Tri-directional articulating catheter

• US 20070276324A1
• Filed: 12/12/2006
• Published: 11/29/2007
• Est. Priority Date: 12/12/2005
• Status: Active Grant

• Current Assignee: Taheri Laduca LLC
• Original Assignee: Duke Fiduciary, LLC
• Inventors: Laduca, Robert, Laduca, Paul
• Granted Patent: US 8,066,664 B2
• Time in Patent Office: Days
• US Class Current: 604/95.40
• CPC Class Codes: A61M 25/008 Strength or flexibility characteristics of the catheter tip
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires

Abstract

A catheter capable of articulating in two and three directions is provided. Articulation at the distal tip of the catheter is facilitated by applying selective tension on a steering wire disposed in a lumen that resides peripheral to a central working lumen. Tension on the steering wire through the peripheral lumen causes the catheter tip to bend while the central working lumen resists compression.

Claims

1. A catheter for accessing an interior site of a mammalian subject comprising:

a. an elongate catheter body having a distal tip and a proximal end, a central working lumen running from the distal tip to the proximal end, first and second opposed peripheral lumens on an exterior surface of said central working lumen, said peripheral lumens in a plane of articulation relative to one another, first and second steering wires disposed through each of said first and second peripheral lumens,

b. an attachment at the distal tip for attaching the steering wires disposed through said peripheral lumens and

c. means for applying selective tension to the steering wires, said means located at the proximal end,

wherein the distal tip steerable by the first and second steering wires comprises a flexible non-compressible material so that application of selective tension to the first or second steering wire causes a bend in a direction within the plane of articulation at the distal tip, said bend accomplished while a length of the elongate catheter at the distal tip along said bend resists compression of the central working lumen.

2. The catheter of claim 1, further comprising

d. a third peripheral lumen on the exterior surface of said central working lumen having a third steering wire disposed therethrough, said third steering wire having a first attachment at the distal tip and a second attachment at the proximal end,

e. means for applying selective tension to the third steering wire, said means located at the proximal end,

wherein application of selective tension to the third steering wire causes a bend in a direction outside the plane of articulation of said first and second steeling wires, said bend accomplished while the length of the elongate catheter at the distal tip along said bend resists compression of the central working lumen.

3. The catheter of claim 1 or 2, wherein the flexible non-compressible material comprises a configuration selected from the group consisting of

a. a braid angle change in braided wire embedded in composite polymer or plastic embedded running from the distal tip proximally so that the pies per inch decrease proximally,

b. a gradual diameter shift in the central working lumen running from the distal tip proximally so that the distal tip is narrow and the diameter of the lumen gradually increases proximally along the length of the elongate catheter,

c. an increasing durometer of composite plastic or polymer material moving from the distal tip proximally, and

d. a combination of a metal coil covered with a metal braid and embedded in composite polymer or plastic material.

4. The catheter of claim 1 or 2, wherein means for applying selective tension to the first and second steering wires comprises a rotatable steering unit having a rotatable steering knob for steering the distal tip in a direction within the plane of articulation, said steering unit located at the proximal end on the catheter body outside the mammalian subject wherein said first and second wires attach to the rotatable steering knob on opposite sides of said steering knob, and further wherein turning the steering knob counterclockwise articulates the distal tip in the plane of articulation in one direction, and turning the steering knob clockwise articulates the distal tip in the plane of articulation in an opposite direction.

5. The catheter of claim 4, wherein said steering knob has an internal chamber having radially opposed circumferential tracks each comprising a pin attached to an internal surface of a rotating member of the knob, said pins slidable in their respective tracks, said first and second wires attached one on each of said opposed pins for articulating the tip in a direction in the plane of articulation when the rotating member of the knob turns clockwise or counterclockwise.

6. The catheter of claim 4 or 5, wherein said steering knob comprises a locking mechanism for locking movement of the first and second wires, whereupon release of the locking mechanism releases the steering knob to turn and steer the first or second wire and so steer or bend the catheter tip in a direction within the plane of articulation.

7. The catheter of claim 4, 5, or 6, further comprising means for adjustable friction at the steering knob so that tip deflection is maintained during a procedure.

8. The catheter of claim 2, wherein said third wire is attached at the proximal end at a slidable unit located there at, said slidable unit for providing selective tension to the third steering wire, said slidable unit able to slide along the elongate catheter in a proximal direction pulling the third wire attached at the distal tip and causing the tip to bend along the length of the elongate catheter in a direction outside the plane of articulation of said first and second peripheral lumens, said bend accomplished while the length of the elongate catheter at the distal tip along said bend resists compression of the central working lumen.

