Steerable Intravascular Devices And Associated Devices, Systems, and Methods

• US 20140180124A1
• Filed: 12/19/2013
• Published: 06/26/2014
• Est. Priority Date: 12/21/2012
• Status: Active Grant

• Current Assignee: Volcano Corporation (Koninklijke Philips N.V.)
• Original Assignee: Volcano Corporation (Koninklijke Philips N.V.)
• Inventors: Whiseant, Chester, Dunn, Richard
• Granted Patent: US 10,207,078 B2
• Time in Patent Office: Days
• US Class Current: 600/467
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61B 8/0883 for diagnosis of the heart
• CPC Class Codes: A61B 8/0891 for diagnosis of blood vessels
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/445 Details of catheter construction
• CPC Class Codes: A61M 25/0136 Handles therefor
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires

Abstract

A steerable sheath for a catheter delivery system and associated devices and methods are disclosed. In some embodiments, the catheter delivery system includes a catheter sheath having a steerable distal portion and a flexible elongate member connecting to a steering unit. The flexible elongate member has a central lumen through which a therapeutic or diagnostic device of a first modality can be inserted, used to perform a procedure, and then removed and replaced by a different therapeutic or diagnostic device while the catheter sheath remains substantially at the same location within a patient.

Claims

1. A method for directing multiple intravascular devices to a region of interest within a vessel of a patient, the method comprising:

inserting a catheter sheath into the patient;

guiding a distal portion of the catheter sheath to the region of interest utilizing a steering actuator coupled to a proximal portion of the catheter sheath;

performing a first procedure at the region of interest with a first intravascular device at least partially received within the distal portion of the catheter sheath; and

performing a second procedure at the region of interest with a second intravascular device at least partially received within the distal portion of the catheter sheath, the second procedure being a different modality than the first procedure.

2. The method of claim 1, further comprising:

inserting the first intravascular device into a lumen of the catheter sheath after the catheter sheath has been inserted into the patient.

3. The method of claim 1, further comprising:

inserting the first intravascular device into a lumen of the catheter sheath prior to guiding the distal portion of the catheter sheath to the region of interest.

4. The method of claim 3, wherein data obtained from the first intravascular device is utilized in guiding the distal portion of the catheter sheath to the region of interest.

5. The method of claim 4, wherein the data obtained from the first intravascular device is at least one of imaging data, pressure data, and flow data.

6. The method of claim 1, wherein the first procedure is a diagnostic procedure.

7. The method of claim 6, wherein the second procedure is a treatment procedure.

8. The method of claim 6, wherein the second procedure is a diagnostic procedure.

9. The method of claim 1, wherein an array of ultrasound transducers are coupled to the distal portion of the catheter sheath.

10. The method of claim 9, wherein imaging data from the array of ultrasound transducers is utilized in guiding the distal portion of the catheter sheath to the region of interest.

11. The method of claim 1, further comprising:

removing the first intravascular device from the catheter sheath; and

inserting the second intravascular device into the catheter sheath;

wherein the distal portion of the catheter sheath is maintained at the region of interest during the removal of the first intravascular device and insertion of the second intravascular device.

12. The method of claim 1, wherein the catheter sheath comprises:

a flexible elongate member having a central lumen and a plurality of peripheral lumens; and

a plurality of steering lines received within at least some of the plurality of peripheral lumens.

13. The method of claim 12, wherein a proximal section of each of the plurality of steering lines is coupled to a steering actuator.

14. The method of claim 13, wherein the steering actuator comprises a joystick coupled to a housing sized and shaped for handheld use by a user.

15. The method of claim 14, wherein the joystick is positioned on the housing for control by the user'"'"'s thumb.

16. The method of claim 15, wherein a trigger mechanism is coupled to the housing opposite the joystick, the trigger mechanism configured to engage with the joystick to prevent the joystick from moving.

17. The method of claim 12, wherein the catheter sheath further comprises a tubular member positioned around the flexible elongate member, the tubular member having a total length greater than a total length of the flexible elongate member.

18. A catheter delivery system comprising:

a catheter sheath having a steerable distal portion, the catheter sheath having a plurality of steering lines running through a plurality of peripheral lumens of a first flexible elongate member having a central lumen, the distal ends of the plurality of steering lines being connected to a steering ring in the steerable distal portion of the catheter sheath and the proximal ends of the plurality of steering lines being connected to a steering actuator coupled to a housing sized and shaped for handheld use, wherein the housing includes an opening extending therethrough in communication with the central lumen of the first flexible elongate member to allow the insertion of intravascular devices of different modalities into the central lumen of the first flexible elongate member and removal of the intravascular devices of different modalities from the central lumen of the first flexible elongate member.

19. The catheter delivery system of claim 18, further comprising a second flexible elongate member having a central lumen, the first flexible elongate member being positioned within the central lumen of the second flexible elongate member.

20. The catheter delivery system of claim 18, wherein the steering actuator comprises a joystick.

21. The catheter delivery system of claim 20, wherein the steering actuator further comprises a plurality of cams coupled to the joystick steering actuator.

22. The catheter delivery system of claim 21, wherein the joystick is positioned on the housing for control by the user'"'"'s thumb.

23. The catheter delivery system of claim 22, wherein a trigger mechanism is coupled to the housing opposite the joystick, the trigger mechanism configured to prevent the joystick from moving when engaged with the joystick.

24. The catheter delivery system of claim 18, wherein the first flexible elongate member includes an opening at its distal end in communication with the central lumen such that the intravascular devices of different modalities can be advanced distally beyond the distal end of the first flexible elongate member through the opening.

25. The catheter delivery system of claim 18, further comprising at least one rotational actuator positioned within the housing, the rotational actuator configured to rotate at least a portion of an intravascular device passing through the housing and into the central lumen of the first flexible elongate member.

26. The catheter delivery system of claim 25, wherein the rotational actuator comprises a motor.

27. The catheter delivery system of claim 25, wherein the rotational actuator is configured to impart rotation to a drive shaft of the intravascular device passing through the housing and into the central lumen of the first flexible elongate member.

28. The catheter delivery system of claim 25, wherein the rotational actuator comprises an engagement feature configured to selectively fixedly engage a section of the intravascular device such that the rotational actuator can impart rotation to the section of the intravascular device.

29. A catheter delivery system comprising:

a housing, the housing including a joystick; and

a catheter sheath, the catheter sheath having a steerable distal portion and a plurality of steering lines plurality of steering lines being connected to the joystick at a proximal end and a steering ring at a distal end, the steering ring being positioned within the steerable distal portion of the catheter sheath.