Apparatus and method for targeting a body tissue

• US 9,492,623 B2
• Filed: 10/22/2013
• Issued: 11/15/2016
• Est. Priority Date: 10/06/2006
• Status: Active Grant

• Current Assignee: Bavaria Medizin Technologie GmbH (Berkshire Hathaway Incorporated), Cleveland Clinic Foundation
• Original Assignee: Cleveland Clinic Foundation
• Inventors: Kapadia, Samir, Berrada, Marwane, Fuentes-Ortega, Cesar, Mok, Daniel Wing Fai
• Primary Examiner(s): Schmidt, Emily
• Assistant Examiner(s): FREHE, WILLIAM R
• Application Number:
  US14/060,256
• Publication Number:
  US 20140114245A1
• Time in Patent Office: 1,120 Days
• Field of Search: 600/424, 600433-435
• US Class Current: 1/1
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• 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 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/22069 Immobilising; Stabilising
• CPC Class Codes: A61B 2017/22095 accessing a blood vessel true lumen from the sub-intimal space
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61B 2017/3411 with a plurality of holes, e.g. holes in matrix arrangement
• CPC Class Codes: A61B 2017/3488 Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2018/00279 deployable
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/0038 Foramen ovale
• CPC Class Codes: A61B 2018/00386 Coronary vessels
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61M 5/427 Locating point where body is to be pierced, e.g. vein location means using ultrasonic waves, injection site templates

Abstract

An apparatus for targeting a desired target site on a body tissue comprising a wall of a first body cavity of a patient includes a target catheter. A framing member has a collapsed condition and an expanded condition. The framing member has a framing member body which includes a bulbous portion defining a maximum body footprint having proximal and distal body ends which are both longitudinally spaced from the maximum body footprint. The framing member is comprised of a plurality of framing member beams. At least three framing member beam arrays of framing member beams are arranged in non-overlapping longitudinal sequence to form at least a portion of the framing member. The framing member beams that make up the framing member substantially each have a width-to-thickness fractional ratio in the range of 0.6-3.0.

Claims

1. An apparatus for targeting a desired target site on a body tissue comprising a wall of a first body cavity of a patient, the apparatus comprising:

a target catheter having a longitudinally extending target catheter lumen surrounded by a tubular target catheter wall having an outer surface;

a framing member having a collapsed condition in which the framing member is adapted for insertion into the first body cavity and an expanded condition in which the framing member is adapted for placement within the first body cavity, the framing member, when deployed into the expanded condition, having;

a framing member body which includes a three-dimensionally bulbous portion defining a maximum body footprint in a lateral dimension and having longitudinally spaced proximal and distal body ends which are both longitudinally spaced from the maximum body footprint, a diameter of the bulbous portion being significantly smaller at the proximal and distal body ends than at the maximum body footprint, the proximal body end being attached to the outer surface of the target catheter wall;

at least one target point carried by the framing member and adapted for placement adjacent the desired target site; and

at least one target pathway attached to at least one target point, at least a portion of the target pathway extending through the target catheter lumen, and the target pathway being substantially spaced apart from the framing member body;

wherein the framing member is comprised of a plurality of framing member beams, with at least three framing member beam arrays of framing member beams arranged in non-overlapping longitudinal sequence to form at least a portion of the framing member; and

wherein the framing member beams that make up the framing member substantially each have a width-to-thickness fractional ratio in the range of 0.6-3.0.

2. The apparatus of claim 1, wherein each framing member beam array includes a plurality of framing member beams that are substantially similar to each other framing member beam in the same framing member beam array, the framing member beams in a chosen framing member beam array having substantially different values in at least one dimension from the framing member beams in a longitudinally adjacent framing member beam array, and each framing member beam array having a substantially cylindrical aspect formed by a laterally circular arrangement of the framing member beams of that framing member beam array.

3. The apparatus of claim 2, wherein:

a proximal-most framing member beam array extends longitudinally between, and is connected to both of, the proximal body end and a center framing member beam array;

the center framing member beam array extends longitudinally between, and is connected to both of, the proximal-most framing member beam array and a distal-most framing member beam array, the center framing member beam array defining, when the framing member is in the expanded condition, a substantially cylindrical maximum body footprint; and

the distal-most framing member beam array extends longitudinally between, and is connected to both of, the center framing member beam array and the distal body end.

4. The apparatus of claim 3, wherein a majority of the framing member beams that make up the proximal-most framing member beam array have a width-to-thickness fractional ratio in the range of 0.80-0.95, a majority of the framing member beams that make up the center framing member beam array have a width-to-thickness fractional ratio in the range of 0.75-2.8, and a majority of the framing member beams that make up the distal-most framing member beam array have a width-to-thickness fractional ratio in the range of 0.70-0.95.

5. The apparatus of claim 3, wherein a protrusion is located at the distal body end and is formed by a protrusion framing member beam array connected to a distal end of the distal-most framing member beam array such that the protrusion extends longitudinally distally from the distal body end of the bulbous portion, a majority of the framing member beams that make up the protrusion framing member beam array have a width-to-thickness fractional ratio in the range of 0.85-2.12, and when the framing member is in the expanded condition, the protrusion has a diameter which is smaller than the diameter of the maximum body footprint.

6. The apparatus of claim 3, wherein a mounting framing member beam array extends longitudinally between, and is connected to both of, the target catheter wall and a proximal end of the proximal-most framing member such that the mounting framing member beam array attaches the framing member to the target catheter wall, a majority of the framing member beams that make up the mounting framing member beam array have a width-to-thickness fractional ratio in the range of 1.5-2.12.

7. The apparatus of claim 1, wherein at least one framing member beam of a chosen framing member beam array includes at least one longitudinal slit along a portion of a longitudinal length of the at least one framing member beam.

8. The apparatus of claim 1, wherein the framing member is substantially rotationally symmetrical.

9. The apparatus of claim 1, including a delivery catheter having a delivery catheter lumen extending longitudinally between proximal and distal delivery catheter ends, the delivery catheter lumen being configured to substantially laterally surround the framing member in the collapsed condition, at least one target point, and at least one target wire to carry the collapsed framing member, at least one target point, and at least one target wire to the first body cavity of the patient, and the framing member, at least one target point, and at least one target wire exiting distally from the distal delivery catheter end for deployment in the first body cavity of the patient.

10. The apparatus of claim 1, including a puncture needle adapted for insertion through the target catheter lumen and into the first body cavity, the puncture needle having a first needle end operative to puncture the body tissue at the target site.

11. The apparatus of claim 1, including a puncture needle guided by the target pathway and adapted for insertion through the target catheter lumen and into the first body cavity, the puncture needle having a first needle end operative to puncture the body tissue responsive to guidance by the target pathway.

12. The apparatus of claim 1, wherein at least one target point has an associated radiopaque marker to indicate a position of the target point relative to the body tissue in cooperation with an external imaging system.

13. The apparatus of claim 1, wherein the first body cavity is at least one of a left atrium, a right atrium, a peritoneal cavity, a chest cavity, a left atrial appendage, a right atrial appendage, a left pulmonary vein, a blood vessel, a common iliac artery, a subintimal space, a portion of the heart, a gastrointestinal organ, a genitourinary organ, and a space external to the patient'"'"'s body.