th ed. 1997), in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 9 pages (Filed Apr. 26, 2017).
Dermafocus Exhibit 2026, Bo Eklof et al, “Revision of the CEAP Classification for Chronic Venous Disorders: Consensus Statement,” Journal of Vascular Surgery, vol. 40, No. 6 (2004), 1248-1252.el, in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 6 pages (Filed Apr. 26, 2017).
Ulthera, Inc., Reply in Support of Petition for Inter Partes Review in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 33 pages (Filed Aug. 2, 2017).
Ulthera Exhibit 1022, Use of the Argon and Carbon Dioxide Lasers for Treatment of Superficial Venous Varicosities of the Lower Extremity, D. Apfelberg et al., Lasers in Surgery and Medicine, vol. 4.3, pp. 221-231 (1984) (filed Aug. 2, 2017 in re IPR2016-01459).
Ulthera Exhibit 1023, 532-Nanometer Green Laser Beam Treatment of Superficial Varicosities of the Lower Extremities, T. Smith et al., Lasers in Surgery and Medicine, vol. 8.2, pp. 130-134 (1988) (filed Aug. 2, 2017 in re IPR2016-01459).
Ulthera Exhibit 1024, Deposition Transcript of Dr. Mark Palmeri on Jul. 11, 2017 (filed Aug. 2, 2017 in re IPR2016-01459).
Ulthera Exhibit 1025, Ulthera Oral Proceeding Demonstrative Slides (filed Oct. 2, 2017 in re IPR2016-01459).
Dermafocus Exhibit 2027, DermaFocus Oral Proceeding Demonstrative Slides (filed Oct. 2, 2017 in re IPR2016-01459).
PTAB Record of Oral Hearing held Oct. 4, 2017 in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 67 pages (PTAB Document sent to Ulthera on Nov. 1, 2017).
Final Written Decision of Inter Partes Review in Re U.S. Pat. No. 6,113,559; IPR2016-01459; 37 pages [030] (Entered Jan. 19, 2018).
Ulthera, Inc., Petitioner Notice of Appeal to Federal Circuit 2018-1542 re: IPR2016-01459; 4 pages from [001] (no appendices) (Filed Feb. 9, 2018).
Federal Circuit Order Granting Ulthera Motion to Remand, re: 2018-1542; 4 pages [022] (Dated May 25, 2018).
Ulthera Brief (Corrected), Fed. Cir. Appeal Case 19-1006 from re: IPR2016-01459; 136 pages [030] (Dated Apr. 3, 2019).
DermaFocus Brief (Corrected), Fed. Cir. Appeal Case 19-1006 from re: IPR2016-01459; 73 pages [032] (Dated Apr. 4, 2019).
U.S. Appl. No. 12/996,616, filed, Jan. 12, 2011, Hand Wand for Ultrasonic Cosmetic Treatment and Imaging.
U.S. Appl. No. 16/703,019, filed Dec. 6, 2019, System and Method for Ultrasound Treatment.
U.S. Appl. No. 13/245,822, filed Sep. 26, 2011, System and Method for Cosmetic Treatment.
U.S. Appl. No. 13/245,852, filed Sep. 26, 2011, Systems for Cosmetic Treatment.
U.S. Appl. No. 13/245,864, filed Sep. 27, 2011, Methods for Non-Invasive Cosmetic Treatment of the Eye Region.
U.S. Appl. No. 13/246,117, filed Sep. 27, 2011, Methods for Non-Invasive Lifting and Tightening of the Lower Face and Neck.
U.S. Appl. No. 13/246,112, filed Sep. 27, 2011, Tissue Imaging and Treatment Method.
U.S. Appl. No. 14/193,234, filed Feb. 28, 2014, Devices and Methods for Multi-Focus Ultrasound Therapy.
U.S. Appl. No. 16/541,476, filed Aug. 15, 2019, Devices and Methods for Multi-Focus Ultrasound Therapy.
