Complex shape steerable tissue visualization and manipulation catheter

{
  "publication_number": "US2008275300A1",
  "country": "US",
  "kind": "A1",
  "title": "Complex shape steerable tissue visualization and manipulation catheter",
  "abstract": "Complex shape steerable tissue visualization and manipulation catheters and their methods of use of disclosed herein. The deployment catheter may be articulated utilizing various steering mechanisms to adjust a position of a visualization hood or membrane through which underlying tissue may be visualized.",
  "claims": [
    "1. An apparatus for accessing a difficult-to-reach tissue surface in a region of a body having a continuous interfering blood flow comprising: a deployment catheter shaft having an articulatable assembly near or at a distal portion of the catheter, the articulatable assembly having a proximal steerable section and a distal steerable section connected distally of the proximal section; a barrier or membrane attached to a distal end of the distal steerable section and which is configurable between a delivery profile and an deployment profile, the barrier or membrane defining an open area in the deployment profile and in fluid communication with a lumen defined through the catheter; wherein the proximal steerable section is adapted to articulate within a single plane relative to a longitudinal axis of the catheter, and wherein the distal steerable section is adapted to articulate within one or more planes relative to a longitudinal axis of the proximal steerable section. 2. The apparatus of claim 1 further comprising a visualization element disposed within or along the barrier or membrane for visualizing tissue adjacent to the open area. 3. The apparatus of claim 1 wherein the articulatable assembly is steered via one or more pull wires. 4. The apparatus of claim 1 wherein the proximal and distal steerable sections are separately controlled during a procedure. 5. The apparatus of claim 1 further comprising one or more terminal locations along the articulatable assembly for attachment one or more pull wires. 6. The apparatus of claim 1 further comprising a conformable lip coupled to a circumferential edge of the barrier or membrane. 7. The apparatus of claim 1 further comprising one or more steerable leaflets disposed along the barrier or membrane. 8. The apparatus of claim 1 wherein the barrier or membrane is articulatable relative to the catheter. 9. The apparatus of claim 1 wherein the proximal and distal steerable sections each comprise a plurality of serially aligned links which are selected from pin links, bump links, ring links, one-way links, and four-way links. 10. The apparatus of claim 1 wherein the proximal and distal steerable sections each comprise a durometer different from one another. 11. The apparatus of claim 10 wherein the proximal and distal steerable sections define a variation in durometer from a relatively less flexible to a relatively more flexible durometer, respectively. 12. The apparatus of claim 1 further comprising a sheath or covering over the articulatable assembly. 13. The apparatus of claim 1 further comprising an outer sheath through which the deployment catheter is advanced. 14. The apparatus of claim 13 wherein a distal portion of the outer sheath is passively or actively articulatable. 15. The apparatus of claim 1 further comprising an instrument positionable through the catheter and within the barrier or membrane. 16. An apparatus for accessing a tissue surface within a blood flow of a patient body, the apparatus comprising: a deployment catheter having an articulatable assembly near or at a distal portion of the catheter, the articulatable assembly having a proximal steerable section and a distal steerable section connected distally of the proximal section; a tissue surface imaging or treatment member disposed distally of the distal steerable section; a first articulation mechanism extending distally to the proximal steering section so as to limit controlled axial flexing of the catheter to a single plane along a longitudinal axis of the catheter; and a second articulation mechanism extending distally to the distal steering section, the second articulation mechanism and distal steering section effecting controlled axial flexing of the catheter across a plurality of planes along the longitudinal axis. 17. A method of accessing difficult-to-reach target tissue in a region of a body having continuous interfering blood flow, the method comprising: advancing a deployment catheter shaft having an articulatable assembly near or at a distal portion of the catheter into the region of the body, the articulatable assembly having a proximal steerable section and a distal steerable section connected distally of the proximal section; articulating the proximal section such that a barrier or membrane attached to a distal end of the distal steerable section is articulated in a first plane relative to a longitudinal axis of the catheter; and articulating the distal section in one or more additional planes relative to a longitudinal axis of the proximal section such that the barrier or membrane is positioned in proximity to the target tissue. 