Devices and methods for inducing ablation in or around occluded implants

Patent metadata

Field	Value
Publication number	US-12137970-B2
Application number	US-202318481996-A
Country	US
Kind code	B2
Filing date	Oct 5, 2023
Priority date	Dec 18, 2018
Publication date	Nov 12, 2024
Grant date	Nov 12, 2024

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 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, wherein an exposed metallic distal portion of the elongate shaft forms 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
ablating the stenosis by energizing the bipolar ablation device with the electrode lead in electrical contact with the previously implanted 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.

2. The method 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 method of claim 2 , wherein the engagement feature includes a grasping metallic clip.

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

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

6. The method of claim 2 , wherein the engagement feature includes a magnetic coupler.

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

8. The method of claim 1 , wherein the elongate shaft includes an insulator disposed over at least a portion of the elongate shaft proximal of the exposed metallic distal portion.

9. The method of claim 1 , wherein energizing the bipolar ablation device provides omnidirectional ablation energy between the at least one electrode and the previously implanted metallic stent.

10. The method of claim 9 , wherein the at least one electrode extends about an entire circumference of the elongate shaft.

11. The method of claim 1 , wherein energizing the bipolar ablation device provides non-omnidirectional ablation energy between the at least one electrode and the previously implanted metallic stent.

12. The method of claim 11 , wherein the at least one electrode extends about only a portion of a circumference of the elongate shaft.

13. 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 exposed metallic distal portion of an elongate shaft from the endoscope and into a lumen of the previously implanted metallic stent such that the exposed metallic distal portion is spaced apart from the previously implanted metallic stent, wherein the exposed metallic distal portion forms a first pole of a bipolar ablation device, wherein a length of the exposed metallic distal portion is equal to or greater than 25% of a length of the previously implanted metallic stent;
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
ablating the stenosis by energizing the bipolar ablation device with the electrode lead in electrical contact with the previously implanted metallic stent and the exposed metallic distal portion disposed within the lumen of the previously implanted metallic stent and spaced apart radially inward from the previously implanted metallic stent.

14. The method of claim 13 , wherein the length of the exposed metallic distal portion is equal to or greater than 50% of the length of the previously implanted metallic stent.

15. The method of claim 13 , wherein the exposed metallic distal portion extends around only a portion of a circumference of the elongate shaft.

16. The method of claim 15 , wherein energizing the bipolar ablation device with the electrode lead in electrical contact with the previously implanted metallic stent and the exposed metallic distal portion disposed within the lumen of the previously implanted metallic stent and spaced apart radially inward from the previously implanted metallic stent provides directional ablation of the stenosis within the previously implanted metallic stent.

17. The method of claim 13 , wherein the exposed metallic distal portion extends completely around a circumference of the elongate shaft.

18. The method of claim 17 , wherein energizing the bipolar ablation device with the electrode lead in electrical contact with the previously implanted metallic stent and the exposed metallic distal portion disposed within the lumen of the previously implanted metallic stent and spaced apart radially inward from the previously implanted metallic stent provides onmidirectional ablation of the stenosis within the previously implanted metallic stent.

19. The method of claim 13 , wherein the electrode lead includes an engagement feature configured to releasably contact the electrode lead to the previously implanted metallic stent.

20. The method of claim 19 , wherein advancing the electrode lead that is spaced apart from the elongate shaft from the endoscope and into electrical contact with the previously implanted metallic stent includes releasably engaging the engagement feature with the previously implanted metallic stent.

Assignees

• Boston Scient Scimed Inc

Inventors

• Favreau John T
• Henchie Travis
• Tarabein Karim

Classifications

• A61B2018/144

  Wire · CPC title

• A61B2018/126

  bipolar · CPC title

• A61B2018/00613

  Irreversible electroporation · CPC title

• A61B2018/00577

  Ablation · CPC title

• A61B2018/00535

  Biliary tract · CPC title