Apparatus and methods for stimulating revascularization and/or tissue growth
First Claim
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1. Apparatus for treating an interior region of a cardiac chamber, the apparatus comprising:
- a catheter configured for insertion into a cardiac chamber, the catheter having a deflectable end region;
an end effector disposed within distal to the delectable end region, the end effector adapted to form a needle track at a treatment site in an interior region of the cardiac chamber, the end effector movable between a first position, wherein the end effector is retracted within the end region, and a second position, wherein the end effector is extended beyond a distal endface of the catheter; and
means for moving the end region between the first and second positions, wherein the end effector further comprises means for depositing a controlled amount of a bioactive agent at the treatment site and wherein the catheter has a plurality of lumens, one of which contains the bioactive agent and wherein the catheter has a conductor extending from a proximal end of the catheter to an electrode which is distal to the deflectable end region.
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Abstract
Apparatus and methods for stimulating revascularization and tissue growth are provided using an apparatus having a directable end region carrying a tissue piercing end effector. The apparatus optionally includes electrodes for depositing RF energy to form a controlled degree of scar tissue formation, means for delivering a controlled amount of a bioactive agent at the treatment site, or both.
224 Citations
60 Claims
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1. Apparatus for treating an interior region of a cardiac chamber, the apparatus comprising:
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a catheter configured for insertion into a cardiac chamber, the catheter having a deflectable end region; an end effector disposed within distal to the delectable end region, the end effector adapted to form a needle track at a treatment site in an interior region of the cardiac chamber, the end effector movable between a first position, wherein the end effector is retracted within the end region, and a second position, wherein the end effector is extended beyond a distal endface of the catheter; and means for moving the end region between the first and second positions, wherein the end effector further comprises means for depositing a controlled amount of a bioactive agent at the treatment site and wherein the catheter has a plurality of lumens, one of which contains the bioactive agent and wherein the catheter has a conductor extending from a proximal end of the catheter to an electrode which is distal to the deflectable end region. - View Dependent Claims (2, 3, 4, 5, 6, 7)
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8. Apparatus for treating an interior region of a cardiac chamber, the apparatus comprising:
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a catheter having a deflectable end region; an end effector adapted to form a needle track at a treatment site in an interior region of the cardiac chamber, the end effector movable between a first position, wherein the end effector is retracted within the end region, and a second position, wherein the end effector is extended beyond a distal endface of the catheter; and means for depositing a bioactive agent in the needle track when the end effector is in the second position and wherein the catheter has a plurality of lumens, one of which contains the bioactive agent and wherein the catheter has a conductor extending from a proximal end of the catheter to an electrode which is distal to the deflectable end region. - View Dependent Claims (9, 10, 11, 12)
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13. A method of treating an interior region of a cardiac chamber the method comprising:
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providing apparatus having a catheter adapted for insertion into a cardiac chamber, the catheter having a deflectable end region including an end effector adapted to form a needle track at a treatment site in an interior region of the cardiac chamber, wherein the catheter has a plurality of lumens, one of which contains a bioactive agent, wherein the catheter has a conductor extending from the proximal end of the catheter to the distal end of the catheter and the conductor is coupled to the end effector; inserting the apparatus within a cardiac chamber; deflecting the end region to dispose the end effector at a selected orientation relative to an endocardial surface; actuating the end effector to form a needle track in an interior region of the cardiac chamber at a treatment site; and delivering a controlled amount of a the bioactive agent at the treatment site, wherein the needle track, after the delivering, is substantially closed onto the bioactive agent. - View Dependent Claims (14, 15, 16, 17, 18)
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19. An apparatus, comprising:
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a catheter configured for percutaneous insertion into a cardiac tissue, the catheter having a proximal region, a steerable distal region, and a lumen extending from the proximal region to the steerable distal region; a needle disposed distal to the steerable distal region and movable between a first position, wherein the needle is retracted within the distal region, and a second position, wherein the needle is extended beyond the distal region; and a controller coupled near the proximal region and having a source of a bioactive agent, wherein the controller mechanically measures a controlled amount of the bioactive agent, and wherein the bioactive agent is passed through the lumen, in fluid communication with the needle, for delivery into the cardiac tissue, wherein the needle further comprises a means for depositing the controlled amount of the bioactive agent into the cardiac tissue, and wherein the catheter has a plurality of lumens, one of which contains the bioactive agent and wherein the catheter has a conductor extending from a proximal end of the catheter to an electrode which is distal to the steerable distal region. - View Dependent Claims (20, 21, 22, 23, 24, 25, 26)
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27. An apparatus, comprising:
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a catheter configured for percutaneous insertion into a cardiac tissue, the catheter having a proximal region, a steerable distal region, and a lumen extending from the proximal region to the steerable distal region; a needle disposed distal to the steerable distal region and movable between a first position, wherein the needle is retracted within the distal region, and a second position, wherein the needle is extended beyond the distal region; and a controller coupled near the proximal region and having a source of a bioactive agent, wherein the controller passes a predetermined amount of the bioactive agent through the lumen, in fluid communication with the needle, for delivery into the cardiac tissue, wherein the needle further comprises a means for depositing the predetermined amount of the bioactive agent into the cardiac tissue, and wherein the catheter has a plurality of lumens, one of which contains the bioactive agent and wherein the catheter has a conductor extending from a proximal end of the catheter to an electrode which is distal to the steerable distal region. - View Dependent Claims (28, 29, 30, 31, 32)
