US-20260123955-A1 - ACCESS CATHETER

US20260123955A1US 20260123955 A1US20260123955 A1US 20260123955A1US-20260123955-A1

Abstract

The present disclosure relates to novel and advantageous systems and methods for deploying a surgical tool or guidewire. Particularly, the present disclosure relates to novel and advantageous systems and methods for deploying a surgical tool for use in changing the shape of portions of luminal systems. More particularly, the present disclosure relates to novel and advantageous systems and methods including an access catheter to direct an implement, such as a guide wire, off axis into a wall of a vessel or a wall of a tissue structure.

Inventors

Nasser Rafiee
Stuart MacDonald
Koosha Rafiee

Assignees

TRANSMURAL SYSTEMS LLC

Dates

Publication Date: 20260507
Application Date: 20251001

Claims (19)

1 . An access catheter to access an target location inside a tissue structure, comprising: an outer elongate body having a proximal end, a distal end and defining a longitudinal axis of the access catheter; and a transverse accessor body having a proximal end and a distal end, wherein the transverse accessor body is slidably coupled to at least a portion of the outer elongate body, and further wherein a distal end region of the transverse accessor body includes a shape memory attribute that causes the distal end region of the transverse accessor body to bend away from the outer elongate body to bring the distal end of the transverse accessor body into an alignment that is oblique or orthogonal with respect to the longitudinal axis of the outer elongate body.
2 . The access catheter of claim 1 , wherein: the outer elongate body is a tubular member defined by a sidewall that in turn defines and surrounds a first lumen along a length of the outer elongate body to slidably receive the transverse accessor body therein; and the outer elongate body defines a first exit port through the sidewall in a distal end region of the outer elongate body in fluid communication with the first lumen, the distal end of the transverse accessor body being configured to exit the first lumen of the outer elongate body through the first exit port as the transverse accessor body is advanced distally with respect to the outer elongate body.
3 . The access catheter of claim 2 , further comprising an intermediate elongate body slidably disposed within the lumen of the outer elongate body, the intermediate elongate body defining a second lumen therethrough to slidably receive the transverse accessor body.
4 . The access catheter of claim 3 , wherein the intermediate elongate body defines a second exit port in fluid communication with the second lumen, wherein the intermediate elongate body can be rotated within the first lumen to align the second exit port of the intermediate elongate body with the first exit port of the outer elongate body.
5 . The access catheter of claim 4 , wherein at least one of the outer elongate body and intermediate elongate body includes a rotational marker to permit a user to determine the rotational orientation of said at least one of the outer elongate body and intermediate elongate body with respect to surrounding anatomy under a visualization modality.
6 . The access catheter of claim 5 , wherein the outer elongate body includes said rotational marker.
7 . The access catheter of claim 5 , wherein the intermediate elongate body includes said rotational marker.
8 . The access catheter of claim 5 , wherein the outer elongate body and intermediate elongate body both include a rotational marker.
9 . The access catheter of claim 5 , wherein the rotational marker includes two portions having a “C” shaped cross section coupled by a third section.
10 . The access catheter of claim 3 , wherein the intermediate elongate body includes a distal tip that interfits with a coupling defined in a distal end region of the first lumen within the elongate body.
11 . The access catheter of claim 1 , wherein the transverse accessor body is tubular in shape.
12 . The access catheter of claim 11 , wherein the accessor body is made at least in part from a nickel-titanium alloy.
13 . The access catheter of claim 1 , wherein the transverse accessor body is configured to guide a guide wire into the tissue structure.
14 . The access catheter of claim 1 , wherein the distal end region of the transverse accessor body is coated with a radiopaque material.
15 . The access catheter of claim 1 , wherein the distal end region of the transverse accessor body has an uneven surface configured to enhance its signature under a visualization modality.
16 . An access catheter to access an target location inside a tissue structure, comprising: an elongate body having a proximal end and a distal end; and a marker disposed on the elongate body to permit a user to detect its rotational orientation with respect to anatomy under at least one imaging modality.
17 . The access catheter of claim 16 , wherein the marker is radiopaque.
18 . The access catheter of claim 16 , wherein the marker includes at least two non-uniform loop-like portions spaced apart from one another along a length of the elongate body that each at least partially surround a longitudinal axis of the catheter.
