• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
  • 引用文献
  • 法律状态
  • 优先权
    • 专利摘要:
    system for combined ablation and ultrasound image of the associated tissue, method for assessing a risk of imminent tissue damage due to a rapid release of a bubble energy, use of a system for combined ablation and ultrasound image of the associated tissue and product computer program being adapted to a computer system. the present invention relates to a system (100) for combined ablation and ultrasound imaging of the associated tissue (40), which is particularly useful for use in an ablation process. the system comprises an interventional device (20) with an ultrasound transducer and an ablation unit. during the ablation process, the interventional device (20) can be applied to both the ablation and the image of the tissue (40) subjected to the ablation. a control unit (ctrl) is additionally understood within the system, and arranged to calculate a predictive value based on one or more signals from the ultrasound transducer, where the predictive value refers to a risk of imminent tissue damage due to a quick release of bubble energy. according to a specific realization, a primary signal is sent if the predictive value exceeds a limit value, so that appropriate measures can be taken.
    公开号:BR112012019262A2
    申请号:R112012019262-0
    申请日:2011-02-03
    公开日:2021-03-09
    发明作者:Godefridus Antonius Harks；Szabolcs Deladi；Jan Frederik Suijver；Maya Ella Barley；Edwin Gerardus Johannus Maria Bongers
    申请人:Koninklijke Philips Electronics N.V.；
    IPC主号:
    专利说明:

    SYSTEM FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE, METHOD FOR ASSESSING A RISK
    OF AN IMPENDING TISSUE DAMAGE DUE TO A QUICK RELEASE FROM A BUBBLE ENERGY, USE OF A SYSTEM FOR COMBINED ABLATION 5 AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE AND PRODUCT OF COMPUTER PROGRAM BEING ADAPTED TO A SYSTEM OF COMPUTER
    FIELD OF INVENTION The present invention relates to the field of 10 interventional devices and control units, and more specifically to a system and method for combined ablation and ultrasound imaging.
    BACKGROUND OF THE INVENTION Ablation, like ablation using a catheter, is a minimally invasive procedure. In this procedure, the cardiac tissue is locally affected in order to block unwanted conduction pathways. This can be achieved through hyperthermia using, for example, radio frequency (RF) as an energy source. After the administration of energy, a lesion 20 begins to grow through the depth of the tissue wall, which becomes a non-conductive scar tissue. Electro physiologists aim to create lesions that pass completely through the tissue wall (ie, transmural) and are permanent (ie, coagulated tissue, recovery is not possible). Tissue ablation is not without risk. One or more bubbles can form in the tissue during ablation, and rapid release of the bubble's energy can be induced. If the tissue temperature rises rapidly, intramural evaporation can occur and a gas bubble can develop inside the tissue under the electrode. Continuous application of RF energy will cause the bubble to expand and its pressure to increase which can lead to the gas bubble erupting through the weakest pathway, leaving a hole.
    The release of the gas bubble is associated with a popping sound and, possibly, with the rupture of cardiac tissue.
    In the following, such rapid release of bubble 5 energy is referred to as a so-called "burst" or "burst of tissue". This is associated with serious complications, such as plugging in the case of cardiac ablation, and clinicians try to prevent the formation of such bursts.
    The reference “Detection of microbubble formation 10 during radiofrequency ablation using phonocardiography ', published in Europace (2006), 8, 333-335, reveals that the characteristic acoustic signatures are present before the burst and correspond to the formation of microbubbles (MB). However, the ability to record the acoustic sounds of the 15 MB formation in vivo is not known and can be complicated by respiratory, cardiac and muscle artifacts.
    US 2005/0283074 A1 describes that bubble generation during the tissue ablation procedure is identified or detected.
    The ultrasound image is optimized to better detect the generation of bubbles for more refined visualization and to control the ablation procedure.
    The generation of bubbles can alternatively or additionally be quantified to aid control and / or diagnosis during an ablation procedure.
    Signals 25 are generated based on the detection of a change in the characteristics of the bubble.
    For example, type 2 or type 1 bubble generation detection is used to generate audio or visual warning signals.
    As another example, the detection of type 1 or type 2 bubbles triggers the generation of a control signal to increase, decrease or terminate the ablation energy.
    The generation of the control signal is performed automatically instead of relying on the user's visualization and reaction.
    US 2009/0287205 A1 describes a system for controllably delivering ablation energy to tissue that includes an operable ablation device to supply ablation energy to body tissue causing 5 bubbles to form in the tissue, an ultrasound transducer configured to detect spontaneously emitted energy bursting or shrinking bubbles that are resonating in the tissue, and an operable control element coupled to the ablation device and the ultrasound transducer element, 10 the control element being configured to adjust the provided ablation energy to the tissue in response to the energy detected by the ultrasound transducer to prevent tissue bursting caused by the expansion of the bubble. Consequently, there is a need for a solution that overcomes the aforementioned disadvantages and provides a safer ablation process; this would prevent injury during ablation procedures.
    SUMMARY OF THE INVENTION The present invention preferably seeks to alleviate or eliminate the above mentioned disadvantages during an ablation process. In particular, it may seem an objective of the present invention to provide a system for ablation and ultrasound imaging that is capable of calculating a predictive value, where the predictive value refers to a risk of preventing tissue damage for rapid release of the tissue. bubble energy. It is another object of the present invention to provide an alternative to the prior art; In this way, the described objective and several other objectives are intended to be obtained in a first aspect of the invention by providing a system for combined ablation and ultrasound image of associated tissues as defined in pending claim 1.
    The invention is particularly, but not exclusively, advantageous for obtaining a safer ablation process.
    Electro physiologists have indicated that it is extremely valuable to predict so-called “pops” or 5 “tissue pops”. The ablation can induce the formation of one or more bubbles in the tissue during the ablation, and this can lead to a rapid and potentially damaging release of the bubble's energy.
    In the following, such a rapid release of bubble energy is referred to as a so-called “burst” or a “burst of tissue”. A prediction of an imminent burst, or a knowledge of a risk of imminent tissue damage due to a rapid release of bubble energy, can allow relevant parameters to be properly regulated in order to prevent the burst.
    This is expected to significantly increase the safety of ablation procedures.
    Another advantage would be that the invention reveals a miniaturized and integrated device that allows for safe ablation.
