Method and apparatus for catheterization by detecting signals indicating proximity to anatomical features

• US 20050049510A1
• Filed: 09/02/2003
• Published: 03/03/2005
• Est. Priority Date: 09/02/2003
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Tockman, Bruce, Carlson, Gerrard Merrill, Haldeman, Paul Craig, Salo, Rodney
• Granted Patent: US 8,000,771 B2
• Time in Patent Office: Days
• US Class Current: 600/483
• CPC Class Codes: A61B 2562/0219 Inertial sensors, e.g. accelerometers, gyroscopes, tilt switches
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/02 Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
• CPC Class Codes: A61B 5/489 Blood vessels
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00

Abstract

A guiding catheter for use in medical procedures includes a flexible shaft with one or more audio transducers and a distal tip. An audio signal may be sent to one or more of the transducers and a reflected signal is received at one or more transducers. The reflected signal is used to detect the presence of an anatomical structure to assist in navigating the catheter to its destination. In another arrangement, the transducer can be used passively to detect physical characteristics of the heart such as sound, subsonic energy or temperature, that indicate relative proximity of a destination vessel.

Claims

1. A catheter for locating a destination vessel, comprising:

a flexible shaft having a proximal end and a distal end;

a transducer configured to detect an energy parameter associated with cardiac activity measurable at the distal end of the flexible shaft, the energy parameter varying as a function of a distance between the destination vessel and the distal end of the flexible shaft; and

a proximal device coupled to the transducer, the proximal device arranged to produce a user perceivable representation of the energy parameter, a variation of the energy parameter indicating a relative proximity to the destination vessel to assist in navigating the distal end of the flexible shaft to the destination vessel.

2. The catheter of claim 1, wherein the transducer comprises an audio transducer, and the energy parameter comprises an acoustic signal generated by cardiac activity.

3. The catheter of claim 2, further comprising an audio speaker coupled to the proximal device and configured to reproduce the acoustic signal.

4. The catheter of claim 1, wherein the transducer comprises a temperature transducer, and the energy parameter comprises a blood temperature.

5. The catheter of claim 1, wherein the transducer comprises an accelerometer, and the energy parameter comprises a subsonic signal generated by cardiac activity.

6. The catheter of claim 1, further comprising a steering mechanism, and wherein the distal end of the flexible shaft is deflectable by actuation of the steering mechanism at a proximal end of the catheter to steer the catheter in a desired direction.

7. The catheter of claim 1, further comprising a video display coupled to the proximal device and configured to provide a visual representation of the energy parameter.

8. A catheter for locating a destination vessel associated with one or more anatomical features, comprising:

a flexible shaft having a proximal end and a distal end;

a sound transmitter configured to transmit an audio frequency signal from the distal end of the flexible shaft;

a sound receiver configured to detect a reflected signal received at the distal end of the flexible shaft; and

a proximal device coupled to the sound receiver, the proximal device arranged to receive the reflected signal and produce a user perceivable representation of a variation in the reflected signal, the variation in the reflected signal indicating a presence of the anatomical features to assist in navigating the distal end of the flexible shaft to the destination vessel.

9. The catheter of claim 8, further comprising a steering mechanism, and wherein the distal end of the flexible shaft is deflectable by actuation of the steering mechanism at a proximal end of the catheter to steer the catheter in a desired direction.

10. The catheter of claim 9, wherein the steering mechanism comprises a steering tendon connected to an anchor member positioned at a distal portion of the catheter, the steering mechanism providing uni-directional steering of the catheter.

11. The catheter of claim 9, wherein the steering mechanism comprises at least two steering tendons connected to one or more anchor members positioned at a distal portion of the catheter, the steering mechanism providing bi-directional steering of the catheter.

12. The catheter of claim 8, further comprising an audio speaker coupled to the proximal device and configured to reproduce the reflected signal.

13. The catheter of claim 8, further comprising a video display coupled to the proximal device and configured to provide a visual representation of the reflected signal.

