Method for ablating tissue to facilitate implantation and apparatus and kit for use therewith

Abstract

A method for treating a mammalian body having tissue comprising creating a cavity in the tissue formed by an internal surface of the tissue. The internal surface is ablated. An implant-forming material is introduced into the cavity to create an implant in the tissue. The ablation of the internal surface inhibits migration of the implant. An apparatus and kit for use with the method are provided.

1 . A method for treating a mammalian body having tissue comprising creating a cavity in the tissue formed by an internal surface of the tissue, ablating the internal surface and introducing an implant-forming material into the cavity to create an implant in the tissue whereby the ablation of the internal surface inhibits migration of the implant. 
   
   
       2 . The method of  claim 1  wherein the creating step includes dissecting the tissue. 
   
   
       3 . The method of  claim 2  wherein the dissecting step includes inflating a balloon in the tissue. 
   
   
       4 . The method of  claim 3  wherein the ablating step includes utilizing the balloon to ablate the tissue. 
   
   
       5 . The method of  claim 4  wherein the inflating step includes inflating the balloon with a conductive material and the ablating step includes weeping the conductive material from the balloon. 
   
   
       6 . The method of  claim 5  wherein the ablating step includes energizing an electrode within the balloon to couple radio frequency energy to the conductive material. 
   
   
       7 . The method of  claim 4  wherein the ablating step includes energizing conductive pathways on a surface of the balloon. 
   
   
       8 . The method of  claim 4  wherein the ablating step includes energizing a conductive coating on a surface of the balloon. 
   
   
       9 . The method of  claim 1  wherein the creating step includes providing a catheter having a distal extremity and introducing the distal extremity into tissue of a wall of the body forming a natural body cavity in the body. 
   
   
       10 . The method of  claim 9  wherein the creating step includes introducing the distal extremity into a natural body opening to access the natural body cavity. 
   
   
       11 . The method of  claim 9  wherein the creating step includes providing an incising element on the distal extremity of the catheter and incising the tissue with the incising element. 
   
   
       12 . The method of  claim 11  wherein the creating step includes providing a lumen within the catheter which extends to and opens at the distal extremity of the catheter and sliding the incising element through the lumen to the distal extremity of the catheter. 
   
   
       13 . The method of  claim 9  wherein the creating step includes providing a balloon on the distal extremity of the catheter and inflating the balloon in the tissue. 
   
   
       14 . A method for treating a mammalian body having a wall formed by a plurality of tissue layers comprising introducing a balloon into the wall, inflating the balloon with a fluid having a pressure and measuring the pressure of the fluid so as to determine in which of the plurality of layers the balloon is disposed. 
   
   
       15 . The method of  claim 14  wherein the measuring step includes comparing the measured pressure to a plurality of predetermined pressures corresponding respectively to the plurality of tissue layers. 
   
   
       16 . The method of  claim 14  further comprising deflating the balloon to provide a cavity in the wall. 
   
   
       17 . The method of  claim 16  further comprising forming an implant in the cavity. 
   
   
       18 . The method of  claim 14  further comprising ablating the wall in the vicinity of the balloon. 
   
   
       19 . A method for treating a mammalian body having a wall having a surface and formed by a plurality of tissue layers comprising introducing a balloon into the wall, inflating the balloon whereby a bulge is formed on the surface of the wall which changes a characteristic of the surface of the wall and observing the changed characteristic to determine in which of the plurality of layers the balloon is disposed. 
   
   
       20 . The method of  claim 19  wherein the changed characteristic is selected from the group consisting of color of the surface under fluoroscopy, color of the surface under ultrasound and color of the surface under optical visualization. 
   
   
       21 . The method of  claim 19  further comprising deflating the balloon to provide a cavity in the wall. 
   
   
       22 . The method of  claim 21  further comprising forming an implant in the cavity. 
   
   
       23 . The method of  claim 19  further comprising ablating the wall in the vicinity of the balloon. 
   
   
       24 . A method for treating a mammalian body having tissue comprising creating a cavity in the tissue formed by an internal surface of the tissue and ablating the internal surface of the cavity to treat the tissue. 
   