18. The method of claim 17 wherein advancing comprises advancing the deployment catheter into a heart of a patient. 19. The method of claim 17 wherein articulating the proximal section comprises constraining the proximal section to curve within the first plane. 20. The method of claim 17 wherein articulating the distal section comprises articulating the distal section in a plurality of planes relative to the longitudinal axis of the catheter. 21. The method of claim 17 further comprising positioning an open area of the barrier or membrane against or adjacent to the target tissue. 22. The method of claim 21 further comprising displacing blood with a translucent transparent fluid from an open area defined by the barrier or membrane. 23. The method of claim 22 further comprising visualizing the target tissue within the an open area through the transparent fluid. 24. The method of claim 23 further comprising ablating at least a portion of the target tissue within the open area. 25. The method of claim 24 further comprising ablating tissue circumferentially surrounding an ostium of a pulmonary vein. 26. The method of claim 17 further comprising repositioning the barrier or membrane relative to the target tissue by re-articulating the distal section. 27. A method of accessing a target tissue in a chamber of a heart, the method comprising: advancing a deployment catheter shaft having an articulatable assembly near or at a distal portion of the catheter into the region of the body, the articulatable assembly having a proximal steerable section and a distal steerable section connected distally of the proximal section; positioning the distal section within range of the target tissue by articulating the proximal section such that a distal end of the distal steerable section is articulated in a first plane relative to a longitudinal axis of the catheter, and by rotating the proximal section; and articulating the distal section in two planes relative to a longitudinal axis of the proximal section such that the barrier or membrane is positioned in proximity to the target tissue. 28. An apparatus for accessing a tissue surface within a blood flow of a patient body, the apparatus comprising: a deployment catheter having an unarticulated flexible body, an articulatable assembly supported by the unarticulated body of the catheter, the articulatable assembly having a proximal steerable section and a distal steerable section connected distally of the proximal section; a tissue surface imaging or treatment member disposed distally of the distal steerable section; a first articulation mechanism extending distally to the proximal steering section so as to effect controlled axial flexing of the catheter in a first direction in a plane along a longitudinal axis of the catheter; and a second articulation mechanism extending distally to the distal steering section so as to effect controlled axial flexing of the catheter in a second direction in the plane, the second direction being opposite the first direction. 29. An apparatus for accessing a difficult-to-reach tissue surface in a region of a body having a continuous interfering blood flow comprising: a deployment catheter shaft having an articulable section near or at a distal portion of the catheter; a barrier or membrane attached to a distal end of the articulable section and which is configurable between a delivery profile and an deployment profile, the barrier or membrane defining an open area in the deployment profile and in fluid communication with a lumen defined through the catheter, the open area defining a plane extending across an axis of the catheter; and an articulation mechanism extending to the barrier or membrane so as to vary shape of the barrier or membrane and a slant of the plane relative to the axis."
  ],
  "cpc": [
    "A61B 1/0008",
    "A61B 1/00082",
    "A61B 1/00085",
    "A61B 1/00089",
    "A61B 1/00096",
    "A61B 1/00154",
    "A61B 1/0051",
    "A61B 1/0052",
    "A61B 1/0057",
    "A61B 1/008",
    "A61B 1/01",
    "A61B 1/015",
    "A61B 1/018",
    "A61B 1/042",
    "A61B 1/05",
    "A61B 5/02007",
    "A61M 2025/0161",
    "A61M 25/0138",
    "A61M 25/0147"
  ],
  "assignees": [
    "VOYAGE MEDICAL INC"
  ],
  "filing_date": "2008-04-24",
  "publication_date": "2008-11-06",
  "priority_date": "2007-04-27",
  "application_number": "US-10881208-A",
  "family_id": "39926079",
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