Abstract: Catheter-supported therapeutic and diagnostic tools can be introduced into a patient body with a sheath slidably disposed over the tool. Once the tool is aligned with a target tissue, a fluid-driven actuator can move the sheath axially from over the tool, for example, to allow a stent, stent-graft, prosthetic valve, or the like to expand radially within the cardiovascular system, without having to transmit large deployment forces along the catheter shaft and sheath from outside the patient. Well-behaved articulation structures will often include simple balloon arrays, with inflation of the balloons interacting with elongate skeletal support structures so as to improve articulation behavior of the skeleton. The array can be used to improve uniformity of bending along a segment of a flexible body such as a catheter.

Abstract: Medical devices, systems, and methods provide improved control over the flexing of an articulated catheter adjacent a therapeutic or diagnostic tool by laterally bending the catheter so as to anchor an articulated portion of the catheter locally relative to an internal tissue site. Alternative embodiments may be used for a wide variety of non-medical applications, including with borescope systems and for other industrial applications.

Abstract: Articulation devices, systems, methods for articulation, and methods for fabricating articulation structures make use of balloon arrays, with inflation of the balloons locally altering articulation. Inflation fluid may be directed toward the balloons from an inflation fluid source via a series of channels, the balloons and channels included in a helical multi-balloon assembly. The balloons may be supported by encasing the helical balloon assembly in a polymer matrix, such as by winding the balloon assembly onto a mandrel and dip-coating some or all of the assembly in an elastomer such as a silicone, a urethane, or the like. The balloons may be supported by one or more spring, with loops of the spring(s) optionally being inward of the balloons, outward of the balloons, or interspersed between the balloons, and/or a mesh tube, braid, or other compliant materials may be included.

Abstract: Medical devices, systems, and methods for catheter-based structural heart therapies, including positioning of prosthetic mitral valves, make use of catheter structures that can flex when advanced over a pre-bent guidewire. Telescoping transseptal access systems use steering segments that are disposed proximal of a relatively rigid catheter segment (the segment optionally supporting a prosthetic valve) by engaging tissue adjacent the right atrium near the proximal end of the valve, and by telescoping a relatively rigid needle guide distally from the valve across the right atrium to engage tissue of the fossa ovalis. Hybrid pull-wire/balloon articulation systems may optionally employ relatively stiff pull-wire articulation within the right atrium, and relatively flexible balloon articulation systems within the left atrium. More generally, hybrid systems may have catheter systems with pullwires or movable sheath, along with fluid drive and robotic control components.

Abstract: Improved systems for diagnosing and/or treating arrhythmia of a heart makes use of an array of articulation balloons to control movement of a distal portion of a catheter inside the heart, and may be used to align a diagnostic or treatment tool with a target tissue surface region along or adjacent an inner surface of one of the chambers of the heart. The articulation balloons can generate articulation forces at the site of articulation, and the movement may provide greater dexterity than movements induced by transmitting articulation forces proximally along a catheter body that winds through a tortuous vascular pathway.

Abstract: Articulation devices, systems, and methods for articulating elongate flexible structures can locally contract a flexible elongate frame or skeleton of an elongate flexible body such as a catheter. Balloons along one side of an axial segment of the elongate flexible body can be inflated so as to help define a resting shape of the elongate body. The skeleton may have pairs of corresponding axially oriented surface regions coupled to each other by a loop of a deformable helical coil structure. Balloons may be between the regions, and the pairs may be separated by an offset that increases when the axis of the skeleton is axially compressed. Inflation of the balloons can axially contract or shorten the skeleton adjacent the balloons so that the elongate body bends toward the balloons.

Abstract: Articulation devices, systems, methods for articulation, and methods for fabricating articulation structures will often include simple balloon arrays, with inflation of the balloons interacting with elongate skeletal support structures so as to locally alter articulation of the skeleton. The skeleton may comprise a simple helical coil or interlocking helical channels, and the array can be used to locally deflect or elongate an axis of the coil under control of a processor. Liquid inflation fluid may be directed so as to pressurize the balloons from an inflation fluid canister, and may vaporize within a plenum or the channels or balloons of the articulation system, with the inflation system preferably including valves controlled by the processor. The articulation structures can be employed in minimally invasive medical catheter systems, and also for industrial robotics, for supporting imaging systems, for entertainment and consumer products, and the like.