U.S. Appl. No. 15/302,436, filed Oct. 6, 2016, Band Transducer Ultrasound Therapy.
U.S. Appl. No. 15/855,949, filed Dec. 27, 2017, Band Transducer Ultrasound Therapy.
U.S. Appl. No. 16/797,393, filed Feb. 21, 2020, Band Transducer Ultrasound Therapy.
U.S. Appl. No. 15/562,384, filed Oct. 27, 2017, Systems and Methods for Cosmetic Ultrasound Treatment of Skin.
U.S. Appl. No. 16/069,319, filed Jul. 11, 2018, Compact ultrasound device having annular ultrasound array peripherally electrically connected to flexible printed circuit board and method of assembly thereof.
U.S. Appl. No. 16/964,914, filed Jul. 24, 2020, Systems and Methods for Simultaneous Multi-Focus Ultrasound Therapy in Multiple Dimensions.
U.S. Appl. No. 16/970,772, filed Aug. 18, 2020, Systems and Methods for Combined Cosmetic Treatment of Cellulite With Ultrasound.
U.S. Appl. No. 17/297,145, filed May 26, 2021, Systems and Methods for Enhancing Efficacy of Ultrasound Treatment.
U.S. Appl. No. 08/950,353, filed Oct. 14, 1997, Imaging, Therapy and Temperature Monitoring Ultrasonic System.
U.S. Appl. No. 09/502,174, filed Feb. 10, 2000, Imaging, Therapy and Temperature Monitoring Ultrasonic System.
U.S. Appl. No. 10/193,419, filed Jul. 10, 2002, Imaging, Therapy and Temperature Monitoring Ultrasonic System.
U.S. Appl. No. 10/944,499, filed Sep. 16, 2004, Method and System for Ultrasound Treatment With a Multi-Directional Transducer.
U.S. Appl. No. 11/163,177, filed Oct. 7, 2005, Method and System for Treating Acne and Sebaceous Glands.
U.S. Appl. No. 10/950,112, filed Sep. 24, 2004, Method and System for Combined Ultrasound Treatment.
U.S. Appl. No. 11/163,178, filed Oct. 7, 2005, Method and System for Treating Stretch Marks.
U.S. Appl. No. 11/245,999, filed Oct. 6, 2005, System and Method for Ultra-High Frequency Ultrasound Treatment.
U.S. Appl. No. 10/944,500, filed Sep. 16, 2004, System and Method for Variable Depth Ultrasound Treatment.
U.S. Appl. No. 11/744,655, filed May 4, 2007, Imaging, Therapy and Temperature Monitoring Ultrasonic System.
U.S. Appl. No. 13/937,190, filed Jul. 8, 2013, Imaging, Therapy and Temperature Monitoring Ultrasonic System.
U.S. Appl. No. 12/135,962, filed Jun. 9, 2008, Method and System for Ultrasound Treatment With a Multi-Directional Transducer.
U.S. Appl. No. 12/792,934, filed Jun. 3, 2010, System and Method for Ultra-High Frequency Ultrasound Treatment.
U.S. Appl. No. 13/914,945, filed Jun. 11, 2013, System and Method for Ultra-High Frequency Ultrasound Treatment.
U.S. Appl. No. 12/834,754, filed Jul. 12, 2010, System and Method for Variable Depth Ultrasound Treatment.
U.S. Appl. No. 14/264,732, filed Apr. 29, 2014, System and Method for Variable Depth Ultrasound Treatment.
U.S. Appl. No. 11/126,760, filed May 11, 2005, filed Method and System for Three-Dimensional Scanning and Imaging.
U.S. Appl. No. 13/564,552, filed Aug. 1, 2012, Method and System for Controlled Scanning, Imaging and/or Therapy.
U.S. Appl. No. 12/437,726, filed May 8, 2009, Method and System for Combined Ultrasound Treatment.
