Apparatus and methods for coronary sinus access
First Claim
1. A method for accessing a body lumen, comprising:
- inserting a distal end of a tubular member into a first body lumen, the tubular member comprising a substantially transparent expandable member thereon in a contracted condition;
expanding the expandable member within the first body lumen;
placing a distal surface of the expanded expandable member in contact with a wall of the first body lumen in order to image the wall through a substantially circular central region the distal surface adjacent and surrounding a central axis of the tubular member;
manipulating the tubular member to move the expandable member along the wall, while imaging the wall through the central region of the distal surface, until a second body lumen is identified; and
after identifying the second body lumen, advancing an instrument from the tubular member into the second body lumen.
1 Assignment
0 Petitions
Accused Products
Abstract
Apparatus and methods for locating morphological features within a body cavity using a catheter including proximal and distal ends, a transparent balloon carried on the distal end, and an optical imaging assembly carried on the distal end for imaging through the balloon. The balloon includes a channel extending therethrough to a lumen extending through the catheter. A guidewire or other localization member is received in the lumen that is extendable through the channel. During use, the catheter is inserted into a right atrium of a heart, and the balloon is expanded and placed against the wall of the heart to locate the coronary sinus. Sufficient force is applied to clear blood between the surface and the wall and clear the field of view of the imaging assembly. The catheter is manipulated to locate the coronary sinus, whereupon the localization member is advanced into the coronary sinus.
149 Citations
40 Claims
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1. A method for accessing a body lumen, comprising:
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inserting a distal end of a tubular member into a first body lumen, the tubular member comprising a substantially transparent expandable member thereon in a contracted condition; expanding the expandable member within the first body lumen; placing a distal surface of the expanded expandable member in contact with a wall of the first body lumen in order to image the wall through a substantially circular central region the distal surface adjacent and surrounding a central axis of the tubular member; manipulating the tubular member to move the expandable member along the wall, while imaging the wall through the central region of the distal surface, until a second body lumen is identified; and after identifying the second body lumen, advancing an instrument from the tubular member into the second body lumen. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A method for imaging a wall of a body cavity of a patient, comprising:
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inserting a distal end of a tubular member into the body cavity, the tubular member comprising a substantially transparent expandable member thereon in a contracted condition; expanding the expandable member within the body cavity; placing a distal surface of the expanded expandable member in contact with a wall of the body cavity in order to image the wail through a substantially circular central region of the distal surface intersecting and surrounded by a central longitudinal axis of the tubular member; applying sufficient force to at least partially clear fluid from between the central region of the distal surface and the wall to enhance imaging the wall; manipulating the tubular member to move the expandable member along the wall, while imaging the wall through the central region of the distal surface, until a desired body structure is identified; and wherein the desired body structure comprises a body lumen communicating with the body cavity, the method further comprising advancing an instrument from the tubular member into the body lumen. - View Dependent Claims (17, 18, 19, 20, 21, 22, 23)
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24. A method for imaging a wall of a body cavity of a patient, comprising:
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inserting a distal end of a tubular member into the body cavity, the tubular member comprising a substantially transparent expandable member thereon in a contracted condition; expanding the expandable member within the body cavity; placing a distal surface of the expanded expandable member in contact with a wall of the body cavity in order to image the wall through a substantially circular central region of a distal surface of the expandable member; manipulating the tubular member to move the expandable member along the wall, while imaging the wall through the central region of the expandable member, until a body lumen is identified; substantially stabilizing the distal end of the tubular member relative to the wall of the body cavity by advancing at least a portion of the tubular member to extend the distal end beyond the surface of the expanded expandable member; and advancing an instrument from the tubular member into the body lumen. - View Dependent Claims (25, 26, 27, 28, 29, 30, 31, 32)
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33. A method for accessing a body lumen, comprising:
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inserting a distal end of a tubular member into a first body lumen, the tubular member comprising a substantially transparent expandable member thereon in a contracted condition; expanding the expandable member within the first body lumen.; placing a distal surface of the expanded expandable member in contact with a wall of the first body lumen in order to image the wall through a substantially circular central region of the distal surface; manipulating the tubular member to move the expandable member along the wall, while imaging the wall through the central region of the distal surface, until a second body lumen is identified; and after identifying the second body lumen, advancing the distal end of the tubular member into the second body lumen with the expandable member at least partially expanded. - View Dependent Claims (34, 35)
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36. A method for imaging a wall of a body cavity of a patient using a tubular member comprising proximal and distal ends defining a central longitudinal axis therebetween, a tubular extension attached eccentrically to the distal end and extending distally from the distal end substantially parallel to the longitudinal axis, and a substantially transparent expandable member comprising a proximal end attached to the distal end of the tubular member and a distal end attached to the tubular extension thereon such that the expandable member defines a distal surface having a central region contacting and surrounding a distal tip of the tubular extension, the method comprising:
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inserting the distal end of the tubular member into the body cavity with the expandable member in a contracted condition; expanding the expandable member within the body cavity;
placing a distal surface of the expanded expandable member in contact with a wall of the body cavity in order to image the wall through the central region of the distal surface using an optical imaging element on the distal end that is disposed away from the central longitudinal axis to minimize obstruction of a field of view of the optical imaging element by the tubular extension;applying sufficient force to at least partially clear fluid from between the distal surface and the wall to enhance imaging the wall; manipulating the tubular member to move the expandable member along the wall, while imaging the wall through the central region of the distal surface, until a desired body structure is identified, wherein the desired body structure comprises a body lumen communicating with the body cavity, and advancing an instrument from the tubular member into the body lumen. - View Dependent Claims (37, 38, 39, 40)
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Specification