Endoscopic ultrasound-guided biliary access system

Abstract

The present disclosure provides an access system having a steerable catheter assembly configured to provide access to and guide a target vessel for subsequent treatment. The access system includes an adjustable delivery handle assembly and an access catheter subassembly having a steerable access catheter configured to be delivered to a target site (e.g., into the duodenum) for Adjunctive treatment of conditions (e.g. biliary drainage via endoscopic ultrasound-guided biliary drainage (EUS‑BD) techniques). The access catheter includes at least a distal segment having an adjustable portion along its length configured to transition into a predetermined arcuate shape in order to guide it through a vessel, such as a bile duct ), provide directional control to the distal end of the catheter. The handle assembly includes additional elements configured to allow the clinician to manipulate and manipulate the distal end of the access catheter.

Description

Technical field [0001] The present disclosure relates generally to minimally invasive access devices, and more particularly to an endoscopic ultrasound (EUS) guided access system having a steerable catheter assembly configured to provide access Approach to the target vessel and guide the target vessel for subsequent treatment. Background technique [0002] Diseases and dysfunctions of the gallbladder, pancreas, and bile ducts (eg, pancreaticobiliary duct system) are associated with extremely high morbidity, mortality, and affect the quality of life. There may be obstructions, tumors, injuries, leaks and lesions in these structures, which may eventually lead to such as biliary colic, cholecystitis, choledocholithiasis, gallstone disease, pancreatitis, pancreatic duct stones and chronic abdominal pain. Disease. In addition, diseases / dysfunctions of the pancreaticobiliary system may be related to nutritional disorders such as malnutrition, obesity, and high cholesterol. [0003] fi...

AI Technical Summary

Problems solved by technology

Specifically, existing needle designs are rigid, thus severely limiting the clinician's ability to guide the guide wire

Furthermore, biliary drainage by rendezvous technique may not be feasible in cases where the guidewire cannot be advanced through the ampulla due to difficult angulation or narrowing of distal biliary structures

Therefore, biliary drainage by the needle rendezvous technique may require repeated punctures with different angles, often resulting in a prolonged high-intensity procedure with the risk of shearing the guide wire and / or bile leakage

Additional difficulties currently identified by clinicians performing the EUS / ERCP rendezvous technique are difficulty in advancing a guidewire or navigating a guidewire through an obstruction, difficulty achieving penetration into the bile duct, clinical complications such as pancreas from trauma to the duct Inflammation etc.

Also, endoscope exchange between an EUS endoscope and an ERCP endoscope in order to retrieve the guidewire can be tedious and difficult to maneuver

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