Actuating elements for bending medical devices

Abstract

To provide actuating elements for bending medical devices and medical devices having such actuating elements.SOLUTION: A medical device 100 includes: an elongated tube 110 having a wall 130 defining a lumen for the elongated tube, wherein the wall of the elongated tube comprises a first opening 140; and a first actuating element 120 coupled directly or indirectly to the wall of the elongated tube; wherein at least a part of the first actuating element and the first opening of the wall are located at a same longitudinal position with respect to a longitudinal axis of the elongated tube; and wherein the first actuating element is configured to change size to induce stress and / or displacement at the wall of the elongated tube to cause the elongated tube to bend.SELECTED DRAWING: Figure 1

Description

Technical Field

[0001] The field of the present application relates to medical devices, and more specifically, to an actuating element for bending a medical device and a medical device having such an actuating element.

Background Art

[0002] Many medical devices need to be bent during use. For example, a catheter for delivering a substance into and / or removing a substance from a patient needs to be bent while the catheter is being advanced inside the patient. In many cases, the bending of the catheter can be achieved using an operating wire attached to the distal end of the catheter. However, the use of an operating wire for bending the catheter can be undesirable because it requires the operating wire to extend all the way from the distal portion of the catheter to the proximal end of the catheter. This requires the catheter to store the operating wire, preventing the catheter from achieving a certain minimum size. Also, the use of an operating wire can result in the user inadvertently moving the catheter while attempting to actuate the deflection. Further, since the operating wire causes the bending of the catheter by the tension applied from the proximal end of the catheter, the use of the operating wire can cause compression of the catheter body, which can result in some shortening of the catheter when the catheter is in a deflected or bent state and the proximal portion of the catheter may become straightened. Additionally, a catheter with an operating wire can have mechanical problems such as separation of the operating wire from the catheter body, and the operating wire can become immobile due to frictional contact with the catheter body.

[0003] Another type of medical device that requires bending during use is a guidewire. Guidewires are used in the medical field to access internal passageways in patients. In some cases, it may be desirable for the distal segment of the guidewire to achieve a somewhat curved shape during use. This allows the distal segment of the guidewire to access certain passageways having a particular geometry within the patient. Generally, such guidewires have a pre-curved shape, and such a pre-curved shape is assumed by the guidewire when the guidewire is in a relaxed configuration (e.g., when no force is applied to the guidewire). The guidewire may have a relatively straight configuration when confined within a delivery tube. When the guidewire is deployed outside of the delivery tube within the patient, there, the guidewire automatically resumes its pre-curved shape. After the guidewire is deployed within the patient, the curvature of the pre-curved shape of the guidewire generally is not adjustable. The pre-curved guidewire can change shape during use and cause less impact when accessing the treatment site of a disease. Further, the pre-curved guidewire can have the property of grasping its tip within smaller "perforating" blood vessels or on devices such as stents that have been previously deployed or are being deployed by virtue of its pre-curved curvature.

[0004] Another type of medical device that requires bending during use is an implant such as a vascular occlusion device. In some cases, the vascular occlusion device may have a particular three-dimensional pre-bent configuration. The vascular occlusion device may be confined within a delivery tube and may have a relatively straight configuration when inside the delivery tube. When the vascular occlusion device is deployed outside the delivery tube inside the patient, the vascular occlusion device then automatically resumes its three-dimensional pre-bent configuration. After the vascular occlusion device is deployed inside the patient, the curvature of the pre-bent shape of the vascular occlusion device is generally not adjustable. Also, the vascular occlusion device may sometimes be difficult to advance within the delivery tube. This is because when the vascular occlusion device is bent from its pre-bent shape to a more straight shape when confined inside the delivery tube, the vascular occlusion device presses against the inner wall of the delivery tube, resulting in a fairly large frictional force against the inner wall of the delivery tube.

[0005] Accordingly, new techniques for fabricating bendable medical devices are desired. SUMMARY OF THE INVENTION

[0006] A medical device includes an elongated tube having a wall, the wall of the elongated tube including a first opening, and a first actuating element positioned within the first opening of the wall of the elongated tube, the first actuating element within the first opening of the wall being operable to cause stress and / or displacement in the wall of the elongated tube to bend the elongated tube.

[0007] Optionally, the size of the first actuating element is variable to cause stress and / or displacement in the wall of the elongated tube to bend the elongated tube.

[0008] Optionally, the size of the actuating element is variable in a direction parallel to the longitudinal axis of the elongated tube.

[0009] Optionally, the size of the actuating element is variable in a direction perpendicular to the longitudinal axis of the elongated tube.

[0010] Optionally, the first actuating element is on the first side of the elongated tube, and the elongated tube has one or more slots or other structural features on the second side of the elongated tube, and the second side is opposite the first side.

[0011] Optionally, the first actuating element is configured to expand, contract, or both expand and contract.

[0012] Optionally, the first actuating element is configured to expand within the first opening of the wall to bend the elongated tube in a first direction, and the first actuating element is configured to contract within the opening of the wall to bend the elongated tube in a second direction opposite the first direction.

[0013] Optionally, the wall of the elongated tube comprises a first linkage and a second linkage coupled to respective opposing side surfaces of the first actuating element.

[0014] Optionally, the first actuating element is configured to apply opposing forces towards the first and second linkages to cause stress and / or displacement in the wall of the elongated tube.

[0015] Optionally, the first linkage comprises a first portion of the wall, the second linkage comprises a second portion of the wall, and the first and second portions of the wall are formed by laser cutting the elongated tube, etching the elongated tube, or removing material from the elongated tube.

[0016] Optionally, the first actuating element comprises a piezo element, a balloon, an electro-responsive polymer, or a shape memory element.

[0017] Optionally, the first actuating element is operable in response to electrical energy, high frequency energy, temperature change, fluid delivery, or pressure.

[0018] Optionally, the wall of the elongated tube comprises a second opening, and the medical device further comprises a second actuating element located within the second opening of the wall of the elongated tube.

[0019] Optionally, the first actuating element and the second actuating element are located on the same side of the elongated tube.

[0020] Optionally, the first actuating element and the second actuating element are located on different respective sides of the elongated tube.

[0021] Optionally, the first actuating element is configured to bend the elongated tube in a first direction, and the second actuating element is configured to bend the elongated tube in a second direction different from the first direction.

[0022] Optionally, the elongated tube is part of a catheter.

[0023] Optionally, the elongated tube is part of a guide wire.

[0024] Optionally, the elongated tube is part of an implant.

[0025] Optionally, the implant is configured to deform plastically.

[0026] Optionally, the first actuating element and / or the elongated tube are configured to deform elastically.

[0027] Optionally, the first actuating element and / or the elongated tube are configured to deform plastically.

[0028] The medical device is an elongated tube having a wall that defines a lumen for the elongated tube, the wall of the elongated tube comprising a first opening, the elongated tube and a first actuating element directly or indirectly coupled to the wall of the elongated tube, at least a portion of the first actuating element and the first opening of the wall being located at the same longitudinal position with respect to the longitudinal axis of the elongated tube, the first actuating element being configured to change in size to cause stress and / or displacement in the wall of the elongated tube to bend the elongated tube.

[0029] Optionally, the first actuating element is configured to change the cross-sectional dimensions of the first opening so as to cause stress and / or displacement in the wall of the elongated tube.

[0030] Optionally, the first actuating element is operable and is located within the first opening in the wall of the elongated tube.

[0031] Optionally, the wall of the elongated tube comprises a first linkage and a second linkage coupled to respective opposing sides of the first actuating element.

[0032] Optionally, the first actuating element is configured to apply opposing forces towards the first and second linkages so as to cause stress and / or displacement in the wall of the elongated tube.

[0033] Optionally, the wall of the elongated tube comprises a second opening, and the medical device further comprises a second actuating element located within the second opening in the wall of the elongated tube.

[0034] Optionally, the first actuating element is configured to bend the elongated tube in a first direction, and the second actuating element is configured to bend the elongated tube in a second direction that is the same as or different from the first direction.

[0035] Optionally, the first actuating element extends across the first opening in the wall of the elongated tube.

[0036] Optionally, the first actuating element is coupled to the outer surface of the elongated tube.

[0037] Optionally, the first actuating element is coupled to the inner surface of the elongated tube.

[0038] Optionally, the wall of the elongated tube further comprises a second opening, and the first actuating element also extends across the second opening in the wall of the elongated tube.

[0039] Optionally, the elongated tube comprises a distal end and a proximal end, and the first actuating element is located between the distal end and the proximal end of the elongated tube.

[0040] Optionally, the medical device further includes a structural member coupled between opposing side surfaces of the first opening, and the first actuating element is located within the lumen of the elongate tube and is configured to apply a force toward the structural member.

