|Publication number||USRE40305 E1|
|Application number||US 10/193,201|
|Publication date||May 6, 2008|
|Filing date||Sep 19, 2002|
|Priority date||Jul 31, 1998|
|Also published as||CA2270021A1, CA2270021C, CN1243755A, DE19935827A1, DE19935827B4, DE69942794D1, EP0976417A1, EP0976417B1, EP2204207A1, EP2204207B1, US6238401, WO2000006064A1|
|Publication number||10193201, 193201, US RE40305 E1, US RE40305E1, US-E1-RE40305, USRE40305 E1, USRE40305E1|
|Original Assignee||Zuli Holdings Ltd.|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (57), Referenced by (9), Classifications (18), Legal Events (4)|
|External Links: USPTO, USPTO Assignment, Espacenet|
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.
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 trackability 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 trackability 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.
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 with 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:
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:
More generally, embodiments of the present invention employ a piezoelectric micromotor to move a device to a target area in a lumen. In one embodiment, the motor is attached to a catheter and frictionally engages a guide wire. Energizing the motor brings about relative motion between the wire and catheter. This allows moving the wire to a target area in a lumen with the catheter fixed and/or moving the catheter to the target area while holding the guide wire fixed. The catheter may have a balloon to be expanded in the lumen at the target area. Similarly, the catheter may deliver a stent to the target area where it can be expanded. When there is an obstruction that prevents reaching the target area, the guide wire and motor may be used to clear the obstruction to permit the guide wire and catheter to be moved to the target area.
Miniature Oscillating Ceramic Motors (OCM) are well known in the art and are disclosed in U.S. Pat. No. 5,453,653 to Zumeris the specification of which is incorporated herein by reference. These motors can be made very small and in any shape and they operate by contacting a surface in an amount sufficient to generate sufficient friction to permit the motor to “crawl” along the contacted surface and change its position relative to the contracted surface when the motor is energized. These motors can be adequately insulated to act in aqueous environments. Their small size and low energy level requirements make them especially suitable for use inside living organisms.
In another embodiment of this invention, shown in
In operation, an expandable stent 20 is secured to the balloon portion 19 of the catheter 15 and the guide wire 2 is placed into the bore 18 of the catheter 15. The guide wire 2 is then introduced into the lumen to be treated and is advanced by pushing it until it is near the target area. The guide wire 2 is then secured. The micro-motor 1 is then energized so that it crawls along the guide wire 2 which pulls the catheter 15 into the proximity of the target area to be treated. Because the catheter 15 is “pulled” into position as shown in
In another embodiment of this invention shown in
In some applications, one or more passes may be utilized to clear the obstruction. As has been recognized by those skilled in the art, vibrating the guide wire facilitates the wire passing through an obstruction. As explained in U.S. Pat. No. 5,453,653 to Zumeris, excitation of the micro-motor of the present invention with an AC voltage is possible. If excited with AC, a vibration in the range of 20 - 100 KHz., depending on the resonant frequency of the material used for the piezoelectric ceramic will result. As further explained, in a pulsed method of operation two electrodes are excited by a positive DC voltage and two electrodes are excited by a negative DC voltage. Under this excitation the left side of piezoelectric ceramic becomes longer than the right side and ceramic moves to the right. When the voltage is removed, the ceramic will move back to its original position. However, if a non-symmetrical voltage pulse is applied to the electrodes, then, during the return to zero, the inertia of body will cause the body not to return the ceramic to the starting position. Thus, when operating in the DC pulsed mode, a vibrating or pulsating motion will occur at a rate dependent on the pulse time, e.g., 10 - 50 ms. Stated another way, in each case, an oscillatory motion takes place.
The guide wire 2 is then secured, the motor 1 is energized, and the catheter 15 is advanced through the vessel past the area from which the guide wire 2 has cleared the obstruction 21 from the target area as shown in FIG. 8D. This method may be used to simply clear an obstruction in a lumen as discussed above or may be used in conjunction with other embodiments of the invention, e.g., to facilitate the placement of an expandable stent in the target area of a lumen by first clearing the target area of any obstructions.