U.S. Appl. No. 11/163,148, filed Oct. 6, 2005, Method and System for Controlled Thermal Injury of Human Superficial Tissue.
U.S. Appl. No. 13/444,688, filed Apr. 11, 2012, Customized Cosmetic Treatment.
U.S. Appl. No. 16/427,969, filed May 31, 2019, Customized Cosmetic Treatment.
U.S. Appl. No. 11/163,152, filed Oct. 6, 2005, Method and System for Treatment of Sweat Glands.
U.S. Appl. No. 13/444,485, filed Apr. 11, 2012, Methods for Treatment of Sweat Glands.
U.S. Appl. No. 13/603,159, filed Sep. 4, 2012, Methods for Treatment of Hyperhidrosis.
U.S. Appl. No. 13/603,279, filed Sep. 4, 2012, Energy Based Hyperhidrosis Treatment.
U.S. Appl. No. 13/950,728, filed Jul. 25, 2013, Energy Based Hyperhidrosis Treatment.
U.S. Appl. No. 14/571,835, filed Dec. 16, 2014, Energy Based Hyperhidrosis Treatment.
U.S. Appl. No. 15/243,081, filed Aug. 22, 2016, Energy Based Hyperhidrosis Treatment.
U.S. Appl. No. 16/049,364, filed Jul. 30, 2018, Energy Based Hyperhidrosis Treatment.
U.S. Appl. No. 17/209,808, filed Mar. 23, 2021, Energy Based Skin Gland Treatment.
U.S. Appl. No. 11/163,151, filed Oct. 6, 2005, Method and System for Noninvasive Face Lifts and Deep Tissue Tightening.
U.S. Appl. No. 13/444,336, filed Apr. 11, 2012, Treatment of Sub-Dermal Regions for Cosmetic Effects.
U.S. Appl. No. 13/679,430, filed Nov. 16, 2012, Ultrasound Treatment of Sub-Dermal Tissue for Cosmetic Effects.
U.S. Appl. No. 13/924,376, filed Jun. 21, 2013, Noninvasive Tissue Tightening for Cosmetic Effects.
U.S. Appl. No. 13/924,355, filed Jun. 21, 2013, Noninvasive Aesthetic Treatment for Tightening Tissue.
U.S. Appl. No. 13/924,323, filed Jun. 21, 2013, Energy-Based Tissue Tightening.
U.S. Appl. No. 14/200,852, filed Mar. 7, 2014, Noninvasive Tissue Tightening System.
U.S. Appl. No. 14/200,961, filed Mar. 7, 2014, Energy-Based Tissue Tightening System.
U.S. Appl. No. 16/543,137, filed Aug. 16, 2019, Noninvasive Tissue Tightening System.
U.S. Appl. No. 12/028,636, filed Feb. 8, 2008, Method and System for Noninvasive Face Lifts and Deep Tissue Tightening.
U.S. Appl. No. 13/964,820, filed Aug. 12, 2013, Methods for Noninvasive Skin Tightening.
U.S. Appl. No. 14/201,256, filed Mar. 7, 2014, System for Noninvasive Skin Tightening.
U.S. Appl. No. 15/098,139, filed Apr. 13, 2016, System and Method for Noninvasive Skin Tightening.
U.S. Appl. No. 15/958,939, filed Apr. 20, 2018, System and Method for Noninvasive Skin Tightening.
U.S. Appl. No. 16/698,122, filed Nov. 27, 2019, System and Method for Noninvasive Skin Tightening.
U.S. Appl. No. 17/209,912, filed Mar. 23, 2021, System and Method for Noninvasive Skin Tightening.
U.S. Appl. No. 14/685,390, filed Apr. 13, 2015, Energy-Based Tissue Tightening System.
U.S. Appl. No. 11/163,150, filed Oct. 6, 2005, Method and System for Photoaged Tissue.
U.S. Appl. No. 13/230,498, filed Sep. 12, 2011, Method and System for Photoaged Tissue.
U.S. Appl. No. 14/169,709, filed Jan. 31, 2014, Methods for Treating Skin Laxity.
U.S. Appl. No. 14/692,114, filed Apr. 21, 2015, Systems for Treating Skin Laxity.
U.S. Appl. No. 15/248,407, filed Aug. 25, 2016, Systems for Treating Skin Laxity.
