SYSTEM AND METHOD FOR ENDOLUMINAL AND TRANSLUMENAL THERAPY

• US 20190314616A1
• Filed: 06/04/2019
• Published: 10/17/2019
• Est. Priority Date: 01/20/2011
• Status: Active Application

• Current Assignee: Auris Health, Inc. (Johnson & Johnson)
• Original Assignee: Auris Health, Inc. (Johnson & Johnson)
• Inventors: Moll, Frederic H., Schlesinger, Randall L., Soleimani, Farzad, Wallace, Daniel T.
• Application Number:
  US16/431,321
• Publication Number:
  US 20190314616A1
• Time in Patent Office: Days
• CPC Class Codes: A61B 1/307 for the urinary organs, e.g. urethroscopes, cystoscopes
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00053 Mapping
• CPC Class Codes: A61B 2017/00256 Creating an electrical block
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00511 Kidney
• CPC Class Codes: A61B 2018/00517 Urinary bladder or urethra
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/1405 Electrodes having a specific shape
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/2046 Tracking techniques
• CPC Class Codes: A61B 2034/2061 : using shape-sensors, e.g. fiber shape sensors with Bragg gratings
• CPC Class Codes: A61B 2034/301 : for introducing or steering flexible instruments inserted into the body, e.g. catheters or endoscopes
• CPC Class Codes: A61B 2034/302 : specifically adapted for manipulations within body cavities, e.g. within abdominal or thoracic cavities
• CPC Class Codes: A61B 2034/303 : specifically adapted for manipulations within body lumens, e.g. within lumen of gut, spine, or blood vessels
• CPC Class Codes: A61B 2090/364 : Correlation of different images or relation of image positions in respect to the body
• CPC Class Codes: A61B 34/10 : Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 34/20 : Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/30 : Surgical robots
• CPC Class Codes: A61B 5/0066 : Optical coherence imaging
• CPC Class Codes: A61B 5/0084 : for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/02007 : Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/062 : using magnetic field
• CPC Class Codes: A61B 5/065 : Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
• CPC Class Codes: A61B 5/14546 : for measuring analytes not otherwise provided for, e.g. ions, cytochromes
• CPC Class Codes: A61B 5/201 : Assessing renal or kidney functions
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00

Abstract

A system for conducting denervation of the neural plexus adjacent the renal artery, comprises a pre-shaped ablative element operatively coupled to an elongate deployment member configured to be navigated into the renal artery, the pre-shaped ablative element comprising one or more RF electrodes disposed in an arcuate pattern; and an energy source operatively coupled to the one or more RF electrodes and being configured to cause current to flow from the pre-shaped ablative element and cause localized heating sufficient to denervate nearby neural tissue.

Claims

1-17. -17. (canceled)

18. A catheter system for performing a medical procedure, comprising:

a sheath instrument configured to be advanced within a patient, the sheath instrument comprising a proximal portion, a distal portion, and a sheath wall that surrounds and forms a guide insertion lumen;

a guide instrument configured to be advanced through the guide insertion lumen, the guide instrument comprising a proximal portion, a distal portion, and a guide wall that surrounds and forms a pre-shaped instrument lumen; and

a pre-shaped instrument configured to be advanced through the pre-shaped instrument lumen, the pre-shaped instrument comprising a curved proximal end and extending from the proximal portion of the guide instrument; and

wherein, in use, the pre-shaped instrument is advanced to a target site via the pre-shaped instrument lumen to perform the medical procedure.

19. The catheter system of claim 18, wherein the curved proximal end of the pre-shaped instrument comprises a J-curve shape.

20. The catheter system of claim 18, wherein the curved proximal end of the pre-shaped instrument comprises an electrode, the electrode configured to create a lesion at the target site when a current flows through the electrode.

21. The catheter system of claim 20, wherein the pre-shaped instrument is configured to be withdrawn to create an elongate lesion within the target site.

22. The catheter system of claim 21, wherein the current discontinuously flows through the electrode as the pre-shaped instrument is withdrawn.

23. The catheter system of claim 21, wherein the current continuously flows through the electrode as the pre-shaped instrument is withdrawn.

24. The catheter system of claim 21, wherein the elongate lesion comprises a linear or curvy pattern.

25. The catheter system of claim 18, wherein the curved proximal end of the pre-shaped instrument comprises a spiral or helical shape.

26. The catheter system of claim 18, wherein the pre-shaped instrument is coupled to a hypotube.

27. The catheter system of claim 26, wherein the pre-shaped instrument is coupled to the hypotube via a metallic crimping coupler.

28. The catheter system of claim 18, further comprising a restraining tube configured to radially collapse the curved proximal end of the pre-shaped instrument as the pre-shaped instrument is advanced through the pre-shaped instrument lumen, the restraining tube further configured to be removed from the curved proximal end to allow the curved proximal end to radially expand.

29. The catheter system of claim 18, wherein the catheter is used for a renal plexus denervation or a renal neuroplexus diagnostic procedure.

30. The catheter system of claim 18, wherein the sheath instrument and the guide instrument are configured to be controlled robotically by the catheter system.

31. The catheter system of claim 18, wherein the pre-shaped instrument are configured to be controlled robotically by the catheter system.

32. A method for performing a medical procedure using a robotic catheter system, the method comprising:

advancing a sheath instrument within a patient, the sheath instrument comprising a proximal portion, a distal portion, and a sheath wall that surrounds and forms a guide insertion lumen;

advancing a guide instrument through the guide insertion lumen, the guide instrument comprising a proximal portion, a distal portion, and a guide wall that surrounds and forms a pre-shaped instrument lumen, the guide instrument extending from the proximal portion of the sheath instrument;

advancing a pre-shaped instrument through the pre-shaped instrument lumen, the pre-shaped instrument comprising a curved proximal end, the pre-shaped instrument extending from the proximal portion of the guide instrument; and

advancing the pre-shaped instrument to a target site to perform a medical procedure.

33. The method of claim 32, wherein the curved proximal end of the pre-shaped instrument comprises a spiral or helical shape.

34. The method of claim 32, wherein the pre-shaped instrument is coupled to a hypotube.

35. The method of claim 32, wherein the medical procedure comprises renal plexus denervation or a renal neuroplexus diagnostic procedure.

36. The method of claim 32, wherein advancing the sheath instrument and advancing the guide instrument are performed robotically by the robotic catheter system.

37. The method of claim 32, wherein advancing the pre-shaped instrument is performed robotically by the robotic catheter system.