While the invention has been described with respect to a limited number of embodiments, it will be appreciated that many variations, modifications, and other applications of the invention may be made.
|Cited Patent||Filing date||Publication date||Applicant||Title|
|US3760203 *||Feb 22, 1972||Sep 18, 1973||Braun Ag||Depolarization protection for ceramic piezoelectric motor|
|US4389208||Nov 6, 1980||Jun 21, 1983||Leveen Robert F||Catheter advancer|
|US4747407||Jun 2, 1986||May 31, 1988||The Field Surgery Research Department of the Third Military Medical University||Blood vessel anastomat|
|US4854325||Nov 9, 1987||Aug 8, 1989||Stevens Robert C||Reciprocating guidewire method|
|US4886061||Feb 9, 1988||Dec 12, 1989||Medinnovations, Inc.||Expandable pullback atherectomy catheter system|
|US4946466||Mar 3, 1989||Aug 7, 1990||Cordis Corporation||Transluminal angioplasty apparatus|
|US5243997 *||Sep 14, 1992||Sep 14, 1993||Interventional Technologies, Inc.||Vibrating device for a guide wire|
|US5287858||Sep 23, 1992||Feb 22, 1994||Pilot Cardiovascular Systems, Inc.||Rotational atherectomy guidewire|
|US5304115||Jan 11, 1991||Apr 19, 1994||Baxter International Inc.||Ultrasonic angioplasty device incorporating improved transmission member and ablation probe|
|US5318541||Mar 2, 1993||Jun 7, 1994||Cordis Corporation||Apparatus for catheter exchange in vascular dilitation|
|US5328471||Aug 4, 1993||Jul 12, 1994||Endoluminal Therapeutics, Inc.||Method and apparatus for treatment of focal disease in hollow tubular organs and other tissue lumens|
|US5380273||May 19, 1993||Jan 10, 1995||Dubrul; Will R.||Vibrating catheter|
|US5380274||Oct 12, 1993||Jan 10, 1995||Baxter International Inc.||Ultrasound transmission member having improved longitudinal transmission properties|
|US5389100||Nov 6, 1991||Feb 14, 1995||Imagyn Medical, Inc.||Controller for manipulation of instruments within a catheter|
|US5453653||Aug 3, 1993||Sep 26, 1995||Nanomotion Ltd.||Ceramic motor|
|US5498236||Oct 7, 1994||Mar 12, 1996||Dubrul; Will R.||Vibrating catheter|
|US5499632||May 4, 1994||Mar 19, 1996||Devices For Vascular Intervention||Guide wire migration controller|
|US5501228||Jul 21, 1994||Mar 26, 1996||Scimed Life Systems, Inc.||Vibration sensing guide wire|
|US5549119||Sep 13, 1994||Aug 27, 1996||Cordis Corporation||Vibrating tip catheter|
|US5571114||Jul 13, 1994||Nov 5, 1996||Devanaboyina; Udaya-Sankar||Mechanism to advance or withdraw objects in lumens or cavities of mammals|
|US5628719 *||Nov 21, 1994||May 13, 1997||Scimed Life Systems, Inc.||In vivo mechanical energy source and perfusion pump|
|US5632755||Dec 21, 1995||May 27, 1997||Endo Vascular Intruments, Inc.||Intra-artery obstruction clearing apparatus and methods|
|US5643297||Mar 10, 1995||Jul 1, 1997||Endovascular Instruments, Inc.||Intra-artery obstruction clearing apparatus and methods|
|US5643298||May 6, 1996||Jul 1, 1997||Nordgren; Gregory N.||Intra-artery obstruction clearing apparatus and methods|
|US5662587 *||Aug 16, 1994||Sep 2, 1997||Cedars Sinai Medical Center||Robotic endoscopy|
|US5662609||Apr 13, 1994||Sep 2, 1997||Endoluminal Therapeutics, Inc.||Method and apparatus for treatment of focal disease in hollow tubular organs and other tissue lumens|
|US5707376||Jun 7, 1995||Jan 13, 1998||William Cook Europe A/S||Stent introducer and method of use|
|US5713848||Jun 7, 1995||Feb 3, 1998||Dubrul; Will R.||Vibrating catheter|
|US5746758||Oct 21, 1996||May 5, 1998||Evi Corporation||Intra-artery obstruction clearing apparatus and methods|
|US5776153||Jul 4, 1994||Jul 7, 1998||Medical Miracles Company Limited||Angioplasty catheter with guidewire|
|US5908395||Mar 17, 1997||Jun 1, 1999||Advanced Cardiovascular Systems, Inc.||Vibrating guidewire|
|US6001112||Apr 10, 1998||Dec 14, 1999||Endicor Medical, Inc.||Rotational atherectomy device|
|US6183432||Nov 13, 1997||Feb 6, 2001||Lumend, Inc.||Guidewire and catheter with rotating and reciprocating symmetrical or asymmetrical distal tip|
