Apparatus and method for selectively positioning a device...

Surgery – Instruments – Means for inserting or removing conduit within body

Reexamination Certificate

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Details

C604S095010, C128S898000

Reexamination Certificate

active

06238401

ABSTRACT:

FIELD OF THE INVENTION
This invention relates generally to an apparatus and method of selectively positioning the apparatus, e.g., within a lumen. More particularly, this invention relates to a device and method for pulling a catheter along a wire; a device and method for moving a wire relative to a catheter, a device and method for pulling a catheter relative to a guiding catheter or any larger bore pipeline through which it is inserted; and a device and method for pushing or pulling a device on top of a guide wire or inside a guiding catheter.
BACKGROUND OF THE INVENTION
In many different applications of invasive and minimally invasive medicine there is a need to introduce catheters and other devices into the body, usually through open lumens or closed lumens, utilizing percutaneous entry. Conventional procedures for the introduction of the devices and their controlled motion in the body usually utilize a force, either a manual force or a motorized force, applied from the outside of the patient to “push” the device to the target area. One shortcoming of introducing the device via a “push” operation, even when done on top of a guiding wire, is that this procedure often does not provide optimal tractability into a tortuous anatomy, e.g., the coronary arteries. In contrast, a “pull” operation in which a pulling device precedes the apparatus and “pulls” it into place increases the tractability of the device and reduces the likelihood that the device will get caught in a curve of the lumen or cause trauma to the lumen.
Another problem is the need to push wires through occluded lumen sections that have a great resistance to such penetration. The fact that the wire is pushed from the outside may waste all the pushing energy in accessive loops with very little or none of the pushing energy actually reaching the tip of the wire.
OBJECTS AND SUMMARY OF THE INVENTION
It is an object of this invention to provide a device and method for pulling a catheter along a wire.
It is another object of this invention to provide a device and method for pushing a wire relative to a catheter.
In yet another object of this invention to provide a device and method for pulling a catheter relative to a guiding catheter or any larger bore pipeline through which it is inserted.
It is a further object of this invention to provide a device and method for pushing or pulling a device on top of a guidewire or inside a guiding catheter.
It is still a further object of this invention to provide an apparatus and method for selectively positioning a device, e.g., a stent, an Intra Vascular Sound (IVUS) transducer, an atherectomy device (both rotational and directional), pressure sensors, balloons, and pushing wires to open occlusions, by pulling rather than pushing these devices into place.
It is an object of this invention to provide an apparatus for disposing a device in the target area of a lumen, comprising: a cylindrically shaped motor attached to the device, the motor having a longitudinal bore, the motor provided with a motor friction area disposed within the longitudinal bore; a guide wire disposed within the longitudinal bore, the guide wire and the longitudinal bore sized and adapted to impart friction between the friction area of the motor and the guide wire in an amount sufficient to permit the motor to change position relative to the guide wire by crawling against the guide wire when the motor is energized.
It is another object of this invention to provide an apparatus for disposing a device in the target area of a lumen, comprising: a cylindrically shaped motor attached to the device, the motor having an outer surface, the motor provided with a friction area on the outer surface; a cylindrical guide tube having an outer surface and an inner surface defining a longitudinal bore, the outer surface of the motor and the inner surface of the guide tube sized and adapted to impart friction between the friction area of the motor and the inner surface of the cylindrical guide tube in an amount sufficient to permit the cylindrical motor to change position relative to the guide tube by crawling against the inner surface of the guide tube when the motor is energized.
It is still another object of this invention to provide an apparatus for disposing a stent in the target area of a lumen, comprising: a catheter having a proximal end, a distal end, a longitudinal bore therethrough, and an expandable balloon disposed at the distal end; a cylindrically shaped motor disposed at the distal end of the catheter distal to the balloon, the motor having a longitudinal bore communicating with the longitudinal bore of the catheter, the motor provided with a motor friction area disposed within the longitudinal bore; a guide wire disposed within the longitudinal bore of the catheter and the longitudinal bore of the motor, the guide wire and the longitudinal bore of the motor sized and adapted to impart friction between the friction area of the motor and the guide wire in an amount sufficient to permit the motor to change position relative to the guide wire by crawling against the guide wire when the motor is energized.
It is another object of this invention to provide a method of disposing a stent in the target area of a lumen, comprising the steps of:
a) constructing an apparatus comprising: a catheter having a proximal end, a distal end, a longitudinal bore therethrough, and an expandable balloon disposed at the distal end; a cylindrically shaped motor disposed at the distal end of the catheter distal to the balloon, the motor having a longitudinal bore communicating with the longitudinal bore of the catheter, the motor provided with a motor friction area disposed within the longitudinal bore, a guide wire disposed within the longitudinal bore of the catheter and the longitudinal bore of the motor, the guide wire and the longitudinal bore of the motor sized and adapted to impart friction between the friction area of the motor and the guide wire in an amount sufficient to permit the motor to change position relative to the guide wire by crawling against the guide wire when the motor is energized;
b) advancing the guide wire to the target area;
c) securing the guide wire;
d) energizing the motor so that it advances along the guide wire to the target area to dispose the stent in the target area of lumen;
e) inflating the balloon to secure the stent in the target area of the lumen;
f) deflating the balloon; and
g) withdrawing the guide wire, motor, and catheter from the lumen.
It is yet another object of this invention to provide a method of disposing a stent in an obstructed target area of a lumen, comprising the steps of:
a) constructing an apparatus comprising: a catheter having a proximal end, a distal end, a longitudinal bore therethrough, and an expandable balloon disposed at the distal end; a cylindrically shaped motor disposed at the distal end of the catheter distal to the balloon, the motor having a longitudinal bore communicating with the longitudinal bore of the catheter, the motor provided with a motor friction area disposed within the longitudinal bore, a guide wire disposed within the longitudinal bore of the catheter and the longitudinal bore of the motor, the guide wire and the longitudinal bore of the motor sized and adapted to impart friction between the friction area of the motor and the guide wire in an amount sufficient to permit the motor to change position relative to the guide wire by crawling against the guide wire when the motor is energized;
b) advancing the guide wire to the target area;
c) securing the guide wire;
d) energizing the motor so that the motor advances along the guide wire to the obstructed target area;
e) securing the catheter;
f) energizing the motor so that the guide wire advances through the longitudinal bore of the motor and into the obstructed target area of the lumen;
g) securing the guide wire;
h) energizing the motor so that the motor advances along the guide wire and disposes the stent in the target area of the lumen;
i) inflating the balloon to secure the stent in the target a

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