Methods and systems for accessing the pericardial space
First Claim
1. A system for accessing a desired location through a tissue wall within a patient'"'"'s body;
- comprising;
an elongated fixation catheter having a fixation catheter lumen extending between proximal and distal fixation catheter lumen openings, a penetrable seal closing the distal fixation catheter lumen opening, and a distal tissue fixation mechanism,an elongated steerable fixation instrument adapted to engage the elongated fixation catheter and steer the guide catheter distal end to the tissue wall, the steerable fixation instrument enabling extension of the distal fixation mechanism into the tissue wall to engage and stabilize the tissue wall;
an elongated penetration instrument comprising a guidewire having a tissue penetrating distal tip sized and adapted to be passed through the fixation catheter lumen, through the penetrable seal, and through the tissue wall, thereby creating a perforation through the tissue wall and into the desired location; and
a therapeutic catheter having a therapeutic catheter lumen terminating in at least one distal therapeutic catheter lumen opening adapted to be advanced over the guidewire and through the fixation catheter lumen, through the penetrable seal, and through the tissue wall perforation to dispose the distal therapeutic catheter lumen opening in the desired location.
1 Assignment
0 Petitions
Accused Products
Abstract
Methods and systems for transvenously accessing the pericardial space via the vascular system and atrial wall, particularly through the superior vena cava and right atrial wall, to deliver treatment in the pericardial space are disclosed. A steerable instrument is advanced transvenously into the right atrium of the heart, and a distal segment is deflected into the right atrial appendage. A fixation catheter is advanced employing the steerable instrument to affix a distal fixation mechanism to the atrial wall. A distal segment of an elongated medical device, e.g., a therapeutic catheter or an electrical medical lead, is advanced through the fixation catheter lumen, through the atrial wall, and into the pericardial space. The steerable guide catheter is removed, and the elongated medical device is coupled to an implantable medical device subcutaneously implanted in the thoracic region. The fixation catheter may be left in place.
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Citations
21 Claims
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1. A system for accessing a desired location through a tissue wall within a patient'"'"'s body;
- comprising;
an elongated fixation catheter having a fixation catheter lumen extending between proximal and distal fixation catheter lumen openings, a penetrable seal closing the distal fixation catheter lumen opening, and a distal tissue fixation mechanism, an elongated steerable fixation instrument adapted to engage the elongated fixation catheter and steer the guide catheter distal end to the tissue wall, the steerable fixation instrument enabling extension of the distal fixation mechanism into the tissue wall to engage and stabilize the tissue wall; an elongated penetration instrument comprising a guidewire having a tissue penetrating distal tip sized and adapted to be passed through the fixation catheter lumen, through the penetrable seal, and through the tissue wall, thereby creating a perforation through the tissue wall and into the desired location; and a therapeutic catheter having a therapeutic catheter lumen terminating in at least one distal therapeutic catheter lumen opening adapted to be advanced over the guidewire and through the fixation catheter lumen, through the penetrable seal, and through the tissue wall perforation to dispose the distal therapeutic catheter lumen opening in the desired location. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
- comprising;
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20. A system for accessing a desired location through a tissue wall within a patient'"'"'s body;
- comprising;
an elongated fixation catheter having a fixation catheter lumen extending between proximal and distal fixation catheter lumen openings, a penetrable seal closing the distal fixation catheter lumen opening, and a distal tissue fixation mechanism, an elongated steerable fixation instrument comprising a steerable guide catheter that comprises a guide catheter hub and an elongated guide catheter body having a guide catheter body sidewall extending between a guide catheter body proximal end and a guide catheter body distal end, the guide catheter body further comprising; a delivery lumen extending between a delivery lumen entry port and a delivery lumen exit port at the guide catheter body distal end; a deflection wire lumen extending between a wire port through the sidewall of the guide catheter body and a deflection wire lumen distal end; and a deflection wire extending from a deflection wire proximal end through the wire port and through the deflection wire lumen to a deflection wire distal end fixed to the guide catheter body at the deflection wire lumen distal end; and an elongated penetration instrument having a tissue-penetrating element sized and adapted to be passed through the fixation catheter lumen, through the penetrable seal, and through the tissue wall, thereby creating a perforation through the tissue wall and into the desired location, wherein the fixation catheter is sized to be extend through said guide catheter delivery lumen to dispose said distal fixation mechanism and distal fixation catheter lumen opening proximate the tissue wall, the elongated fixation catheter adapted to be manipulated to extend the distal fixation mechanism away from the distal guide catheter delivery lumen opening into the tissue wall to engage and stabilize the tissue wall.
- comprising;
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21. A system for accessing a desired location through a tissue wall within a patient'"'"'s body;
- comprising;
an elongated fixation catheter having a fixation catheter lumen extending between proximal and distal fixation catheter lumen openings, a penetrable seal closing the distal fixation catheter lumen opening, and a distal tissue fixation mechanism, an elongated steerable fixation instrument comprising a steerable stylet having a tubular outer member having an outer member lumen and an inner member disposed in the outer member lumen, the tubular outer member sized to extend through the fixation catheter lumen, and the outer and inner members selectively movable with respect to one another to deflect a distal segment of the outer member and to thereby deflect a distal segment of the fixation catheter and to steer the fixation catheter distal end to the tissue wall and adapted to engage the elongated fixation catheter and steer the guide catheter distal end to the tissue wall, the steerable fixation instrument enabling extension of the distal fixation mechanism into the tissue wall to engage and stabilize the tissue wall; and an elongated penetration instrument having a tissue-penetrating element sized and adapted to be passed through the fixation catheter lumen, through the penetrable seal, and through the tissue wall, thereby creating a perforation through the tissue wall and into the desired location.
- comprising;
Specification