9. The catheter of claim 1 or 2, further comprising a plurality of peripheral lumens disposed circumferentially on the exterior surface of said central working lumen, said peripheral lumens available for instrument access to the interior site in the mammalian subject.

10. The catheter of claim 1, 2, or 9 further comprising a donut shaped balloon encasing the peripheral lumens and forming an expanded border around an opening for the central working lumen.

11. A catheter as in claim 1, further comprising a plurality of peripheral lumens disposed circumferentially on the exterior surface of said central working lumen, said peripheral lumens available for instrument access to the interior site in the mammalian subject.

12. A catheter as in claim 1, further comprising a donut shaped balloon encasing the peripheral lumens and forming an expanded border around an opening for the central working lumen.

13. A catheter as in claim 11, further comprising a donut shaped balloon encasing the peripheral lumens and forming an expanded border around an opening for the central working lumen.

16. A method of depositing a composition at a site in a mammalian subject comprising the steps of:

a. a. accessing an interior site of the mammalian subject with a catheter of claim 1, 2, 9 or 10,

b. contacting the site through the central working lumen of the catheter with one or more instruments capable of depositing the composition, and

c. depositing the composition at the site.

18. A method of accessing an interior site of a mammalian subject comprising the steps of:

a. accessing an interior site of the mammalian subject with a catheter of claim 1, 2, 9, or 10.

19. A method of placing a pacemaker lead in heart tissue of a mammalian subject comprising:

a. accessing an interior site of the mammalian subject with a catheter of claim 1, 2, 9 or 10,

b. articulating and stabilizing the distal tip of the catheter at the heart,

c. accessing the heart through the central working lumen of the catheter with a device having a pacemaker lead at a distal end of the device,

d. placing the lead in the heart tissue, and

e. withdrawing the lead placement device.

20. A method of facilitating a maze heart procedure comprising:

a. accessing an interior site of the mammalian subject with a catheter of claim 1, 2, 9, or 10,

b. steering the catheter to a proper position for the maze procedure using one or more visualization instruments accessing the site through the catheter,

c. performing the maze procedure.

21. A method of performing a valve replacement procedure comprising:

a. accessing an interior site of a heart of the mammalian subject with a catheter of claim 1, 2, 9, or 10,

b. steering the catheter to a heart valve to be replaced using one or more visualization instruments that access the site through lumens in the catheter,

c. performing the valve replacement procedure.

22. A method for performing a minimally invasive mitral valve repair comprising:

a. accessing an interior site at a heart of a mammalian subject with a catheter of claim 1, 2, 9, or 10,

b. steering the catheter to the mitral valve to be repaired using one or more visualization instruments accessing the site through lumens in the catheter,

c. performing the mitral valve repair.

23. A method for accessing and treating a site in a mammalian subject comprising:

a. accessing an interior site of the mammalian subject with a catheter of claim 1, 2, 9, or 10,

b. steering the catheter to a site within the mammalian subject,

c. stabilizing the catheter at the site using one or more instruments accessing the site through lumens in the catheter;

d. performing a procedure at the site using one or more instruments accessing the site through lumens in the catheter.

24. A method of making a catheter as described in claims 1, 2, 9 and 10, comprising:

a. providing components of the catheter, and

b. assembling said components in an order so as to build a working catheter.

14. A catheter for accessing an interior site of a mammalian subject comprising:

a. an elongate catheter body having a distal tip and a proximal end, a central working lumen running from the distal tip to the proximal end,

b. a peripheral lumen located on the exterior surface of said central working lumen having a steering wire disposed therethrough, said steering wire having a first attachment at the distal tip and a second attachment at the proximal end, and

c. means for applying selective tension to the steering wire, said means located at the proximal end,

wherein application of selective tension to the steering wire causes a bend in a direction of the elongate catheter, said bend accomplished while the length of the elongate catheter at the distal tip along said bend resists compression of the central working lumen, and comprising a plurality of peripheral lumens disposed circumferentially on the exterior surface of said central working lumen, said peripheral lumens available for instrument access to the interior site in the mammalian subject.

15. A catheter as in claim 14, further comprising a donut shaped balloon encasing the peripheral lumens and forming an expanded border around an opening for the central working lumen.

17. (canceled)