Elongate Flexible Torque Instruments And Methods Of Use

Abstract

Torque shafts and other related systems and methods are described herein. In one embodiment, the torque shafts are both flexible and capable of transmitting torque. An apparatus for transmission of torque includes an elongate body, comprising a plurality of joint segments, each joint segment configured to pivot with respect to an adjacent segment and being further configured to have at least two link elements.

1 . An apparatus for transmission of torque, comprising:
 a plurality of segments coupled together in an elongate configuration, wherein each segment comprises:   a first end comprising a male feature; and   a second end comprising a female feature, the female feature having a shape corresponding to the male feature such that the female feature is configured to receive the male feature of the first end of an adjacent segment.   
     
     
         2 . The apparatus of  claim 1 , wherein the male feature has a “T” like shape. 
     
     
         3 . The apparatus of  claim 1 , wherein the male feature has a teardrop shape. 
     
     
         4 . The apparatus of  claim 1 , wherein the male feature is configured to interlock with the female feature. 
     
     
         5 . The apparatus of  claim 1 , wherein the male feature is a first male feature and the female feature is a first female feature, each segment comprising:
 a second male feature on the first end, the second male feature being configured differently from the first male feature; and   a second female feature on the second end, the second female feature being configured differently from the first female feature, the second female feature having a shape corresponding to the second male feature such that the second female feature is configured to receive the second male feature of the first end of an adjacent rigid segment.   
     
     
         6 . The apparatus of  claim 1 , further comprising a segment having a second end that does not have a female feature. 
     
     
         7 . The apparatus of  claim 1 , further comprising a segment having a first end that does not have a male feature. 
     
     
         8 . The apparatus of  claim 1 , wherein a first segment of the plurality of segments is pivotable with respect to an adjacent second segment of the plurality of segments. 
     
     
         9 . The apparatus of  claim 8 , wherein the female feature of the second segment is configured to rotate about the male feature of the first segment. 
     
     
         10 . The apparatus of  claim 9 , wherein each segment comprises a pivot space, the pivot space is adjacent at least one of the male and female features, the female feature is a first female feature, the male feature is a first male feature, and the pivot space is a first pivot space, each segment further comprising:
 a second male feature located opposite the first male feature and having the same configuration as the first male feature;   a second female feature located opposite the first female feature and having the same configuration as the first female feature; and   a second pivot space located opposite the first pivot space and having the same configuration as the first pivot space.   
     
     
         11 . The apparatus of  claim 8 , wherein the first segment is coupled to the second segment by a hinge. 
     
     
         12 . The apparatus of  claim 11 , wherein the hinge is a living hinge, the male feature is configured to slide within the female feature, each segment further comprises a pivot space and at least one of the male or female features is located in at least one of the pivot spaces of the segments, and the living hinge is a first living hinge, the female feature is a first female feature, the male feature is a first male feature, and the pivot space is a first pivot space, each segment further comprising:
 a second living hinge located opposite the first living hinge and having a similar configuration to the first living hinge;   a second male feature located opposite the first male feature and having a similar configuration to the first male feature;   a second female feature located opposite the first female feature and having a similar configuration to the first female feature; and   a second pivot space located opposite the first pivot space.   
     
     
         13 . A medical apparatus, comprising:
 a tubular member configured to interface with a prosthesis;   a torque drive coupled with the tubular member and configured to rotate the tubular member, the torque drive being configured to fit within the vasculature of a patient.   
     
     
         14 . The medical apparatus of  claim 13 , wherein the tubular member is a torque shaft. 
     
     
         15 . The medical apparatus of  claim 14 , further comprising a cable configured to interface with the torque drive. 
     
     
         16 . The medical apparatus of  claim 15 , wherein the torque drive is configured to translate axial motion of the cable into rotational motion of the torque shaft, wherein the torque shaft comprises:
 a sheave; and   a cable hub rotatably coupled to the sheave and fixably coupled with the torque shaft, the cable hub configured to receive the cable in a wrapped state.   
     
     
         17 . An elongate flexible torque instrument for deploying implants, comprising:
 an elongate body comprising a plurality of flexible torque members, wherein each torque member is comprised of segments, the segments being configured to pivot with respect to an adjacent segment, and each torque member is configured to transmit torque from a proximal portion to a distal portion of the torque member;   a handle operatively coupled to the proximal end of each of the flexible torque members; wherein the handle comprises a control lever configured to operate one or more control wires to steer the elongate flexible body and a plurality of control knobs configured to apply torque to the flexible torque members to transmit torque from proximal portions of the flexible torque members to distal portions of the flexible torque members; and   an implant deployment apparatus operatively coupled to the distal ends of the flexible torque members, wherein the implant deployment apparatus is configured to deploy an implant with torque transmitted to the flexible torque members.   
     
     
         18 . The elongate flexible torque instrument of  claim 17 , wherein each segment is coupled to an adjacent segment by a link element. 
     
     
         19 . The elongate flexible torque instrument of  claim 17 , wherein the segments are pivoted about a link element. 
     
     
         20 . The elongate flexible torque instrument of  claim 18 , wherein the link element is a physical link element, a pivotal link element, or a torque link element. 
     
     
         21 . The elongate flexible torque instrument of  claim 17 , wherein each segment is coupled to an adjacent segment by a combination of a physical link element and a torque link element or a pivotal link element and a torque link element. 
     
     
         22 . The elongate flexible torque instrument of  claim 21 , wherein the physical link element is disposed about 90 degrees from the torque link element or the pivotal link element is disposed about 90 degrees from the torque link element. 
     
     
         23 . The elongate flexible torque instrument of  claim 17 , wherein the flexible torque members are configured to apply counter-acting torque, counter-rotating, or opposing torque to the implant deployment apparatus to deploy an implant. 
     
     
         24 . The elongate flexible torque instrument of  claim 20 , wherein the physical link element comprises one or more struts and one or more spaces between the one or more struts. 
     
     
         25 . The elongate flexible torque instrument of  claim 20 , wherein the torque link element comprises a male element and a female element, and wherein the female element of one segment is configured to receive the male element of an adjacent segment. 
     
     
         26 . The elongate flexible torque instrument of  claim 17 , wherein the segment are cut at an angle in the range between about 0 degree and about 90 degrees. 
     
     
         27 . The elongate flexible torque instrument of  claim 17 , wherein the flexible torque member includes a flexible membrane sheath to maintain the segments together. 
     
     
         28 . A method for deploying an implant inside a body of a patient, comprising:
 inserting a distal portion of an elongate flexible torque instrument into a patient, the elongate flexible torque instrument comprising a plurality of flexible torque members, each flexible torque member comprising a plurality of segments;   advancing and navigating the distal portion of the elongate flexible torque instrument through natural pathways inside the patient to a target site;   applying torque to a proximal portion of the elongate flexible torque instrument; and   transmitting the applied torque from the proximal portion to the distal portion of the elongate flexible torque instrument to operate an implant deployment apparatus, wherein the transmitted torque facilitates deployment of an implant from the implant deployment apparatus to the target site.   
     
     
         29 . The method for deploying an implant inside a body of a patient of  claim 28 , wherein counter-acting torque, counter-rotating torque, or opposing torque is applied to operate the implant deployment apparatus. 
     
     
         30 . An apparatus for transmitting torque, comprising:
 an elongate body, the elongate body comprising a plurality of segments, each segment configured to pivot with respect to an adjacent segment and being further configured to have a pair of link elements, each link element having a hub and a plurality of physical link elements extending from said hub and coupled with a rim of an adjacent segment.