[0041] Optionally, the structural member has a length that is longer than the dimension of the opening.

[0042] Optionally, the first actuating element is configured to apply a force in a direction that is perpendicular to the longitudinal axis of the elongate tube.

[0043] Optionally, the first actuating element is on a first side of the elongate tube, and the elongate tube has one or more slots, or other structural features, on a second side of the elongate tube, and the second side is opposite the first side.

[0044] Optionally, the first actuating element is configured to expand, contract, or both expand and contract.

[0045] Optionally, the first actuating element comprises a piezoelectric element, a balloon, an electro-responsive polymer, or a shape memory element.

[0046] Optionally, the first actuating element is operable in response to electrical energy, high frequency energy, a change in temperature, the delivery of a fluid, or pressure.

[0047] Optionally, the elongate tube is part of a catheter, part of a guidewire, or part of an implant.

[0048] Optionally, the implant is configured to deform plastically.

[0049] Optionally, the first actuating element and / or the elongate tube are configured to deform elastically.

[0050] Optionally, the first actuating element and / or the elongate tube are configured to deform plastically.

[0051] Other and further aspects and features will become apparent by reading the following detailed description.

Brief Description of the Drawings

[0052] The drawings illustrate the design and utility of the embodiments, and like elements are referred to by common reference numerals. These drawings are not necessarily to scale. A more detailed description of the embodiments is provided in order to better understand the manner in which the above and other advantages and objects are obtained, and this is shown in the accompanying drawings. These drawings merely illustrate exemplary embodiments and should not be construed as limiting the scope of the claims.

[0053]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Figure 7

Figure 8

Figure 9

Figure 10

[0054] Various embodiments will be described below with reference to the drawings. Note that the drawings are not drawn to scale, and elements having the same structure or function are denoted by the same reference numerals throughout the drawings. Also note that the drawings are only intended to facilitate the description of the embodiments. They are not intended as an exhaustive description of the present invention or as a limitation on the scope of the present invention. Furthermore, the illustrated embodiments need not have all of the aspects or advantages shown. Aspects or advantages described in connection with a particular embodiment are not necessarily limited to that embodiment and may be implemented in any other embodiment, even if not so shown or explicitly described.

[0055] FIGS. 1-2 show a medical device 100 having an elongate tube 110 according to some embodiments and an actuating element 120 for bending the elongate tube 110. The elongate tube 110 has a wall 130 that defines a lumen 168 for the elongate tube 110, and the wall 130 of the elongate tube includes a first opening 140. The medical device 100 also includes an actuating element (first actuating element) 120 located within the first opening 140 of the wall 130 of the elongate tube 110. The first actuating element 120 within the first opening 140 of the wall 130 is operable to cause stress and / or displacement in the wall 130 of the elongate tube 110 to bend the elongate tube 110.

[0056] In the illustrated embodiment, the size of the first actuating element 120 is variable to cause stress and / or displacement in the wall 130 of the elongate tube 110 to bend the elongate tube 110. The size of the actuating element 120 can be variable in a direction parallel to the longitudinal axis 170 of the elongate tube 130, variable in a direction perpendicular to the longitudinal axis 170 of the elongate tube 130, or variable in both a direction parallel to the longitudinal axis 170 and a direction perpendicular to the longitudinal axis 170.

[0057] In some embodiments, the first actuating element 120 is configured to expand within the first opening 140 of the wall 130 of the elongate tube 110 so as to bend the elongate tube 110. In other embodiments, the first actuating element 120 is configured to contract within the first opening 140 of the wall 130 of the elongate tube 110 so as to bend the elongate tube 110. In further embodiments, the first actuating element 120 is configured to perform both expansion and contraction. In such a case, expansion of the first actuating element 120 causes the elongate tube 110 to bend in a first direction, and contraction of the first actuating element 120 causes the elongate tube to bend in a second direction opposite to the first direction.

[0058] As shown in FIG. 1, the wall 130 of the elongate tube 110 includes a first linkage 150a and a second linkage 150b coupled to respective opposing sides of the first actuating element 120. The first linkage 150a includes a first structural member 160a and a second structural member 162a configured to transmit the force caused by the first actuating element 120 to the wall 130 of the elongate tube 110. Both the first structural member 160a and the second structural member 162a are connected to a joint member 164, and the joint member 164 is configured to transmit the forces from the first and second structural members 160a, 162a to the wall 130 of the elongate tube 110. Similarly, the second linkage 150b includes a first structural member 160b and a second structural member 162b configured to transmit the force caused by the first actuating element 120 to the wall 130 of the elongate tube 110. Both the first structural member 160b and the second structural member 162b are connected to a joint member 166, and the joint member 166 is configured to transmit the forces from the first and second structural members 160b, 162b to the wall 130 of the elongate tube 110.

[0059] In the illustrated embodiment, the first linkage 150a includes a first portion of the wall 130, and the second linkage 150b includes a second portion of the wall 130. The first and second portions of the wall 130 that make up the first and second linkages 150a, 150b can be formed by laser cutting or removing material from the elongate tube 110 by other means. Also, the joining members 164, 166 include a part of the wall 130 of the elongate tube 110. The joining members 164, 166 can also be formed by laser cutting or removing material from the elongate tube 110 by other means.

[0060] In the illustrated embodiment, the first actuating element 120 is configured to apply opposing forces toward the first and second linkages 150a, 150b so as to cause stress and / or displacement in the wall 130 of the elongate tube 110. FIG. 3 shows a diagram of forces and movements for the medical device of FIG. 1. As represented by the arrow 200 in the figure, the first actuating element 120 can be configured to expand and / or contract within the first opening 140 of the wall 130 of the elongate tube 110. Expansion of the first actuating element 120 pushes the first and second linkages 150a, 150b away from each other, causing tension in the first and second structural members 160a, 162a of the first linkage 150a and also causing tension in the first and second structural members 160b, 162b of the second linkage 150b. Thereby, the joining members 164, 166 are pulled toward each other (as represented by the arrow 202), thereby shortening the distance between the joining members 164, 166. As a result, the elongate tube 110 bends toward the side of the elongate tube 110 where the first actuating element 120 is located.

[0061] Conversely, the contraction of the first actuating element 120 pulls the first and second linkages 150a, 150b towards each other, causing compression in the first and second structural members 160a, 162a of the first linkage 150a and also causing compression in the first and second structural members 160b, 162b of the second linkage 150b. As a result, the joining members 164, 166 are pulled away from each other, thereby shortening the distance between the joining members 164, 166. Consequently, the elongated tube 110 bends towards the side of the elongated tube 110 opposite to the side where the first actuating element 120 is located.

[0062] Note that the technique of varying the distance between two points on the wall 130 of the elongated tube 110 using the actuating element 120 is advantageous because a small movement or displacement by the actuating element 120 can result in a large deflection at the tip of the elongated tube 110. The linkages and structural members can be configured to amplify the displacement of the actuating element 120 to various degrees by changing the angle of the structural members with respect to the axis of expansion or contraction of the actuating element.

[0063] As shown in FIGS. 1-2, the first actuating element 120 is on the first side of the elongated tube 110, and the elongated tube 110 also includes one or more slots 180, or other structural features, on the second side of the elongated tube 110, and the second side is opposite to the first side. The slots 180 or structural features of the elongated tube 110 enable the elongated tube 110 to be more easily bent by the first actuating element 120.

[0064] The first actuating element 120 may be implemented using different techniques in different embodiments. In some embodiments, the first actuating element 120 may be a piezoelectric element. In such a case, the medical device 100 may include wires connected to the first actuating element 120 to apply energy (e.g., current, voltage, etc.) to drive the piezoelectric element and cause the piezoelectric element to change in size and / or shape. In other embodiments, the first actuating element 120 may be a shape memory (e.g., nitinol or NiTi) element. In such a case, the medical device 100 can include wires connected to the shape memory element to apply current to cause the shape memory element to change in size and / or shape. In some embodiments, the shape memory element can be heated by resistive heating caused by current, and the heating causes the shape memory element to change in size and / or shape. In other embodiments, other means of changing the temperature of the shape memory element may be used, such as delivery of fluid to the element at high temperature, contact of the element or in the vicinity of the element with a hot surface, or use of high-frequency energy that induces eddy currents in the shape memory element, thereby raising its temperature and causing a change in shape. In further embodiments, the first actuating element 120 may be made of one or more electro-responsive polymers that can exhibit a change in size and / or shape when stimulated by an electric field or current. In such a case, the medical device 100 can include wires connected to the first actuating element 120 to apply current to cause the first actuating element 120 to change in size and / or shape. In yet further embodiments, the first actuating element 120 can be a balloon. In such a case, the medical device 100 can include a fluid delivery channel to inflate the balloon and cause the balloon to change in size and / or shape.

