Apparatus for pulling and positioning an apparatus, e.g., a stent, in the target area of a lumen. In one embodiment, a cylindrically shaped motor has a longitudinal bore, a friction area within the longitudinal bore, and a guide wire disposed within the longitudinal bore. The guide wire and friction area of the motor are sized and adapted to contact each other and impart friction between the friction area and the guide wire to permit the motor to pull a catheter to the target arcs by crawling against the guide wire. In another embodiment, a cylindrical motor having a friction area on its outer surface is disposed within a guide tube.
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0. 56. A method comprising using a piezoelectric micromotor to move a device to a target area in a lumen comprising attaching said micro-motor to a catheter, frictionally engaging a guide wire that passes through said catheter with said motor and energizing said motor to bring about relative motion between the wire and catheter.
0. 13. A method comprising:
a) inserting a guide wire into of a catheter to which a micro-motor is attached, the guide wire passing through the catheter and operatively coupled to the micro-motor, into a lumen;
b) advancing the guide wire to a target area;
c) securing the guide wire;
d) energizing the micro-motor so that the micro-motor advances along the guide wire to target area, carrying with it the attached catheter.
0. 60. A method comprising traversing an obstruction in a lumen by causing a guide wire driven by a piezoelectric micro-motor in a oscillatory manner to advance into the obstruction including moving a catheter to which the micro-motor is attached and the guide wire to the target area using the micro-motor, holding the catheter fixed, and driving said micro-motor to cause said guide wire to advance against said obstruction in an oscillatory manner.
0. 52. An apparatus, comprising: a piezoelectric motor provided with a friction area; a cylindrical guide tube defining a longitudinal bore, said motor disposed within said bore in such a manner that said friction area presses against an inner surface of said cylindrical guide tube in such a manner as to impart friction between said friction area of said motor and said inner surface in an amount sufficient to permit said cylindrical motor to change position relative to said guide tube by crawling against said inner surface of said guide tube when said motor is energized.
0. 18. A method comprising:
a) inserting a guide wire into a catheter to which a micro-motor is attached, the guide wire operatively coupled to the micro-motor, into a lumen in which there is an obstruction;
b) advancing the guide wire to a proximal end of the obstruction;
c) securing the guide wire;
d) energizing the micro-motor so that the micro-motor advances distally along the guide wire, carrying with it the attached catheter, toward the proximal end of the obstruction;
e) securing the catheter;
f) energizing the micro-motor so that the guide wire advances distally.
1. An apparatus, comprising: a cylindrically shaped motor, said motor having a longitudinal bore, said motor provided with a motor friction area disposed within said longitudinal bore; a guide wire disposed within said longitudinal bore, said guide wire and said longitudinal bore sized and adapted to impart friction between said friction area of said motor and said guide wire in an amount sufficient to permit said motor to change position relative to said guide wire by crawling against said guide wire when said motor is energized; and, further comprising a biasing means to bias said guide wire against said friction area.
3. An apparatus, comprising: a cylindrically shaped motor, said motor having an outer surface, said motor provided with a friction area on said outer surface; a cylindrical guide tube having an outer surface and an inner surface defining a longitudinal bore, said outer surface of said motor and said inner surface of said guide tube sized and adapted to impart friction between said friction area of said motor and said inner surface of said cylindrical guide tube in an amount sufficient to permit said cylindrical motor to change position relative to said guide tube by crawling against said inner surface of said guide tube when said motor is energized.
8. 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 said distal end; a cylindrically shaped motor disposed at said distal end of said catheter distal to said balloon, said motor having a longitudinal bore communicating with a said longitudinal bore of said catheter, said motor provided with motor friction area disposed within said longitudinal bore of said motor; a guide wire disposed within said longitudinal bore of said catheter and said longitudinal bore of said motor, said guide wire and said longitudinal bore of said motor sized and adapted to impart friction between said friction area of said motor and said guide wire in an amount sufficient to permit said motor to change position relative to said guide wire by crawling against said guide wire when said motor is energized.
6. A method of disposing a device in the target area of a lumen, comprising the steps of:
a) constructing an apparatus comprising: a cylindrically shaped motor attached to said device, said motor having a longitudinal bore, said motor provided with a motor friction area disposed within said longitudinal bore, a guide wire disposed within said longitudinal bore, said guide wire and said longitudinal bore of said motor sized and adapted to impart friction between said friction area of said motor and said guide wire in an amount sufficient to permit said motor to change position relative to said guide wire by crawling against said guide wire when said motor is energized;
b) advancing said guide wire to said target area;
c) securing said guide wire;
d) energizing said motor so that said motor advances along said guide wire to said target area to dispose said device in said target area of said lumen; and
e) withdrawing said guide wire, motor, and catheter from said lumen.