    Previously, the acoustic signatures refer to bubbles that were measured, however, these 20 acoustic signatures refer to bubbles that were formed at the interface between the electrode and the tissue, which is made by means of Intracardiac Ultrasound (ICE). The formation of gas at the interface can be caused by local heating of the fluid around the tip of the electrode, and does not necessarily refer to the formation of gas within the tissue.
    In addition, the ability to record acoustic sounds of microbubble formation at this interface can be complicated in a closed chest procedure and may require the integration of a bulky microphone into a catheter. The ultrasound transducer in the interventional device of the present invention is preferably applied to monitor or image the local cardiac tissue, the ablation process in said cardiac tissue or parameters related, directly or indirectly, to the ablation process.
    For example, the formation of microbubbles within the associated tissue can be monitored.
    It is realized that the invention according to the 1st aspect can alternatively be implemented not using the indication of one or more bubbles within the associated tissue, but other characteristics in the tissue.
    Such other parameters may include the local expansion of the associated tissue.
    In the context of the present invention, monitoring 10 must be largely constructed.
    It includes both 1D monitoring, that is, detection of reflected intensities along the line of sight as well as obtaining a 2D image in which an array of transducers is applied to generate a 2D image as well as an image resolved in time (then called 15 obtaining “M-mode” ultrasound image). In principle, the 3D image can also be obtained.
    In monitoring based on the interventional device, such as catheter based monitoring, it is presently normal to use 1D or 2D monitoring (resolved in time) due to space restrictions in the distal end region, that is, in the tip region.
    As used herein, the term "ablation" refers to any type of suitable ablation within the teaching and general principle of the present invention.
    In this way, it could be based on radio frequency (RF) (including microwave), 25 optically based (for example, an optical emitter, such as a laser, such as a laser emitting wavelengths in the infrared, visible or ultraviolet range) , a heating element, such as a hot water balloon, or ultrasound-based ablation such as a high intensity focused ultrasound (HIFU - High Intensity Focused Ultrasound). In the context of this application, the term “ablation unit” refers to an optical emitter, such as a laser in the case of optical based ablation, an electrode (or other suitable RF emitting device) in the case of ablation based on microwave and RF and for an ultrasound transducer, such as a high-intensity focused ultrasound transducer (HIFU), in the case of ultrasound-based ablation. It is understood that the interventional device can be a unit in which the ablation unit and the ultrasound transducer are integrated, however, it can be incorporated as an interventional device in which the ablation unit and the ultrasound transducer are separate units.
    The interventional device may comprise a catheter, needle, biopsy needle, guidewire, wrapper, or endoscope.
    The ultrasonic signal can be a pulsed echo signal.
    The pulsed echo technique is defined as sending a short ultrasound pulse through a low Q transducer in one medium, and receiving the reflexes back in the transducer from irregularities in the medium (due to the change in acoustic impedance). The transit time from the transmission of the initial pulse to receive the echo is proportional to the depth at which the irregularities are found.
    The control unit can be any unit capable of sending an output signal, such as a control signal to the ultrasound transducer, and capable of receiving an input signal, such as a response signal from the ultrasound transducer. , and still able to calculate a value, such as a predictive value.
    The control unit can be implemented by means of hardware, such as electronic components such as transistors, operational amplifiers and similar components.
    However, it can also be deployed as software, firmware or any combination of these, running on a processor.
    The predictive value is understood to be a value representative of an imminent tissue risk due to the rapid release of bubble energy.
    The predictive value can be a probability of imminent tissue damage due to a rapid release of a bubble energy, but it can also be a parameter, such as a measurable parameter, such as a number of bubbles, such as a volume of bubbles. , such as a rate of change in the number of bubbles, which may be relevant for calculating the risk of imminent tissue damage due to a rapid release of a bubble energy. 10 In another embodiment, the control unit is additionally arranged to send a primary signal (RS) if the predictive value exceeds a threshold value (TV - Threshold Value). The limit can be a number set by a user or set automatically by a device, for use in comparison to the predictive value.
    The limit may vary, or it may be constant.
    In some embodiments of the invention it can always be kept at a value that is always exceeded by the predictive value. 20 The primary signal is a signal that is sent from the control unit, and can be an analog signal, such as a voltage or a digital signal.
    It can also be other forms of signals, such as an acoustic signal, such as an audible signal.
    It can also be an optical signal such as a visible signal.
    The primary signal can have a constant value or can be varied.
    An advantage of sending a primary signal if the predictive value exceeds a threshold value (TV), may be that the primary signal can be received by another unit, such as an alarm unit, such as a speaker or lamp, such as a flashlight.
    Alternatively, the primary signal can be read by personnel performing or monitoring the ablation, who may be able to adjust the parameters related to the ablation in an appropriate manner.
    According to yet another embodiment of the invention, the primary signal (RS) is arranged to regulate a parameter related to ablation. An advantage of this realization can be that the primary signal can be received by another unit, just like any other unit controlling parameters relevant to ablation, it can be any other unit controlling any of the ablation unit, irrigation flow, a force of 10 contact applied between the interventional device and the associated tissue, and a position of the ablation unit, and that this other unit can be adjusted in an appropriate manner.
    According to another embodiment of the invention, the limit value is a function of any of the: ablation force (which is understood to be a force emitted from the ablation unit in order to dissipate the force in the associated tissue), the previous history of the response signal, a contact force measured between the interventional device and the associated tissue, an electrical impedance of the associated tissue, a structure of the associated tissue, an ablation duration, the ability of the associated tissue to exchange heat with the surroundings, a temperature of the associated tissue, the temperature of the ablation electrode and the flow rate of irrigation at the tip of the electrode.
    An advantage of having the limit value as a function of other parameters is that the limit can then be adjusted in order to have an optimal value.
    In an exemplary embodiment, the threshold value is adjusted in response to a previous development of the formation of bubbles in the tissue so that a rapid change in the formation of bubbles within the tissue can cause a relatively low limit, in which a slow development of the formation bubbles may cause a higher limit.
    The ability of the associated fabric to exchange heat with its surroundings can be affected by several factors, for example, the fabric may have a greater or lesser surface area through which heat can be exchanged with the surroundings, and the surroundings can be changed. more or less conductive of heat.
    In another embodiment, the control unit is arranged to vary the primary signal depending on the value of the predictive value. 10 In a simple example, the ablation unit, such as an RF generator that is used in many ablation procedures, can be installed in such a way that it automatically shuts down if it receives a primary signal.