[0065] In the above example, the first actuating element 120 is described as being operable in response to electrical energy (e.g., current or voltage) or fluid energy. In other embodiments, the first actuating element 120 may be operable in response to high-frequency energy. In such a case, the first actuating element 120 can include a receiver configured to receive high-frequency energy and a converter configured to convert the high-frequency energy into electrical energy (e.g., current or voltage). The electrical energy (e.g., current or voltage) can then be utilized by the first actuating element 120 to change its size and / or shape. In some embodiments, the high-frequency energy can be one or more high-frequency signals transmitted from a controller. The controller can comprise a user interface configured to enable a user to provide an input for supplying the high-frequency signal. In further embodiments, the actuating element 120 can be operable in response to other forms of energy such as light energy, ultrasonic energy, etc., which are not mechanical energy associated with the tensioning of an operating wire. Also, in some embodiments, the actuating element 120 can be operable in response to the delivery of a fluid that provides a volume displacement and / or fluid pressure. In other embodiments, the actuating element 120 can be operable in response to a mechanical displacement and / or mechanical pressure.

[0066] In the above embodiment, the medical device 100 has one actuating element (the first actuating element) 120. In other embodiments, the medical device 100 can have a plurality of actuating elements 120. For example, in other embodiments, instead of having one actuating element 120 within the wall opening 140, the medical device 100 may have a plurality of actuating elements 120 stacked in the opening 140. Such a configuration allows for various degrees of deflection by selectively actuating one or more of the plurality of actuating elements simultaneously.

[0067] In a further embodiment, instead of having a plurality of actuating elements 120 all located within the same opening 140 of the wall 130, the plurality of actuating elements 120 may be located within respective different openings 140. For example, as shown in FIG. 4A, in another embodiment, the wall 130 of the elongate tube 110 can include a first opening 140a and a second opening 140b. In such a case, the medical device 100 includes a first actuating element 120a located within the first opening 140a of the wall 130 of the elongate tube 110 and a second actuating element 120b located within the second opening 140b. As shown in the figure, both the first actuating element 120a and the second actuating element 120b are located on the same side of the elongate tube 110. With this configuration, the actuating elements 120a, 120b can bend different segments of the elongate tube 110 toward the same side of the elongate tube 110 (i.e., within the same bending plane).

[0068] In other embodiments, the first actuating element 120a and the second actuating element 120b can be located on respective different sides of the elongate tube 110 (FIG. 4B). With this configuration, the actuating elements 120a, 120b can bend the elongate tube 110 in different bending planes. For example, the first actuating element 120a can be configured to bend the elongate tube 110 in a first direction within a first bending plane, and the second actuating element 120b can be configured to bend the elongate tube 110 in a second direction different from the first direction (within a second bending plane).

[0069] In a further embodiment, the medical device 100 can include three or more actuating elements 120. FIG. 4C shows a medical device 100 having an elongate tube 110 and a plurality of actuating elements 120 for bending the elongate tube 110 according to another embodiment. The medical device 100 is the same as that shown in FIG. 4A except that the wall 130 of the elongate tube 100 further includes a third opening 140c and a third actuating element 120c located within the third opening 140c. The third actuating element 120c has the same configuration as that of the first actuating element 120a. As shown in the figure, the first and second actuating elements 120a, 120b are located at the same circumferential position with respect to the longitudinal axis 170 of the elongate tube 110, and the third actuating element 120c is located at a circumferential position different from that of the first and second actuating elements 120a, 120b with respect to the longitudinal axis 170. With such a configuration, the first and second actuating elements 120a, 120b can bend the elongate tube 110 within a first bending plane, and the third actuating element 120c can also bend the elongate tube 110 within a second bending plane different from the first bending plane. The first and second actuating elements 120a, 120b enable bending of different segments along the length of the elongate tube 110. In a further embodiment, the medical device 100 can optionally include a fourth opening and a fourth actuating element located within the fourth opening. The third and fourth actuating elements can be located at the same circumferential position with respect to the longitudinal axis 170 of the elongate tube 110. This enables the third and fourth actuating elements to bend different segments of the elongate tube 110 within the same bending plane.

[0070] In the above-described embodiment, the medical device 100 is shown as having an elongated tube 110 with a continuous surface along the longitudinal axis 170 of the elongated tube 110. In other embodiments, the elongated tube 110 of the medical device 100 can be a slotted tube having a plurality of slots along the longitudinal axis 170 of the elongated tube 110. FIG. 5A shows a medical device 100 according to another embodiment, having a tube 110 and a plurality of actuating elements 120 for bending this tube. As shown in the figure, the actuating elements 120 are located within respective openings 140 defined by the wall 130 of the elongated tube 110. The openings 140 are elongated slots extending circumferentially with respect to the longitudinal axis 170 of the elongated tube 110. The slots divide the elongated tube 110 into a plurality of ring-shaped elements arranged along the longitudinal axis 170. In the illustrated embodiment, the actuating elements 120 are within the group 500 and are arranged in series longitudinally. Each actuating element 120 can be implemented using any of the techniques described with reference to the embodiment of FIG. 1. Different from the embodiment of FIG. 1, the elongated tube 110 of FIG. 5A does not include linkages 160a, 160b, 162a, 162b. Instead, in the embodiment of FIG. 5A, each actuating element 120 directly abuts two adjacent ring-shaped elements of the elongated tube 110 and is configured to change size and directly exert opposite forces on two adjacent ring-shaped elements of the elongated tube 110.

[0071] In use, one or more of the actuating elements 120 can be actuated to bend the elongate tube 110. Specifically, each actuating element 120 is configured to change size and thereby bend the elongate tube 110. The actuating element 120 can expand to increase the dimension (measured along the longitudinal axis 170) of the opening 140 on one side of the elongate tube 110, can contract to decrease the dimension of the opening 140, or can perform both expansion and contraction. When the actuating element 120 expands to increase the dimension of the opening 140 on one side of the elongate tube 110 (or the spacing between adjacent ring-shaped elements of the elongate tube 110), this causes elongation of that side of the elongate tube 110, thereby bending the elongate tube 110 in a direction opposite to that side of the elongate tube 110. On the other hand, when the actuating element 120 contracts to decrease the dimension of the opening 140 on one side of the elongate tube 110 (or the spacing between adjacent ring-shaped elements of the elongate tube 110), this causes shortening of that side of the elongate tube 110, thereby bending the elongate tube 110 in a direction towards that side of the elongate tube 110. The actuating element 120 can be implemented using any of the techniques described with reference to the embodiment of FIG. 1.

[0072] In some cases, the degree of bending of the elongate tube 110 can correspond to the number of actuating elements 120 that are actuated. For example, if only a slight bend of the elongate tube 110 is desired, only one of the actuating elements 120 can be actuated. On the other hand, if more bending (e.g., a greater curvature) of the elongate tube 110 is desired, more actuating elements 120 can be actuated. In the illustrated embodiment, since the actuating elements 120 are arranged on the same side of the elongate tube 110, actuation of one or more of the actuating elements 120 causes the elongate tube 110 to bend within the same bending plane.

[0073] In the above embodiment, the medical device 100 has one group 500 of actuating elements 120. In other embodiments, the medical device 100 can have multiple groups 500 of actuating elements 120.

[0074] For example, as shown in FIG. 5B, in other embodiments, the medical device 100 includes a first group 500a of actuating elements 120 located within respective openings 140 in the wall 130 of the elongate tube 110, and a second group 500b of actuating elements 120 located within the respective openings. As shown in the figure, both the first group 500a of actuating elements 120 and the second group 500b of actuating elements 120 are located on the same side of the elongate tube 110. With this configuration, the two groups 500a, 500b of actuating elements 120 can bend different segments of the elongate tube 110 toward the same side of the elongate tube 110 (i.e., within the same bending plane).

[0075] In other embodiments, the first group 500a of actuating elements and the second group 500b of actuating elements 120 can be located on different respective sides of the elongate tube 110 (FIG. 5C). With this configuration, the groups 500a, 500b of actuating elements 120 can bend the elongate tube 110 in different bending planes. For example, the first group 500a of actuating elements 120 may be configured to bend the elongate tube 110 in a first direction within a first bending plane, and the second group 500b of actuating elements 120 may be configured to bend the elongate tube in a second direction different from the first direction (within a second bending plane).