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33. A method for delivering a bioactive agent to a patient'"'"'s cardiac tissue, the method comprising:
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providing a catheter adapted for percutaneous insertion into the cardiac tissue, the catheter having a steerable end region and a hollow needle adapted to deliver discrete units of a bioactive agent having a predetermined dosage and a push rod to push the discrete units, wherein the catheter has a plurality of lumens, one of which contains the bioactive agent, wherein the catheter has a conductor extending from the proximal end of the catheter to the distal end of the catheter and the conductor is coupled to an electrode which is distal to the steerable end region; inserting the catheter within the cardiac tissue; steering the steerable end region to dispose the hollow needle at a selected orientation relative to an interior surface of the cardiac tissue; and delivering and mechanically measuring a controlled amount of the bioactive agent to the cardiac tissue. - View Dependent Claims (34, 35, 36, 37, 38, 39)
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40. A method for delivering a bioactive agent to a patient'"'"'s cardiac tissue, the method comprising:
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providing a catheter adapted for percutaneous insertion into the cardiac tissue, the catheter having a steerable end region and a needle adapted to deliver discrete units of a bioactive agent having a predetermined dosage, wherein the catheter has a plurality of lumens, one of which contains the discrete units, and a push rod to push the discrete units, wherein the catheter has a conductor extending from the proximal end of the catheter to the distal end of the catheter and the conductor is coupled to an electrode coupled to the needle near the steerable end region; inserting the catheter within the cardiac tissue; steering the steerable end region to dispose the needle at a selected orientation relative to an interior surface of the cardiac tissue; and mechanically delivering the predetermined dosage of the bioactive agent through the needle into the cardiac tissue using the push rod. - View Dependent Claims (41, 42, 43, 44, 45, 46, 47)
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48. An apparatus for delivering a bioactive agent to a patient'"'"'s cardiac tissue, the apparatus comprising:
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means for providing a catheter adapted for percutaneous insertion into the cardiac tissue, the catheter having a steerable end region and a hollow needle adapted to deliver discrete units of a bioactive agent having a predetermined dosage, wherein the catheter has a plurality of lumens, one of which contains the discrete units, and a push rod to push the discrete units, wherein the catheter has a conductor extending from the proximal end of the catheter to the distal end of the catheter and the conductor is coupled to an electrode which is distal to the steerable end region; means for inserting the catheter within the cardiac tissue; means for steering the steerable end region to dispose the hollow needle at a selected orientation relative to an interior surface of the cardiac tissue; and means for delivering and mechanically measuring a controlled amount of the bioactive agent.
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49. An apparatus for delivering a bioactive agent to a patient'"'"'s cardiac tissue, the apparatus comprising:
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means for providing a catheter adapted for percutaneous insertion into the cardiac tissue, the catheter having a steerable end region and a needle adapted to deliver discrete units of a bioactive agent having a predetermined dosage, wherein the catheter has a plurality of lumens, one of which contains the discrete units, and a push rod to push the discrete units, wherein the catheter has a conductor extending from the proximal end of the catheter to the distal end of the catheter and the conductor is coupled to an electrode which is distal to the steerable end region; means for inserting the catheter within the cardiac tissue; means for steering the steerable end region to dispose the needle at a selected orientation relative to an interior surface of the cardiac tissue; and means for mechanically delivering the predetermined dosage of the bioactive agent through the needle into the cardiac tissue.
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50. An apparatus, comprising:
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a catheter configured for percutaneous insertion into a cardiac tissue, the catheter having a proximal region, a steerable distal region which is deflectable, and a lumen extending from the proximal region to the steerable distal region; a needle disposed distal to the steerable distal region and movable between a first position, wherein the needle is retracted within the distal region, and a second position, wherein the needle is extended beyond the distal region and wherein the needle is deflectable within the steerable distal region; and a controller coupled near the proximal region and having a source of a bioactive agent in the form of discrete units, wherein the controller passes a predetermined amount of the bioactive agent through the lumen, in fluid communication with the needle, for delivery into the cardiac tissue, wherein the needle further comprises a means for depositing the predetermined amount of the bioactive agent into the cardiac tissue, and wherein the catheter has a plurality of lumens, one of which contains the bioactive agent and wherein the catheter has a conductor extending from a proximal end of the catheter to an electrode which is distal to the steerable distal region. - View Dependent Claims (51)
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52. A method for delivering a bioactive agent to a patient'"'"'s cardiac tissue, the method comprising:
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providing a catheter adapted for percutaneous insertion into the cardiac tissue, the catheter having a steerable end region and a hollow needle adapted to deliver granules of a bioactive agent having a predetermined dosage, wherein the catheter has a plurality of lumens, one of which contains the granules, and a push rod to push the granules, wherein the catheter has a plurality of lumens, one of which contains the bioactive agent, wherein the catheter has a conductor extending from the proximal end of the catheter to the distal end of the catheter and the conductor is coupled to an electrode which is distal to the steerable end region; inserting the catheter within the cardiac tissue; steering the steerable end region to dispose the hollow needle at a selected orientation relative to an interior surface of the cardiac tissue; and mechanically delivering a controlled amount of the granules using the push rod. - View Dependent Claims (53, 54, 55, 56, 57, 58, 59, 60)
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Specification