U.S. Appl. No. 15/625,700, filed Jun. 16, 2017, Systems for Treating Skin Laxity.
U.S. Appl. No. 15/821,070, filed Nov. 22, 2017, Ultrasound Probe for Treating Skin Laxity.
U.S. Appl. No. 15/996,255, filed Jun. 1, 2018, Ultrasound Probe for Treating Skin Laxity.
U.S. Appl. No. 16/284,907, filed Feb. 25, 2019, Ultrasound Probe for Treating Skin Laxity.
U.S. Appl. No. 16/797,362, filed Feb. 21, 2020, Ultrasound Probe for Treating Skin Laxity.
U.S. Appl. No. 17/127,721, filed Dec. 18, 2020, Ultrasound Probe for Treating Skin Laxity.
U.S. Appl. No. 11/163,176, filed Oct. 7, 2005, Method and System for Treating Blood Vessel Disorders.
U.S. Appl. No. 13/601,742, filed Aug. 31, 2012, Method and System for Treating Blood Vessel Disorders.
U.S. Appl. No. 12/574,512, filed Oct. 6, 2009, Method and System for Treating Stretch Marks.
U.S. Appl. No. 14/554,668, filed Nov. 26, 2014, Method and System for Treating Stretch Marks.
U.S. Appl. No. 15/260,825, filed Sep. 12, 2016, Method and System for Ultrasound Treatment of Skin.
U.S. Appl. No. 15/625,818, filed Jun. 16, 2017, Method and System for Ultrasound Treatment of Skin.
U.S. Appl. No. 15/829,182, filed Dec. 1, 2017, Ultrasound Probe for Treatment of Skin.
U.S. Appl. No. 15/996,263, filed Jun. 1, 2018, Ultrasound Probe for Treatment of Skin.
U.S. Appl. No. 16/284,920, filed Feb. 25, 2019, Ultrasound Probe for Treatment of Skin.
U.S. Appl. No. 16/797,387, filed Feb. 21, 2020, Ultrasound Probe for Treatment of Skin.
U.S. Appl. No. 11/857,989, filed Sep. 19, 2007, Method and System for Treating Muscle, Tendon, Ligament and Cartilage Tissue.
U.S. Appl. No. 13/494,856, filed Jun. 12, 2012, Method and System for Treating Muscle, Tendon, Ligament and Cartilage Tissue.
U.S. Appl. No. 13/835,635, filed Mar. 15, 2013, Methods for Face and Neck Lifts.
U.S. Appl. No. 13/965,741, filed Aug. 13, 2013, Methods for Preheating Tissue for Cosmetic Treatment of the Face and Body.
U.S. Appl. No. 14/740,092, filed Jun. 15, 2015, Methods for Rejuvenating Skin by Heating Tissue for Cosmetic Treatment of the Face and Body.
U.S. Appl. No. 15/862,400, filed Jan. 4, 2018, Rejuvenating Skin by Heating Tissue for Cosmetic Treatment of the Face and Body.
U.S. Appl. No. 16/409,678, filed May 10, 2019, Rejuvenating Skin by Heating Tissue for Cosmetic Treatment of the Face and Body.
U.S. Appl. No. 17/081,754, filed Oct. 27, 2020, Rejuvenating Skin by Heating Tissue for Cosmetic Treatment of the Face and Body.
U.S. Appl. No. 14/628,198, filed Feb. 20, 2015, System and Method for Treating Cartilage and Injuries to Joints and Connective Tissue.
U.S. Appl. No. 14/554,571, filed Nov. 26, 2014, Methods for Face and Neck Lifts.
U.S. Appl. No. 15/248,454, filed Aug. 26, 2016, Methods for Face and Neck Lifts.
U.S. Appl. No. 16/049,293, filed Jul. 30, 2018, Methods for Face and Neck Lifts.
U.S. Appl. No. 16/697,970, filed Nov. 27, 2019, Methods for Lifting Skin Tissue.
U.S. Appl. No. 12/954,484, filed Nov. 24, 2010, Methods and Systems for Generating Thermal Bubbles for Improved Ultrasound Imaging and Therapy.