[0076] In a further embodiment, the medical device 100 can include three or more groups 500 of the actuating elements 120. FIG. 5D shows a medical device 100 according to another embodiment having an elongate tube 110 and a plurality of actuating elements 120 for bending the elongate tube 110. The medical device 100 is the same as that shown in FIG. 5B except that the medical device 100 further includes a third group 500c of the actuating elements 120. The third group 500c of the actuating elements 120 has the same configuration as that of the first group 500a of the actuating elements 120. As shown in the figure, the first and second groups 500a, 500b of the actuating elements 120 are located at the same circumferential position with respect to the longitudinal axis 170 of the elongate tube 110, and the third group 500c of the actuating elements 120 is located at a circumferential position different from those of the first and second groups 500a, 500b of the actuating elements 120 with respect to the longitudinal axis 170. With such a configuration, the first and second groups 500a, 500b of the actuating elements 120 can bend the elongate tube 110 in a first bending plane, and the third group 500c of the actuating elements 120 can also bend the elongate tube 110 in a second bending plane different from the first bending plane. The first and second groups 500a, 500b of the actuating elements 120 enable the bending of different segments along the length of the elongate tube 110. In a further embodiment, the medical device 100 can optionally include a fourth group of the actuating elements. The third and fourth groups of the actuating elements 120 can be located at the same circumferential position with respect to the longitudinal axis 170 of the elongate tube 110. Thereby, the third and fourth groups of the actuating elements 120 can bend different segments of the elongate tube 110 in the same bending plane.

[0077] In the above embodiment, the actuating element 120 is described as being located within the opening 140 of the wall 130 of the elongate tube 110. In other embodiments, one or more of the actuating elements 120 can be located outside the opening 140 of the wall 130 of the elongate tube 110.

[0078] FIG. 6A shows a medical device having an elongated tube 110 and an actuating element 120 for bending the elongated tube 110 according to another embodiment. In the illustrated embodiment, the elongated tube 110 has a plurality of openings 140 in the form of elongated slots that extend circumferentially with respect to the longitudinal axis 170 of the elongated tube 110. The slots divide the elongated tube 110 into a plurality of ring-shaped elements arranged along the longitudinal axis 170. As shown in the figure, the actuating element 120 is coupled to the outer surface of the elongated tube 110 and extends across a plurality of the openings 140. In other embodiments, the actuating element 120 can extend across only one of the openings 140.

[0079] The actuating element 120 is configured to change size and thereby bend the elongated tube 110. Specifically, the actuating element 120 can expand to increase the dimension (measured along the longitudinal axis 170) of the opening 140 on one side of the elongated tube 110, can contract to decrease the dimension of the opening 140, or can perform both expansion and contraction. When the actuating element 120 expands to increase the dimension of the opening 140 on one side of the elongated tube 110, this causes elongation of that side of the elongated tube 110, thereby bending the elongated tube 110 in a direction opposite to that side of the elongated tube 110. On the other hand, when the actuating element 120 contracts to decrease the dimension of the opening 140 on one side of the elongated tube 110, this causes shortening of that side of the elongated tube 110, thereby bending the elongated tube 110 in the direction facing that side of the elongated tube 110. The actuating element 120 can be implemented using any of the techniques described with reference to the embodiment of FIG. 1.

[0080] In the above-described embodiment of FIG. 6A, the medical device 100 has one actuating element (first actuating element) 120. In other embodiments, the medical device 100 can have a plurality of actuating elements 120. For example, as shown in FIG. 6B, in other embodiments, the medical device 100 can include a first actuating element 120a and a second actuating element 120b coupled to the outer surface of the wall 130 of the elongate tube 110. As shown in the figure, both the first actuating element 120a and the second actuating element 120b are located on the same side of the elongate tube 110. With this configuration, the actuating elements 120a, 120b can bend different segments of the elongate tube 110 toward the same side of the elongate tube 110 (i.e., within the same bending plane).

[0081] In other embodiments, the first actuating element 120a and the second actuating element 120b can be located on different respective sides of the elongate tube 110 (FIG. 6C). With this configuration, the actuating elements 120a, 120b can bend the elongate tube 110 in different bending planes. For example, the first actuating element 120a may be configured to bend the elongate tube 110 in a first direction within a first bending plane, and the second actuating element 120b may be configured to bend the elongate tube 110 in a second direction different from the first direction (within a second bending plane).

[0082] In a further embodiment, the medical device 100 can include three or more actuating elements 120. FIG. 6D shows a medical device 100 according to another embodiment having an elongate tube 110 and a plurality of actuating elements 120 for bending the elongate tube 110. The medical device 100 is the same as that shown in FIG. 6B except that the medical device 100 further includes a third actuating element 120c coupled to the outer surface of the wall 130 of the elongate tube 110. The third actuating element 120c has the same configuration as that of the first actuating element 120a. As shown in the figure, the first and second actuating elements 120a, 120b are located at the same circumferential position with respect to the longitudinal axis 170 of the elongate tube 110, and the third actuating element 120c is located at a circumferential position different from those of the first and second actuating elements 120a, 120b with respect to the longitudinal axis 170. With such a configuration, the first and second actuating elements 120a, 120b can bend the elongate tube 110 within a first bending plane, and the third actuating element 120c can also bend the elongate tube 110 within a second bending plane different from the first bending plane. The first and second actuating elements 120a, 120b enable bending of different segments along the length of the elongate tube 110. In a further embodiment, the medical device 100 can optionally include a fourth opening and a fourth actuating element located at the fourth opening. The third and fourth actuating elements can be located at the same circumferential position with respect to the longitudinal axis 170 of the elongate tube 110. This enables the third and fourth actuating elements to bend different segments of the elongate tube 110 within the same bending plane.

[0083] In other embodiments, instead of coupling the actuating element 120 to the outer surface of the elongate tube 110 as shown in FIGS. 6A-6D, the actuating element 120 may be coupled to the inner surface of the elongate tube 110. For example, one or more actuating elements 120 may be coupled to the inner surface of the wall 130 of the elongate tube 110.

[0084] Also, in any of the embodiments of FIGS. 6A-6D, the actuating element 120 can have any length, which may be different from the example shown. For example, in some embodiments, the actuating element 120 may be made relatively long to achieve a relatively large overall bending movement and a curved profile.

[0085] In the embodiments of FIGS. 5-6, the medical device 100 is not limited to having one opening 140 (e.g., a slot) per longitudinal plane. It should be understood that in other embodiments, the medical device 100 may have two or more openings 140 (e.g., two or more slots) per longitudinal plane. The openings 140 (e.g., slots) need not be of equal size within a given longitudinal plane and / or in other parallel planes. In some embodiments, the openings 140 can be slots that collectively form a helix or other pattern around the tube 110, and the actuating element 120 follows the same helix, thereby causing the actuating element 120 to form a helix or other pattern.

[0086] Also, it should be noted that the medical device 100 is not limited to the described examples, and the medical device 100 may have other configurations in other embodiments. For example, in other embodiments, the medical device 100 may include one or more actuating elements 120 located within the lumen 168 of the elongate tube 100. FIGS. 7A - 7B show another medical device 100 having a bendable elongate tube 110 according to other embodiments. The elongate tube 110 has a wall 130 with an opening 140. The elongate tube 110 also includes a structural member 700 (FIG. 7B) located within the opening 140. In the illustrated embodiment, the structural member 700 is coupled between opposing side surfaces of the opening 140. The structural member 700 has a length that is longer than the dimensions of the opening 140. As shown in FIG. 7B, the medical device 100 further includes an actuating element 120 disposed within the lumen 168 of the elongate tube 110. The actuating element 120 is configured to apply a force towards the structural member 700. In the illustrated embodiment, the actuating element 120 is configured to expand to apply a force in a direction perpendicular to the longitudinal axis 170 of the elongate tube 110. Specifically, upon expansion of the actuating element 120, the middle or central portion of the structural member 700 is pushed into the opening 140 in a direction away from the lumen 168 of the elongate tube 110. As a result, the two opposing ends of the opening 140 are pushed away from each other by the structural member 700 (since the structural member 700 is longer than the dimensions of the opening 140), causing the elongate tube 110 to bend in a direction opposite to the pressing force exerted by the actuating element 120.

