Steerable endoluminal punch
First Claim
1. An apparatus adapted for punching a hole in a body lumen or hollow organ of a mammal comprising:
- an outer axially elongate hollow tube having a proximal end and a distal end;
an inner axially elongate hollow tube having a proximal end and a distal end;
a central lumen within said outer tube and extending substantially the length of said tube, wherein the inner tube can concentrically reside and rotate about its longitudinal axis;
a central lumen within said inner tube and extending substantially the length of said tube;
a first hub affixed to the proximal end of the outer axially elongate tube;
a second hub affixed to the proximal end of the inner axially elongate tube;
lock to selectively fix the rotational position of the first hub relative to the second hub;
a distal end of the either the inner tube or the outer tube configured to be sharp, wherein the sharp distal end is capable of punching a hole in a structure within the body lumen or hollow organ; and
an obturator slidably disposed within the central lumen of the inner tube, wherein the obturator can be advanced forward out the distal end of the tube or it can be removed from the tube by withdrawal through the proximal end of the tube.
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Accused Products
Abstract
This invention is a transvascularly placed punch, further including internal steerability and the ability to articulate in a direction at right angles to its longitudinal axis at or near its distal end. The punch is generally fabricated from stainless steel and includes an outer tube, an intermediate tube, a central stylet, hub structures, and a distal articulating region. The punch can be advanced through a body lumen in its straight configuration and then be selectively articulated or curved to permit negotiation of tortuous curvature or to permit optimal approach or access to a puncture site. The punch is able to create holes in the atrial septum of the heart or other structures and is easier to use than punches that are pre-curved near their distal tip since it is easier to advance through accessory catheters.
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Citations
20 Claims
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1. An apparatus adapted for punching a hole in a body lumen or hollow organ of a mammal comprising:
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an outer axially elongate hollow tube having a proximal end and a distal end;
an inner axially elongate hollow tube having a proximal end and a distal end;
a central lumen within said outer tube and extending substantially the length of said tube, wherein the inner tube can concentrically reside and rotate about its longitudinal axis;
a central lumen within said inner tube and extending substantially the length of said tube;
a first hub affixed to the proximal end of the outer axially elongate tube;
a second hub affixed to the proximal end of the inner axially elongate tube;
lock to selectively fix the rotational position of the first hub relative to the second hub;
a distal end of the either the inner tube or the outer tube configured to be sharp, wherein the sharp distal end is capable of punching a hole in a structure within the body lumen or hollow organ; and
an obturator slidably disposed within the central lumen of the inner tube, wherein the obturator can be advanced forward out the distal end of the tube or it can be removed from the tube by withdrawal through the proximal end of the tube. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. A method of punching a hole in a body lumen or hollow organ wall comprising the steps of:
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Inserting a guidewire into a patient'"'"'s body lumen and routing the guidewire to a location near a target site, wherein the target site is a organ or body lumen wall;
Advancing a guiding catheter over the guidewire to the target site;
Removing the guidewire;
Inserting an axially elongate punch into the guiding catheter and routing the punch to the target site, wherein the punch is substantially straight and uncurved;
Deflecting a region near the distal end of the punch so that the punch is oriented toward and against the target site; and
Punching a hole in the body lumen or hollow organ wall. - View Dependent Claims (9, 10, 11, 12, 14, 15, 16, 17, 18)
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19. An apparatus adapted for punching a hole in a body lumen or hollow organ wall comprising:
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An axially elongate tube comprising a distal end, a proximal end and a central lumen;
A means for punching tissue disposed at or near the distal end of the axially elongate tube;
A means for protecting the sharp distal end of the axially elongate tube while said axially elongate tube is being advanced to the treatment site;
A means for deflecting a region near the distal end of the axially elongate tube from a straight to a substantially curved configuration; and
A means to actuate the punch from the proximal end of the axially elongate tube. - View Dependent Claims (20)
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Specification