7. A method of disposing a device in the target area of a lumen, comprising the steps of:
a) constructing an apparatus comprising: a cylindrically shaped motor having an outer surface, said motor provided with a friction area on said outer surface, a cylindrical guide tube having an outer surface and an inner surface defining a longitudinal bore, said outer surface of said motor and said inner surface of said guide tube sized and adapted to impart friction between said friction area and said inner surface of said cylindrical guide tube in an amount sufficient to permit said cylindrical motor to change position relative to said guide tube by crawling against said inner surface of said guide tube when said motor is energized;
b) advancing said guide tube to said target area;
c) securing said guide tube;
d) inserting said motor attached to said device in said bore of said guide tube;
e) energizing said motor so that said motor advances along said inner surface of said guide tube to said target area to dispose said device in said target area of said lumen; and
f) withdrawing said guide tube, motor, and catheter from said lumen.
11. 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 said distal end; a cylindrically shaped motor disposed at said distal end of said catheter distal to said balloon, said motor having a longitudinal bore communicating with said longitudinal bore of said catheter, said motor provided with a motor friction area disposed within said longitudinal bore of said motor, a guide wire disposed within said longitudinal bore of said catheter and said longitudinal bore of said motor, said guide wire and said longitudinal bore of said motor sized and adapted to impart friction between said friction area of said motor and said guide wire in an amount sufficient to permit said motor to change position relative to said guide wire by crawling against said guide wire when said motor is energized;
b) advancing said guide wire to said target area;
c) securing said guide wire;
d) energizing said motor so that it advances along said guide wire to said target area to dispose said stent in said target area of said lumen;
e) inflating said balloon to secure said stent in said target area of said lumen;
f) deflating the balloon; and
g) withdrawing said guide wire, motor, and catheter from said lumen.
12. 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 said distal end; a cylindrically shaped motor disposed at said distal end of said catheter distal to said balloon, said motor having a longitudinal bore communicating with said longitudinal bore of said catheter, said motor provided with a motor friction area disposed within said longitudinal bore, a guide wire disposed within said longitudinal bore of said catheter and said longitudinal bore of said motor, said guide wire and said longitudinal bore of said motor sized and adapted to impart friction between said friction area of said motor and said guide wire in an amount sufficient to permit said motor to change position relative to said guide wire by crawling against said guide wire when said motor is energized;
b) advancing said guide wire to said target area;
c) securing said guide wire;
d) energizing said motor so that said motor advances along said guide wire to said obstructed target area;
e) securing said catheter;
f) energizing said motor so that said guide wire advances through said longitudinal bore of said motor and into said obstructed target area of said lumen;
g) securing said guide wire;
h) energizing said motor so that said motor advances along said guide wire and disposes said stent in said target area of said lumen;
i) inflating said balloon to secure said stent in said target area of said lumen;
j) deflating the balloon; and
k) withdrawing said guide wire, motor, and catheter from said lumen.
4. The apparatus of
9. The apparatus of
0. 14. The method according to
e) withdrawing the guide wire, micro-motor, and catheter from the lumen.
0. 15. The method according to
a) inflating the balloon in the target area of the lumen; and
b) deflating the balloon.
0. 16. The method according to
0. 17. The method according to
0. 19. The method according to
0. 20. The method according to
0. 21. The method according to
0. 22. The method according to
0. 23. The method according to
0. 24. The method according to
0. 25. The method according to
a) securing the catheter;
b) energizing the micro-motor so that the guide wire advances distally;
c) securing the guide wire;
d) energizing the micro-motor so that the micro-motor advances along the guide wire, carrying with it the attached catheter.
0. 26. The method according to
0. 27. The method according to
0. 28. The method according to
0. 29. The method according to
0. 30. The method according to
0. 31. The method according to
a) energizing the motor so that the guide wire advances distally;
b) energizing the motor so that the guide wire advances proximally; and
c) repeating steps a) and b) a plurality of times.
0. 32. The method according to
0. 33. The method according to
0. 34. The method according to
a) inflating the balloon in the target area of the lumen; and
b) deflating the balloon.
0. 35. The method according to
0. 36. The method according to
0. 37. The method according to
0. 38. The method according to
0. 39. The method according to
0. 40. The method according to
0. 41. The method according to
0. 42. The method according to
0. 43. The method according to
0. 44. The method according to
0. 45. The method according to
0. 46. The method according to
0. 47. The method according to
0. 48. The method according to
0. 49. The method according to
a) inflating the balloon in the target area of the lumen; and
b) deflating the balloon.
0. 50. The method according to
0. 51. The method according to
0. 53. The apparatus of
0. 54. The apparatus of
0. 55. The apparatus of
0. 57. The method according to
0. 58. The method according to
0. 59. The method according to
0. 61. The method of
0. 62. The method of
0. 63. The method according to
0. 64. The method according to
0. 65. The method according to
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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, of the type described above in Zumeris, having a longitudinal bore therethrough. A guide wire 2 is disposed within the longitudinal bore 5.
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.
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