    In this case, the primary signal can be constant or variant 15 depending on the predictive value.
    However, in other examples, it is advantageous instead of varying other relevant parameters, such as the energy dissipated in the tissue during the ablation, in order to support the ablation process.
    An advantage of this may be that it allows for a more controlled and optimized ablation process.
    Another advantage may be that the ablation process can be adjusted to apply enough energy to create transmural lesions, while maintaining a low controlled risk of tissue bursting.
    There is a delicate balance for the ablation configurations to be used in terms of ablation force, duration, flow of irrigation, so that a transmural lesion is created without overflow.
    These configurations may differ for different anatomical positions (for example, related to blood flow and wall thickness) and may depend on the contact force.
    In yet another embodiment, the control unit is arranged to form part of a feedback circuit.
    This is advantageous in order to carry out an ablation process that can be automated, easily controlled and / or optimized.
    In another embodiment, the ultrasound transducer is arranged behind or in an irrigation hole of the interventional device, in order to allow an irrigation fluid to flow out of the irrigation hole, and in order to allow transmission and / or receiving an ultrasonic signal through an irrigation hole.
    It can be seen as an advantage that by placing the ultrasound transducer behind or in the irrigation hole there is no need for an acoustically transparent window.
    The benefit is a better signal-to-noise ratio and an increased dynamic range due to the elimination of reflection and attenuation caused by the acoustic window.
    Specifically, second-order and higher-order reflections from the acoustic window (then called ultrasonic reverberations) are completely avoided.
    This is a great improvement that allows to avoid substantial post-processing due to the fact that these reverberations usually appear overlapping the relevant cardiac structures in the ultrasound data. 20 In the context of this application, the term “in” refers to the displacement of the ultrasound transducer within the irrigation hole itself, where the term “back” refers to any position within the distal tip that is not within the irrigation hole. irrigation and that allows ultrasonic signals 25 generated from the ultrasound transducer to flow through the ultrasound hole undisturbed or with minimal interference from the distal tip.
    In particular, this may also imply that the ultrasound transducer may be able to direct its ultrasonic signals towards the irrigation hole from any displacement.
    According to pending claim 1, the at least one ultrasound transducer is arranged to emit ultrasonic signals having a frequency high enough to detect one or more bubbles in the associated tissue.
    Axial resolution corresponds to the ability to resolve reflective limits approximately spaced in the axial direction of the transducer.
    The axial resolution is ~ Qc / 4f, where 5 Q is the quality factor, c is the speed of sound in the middle, and f is the resonant frequency.
    Considering that the low Q is associated with the reduction of acoustic output force, it cannot be very low.
    In any case, for each pulsed echo image the Q of the transducers is kept low.
    The other 10 parameter for improving axial resolution is frequency.
    The gain by increasing the frequency is much more important for improving axial resolution than the greatest reduction in the Q factor.
    There is an exchange between the depth of penetration, axial resolution and quality factor of the transducer.
    According to pending claim 1, the frequency is above 10 MHz.
    An advantage of choosing the frequency according to this embodiment may be that it is better to allow the response to be able to be indicative of the creation of one or more bubbles, such as one or more smaller bubbles.
    In another embodiment, the 20 frequency is above 20 MHz, such as within 20-25 MHz.
    This only covers the thickness of the heart wall regardless of position, and gives good axial resolution sufficiently.
    In another embodiment, the ablation unit 25 comprises any of: a heating element, a radio frequency electrode, an ultrasound transducer, and a laser.
    In yet another embodiment, the system comprising any of the following devices: an electrode capable of serving as an electrode for measuring electrical impedance, a force sensor capable of measuring a contact force applied between the interventional device and the associated tissue, a temperature sensor and a location sensor.
    A possible advantage of having such a device understood within the system is that it allows the measurement of parameters that can be advantageous to monitor and / or control, such as parts of parameters as input parameter or output parameter in a feedback circuit, according to an embodiment of the present invention.
    The temperature sensor can be any type of thermometer, including contact thermometers or non-contact thermometers, such as thermometers based on the detection of infrared radiation. 10 In another embodiment, the primary signal is controlling or at least having an influence on any of the following entities: the ablation unit, irrigation flow, a contact force applied between the interventional device and the associated tissue, and a position of the ablation unit 15.
    A possible advantage of having such entities controlled by the control unit is that it makes it possible to measure parameters that may be advantageous to control or regulate, such as entities that are relevant parameters in controlling the ablation process.
    In accordance with a second aspect of the invention, a method for assessing a risk of imminent tissue damage due to a rapid release of bubble energy as defined in pending claim 11 is provided. This aspect of the invention is particularly, but not exclusively , advantageous in that the method according to the present invention can be implemented in the available equipment.
    In addition, the method can be implemented in an automated process.
    In addition, as the method produces a predictive value, it provides a basis for decisions regarding the ablation process.
    It is understood that the step of emitting a primary ultrasonic signal, such as an ultrasonic wave, on a tissue can be performed using an ultrasound transducer, and similarly the step of receiving a secondary ultrasonic signal, such as an ultrasonic wave, from the which tissue, as reflected by the tissue, can be performed using an ultrasonic transducer.
    In another embodiment according to the invention, the method further comprises the step of generating a primary signal based on the predictive value.
    This allows the predictive value to be used 10 quantitatively, just as in a feedback system.
    According to a third aspect of the invention, the invention relates to the use of a system for combined ablation and ultrasound imaging of the associated tissue according to the first aspect of the invention, to control an ablation process.
    In accordance with a fourth aspect of the invention, there is shown a computer program product being adapted to allow a computer system comprising at least one computer having data storage means associated with it to operate a processor arranged for receiving the data. information derived from a secondary ultrasonic signal, and - calculating a predictive value based on the information derived from the secondary ultrasonic signal, where the predictive value refers to a risk of imminent tissue damage due to rapid release of the bubble energy.
    Such a computer program product could, for example, comprise a processor executing an algorithm in which the input parameters could comprise parameters related to bubble formation, as well as other parameters, such as ablation force, the previous history of the signal. response, a measured contact force between the interventional device and the associated tissue, an electrical impedance of the associated tissue, a structure of the associated tissue, an ablation duration, the ability of the associated tissue to exchange heat with the surroundings, a temperature of the associated tissue, and where the output parameters could include a primary signal, such as a primary signal controlling any of: the ablation unit, such as ablation force, irrigation flow, a 10 contact force applied between the device interventional and the associated tissue, a position of the ablation unit. In one embodiment, the secondary ultrasonic signal is an ultrasonic pulse echo signal. The first, second, third and fourth aspects of the present invention can each be combined with any of the other aspects. These and other aspects of the invention will be apparent and elucidated with reference to the realizations described here.
