Systems and methods for internal tissue penetration

• US 20040186368A1
• Filed: 03/21/2003
• Published: 09/23/2004
• Est. Priority Date: 03/21/2003
• Status: Active Grant

• Current Assignee: Stryker European Operations Holdings, LLC (Stryker Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: Ramzipoor, Kamal, Koger, James D., Chopra, Gopal
• Granted Patent: US 7,715,896 B2
• Time in Patent Office: Days
• US Class Current: 600/407
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/00087 Tools A61B17/00234 takes precedence
• CPC Class Codes: A61B 1/00135 Oversleeves mounted on the endoscope prior to insertion
• CPC Class Codes: A61B 1/3132 for laparoscopy
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/22075 with motorized advancing or retracting means
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/22078 for rotating the instrument within a channel, e.g. an optical fibre
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 5/0066 Optical coherence imaging
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/445 Details of catheter construction

Abstract

A medical system is a medical device, such as a catheter, that includes an inner core and an imager that is extendable from within an elongated tubular member and configured to penetrate a body tissue within a living body. The elongated tubular member has a distal end and is configured to slideably receive the inner core. The distal end is further configured to allow the inner core to advance outside the elongated member. The inner core has a distal end and is configured to rotate radially around a longitudinal axis of the elongated member. The device can further include an imager located at the distal end of the inner core, and the imager can be configured to image a body tissue and output an image signal to an imaging system communicatively coupled with the imager. The imaging system is configured to generate an image of the body tissue from the image signal of the imager when the imager is rotated and placed into contact with the body tissue such that the imager penetrates the body tissue.

Claims

1. A method of penetrating a body tissue of a living body, comprising:

advancing a distal end of an elongated tubular member into a living body, the member configured to slideably receive an inner core;

rotating the inner core of the elongated member radially around a longitudinal axis;

advancing a distal end of the inner core past the distal end of the member such that an imager located at the distal end of the inner core is placed into contact with a body tissue; and

penetrating the body tissue with the distal end of the rotating inner core.

2. The method of claim 1, wherein rotating the inner core comprises imaging the body tissue with the imager.

3. The method of claim 2, further comprising generating an image of the body tissue with an imaging system.

4. The method of claim 3, further comprising locating an optimum penetration region of the body tissue with the imager.

5. The method of claim 2, wherein the distal end of the elongated member is inserted into a lumen of the body and rotating the inner core comprises imaging the lumen.

6. The method of claim 5, wherein the body lumen is a body canal.

7. The method of claim 1, further comprising advancing the distal end of the elongated member into contact with the body tissue prior to advancing the distal end of the inner core past the distal end of the elongated member.

8. The method of claim 1, further comprising stopping the advancement of the distal end of the inner core once a pre-determined length of the inner core has advanced past the distal end of the elongated member.

9. The method of claim 1, further comprising gauging how far the inner core has advanced past the distal end.

10. The method of claim 1, further comprising suctioning the body tissue to fixate the tissue prior to penetrating the tissue.

11. The method of claim 1, further comprising suctioning fluid from within the body.

12. The method of claim 11, further comprising introducing a fluid into the area adjacent to the penetration region and suctioning the fluid from the adjacent area.

13. The method of claim 1, wherein penetrating the body tissue comprising penetrating the tissue to create more than one opening through the tissue.

14. The method of claim 13, further comprising inserting a prosthesis into the opening.

15. The method of claim 14, further comprising enlarging the prosthesis to dilate the opening.

16. The method of claim 1, further comprising coagulating the body tissue in the penetration region with a coagulation device to suppress bleeding.

17. The method of claim 16, further comprising coagulating the body tissue with radio frequency (RF) energy applied by the imager.

18. The method of claim 1, further comprising ablating the body tissue with radio frequency (RF) energy applied by the imager.

19. The method of claim 1, wherein advancing a distal end of an elongated member comprises:

percutaneously inserting the elongated member into a spinal canal of the living body; and

advancing the elongated member along the spinal canal into proximity with a body tissue.