Abstract: Catheter-supported therapeutic and diagnostic tools can be introduced into a patient body with a sheath slidably disposed over the tool. Once the tool is aligned with a target tissue, a fluid-driven actuator can move the sheath axially from over the tool, for example, to allow a stent, stent-graft, prosthetic valve, or the like to expand radially within the cardiovascular system, without having to transmit large deployment forces along the catheter shaft and sheath from outside the patient. Well-behaved articulation structures will often include simple balloon arrays, with inflation of the balloons interacting with elongate skeletal support structures so as to improve articulation behavior of the skeleton. The array can be used to improve uniformity of bending along a segment of a flexible body such as a catheter.

Abstract: Medical devices, systems, and methods provide improved control over the flexing of an articulated catheter adjacent a therapeutic or diagnostic tool by laterally bending the catheter so as to anchor an articulated portion of the catheter locally relative to an internal tissue site. Alternative embodiments may be used for a wide variety of non-medical applications, including with borescope systems and for other industrial applications.

Abstract: User interface devices, systems, and methods can be used for selectively bending of, altering the bend characteristics of, and/or altering the lengths of catheter bodies, guidewires, steerable trocars, and other flexible structures inserted into a patient during use. Optionally, a housing is coupled to a proximal end of a catheter, and movement of the housing by a hand of a system user is sensed and used as a movement command for articulation of the catheter. Alternatively, a sensor can be coupled to an elongate flexible body flexing outside of the patient so as to alter bending of a catheter within the patient. Movements generated through a combination of manual manipulation and powered articulations are facilitated.

Abstract: Fluid control devices, systems, and methods are useful for articulating catheters and other elongate flexible structures. A modular manifold architecture includes plate-mounted valves to facilitate fluid communication along a plurality of fluid channels included in one or more multi-lumen shafts for articulating actuators comprising balloons within a balloon array, with the balloons often mounted on two or more extruded multi-lumen shafts. Valve/plate modules can be assembled in an array, and a proximal interface of the shaft(s) may have ports for accessing the balloon channels distributed along an axis of the interface. By aligning and engaging the proximal interface with a receptacle that traverses the plates of the manifold assembly, the ports can be quickly and easily sealed to associated channels of the various valve/plate modules using a quick-disconnect fitting.

Abstract: Articulation devices, systems, methods for articulation, and methods for fabricating articulation structures will often include simple balloon arrays, with inflation of the balloons interacting with elongate skeletal support structures so as to locally alter articulation of the skeleton. The balloons can be mounted to a substrate of the array, with the substrate having channels that can direct inflation fluid to a subset of the balloons. The articulation array structure may be formed using simple planar 3-D printing, extrusion, and/or micromachining techniques. The skeleton may comprise a simple helical coil, and the array can be used to locally deflect or elongate an axis of the coil under control of a processor. Inflation fluid may be directed to the balloons from an inflation fluid reservoir of an inflation system, with the inflation system preferably including valves controlled by the processor.

Abstract: Articulation devices, systems, methods for articulation, and methods for fabricating articulation structures will often include simple balloon arrays, with inflation of the balloons interacting with elongate skeletal support structures so as to locally alter articulation of the skeleton. The balloons can be mounted to a substrate of the array, with the substrate having channels that can direct inflation fluid to a subset of the balloons. The articulation array structure may be formed using simple planar 3-D printing, extrusion, and/or laser micromachining techniques. The skeleton may comprise a simple helical coil or interlocking helical channels, and the array can be used to locally deflect or elongate an axis of the coil under control of a processor. Liquid inflation fluid may be directed to the balloons from an inflation fluid canister, and may vaporize within the channels or balloons of the articulation system, with the inflation system preferably including valves controlled by the processor.