   
       25 . The method of  claim 24  wherein the creating step includes inflating a balloon in the tissue. 
   
   
       26 . The method of  claim 25  wherein the ablating step includes utilizing the balloon to ablate the tissue. 
   
   
       27 . The method of  claim 24  wherein the creating step includes providing a catheter having a distal extremity and introducing the distal extremity into tissue of a wall of the body forming a natural body cavity in the body. 
   
   
       28 . The method of  claim 27  wherein the creating step includes introducing the distal extremity into a natural body opening to access the natural body cavity  29 . The method of  claim 24  wherein the creating step includes introducing a plurality of conductive bodies into the tissue. 
   
   
       30 . The method of claim  29  wherein the ablating step includes supplying radio frequency energy to the conductive bodies. 
   
   
       31 . The method of  claim 30  further comprising removing the conductive bodies from the tissue after the ablating step. 
   
   
       32 . An apparatus for creating a cavity in tissue formed by an internal surface of the tissue comprising a flexible elongate member having proximal and distal extremities, an expandable-collapsible body carried by the distal extremity of the flexible elongate member and capable of expanding in the tissue to form the cavity, an ablation element carried by the distal extremity of the flexible elongate member and coupled to the expandable-collapsible body for ablating the internal surface of the tissue forming the cavity, and an incising element carried by the distal extremity of the flexible elongate member for introducing the expandable-collapsible body into the tissue. 
   
   
       33 . The apparatus of  claim 32  wherein the expandable-collapsible body is provided with a plurality of pores and the ablation element includes an electrode disposed on the elongate member within the expandable-collapsible body. 
   
   
       34 . The apparatus of  claim 32  wherein the expandable-collapsible body has an exterior surface and the ablation element includes conductive paths formed on the external surface of the expandable-collapsible body. 
   
   
       35 . The apparatus of  claim 32  wherein the expandable-collapsible body has an exterior surface and the ablation element includes a conductive coating provided on the external surface of the expandable-collapsible body. 
   
   
       36 . The apparatus of  claim 32  wherein the flexible elongate member has a lumen extending to and opening at the distal extremity of the elongate member and the incising element includes a wire slidably disposed in the lumen, the wire having a sharp distal end slidable to an extended position beyond the distal extremity of the flexible elongate member. 
   
   
       37 . A kit for creating a cavity in tissue formed by an internal surface of the tissue and for introducing an implant-forming material into the cavity comprising a package, a first elongate member provided within the package and having proximal and distal extremities, an expandable-collapsible body carried by the distal extremity of the first elongate member and capable of expanding in the tissue to form the cavity, an ablation element carried by the distal extremity of the first elongate member and coupled to the expandable-collapsible body for ablating the internal surface of the tissue forming the cavity and a second elongate member provided within the package and having proximal and distal extremities and a lumen extending from the proximal extremity to the distal extremity of the second elongate member whereby an implant-forming material can be introduced into the lumen at the proximal extremity of the second elongate member for delivering the implant-forming material to the cavity in the tissue. 
   
   
       38 . The kit of  claim 37  further comprising an incising element carried by the distal extremity of the first elongate member. 
   
   
       39 . The kit of  claim 37  wherein the second elongate member includes an elongate sleeve having a lumen extending longitudinally therethrough and a needle member slidably disposed in the lumen of the elongate sleeve. 
   
   
       40 . The kit of  claim 37  further comprising a container of the implant-forming material provided within the package. 
   
   
       41 . The kit of  claim 40  further comprising a container of a biocompatible solvent provided within the package. 
   
   
       42 . The kit of  claim 40  further comprising a syringe for introducing the implant-forming material into the lumen of the second elongate member. 
   
   
       43 . The kit of  claim 37  wherein the implant-forming material is a nonaqueous solution, whereby a nonbiodegradable solid is formed in the cavity from the nonaqueous solution. 
   
   
       44 . The kit of  claim 37  further comprising an incising element provided within the package for facilitating entry of the expandable-collapsible body into the tissue. 
   
   
       45 . The kit of  claim 44  wherein the incising element is a guidewire.