20. The method of claim 19, wherein the body tissue is a cerebral ventricle.

21. The method of claim 20, further comprising penetrating the ventricle with the distal end of the inner core to create an opening sufficient to access the ventricle.

22. The method of claim 21, further comprising draining fluid from the ventricle through the opening.

23. The method of claim 21, further comprising inserting a shunt into the opening.

24. The method of claim 23, further comprising enlarging the prosthesis within the opening.

25. The method of claim 22, further comprising:

advancing the elongated member into the ventricle; and

suctioning fluid from the ventricle with the elongated member.

26. The method of claim 19, wherein percutaneously inserting the elongated member comprises percutaneously inserting the elongated member into the spinal canal through a lumbar region of the living body.

27. The method of claim 26, wherein the elongated member is percutaneously inserted through an L3-L4 lumbar space of the lumbar region.

28. The method of claim 26, wherein the elongated member is percutaneously inserted through an L4-L5 lumbar space of the lumbar region.

29. The method of claim 1, wherein the imager is an acoustic transducer configured to image at an imaging angle offset from the longitudinal axis of the elongated member.

30. The method of claim 1, wherein a distal end of the imager is configured to facilitate penetration of the body tissue.

31. The method of claim 30, wherein a distal end of the imager comprises an abrasive surface to facilitate penetration of the body tissue.

32. The method of claim 30, wherein a distal end of the imager comprises a drill member.

33. The method of claim 30, wherein a distal end of the imager is substantially flat.

34. The method of claim 30, wherein a distal end comprises a plurality of protrusions.

35. The method of claim 30, wherein a distal end of the imager is pointed.

36. The method of claim 30, wherein the imager comprises a flute.

37. The method of claim 1, further comprising imaging the body externally in real-time.

38. The method of claim 1, further comprising imaging the body externally with magnetic resonance imaging.

39. The method of claim 1, further comprising implanting a radioactive material in the body tissue comprising a tumor.

40. The method of claim 20, further comprising circulating fluid within the ventricle.

41. The method of claim 20, further comprising introducing a low temperature fluid into the ventricle to induce local cerebral hypothermia.

42. The method of claim 1, further comprising measuring a level of torque applied to the inner core with a control system when the core is rotating.

43. The method of claim 42, further comprising stopping advancement of the inner core if a maximum torque threshold is reached.

44. A medical system, comprising:

an elongated tubular member comprising a distal end and configured to slideably receive an inner core, wherein the distal end is configured to allow the inner core to advance outside the elongated member;

the inner core comprising a distal end, the inner core configured to rotate radially around a longitudinal axis of the elongated member;

an imager located at or near the distal end of the inner core, the imager configured to image a body tissue and output an image signal, the imager being adapted to be rotated and placed into contact with the body tissue such that the imager penetrates the body tissue; and

an imaging system communicatively coupled with the imager and configured to generate an image of the body tissue from the image signal of the imager.

45. The system of claim 44, wherein a distal end of the imager is configured to penetrate the body tissue.

46. The system of claim 45, wherein the distal end of the imager comprises an abrasive surface to facilitate penetration of the body tissue.

47. The system of claim 45, wherein the distal end of the imager comprises a drill member.

48. The system of claim 45, wherein the distal end of the imager is substantially flat.

49. The system of claim 45, wherein the distal end comprises a plurality of protrusions.

50. The system of claim 45, wherein the distal end of the imager is pointed.

51. The system of claim 44, wherein the imager comprises a flute.

52. The system of claim 44, wherein the imaging system comprises a display configured to display the image and facilitate the location of a safe penetration region of the body tissue.

53. The system of claim 44, further comprising a control system configured to control the rotation of the inner core.

54. The system of claim 53, wherein the control system is further configured to measure a level of torque applied to the inner core.

55. The system of claim 44, wherein the elongated member is insertable into a lumen of the body and the imager is configured to generate an image signal of the lumen.

