Bi-directional control handle for steerable catheter

• US 6,171,277 B1
• Filed: 08/07/1998
• Issued: 01/09/2001
• Est. Priority Date: 12/01/1997
• Status: Expired due to Term

• Current Assignee: Cordis Webster, Inc.
• Original Assignee: Cordis Webster, Inc.
• Inventors: Ponzi, Dean M.
• Primary Examiner(s): Kennedy, Sharon
• Assistant Examiner(s): Hayes, Michael J.
• Application Number:
  US09/130,359
• Time in Patent Office: 886 Days
• Field of Search: 604/20-22, 604/95.04, 604/523, 604/528, 600/434, 600/149, 607/122
• US Class Current: 604/95.04
• 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 2017/003 Steerable
• CPC Class Codes: A61B 2018/00029 open
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61M 2025/015 Details of the distal fixation of the movable mechanical means
• CPC Class Codes: A61M 25/0136 Handles therefor
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires

Abstract

A bidirectional steerable catheter comprises a catheter body, a tip section, and a control handle. The catheter body has a tubular wall, proximal and distal ends, and at least one lumen extending therethrough. The tip section comprises flexible tubing having proximal and distal ends and at least one lumen extending therethrough. The proximal end of the tip section is fixedly attached to the distal end of the catheter body. The control handle is mounted at its distal end to the proximal end of the catheter body. The control handle comprises a housing having proximal and distal ends. Rotatably mounted within the housing is a generally-circular spur gear having gear teeth about its outer circumference. A pair of spaced apart rack gears are slidably mounted longitudinally on diametrically opposed sides of the spur gear within the housing. Each rack gear has an interior edge generally facing the interior edge of the other rack gear and comprises gear teeth along its interior edge for engaging the gear teeth of the spur gear. Each rack gear is longitudinally movable between first and second positions. Proximal movement of one rack gear results in rotational movement of the spur gear, and correspondingly distal movement of the other rack gear. Two puller wires extend from the control handle, through a lumen in the catheter body and into an off axis lumen in the tip section. The distal end of each puller wire is fixedly attached to the tip section, and the proximal end of each puller wire is anchored to a separate associated rack gear in the control handle. Proximal movement of a rack gear and its associated puller wire relative to the catheter body results in deflection of the tip section in the direction of the off axis lumen into which that puller wire extends.

Claims

1. A bi-directionsl steerable catheter comprising:

a catheter body having a tubular wall, proximal and distal ends, and at least one lumen extending therethrough;

a tip section comprising flexible tubing having proximal and distal ends and at least one lumen extending therethrough, the proximal end of the tip section being fixedly attached to the distal end of the catheter body;

a control handle mounted at its distal end to the proximal end of the catheter body comprising;

a housing having proximal and distal ends;

a generally-circular spur gear rotatably mounted within the housing, the spur gear having gear teeth about its outer circumference;

a pair of spaced apart rack gears slidably mounted longitudinally on diametrically opposed sides of the spur gear within the housing, each rack gear having an interior edge generally facing the interior edge of the other rack gear and comprising gear teeth along its interior edge for engaging the gear teeth of the spur gear, each rack gear being longitudinally movable between first and second positions, whereby proximal movement of one rack gear results in rotational movement of the spur gear and distal movement of the other rack gear; and

a manually movable member fixedly attached to one rack gear and extending radially out of the housing through a slot in the housing; and

a pair of puller wires having proximal and distal ends, each puller wire extending from the control handle through a lumen in the catheter body and into an off axis lumen in the tip section, the distal end of each puller wire being fixedly attached to the tip section and the proximal end of each puller wire being anchored to a separate associated rack gear in the control handle whereby proximal movement of a rack gear and its associated puller wire relative to the catheter body results in deflection of the tip section in the direction of the off axis lumen into which that puller wire extends.

2. A catheter according to claim 1, wherein each puller wire is anchored to its associated rack gear by a puller wire coupling mounted at the distal end of the rack gear, the puller wire coupling comprising:

a threaded set screw having an axial bore therethrough through which the proximal end of the puller wire extends;

means for anchoring the proximal end of the puller wire to the threaded set screw; and

a threaded axial hole in the distal end of the rack gear for receiving the threaded set screw.

3. A catheter according to claim 2, wherein the anchoring means comprises a piece of hypodermic stock fixedly attached to the proximal end of the puller wire, said hypodermic stock having an outer diameter greater than the diameter of the axial bore of the set screw.

4. A catheter according to claim 1, wherein the tip section further comprises a tip electrode mounted at the distal end of the flexible tubing.

5. A catheter according to claim 4, wherein the puller wires are anchored at their distal ends to the tip electrode.

6. A catheter according to claim 1, wherein the puller wires are anchored at their distal ends to the flexible tubing.

7. A catheter according to claim 1, wherein the rack gears are slidably movable within rack gear channels within the handle housing.

