Endoscopic ultrasound-guided biliary access system
The present disclosure provides an access system having a maneuverable catheter assembly configured for providing access to and navigating a desired vessel for subsequent treatment thereof. The access system includes an adjustable delivery handle assembly and an access catheter subassembly having a maneuverable access catheter configured to be delivered to desired site (e.g., within duodenum) to assist in treatment of a condition (e.g., drainage of a bile ducts via Endoscopic Ultrasound Guided Biliary Drainage (EUS-BD) techniques). The access catheter includes at least a distal section having an adjustable portion along a length thereof configured to transition to a pre-defined arcuate shape to provide directional control over the distal end of the catheter as it is navigated through a vessel (e.g., bile duct). The handle assembly includes additional elements configured to allow a clinician to maneuver and manipulate the distal end of the access catheter.
1. A system for providing access to a vessel, the system comprising:
an adjustable delivery handle system comprising:
a delivery handle assembly, at least a portion of which comprises an inner lumen configured to receive one of a plurality of exchangeable subassemblies; and
an inner hub housing coupled to a portion of the deliver handle assembly, the inner hub housing having a first plurality of radially-spaced barbs disposed on an inner diameter thereof;
a sheath coupled to a distal end of the handle assembly and having a lumen in fluid communication with the inner lumen of the delivery handle assembly; and
an access catheter subassembly removably disposed within the inner lumen of the delivery handle assembly and lumen of the sheath, the access catheter subassembly comprising:
a catheter hub configured for insertion into the inner hub housing, the catheter hub having a second plurality of radially-spaced barbs disposed on an outer diameter thereof, wherein each of the second plurality of barbs is configured for selective engagement with a corresponding one of the first plurality of barbs to permit incremental rotation of the catheter hub relative to the inner hub housing; and
an access catheter having an elongate tubular body having a proximal section having a proximal end, a distal section having a distal end, an outer surface, and an inner surface defining a lumen extending from the proximal end to the distal end,
wherein the distal section includes an adjustable portion along a length thereof configured to transition to a pre-defined arcuate shape: and
wherein the distal section of the access catheter, including the adjustable portion, is configured to incrementally rotate about a longitudinal axis defined by the lumen of the catheter body in conjunction with incremental rotation of the catheter hub.
2. The system of claim 1 , wherein, when disposed within the lumen of the sheath, the adjustable portion of the distal section of the access catheter is configured to maintain a substantially linear shape.
3. The system of claim 1 , wherein, upon extension from the lumen of the sheath, the adjustable portion of the distal section of the access catheter is configured to transition to the pre-defined arcuate shape.
4. The system of claim 1 , wherein, when in the pre-defined arcuate shape, the adjustable portion forms at least one angle relative to a longitudinal axis defined by the lumen of the catheter body, wherein the at least one angle is between 0 and 170 degrees.
5. The system of claim 1 , further comprising a stylette member removably disposed within the inner lumen of the delivery handle assembly, lumen of the sheath, and lumen of the access catheter, the stylette member having a distal end configured to pierce tissue of a vessel to provide access to an interior of the vessel.
6. The system of claim 5 , wherein, when the stylette member is disposed within a lumen of the adjustable portion of the distal section of the access catheter, the adjustable portion is configured to maintain a substantially linear shape.
7. The system of claim 6 , wherein, upon removal of the stylette member from within the lumen of the adjustable portion, the adjustable portion is configured to transition to the pre-defined arcuate shape.
8. The system of claim 1 , wherein the proximal section and the distal section of the access catheter have different levels of stiffness.
9. The system of claim 8 , wherein the proximal section has a greater level of stiffness than the distal section.
10. The system of claim 1 , wherein the distal section of the access catheter further comprises a portion adjacent the distal end having enhanced echogenicity or acoustic reflection.
11. The system of claim 1 , wherein the distal section of the access catheter has a metallic distal tip.
12. The system of claim 1 , wherein the distal section of the access catheter comprises a tubular body formed from densely packed tubular coil.
13. The system of claim 12 , wherein an interior surface of the lumen of the distal section has a liner disposed thereon having a coefficient of friction.
14. The system of claim 1 , wherein the access catheter further comprises a cutting element positioned on the distal section adjacent to the distal end.
15. The system of claim 1 , wherein the access catheter further comprises at least one control element configured to cause movement of at least the distal end relative to a longitudinal axis defined by the lumen of the catheter body upon application of force thereto.