[0087] In order to fabricate the structural member 700 such that the structural member 700 is longer than the dimensions of the opening 140, different techniques may be used. As shown in FIG. 7A, in the illustrated embodiment, portions 701, 702 of the structural member 700 may be created by cutting a long and narrow tube 110 (e.g., using laser cutting). As shown in the figure, portions 701, 702 are created such that they are not connected together, and there is a gap 710 between portions 701, 702. Next, portions 701, 702 are bent inwardly toward the lumen 168 such that portions 701, 702 form respective non-zero angles with respect to the longitudinal axis 170 of the long and narrow tube 110 (as shown in FIGS. 7A-7B). In some embodiments, the bending of portions 701, 702 may involve plastically deforming or heat setting portions 701, 702. Next, a bridge element 720 may be disposed between portions 701, 702, thereby connecting portions 701, 702 together. The bridge element 720 may be any rigid element. The bridge element 720 may be fixed to portions 701, 702 using any of glue, adhesive, welding, or other techniques known in the art. Portions 701, 702, and the bridge element 720 together form the structural member 700. In other embodiments, the opening 140 may be fabricated without portions 701, 702. In such a case, after the opening 140 is fabricated, the structural member 700 may be disposed within the opening 140 with both opposing ends fixed to opposing sides of the opening 140. In such an embodiment, the structural member 700 may be a single-piece component such as a strip of material having a bent configuration. In other embodiments, the bridge element 720 may be a single integral element that bridges from one end of the opening to the opposite end, and the bridge element 720 may be plastically deformed (stretched) inwardly into the lumen 168 of the long and narrow tube 110.

[0088] In other embodiments, the structural member 700 can have a length that is the same as the dimension of the opening 140. In such a case, the actuating element 120 can be configured to contract to pull at least a portion of the structural member 700 from the opening 140 in a direction facing the lumen 168 of the elongate tube 110. As a result, the opposite ends of the opening 140 are pulled towards each other, causing the elongate tube 110 to bend in a direction opposite to the tensile force exerted on the actuating element 120.

[0089] In some embodiments, the actuating element 120 can be in the form of a ring with a central opening. Such a configuration allows substances or objects within the lumen 168 of the elongate tube 110 to pass therethrough. In other embodiments, the actuating element 120 can have other shapes. For example, in other embodiments, the actuating element 120 can have a block-like configuration that does not completely fill the lumen 168. In further embodiments, the actuating element 120 can completely fill the lumen 168. The actuating element 120 can be implemented using any of the techniques described with reference to FIG. 1.

[0090] In the illustrated embodiment, the portions 701, 702 have respective major lengths that are oriented in a direction parallel to the longitudinal axis 170 of the elongate tube 110. In other embodiments, the portions 701, 702 can extend circumferentially rather than longitudinally, as illustrated. In still further embodiments, the medical device 100 of FIG. 7A can optionally include linkages, such as the linkages 60a, 62a, 60b, 62b described with reference to FIG. 1, to amplify the deflection. In such a case, the linkages can be coupled to the structural member 700 that receives the force applied by the structural member 700 upon actuation of the actuating element 120.

[0091] As shown in FIG. 7A, the medical device 100 includes only one actuating element 120. In other embodiments, the medical device 100 can include a plurality of actuating elements 120 disposed at different longitudinal positions with respect to the longitudinal axis 170 of the elongate tube 110. For example, in other embodiments, the medical device 100 can include a first actuating element 120 and a second actuating element 120 located within respective openings 140 in the wall 130 of the elongate tube 110. The first actuating element 120 and the actuating element 120 can be configured to push and / or pull respective structural members 700 located on the same side of the elongate tube 110. With this configuration, the actuating element 120 can bend different segments of the elongate tube 110 towards the same side of the elongate tube 110 (i.e., within the same bending plane).

[0092] In other embodiments, the first actuating element 120 and the second actuating element 120 may be configured to push and / or pull respective structural members 700 located on different respective sides of the elongate tube 110. With this configuration, the actuating element 120 can bend the elongate tube 110 in different bending planes. For example, the first actuating element 120 may be configured to bend the elongate tube 110 in a first direction within a first bending plane, and the second actuating element 120 may be configured to bend the elongate tube (within a second bending plane) in a second direction different from the first direction.

[0093] In further embodiments, the medical device 100 may include more than three actuating elements 120 configured to push and / or pull respective structural members 700 disposed on different segments of the elongate tube 110.

[0094] In any of the embodiments described herein, the actuating element 120 may be operable to impart different degrees of bending. For example, if the actuating element 120 is operable in response to energy, the amount of energy may be variable to cause the actuating element 120 to impart different degrees of bending to the elongate tube 110. In other embodiments, the actuating element 120 may be bimodal in that it can simply be turned on or off. In such cases, the actuating element 120 does not impart different degrees of bending but rather imparts a predetermined degree of bending. Similarly, if the medical device 100 includes a plurality of such actuating elements 120 (where the degree of expansion / contraction of each actuating element 120 is bimodal (on / off) rather than incrementally controllable), different numbers and / or combinations of actuating elements 120 may be selectively actuated to achieve different degrees of bending for the elongate tube 110.

[0095] In any of the embodiments described herein, the elongate tube 110 may be part of a catheter, a guidewire, or an implant. Accordingly, any of the actuating elements 120 described herein may be implemented as a catheter component for bending a catheter, a guidewire component for bending a guidewire, or an implant component for bending an implant.

[0096] FIG. 8 shows an elongated tube 110 that is part of a catheter according to some embodiments. In the illustrated embodiment, the medical device 100 that is a catheter includes a catheter body 804 having a distal end 800 and a proximal end 802. The medical device 100 also includes a handle 810 coupled to the proximal end 802 of the catheter body 804 and a user interface 820 configured to enable a user to control the bending of the catheter body 804. The user interface 820 is shown as being implemented on the handle 810, but in other embodiments, the user interface 820 may be implemented as a separate device that is separate from the handle 810. For example, in other embodiments, the user interface 820 may be a computer or any electronic device (e.g., a mobile phone, a tablet, etc.) capable of generating an electrical signal and / or a high-frequency signal. As shown in the figure, the catheter body 804 includes an actuating element 120 that can be any of the embodiments of the actuating element 120 described herein. The actuating element 120 is operable in response to an electrical signal or a high-frequency signal provided by the user interface 820, thereby bending the catheter body 804. In other embodiments, the catheter body 804 may include a plurality of actuating elements 120. The user interface 820 can include one or more control units for enabling the user to activate the actuating element 120 in the catheter body 804, thereby bending the catheter body 804. In some embodiments, the one or more control units can be one or more physical buttons, knobs, switches, etc. In other embodiments, the one or more control units may be a touch screen having graphical elements configured to enable the user to activate the actuating element 120 in the catheter body 804.

[0097] During the use of the catheter, the catheter body 804 is inserted into the patient's body. When the catheter body 804 is being advanced inside the patient, the user interface 820 can be operated by the user to activate the actuating element 120 so as to bend the distal segment of the catheter body 804 in a desired manner. The bending of the catheter body 804 enables the distal end 800 of the catheter body 804 to be manipulated along the inner passage (e.g., blood vessel) of the patient by different curvatures. In some embodiments, the catheter body 804 can be rotated about its longitudinal axis so as to allow bending to occur in different bending planes. Also, in some embodiments, the degree of bending (e.g., curvature, angle, etc.) of the catheter body 804 can be adjusted by changing the energy (e.g., current or voltage) or the magnitude of displacement provided by the user interface 820. In some examples, the bending of the catheter body can also serve to position the catheter tip at a desired position or orientation, or to hold the catheter in a specific orientation or position within the patient. Further, the bending or straightening of the catheter body can serve to modify the shape of the passage (e.g., blood vessel) through which the catheter body is deployed.

[0098] After the distal end 800 of the catheter body 804 is desirably positioned inside the patient, the catheter body 804 can then be utilized for medical procedures to diagnose and / or treat the patient. For example, in different embodiments, the catheter body 804 can be used to deliver substances (e.g., drugs, medications, contrast agents, saline, etc.), deploy devices (e.g., implants, tissue dissection instruments, imaging scopes, treatment energy sources, etc.), or perform other functions.

[0099] FIG. 9 shows an elongated tube 110 that is part of a guide wire according to some embodiments. In the illustrated embodiment, the medical device 100 that is a guide wire includes a guide wire body 904 having a distal end 900 and a proximal end 902. The medical device 100 also includes a handle 910 coupled to the proximal end 902 of the guide wire body 904 and a user interface 920 configured to enable a user to control the bending of the guide wire body 904. The user interface 920 is shown as being implemented on the handle 910, but in other embodiments, the user interface 920 can be implemented as a separate device that is separate from the handle 910. For example, in other embodiments, the user interface 920 can be a computer or any electronic device (e.g., a mobile phone, a tablet, etc.) capable of generating electrical signals and / or high-frequency signals. As shown in the figure, the guide wire body 904 includes an actuating element 120 that can be any of the embodiments of the actuating element 120 described herein. The actuating element 120 is operable in response to an electrical signal or a high-frequency signal provided by the user interface 920, thereby bending the guide wire body 904. In other embodiments, the guide wire body 904 can include a plurality of actuating elements 120. The user interface 820 can include one or more control units for enabling a user to activate the actuating element 120 in the guide wire body 904, thereby bending the guide wire body 904. In some embodiments, the one or more control units can be one or more physical buttons, knobs, switches, etc. In other embodiments, the one or more control units can be a touch screen having graphical elements configured to enable a user to activate the actuating element 120 in the guide wire body 904.

