Steerable endoluminal punch
An endoluminal needle or punch is describes wherein the distal end of the endoluminal needle is able to articulate laterally out of the longitudinal axis of the steerable endoluminal needle. The endoluminal needle further comprise a blunted distal end configuration that is minimally traumatic. Under control by the user, at the proximal end of the endoluminal needle, a sharp stylet can be advanced to punch tissue and then be retracted to maximize safety. The endoluminal needle is configured for use within an introducer.
1. A method of crossing an atrial septum of a patient, said method comprising:
providing a steerable endoluminal punch comprising:
an outer tube, said outer tube characterized by a distal end, and proximal end, and an outer tube lumen extending from the distal end to the proximal end thereof, said outer tube having a flexible region near the distal end of the outer tube;
a first control rod disposed within the outer tube, said first control rod characterized by a distal end and a proximal end, said first control rod comprising a partial hollow cylinder, wherein the first control rod is longitudinally fixed to the distal end of the outer tube and extends proximally to the proximal end of the outer tube; and
a second control rod disposed within the outer tube, said second control rod characterized by a distal end and a proximal end, said second control rod comprising a partial hollow cylinder, wherein the second control rod is longitudinally fixed to the distal end of the outer tube and extends proximally to the proximal end of the outer tube;
an inner tube, disposed within the outer tube lumen, with the first control rod and second control rod disposed between the inner tube and the outer tube, said inner tube having a sharpened distal tip extending distally from the distal end of outer tube;
at least one keeper disposed circumferentially between the first control rod and second control rod and disposed between the inner tube and the outer tube; and
an RF energy source operably connected to the inner tube,
wherein the inner tube is operable to conduct RF energy from the RF energy source to a tissue within a body of a patient; and
navigating the steerable endoluminal punch through a vasculature of the patient to locate the sharpened distal tip of the inner tube against the atrial septum of the patient;
applying RF energy through the inner tube to the atrial septum;
advancing the inner tube through the atrial septum into a left atrium of the patient.
2. The method of claim 1 , further comprising the steps of:
Advancing a distal end of guide catheter and a distal end of an obturator and/or dilator, across the atrial septum until the distal end of the guide catheter resides within the left atrium; and
Withdrawing the obturator and/or dilator along with the steerable endoluminal punch from the left atrium and from the guide catheter to allow for catheter placement through the guiding catheter.
3. A method of crossing an atrial septum of a patient, said method comprising:
control rod characterized endoluminal punch comprising:
an outer tube, said outer tube characterized by a distal end, and proximal end, and an outer tube lumen extending from the distal end to the proximal end thereof, said outer tube having a flexible region near the distal end of the outer tube;
a first control rod disposed within the outer tube, said first providing endoluminal by a distal end and a proximal end, said first control rod comprising a partial hollow cylinder, wherein the first control rod is longitudinally fixed to the distal end of the outer tube and extends proximally to the proximal end of the outer tube; and
a second control rod disposed within the outer tube, said second control rod characterized by a distal end and a proximal end, said second control rod comprising a partial hollow cylinder, wherein the second control rod is longitudinally fixed to the distal end of the outer tube and extends proximally to the proximal end of the outer tube;
an inner tube, disposed within the outer tube lumen, with the first control rod and second control rod disposed between the inner tube and the outer tube, said inner tube having a distal tip extending distally from the distal end of the outer tube;
a stylet disposed within the inner tube, said stylet having a distal end and being slidably disposed within the inner tube such that the distal end extends distally from the distal end of the inner tube;
at least one keeper disposed circumferentially between the first control rod and second control rod and disposed between the inner tube and the outer tube; and
an RF energy source operably connected to the stylet,
wherein the stylet is operable to conduct RF energy from the RF energy source to a tissue within a body of a patient; and
navigating the steerable endoluminal punch through a vasculature of the patient to locate the distal tip of the stylet against the atrial septum of the patient;
applying RF energy through the stylet to the atrial septum;
advancing the stylet and inner tube through the atrial septum into a left atrium of the patient.
4. The method of claim 3 , further comprising the steps of:
Advancing a distal end of a guide catheter and a distal end of an obturator and/or dilator, across the atrial septum until the distal end of the guide catheter resides within the left atrium; and
withdrawing the obturator and/or dilator along with the steerable endoluminal punch from the left atrium and from the guide catheter to allow for catheter placement through the guiding catheter.
5. The method of claim 3 , wherein the inner tube has a blunt distal tip.