56. The system of claim 55, wherein the lumen is a body canal.

57. The system of claim 44, further comprising a stop device configured to prevent the transducer from advancement greater than a pre-determined length past the distal end of the elongated member.

58. The system of claim 44, further comprising a gauge configured to gauge the advancement of the transducer past the distal end of the elongated member.

59. The system of claim 44, further comprising a prosthesis insertable into an opening in the body tissue and configured to dilate the opening.

60. The system of claim 59, wherein the prosthesis is located on the elongated member.

61. The system of claim 59, wherein the prosthesis is a narrow circumference dumbbell balloon.

62. The system of claim 59, wherein the prosthesis is detachable and configured to maintain the opening.

63. The system of claim 44, further comprising a suction system configured to suction fluid or debris from within the body.

64. The system of claim 63, wherein the suction system is coupled with the elongated member and is configured to suction through the elongated member.

65. The system of claim 63, wherein the suction system is coupled with an elongated tubular suction member and is configured to suction through the elongated suction member.

66. The system of claim 65, wherein the suction member is configured to suction the body tissue and fixate the tissue with respect to the inner core.

67. The system of claim 65, further comprising an elongated tubular guide member configured to slideably receive the elongated member and the elongated suction member.

68. The system of claim 65, further configured to introduce fluid to the body and suction fluid from the body such that the fluid is circulated within the body.

69. The system of claim 44, further comprising a coagulation device insertable into the body and configured to coagulate the body tissue to suppress bleeding.

70. The system of claim 69, wherein the coagulation device is the imager and wherein the imager is electrically coupled with a radio frequency (RF) energy source.

71. The system of claim 69, wherein the coagulation device is located on the elongated member.

72. The system of claim 44, further comprising an ablation device.

74. The system of claim 72, wherein the ablation device is the imager and wherein the imager is electrically coupled with a radio frequency (RF) energy source.

75. The system of claim 69, further comprising a second elongated tubular member comprising the coagulation device.

76. The system of claim 69, further comprising an elongated tubular guide member insertable into the body and configured to slideably receive the elongated tubular member and the second elongated tubular member.

77. The system of claim 44, wherein the elongated member is percutaneously insertable into a spinal canal of the living body.

78. The system of claim 44, wherein the body tissue is a cerebral ventricle.

79. The system of claim 78, wherein the imager is configured to penetrate the ventricle and create an opening sufficient to access the ventricle.

80. The system of claim 78, wherein the elongated member is insertable into a spinal canal of the living body through a lumbar region.

81. The system of claim 44, wherein the imager is an acoustic transducer configured to image at an imaging angle offset from the longitudinal axis of the elongated member.

82. The system of claim 44, further comprising an external imaging system configured to image the body in real-time.

83. The system of claim 82, wherein the external imaging system is a magnetic resonance imaging system and wherein the elongated member and inner core are comprised of materials that do not substantially interfere with an image produced by the magnetic resonance imaging system.

84. The system of claim 44, wherein said elongated tubular member is part of a catheter.

85. The system of claim 44, further comprising a control system coupled to a proximal end of the inner core and configured to measure a level of torque applied to the inner core when the inner core penetrates the body tissue.

86. The system of claim 85, wherein the control system is further configured to control advancement of the inner core outside the elongated member and to stop advancement of the inner core when a pre-determined level of torque on the inner core is reached.

87. A method of manufacturing a medical system, comprising:

providing an elongated tubular member comprising a distal end and a proximal end and configured to slideably receive an inner core, wherein the distal end is configured to allow the inner core to advance outside the elongated member; and

providing the inner core comprising an imager configured to penetrate a body tissue when rotated radially around a longitudinal axis of the elongated member and placed into contact with the tissue, wherein the imager is located at a distal end of the inner core and is configured to image the body tissue and output an image signal; and

providing an imaging system communicatively coupled with the imager and configured to generate an image of the body tissue from the image signal of the imager and display the image on a display.