U.S. Appl. No. 12/350,383, filed Jan. 8, 2009, Method and System for Treating Acne and Sebaceous Glands.
U.S. Appl. No. 12/116,845, filed May 7, 2008, Method and System for Combined Energy Profile.
U.S. Appl. No. 14/643,749, filed Mar. 10, 2015, Method and System for Combined Energy Profile.
U.S. Appl. No. 08/766,083, filed Dec. 16, 1996, Method and Apparatus for Surface Ultrasound Imaging.
U.S. Appl. No. 09/113,227, filed Jul. 10, 1998, Method and Apparatus for Three Dimensional Ultrasound Imaging.
U.S. Appl. No. 08/944,261, filed Oct. 6, 1997, Wideband Acoustic Transducer.
U.S. Appl. No. 09/434,078, filed Nov. 5, 1999, Method and Apparatus for Three Dimensional Ultrasound Imaging.
U.S. Appl. No. 09/523,890, filed Mar. 13, 2000, Method and Apparatus for Three Dimensional Ultrasound Imaging.
U.S. Appl. No. 09/419,543, filed Oct. 18, 1999, Peripheral Ultrasound Imaging System.
U.S. Appl. No. 09/750,816, filed Dec. 28, 2000, Visual Imaging System for Ultrasonic Probe.
U.S. Appl. No. 10/358,110, filed Feb. 4, 2003, Visual Imaging System for Ultrasonic Probe.
U.S. Appl. No. 11/380,161, filed Apr. 25, 2006, Method and System for Enhancing Computer Peripheral Safety.
U.S. Appl. No. 11/554,272, filed Oct. 30, 2006, Visual Imaging System for Ultrasonic Probe.
U.S. Appl. No. 13/071,298, filed Mar. 24, 2011, Visual Imaging System for Ultrasonic Probe.
U.S. Appl. No. 13/854,936, filed Mar. 25, 2013, Visual Imaging System for Ultrasonic Probe.
U.S. Appl. No. 12/509,254, filed Jul. 24, 2009, Method and System for Enhancing Computer Peripheral Safety.
U.S. Appl. No. 13/453,847, filed Apr. 23, 2012, Method and System for Enhancing Computer Peripheral Safety.
U.S. Appl. No. 11/538,794, filed Oct. 4, 2006, Ultrasound System and Method for Imaging and/or Measuring Displacement of Moving Tissue and Fluid.
U.S. Appl. No. 09/502,175, filed Feb. 10, 2000, Method and Apparatus for Safely Delivering Medicants to a Region of Tissue, Using Imaging, Therapy and Temperature Monitoring.
U.S. Appl. No. 08/943,728, filed Oct. 3, 1997, Method and Apparatus for Safely Delivering Medicants to a Region of Tissue Using Ultrasound.
U.S. Appl. No. 12/415,945, filed Mar. 31, 2009, Method and System for Noninvasive Mastopexy.
U.S. Appl. No. 11/163,155, filed Oct. 6, 2005, Method and System for Noninvasive Mastopexy.
U.S. Appl. No. 11/163,154, filed Oct. 6, 2005, Method and System for Treatment of Cellulite.
U.S. Appl. No. 13/356,405, filed Jan. 23, 2012, Method and System for Treatment of Cellulite.
U.S. Appl. No. 13/789,562, filed Mar. 7, 2013, Method and System for Ultrasound Treatment of Fat.
U.S. Appl. No. 14/164,598, filed Jan. 27, 2013, Method for Fat and Cellulite Reduction.
U.S. Appl. No. 14/550,720, filed Nov. 21, 2014, System and Method for Fat and Cellulite Reduction.
U.S. Appl. No. 15/041,829, filed Feb. 11, 2016, System and Method for Fat and Cellulite Reduction.
U.S. Appl. No. 15/374,918, filed Dec. 9, 2016, System and Method for Fat and Cellulite Reduction.
U.S. Appl. No. 15/650,246, filed Jul. 14, 2017, System and Method for Fat and Cellulite Reduction.
