Devices and methods for inducing ablation in or around occluded implants

Patent metadata

Field	Value
Publication number	US-11813018-B2
Application number	US-201916717439-A
Country	US
Kind code	B2
Filing date	Dec 17, 2019
Priority date	Dec 18, 2018
Publication date	Nov 14, 2023
Grant date	Nov 14, 2023

Abstract

A bipolar ablation device for treatment of a stenosis within an implanted metallic stent may include an elongate shaft slidably disposable within an endoscope, the elongate shaft including at least one electrode configured to form a first pole of the bipolar ablation device, and an electrode lead slidably disposable within the endoscope. The electrode lead may be configured to electrically engage the implanted metallic stent to form a second pole of the bipolar ablation device. The elongate shaft may be positionable within a lumen of the implanted metallic stent.

First claim

What is claimed is:

1. A bipolar ablation device for treatment of a stenosis within a previously implanted metallic stent, comprising:
an elongate shaft slidably disposable within an endoscope, the elongate shaft including at least one electrode configured to form a first pole of the bipolar ablation device; and
an electrode lead slidably disposable within the endoscope, the electrode lead being detached from the previously implanted metallic stent and configured to be moved into contact with the previously implanted metallic stent in vivo to electrically engage the previously implanted metallic stent to form a second pole of the bipolar ablation device;
wherein the elongate shaft is positionable within a lumen of the previously implanted metallic stent such that the at least one electrode is spaced apart from the previously implanted metallic stent while the electrode lead engages the previously implanted metallic stent;
wherein bipolar ablation energy is generated between the previously implanted metallic stent and the at least one electrode spaced apart radially inward from the previously implanted metallic stent when the bipolar ablation device is energized.

2. The bipolar ablation device of claim 1 , wherein the electrode lead includes an engagement feature configured to releasably contact the electrode lead to the previously implanted metallic stent.

3. The bipolar ablation device of claim 2 , wherein the engagement feature includes a grasping metallic clip.

4. The bipolar ablation device of claim 2 , wherein the engagement feature includes at least one flared metallic element.

5. The bipolar ablation device of claim 2 , wherein the engagement feature includes an expandable metallic cage.

6. The bipolar ablation device of claim 2 , wherein the engagement feature includes a magnetic coupler.

7. The bipolar ablation device of claim 2 , wherein the engagement feature includes at least one electrode element disposed on an outer surface of an inflatable balloon.

8. The bipolar ablation device of claim 1 , further comprising an energy source in electrical communication with the at least one electrode and the electrode lead.

9. The bipolar ablation device of claim 1 , wherein the at least one electrode, when positioned within the previously implanted metallic stent, is configured for directional ablation of the stenosis.

10. The system of claim 1 , wherein the electrode lead is independently moveable relative to the elongate shaft.

11. The bipolar ablation device of claim 1 , wherein the at least one electrode comprises a plurality of discrete electrodes.

12. A metallic stent for maintaining patency of a body lumen, comprising:
a first electrode wire configured to form a first pole of a bipolar ablation device;
a second electrode wire spaced apart from the first electrode wire, the second electrode wire being configured to form a second pole of the bipolar ablation device; and
at least one non-conductive filament interwoven with the first electrode wire and the second electrode wire;
wherein the first electrode wire extends helically around a central longitudinal axis of the metallic stent in a first direction;
wherein the second electrode wire extends helically around the central longitudinal axis of the metallic stent in the first direction parallel to the first electrode wire;
wherein the first and second electrode wires are spaced apart from one another along an entire length of the metallic stent.

13. The metallic stent of claim 12 , wherein the at least one non-conductive filament extends helically around the central longitudinal axis of the metallic stent in a second direction opposite the first direction.

14. The metallic stent of claim 12 , wherein the first electrode wire and the second electrode wire are electrically connectable to an energy source configured to supply bipolar ablation energy.

15. A method of treating a stenosis within a previously implanted metallic stent, comprising:
advancing an endoscope to a position adjacent the previously implanted metallic stent;
advancing an elongate shaft from the endoscope and into a lumen of the previously implanted metallic stent such that the elongate shaft is spaced apart from the previously implanted metallic stent, the elongate shaft including at least one electrode configured to form a first pole of a bipolar ablation device;
separately advancing an electrode lead that is spaced apart from the elongate shaft from the endoscope and into electrical contact with the previously implanted metallic stent such that the previously implanted metallic stent forms a second pole of the bipolar ablation device; and
energizing the bipolar ablation device with the electrode lead in electrical contact with the previously implant metallic stent and the at least one electrode disposed within the lumen of the previously implanted metallic stent and spaced apart radially inward from the previously implanted metallic stent to ablate the stenosis.

16. The method of claim 15 , wherein energizing the bipolar ablation device directs ablation energy within the lumen of the previously implanted metallic stent.

17. The method of claim 15 , further comprising:
connecting the at least one electrode and the electrode lead to an energy source.

18. The method of claim 15 , wherein energizing the bipolar ablation device provides omnidirectional ablation energy between the at least one electrode and the previously implanted metallic stent.

19. The method of claim 15 , wherein the stenosis includes non-concentric tissue ingrowth and the at least one electrode is configured to direct ablation energy toward the non-concentric tissue ingrowth.

Assignees

• Boston Scient Scimed Inc

Inventors

• Favreau John T
• Henchie Travis
• Tarabein Karim

Classifications

• A61B18/1492 Primary

  having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence) · CPC title

• A61B2017/00336

  with a protective sleeve, e.g. retractable or slidable · CPC title

• A61B2017/00867

  shape memory effect · CPC title

• A61B2018/00404

  Blood vessels other than those in or around the heart · CPC title

• A61B2018/00488

  Esophagus · CPC title