Apparatus and method for selectively positioning a device and manipulating it

Abstract

Apparatus for pulling and positioning an apparatus, e.g., a stent, in the target area of a lumen. In one embodiment, a cylindrically shaped motor has a longitudinal bore, a friction area within the longitudinal bore, and a guide wire disposed within the longitudinal bore. The guide wire and friction area of the motor are sized and adapted to contact each other and impart friction between the friction area and the guide wire to permit the motor to pull a catheter to the target arcs by crawling against the guide wire. In another embodiment, a cylindrical motor having a friction area on its outer surface is disposed within a guide tube.

1. An apparatus, comprising: a cylindrically shaped motor, said motor having a longitudinal bore, said motor provided with a motor friction area disposed within said longitudinal bore; a guide wire disposed within said longitudinal bore, said guide wire and said longitudinal bore sized and adapted to impart friction between said friction area of said motor and said guide wire in an amount sufficient to permit said motor to change position relative to said guide wire by crawling against said guide wire when said motor is energized; and, further comprising a biasing means to bias said guide wire against said friction area. 
     
     
       2. The apparatus of  claim 1 , wherein said biasing means is a leaf spring. 
     
     
       3. An apparatus, comprising: a cylindrically shaped motor, said motor having an outer surface, said motor provided with a friction area on said outer surface; a cylindrical guide tube having an outer surface and an inner surface defining a longitudinal bore, said outer surface of said motor and said inner surface of said guide tube sized and adapted to impart friction between said friction area of said motor and said inner surface of said cylindrical guide tube in an amount sufficient to permit said cylindrical motor to change position relative to said guide tube by crawling against said inner surface of said guide tube when said motor is energized. 
     
     
       4. The apparatus of  claim 3 , further comprising a biasing means to bias said inner surface of said guide tube against said friction area. 
     
     
       5. The apparatus of  claim 4 , wherein said biasing means is a leaf spring. 
     
     
       6. A method of disposing a device in the target area of a lumen, comprising the steps of:
 a) constructing an apparatus comprising: a cylindrically shaped motor attached to said device, said motor having a longitudinal bore, said motor provided with a motor friction area disposed within said longitudinal bore, a guide wire disposed within said longitudinal bore, said guide wire and said longitudinal bore of said motor sized and adapted to impart friction between said friction area of said motor and said guide wire in an amount sufficient to permit said motor to change position relative to said guide wire by crawling against said guide wire when said motor is energized;  
 b) advancing said guide wire to said target area;  
 c) securing said guide wire;  
 d) energizing said motor so that said motor advances along said guide wire to said target area to dispose said device in said target area of said lumen; and  
 e) withdrawing said guide wire, motor, and catheter from said lumen.  
 
     
     
       7. A method of disposing a device in the target area of a lumen, comprising the steps of:
 a) constructing an apparatus comprising: a cylindrically shaped motor having an outer surface, said motor provided with a friction area on said outer surface, a cylindrical guide tube having an outer surface and an inner surface defining a longitudinal bore, said outer surface of said motor and said inner surface of said guide tube sized and adapted to impart friction between said friction area and said inner surface of said cylindrical guide tube in an amount sufficient to permit said cylindrical motor to change position relative to said guide tube by crawling against said inner surface of said guide tube when said motor is energized;  
 b) advancing said guide tube to said target area;  
 c) securing said guide tube;  
 d) inserting said motor attached to said device in said bore of said guide tube;  
 e) energizing said motor so that said motor advances along said inner surface of said guide tube to said target area to dispose said device in said target area of said lumen; and  
 f) withdrawing said guide tube, motor, and catheter from said lumen.  
 
     
     
       8. An apparatus for disposing a stent in the target area of a lumen, comprising: a catheter having a proximal end, a distal end, a longitudinal bore therethrough, and an expandable balloon disposed at said distal end; a cylindrically shaped motor disposed at said distal end of said catheter distal to said balloon, said motor having a longitudinal bore communicating with a said longitudinal bore of said catheter, said motor provided with motor friction area disposed within said longitudinal bore of said motor; a guide wire disposed within said longitudinal bore of said catheter and said longitudinal bore of said motor, said guide wire and said longitudinal bore of said motor sized and adapted to impart friction between said friction area of said motor and said guide wire in an amount sufficient to permit said motor to change position relative to said guide wire by crawling against said guide wire when said motor is energized. 
     
