Percutaneous myocardial revascularization basket delivery system and radiofrequency therapeutic device

• US 6,063,082 A
• Filed: 03/05/1998
• Issued: 05/16/2000
• Est. Priority Date: 11/04/1997
• Status: Expired due to Fees

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Scimed Life Systems Incorporated (Boston Scientific Corporation)
• Inventors: Guo, Zihong, Lafontaine, Daniel M., Ellis, Louis, Hendrickson, Gary L., Kaveckis, Ryan, DeVore, Lauri
• Primary Examiner(s): Cohen, Lee
• Application Number:
  US09/035,738
• Time in Patent Office: 803 Days
• Field of Search: 606/41, 606/45, 606/47, 606/48, 606/167, 606/170, 606/186, 607/99, 607/122
• US Class Current: 606/45
• CPC Class Codes: A61B 17/32037 for removing obstructions from inner organs or blood vessels, e.g. for atherectomy
• CPC Class Codes: A61B 17/32056 Surgical snare instruments for removing or smashing calculi A61B2017/2212; tonsillotomes A61B17/26
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/320084 Irrigation sleeves
• CPC Class Codes: A61B 2018/00077 high, i.e. electrically conducting
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• CPC Class Codes: A61B 2018/00136 with polymer
• CPC Class Codes: A61B 2018/00148 with metal
• CPC Class Codes: A61B 2018/00196 reciprocating lengthwise
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00279 deployable
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/1253 : monopolar
• CPC Class Codes: A61B 2018/126 : bipolar
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/143 : multiple needles
• CPC Class Codes: A61B 2018/1432 : curved
• CPC Class Codes: A61B 2018/1435 : Spiral
• CPC Class Codes: A61B 2018/1467 : using more than two electrodes on a single probe
• CPC Class Codes: A61B 2090/3966 : Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 2218/002 : Irrigation
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61M 2025/009 : the needle having a bent tip, i.e. the needle distal tip is angled in relation to the longitudinal axis of the catheter

Abstract

An intravascular device and methods for forming multiple percutaneous myocardial revascularization (PMR) holes in a heart chamber wall simultaneously. One device includes a basket formed of flexible arms carrying cutting probes over their length. The basket arms are outwardly arcuately biased so as to assume an outwardly bowed, arcuate shape when unconstrained. The device includes an inner shaft distally secured to a proximal portion of the basket and slidably disposed within an outer shaft. The inner shaft and collapsed basket can be retracted within the outer shaft, delivered intravascularly to the left ventricle, and distally advanced, forcing the basket to assume the bowed shape. Radio frequency current supplied to the electrical cutting probes burn holes into the ventricle wall and myocardium. One embodiment has high pressure fluid jet cutting means. Another embodiment uses a basket as an anchor to position a steerable cutting probe. Yet another embodiment includes a brush formed of multiple, arcuate, outwardly splayed electrodes that can contact heart chamber walls once advanced distally from a constraining outer shaft.

Claims

1. A PMR device for forming a plurality of holes in a heart chamber wall comprising:

an elongate tubular shaft having a longitudinal axis, a proximal end and a distal end;

a basket, said basket being expandable and collapsible and including a plurality of arms;

means for expanding and collapsing said basket;

a plurality of cutting means carried on said arms and disposed outward relative to said longitudinal axis,

such that said plurality of holes can be formed in said heart chamber wall by expanding said basket, causing said cutting means to be brought into close proximity with said heart chamber wall.

2. A medical device as recited in claim 1, wherein said shaft has a lumen, further comprising means for advancing said basket through said shaft lumen and out said shaft distal end.

3. A medical device as recited in claim 2, wherein said basket is biased to expand upon being advanced from said shaft distal end.

4. A medical device as recited in claim 3, wherein said cutting means are electrodes.

5. The device in accordance with claim 4, wherein said electrodes are disposed in a plurality of groupings.

6. A device in accordance with claim 5, wherein each grouping includes at least three electrodes.

7. The device in accordance with claim 5, wherein said electrodes are generally elongate.

8. The device in accordance with claim 7, wherein said electrodes have a width of about 0.001 inches to about 0.009 inches.

9. The device in accordance with claim 4, wherein said electrodes have a loop shape.

10. The device in accordance with claim 9, wherein the loop shape is generally semi-circular.

11. The device in accordance with claim 9, wherein at least one of the electrodes includes a wire having a diameter of about 0.04 inches to about 0.2 inches.

12. A PMR basket for forming a plurality of holes in a heart chamber wall comprising:

a plurality of elongate flexible arms each having a longitudinal axis, a distal end and a proximal end, said elongate arms being secured together at said distal ends and said proximal ends, said arms being biased so as to bow outward relative to an axis through said secured distal and proximal ends,

said flexible arms carrying a plurality of cutting means disposed outward relative to said axis through said arm distal and proximal ends,

such that said plurality of holes can be formed in said heart chamber wall by allowing said biased flexible arms carrying said cutting means to bow outward against said heart chamber walls.

13. A PMR basket as recited in claim 12, wherein said cutting means are electrodes protruding outward from said flexible arms and said flexible arms include means for delivering radio frequency current to said electrodes.

14. A PMR basket as recited in claim 13, wherein said flexible arms have insulated conducting wires disposed within said arms, said wires being in electrical communication with said electrodes.

15. The device in accordance with claim 14, wherein said electrodes are disposed in a plurality of groupings.

16. A device in accordance with claim 15, wherein each grouping includes at least three electrodes.

17. The device in accordance with claim 15, wherein said electrodes are generally elongate.

18. The device in accordance with claim 17, wherein said electrodes have a width of about 0.001 inches to about 0.009 inches.

19. The device in accordance with claim 14, wherein said electrodes have a loop shape.

20. The device in accordance with claim 19, wherein the loop shape is generally semi-circular.

21. The device in accordance with claim 19, wherein at least one of the electrodes includes a wire having a diameter of about 0.04 inches to about 0.2 inches.

22. A PMR basket as recited in claim 12, wherein said cutting means are needles.