    BRIEF DESCRIPTION OF THE FIGURES 20 The system and method for ablation and ultrasound imaging according to the invention will now be described in more detail with respect to the accompanying figures. The figures show a way to implement the present invention and are not construed as limiting the other 25 possible realizations within the scope of the set of claims attached. FIG. 1 shows a system for ablation and ultrasound imaging according to an embodiment of the invention, FIG. 2 shows an interventional device according to an embodiment of the invention, FIG. 3 shows a perspective view of a catheter according to an embodiment of the invention, FIG. 4 shows experimental data of an open-breasted sheep model according to an embodiment of the invention, FIG. 5 shows a schematic drawing of a system according to an embodiment of the invention, FIG. 6 shows another schematic drawing of a system according to an embodiment of the invention, FIG. 7 is a flow chart of a method according to an aspect of the invention, and FIG. 8 shows a diagrammatic representation of a control unit, according to an embodiment of the invention.
    DETAILED DESCRIPTION OF AN EMBODIMENT The embodiments of the present invention are disclosed below. FIG. 1 shows a general system 100 for performing the ablation, the system comprising a controllable energy source for supplying energy to the ablation unit and / or the ultrasonic transducer (none shown in this figure). In addition, a sample arm 30 is coupled to a power source, the sample arm at its distal end an interventional device 20 according to an embodiment of the present invention. The interventional device can include any of the non-exhaustive list comprising a catheter, needle, biopsy needle or endoscope. It is also contemplated that a plurality of ultrasound transducers could be understood within the interventional device, and some ultrasound transducers could only be emitting in which other transducers could be only receiving. The system 100 30 additionally comprises a control unit (CTRL), which is in some embodiments, arranged to send a primary signal 110 if a predictive value exceeds a limit value. The invention can be used in the image of tissue during use, for example, in connection with cardiac arrhythmias or in oncology, where it is advantageous to assess an imminent risk of data to the tissue due to a rapid release of the bubble energy and thus form a base 5 to decide how to operate the ablation unit. In particular, the invention can assist in optimizing the ablation process, for example, forming apart from a feedback circuit ensuring optimal conditions during ablation. The condition during ablation can be a function of 10 a number of parameters including ablation force, temperature, an irrigation flow, contact force between the interventional device and the associated tissue, and the position of the ablation unit in relation to the tissue. which is the object of ablation. FIG. 2 shows a schematic cross-sectional drawing of an interventional device 20, in the particular figure, the interventional device is a catheter adapted for irrigated ablation of open curve of a tissue
    40. However, it should be understood that the interventional device 20 could also be other types of interventional devices, such as a needle or the like. The catheter 20 is adapted for irrigated ablation of the open curve, for example, RF ablation, of a tissue 40, the catheter 20 having a distal tip 22, that is, the right part 25 of the catheter shown covered by the support, where the tip distal comprises an ablation entity 15 adapted to perform tissue ablation 40. Note that although in FIG. 2 the ablation entity being represented as covering only the right side of the catheter, it can also cover another 30 of the sides of the catheter. The radiation to perform the ablation is shown schematically by the dotted arrow A1. The wiring required to power and / or control the ablation entity is not shown in this figure for clarity.
    In addition, an irrigation hole 21 is provided.
    The irrigation fluid is flowing out of a dedicated irrigation fluid conductor 10, for example, a flexible tube, as shown schematically by the solid arrow 5 A3. The irrigation fluid is functioning as an acoustic coupling medium, which can be defined as a substantially transparent medium for ultrasonic signals, such as a saline solution or water or other similar liquids available to the person skilled in the art implementing this embodiment of the invention.
    In addition, an ultrasound transducer 5 is positioned at the distal tip, the transducer being adapted to transmit and / or receive ultrasonic signals as schematically indicated by a dotted two-headed arrow A2 in Figure 15 2. According to an embodiment of the invention, the the ultrasound transducer is arranged behind (as shown in this figure) or in the irrigation hole 21 of the catheter 20, in order to allow an irrigation fluid A3 to flow out of the irrigation hole, and in order to allow transmission and / or 20 receiving ultrasonic signals through the same irrigation hole 21. Advantageously, catheter 20 can be used for ablation of irrigated open-frequency radio frequency (RF).
    In particular embodiments, the catheter may be a catheter with a platinum ring electrode or a catheter with an acoustically transparent sheet, such as a Polymethylpentene (TPX) sheet, such as a Polymethylpentene (TPX) sheet coated with a layer metal for ablation.
    The acoustically transparent window must mediate the contact between the catheter and the tissue, and the outside of the catheter must be coated with a very thin conductive layer (for example, 150 nm) in order to allow RF ablation.
    The acoustically transparent window, therefore, should have significantly similar acoustic impedance compared to the irrigation fluid (which is mediating the contact between the ultrasound transducer and the inner face of the acoustic window), and similar acoustic impedance as the blood or tissue that is found 5 from the outside of the acoustic window in order to avoid loss of acoustic strength due to the reflection of the interfaces.
    We identified materials that would be appropriate for this purpose, including Polymethylpentene (TPX) Z = 1.73 [MRayls] and Pebax 4033 Z = 1.67 [MRayls] or 5533 Z = 1.75 [MRayls]. Blood 10 has Z = 1.68 [MRayls]. FIG. 3 shows a perspective view of a catheter 20 suitable for use as an interventional device in accordance with an embodiment of the present invention.
    The tip 22 of the catheter is mounted on a flexible tube 52 for easy manipulation through the human body.
    Additional ring molded electrodes 51 on the tube can measure properties such as strength and temperature.
    Tube 52 will contain the wires needed to address the transducers and will supply the irrigation liquid. FIG. 4 shows the experimental data of an open-breasted sheep model.
    Radio frequency energy was administered epicardially to create lesions that were monitored simultaneously with changes in electrical impedance and ultrasound.
    The deliberately induced tissue bursts and US data were compared with the impedance data.
    The presence of bursts was independently signaled by the doctor who performed the ablation and who had no access to US or impedance data.
