Device and method for generating forward directed shock waves
Described herein is a shock wave device for the treatment of vascular occlusions. The shock wave device includes an outer covering and an inner member inner connected at a distal end of the device. First and second conductive wires extend along the length of the device within the volume between the outer covering and the inner member. A conductive emitter band circumscribes the ends of the first and second wires to form a first spark gap between the end of the first wire and the emitter band and a second spark gap between the end of the second wire and the emitter band. When the volume is filled with conductive fluid and a high voltage pulse is applied across the first and second wires, first and second shock waves can be initiated from the first and second spark gaps.
1. A shock wave device, comprising:
an outer covering;
an inner member, wherein the outer covering and the inner member are connected at a distal end of the device, and wherein a volume between the outer covering and the inner member is fillable with a conductive fluid;
a first conductive wire and a second conductive wire extending along a length of the device within the volume between the outer covering and the inner member and ending proximate to the distal end of the device, wherein lengths of the first and second conductive wires are insulated and wherein there is an uninsulated portion on each of the first and second conductive wires at a distal end face thereof; and
an electrically conductive emitter band circumscribing distal ends of the first and second conductive wires and forming a first spark gap between the distal end face of the first conductive wire and the electrically conductive emitter band and a second spark gap between the distal end face of the second conductive wire and the electrically conductive emitter band, with a distal end of the electrically conductive emitter band extending distally beyond the distal ends of the first and second conductive wires, wherein when the volume is filled with the conductive fluid and a high voltage pulse is applied across the first and second conductive wires, first and second shock waves will be initiated from the first and second spark gaps.
2. The device of claim 1 , further comprising:
an insulating sheath circumscribing the inner member in a region proximate to the distal ends of the first and second conductive wires.
3. The device of claim 1 , wherein the outer covering comprises an angioplasty balloon.
4. The device of claim 1 , wherein the electrically conductive emitter band is a cylindrical tube.
5. The device of claim 1 , further comprising:
a fluid pump connected to a proximal end of the device configured to provide the conductive fluid to the volume between the outer covering and the inner member; and
a fluid return line having an inlet proximate to the distal end of the device and configured to remove the conductive fluid from the volume between the outer covering and the inner member,
wherein the fluid pump and the fluid return line are configured to circulate the conductive fluid under pressure within the volume between the outer covering and the inner member.
6. The device of claim 5 , further comprising:
a pressure relief valve at an outlet of the fluid return line.
7. The device of claim 1 , wherein the conductive fluid comprises saline or a combination of saline and a contrasting agent.
8. The device of claim 1 , further comprising:
one or more secondary electrically conductive emitter bands disposed at a medial location of the device and configured to initiate third shock waves from the medial location.
9. The device claim 1 , wherein the inner member includes a guide wire lumen.
10. A shock wave device, comprising
an outer covering;
an inner member, wherein the outer covering and the inner member are connected at a distal end of the device, and wherein a volume between the outer covering and the inner member is fillable with a conductive fluid;
a first conductive wire and a second conductive wire extending along a length of the device within the volume between the outer covering and the inner member and ending proximate to the distal end of the device, wherein lengths of the first and second conductive wires are insulated and wherein there is an uninsulated portion on each of the first and second conductive wires at a distal end face thereof; and
an electrically conductive emitter band circumscribing distal ends of the first and second conductive wires and forming a first spark gap between the distal end face of the first conductive wire and the electrically conductive emitter band and a second spark gap between the distal end face of the second conductive wire and the electrically conductive emitter band, wherein when the volume is filled with the conductive fluid and a first high voltage pulse is applied across the first and second conductive wires, first and second shock waves will be initiated from the first and second spark gaps, and further including:
a third conductive wire and a fourth conductive wire extending along the length of the device within the volume between the outer covering and the inner member and ending proximate to the distal end of the device, wherein lengths of the third and fourth conductive wires are insulated and wherein there is an uninsulated portion on each of the third and fourth conductive wires at a distal end face thereof; and
wherein the electrically conductive emitter band circumscribes distal ends of the third and fourth conductive wires and forms a third spark gap between the distal end face of the third conductive wire and the electrically conductive emitter band and a fourth spark gap between the distal end face of the fourth conductive wire and the electrically conductive emitter band, wherein when the volume is filled with the conductive fluid and a second high voltage pulse is applied across the third and fourth conductive wires, third and fourth shock waves will be initiated from the third and fourth spark gaps.
11. A method for treating vascular plaques, comprising:
introducing a shock wave device into a patient's vasculature, the shock wave device comprising:
an outer covering;
an inner member, wherein the outer covering and the inner member are connected at a distal end of the device, and wherein a volume between the outer covering and the inner member is filled with a conductive fluid;
a first conductive wire and a second conductive wire extending along a length of the device within the volume between the outer covering and the inner member and ending proximate to the distal end of the device, wherein lengths of the first and second conductive wires are insulated and wherein there is an uninsulated portion on each of the first and second conductive wires at a distal end face thereof;
an electrically conductive emitter band circumscribing distal ends of the first and second conductive wires and forming a first spark gap between the distal end face of the first conductive wire and the electrically conductive emitter band and a second spark gap between the distal end face of the second conductive wire and the electrically conductive emitter band, with a distal end of the electrically conductive emitter band extending distally beyond the distal ends of the first and second conductive wires;
advancing the shock wave device within the vasculature such that the distal end of the shock wave device faces a first treatment region; and
applying a high voltage pulse across the first and second conductive wires to initiate first and second shock waves from the first and second spark gaps.
12. The method of claim 11 , wherein the outer covering comprises an angioplasty balloon and the method further comprises:
after the applying step, advancing the shock wave device further within the vasculature such that the angioplasty balloon is aligned with the first treatment region; and
inflating the angioplasty balloon.
13. The method of claim 11 , wherein the outer covering comprises an angioplasty balloon, the method further comprising:
after the applying step, advancing the shock wave device further within the vasculature such that the angioplasty balloon is aligned with a second treatment region; and
inflating the angioplasty balloon.
14. The method of claim 11 , wherein the shock wave device further comprises one or more secondary electrically conductive emitter bands disposed at a medial location of the device, the method further comprising:
after the applying step, advancing the shock wave device further within the vasculature such that the one or more secondary electrically conductive emitter bands is aligned with the first treatment region; and
initiating third shock waves from the one or more secondary electrically conductive emitter bands.
15. The method of claim 11 , wherein the shock wave device further comprises one or more secondary electrically conductive emitter bands disposed at a medial location of the device, the method further comprising:
after the applying step, advancing the shock wave device further within the vasculature such that the one or more secondary electrically conductive emitter bands is aligned with a second treatment region; and
initiating third shock waves from the one or more secondary electrically conductive emitter bands.
16. The method of claim 11 , wherein the vasculature is a blood vessel of a patient's vascular system or a ureter of a patient's urinary system.
17. The method of claim 11 , wherein the first treatment region includes a chronic total occlusion (CTO), circumferential calcium, or a kidney stone.