Devices and methods for ablation of tissue
Devices and methods for the treatment of heart conditions, hypertension, and other medical disorders are described. For example, this document describes devices and methods for treating atrial fibrillation by performing thoracic vein ablation procedures, including pulmonary vein myocardium ablation. In some embodiments, the ablation is performed in coordination with the delivery a pharmacological agent that can abate the formation of tissue stenosis or neointimal hyperplasia caused by the ablation. Additionally, in some embodiments, particulate matter, such as thrombus or crystalline drug compounds, created during the ablation is captured and removed from the patient using devices and methods provided herein. Further, devices and methods for non-thermal methods of causing cell death, such as tissue suction and tissue stretching, are also described.
1. A method for treating a tissue of a patient, said method comprising:
inserting a catheter-based system into said patient, said system comprising:
an ablation catheter device comprising an expandable member including one or more electrodes; and
a catheter defining a lumen, the ablation catheter device being slidably disposed within the lumen, the catheter including an expandable distal end portion that has a conical or frustoconical shape when expanded;
deploying said ablation catheter device near said tissue by inserting the expandable member into a vein or artery and then expanding the expandable member therein;
expanding said expandable distal end portion into the conical or frustoconical shape;
deploying said expanded expandable distal end portion by pressing the conical or frustoconical shape against a tissue wall surrounding an ostium of the vein or artery to enclose a space adjacent the ostium;
supplying ablation energy from the one or more electrodes of the expandable member to the tissue; and
suctioning said space via said catheter.
2. The method of claim 1 , wherein the vein or artery is a pulmonary vein.
3. The method of claim 1 , wherein the vein or artery is a renal artery.
4. The method of claim 1 , further comprising, after said suctioning, irrigating said space with an irrigant supplied via said catheter.
5. The method of claim 4 , further comprising, after said irrigating, suctioning said space via said catheter.
6. The method of claim 1 , wherein the expandable member comprises a balloon member made of a porous or microporous material.
7. The method of claim 6 , further comprising transmitting a liquid pharmacological agent through the porous or microporous material and to the tissue.
8. The method of claim 7 , wherein the transmitting the liquid pharmacological agent to the tissue is performed simultaneously with the supplying the ablation energy to the tissue.
9. The method of claim 1 , wherein the expandable member comprises one or more spikes or spindles on an outer surface of the expandable member.
10. The method of claim 9 , wherein the expanding the expandable member results in the one or more spikes or spindles being positioned adjacent the tissue.
11. The method of claim 1 , wherein the expandable member comprises a balloon member that comprises a bulbous proximal balloon portion and a generally cylindrical portion extending distally from the bulbous proximal balloon portion.
12. The method of claim 11 , wherein the deploying said ablation catheter device comprises inserting the generally cylindrical portion into the vein or artery while the bulbous proximal balloon portion remains outside of the vein or artery.
13. The method of claim 1 , wherein the expandable distal end portion comprises one or more return electrodes.
14. The method of claim 13 , wherein the one or more return electrodes of the expandable distal end portion receive the ablation energy supplied from the one or more electrodes of the expandable member and passed through the tissue.
15. The method of claim 1 , wherein the suctioning said space takes place during the supplying ablation energy and prior to contraction of the expandable member.
16. The method of claim 1 , wherein the expandable distal end portion comprises ePTFE material.
17. The method of claim 16 , wherein the expandable distal end portion comprises a framework or mesh of Nitinol material.
18. The method of claim 16 , wherein the expandable distal end portion acts as a filter device to provide embolic protection.