    In clinical practice, loud bursts are audible even through the patient's chest, such as a sheep's chest.
    The figure shows the data obtained with a set of ultrasound measurements and corresponding impedance measurements for an epicardial ablation with an integrated ring catheter.
    The ultrasound measurements are visualized in a so-called M image of M-mode.
    The graph G shown shows a temporal development of the electrical impedance during the ablation process.
    Time t is shown on the bottom axis, and the G 5 graph and the M-mode M image share this time axis.
    The RF energy dissipated per time interval is 9 watt during the 20 second period denoted by t_a.
    The depth of the tissue in the M-mode M image is denoted by d_t.
    The absolute scale of the M-mode image is indicated by the 10 scale bar denoted by d1, the scale bar corresponds to 1 millimeter.
    The vertical axis R in graph G corresponds to the electrical impedance measured in Ohm.
    The electrical impedance is measured between the ablation electrode and a ground electrode, which is on the back of the object being investigated, just like on the back of a person or an animal, so that the electrical impedance is measured through the tissue.
    Typically, the electrical impedance measured at the tip of the catheter increases in the case of bursts.
    The solid line indicated p_i indicates the incidence of a tissue burst, the dotted line d_o 20 indicates the start of changes in the ultrasound that precede the bursts.
    The figure shows that changes in ultrasound measurements before tissue overflows preceded changes in impedance over many seconds.
    From the ultrasound M-mode image recorded during the ablation procedure, the change in the ultrasound signal could be associated with the formation of the bubble, before the doctor signaled the burst.
    FIG. 5 shows a schematic drawing of a system according to an embodiment of the invention, 30 comprising an ultrasound transducer 505, an ablation unit 516, a control unit (CTRL). In addition, an associated fabric 540 is shown. In the figure, the control unit sends and receives a control signal respectively
    (CoS - Control Signal) and a response signal (ReS - Response Signal) to and from the 505 ultrasound transducer, the response signal being indicative of the presence of one or more bubbles within said associated tissue.
    Control unit 5 calculates a predictive value, where the predictive value refers to a risk of imminent tissue damage due to a rapid release of bubble energy, and sends a primary signal (RS) if the predictive value exceeds a value limit.
    In the shown embodiment, the primary signal (RS) is sent to the ablation unit 516. In such an embodiment, the primary signal (RS) can then serve to decrease an ablation force in order to decrease a risk of imminent damage to the tissue due to a quick release of bubble energy ... FIG. 6 shows another schematic drawing of a system according to an embodiment of the invention, similar to the embodiment shown in FIG. 5, except that the primary signal is sent to another entity in addition to the ablation unit.
    This other entity can be any entity, in particular, it can be any entity controlling the flow of irrigation, 20 a contact force applied between the interventional device and the associated tissue, a position of the ablation unit.
    FIG. 7 is a flow chart of a method for performing ablation in accordance with an aspect of the present invention.
    This method comprises the steps of: - S1 emission of a primary ultrasonic signal in a tissue, and - S2 receipt of a secondary ultrasonic signal from within the tissue, and 30 - S3 determination if one or more bubbles are formed within the tissue , based on information derived from the secondary ultrasonic signal, and - sending S4 of information derived from the secondary ultrasonic signal to a processor, and - S5 calculation of a predictive value based on information derived from the secondary ultrasonic signal, where the predictive value refers to a risk of 5 imminent tissue damage due to a rapid release of the bubble's energy.
    Steps S2 and S5 are performed using the understanding that usually the bursting of the tissue is preceded by a sudden increase in intensity from the ultrasound image.
    In particular embodiments, image analysis based on different aspects can be applied to one or more images based on ultrasound measurements in order to identify a relevant increase in intensity, including checking if there is a sudden significant gradient on the correlation map. .
    This change can be consistent within a certain depth range (therefore different from noise), or monitor the histogram of one or more current lines in an M-mode image (also known as A lines), 20 to check if there is a significant change in the distribution of the gray level as compared to the previous A line (s).
    Several metric distances can be applied to compare histograms such as correlation, Chi-Square, Bhattacharyya distance, etc.
    This approach can be varied 25 to include that the histogram (distribution) does not have to be performed over the entire line A.
    Line A can be segmented into small segments and the histograms of these small segments can be checked. 30 As an alternative for direct comparison of distributions, the mean, variance or higher order moments can be used to check the difference in histograms, or statistical aspects for characterizing the texture, such as entropy or texture parameter estimated from auto regressive models.
    These aspects can be used as alternatives to detect the change in texture 5 when the tissue overflows.
    Along a single line A, there is a slight variation in intensity (or intensity distribution) along the depth.
    FIG. 8 shows a diagrammatic representation of a control unit (CTRL) according to an embodiment of the invention, wherein the control unit (CTRL) sends a control signal (CoS), such as a control signal to control a transducer ultrasound (not shown), and receives a response signal (ReS), such as a signal received from an ultrasound transducer, such as a signal representative of a measured ultrasound signal incident on the ultrasound transducer.
    In the shown embodiment, the control unit (CTRL) also receives an extra signal (XS) which can be any one of a number of signals, such as a signal representing a temperature, an irrigation flow, or a contact force. between the interventional device and a tissue.
    The control unit (CTRL) in this embodiment uses a first calculation unit (C1) and a second calculation unit (C2), which both receive both the 25 response (ReS) and the extra signal (XS) signals to calculate respectively a predictive value (PV - Predictor Value) and a limit value (TV). In some embodiments, the first calculation unit (C1) and the second calculation unit (C2) also receive the control signal (CoS). A third calculation unit (C3) 30 compares the predictive value (PV) with the limit value (TV) and can generate a primary signal (RS) that can also be generated by the control unit if the predictive value (PV) exceeds the limit value (TV).
    In addition, the present invention relates to a system (100) for combined ablation and ultrasound imaging of the associated tissue (40), which is particularly useful for use in an ablation process.
    The system comprises an interventional device 5 (20) with an ultrasound transducer and an ablation unit.
    During an ablation process, the interventional device (20) can be applied to both the ablation and tissue image (40) subjected to ablation.
    A control unit (CTRL) is additionally comprised 10 within the system, and arranged to calculate a predictive value based on one or more signals from the ultrasound transducer, where the predictive value refers to a risk of imminent damage to the tissue due to a quick release of bubble energy.