     
       9. The apparatus of  claim 8 , further comprising a biasing means to bias said guide wire against said friction area. 
     
     
       10. The apparatus of  claim 9 , wherein said biasing means is a leaf spring. 
     
     
       11. A method of disposing a stent in the target area of a lumen, comprising the steps of:
 a) constructing an apparatus comprising: a catheter having a proximal end, a distal end, a longitudinal bore therethrough, and an expandable balloon disposed at said distal end; a cylindrically shaped motor disposed at said distal end of said catheter distal to said balloon, said motor having a longitudinal bore communicating with said longitudinal bore of said catheter, said motor provided with a motor friction area disposed within said longitudinal bore of said motor, a guide wire disposed within said longitudinal bore of said catheter and said longitudinal bore of said motor, said guide wire and said longitudinal bore of said motor sized and adapted to impart friction between said friction area of said motor and said guide wire in an amount sufficient to permit said motor to change position relative to said guide wire by crawling against said guide wire when said motor is energized;  
 b) advancing said guide wire to said target area;  
 c) securing said guide wire;  
 d) energizing said motor so that it advances along said guide wire to said target area to dispose said stent in said target area of said lumen;  
 e) inflating said balloon to secure said stent in said target area of said lumen;  
 f) deflating the balloon; and  
 g) withdrawing said guide wire, motor, and catheter from said lumen.  
 
     
     
       12. A method of disposing a stent in an obstructed target area of a lumen, comprising the steps of:
 a) constructing an apparatus comprising: a catheter having a proximal end, a distal end, a longitudinal bore therethrough, and an expandable balloon disposed at said distal end; a cylindrically shaped motor disposed at said distal end of said catheter distal to said balloon, said motor having a longitudinal bore communicating with said longitudinal bore of said catheter, said motor provided with a motor friction area disposed within said longitudinal bore, a guide wire disposed within said longitudinal bore of said catheter and said longitudinal bore of said motor, said guide wire and said longitudinal bore of said motor sized and adapted to impart friction between said friction area of said motor and said guide wire in an amount sufficient to permit said motor to change position relative to said guide wire by crawling against said guide wire when said motor is energized;  
 b) advancing said guide wire to said target area;  
 c) securing said guide wire;  
 d) energizing said motor so that said motor advances along said guide wire to said obstructed target area;  
 e) securing said catheter;  
 f) energizing said motor so that said guide wire advances through said longitudinal bore of said motor and into said obstructed target area of said lumen;  
 g) securing said guide wire;  
 h) energizing said motor so that said motor advances along said guide wire and disposes said stent in said target area of said lumen;  
 i) inflating said balloon to secure said stent in said target area of said lumen;  
 j) deflating the balloon; and  
 k) withdrawing said guide wire, motor, and catheter from said lumen.  
 
     
     
       13. A method comprising:
   a )  inserting a guide wire into of a catheter to which a micro - motor is attached, the guide wire passing through the catheter and operatively coupled to the micro - motor, into a lumen;        b )  advancing the guide wire to a target area;        c )  securing the guide wire;        d )  energizing the micro - motor so that the micro - motor advances along the guide wire to target area, carrying with it the attached catheter.     
     
     
       14. The method according to  claim 13  and further including:
   e )  withdrawing the guide wire, micro - motor, and catheter from the lumen.     
     
     
       15. The method according to  claim 14  wherein a balloon is disposed on the distal end of the catheter and further including, prior to withdrawing the guide wire, micro- motor, and catheter from the lumen:      a )  inflating the balloon in the target area of the lumen; and        b )  deflating the balloon.     
     
     
       16. The method according to  claim 15  wherein a stent is disposed over the balloon and the inflating of the balloon in the target area of the lumen expands the stent to dispose it in the target area. 
     
     
       17. The method according to  claim 14  wherein a stent is provided at the distal end of the catheter and further comprising expanding the stent in the target area of the lumen to dispose it in the target area prior to withdrawing the guide wire, micro- motor, and catheter from the lumen.   
     
     
       18. A method comprising:
   a )  inserting a guide wire into a catheter to which a micro - motor is attached, the guide wire operatively coupled to the micro - motor, into a lumen in which there is an obstruction;        b )  advancing the guide wire to a proximal end of the obstruction;        c )  securing the guide wire;        d )  energizing the micro - motor so that the micro - motor advances distally along the guide wire, carrying with it the attached catheter, toward the proximal end of the obstruction;        e )  securing the catheter;        f )  energizing the micro - motor so that the guide wire advances distally.     
     
