Method of treating a hollow anatomical structure with a thermal catheter
A working end of a catheter includes at least one therapeutic element, such as a resistive heating element, usable to deliver energy for ligating, or reducing the diameter of, a hollow anatomical structure. In certain examples, the catheter includes a lumen to accommodate a guide wire or to allow fluid delivery. In certain embodiments, a balloon is inflated to place resistive element(s) into apposition with a hollow anatomical structure and to occlude the structure. Indexing devices and methods are also disclosed for successively treating portions of the hollow anatomical structure. In certain examples, marks along the catheter shaft provide visual verification to the physician of the relative position of the therapeutic element of the catheter. Embodiments of indexing devices may include pairs of rings and/or hinged arms that move a catheter a desired indexed position between successive treatments.
1 . A method of treating a hollow anatomical structure, said method comprising:
inserting an electrically driven heating element into said hollow anatomical structure, said heating element extending distally along a longitudinal axis of said element, said heating element having a length and a width measured orthogonal to said longitudinal axis, said length being greater than said width;
powering said heating element and thereby causing said heating element to reach or exceed a minimal treatment temperature;
moving said heating element within said hollow anatomical structure along a lengthwise direction of said hollow anatomical structure, and
maintaining said heating element at or above said minimal treatment temperature while moving said heating element along said lengthwise direction.
2 . A method of treating a hollow anatomical structure in accordance with claim 1 , wherein said moving comprises moving said heating element without stopping along a treatment length of said hollow anatomical structure, said treatment length being greater than said heating element length.
3 . A method of treating a hollow anatomical structure in accordance with claim 1 , further comprising temporarily stopping or slowing movement of said heating element when a temperature of said heating element deviates from a target treatment temperature by more than 3 degrees Celsius.
4 . A method of treating a hollow anatomical structure in accordance with claim 1 , wherein said minimal treatment temperature is an internal temperature of said heating element.
5 . A method of treating a hollow anatomical structure in accordance with claim 1 , wherein said minimal treatment temperature is a temperature measured at or adjacent to said heating element.
6 . A method of treating a hollow anatomical structure in accordance with claim 1 , wherein said minimal treatment temperature is sufficient to cause durable reduction of the diameter of said hollow anatomical structure.
7 . A method of treating a hollow anatomical structure in accordance with claim 1 , wherein said minimal treatment temperature is sufficient to cause absence of patency of said hollow anatomical structure.
8 . A method of treating a hollow anatomical structure in accordance with claim 1 , further comprising initiating movement of said heating element after an initial delay after said minimal treatment temperature is reached.
9 . A method of treating a hollow anatomical structure in accordance with claim 1 , wherein said minimal treatment temperature is within a range of 80-140 degrees Celsius.
10 . A method of treating a hollow anatomical structure in accordance with claim 1 , wherein said minimal treatment temperature is approximately 120 degrees Celsius.
11 . A method of treating a hollow anatomical structure in accordance with claim 1 , wherein said minimal treatment temperature is approximately 95 degrees Celsius.
12 . A method of treating a hollow anatomical structure in accordance with claim 1 , wherein said heating element is coupled to a shaft of a catheter.
13 . A method of treating a hollow anatomical structure in accordance with claim 12 , further comprising delivering heated fluid from a tip of said catheter while moving said heating element.
14 . A method of treating a hollow anatomical structure in accordance with claim 13 , further comprising passing said fluid through a lumen of said catheter and heating said fluid with said heating element as said fluid passes through said lumen before said fluid exits said catheter tip.
15 . A method of treating a hollow anatomical structure in accordance with claim 1 , wherein said length of said heating element is at least equal to fifteen times said width thereof.
16 . A method of treating a hollow anatomical structure in accordance with claim 1 , wherein said heating element is a coil having a variable pitch.
17 . A method of treating a hollow anatomical structure in accordance with claim 12 , wherein said heating element extends to a distal end of said catheter.
18 . A method of treating a hollow anatomical structure in accordance with claim 12 , further comprising applying laser light to said hollow anatomical structure with said catheter.
19 . A method of treating a hollow anatomical structure, said method comprising:
inserting an electrically driven heating element into said hollow anatomical structure, said heating element extending distally along a longitudinal axis of said element, said heating element having a length and a width measured orthogonal to said longitudinal axis, said length being greater than said width;
moving said heating element within said hollow anatomical structure along a lengthwise direction of said hollow anatomical structure while applying electrical power to said heating element within a treatment power level range, and
applying power to said heating element within said treatment power level range while moving said heating element along said lengthwise direction.
20 . A method of treating a hollow anatomical structure in accordance with claim 19 , wherein said moving comprises moving said heating element without stopping along a treatment length of said hollow anatomical structure, said treatment length being greater than said heating element length.
21 . A method of treating a hollow anatomical structure in accordance with claim 19 , wherein said treatment power level range is 20-40W.
22 . A method of treating a hollow anatomical structure in accordance with claim 19 , wherein said heating element is coupled to a shaft of a catheter.
23 . A method of treating a hollow anatomical structure in accordance with claim 22 , further comprising delivering heated fluid from a tip of said catheter while moving said heating element.
24 . A method of treating a hollow anatomical structure in accordance with claim 23 , further comprising passing said fluid through a lumen of said catheter and heating said fluid with said heating element as said fluid passes through said lumen before said fluid exits said catheter tip.
25 . A method of treating a hollow anatomical structure in accordance with claim 19 , wherein said length of said heating element is at least equal to fifteen times said width thereof.
26 . A method of treating a hollow anatomical structure in accordance with claim 19 , wherein said heating element is a coil having a variable pitch.
27 . A method of treating a hollow anatomical structure in accordance with claim 22 , wherein said heating element extends to a distal end of said catheter.
28 . A method of treating a hollow anatomical structure in accordance with claim 22 , further comprising applying laser light to said hollow anatomical structure with said catheter.
29 . A method of treating a hollow anatomical structure, said method comprising:
inserting an electrically driven heating element into said hollow anatomical structure, said heating element extending distally along a longitudinal axis of said element, said heating element having a fixed profile in a plane orthogonal to a longitudinal axis thereof;
powering said heating element and thereby causing said heating element to reach or exceed a minimal treatment temperature;
moving said heating element within said hollow anatomical structure along a lengthwise direction of said hollow anatomical structure, and
maintaining said heating element at or above said minimal treatment temperature while moving said heating element along said lengthwise direction.
30 . A method of treating a hollow anatomical structure in accordance with claim 29 , wherein said moving comprises moving said heating element without stopping along a treatment length of said hollow anatomical structure, said treatment length being greater than a length of said heating element.
31 . A method of treating a hollow anatomical structure in accordance with claim 29 , wherein said minimal treatment temperature is sufficient to cause durable reduction of the diameter of said hollow anatomical structure.
32 . A method of treating a hollow anatomical structure in accordance with claim 29 , wherein said minimal treatment temperature is sufficient to cause absence of patency of said hollow anatomical structure.
33 . A method of treating a hollow anatomical structure in accordance with claim 29 , wherein said heating element is coupled to a shaft of a catheter.
34 . A method of treating a hollow anatomical structure in accordance with claim 33 , further comprising delivering heated fluid from a tip of said catheter while moving said heating element.
35 . A method of treating a hollow anatomical structure in accordance with claim 34 , further comprising passing said fluid through a lumen of said catheter and heating said fluid with said heating element as said fluid passes through said lumen before said fluid exits said catheter tip.
36 . A method of treating a hollow anatomical structure in accordance with claim 33 , further comprising applying laser light to said hollow anatomical structure with said catheter.