    According to a specific embodiment, a primary signal is sent if the predictive value exceeds a threshold value, so that appropriate measures can be taken.
    Although the present invention has been described in connection with the specified embodiments, it should not be construed as being limited in any way to the examples presented.
    The scope of the present invention is established by the accompanying claim set.
    In the context of the claims, the terms "comprising" or "comprises" do not exclude other possible elements or steps.
    Also, the mention of references 25 such as "one" or "one" etc., should not be construed as excluding a plurality.
    The use of reference signs in the claims in relation to the elements indicated in the figures should also not be interpreted as limiting the scope of the invention.
    In addition, the individual aspects mentioned in the different claims may possibly be advantageously combined, and the mention of these aspects in the different claims does not exclude that the combination of these aspects is not possible and advantageous.
    权利要求:
    Claims (14)
    [1]
    1. SYSTEM (100) FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE (40, 540), the system is characterized by comprising an interventional device (20), the interventional device comprising an ultrasound transducer (5, 505), and an ablation unit (15, 516); and a control unit (CTRL) being operably connected to the interventional device 20, the control unit (CTRL) being arranged to send a control signal (Cos) to the ultrasound transducer (5, 505), to receive a signal from response (ReS) from the ultrasound transducer, the response signal (ReS) being indicative of the presence of one or more bubbles within said associated tissue (40, 540), and calculating a predictive value (PV), in which the predictive value (PV) refers to a risk of an imminent given 20 to the tissue due and a rapid release of a bubble energy, in which the ultrasound transducer (5, 505) is willing to emit ultrasonic signals (A2) having a frequency high enough to detect one or more bubbles in the associated tissue (40, 540), and where the frequency is above 25 from 10 MHz.
    [2]
    2. SYSTEM (100) FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE, according to claim 1, characterized in that the control unit (CTRL) is additionally arranged to send a primary signal (RS) if the predictive value exceeds a limit value (TV).
    [3]
    3. SYSTEM (100) FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF ASSOCIATED TISSUE, according to the claim
    2, characterized in that the primary signal (RS) is arranged to regulate a related parameter for ablation.
    [4]
    4. SYSTEM (100) FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE, according to claim 5 1, characterized in that the limit value (TV) is a function of any of: a force dissipated in the associated tissue (40 , 540), the previous history of the response signal, a measured contact force between the interventional device and the associated tissue (40, 540), an electrical impedance of the associated tissue (40, 540), a structure of the associated tissue ( 40, 540), an ablation duration, the ability of the associated tissue to exchange heat with the surroundings, a temperature of the associated tissue (40, 540), the temperature of the ablation electrode, and the rate of irrigation flow at the tip of the electrode. 15
    [5]
    5. SYSTEM (100) FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE (40, 540), according to claim 2, characterized in that the control unit (CTRL) is arranged to vary the primary signal (RS) depending of the predictive value (PV) value. 20
    [6]
    6. SYSTEM (100) FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE (40, 540), according to claim 2, characterized in that the control unit (CTRL) is arranged to form part of a feedback circuit. 25
    [7]
    7. SYSTEM (100) FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE (40, 540), according to claim 1, characterized in that the ultrasound transducer (5, 505) is arranged behind or in an irrigation hole (21) of the interventional device (20), in order to allow an irrigation fluid to flow out of the irrigation hole (21), and in order to allow the transmission and / or receipt of an ultrasonic signal (A2) through the irrigation hole (21).
    [8]
    8. SYSTEM (100) FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE (40, 540), according to claim 1, characterized in that the ablation unit (15, 516) comprises any of: an element of 5 heating, a radio frequency electrode, an ultrasound transducer, and a laser.
    [9]
    9. SYSTEM (100) FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE (40, 540), according to claim 1, the system is characterized by comprising 10 any of: an electrode capable of serving as an electrode to measure the electrical impedance, tissue (40, 540) a force sensor capable of measuring a contact force applied between the interventional device and the associated tissue (40, 540), and a temperature sensor and location sensor. 15
    [10]
    10. SYSTEM (100) FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE (40, 540), according to claim 2, characterized in that the primary signal (RS) is controlling any of: the ablation unit (15 , 516), an irrigation flow, an applied contact force 20 between the interventional device and the associated tissue (40, 540), and a position of the ablation unit.
    [11]
    11. METHOD FOR ASSESSING AN IMMINENT RISK
    [12]
    TISSUE DAMAGE DUE TO A QUICK RELEASE FROM A BUBBLE ENERGY, the method is characterized by comprising 25 emission (S1) of a primary ultrasonic signal in a tissue, and receipt (S2) of a secondary ultrasonic signal from within the tissue , and determining (S3) whether one or more bubbles are formed within the tissue, based on information derived from the secondary ultrasonic signal, and sending (S4) of information derived from the secondary ultrasonic signal to a processor, and calculating (S5) of a predictive value (PV) based on information derived from the secondary ultrasonic signal, where the predictive value (PV) refers to the imminent risk of tissue damage due to the rapid release of the bubble energy, in 5 that the ultrasonic signals (A2) having a frequency high enough to detect one or more bubbles in the associated tissue (40, 540), and where the frequency is above 10 MHz. 10 12. METHOD, according to the claim 12, the method is characterized by additionally understanding the step of generating a primary signal (RS) based on the predictive value (PV).
    [13]
    13. USE OF A SYSTEM (100) FOR COMBINED ABLATION 15 AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE (40, 540), as defined in any one of claims 1 to 11, characterized by controlling an ablation process.
    [14]
    14. COMPUTER PROGRAM PRODUCT BEING ADAPTED TO A COMPUTER SYSTEM, characterized in that it comprises at least one computer having data storage means associated with it to operate a processor arranged to receive information derived from an ultrasonic signal, and 25 calculate a predictive value (PV) based on information derived from the secondary ultrasonic signal, where the predicted value refers to a risk of imminent tissue damage due to a rapid release of energy from the bubble.