     
       19. The method according to  claim 18  wherein said energizing the micro- motor so that the guide wire advances distally comprises energizing in an oscillatory manner.   
     
     
       20. The method according to  claim 19  wherein said micro- motor is a piezoelectric motor and said energizing comprises energizing with an AC voltage, thereby introducing a vibration to said guide wire.   
     
     
       21. The method according to  claim 20  wherein said AC voltage has a frequency in the range of  20 -   100  kHz.   
     
     
       22. The method according to  claim 19  wherein said micro- motor is a piezoelectric motor and said energizing comprises energizing with a pulsed DC voltage thereby imparting a pulsating motion to said guide wire.   
     
     
       23. The method according to  claim 18  and further comprising disposing said guide wire within a bore in said motor. 
     
     
       24. The method according to  claim 23  wherein said micro- motor is cylindrical with a bore, and said guide wire is passed through said bore of said micro - motor.   
     
     
       25. The method according to  claim 18  wherein said step of energizing the motor so that the guide wire advances distally comprises repeatedly, until said guidewire and catheter pass substantially through said obstruction:
   a )  securing the catheter;        b )  energizing the micro - motor so that the guide wire advances distally;        c )  securing the guide wire;        d )  energizing the micro - motor so that the micro - motor advances along the guide wire, carrying with it the attached catheter.     
     
     
       26. The method according to  claim 25  wherein said steps b)  and d )  comprise energizing in an oscillatory manner.   
     
     
       27. The method according to  claim 26  wherein said micro- motor is a piezoelectric motor and said energizing comprises energizing with an AC voltage, thereby introducing a vibration to said guide wire.   
     
     
       28. The method according to  claim 27  wherein said AC voltage has a frequency in the range of  20 -   100  kHz.   
     
     
       29. The method according to  claim 26  wherein said micro- motor is a piezoelectric motor and said energizing comprises energizing with an pulsed DC voltage thereby imparting a pulsating motion to said guide wire.   
     
     
       30. The method according to  claim 25  and further including withdrawing the guide wire, motor, and catheter from the lumen. 
     
     
       31. The method according to  claim 18  wherein said step of energizing the motor so that the guide wire advances distally comprises alternatively:
   a )  energizing the motor so that the guide wire advances distally;        b )  energizing the motor so that the guide wire advances proximally; and        c )  repeating steps a )  and b )  a plurality of times.     
     
     
       32. The method according to  claim 31  comprising repeating steps a)  and b )  until the guide wire has substantially cleared the obstruction.   
     
     
       33. The method according to  claim 32  and further including withdrawing the guide wire, motor, and catheter from the lumen. 
     
     
       34. The method according to  claim 33  wherein said obstruction is at or proximal to a target area of the lumen and wherein a balloon is disposed on the distal end of the catheter and further including, prior to withdrawing the guide wire, motor, and catheter from the lumen:
   a )  inflating the balloon in the target area of the lumen; and        b )  deflating the balloon.     
     
     
       35. The method according to  claim 34  wherein a stent is disposed over the balloon and the inflating of the balloon in the target area of the lumen expands the stent to dispose it in the target area. 
     
     
       36. The method according to  claim 33  wherein a stent is provided at the distal end of the catheter and further comprising expanding the stent in the target area of the lumen to dispose it in the target area prior to withdrawing the guide wire, motor, and catheter from the lumen. 
     
     
       37. The method according to  claim 31  wherein said steps a)  and b )  comprise energizing in an oscillatory manner.   
     
     
       38. The method according to  claim 37  wherein said micro- motor is a piezoelectric motor and said energizing comprises energizing with an AC voltage, thereby introducing a vibration to said guide wire.   
     
     
       39. The method according to  claim 38  wherein said AC voltage has a frequency in the range of  20 -   100  kHz.   
     
     
       40. The method according to  claim 37  wherein said micro- motor is a piezoelectric motor and said energizing comprises energizing with an pulsed DC voltage thereby imparting a pulsating motion to said guide wire.   
     
     
       41. The method according to  claim 18  wherein said step f)  comprises energizing the motor so that the guide wire advances through the obstruction.   
     
