STEPWISE ADVANCEMENT OF A MEDICAL TOOL

• US 20090306547A1
• Filed: 06/18/2009
• Published: 12/10/2009
• Est. Priority Date: 03/08/2007
• Status: Active Grant

• Current Assignee: Sync-Rx, Ltd. (Koninklijke Philips N.V.)
• Original Assignee: Sync-Rx, Ltd. (Koninklijke Philips N.V.)
• Inventors: IDDAN, Gavriel, Blank, Jacob, Cohen, Ran, Tolkowsky, David
• Granted Patent: US 8,700,130 B2
• Time in Patent Office: Days
• US Class Current: 600/585
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/00694 with means correcting for movement of or for synchronisation with the body
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• CPC Class Codes: A61B 2017/22044 with a pointed tip
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 6/503 for diagnosis of the heart
• CPC Class Codes: A61B 6/5217 extracting a diagnostic or physiological parameter from medical diagnostic data
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 8/02 Measuring pulse or heart rate
• CPC Class Codes: A61F 2/9517 handle assemblies therefor
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61M 2025/09116 Design of handles or shafts or gripping surfaces thereof for manipulating guide wires
• CPC Class Codes: A61M 25/09041 Mechanisms for insertion of guide wires
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Apparatus is provided, including a sensor for sensing a phase of cyclic activity of a subject'"'"'s body system. A tool modulator includes a gate configured:

• • in a first cycle of the cyclic activity, to allow movement of a tool, in response to the cyclic activity being at a first given phase thereof,
  • following the given phase in the first cycle and prior to an occurrence of the given phase in a subsequent cycle of the cyclic activity, to inhibit the movement of the tool, and
  • in a second cycle of the cyclic activity, subsequent to the inhibiting of the movement, to allow movement of the tool, in response to the second cycle of the cyclic activity being at the given phase thereof.

An accumulation facilitator facilitates an accumulation of the tool in the tool modulator, and/or an accumulation of energy in the tool.

Claims

1. Apparatus for use with a portion of a body of a subject that moves as a result of cyclic activity of a body system of the subject, the apparatus comprising:

a sensor for sensing a phase of the cyclic activity;

a tool configured to be moved with respect to the portion of the subject'"'"'s body by being pushed by a user; and

a tool modulator comprising;

a gate, configured;

in a first cycle of the cyclic activity, to allow movement of at least a distal portion of the tool in a distal direction, in response to the sensor sensing that the cyclic activity is at a first given phase thereof,

following the given phase in the first cycle and prior to an occurrence of the given phase in a subsequent cycle of the cyclic activity, to inhibit the movement of the distal portion of the tool, and

in a second cycle of the cyclic activity, subsequent to the inhibiting of the movement, to allow movement of the at least the distal portion of the tool in the distal direction, in response to the sensor sensing that the second cycle of the cyclic activity is at the given phase thereof; and

an accumulation facilitator configured, following the given phase in the first cycle and prior to the occurrence of the given phase in the subsequent cycle of the cyclic activity, and in response to the user pushing the tool, to facilitate an accumulation selected from the group consisting of;

an accumulation of the tool in the tool modulator, and an accumulation of energy in the tool.

2. The apparatus according to claim 1, wherein the tool modulator is configured to provide force feedback to the user that is smoothened with respect to the cyclic activity.

3. The apparatus according to claim 1, wherein the given phase includes a phase selected from the group consisting of a diastolic phase and an end-diastolic phase, and wherein the gate is configured to allow movement of the distal portion of the tool in the distal direction, in response to the sensor sensing that the cyclic activity is at the selected phase.

4. The apparatus according to claim 1, wherein the gate is configured to allow continuous movement of the tool in a proximal direction, when the tool is being withdrawn from the portion of the subject'"'"'s body.

5. The apparatus according to claim 1, wherein the accumulation facilitator comprises a pushing element configured to push a portion of the tool at least partially in a non-distal direction, in response to the user pushing the tool in the distal direction.

6. The apparatus according to claim 1, wherein the accumulation facilitator is configured to facilitate accumulation of the tool in the tool modulator.

7. The apparatus according to claim 1, wherein the accumulation facilitator is configured to facilitate accumulation of energy in the tool.

8. The apparatus according to claim 7, wherein the accumulation facilitator is configured to facilitate accumulation of elastic energy in the tool.