    类似技术:
    公开号 | 公开日 | 专利标题
    BR112012019262A2|2021-03-09|SYSTEM FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE ASSOCIATED TISSUE, METHOD FOR ASSESSING A RISK OF IMPENDING TISSUE DAMAGE DUE TO A QUICK RELEASE OF BUBBLE ENERGY, USE OF A SYSTEM FOR COMBINED ABLATION AND ULTRASOUND IMAGE OF THE FABRIC PRODUCT OF COMPUTER PROGRAM BEING ADAPTED TO A COMPUTER SYSTEM
    JP5830614B2|2015-12-09|Ablation probe with fluid-based acoustic coupling for ultrasound tissue imaging and ablation and ultrasound imaging system
    JP5976782B2|2016-08-24|Apparatus and interface for an RF ablation system using acoustic feedback
    EP2814397B1|2020-01-15|System for assessing effects of ablation therapy on cardiac tissue using photoacoustics
    US8702690B2|2014-04-22|Device and method for real-time lesion estimation during ablation
    JP5976781B2|2016-08-24|Acoustic transducer for pulse echo monitoring and control of lesion formation by thermal ablation in layered and non-layered tissue, catheter contact monitoring, tissue thickness measurement, and prepop warning
    EP1643912B1|2020-02-26|A combination of a therapy and an imaging instrument
    JP2011131061A|2011-07-07|Estimation and mapping of ablation volume
    RU2539010C2|2015-01-10|Device, method and computer program for cardiac value measurement
    AU2014203530B2|2018-07-19|Real-time prediction of steam-pop events during ablation
    US20200375569A1|2020-12-03|Medical ultrasound device with temperature detection at distal end
    JP6548948B2|2019-07-24|Prevention of steam pop during ablation
    ES2735725T3|2019-12-20|Measurement of tissue thickness using ultrasound and force measurements
    WO2013123020A1|2013-08-22|Ablation catheter with optic energy delivery system for photoacoustic tissue response
    JP6133779B2|2017-05-24|Sensing device for sensing objects
    JP6456652B2|2019-01-23|Real-time estimation of the risk of tissue perforation during minimally invasive medical procedures
    BR112013012207B1|2018-12-18|INTERFERENCE REDUCTION APPARATUS FOR RADIO FREQUENCY ABLATION USES USING REAL-TIME ULTRASOUND MONITORING AND DIFFERENCE REDUCTION METHOD USING ULTRASOUND ABLATION APPLICATIONS USING
    JP2020036932A|2020-03-12|Energy application apparatus
    US20190059782A1|2019-02-28|System and method using cardiac-esophageal impedance mapping to predict and detect esophageal injury during cardiac ablation procedures
    CN112641507A|2021-04-13|Contact indication of balloon catheter ablation electrodes via balloon surface temperature measurement
    同族专利:
    公开号 | 公开日
    US10383687B2|2019-08-20|
    CN102781358B|2015-06-24|
    RU2576440C2|2016-03-10|
    US20120302877A1|2012-11-29|
    JP6472940B2|2019-02-20|
    EP2531133A1|2012-12-12|
    CN102781358A|2012-11-14|
    EP2531133B1|2015-04-08|
    WO2011095937A1|2011-08-11|
    JP2013518659A|2013-05-23|
    RU2012137787A|2014-03-10|
    引用文献:
    公开号 | 申请日 | 公开日 | 申请人 | 专利标题
    GB9106686D0|1991-03-28|1991-05-15|Hafslund Nycomed As|Improvements in or relating to contrast agents|
    US5246436A|1991-12-18|1993-09-21|Alcon Surgical, Inc.|Midinfrared laser tissue ablater|
    EP1272117A2|2000-03-31|2003-01-08|Rita Medical Systems, Inc.|Tissue biopsy and treatment apparatus and method|
    RU2232547C2|2002-03-29|2004-07-20|Общество с ограниченной ответственностью "АММ - 2000"|Method and device for making ultrasonic images of cerebral structures and blood vessels|
    US6709432B2|2002-04-26|2004-03-23|Medtronic, Inc.|Ablation methods and medical apparatus using same|
    JP2007516809A|2003-12-30|2007-06-28|ライポソニックス，インコーポレイテッド|Ultrasonic transducer components|
    US20050283074A1|2004-06-22|2005-12-22|Siemens Medical Solutions Usa, Inc.|Ultrasound feedback for tissue ablation procedures|
    US7918850B2|2006-02-17|2011-04-05|Biosense Wabster, Inc.|Lesion assessment by pacing|
    US7942871B2|2006-05-12|2011-05-17|Vytronus, Inc.|Device for ablating body tissue|
    WO2008017992A2|2006-08-11|2008-02-14|Koninklijke Philips Electronics, N.V.|Systems and methods for associating nucleic acid profiles and proteomic profiles with healthcare protocols and guidelines in a decision support system|
    EP2051649B1|2006-08-11|2012-04-25|Koninklijke Philips Electronics N.V.|Image-based power feedback for optimal ultrasound imaging of radio frequency tissue ablation|
    US20080154257A1|2006-12-22|2008-06-26|Shiva Sharareh|Real-time optoacoustic monitoring with electophysiologic catheters|
    JP2010526598A|2007-05-11|2010-08-05|ボエッジメディカル，インコーポレイテッド|Visual electrode ablation system|
    US20090287205A1|2008-05-16|2009-11-19|Boston Scientific Scimed, Inc.|Systems and methods for preventing tissue popping caused by bubble expansion during tissue ablation|
    US8414508B2|2008-10-30|2013-04-09|Vytronus, Inc.|System and method for delivery of energy to tissue while compensating for collateral tissue|US9277961B2|2009-06-12|2016-03-08|Advanced Cardiac Therapeutics, Inc.|Systems and methods of radiometrically determining a hot-spot temperature of tissue being treated|
    US10098694B2|2013-04-08|2018-10-16|Apama Medical, Inc.|Tissue ablation and monitoring thereof|
    US9655677B2|2010-05-12|2017-05-23|Shifamed Holdings, Llc|Ablation catheters including a balloon and electrodes|
    US10349824B2|2013-04-08|2019-07-16|Apama Medical, Inc.|Tissue mapping and visualization systems|
    US9795442B2|2008-11-11|2017-10-24|Shifamed Holdings, Llc|Ablation catheters|