U.S. Appl. No. 15/821,281, filed Nov. 22, 2017, Ultrasound Probe for Fat and Cellulite Reduction.
U.S. Appl. No. 15/996,295, filed Jun. 1, 2018, Ultrasound Probe for Fat and Cellulite Reduction.
U.S. Appl. No. 16/272,453, filed Feb. 11, 2019, Ultrasound Probe for Tissue Treatment.
U.S. Appl. No. 16/794,717, filed Feb. 19, 2020, Ultrasound Probe for Tissue Treatment.
U.S. Appl. No. 17/127,705, filed Dec. 18, 2020, Ultrasound Probe for Tissue Treatment.
U.S. Appl. No. 11/738,682, filed Apr. 23, 2007, Method and System for Non-Ablative Acne Treatment and Prevention.
U.S. Appl. No. 12/116,810, filed May 7, 2008, Methods and Systems for Modulating Medicants Using Acoustic Energy.
U.S. Appl. No. 12/116,828, filed May 7, 2008, Methods and Systems for Coupling and Focusing Acoustic Energy Using a Coupler Member.
U.S. Appl. No. 12/646,609, filed Dec. 23, 2009, Methods and System for Fat Reduction and/or Cellulite Treatment.
U.S. Appl. No. 14/192,520, filed Feb. 27, 2014, Energy Based Fat Reduction.
U.S. Appl. No. 14/550,772, filed Nov. 21, 2014, Energy Based Fat Reduction.
U.S. Appl. No. 15/401,804, filed Feb. 11, 2016, Energy Based Fat Reduction.
U.S. Appl. No. 15/380,267, filed Dec. 15, 2016, Energy Based Fat Reduction.
U.S. Appl. No. 15/650,525, filed Jul. 18, 2017, Energy Based Fat Reduction.
U.S. Appl. No. 15/829,175, filed Dec. 1, 2017, Energy Based Fat Reduction.
U.S. Appl. No. 15/996,249, filed Jun. 1, 2018, Energy Based Fat Reduction.
U.S. Appl. No. 16/272,427, filed Feb. 11, 2019, Energy Based Fat Reduction.
U.S. Appl. No. 16/794,701, filed Feb. 19, 2020, Energy Based Fat Reduction.
U.S. Appl. No. 17/127,691, filed Dec. 18, 2020, Energy Based Fat Reduction.
U.S. Appl. No. 13/291,312, filed Nov. 11, 2011, Devices and Methods for Acoustic Shielding.
U.S. Appl. No. 14/487,504, filed Sep. 16, 2014, Devices and Methods for Acoustic Shielding.
U.S. Appl. No. 13/136,538, filed Aug. 2, 2011, Systems and Methods for Treating Acute and/or Chronic Injuries in Soft Tissue.
U.S. Appl. No. 13/136,542, filed Aug. 2, 2011, System and Method for Treating Cartilage.
U.S. Appl. No. 13/163,541, filed Aug. 2, 2011, Methods and Systems for Treating Plantar Fascia.
U.S. Appl. No. 13/136,544, filed Aug. 2, 2011, Systems and Methods for Ultrasound Treatment.
U.S. Appl. No. 13/547,023, filed Jul. 11, 2012, Systems and Methods for Coupling an Ultrasound Source to Tissue.
U.S. Appl. No. 13/545,931, filed Jul. 10, 2012, Methods and Systems for Controlling Acoustic Energy Deposition Into a Medium.
U.S. Appl. No. 13/545,953, filed Jul. 10, 2012, Systems and Methods for Accelerating Healing of Implanted Material and/or Native Tissue.
U.S. Appl. No. 13/547,011, filed Jul. 11, 2012, Systems and Methods for Monitoring and Controlling Ultrasound Power Output and Stability.
U.S. Appl. No. 13/548,954, filed Jul. 10, 2012, Systems and Methods for Improving an Outside Appearance of Skin Using Ultrasound as an Energy Source.
U.S. Appl. No. 13/545,945, filed Jul. 10, 2012, Systems and Methods for Treating Injuries to Joints and Connective Tissue.