[0100] During the use of the guide wire, the guide wire body 904 is inserted into the patient's body. When the guide wire body 904 is being advanced inside the patient, the user interface 920 can be operated by the user to actuate the actuating element 120 to bend the distal segment of the guide wire body 904 in a desired manner. Bending of the guide wire body 904 enables the distal end 900 of the guide wire body 904 to be maneuvered along the inner passage (e.g., blood vessel) of the patient by different curvatures. In some embodiments, the guide wire body 904 can be rotated about its longitudinal axis to allow bending to occur in different bending planes. Also, in some embodiments, the degree of bending (e.g., curvature, angle, etc.) of the guide wire body 904 can be adjusted by changing the energy (e.g., current or voltage) or the magnitude of displacement provided by the user interface 820. In some examples, the bending of the guide wire body can also serve to position the guide wire tip in a desired position or orientation, or to hold the guide wire in a particular orientation or position within the patient. Further, the bending or straightening of the guide wire body can serve to modify the shape of the passage (e.g., blood vessel) through which the catheter body is deployed.

[0101] After the distal end 900 of the guide wire body 904 is desirably positioned inside the patient, the guide wire body 904 can then be utilized for a medical procedure. For example, another device (which can be a diagnostic device or a treatment device) inserted by the guide wire body 904 can be advanced inside the patient using the guide wire body 904 as a guide to reach a target position inside the patient.

[0102] Figure 10 shows an elongated tube 110 that is part of an implant according to some embodiments. In the illustrated embodiment, the medical device 100 that is the implant includes a distal end 1000, a proximal end 1002, and an implant body 1004 that extends between the distal end 1000 and the proximal end 1002. In the illustrated example, the implant 100 is a vascular occlusion implant configured to be delivered within a blood vessel until it reaches an artery for treating an aneurysm. In other examples, the implant 100 can be other types of implants such as a stent. As shown in the figure, the proximal end 1002 of the implant 100 is removably coupled to a delivery wire 1200. The implant 100 with the delivery wire 1200 can be housed within a delivery tube 1220 during use. The delivery tube 1220 includes a distal end 1222 and a proximal end 1224. The proximal end 1224 of the delivery tube 1220 is attached to a handle 1230 that includes a user interface 1240. The user interface 1240 may be implemented to have the same features as those described with reference to FIGS. 8 and 9. The user interface 1240 can be configured to enable a user to control the bending of the implant 100. Although the user interface 1240 is shown as being implemented on the handle 1230, in other embodiments, the user interface 1240 can be implemented as a separate device that is separate from the handle 1230. For example, in other embodiments, the user interface 1240 can be a computer or any electronic device (e.g., a mobile phone, a tablet, etc.) that can generate an electrical signal and / or a high-frequency signal. As shown in the figure, the implant 100 includes actuating elements 120, each of which can be any of the embodiments of the actuating elements 120 described herein. The actuating elements 120 are operable in response to an electrical signal or a high-frequency signal provided by the user interface 1240, thereby bending the implant 100.

[0103] During use, the implant 100 and the delivery wire 1200 are housed within the delivery tube 1220. The delivery tube 1220 is inserted into a patient's blood vessel and advanced until it reaches a target site such as an aneurysm. If the delivery tube 1220 has an operating function as in any of the bending techniques described herein, or if the delivery tube 1220 has an operating wire, the delivery tube 1220 can be bent to navigate through the patient's internal blood vessels. After the delivery tube 1220 reaches the aneurysm, the delivery wire 1200 can be advanced relative to the delivery tube 1220 to deploy the implant 100 from the delivery tube 1220 into the aneurysm. When the implant 100 is deployed within the aneurysm, or after the implant 100 has been deployed within the aneurysm, the user interface 1240 can be operated by the user to activate the actuating element 120 to bend some portions of the implant 100 in a desired manner. Bending of the implant 100 enables the implant 100 to have a certain geometric shape (e.g., size and / or shape) that fits within the aneurysm in a desired manner. Also, in some embodiments, the degree of bending of the implant 100 (e.g., curvature, angle, etc.) can be adjusted by varying the magnitude of the energy (e.g., current, voltage, or another type of energy) provided by the user interface 1240. Further, in some embodiments, the implant 100 can have a pre-bent configuration that includes a series of loops. In such cases, the implant 100 can have actuating elements 120 disposed between adjacent loops and / or actuating elements 120 disposed along segments of the loops. The pre-bent configuration of the implant 100 gives the implant 100 a certain loose three-dimensional configuration, and the actuating elements 120 can be selectively activated to adjust such a loose three-dimensional configuration. Alternatively, the position of a particular loop of the implant can be adjusted during deployment of the implant, thereby optimizing the placement of the implant loops for occlusion of the aneurysm.In other embodiments, a pre-bent implant can be delivered in a relatively straight configuration and its structure can be tightened by returning to its pre-bent shape when the activation signal is interrupted. This can improve the packing density and connection with other occlusive devices inside the aneurysm, thus improving occlusion. In other embodiments, the implant 100 may not have any pre-bent configuration. Instead, the implant 100 can have a relatively straight and loose profile. In such a case, the implant 100 can have a plurality of activation elements 120 disposed along most of its length. When the implant 100 is being delivered into the aneurysm, the user interface 1240 can be operated to selectively bend some segments of the implant 100 to form a three-dimensional configuration in situ. When the activation signal is interrupted, the implant attempts to return to its relatively straight and loose profile but can be constrained from doing so by a restraining membrane or structure such as a sac-like inner device.

[0104] In some embodiments, the implant can have one or more activation elements that incorporate plastic deformation, whereby the implant is bent during or after deployment and retains the bent configuration after removal of the activation signal. One application of such a configuration is to ensure that the proximal end of the implant, e.g., a vascular occlusion coil, remains inside the aneurysm where the implant is deployed rather than protruding into the parent vessel.

[0105] In some embodiments, one technique for bending a selected portion of an implant is to use a shape memory element as an actuator. The shape memory element can be resistively heated by the application of an electric current before detachment from the delivery wire. Alternatively, the shape memory element can be inductively heated by high frequency energy generated within the delivery catheter or by another device (e.g., a guide wire), by contact with a hot surface or in the vicinity of a hot surface, or by delivery of a hot fluid. This technique allows the implant to have multiple actuator elements, but gives the physician the option to activate some of the actuators, not activate any of the actuators, or activate all of the actuators depending on the deployment state of a particular implant.

[0106] In any of the embodiments described herein, the elongate tube 110 can be made of any material such as a polymer, metal, alloy, etc. In some embodiments, the elongate tube 110 can be a hypotube. Also, in any of the embodiments described herein, the medical device 100 can further include an outer tubular layer disposed over the elongate tube 110. The outer tubular layer can be attached directly or indirectly to the outer surface of the wall 130 of the elongate tube 110. The outer tubular layer can function to achieve a smooth surface that houses the actuating element 120 and / or covers the region where the opening 140 is located. Also, in any of the embodiments described herein, the medical device 100 can include an inner tubular layer disposed within the lumen 168 of the elongate tube 110. The inner tubular layer can be attached directly or indirectly to the inner surface of the wall 130 of the elongate tube 110. The inner tubular layer can function to cover the opening 140. The outer tubular layer and the inner tubular layer can be made of a material that is softer than the material of the elongate tube 110 so that they do not interfere with the bending of the elongate tube 110.

[0107] It should be noted that the medical device 100 described in this specification can have other features and configurations in other embodiments. For example, in other embodiments, the geometric shape (e.g., size, orientation, shape, etc.) of the opening 140, and / or the configuration of the actuating element 120 may be adapted to achieve a certain deflection of the elongate tube 110. In further embodiments, if the medical device 100 includes linkages (e.g., linkages 160, 162 described with reference to the embodiment of FIG. 1), the linkages may be adapted to achieve a certain deflection of the elongate tube 110. Also, in other embodiments, the direction of the pressing force or tensile force applied by the actuating element 120 can be selectively configured to be in any direction different from the examples described in this specification. Further, in other embodiments, the geometric shape of the opening 140, the configuration of the actuating element 120, the linkages, or any combination of the foregoing may be selectively adapted to achieve an amplification of a certain force or an amplification of an amplitude. In force amplification, a certain force applied by the actuating element 120 results in a certain amount of bending force. In amplitude amplification, a certain amplitude of movement of the actuating element 120 (due to a change in the size of the actuating element 120) results in a certain amount of displacement at the tip of the elongate tube 110.

