公开(公告)号：US07653438B2

公开(公告)日：2010-01-26

申请号：US11129765

申请日：2005-05-13

Applicant: Mark Deem ,  Hanson Gifford, III ,  Denise Demarais ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

Inventor： Mark Deem ,  Hanson Gifford, III ,  Denise Demarais ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

IPC: A61N1/00 ,  A61N1/30

CPC classification number: A61N1/36007 ,  A61B8/0891 ,  A61B8/12 ,  A61B18/1206 ,  A61B18/1233 ,  A61B18/1492 ,  A61B18/18 ,  A61B2018/00071 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00267 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00613 ,  A61B2018/00642 ,  A61B2018/00904 ,  A61B2018/126 ,  A61B2018/1467 ,  A61M5/14 ,  A61M25/0023 ,  A61N1/0412 ,  A61N1/05 ,  A61N1/0551 ,  A61N1/18 ,  A61N1/205 ,  A61N1/326 ,  A61N1/327 ,  A61N1/36017 ,  A61N1/36057 ,  A61N1/3606 ,  A61N1/36103 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/36139 ,  A61N5/00 ,  A61N7/00 ,  A61N2007/0021 ,  A61N2007/003

Abstract: Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

Abstract translation: 提供使用脉冲电场进行肾神经调节以实现电穿孔或电融合的方法和装置。 预期肾脏神经调节（例如去神经支配）可以减少急性心肌梗塞的扩张，减少或预防与充血性心力衰竭有关的形态学变化的发生，和/或有效治疗 晚期肾脏疾病。 本发明的实施例被配置用于经皮血管内递送脉冲电场以实现这种神经调节。

公开(公告)号：US07617005B2

公开(公告)日：2009-11-10

申请号：US11504117

申请日：2006-08-14

Applicant: Denise Demarais ,  Nicolas Zadno ,  Benjamin J. Clark ,  Erik Thai ,  Howard R. Levin ,  Mark Gelfand

Inventor： Denise Demarais ,  Nicolas Zadno ,  Benjamin J. Clark ,  Erik Thai ,  Howard R. Levin ,  Mark Gelfand

IPC: A61N1/00

CPC classification number: A61N7/022 ,  A61B18/02 ,  A61B18/04 ,  A61B18/12 ,  A61B18/1492 ,  A61B2018/0022 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61F7/007 ,  A61F7/12 ,  A61F7/123 ,  A61F2007/126 ,  A61M5/44 ,  A61M2210/1082 ,  A61N1/28 ,  A61N1/36007 ,  A61N1/403 ,  A61N5/00 ,  A61N5/025 ,  A61N5/045 ,  A61N5/0603 ,  A61N7/00 ,  A61N7/02 ,  A61N2007/003 ,  A61N2007/0078

Abstract: Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues.

Abstract translation: 提供了用于热诱导的肾神经调节的方法和装置。 热诱导的肾神经调节可以通过直接和/或通过间接施加热能来加热或冷却有助于肾功能的神经纤维或者供给或灌注神经纤维的血管结构来实现。 在一些实施例中，神经纤维，非目标组织或热能递送元件的参数可以经由一个或多个传感器来监测，以控制热诱导的神经调节。 在一些实施方案中，可以提供保护元件以减少在非靶组织中诱导的热损伤程度。

公开(公告)号：US20090234431A1

公开(公告)日：2009-09-17

申请号：US12389986

申请日：2009-02-20

Applicant: Judah Weinberger ,  Nick Gately ,  Mark Gelfand

Inventor： Judah Weinberger ,  Nick Gately ,  Mark Gelfand

IPC: A61F2/06

CPC classification number: A61F2/06 ,  A61F2002/068 ,  A61M1/3655

Abstract: Blood flow restrictors are discussed. In some examples, a restrictor apparatus includes a converging entry portion, a diverging exit portion, and optionally a narrowed portion therebetween to restrict the flow of blood through an arteriovenous graft from a subject's artery to a vein. The structure of the restrictor apparatus decreases the pressure and volume of blood flow between the artery and vein to reduce or prevent hyperplasia or stenosis on the venous side, an increased load on the heart, or blood steal, among other things. The restrictor apparatus can be separate from, but couplable to, the arteriovenous graft. The restrictor apparatus can be integral with the arteriovenous graft. In some examples, the restrictor apparatus can be inserted into the arteriovenous graft in a compressed size and shape, and subsequently be allowed to expand to an uncompressed size and shape. Methods of forming and using the restrictor apparatus are also discussed.