9. The apparatus according to claim 1, wherein the tool comprises a guide wire configured to be moved within a blood vessel of the subject.

10. The apparatus according to claim 9, wherein:

by allowing movement of at least the distal portion of the tool in the distal direction, the gate is configured to allow movement of a distal portion of the guide wire into a side branch that branches from the blood vessel, when the side branch is at a first angle from the blood vessel, and

by inhibiting movement of at least the distal portion of the tool, the gate is configured to inhibit movement of the distal portion of the guide wire into the side branch, when the side branch is at another angle from the blood vessel.

11. The apparatus according to claim 9, wherein the gate, by inhibiting the movement of the distal portion of the tool, is configured to inhibit a distal portion of the guide wire from moving in an undesirable direction with respect to the blood vessel.

12. The apparatus according to claim 11, wherein the gate, by inhibiting the movement of the distal portion of the tool, is configured to inhibit a distal portion of the guide wire from puncturing the blood vessel.

13. A method for automatically controlling movement of a tool when the tool is used with a portion of a body of a subject that moves as a result of cyclic activity of a body system of the subject, the method comprising:

sensing a phase of the cyclic activity;

in a first cycle of the cyclic activity, allowing movement of at least a distal portion of the tool in a distal direction with respect to the portion, in response to sensing that the cyclic activity is at a first given phase thereof,

following the given phase in the first cycle, and prior to an occurrence of the given phase in a subsequent cycle of the cyclic activity;

inhibiting the movement of the distal portion of the tool, and

in response to a user pushing the tool, facilitating an accumulation selected from the group consisting of;

an accumulation of the tool in a housing, and an accumulation of energy in the tool; and

in a second cycle of the cyclic activity, subsequent to the inhibiting of the movement of the distal portion of the tool, allowing movement of the at least the distal portion of the tool in the distal direction, in response to sensing that the second cycle of the cyclic activity is at the given phase thereof.

14. The method according to claim 13, further comprising providing force feedback to the user that is smoothened with respect to the cyclic activity.

15. The method according to claim 13, wherein the given phase includes a phase selected from the group consisting of a diastolic phase and an end-diastolic phase, and wherein allowing movement of the distal portion of the tool in the distal direction comprises allowing movement of the distal portion of the tool in the distal direction, in response to sensing that the cyclic activity is at the selected phase.

16. The method according to claim 13, further comprising allowing continuous movement of the tool in a proximal direction, when the tool is being withdrawn from the portion of the subject'"'"'s body.

17. The method according to claim 13, wherein facilitating the accumulation comprises pushing a portion of the tool at least partially in a non-distal direction, in response to the user pushing the tool

18. The method according to claim 13, wherein facilitating the accumulation comprises facilitating accumulation of the tool in the housing.

19. The method according to claim 13, wherein facilitating the accumulation comprises facilitating accumulation of energy in the tool.

20. The method according to claim 19, wherein facilitating the accumulation comprises facilitating accumulation of elastic energy in the tool.

21. The method according to claim 13, wherein the tool includes a guide wire configured to be moved within a blood vessel of the subject, and wherein allowing movement of at least the distal portion of the tool with respect to the portion comprises allowing movement of at least a distal portion of the guide wire within the blood vessel.

22. The method according to claim 21, wherein:

allowing movement of at least the distal portion of the tool in the distal direction comprises allowing movement of a distal portion of the guide wire into a side branch that branches from the blood vessel, when the side branch is at a first angle from the blood vessel, and

inhibiting the movement of at least the distal portion of the tool comprises inhibiting movement of the distal portion of the guide wire into the side branch, when the side branch is at another angle from the blood vessel.

23. The method according to claim 21, wherein inhibiting the movement of the distal portion of the tool comprises inhibiting the guide wire from moving in an undesirable direction with respect to the blood vessel.

24. The method according to claim 23, wherein inhibiting the movement of the distal portion of the tool comprises inhibiting the guide wire from puncturing the blood vessel.