[0108] In some embodiments, the geometric shape of the opening 140, the configuration of the actuating element 120, the linkage, the material properties of the elongate tube 110, or any combination of the foregoing may be selectively adapted to achieve elastic deformation of the element 120 and / or the elongate tube 110 (and thus reversible bending of the elongate tube 110), such that when the energy source is turned off, the elongate tube 110 returns to its original shape. In other embodiments, the geometric shape of the opening 140, the configuration of the actuating element 120, the linkage, the material properties of the elongate tube 110, or any combination of the foregoing may be selectively adapted to achieve plastic deformation of the element 120 and / or the elongate tube 110 (and thus irreversible bending of the elongate tube 110), such that when the energy source is turned off, the elongate tube 110 does not return to its original shape. In further embodiments, the medical device 100 can incorporate both elastic and plastic deformation to different degrees and percentages. For example, in some embodiments, the geometric shape of the opening 140, the configuration of the actuating element 120, the material properties of the elongate tube 110, or any combination of the foregoing may be selectively adapted to achieve both elastic and plastic deformation to different degrees and percentages at one or more locations within the medical device 100.

[0109] The technique of bending the elongate tube 110 described herein is advantageous because it allows for selective bending of the elongate tube 110 while being disposed within the patient without using an operating wire. Unlike an operating wire that extends all the way from the distal end to the proximal end of a medical device, the actuating element 120 described herein does not extend to the proximal end of the medical device 100. Instead, the spread of the actuating element 120 remains localized within a certain area in a segment of the elongate tube 110. As shown, in the above embodiment, at least a portion of the actuating element 120 and the corresponding opening 140 of the wall 130 are located at the same longitudinal position with respect to the longitudinal axis 170 of the elongate tube 110. Since no operating wire is required, the elongate tube 110 and the medical device 100 comprising such an elongate tube 110 can be made smaller. A similar medical device 100 is desirable because it can navigate and reach smaller spaces inside the patient. For example, if the medical device 100 is a catheter, a guide wire, or an implant, such a medical device 100 can reach a target area in a narrower blood vessel such as a target area in the patient's brain. Also, since the bending of the medical device 100 does not require any operating wire (such as a tension wire), there is a minimum or zero net shortening of the medical device 100 in its deflected or bent state, and there is no tendency to straighten the proximal portion of the medical device 100 (which can occur due to the tensioning exerted on a tension wire). Furthermore, since there is no tension wire in the medical device 100, there is no risk of the user accidentally moving the medical device 100 while attempting to actuate its deflection. Additionally, since the medical device 100 does not require any operating wire, there are no mechanical problems associated with the use of such an operating wire, such as detachment of the operating wire from the catheter body, jamming of the operating wire due to frictional contact with the catheter body, etc.

[0110] Also, the bending techniques described herein are advantageous because they enable the generation of sharp bends in the medical device 100. When the medical device 100 is a catheter or a guidewire, this feature enables the medical device 100 to navigate through sharp bends in a patient's blood vessel.

[0111] Furthermore, for the case where the medical device 100 is a guidewire or an implant (e.g., a vascular occlusion device), the technique of bending the elongate tube 110 described herein is also advantageous for these applications because the absence of an operating wire allows the guidewire or implant to be made smaller. The techniques of bending the guidewire or implant described herein enable the guidewire or implant to be selectively bent in one or more directions while the guidewire or implant is inside the patient. Further, since the guidewire or implant can be selectively bent in one or more directions even after they have been delivered inside the patient, the guidewire / implant can have a relatively straight profile that conforms to the profile of the delivery tube that houses such a guidewire or implant. Thereby, the guidewire or implant can be advanced inside the delivery tube with minimal friction.

[0112] The following items are exemplary features of the embodiments described herein. Each item may be an embodiment itself or a part of an embodiment. One or more of the items described below may be combined with other items in an embodiment.

[0113] Item 1: The medical device is an elongate tube having a wall, the wall of the elongate tube comprising a first opening, and a first actuating element positioned within the first opening of the wall of the elongate tube, the first actuating element within the first opening of the wall being operable to cause stress and / or displacement in the wall of the elongate tube to bend the elongate tube.

[0114] Clause 2: The size of the first actuating element is variable to cause stress and / or displacement in the wall of the elongate tube to bend the elongate tube.

[0115] Clause 3: The size of the actuating element is variable in a direction parallel to the longitudinal axis of the elongate tube.

[0116] Clause 4: The size of the actuating element is variable in a direction perpendicular to the longitudinal axis of the elongate tube.

[0117] Clause 5: The first actuating element is on a first side of the elongate tube, and the elongate tube has one or more slots, or other structural features, on a second side of the elongate tube, the second side being opposite the first side.

[0118] Clause 6: The first actuating element is configured to expand, contract, or both expand and contract.

[0119] Clause 7: The first actuating element is configured to expand within a first opening in the wall to bend the elongate tube in a first direction, and the first actuating element is configured to contract within the opening in the wall to bend the elongate tube in a second direction opposite the first direction.

[0120] Clause 8: The wall of the elongate tube comprises a first linkage and a second linkage coupled to respective opposing sides of the first actuating element.

[0121] Clause 9: The first actuating element is configured to apply opposing forces towards the first and second linkages to cause stress and / or displacement in the wall of the elongate tube.

[0122] Clause 10: The first linkage comprises a first portion of the wall, the second linkage comprises a second portion of the wall, and the first and second portions of the wall are formed by laser cutting the elongate tube, etching the elongate tube, or removing material from the elongate tube.

[0123] Clause 11: The first actuating element comprises a piezo element, a balloon, an electro-responsive polymer, or a shape memory element.

[0124] Clause 12: The first actuating element is operable in response to electrical energy, high-frequency energy, thermal energy, fluid delivery, or pressure.

[0125] Clause 13: The wall of the elongate tube comprises a second opening, and the medical device further comprises a second actuating element located within the second opening in the wall of the elongate tube.

[0126] Clause 14: The first actuating element and the second actuating element are located on the same side of the elongate tube.

[0127] Clause 15: The first actuating element and the second actuating element are located on different respective sides of the elongate tube.

[0128] Clause 16: The first actuating element is configured to bend the elongate tube in a first direction, and the second actuating element is configured to bend the elongate tube in a second direction different from the first direction.

[0129] Clause 17: The elongate tube is part of a catheter.

[0130] Clause 18: The elongate tube is part of a guide wire.

[0131] Clause 19: The elongate tube is part of an implant.

[0132] Clause 20: The implant is configured to deform plastically.

[0133] Clause 21: The first actuating element and / or the elongate tube are configured to deform elastically.

[0134] Clause 22: The first actuating element and / or the elongate tube are configured to deform plastically.

[0135] Clause 23: The medical device is an elongated tube having a wall that defines a lumen for the elongated tube, the wall of the elongated tube comprising a first opening, and an elongated tube and a first actuating element directly or indirectly coupled to the wall of the elongated tube, at least a portion of the first actuating element and the first opening of the wall being located at the same longitudinal position with respect to the longitudinal axis of the elongated tube, the first actuating element being configured to change in size so as to cause stress and / or displacement in the wall of the elongated tube to bend the elongated tube.

[0136] Clause 24: The first actuating element is configured to change the cross-sectional dimensions of the first opening so as to cause stress and / or displacement in the wall of the elongated tube.

[0137] Clause 25: The first actuating element is operable and is located within the first opening of the wall of the elongated tube.

[0138] Clause 26: The wall of the elongated tube comprises a first linkage and a second linkage coupled to respective opposing sides of the first actuating element.

[0139] Clause 27: The first actuating element is configured to apply opposing forces toward the first and second linkages so as to cause stress and / or displacement in the wall of the elongated tube.

[0140] Clause 28: The wall of the elongated tube comprises a second opening, and the medical device further comprises a second actuating element located within the second opening of the wall of the elongated tube.

[0141] Clause 29: The first actuating element is configured to bend the elongated tube in a first direction, and the second actuating element is configured to bend the elongated tube in a second direction that is the same as or different from the first direction.

[0142] Clause 30: The first actuating element extends across the first opening of the wall of the elongated tube.

[0143] Clause 31: The first actuating element is coupled to the outer surface of the elongate tube.

[0144] Clause 32: The first actuating element is coupled to the inner surface of the elongate tube.

[0145] Clause 33: The wall of the elongate tube further comprises a second opening, and the first actuating element also extends across the second opening in the wall of the elongate tube.

[0146] Clause 34: The elongate tube has a distal end and a proximal end, and the first actuating element is located between the distal end and the proximal end of the elongate tube.