Abstract translation: 讨论血流限制器。 在一些示例中，限流装置包括会聚进入部分，发散出口部分和可选地在其间的狭窄部分，以限制血液通过动静脉移植物从受试者的动脉到静脉的流动。 节流器装置的结构减小动脉和静脉之间血流的压力和体积，以减少或防止静脉侧的增生或狭窄，心脏负荷增加或血液流血等。 限制器装置可以与动静脉移植物分开，但是可以连接到动静脉移植物上。 限流装置可以与动静脉移植物成一体。 在一些示例中，限制器装置可以以压缩的尺寸和形状插入动静脉移植物中，并随后允许扩张至未压缩的尺寸和形状。 还讨论了形成和使用限流装置的方法。

公开(公告)号：US20080188900A1

公开(公告)日：2008-08-07

申请号：US11962966

申请日：2007-12-21

Applicant: Howard Levin ,  Mark Gelfand

Inventor： Howard Levin ,  Mark Gelfand

IPC: A61N1/05

CPC classification number: A61N1/056 ,  A61N1/3621

Abstract: A method and apparatus to slow a heart rate with subthreshold electric stimulation of the SA node. Stimulation is applied at a specific time in the cardiac cycle and at a specific subthreshold level. To control the heart rate, the stimulating signal may be modified automatically based on physiologic feedbacks. Stimulation may be applied using an implantable pulse generator directly to the SA node of the heart.

Abstract translation: 一种通过SA节点的亚阈值电刺激来减慢心率的方法和装置。 在心脏周期和特定亚阈值水平的特定时间施加刺激。 为了控制心率，刺激信号可以根据生理反馈自动修改。 刺激可以使用可植入脉冲发生器直接应用于心脏的SA节点。

公开(公告)号：US20080140085A1

公开(公告)日：2008-06-12

申请号：US12000265

申请日：2007-12-11

Applicant: Nicholas V. Gately ,  Mark Gelfand

Inventor： Nicholas V. Gately ,  Mark Gelfand

IPC: A61B17/58 ,  A61B17/00

CPC classification number: A61F2/4611 ,  A61F2/4465 ,  A61F2002/30133 ,  A61F2002/30523 ,  A61F2002/30538 ,  A61F2002/30904 ,  A61F2002/4622 ,  A61F2002/4627 ,  A61F2002/4629 ,  A61F2220/0025 ,  A61F2230/0015 ,  A61F2250/0006

Abstract: A method to insert a spinal implant into a vertebral space, the method including the steps of: grasping the implant with a distal end of an implant insertion tool; holding a proximal end of the implant insertion tool and inserting the implant toward the vertebral space; and manipulating the proximal end to apply a yaw movement to the implant while the implant is attached to the tool and in the vertebral space.

Abstract translation: 一种将脊柱植入物插入脊椎空间的方法，所述方法包括以下步骤：用植入物插入工具的远端抓住植入物; 保持植入物插入工具的近端并将植入物插入椎体空间; 并且当所述植入物附接到所述工具和所述脊椎空间中时，操纵所述近端以向所述植入物施加偏转运动。

公开(公告)号：US20080045877A1

公开(公告)日：2008-02-21

申请号：US11839305

申请日：2007-08-15

Applicant: Howard Levin ,  Mark Gelfand

Inventor： Howard Levin ,  Mark Gelfand

IPC: A61M1/36

CPC classification number: A61M1/342 ,  A61M1/02 ,  A61M1/16 ,  A61M1/1611 ,  A61M1/3441 ,  A61M1/3458 ,  A61M1/36 ,  A61M1/3607 ,  A61M2205/3331 ,  A61M2205/3334 ,  A61M2205/3365 ,  A61M2205/3368 ,  A61M2205/50

Abstract: A method and apparatus for replacement of renal function by periodically removing a substantial volume of patient's blood and simultaneously replacing it with the reconstituted blood. Reconstituted blood consists of the patient's own condensed blood cells and proteins diluted with the sterile physiologic solution. As a result, small molecules and excess water are periodically removed and discarded. Blood cells and proteins are safely stored to be used at the next therapy session.

Abstract translation: 一种通过周期性地去除大量患者血液并同时用重构血液代替肾功能来替代肾功能的方法和装置。 重建的血液由患者自己的浓缩血细胞和用无菌生理溶液稀释的蛋白质组成。 结果，小分子和过量的水被周期性地去除并丢弃。 血细胞和蛋白质被安全地储存在下次治疗期间使用。

公开(公告)号：US20070118183A1

公开(公告)日：2007-05-24

申请号：US11601150

申请日：2006-11-17

Applicant: Mark Gelfand ,  Howard Levin ,  Andrew Halpert

Inventor： Mark Gelfand ,  Howard Levin ,  Andrew Halpert

IPC: A61N1/00

CPC classification number: A61N1/3611 ,  A61N1/0551 ,  A61N1/3601 ,  A61N1/36135

Abstract: An implantable medical device for treating breathing disorders such as central sleep apnea wherein stimulation is provided to the phrenic never through a transvenous lead system with the stimulation beginning after inspiration to extend the duration of a breath and to hold the diaphragm in a contracted condition.