     
       42. The method according to  claim 41  wherein said energizing the micro- motor so that the guide wire advances through the obstruction comprises energizing in an oscillatory manner.   
     
     
       43. The method according to  claim 42  wherein said micro- motor is a piezoelectric motor and said energizing comprises energizing with an AC voltage, thereby introducing a vibration to said guide wire.   
     
     
       44. The method according to  claim 43  wherein said AC voltage has a frequency in the range of  20 -   100  kHz.   
     
     
       45. The method according to  claim 42  wherein said micro- motor is a piezoelectric motor and said energizing comprises energizing with an pulsed DC voltage thereby imparting a pulsating motion to said guide wire.   
     
     
       46. The method according to  claim 45  and further comprising disposing said guide wire within a bore in said motor. 
     
     
       47. The method according to  claim 46  wherein said micro- motor is cylindrical with a bore, and said guide wire is passed through said bore of said micro - motor.   
     
     
       48. The method according to  claim 41  and further including withdrawing the guide wire, motor, and catheter from the lumen. 
     
     
       49. The method according to  claim 48  wherein said obstruction is at or proximal to a target area of the lumen and wherein a balloon is disposed on the distal end of the catheter and further including, prior to withdrawing the guide wire, motor, and catheter from the lumen:
   a )  inflating the balloon in the target area of the lumen; and        b )  deflating the balloon.     
     
     
       50. The method according to  claim 49  wherein a stent is disposed over the balloon and the inflating of the balloon in the target area of the lumen expands the stent to dispose it in the target area. 
     
     
       51. The method according to  claim 48  wherein a stent is provided at the distal end of the catheter and further comprising expanding the stent in the target area of the lumen to dispose it in the target area prior to withdrawing the guide wire, motor, and catheter from the lumen. 
     
     
       52. An apparatus, comprising: a piezoelectric motor provided with a friction area; a cylindrical guide tube defining a longitudinal bore, said motor disposed within said bore in such a manner that said friction area presses against an inner surface of said cylindrical guide tube in such a manner as to impart friction between said friction area of said motor and said inner surface in an amount sufficient to permit said cylindrical motor to change position relative to said guide tube by crawling against said inner surface of said guide tube when said motor is energized. 
     
     
       53. The apparatus of  claim 52 , further comprising a biasing means to bias said inner surface of said guide tube against said friction area. 
     
     
       54. The apparatus of  claim 53 , wherein said biasing means is a leaf spring. 
     
     
       55. The apparatus of  claim 52 , further comprising a device to be placed in a lumen disposed within said guide tube and contacting said motor. 
     
     
       56. A method comprising using a piezoelectric micromotor to move a device to a target area in a lumen comprising attaching said micro- motor to a catheter, frictionally engaging a guide wire that passes through said catheter with said motor and energizing said motor to bring about relative motion between the wire and catheter.   
     
     
       57. The method according to  claim 56  wherein said relative motion comprises first moving the wire to a target area in a lumen with the catheter fixed and then moving the catheter to the target area while holding the guide wire fixed. 
     
     
       58. The method according to  claim 57  and further including delivering a balloon on the end of said catheter to said target area and expanding said balloon at the target area. 
     
     
       59. The method according to  claim 57  and further including delivering a stent on the end of said catheter to said target area and expanding said stent at the target area. 
     
     
       60. A method comprising traversing an obstruction in a lumen by causing a guide wire driven by a piezoelectric micro- motor in a oscillatory manner to advance into the obstruction including moving a catheter to which the micro - motor is attached and the guide wire to the target area using the micro - motor, holding the catheter fixed, and driving said micro - motor to cause said guide wire to advance against said obstruction in an oscillatory manner.   
     
     
       61. The method of  claim 60  wherein said guide wire advances through said obstruction. 
     
     
       62. The method of  claim 61  comprising alternatively advancing the catheter and the guide wire until the catheter and guide wire are clear of the obstruction. 
     
     
       63. The method according to  claim 61  wherein said driving comprises energizing with an AC voltage, thereby introducing a vibration to said guide wire. 
     
     
       64. The method according to  claim 63  wherein said AC voltage has a frequency in the range of  20 -   100  kHz.   
     
     
       65. The method according to  claim 61  wherein said driving comprises energizing with an pulsed DC voltage thereby imparting a pulsating motion to said guide wire.