14. The catheter of claim 8, wherein the audio frequency signal comprises a cyclic signal.

15. The catheter of claim 8, wherein the audio frequency signal comprises a random signal.

16. A method of locating a destination vessel, comprising:

introducing a guiding catheter into an access vessel that provides access to the destination vessel;

detecting an energy parameter associated with cardiac activity measurable at a distal end of the guiding catheter, the energy parameter varying as a function of a distance between the destination vessel and the distal end of the guiding catheter;

providing a user perceivable representation of the energy parameter; and

navigating the guiding catheter to the destination vessel based on a user perceivable variation of the energy parameter indicating a relative proximity to the destination vessel.

17. The method of claim 16, wherein navigating the guiding catheter further comprises selectively deflecting the distal end of the guiding catheter to steer the catheter in a desired direction.

18. The method of claim 16, wherein detecting the energy parameter comprises detecting an audio signal.

19. The method of claim 16, wherein detecting the energy parameter comprises detecting a subsonic signal.

20. The method of claim 16, wherein detecting the energy parameter comprises detecting a blood temperature.

21. A method of locating a destination vessel associated with an anatomical feature, comprising:

introducing a guiding catheter into an access vessel that provides access to the destination vessel;

transmitting an audio signal from a distal part of the guiding catheter;

detecting a reflected signal at the distal part of the guiding catheter;

producing a user perceivable representation of the reflected signal;

detecting the anatomical feature near the distal part of the guiding catheter based on a change of the reflected signal; and

navigating the guiding catheter to the destination vessel based on a location of the anatomical feature detected by the user perceivable representation of the reflected signal.

22. The method of claim 21, wherein navigating the guiding catheter further comprises selectively deflecting the distal end of the guiding catheter to steer the catheter in a desired direction.

23. The method of claim 22, wherein deflecting the distal end of the guiding catheter comprises uni-directionally deflecting the distal end of the guiding catheter by actuating a steering tendon connected to a distal portion of the catheter.

24. The method of claim 22, wherein deflecting the distal end of the guiding catheter comprises bi-directionally deflecting the distal end of the guiding catheter by actuating at least two steering tendons connected to a distal portion of the catheter.

25. The method of claim 21, wherein detecting the anatomical feature further comprises listening to the reflected signal.

26. The method of claim 21, wherein detecting the anatomical feature further comprises watching a visual representation of the reflected signal.

27. The method of claim 21, wherein transmitting the audio signal comprises transmitting a cyclic audio signal.

28. The method of claim 21, wherein transmitting the audio signal comprises transmitting a random audio signal.

29. A guiding catheter, comprising:

a flexible shaft having a proximal end and a distal end;

sound transmission means for sending an audio frequency signal from the distal end of the shaft;

sound receiving means for detecting a reflected signal at the distal end of the shaft; and

processing means for receiving the reflected signal from the sound receiving means and presenting a user perceivable indication of a variation in the reflected signal, the variation in the reflected signal indicating the presence of an anatomical structure to assist in guiding the distal end of the flexible shaft.

30. The guiding catheter of claim 29, further comprising steering means for selectably deflecting the distal end of the flexible shaft to steer the catheter in a desired direction.

31. The guiding catheter of claim 29, further comprising audio playback means coupled to the catheter for audibly representing the reflected signal.

32. The guiding catheter of claim 29, further comprising display means coupled to the catheter for visually representing the reflected signal.

33. The guiding catheter of claim 29, wherein the audio frequency signal comprises a cyclic signal.

34. The guiding catheter of claim 29, wherein the audio frequency signal comprises a random signal.

35. A guiding catheter, comprising:

a flexible shaft having a proximal end and a distal end;

means for detecting an energy parameter associated with cardiac activity measurable at the distal end of the flexible shaft, the energy parameter varying as a function of a distance between a destination vessel and the distal end of the flexible shaft; and

means for presenting a user perceivable indication of a variation in the energy parameter, the variation in the energy parameter indicating a relative proximity to the destination vessel to assist in guiding the distal end of the flexible shaft.

36. The guiding catheter of claim 35, wherein the guiding catheter further comprises steering means for selectively deflecting the distal end of the flexible shaft to steer the catheter in a desired direction.

37. The guiding catheter of claim 35, wherein the detecting means comprises an audio signal detector.

38. The guiding catheter of claim 35, wherein the detecting means comprises a subsonic signal detector.

39. The guiding catheter of claim 35, wherein the detecting means comprises a blood temperature detector.