Abstract translation: 一种用于治疗诸如中枢性睡眠呼吸暂停的呼吸障碍的可植入医疗装置，其中刺激从未通过经静脉引导系统提供给膈神经，其中在吸气之后开始刺激以延长呼吸持续时间并且将膈肌保持在收缩状态。

公开(公告)号：US07175809B2

公开(公告)日：2007-02-13

申请号：US10801059

申请日：2004-03-16

Applicant: Mark Gelfand ,  John O'Mahony ,  Howard R. Levin

Inventor： Mark Gelfand ,  John O'Mahony ,  Howard R. Levin

IPC: A61M37/00 ,  A61M1/00 ,  C02F1/44 ,  A61M1/14 ,  B01D61/00

CPC classification number: A61M1/34 ,  A61M1/341 ,  A61M1/36 ,  A61M2205/3303 ,  A61M2205/3306 ,  A61M2205/3331 ,  A61M2205/3375 ,  A61M2205/50 ,  A61M2230/205 ,  A61M2230/005

Abstract: A method and system for the extracorporeal treatment of blood to remove fluid from the fluid overloaded patient is disclosed that non-invasively measures an oxygen level in the venous blood. The oxygen blood level is used to detect when hypotension is about to occur in a patient. The oxygen level measurements are used as feedback signals. These feedback signals are applied to automatically control the rate of fluid extraction to achieve the desired clinical outcome and avoid precipitating a hypotensive crisis in the patient.

Abstract translation: 公开了一种用于体外处理血液以从流体过载患者中去除流体的方法和系统，其非侵入性地测量静脉血中的氧水平。 氧气血液浓度用于检测患者中何时会发生低血压。 氧气测量值用作反馈信号。 这些反馈信号被应用于自动控制流体提取的速率以达到期望的临床结果，并避免在患者体内产生低血压危象。

公开(公告)号：US07162303B2

公开(公告)日：2007-01-09

申请号：US10408665

申请日：2003-04-08

Applicant: Howard R. Levin ,  Mark Gelfand

Inventor： Howard R. Levin ,  Mark Gelfand

IPC: A61N1/00

CPC classification number: A61B18/1492 ,  A61B18/04 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61M1/3627 ,  A61M5/142 ,  A61M5/14276 ,  A61M5/1723 ,  A61M2210/1082 ,  A61N1/05 ,  A61N1/0551 ,  A61N1/326 ,  A61N1/36007 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/36125 ,  A61N1/36135 ,  A61N1/3627 ,  A61N1/40 ,  A61N1/403 ,  A61N5/00

Abstract: A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based.

Abstract translation: 一种通过刺激肾神经来治疗心力衰竭，高血压和肾功能衰竭的方法和装置。 治疗的目的是减少肾神经的交感神经活动。 通过药物输注或电刺激至少部分阻断神经来完成治疗。 装置可以永久植入或基于导管。

公开(公告)号：US20060270971A1

公开(公告)日：2006-11-30

申请号：US11408851

申请日：2006-04-21

Applicant: Mark Gelfand ,  Howard Levin

Inventor： Mark Gelfand ,  Howard Levin

IPC: A61M31/00 ,  A61M1/00

CPC classification number: A61M5/1723 ,  A61B5/201 ,  A61B5/208 ,  A61B5/4839 ,  A61M5/007 ,  A61M5/142 ,  A61M5/16895 ,  A61M5/365 ,  A61M2205/18 ,  A61M2205/3355 ,  A61M2205/3393 ,  G01G17/04

Abstract: A patient hydration system including an infusion device for administering hydration fluid to a patient, and a hydration fluid measurement device responsive to a source of hydration fluid, a patient urine output measurement device. A controller is responsive to the hydration fluid measurement device and the patient urine output measurement device. The controller operates the infusion device, in response to the patient urine output measurement device and the hydration fluid measurement device, to hydrate the patient based on the patient's urine output. The controller also monitors the operation history of the infusion device thereby providing redundancy in the measurement of the amount of hydration fluid administered to the patient.

Abstract translation: 一种患者水合系统，包括用于向患者施用水合流体的输注装置，以及响应于水合流体源的水合流体测量装置，患者尿液输出测量装置。 控制器响应于水合流体测量装置和患者尿液输出测量装置。 控制器响应于患者尿液输出测量装置和水合流体测量装置操作输液装置，以基于患者的尿液输出水合患者。 控制器还监测输注装置的操作历史，从而在测量给予患者的水合液量的量方面提供冗余。