Systems and methods for electrosurgical treatment of vascular disorders

Abstract

Systems and methods are provided for treating a discolored blood vessel in tissue under the surface of the skin. In this method, one or more active electrode(s) are positioned in close proximity to a target region of the blood vessel, and a sufficient high frequency voltage is applied to the electrode terminal(s) to cause thermal damage to a target region within the blood vessel. The thermal injury causes the vessel to shrink or to thrombose and collapse so that blood flow through the vessel is restricted or completely interrupted. Preferably, the vessel is injured with minimal thermal energy being applied to the surrounding tissue, which prevents the tissue discoloration or scarring associated with prior art thermal processes. The electrode terminal(s) may be positioned on the external surface of the skin, or they may be introduced through a percutaneous penetration in the outer skin surface to the blood vessel. In the latter embodiment, the percutaneous penetration may be formed by advancing one or more needle electrodes through the outer surface of the skin to the target region of the vessel.

What is claimed is:  
     
         1 . A method of treating a discolored blood vessel located in tissue under the surface of the skin comprising: 
 positioning an active electrode in close proximity to a target region of the blood vessel; and    applying high frequency electrical energy to the active electrode, the electrical energy being sufficient to effect coagulation of blood within at least a portion of the target region of the vessel.    
     
     
         2 . The method of    claim 1    wherein the electrode terminal is positioned adjacent an outer surface of the skin, the electrical energy being sufficient to coagulate the target region of the blood vessel through the skin.  
     
     
         3 . The method of    claim 1    wherein the electrical terminal is introduced through a percutaneous penetration in the outer surface of the skin, and delivered to a location adjacent to or near the target region of the blood vessel.  
     
     
         4 . The method of    claim 1    wherein the positioning step comprises applying sufficient high frequency voltage to the outer surface of the skin to remove a portion of the skin and form a hole to the blood vessel, inserting the electrode terminal through the hole to a position adjacent the target region of the blood vessel, and applying sufficient high frequency voltage to the electrode terminal to coagulate blood within the vessel.  
     
     
         5 . The method of    claim 3    further comprising: 
 inserting at least a distal portion of a needle electrode through the outer surface of the skin to the target region of the blood vessel; and  
 applying sufficient high frequency voltage between the needle electrode and a return electrode to coagulate the target region.  
 
     
     
         6 . The method of    claim 5    further comprising positioning the return electrode on the outer surface of the skin.  
     
     
         7 . The method of    claim 5    further comprising inserting the return electrode through the outer surface of the skin to a location near the target region and the distal portion of the needle electrode.  
     
     
         8 . The method of    claim 7    wherein the return electrode comprises a hollow shaft, the method further comprising introducing a fluid through the hollow shaft into the target site.  
     
     
         9 . The method of    claim 7    further comprising spacing the distal end of the return electrode from an exposed portion of the needle electrode by a distance of about 0.05 to about 5.0 mm.  
     
     
         10 . The method of    claim 8    wherein the fluid comprises an electrically conductive fluid.  
     
     
         11 . The method of    claim 8    wherein the fluid comprises an anesthetic.  
     
     
         12 . The method of    claim 1    wherein the target site is a vascular lesion.  
     
     
         13 . The method of    claim 1    further comprising applying sufficient electrical energy to coagulate the target region of the blood vessel without causing permanent thermal injury to the tissue between the skin surface and said region of the blood vessel.  
     
     
         14 . The method of    claim 1    further comprising varying a distance between A distal portion of the return electrode and an exposed region of the active electrode to control a size of tissue coagulation or necrosis around the blood vessel.  
     
     
         15 . An apparatus for treating a discolored blood vessel located in tissue under the surface of the skin comprising: 
 an instrument having proximal and distal end portions and an active electrode on the distal end portion;    a return electrode; and    a high frequency power supply coupled to the active and return electrodes for applying a high frequency voltage difference therebetween, the high frequency voltage difference being sufficient to coagulate a target region of a blood vessel.    
     
     
         16 . The apparatus of    claim 15    wherein the instrument comprises a conductive needle having an insulated proximal portion and an exposed distal portion, the needle having a diameter less than about 0.05 to 2.0 mm.  
     
     
         17 . The apparatus of    claim 16    wherein the exposed distal portion has a length of about 0.5 to about 5.0 mm.  
     
     
         18 . The apparatus of    claim 15    wherein the return electrode comprises an instrument configured for insertion through the surface of the skin to a location near or adjacent to the target region of the blood vessel.  
     
     
         19 . The apparatus of    claim 15    wherein the return electrode comprises a hollow shaft having an inner lumen for receiving the active electrode, and a distal end configured for insertion through the outer surface of the skin to a location underneath the skin.  
     
     
         20 . The apparatus of    claim 19    wherein the hollow shaft has a fluid lumen for delivering an electrically conductive fluid to the target site.  
     
     
         21 . The apparatus of    claim 19    wherein the active electrode is axially movable relative to the hollow shaft.  
     
     
         22 . The apparatus of    claim 15    further comprising depth markings on either the instrument or the return electrode for determining a depth of penetration beneath the outer surface of the skin.