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 Methods for electrosurgical tendon vascularization

Details
Inventors: Tasto, James P.; Woloszko, Jean; Baker, Michael A.; Pacek, James L.; Eggers, Philip E.; Thapliyal, Hira V.;
Assignee: Arthrocare Corporation (Sunnyvale, CA)
Primary Examiner: Peffley; Michael
Assistant Examiner:
Attorney, Agent or Firm: Raffle; John T., Batt; Richard R.

Systems, apparatus, and methods are provided for promoting blood flow to a target tissue. In one variation, the invention involves creating a pattern of voids in connective tissue, or through a tissue having sparse vascularity, such as a tendon or a meniscus, in order to increase blood flow within the tissue. This also includes using a template device to assist in the creation of the pattern of voids. Also included is an electrosurgical device with a self-contained fluid supply for providing conductive fluid to the target tissue or to active electrodes of the device.

DETAILED DESCRIPTION The present invention provides systems, apparatus and methods for selectively applying electrical energy to structures within or on the surface of a patient's body.
The systems, apparatus, and methods of the present invention are particularly useful for treating acute and chronic musculoskeletal or neurological injuries and disorders, such as strains, sprains, tendinitis, fasciitis, arthritis, bursitis and tenosynovitis.
In particular, the systems and methods of the present invention are useful for increasing blood flow to a target tissue, by canalization of tissue, stimulating the body's wound healing responses, such as inducing vascularization of tissue, stimulating collagen growth, altering cellular function, or other metabolic or physiologic events that promote healing and regeneration of injured tissue.
Systems and apparatus according to the present invention generally include an electrosurgical probe or catheter having a shaft with proximal and distal ends, one or more active electrode(s) at the distal end, and one or more connectors for coupling the active electrode(s) to a source of high frequency electrical energy.
The distal end portion of the shaft will usually have a diameter of less than 3 mm, preferably less than 1 mm.
The active electrode(s) are preferably supported within an electrically insulating support member typically formed of an inorganic material, such as a ceramic, a silicone rubber, or a glass.
In one method of the present invention, an active electrode is positioned in close proximity to tissue at a target site, and a high frequency voltage difference is applied between an active electrode and a return electrode to volumetrically remove or ablate tissue at the target site.
The active electrode(s) may be translated or otherwise moved relative to the body structure during or after the application of electrical energy to form a void within the body structure, such as a hole, channel, stripe, crater, divot, surface damage, or the like.
In some embodiments, the active electrode(s) are axially moved toward the body structure to volumetrically remove one or more channel(s), divot(s) or hole(s) through a portion of the structure



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