Tissue heating device and rf heating method with tissue attachment feature

Abstract

A tissue heating instrument includes a device with a window at its distal end for admitting tissue against or into a compartment within the device. A cylindrical cartridge in the compartment includes a heating surface that supports an electrically conductive heating element, e.g. a band or wire. The tissue adjacent to the heating element can be heated to a selected temperature by generating an electrical current through the heating element. The device is maneuverable to position its distal end near the tissue to be treated. The device also incorporates a vacuum feature that urges tissue into the compartment prior to heating and assists in holding the tissue during the heating process. The device incorporates a dilatation balloon or other feature to urge the device against the tissue, so that at least part of the tissue may come in contact with, or enter the compartment through the window. Then, the cartridge is manipulated from the device's proximal end to move the heating element across the window, heating the adjacent tissue. According to alternative embodiments, the cartridge is either rotated or moved axially relative to the device and, in either event may be capable of closing the device window when the heating is complete. An additional feature of the device includes fluid (therapeutic or other) infusion before, during or after heating the targeted tissue.

69 . A device for heating tissue comprising: 
 an elongate catheter having a proximal end and a distal end, a catheter wall defining a compartment within the catheter, a window through the catheter wall open to the compartment, and at least one lumen passing between a first opening in the proximal end and a second opening in the compartment, the first opening being connected to a vacuum source;    a cartridge at least partially disposed within the compartment, the cartridge having a surface with a heating element disposed along the cartridge, and an energy source operatively coupled to the heating element, the cartridge being operable to urge tissue into the compartment when the first opening is connected to the vacuum source; and    a controller coupled to the cartridge and operable to selectively position and move the cartridge relative to the catheter and thereby provide a controlled movement of the heating surface along the window.    
   
   
       70 . The device of  claim 69  wherein the second opening is either distal to the window in the catheter wall or proximal to the window in the catheter wall.  
   
   
       71 . The device of  claim 69  wherein the second opening is positioned to be open to the compartment.  
   
   
       72 . The device of  claim 69  wherein a drive tube couples the controller to the cartridge.  
   
   
       73 . The device of  claim 72  wherein the drive tube includes a lumen having an opening in the compartment and the lumen is configured to be connected to the vacuum source.  
   
   
       74 . The device of  claim 72  wherein the drive tube is positioned in the lumen.  
   
   
       75 . The device of  claim 69  wherein the catheter is maneuverable to locate the window against a tissue wall segment and the heating element is configured to heat tissue when vacuum is applied to the window.  
   
   
       76 . The device of  claim 75  wherein the application of vacuum from the vacuum source to the window when the window is located against the tissue wall segment causes the application of vacuum to at least the tissue wall segment.  
   
   
       77 . The device of  claim 69  further comprising a second lumen passing between a first opening in the proximal end and a second opening in the distal end.  
   
   
       78 . The device of  claim 77  further comprising a fluid source connected to the first opening of the second lumen.  
   
   
       79 . The device of  claim 78  wherein the fluid source comprises one or both of a therapeutic agent and a contrast agent.  
   
   
       80 . The device of  claim 69  wherein the heating element is configured to heat tissue adjacent to the heating element.  
   
   
       81 . The device of  claim 69  further including a temperature sensing means for detecting the temperature of the heating element.  
   
   
       82 . The device of  claim 69  wherein the cartridge is moveable axially relative to the catheter to provide the controlled movement of the heating element.  
   
   
       83 . The device of  claim 69  wherein the cartridge is rotatable relative to the catheter to provide the controlled movement of the heating element.  
   
   
       84 . A tissue heating system comprising: 
 a tissue heating device comprising:    an elongate catheter having a proximal end and a distal end, a catheter wall defining a compartment within the catheter, a window through the catheter wall open to the compartment, a first lumen passing between a first opening in the proximal end and a first opening in the compartment, and a second lumen passing between a second opening in the proximal end and a second opening in the compartment,    a cartridge at least partially disposed within the compartment, the cartridge having a heating surface with a heating element disposed along the cartridge, and an energy source operatively coupled to the heating element, and    a controller coupled to the cartridge and operable to selectively position and move the cartridge relative to the catheter and thereby provide a controlled movement of the heating element along the window, wherein the catheter is maneuverable to locate the window against a tissue wall segment;    a vacuum source connectable to the first lumen; and    a fluid source connectable to the second lumen, wherein the cartridge is operable to urge tissue into the compartment when the first lumen is connected to the vacuum source.    
   
   
       85 . The tissue heating system of  claim 84  wherein the heating element is configured to heat tissue adjacent the heating element.  
   
   
       86 . A method of heating tissue, the method comprising: 
 providing a tissue heating device comprising:    an elongate catheter having a proximal end and a distal end, a catheter wall defining a compartment within the catheter, a window through the catheter wall open to the compartment, and a first lumen passing between a first opening in the proximal end and a first opening in the compartment,    a cartridge at least partially disposed within the compartment, the cartridge having a heating surface with a heating element disposed along the cartridge surface, and an energy source operatively coupled to the heating element, and    a controller coupled to the cartridge and operable to selectively position and move the cartridge relative to the catheter and thereby provide a controlled movement of the heating surface along the window, a drive tube coupling the controller to the cartridge, the drive tube including a second lumen having an opening in the compartment and being configured to be connected to a vacuum source, wherein the catheter is maneuverable to locate the window against a tissue wall segment;    connecting a vacuum source to one of the first lumen and the second lumen;    applying a vacuum to the tissue heating device, wherein the cartridge is operable to urge tissue into the compartment when one of the first lumen and the second lumen is connected to the vacuum source;    connecting a fluid source to the other of the first lumen and the second lumen; and    applying a fluid to the tissue heating device to supply the fluid to the tissue.    
   
   
       87 . The method of heating tissue of  claim 86  wherein the fluid comprises one or more of a treatment agent, a contrast agent, and a therapeutic agent  
   
   
       88 . The method of  claim 86  further comprising heating tissue adjacent the heating element.