8. A catheter according to claim 1 wherein each rack gear contains a bore for receiving the proximal end of the puller wire associated with that rack gear when that rack gear is moved distally relative to the catheter body.

9. A catheter according to claim 1, wherein the catheter body has a single lumen.

10. A catheter according to claim 9, further comprising two compression coils extending through the catheter body, each in surrounding relation to a corresponding puller wire.

11. A catheter according to claim 10, wherein the catheter body has a single lumen.

12. A catheter according to claim 11, further comprising two compression coils extending through the catheter body each in surrounding relation to a corresponding puller wire.

13. A bi-directional steerable catheter comprising:

a catheter body having an outer wall, proximal and distal ends, and at least one lumen extending therethrough;

a tip section comprising flexible tubing having proximal and distal ends and at least one lumen extending therethrough, the proximal end of the tip section being fixedly attached to the distal end of the catheter body;

a control handle comprising a housing having proximal and distal ends, the handle being mounted at its distal end to the proximal end of the catheter body and containing;

two off-axis rack gear channels,

a rack gear slidably mounted within each rack gear channel, each rack gear having an interior edge generally facing the interior edge of the other rack gear and each rack gear having teeth along its interior edge,

a generally-circular spur gear mounted between the rack gears, the spur gear having teeth around its circumference capable of receiving the teeth of the rack gears, whereby proximal movement of one rack gear results in rotational movement of the spur gear and distal movement of the other rack gear; and

a manually movable member fixedly attached to one rack gear and extending radially out of the housing through a slot in the housing; and

two puller wires having proximal and distal ends and extending through a lumen in the catheter body and a lumen in the tip section, the distal end of each puller wire being fixedly attached to the tip section and the proximal end of each puller wire being anchored to a separate rack gear in the control handle;

whereby proximal movement of a rack gear relative to the catheter body results in deflection of the tip section on the side to which the puller wire connected to the proximally-moved rack gear is attached.

14. A catheter according to claim 13, wherein each puller wire is anchored to its associated rack gear by a puller wire coupling mounted at the distal end of the rack gear, the puller wire coupling comprising:

a threaded set screw having an axial bore therethrough through which the proximal end of the puller wire extends;

means for anchoring the proximal end of the puller wire to the threaded set screw; and

a threaded axial hole in the distal end of the rack gear for receiving the threaded set screw.

15. A catheter according to claim 14, wherein the anchoring means comprises a piece of hypodermic stock fixedly attached to the proximal end of the puller wire, said hypodermic stock having an outer diameter greater than the diameter of the axial hole of the set screw.

16. A catheter according to claim 13, wherein the tip section further comprises a tip electrode mounted at the distal end of the flexible tubing.

17. A catheter according to claim 16, wherein the puller wires are anchored at their distal ends to the tip electrode.

18. A catheter according to claim 13, wherein the puller wires are anchored at their distal ends to the flexible tubing.

19. A catheter according to claim 13, wherein the rack gear channels are located in opposite quadrants within the housing.

20. A bi-directional steerable catheter comprising:

a catheter body having a tubular wall, proximal and distal ends, and at least one lumen extending therethrough;

a tip section comprising flexible tubing having proximal and distal ends and at least one lumen extending therethrough, the proximal end of the tip section being fixedly attached to the distal end of the catheter body;

a control handle mounted at its distal end to the proximal end of the catheter body comprising;

a housing having proximal and distal ends;

a generally-circular spur gear rotatably mounted within the housing, the spur gear having gear teeth about its outer circumference;

a pair of spaced apart rack gears slidably mounted longitudinally on diametrically opposed sides of the spur gear within the housing, each rack gear having an interior edge generally facing the interior edge of the other rack gear and comprising gear teeth along its interior edge for engaging the gear teeth of the spur gear, each rack gear being longitudinally movable between first and second positions, whereby proximal movement of one rack gear results in rotational movement of the spur gear and distal movement of the other rack gear; and

a manually movable member fixedly attached to one rack gear in perpendicular relation to the attached rack gear; and

a pair of puller wires having proximal and distal ends, each puller wire extending from the control handle through a lumen in the catheter body and into an off axis lumen in the tip section, the distal end of each puller wire being fixedly attached to the tip section and the proximal end of each puller wire being anchored to a separate associated rack gear in the control handle whereby proximal movement of a rack gear and its associated puller wire relative to the catheter body results in deflection of the tip section in the direction of the off axis lumen into which that puller wire extends.

21. A catheter according to claim 20, wherein each puller wire is anchored to its associated rack gear by a puller wire coupling mounted at the distal end of the rack gear, the puller wire coupling comprising:

a threaded set screw having an axial hole therethrough through which the proximal end of the puller wire extends;

means for anchoring the proximal end of the puller wire to the threaded set screw; and

a threaded axial hole in the distal end of the rack gear for receiving the threaded set screw.

22. A catheter according to claim 20, wherein each rack gear contains a bore for receiving the proximal end of the puller wire associated with that rack gear when that rack gear is moved distally relative to the catheter body.