25. Apparatus for use with a portion of a body of a subject that moves as a result of cyclic activity of a body system of the subject, the apparatus comprising:

a sensor for sensing a phase of the cyclic activity;

a guide wire configured to be moved with respect to the portion of the subject'"'"'s body; and

a guide wire modulator configured;

in a first cycle of the cyclic activity, to allow movement of at least a distal portion of the guide wire in a distal direction, in response to the sensor sensing that the cyclic activity is at a first given phase thereof,

following the given phase in the first cycle and prior to an occurrence of the given phase in a subsequent cycle of the cyclic activity, to inhibit the movement of the distal portion of the guide wire, and

in a second cycle of the cyclic activity, subsequent to the inhibiting of the movement, to allow movement of the at least the distal portion of the guide wire in the distal direction, in response to the sensor sensing that the second cycle of the cyclic activity is at the given phase thereof.

26. The apparatus according to claim 25, wherein the guide wire modulator is configured to provide force feedback to a user that is smoothened with respect to the cyclic activity.

27. The apparatus according to claim 25, wherein the given phase includes a phase selected from the group consisting of a diastolic phase and an end-diastolic phase, and wherein the guide wire modulator is configured to allow movement of the distal portion of the guide wire in the distal direction, in response to the sensor sensing that the cyclic activity is at the selected phase.

28. The apparatus according to claim 25, wherein the guide wire modulator is configured to allow continuous movement of the guide wire in a proximal direction, when the guide wire is being withdrawn from the portion of the subject'"'"'s body.

29. The apparatus according to claim 25, wherein:

by allowing movement of at least the distal portion of the guide wire in the distal direction, the guide wire modulator is configured to allow movement of the distal portion of the guide wire into a side branch that branches from the blood vessel, when the side branch is at a first angle from the blood vessel, and

by inhibiting movement of at least the distal portion of the guide wire, the guide wire modulator is configured to inhibit movement of the distal portion of the guide wire into the side branch, when the side branch is at another angle from the blood vessel.

30. The apparatus according to claim 25, wherein the guide wire is configured to be inserted into a blood vessel, and wherein the guide wire modulator, by inhibiting the movement of the distal portion of the tool, is configured to inhibit the guide wire from moving in an undesirable direction with respect to the blood vessel.

31. The apparatus according to claim 30, wherein the guide wire, by inhibiting the movement of the distal portion of the tool, is configured to inhibit the guide wire from puncturing the blood vessel.

32. A method for use with a portion of a body of a subject that moves as a result of cyclic activity of a body system of the subject, the method comprising:

sensing a phase of the cyclic activity;

in a first cycle of the cyclic activity, allowing movement of at least a distal portion of a guide wire in a distal direction with respect to the portion, in response to sensing that the cyclic activity is at a first given phase thereof,

following the given phase in the first cycle and prior to an occurrence of the given phase in a subsequent cycle of the cyclic activity, inhibiting the movement of the distal portion of the guide wire; and

in a second cycle of the cyclic activity, subsequent to the inhibiting of the movement, allowing movement of the at least the distal portion of the guide wire in the distal direction, in response to the sensor sensing that the second cycle of the cyclic activity is at the given phase thereof.

33. The method according to claim 32, further comprising providing force feedback to a user that is smoothened with respect to the movement of the portion of the subject'"'"'s body.

34. The method according to claim 32, wherein the given phase includes a phase selected from the group consisting of a diastolic phase and an end-diastolic phase, and wherein allowing movement of the distal portion of the guide wire in the distal direction, comprises allowing movement of the distal portion of the guide wire in the distal direction, in response to sensing that the cyclic activity is at the selected phase.

35. The method according to claim 32, further comprising allowing continuous movement of the guide wire in a proximal direction, when the guide wire is being withdrawn from the portion of the subject'"'"'s body.

36. The method according to claim 32, wherein:

allowing movement of at least the distal portion of the guide wire in the distal direction, comprises allowing movement of the distal portion of the guide wire into a side branch that branches from a main blood vessel, when the side branch is at a first angle from the blood vessel, and

inhibiting the movement of at least the distal portion of the tool comprises inhibiting movement of the distal portion of the guide wire into the side branch, when the side branch is at another angle from the blood vessel.

37. The method according to claim 32, wherein the guide wire is configured to be moved within a blood vessel of the subject, and wherein inhibiting the movement of the distal portion of the guide wire comprises inhibiting the guide wire from moving in an undesirable direction with respect to the blood vessel.

38. The method according to claim 37, wherein inhibiting the movement of the distal portion of the guide wire comprises inhibiting the guide wire from puncturing the blood vessel.