[0147] Clause 35: The medical device further includes a structural member coupled between opposing side surfaces of the first opening, and the first actuating element is located within the lumen of the elongate tube and is configured to apply a force toward the structural member.

[0148] Clause 36: The structural member has a length that is longer than the dimension of the opening.

[0149] Clause 37: The first actuating element is configured to apply a force in a direction that is perpendicular to the longitudinal axis of the elongate tube.

[0150] Clause 38: The first actuating element is on a first side of the elongate tube, and the elongate tube has one or more slots, or other structural features, on a second side of the elongate tube, and the second side is opposite the first side.

[0151] Clause 39: The first actuating element is configured to expand, contract, or both expand and contract.

[0152] Clause 40: The first actuating element comprises a piezo element, a balloon, an electro-responsive polymer, or a shape memory element.

[0153] Clause 41: The first actuating element is operable in response to electrical energy, high frequency energy, thermal energy, delivery of a fluid, or pressure.

[0154] Clause 42: The elongated tube is part of a catheter, part of a guide wire, or part of an implant.

[0155] Clause 43: The implant is configured to plastically deform.

[0156] Clause 44: The first actuating element and / or the elongated tube are configured to elastically deform.

[0157] Clause 45: The first actuating element and / or the elongated tube are configured to plastically deform.

Description of Reference Numerals

[0158] 100 Medical device 110 Elongated tube 120 Actuating element (first actuating element) 120a First actuating element 120b Second actuating element 120c Third actuating element 130 Wall, elongated tube 140 First opening, opening 140a First opening 140b Second opening 140c Third opening 150a First linkage 150b Second linkage 160a First structural member, linkage 160b First structural member, linkage 162a Second structural member, linkage 162b Second structural member, linkage 164 Joining member 166 Joining member 168 Lumen 170 Longitudinal axis 180 Slot 500 Group 500a First group 500b Second group 500c Third group 700 Structural member 701 Portion 702 Portion 710 Spacing 720 Bridge element 800 Distal end 802 Proximal end 804 Catheter body 810 Handle 820 User interface 900 Distal end 902 Proximal end 904 Guide wire body 910 Handle 920 User interface 1000 Distal end 1002 Proximal end 1004 Implant body 1010 Handle 1020 User interface 1200 Delivery wire 1220 Delivery tube 1222 Distal end 1224 Proximal end 1230 Handle 1240 User interface

Claims

1. An elongated tube having a wall, wherein the wall of the elongated tube comprises a first opening, and the elongated tube, a first actuating element located within the first opening of the wall of the elongated tube, comprising The first actuating element within the first opening of the wall is operable to cause stress and / or displacement in the wall of the elongated tube to bend the elongated tube, a medical device.

2. The size of the first actuating element is variable for causing the stress and / or the displacement in the wall of the elongated tube to bend the elongated tube, the medical device according to claim 1.

3. The size of the actuating element is variable in a direction parallel to the longitudinal axis of the elongated tube, the medical device according to claim 2.

4. The size of the actuating element is variable in a direction perpendicular to the longitudinal axis of the elongated tube, the medical device according to claim 2.

5. The first actuating element is on a first side of the elongated tube, and the elongated tube comprises one or more slots, or other structural features, on a second side of the elongated tube, the second side being opposite the first side, the medical device according to claim 1.

6. The first actuating element is configured to expand, contract, or both expand and contract, the medical device according to any one of claims 1 to 5.

7. The first actuating element is configured to expand within the first opening of the wall to bend the elongated tube in a first direction, and the first actuating element is configured to contract within the opening of the wall to bend the elongated tube in a second direction opposite the first direction, the medical device according to claim 6.

8. The wall of the elongated tube comprises a first linkage and a second linkage coupled to respective opposing side surfaces of the first actuating element, the medical device according to any one of claims 1 to 7.

9. The first actuating element is configured to apply opposing forces to the first and second linkages to cause the stress and / or the displacement in the wall of the elongated tube, the medical device according to claim 8.

10. The first linkage comprises a first portion of the wall, the second linkage comprises a second portion of the wall, and the first and second portions of the wall are formed by laser cutting the elongated tube, etching the elongated tube, or removing material from the elongated tube, the medical device according to claim 8.

11. The first actuating element comprises a piezoelectric element, a balloon, an electro-responsive polymer, or a shape memory element, the medical device according to any one of claims 1 to 9.

12. The first actuating element is operable in response to electrical energy, high frequency energy, a temperature change, a fluid delivery, or a pressure, the medical device according to any one of claims 1 to 9.

13. The wall of the elongated tube comprises a second opening, and the medical device further comprises a second actuating element located within the second opening of the wall of the elongated tube, the medical device according to any one of claims 1 to 12.

14. The first actuating element and the second actuating element are located on the same side of the elongated tube, the medical device according to claim 13.

15. The first actuating element and the second actuating element are located on different respective sides of the elongated tube, the medical device according to claim 13.

16. The first actuating element is configured to bend the elongated tube in a first direction, and the second actuating element is configured to bend the elongated tube in a second direction different from the first direction, the medical device according to claim 13.

17. The elongated tube is part of a catheter, a guide wire, or an implant, the medical device according to any one of claims 1 to 17.

18. The first actuating element and / or the elongated tube are configured to deform elastically, the medical device according to any one of claims 1 to 17.

19. The first actuating element and / or the elongated tube are configured to deform plastically, the medical device according to any one of claims 1 to 18.

20. An elongated tube having a wall defining a lumen for the elongated tube, the wall of the elongated tube comprising a first opening, the elongated tube; A first actuating element directly or indirectly coupled to the wall of the elongated tube; Comprising At least a part of the first actuating element and the first opening of the wall are located at the same longitudinal position with respect to the longitudinal axis of the elongated tube. The first actuating element is a medical device configured to change in size so as to cause stress and / or displacement on the wall of the elongated tube so as to bend the elongated tube. **Claim 21** The medical device according to claim 20, wherein the first actuating element is configured to change the cross-sectional dimension of the first opening so as to cause the stress and / or the displacement on the wall of the elongated tube. **Claim 22** The medical device according to claim 20, wherein the first actuating element is operable and is located within the first opening of the wall of the elongated tube. **Claim 23** The medical device according to claim 22, wherein the wall of the elongated tube comprises a first linkage and a second linkage coupled to respective opposing side surfaces of the first actuating element. **Claim 24** The medical device according to claim 23, wherein the first actuating element is configured to apply opposing forces towards the first and second linkages so as to cause the stress and / or the displacement on the wall of the elongated tube. **Claim 25** The medical device according to claim 22, wherein the wall of the elongated tube comprises a second opening, and the medical device further comprises a second actuating element located within the second opening of the wall of the elongated tube. **Claim 26** The medical device according to claim 25, wherein the first actuating element is configured to bend the elongated tube in a first direction, and the second actuating element is configured to bend the elongated tube in a second direction that is the same as or different from the first direction. **Claim 27** The medical device according to claim 20, wherein the first actuating element extends across the first opening of the wall of the elongated tube. **Claim 28** The medical device according to claim 27, wherein the first actuating element is coupled to the outer surface of the elongated tube. **Claim 29** The medical device according to claim 27, wherein the first actuating element is coupled to the inner surface of the elongated tube. **Claim 30** The medical device according to claim 27, wherein the wall of the elongated tube further comprises a second opening, and the first actuating element also extends across the second opening of the wall of the elongated tube. **Claim 31** The elongated tube has a distal end and a proximal end, and the first actuating element is located between the distal end and the proximal end of the elongated tube. The medical device according to claim 27.

32. The medical device according to claim 20, further comprising a structural member coupled between opposing side surfaces of the first opening, wherein the first actuating element is located within the lumen of the elongated tube and is configured to apply a force toward the structural member.

33. The medical device according to claim 32, wherein the structural member has a length that is longer than the dimension of the opening.

34. The medical device according to claim 32, wherein the first actuating element is configured to apply the force in a direction that is perpendicular to the longitudinal axis of the elongated tube.

35. The first actuating element is on a first side of the elongated tube, and the elongated tube has one or more slots or other structural features on a second side of the elongated tube, the second side being opposite the first side. The medical device according to claim 20.

36. The medical device according to any one of claims 20 to 35, wherein the first actuating element is configured to expand, contract, or both expand and contract.

37. The medical device according to any one of claims 20 to 35, wherein the first actuating element comprises a piezoelectric element, a balloon, an electro-responsive polymer, or a shape memory element.

38. The medical device according to any one of claims 20 to 35, wherein the first actuating element is operable in response to electrical energy, high-frequency energy, a change in temperature, the delivery of a fluid, or pressure.

Images