U.S. Appl. No. 13/545,929, filed Jul. 10, 2012, Methods and Systems for Ultrasound Treatment.
U.S. Appl. No. 13/863,249, filed Apr. 15, 2013, Systems for Cosmetic Treatment.
U.S. Appl. No. 14/847,626, filed Apr. 15, 2013, Methods for Non-invasive Cosmetic Treatment.
U.S. Appl. No. 14/847,626, filed Sep. 8, 2015, Systems for Cosmetic Treatment.
U.S. Appl. No. 13/863,362, filed Apr. 15, 2013, Thick Film Transducer Arrays.
U.S. Appl. No. 14/217,110, filed Mar. 17, 2014, Ultrasound Treatment Device and Method of Use.
U.S. Appl. No. 14/217,382, filed Mar. 17, 2014, Ultrasound Treatment Device and Method of Use.
U.S. Appl. No. 14/225,189, filed Mar. 25, 2014, Reflective Ultrasound Technology for Dermatological Treatments.
U.S. Appl. No. 15/345,908, filed Nov. 8, 2016, Reflective Ultrasound Technology for Dermatological Treatments.
U.S. Appl. No. 15/719,377, filed Sep. 28, 2017, Reflective Ultrasound Technology for Dermatological Treatments.
U.S. Appl. No. 14/270,859, filed May 6, 2014, Methods and Systems for Generating Thermal Bubbles for Improved Ultrasound Imaging and Therapy.
U.S. Appl. No. 14/679,494, filed Apr. 6, 2015, Methods and Systems for Generating Thermal Bubbles for Improved Ultrasound Imaging and Therapy.
U.S. Appl. No. 14/405,368, filed Dec. 3, 2014, Devices and Methods for Ultrasound Focal Depth Control.
U.S. Appl. No. 14/568,954, filed Dec. 12, 2014, System and Method for Cosmetic Enhancement of Lips.
U.S. Appl. No. 14/569,001, filed Dec. 12, 2014, System and Method for Non-Invasive Treatment With Improved Efficiency.
U.S. Appl. No. 14/600,782, filed Jan. 20, 2015, Methods and Systems for Controlling and Acoustic Energy Deposition in Various Media.
U.S. Appl. No. 14/738,420, filed Jun. 12, 2015, Systems and Methods for Fast Ultrasound Treatment.
U.S. Appl. No. 14/751,349, filed Jun. 26, 2015, Methods and Systems for Tattoo Removal.
U.S. Appl. No. 15/001,712, filed Jan. 20, 2016, Methods and Systems for Removal of a Targeted Tissue from a Body.
U.S. Appl. No. 15/001,621, filed Jan. 20, 2016, Methods and Systems for Removal of a Foreign Object from Tissue.
U.S. Appl. No. 15/059,773, filed Mar. 3, 2016, Methods and Systems for Material Transport Across an Impermeable or Semi-Permeable Membrane Via Artificially Created Microchannels.
U.S. Appl. No. 15/059,774, filed Apr. 8, 2016, System and Method for Increased Control of Ultrasound Treatments.
Narayanasamy et al., “Spatial registration of temporally separated whole breast 3D ultrasound images” Med Phys. Sep. 2009;36(9):4288-300. doi: 10.1118/1.3193678. PMID: 19810503; PMCID: PMC2749445 (2009).

Related Publications (1)

	Number	Date	Country
	20210378630 A1	Dec 2021	US

Provisional Applications (1)

	Number	Date	Country
	61059477	Jun 2008	US

Continuations (2)

	Number	Date	Country
Parent	16703019	Dec 2019	US
Child	17410780		US
Parent	12996616		US
Child	16703019		US

Systems for ultrasound treatment

Information

Patent Number

Date Filed

Date Issued

Inventors

Original Assignees

Examiners

Agents

CPC

Field of Search

US

International Classifications

Disclaimer

Abstract