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: Devices, systems, and methods are provided for image-guided interventional procedures and other uses. Nested articulated catheter shaft systems may have an imaging catheter with an ultrasound transducer supported by a fluid-driven articulated sheath portion. Drive fluid can be transmitted distally along an asymmetric sheath via eccentric passages to an articulated portion of the imaging catheter distal of a port. An articulated shaft supporting a therapeutic tool can be advanced within a working lumen of the imaging sheath to the port so that the tool is within a field of view of the transducer. The fluid transmission channels may take much less cross-sectional area of the sheath than a mechanical pull-wire system, allowing the nested sheath/shaft system to provide safer access to a chamber of the heart and to facilitate precise independent control over 3D ultrasound imaging and image-guided structural heart therapies or the like.

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: Devices, systems, and methods are provided for control over automated movement of catheters and other elongate bodies. Fluid and/or pull-wire drive systems can be used to provide robotically coordinated lateral bending motions and a processor of the system can generate synchronized actuator drive signals to move the tool along an at least partially laterally constrained path, with the path optionally extending along the axis of a virtual model of the catheter that has been driven in silico into alignment with a target tissue adjacent an open workspace such as an open chamber of the heart.

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: 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 first fluid-driven actuator can move the sheath axially from over the tool, for example, to allow a stent, stent-graft, prosthetic valve, or other self-expanding tool, to expand radially within the cardiovascular system, without having to transmit large deployment forces along the catheter shaft and sheath from outside the patient. A second fluid-driven actuator can be arranged in opposition to the first actuator to control release of the expanding tool or to recapture the tool within the sheath. The first and/or second actuators may comprise a balloon having a diameter larger than the sheath to provide the desired deployment and recapture forces with moderate fluid pressure.

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: Devices, systems, and methods are provided for user input to control automated movement of catheters and other elongate bodies. Fluid drive systems can be used to provide robotically coordinated motion. Precise control over actual robotic catheter-supported tools are enhanced by moving a virtual version of the tool from a starting location of an actual tool to a desired ending position and orientation. A processor of the system can then generate synchronized actuator drive signals to move the tool without following the (often meandering) path input by the system user. The progress of the tool along a multi-degree-of-freedom trajectory can be controlled with a simple 1D input. Standard planar or proprietary input devices can be used for orientation and translation movements. Hybrid image display with 2D and 3D components is provided, along with spacial constrained movement to workspace boundaries.

Abstract: Image-guided interventional systems, devices, and method make use of fluid-driven articulated structures having an asymmetric cross-section. An inner sheath may be offset eccentrically within an outer sheath with an axial series of asymmetric plates disposed between them. Balloons may be mounted between adjacent plates, a series of the balloons coupled end-to-end by neck regions having smaller diameters than those of the balloons to define balloon strings. The necks can extend through channels in the plates, so that the balloons of a particular balloon string can be inflated as a unit. Ends of the balloons engage the plates where the space between the inner and outer sheaths is relatively large, and can push the adjacent plates apart with a relatively high bending force. Passages through the plates near the center of lateral bending can accommodate additional inflation fluid tubes to articulate distal segments, and a pair of articulation balloon strings may be included.

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: Devices, systems, and methods can articulate catheters and other tools using fluid drive systems that provide robotically coordinated motion. The drive power will often be transmitted from a fluidic driver to the catheter through a series of pneumatic or hydraulic channels and the driver can be isolated from a sterile field by encasing the driver in a sterile housing and directing drive fluid through a sterile junction between the catheter and driver. Interventional physicians can retain tactile feedback by manually advancing the catheter over a wire or the like, and can subsequently bring an interface of the catheter down into engagement with a corresponding driver interface once a therapeutic tool approaches a target site. A sensor may provide signals during manual advancement of the driver and catheter along the catheter axis.

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: 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: 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: 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 skeleton may include a simple helical coil. Liquid inflation fluid may be directed to the balloons from an inflation fluid canister, and may vaporize within the articulation system, with the inflation system preferably including valves controlled by a processor. The articulation structures can be employed in minimally invasive medical catheter systems.

Abstract: Articulation devices and methods include balloon arrays interacting with elongate skeletal support structures so as to locally alter articulation of the skeleton. The skeleton may include a helical coil, and the array can be under control of a processor. Inflation fluid may be directed to the balloons from an inflation system including valves controlled by the processor. The articulation structures can be employed in minimally invasive medical catheter systems.

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: Devices, systems, and methods for articulating elongate flexible structures such as catheters optionally include an array of fluid-expandable bodies such as balloons. The array can be formed using separate strings of balloons formed along single-lumen balloon tube material. The balloon strings can be twisted together to form a multi-channel bundle, or the balloon strings may be circumferentially separated, each extending axially. Regardless, the balloons along a common lumen may be aligned so as to bend the catheter in a desired lateral direction. The fluid-expandable bodies may include an elastomeric bladder with a fiber braid so that inflation of the bladder shortens the assembly and applies axial tension to articulate the catheter. The elongate flexible structures may be pre-biased so as to form a bend when in a relaxed configuration, with the structures being articulatable from the bend.

Abstract: Devices, systems, and methods for articulating elongate flexible structures such as catheters optionally include an array of fluid-expandable bodies such as balloons. A user may alter a bend characteristic of the flexible structure by manually moving a handle of a pump. The pump may induce a flow of inflation fluid into a subset of the expandable bodies, and the resulting expansion can change a bend characteristic of the flexible structure. The pump may comprise a threaded syringe pump, one or more balloon that is manually compressed by movement of the handle (so that the balloon acts as a displacement pump), a multi-axis displacement pump (optionally with laterally offset piston-cylinder assemblies coupled to the handle to induce laterally offset bending of the flexible structure), or the like, providing easily-modulated articulation with a low-cost, light-weight, and/or at least partially disposable user interface.