METHODS AND APPARATUS FOR PERCUTANEOUS PATIENT ACCESS AND SUBCUTANEOUS TISSUE TUNNELING
First Claim
1. A method of percutaneously accessing a patient with an elongated probe, comprising:
- placing an atraumatic distal tip of the probe against the derma of the patient;
conveying electrical energy to or from the distal tip to ablate tissue immediately adjacent the distal tip; and
advancing the probe through the derma while the tissue immediately adjacent the distal tip is ablated.
1 Assignment
0 Petitions
Accused Products
Abstract
Methods and apparatus for percutaneous blood vessel access and tissue tunneling, including guidewire placement, are provided. In one embodiment, an atraumatic distal tip of a tissue tunneling, medical probe is pressed against the derma, and electrical energy (e.g., radio frequency (RF) energy) is conveyed to or from the distal tip to ablate tissue immediately adjacent the distal tip, thereby advancing the probe through the derma while the tissue immediately adjacent the distal tip is ablated. In one embodiment, the medical probe comprises an elongated, rigid, electrically conductive, shaft, and an electrically insulative sheath disposed on the shaft to form an exposed tip electrode configured for electrosurgically ablating solid tissue located immediately axial to the tip electrode to facilitate rapid advancement of the medical probe through solid tissue. The probe may include an axially extending lumen through which an elongated guidewire may be introduced.
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Citations
46 Claims
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1. A method of percutaneously accessing a patient with an elongated probe, comprising:
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placing an atraumatic distal tip of the probe against the derma of the patient; conveying electrical energy to or from the distal tip to ablate tissue immediately adjacent the distal tip; and advancing the probe through the derma while the tissue immediately adjacent the distal tip is ablated. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method of subcutaneously creating a tunnel through tissue with an elongated tunneling probe, comprising:
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conveying electrical energy to or from an atraumatic distal tip of the tunneling probe to ablate tissue immediately adjacent the distal tip; and subcutaneously advancing the tunneling probe within the patient while the tissue immediately adjacent the distal tip is ablated. - View Dependent Claims (14, 15, 16)
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17. A medical probe, comprising:
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an elongated, rigid, electrically conductive, shaft; and an electrically insulative sheath disposed on the shaft to form an exposed atraumatic tip electrode configured for electrosurgically ablating solid tissue located immediately axial to the tip electrode to facilitate rapid advancement of the medical probe through the solid tissue without substantially ablating solid tissue immediately radial to the tip electrode. - View Dependent Claims (18, 19, 20, 21)
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22. A percutaneous access system, comprising:
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a catheter having a lumen; and a guidewire configured for being introduced through the catheter lumen, wherein the guidewire includes an electrically conductive, shaft and an electrically insulative sheath disposed on the shaft to form an exposed atraumatic tip electrode configured for electrosurgically ablating solid tissue located immediately axial to the tip electrode to facilitate rapid advancement of the guidewire through the solid tissue without substantially ablating solid tissue immediately radial to the tip electrode. - View Dependent Claims (23, 24, 25, 26)
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27. A catheter assembly, comprising:
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a flexible therapeutic or diagnostic catheter having an elongated shaft and a lumen axially extending through the catheter shaft; and a flexible guidewire configured for being removably introduced through the catheter lumen, the guidewire having an elongated, electrically conductive, shaft and an electrically insulative sheath disposed on the guidewire shaft to form an exposed atraumatic tip electrode that extends from a distal end of the catheter shaft when the guidewire is inserted within the catheter lumen, the tip electrode configured for electrosurgically ablating solid tissue located immediately axial to the tip electrode to facilitate rapid advancement of the catheter through solid tissue. - View Dependent Claims (28, 29, 30, 31, 32, 33, 34)
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35. A medical probe, comprising:
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an elongated, electrically conductive, shaft; a lumen extending through the shaft; and an electrically insulative sheath disposed on the shaft to form an exposed atraumatic tip electrode configured for electrosurgically ablating solid tissue located immediately axial to the tip electrode to facilitate rapid advancement of the medical probe through the solid tissue. - View Dependent Claims (36, 37, 38, 39)
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40. A method of percutaneously introducing a guidewire into a patient, comprising:
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placing an atraumatic distal tip of the guidewire against the derma of the patient; conveying electrical energy to or from the distal tip to ablate tissue immediately adjacent the distal tip; and advancing the catheter with the guidewire through the derma while the tissue immediately adjacent the distal tip is ablated. - View Dependent Claims (41, 42, 43, 44, 45)
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46. A catheter assembly, comprising:
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a flexible therapeutic or diagnostic catheter having an elongated shaft and a lumen axially extending through the catheter shaft; a flexible guidewire configured for being removably introduced through the catheter lumen, the guidewire having an elongated, electrically conductive, shaft and an electrically insulative sheath disposed on the guidewire shaft to form an exposed atraumatic tip electrode that extends from a distal end of the catheter shaft when the guidewire is inserted within the catheter lumen; and an electrical connector electrically coupled to the guidewire shaft, wherein the tip electrode is configured for electrosurgically ablating solid tissue located immediately axial to the tip electrode without substantially ablating solid tissue immediately radial to the tip electrode.
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Specification