    EP3391845B1|2009-06-30|2020-02-12|Boston Scientific Scimed, Inc.|Map and ablate open irrigated hybrid catheter|
    AU2011252976A1|2010-05-12|2012-11-08|Shifamed Holdings, Llc|Low profile electrode assembly|
    US9089340B2|2010-12-30|2015-07-28|Boston Scientific Scimed, Inc.|Ultrasound guided tissue ablation|
    WO2012166239A1|2011-06-01|2012-12-06|Boston Scientific Scimed, Inc.|Ablation probe with ultrasonic imaging capabilities|
    CA2847846A1|2011-09-14|2013-03-21|Boston Scientific Scimed, Inc.|Ablation device with multiple ablation modes|
    AU2012308464B2|2011-09-14|2016-10-20|Boston Scientific Scimed, Inc.|Ablation device with ionically conductive balloon|
    US9241761B2|2011-12-28|2016-01-26|Koninklijke Philips N.V.|Ablation probe with ultrasonic imaging capability|
    CN104039257A|2012-01-10|2014-09-10|波士顿科学医学有限公司|Electrophysiology system|
    WO2013115941A1|2012-01-31|2013-08-08|Boston Scientific Scimed, Inc.|Ablation probe with fluid-based acoustic coupling for ultrasonic tissue imaging|
    US8926605B2|2012-02-07|2015-01-06|Advanced Cardiac Therapeutics, Inc.|Systems and methods for radiometrically measuring temperature during tissue ablation|
    US9226791B2|2012-03-12|2016-01-05|Advanced Cardiac Therapeutics, Inc.|Systems for temperature-controlled ablation using radiometric feedback|
    US8954161B2|2012-06-01|2015-02-10|Advanced Cardiac Therapeutics, Inc.|Systems and methods for radiometrically measuring temperature and detecting tissue contact prior to and during tissue ablation|
    US9283033B2|2012-06-30|2016-03-15|Cibiem, Inc.|Carotid body ablation via directed energy|
    WO2014145139A1|2013-03-15|2014-09-18|St. Jude Medical, Cardiology Division, Inc.|Force-sensing ablation catheter|
    EP2983603B1|2013-04-08|2020-03-25|Apama Medical, Inc.|Cardiac ablation catheters|
    US9955946B2|2014-03-12|2018-05-01|Cibiem, Inc.|Carotid body ablation with a transvenous ultrasound imaging and ablation catheter|
    JP6599885B2|2014-03-27|2019-10-30|コーニンクレッカフィリップスエヌヴェ|A method for thermal fracture mark size control based on normalized displacement difference|
    US10524684B2|2014-10-13|2020-01-07|Boston Scientific Scimed Inc|Tissue diagnosis and treatment using mini-electrodes|
    CN106604675B|2014-10-24|2020-01-10|波士顿科学医学有限公司|Medical device having a flexible electrode assembly coupled to an ablation tip|
    EP3220844B1|2014-11-19|2020-11-11|EPiX Therapeutics, Inc.|Systems for high-resolution mapping of tissue|
    KR20170107428A|2014-11-19|2017-09-25|어드밴스드 카디악 테라퓨틱스, 인크.|Ablation devices, systems and methods of using a high-resolution electrode assembly|
    JP6673598B2|2014-11-19|2020-03-25|エピックス セラピューティクス，インコーポレイテッド|High resolution mapping of tissue with pacing|
    CN106999080B|2014-12-18|2020-08-18|波士顿科学医学有限公司|Real-time morphological analysis for lesion assessment|
    JP6858127B2|2015-02-17|2021-04-14|コーニンクレッカ フィリップス エヌ ヴェＫｏｎｉｎｋｌｉｊｋｅ Ｐｈｉｌｉｐｓ Ｎ．Ｖ．|Equipment and methods to support tissue ablation|
    US9636164B2|2015-03-25|2017-05-02|Advanced Cardiac Therapeutics, Inc.|Contact sensing systems and methods|
    CN108348146A|2015-11-16|2018-07-31|阿帕玛医疗公司|Energy transmission device|
    US11160607B2|2015-11-20|2021-11-02|Biosense WebsterLtd.|Hyper-apertured ablation electrode|
    WO2017160808A1|2016-03-15|2017-09-21|Advanced Cardiac Therapeutics, Inc.|Improved devices, systems and methods for irrigated ablation|
    US20170312008A1|2016-05-02|2017-11-02|Affera, Inc.|Pulsed radiofrequency ablation|
    RU2654764C2|2016-08-17|2018-05-22|Федеральное государственное бюджетное образовательное учреждение высшего образования "Саратовский национальный исследовательский государственный университет имени Н.Г. Чернышевского"|Method of laser ablation of the pathological area of heart|
    US20180235576A1|2017-02-22|2018-08-23|Covidien Lp|Ultrasound doppler and elastography for ablation prediction and monitoring|
    WO2018200865A1|2017-04-27|2018-11-01|Epix Therapeutics, Inc.|Determining nature of contact between catheter tip and tissue|
    US10828020B2|2018-08-22|2020-11-10|Covidien Lp|Surgical retractor including three-dimensionalimaging capability|
    CN110755148B|2019-09-20|2020-09-08|姚陈果|Pulsed electric field tumor ablation parameter optimization system|
    WO2022002653A1|2020-06-30|2022-01-06|Koninklijke Philips N.V.|Systems for laser catheter treatment in a vessel lumen|
    法律状态:
    2021-03-16| B08F| Application dismissed because of non-payment of annual fees [chapter 8.6 patent gazette]|Free format text: REFERENTE A 10A ANUIDADE. |
    2021-04-20| B25D| Requested change of name of applicant approved|Owner name: KONINKLIJKE PHILIPS N.V. (NL) |
    2021-05-11| B25G| Requested change of headquarter approved|Owner name: KONINKLIJKE PHILIPS N.V. (NL) |
    2021-07-06| B08K| Patent lapsed as no evidence of payment of the annual fee has been furnished to inpi [chapter 8.11 patent gazette]|Free format text: EM VIRTUDE DO ARQUIVAMENTO PUBLICADO NA RPI 2619 DE 16-03-2021 E CONSIDERANDO AUSENCIA DE MANIFESTACAO DENTRO DOS PRAZOS LEGAIS, INFORMO QUE CABE SER MANTIDO O ARQUIVAMENTO DO PEDIDO DE PATENTE, CONFORME O DISPOSTO NO ARTIGO 12, DA RESOLUCAO 113/2013. |
    2021-12-14| B350| Update of information on the portal [chapter 15.35 patent gazette]|
    优先权:
    申请号 | 申请日 | 专利标题
    EP10152815|2010-02-05|
    EP10152815.6|2010-02-05|
    PCT/IB2011/050462|WO2011095937A1|2010-02-05|2011-02-03|Combined ablation and ultrasound imaging|
    [返回顶部]