|US6184609 *||Mar 26, 1997||Feb 6, 2001||Piezomotors Uppsala Ab||Piezoelectric actuator or motor, method therefor and method for fabrication thereof|
|US6228046||Mar 3, 1998||May 8, 2001||Pharmasonics, Inc.||Catheters comprising a plurality of oscillators and methods for their use|
|US6238401||Jul 31, 1998||May 29, 2001||Zuli Holdings Ltd.||Apparatus and method for selectively positioning a device and manipulating it|
|US6258052||Nov 18, 1999||Jul 10, 2001||Lumend, Inc.||Guidewire and catheter with rotating and reciprocating symmetrical or asymmetrical distal tip|
|US6287271||Jan 9, 1998||Sep 11, 2001||Bacchus Vascular, Inc.||Motion catheter|
|US6290675 *||Jan 9, 1998||Sep 18, 2001||Endosonics Corporation||Device for withdrawing a catheter|
|US6302875||Apr 11, 1997||Oct 16, 2001||Transvascular, Inc.||Catheters and related devices for forming passageways between blood vessels or other anatomical structures|
|US6348040||Apr 6, 1999||Feb 19, 2002||Advanced Cardiovascular Systems, Inc.||Vibrating guidewire|
|DE4329162A1||Aug 30, 1993||Mar 2, 1995||Stm Medtech Starnberg||Endoscope with movable front terminal region|
|EP0541258A1||Oct 13, 1992||May 12, 1993||Imagyn Medical, Inc.||Controller for manipulation of instruments within a catheter|
|GB2328877A||Title not available|
|JPH0558338A||Title not available|
|JPH0584296A *||Title not available|
|JPH0937571A||Title not available|
|JPH02129193A||Title not available|
|JPH04176770A||Title not available|
|JPH06269185A||Title not available|
|JPH07156843A||Title not available|
|JPH08207755A||Title not available|
|JPH08216876A||Title not available|
|JPH10113396A||Title not available|
|JPH10165510A||Title not available|
|WO1995032539A1||May 24, 1995||Nov 30, 1995||Kinetron B.V.||Micro motor and guide wire, in particular for guiding catheters, with such a micro motor|
|WO1998030266A1 *||Jan 9, 1998||Jul 16, 1998||Endosonics Corporation||Device for withdrawing a catheter|
|Citing Patent||Filing date||Publication date||Applicant||Title|
|US8628550||Feb 19, 2009||Jan 14, 2014||Cardiovascular Systems, Inc.||Rotational atherectomy segmented abrading head and method to improve abrading efficiency|
|US8636750||Aug 27, 2009||Jan 28, 2014||Applisonix Ltd.||Hair removal device|
|US9636127 *||Mar 31, 2015||May 2, 2017||Terumo Kabushiki Kaisha||Method for retrieving objects from a living body|
|US9662097 *||Mar 31, 2015||May 30, 2017||Terumo Kabushiki Kaisha||Method for retrieving objects from a living body and expanding a narrowed region in the living body|
|US20090137872 *||Nov 24, 2008||May 28, 2009||Tyco Healthcare Group Lp||Method and Apparatus for Controlling Endoscopic Instruments|
|US20100211088 *||Feb 19, 2009||Aug 19, 2010||Cardiovascular Systems, Inc.||Rotational atherectomy segmented abrading head and method to improve abrading efficiency|
|US20110224692 *||Jun 9, 2009||Sep 15, 2011||Alon Goren||Device for applying high-frequency vibrations to hair for removing same|
|US20110238085 *||Aug 27, 2009||Sep 29, 2011||Applisonix Ltd.||Hair removal device|
|US20120283565 *||Jul 19, 2012||Nov 8, 2012||Oscillon Ltd.||Apparatus and method for guided chronic total occlusion penetration|
|U.S. Classification||606/108, 128/898, 604/95.01|
|International Classification||A61B17/22, A61M25/082, A61B17/00, A61M25/01, A61M31/00, A61M25/00|
|Cooperative Classification||A61M25/0105, A61B2017/22075, A61M25/09041, A61B1/00147, A61B2017/00398, A61M25/0113|
|European Classification||A61B1/00P, A61M25/01C3, A61M25/09C|
|Dec 1, 2008||FPAY||Fee payment|
Year of fee payment: 8
|Jan 22, 2010||AS||Assignment|
Owner name: OSCILLON LTD., ISRAEL
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:ZULI HOLDINGS, LTD.;REEL/FRAME:023832/0679
Effective date: 20100118
|Nov 29, 2012||FPAY||Fee payment|
Year of fee payment: 12
|Oct 9, 2014||AS||Assignment|
Owner name: MEDINOL LTD., ISRAEL
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:OSCILLON LTD.;REEL/FRAME:033923/0374
Effective date: 20141007