19 . The access catheter of claim 8 , wherein each of said loop-like portions includes a first end spaced apart from a second end, such that each said loop portion has a “C” shaped cross section.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS The present patent application is a continuation-in-part of and claims the benefit of priority to U.S. patent application Ser. No. 17/709,869, filed Mar. 31, 2022, which in turn is a continuation-in-part of and claims the benefit of priority to International Patent Application No. PCT/US2022/018585, filed Mar. 2, 2022, which in turn claims the benefit of priority to U.S. Provisional Application No. 63/155,707, filed 2 Mar. 2021. The content of each of the aforementioned patent applications is hereby incorporated by reference herein in its entirety for all purposes. FIELD OF THE DISCLOSURE The present disclosure relates to novel and advantageous systems and methods for deploying a surgical tool or guidewire. Particularly, the present disclosure relates to novel and advantageous systems and methods for deploying a surgical tool for use in changing the shape of portions of luminal systems. More particularly, the present disclosure relates to novel and advantageous systems and methods including an access catheter to facilitate tunneling into the tissue of a wall of a luminal system. BACKGROUND OF THE DISCLOSURE The background description provided herein is for the purpose of generally presenting the context of the disclosure. Work of the presently named inventors, to the extent it is described in this background section, as well as aspects of the description that may not otherwise qualify as prior art at the time of filing, are neither expressly nor impliedly admitted as prior art against the present disclosure. Many devices and systems exist for accessing and traversing tissue structures. The present disclosure provides improved devices and related methods that are believed to improve significantly upon the state of the art. BRIEF SUMMARY OF THE INVENTION The following presents a simplified summary of one or more aspects of the present disclosure in order to provide a basic understanding of various implementations described by the present disclosure. This summary is not an extensive overview of all contemplated embodiments, and is intended to neither identify key or critical elements of all embodiments, nor delineate the scope of any or all embodiments. The present disclosure relates to novel and advantageous systems and methods for deploying a surgical implement or guidewire. Particularly, the present disclosure relates to novel and advantageous systems and methods for deploying a surgical implement or tool off the axis of travel of a catheter, which can be challenging, particularly in the context of tunneling into the walls of tissue structures within a luminal system of a patient. In some aspects, the present disclosure relates to novel and advantageous systems and methods including an access catheter such as a myocardial access device for use with a system for cerclage of luminal systems. It will be appreciated however that the teachings of the present disclosure are germane to the design and implementation of medical devices for many different applications where a device that has been introduced percutaneously needs to be redirected along a significantly different direction of travel, such as an oblique or orthogonal direction of travel. The present disclosure, in one or more embodiments, provides implementations of a system that facilitate guidewire deployment, for example, in a first direction followed by deployment in a second direction perpendicular or oblique to the first direction. This can be useful to tunnel into or pass through the wall of a tissue structure, such as to tunnel into the myocardium of a heart from a location within a chamber of a heart or within a vascular passageway defined within the heart. But, it will also be appreciated that such a device can be advantageously used to traverse a wall of a blood vessel to form an opening into the vessel wall to permit passage of a catheter for various purposes, such as delivering a vascular shunt or performing an end to side anastomosis procedure. For example, in accordance with some aspects, the present disclosure provides implementations of a system that facilitates achieving a 90 degree, or near 90 degree, turn of a guidewire during guidewire deployment. While multiple embodiments are disclosed, still other embodiments of the present disclosure will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. As will be realized, the various embodiments of the present disclosure are capable of modifications in various obvious aspects, all without departing from the spirit and scope of the present disclosure. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive. BRIEF DESCRIPTION OF THE DRAWINGS While the specification concludes with claims particularly pointing out and distinctly claiming the subject matter that is regarded as forming the various em