Mechanical actuation of the catheter

Abstract

The medical system includes an electronically controlled actuator system and a catheter system for providing access into a body cavity. The electronically controlled actuator system includes a plurality of carriages mounted with a frame and movable along a longitudinal axis relative to the frame, and a carriage drive system configured to adjust the position of each of the carriages. The catheter system includes a distal end, a proximal end, a plurality of lumens extending between the distal and proximal ends, and a plurality of adapters. Each of the adapters is coupled to a corresponding carriage and can be attached to the lumen such that adjusting the position of the corresponding carriage actuates the attached lumen. The actuator system has a control system having executable instructions for controlling the plurality of carriages and, therefore, the lumen of the catheter system.

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims the benefit of U.S. Provisional Patent Application No. 63 / 395,159, filed August 4, 2022, the entire contents of which are hereby incorporated by reference herein.

[0002] SUMMARY OF THE INVENTION The embodiments disclosed herein generally relate to a catheter system for delivery of a prosthesis and its control system. [Background technology]

[0003] Human heart valves, including the aortic, pulmonary, mitral, and tricuspid valves, function as one-way valves that operate in sync with the heartbeat. The valves allow blood to flow downstream but prevent blood from flowing upstream. Affected heart valves exhibit defects such as valve stenosis or regurgitation, which inhibit the valve's ability to control blood flow. Such defects reduce the heart's blood-pumping efficiency and can be debilitating and life-threatening. For example, valve dysfunction can lead to symptoms such as cardiac hypertrophy and ventricular dilation. Therefore, extensive efforts have been made to develop methods and devices for repairing or replacing defective heart valves.

[0004] Prostheses exist to correct problems associated with faulty heart valves. For example, mechanical and tissue-based heart valve prostheses can be used to replace faulty native heart valves. Recently, significant efforts have been made to develop replacement heart valves, particularly tissue-based replacement heart valves that can be delivered with less trauma to the patient compared to open-heart surgery. Replacement valves are designed to be delivered with minimal procedures, even non-invasive percutaneous procedures. Such replacement valves often include a tissue-based valve body connected to an expandable frame and then delivered to the native valve annulus.

[0005] Developing prostheses, including but not limited to replacement heart valves, that can be compressed for delivery and then controllably expanded for precise implantation has proven difficult. Additional challenges relate to the ability to secure such prostheses to intraluminal tissue, such as any body lumen or tissue within a body cavity, in an atraumatic manner.

[0006] It can also be difficult to deliver a prosthesis to a desired location within the human body, such as, for example, delivering a replacement heart valve to a mitral valve. Gaining access to perform a procedure in the heart or other anatomical locations can require delivering the device percutaneously through tortuous vasculature or through an open or semi-open surgical procedure. Catheter-based implantation of a prosthesis can be particularly challenging when multiple catheter shafts and actuation mechanisms are manipulated by the clinician during the procedure. Thus, there is a need to simplify the procedure and improve the clinician's ability to precisely control the navigation of the catheter through the vasculature and the deployment of the prosthesis at the desired location. Summary of the Invention

[0007] The medical system includes an electronically controlled actuator system and a catheter system for providing access into a body cavity. The electronically controlled actuator system may include a frame extending along a longitudinal axis, a plurality of carriages attached to the frame and movable along the longitudinal axis relative to the frame, and a carriage drive system configured to adjust the position of each of the carriages along the longitudinal axis based on at least one control signal. Each of the plurality of carriages may include a nest coupled thereto and configured to rotate about the longitudinal axis. The catheter system may include a distal end, a proximal end, a plurality of lumens extending between the distal end and the proximal end, and a plurality of adapters. Each of the adapters may be attachable to a lumen of one of the plurality of lumens. Preferably, each of the plurality of adapters is coupled to a corresponding carriage of the plurality of carriages such that adjusting the position of the corresponding carriage along the longitudinal axis actuates the attached lumen.

[0008] According to another aspect, the actuator system includes a control system having at least one computer-readable memory having executable instructions stored thereon and one or more processors in communication with the at least one computer-readable memory, executing the instructions to cause the system to at least receive input signals and generate at least one control signal based on the input signals. According to another aspect, the actuator system includes a user interface for providing the input signals. According to another aspect, the user interface is located remotely from the actuator system and in wired or wireless communication with the control system. According to another aspect, the multiple lumens of the catheter system include an outer sheath assembly, a midshaft assembly, a rail assembly, and an inner shaft assembly.

[0009] According to another aspect, the first load cell measures a force applied to a first lumen of the multiple lumens by a first carriage of the multiple carriages. According to another aspect, the first load cell is mounted on the first carriage and, when coupled with the first load cell, contacts a first adapter of the multiple adapters. According to another aspect, the user interface displays the force measured by the first load cell relative to an allowable force limit associated with the first lumen. According to another aspect, the user interface displays an available range of motion of the first lumen based on the force measured by the first load cell and the allowable force limit. According to another aspect, execution of the instructions further causes the system to receive a force signal from the first load cell and generate at least one control signal further based on a comparison of the force signal to the allowable force limit. The at least one force signal prevents exceeding one or more allowable force limits.

[0010] According to another aspect, the at least one control signal adjusts the position of at least two of the plurality of carriages as a first group along the longitudinal axis. According to another aspect, each carriage of the plurality of carriages includes a receiving slot configured to receive one of the plurality of adapters therein. According to another aspect, each of the adapters includes one or more lateral protrusions extending perpendicular to the longitudinal axis of the frame, and each of the receiving slots includes one or more upward protrusions configured to engage with the one or more lateral protrusions. According to another aspect, the proximal end of the catheter system includes a handle shell including one or more shell members. According to another aspect, the plurality of adapters protrude laterally outward from within the handle shell. According to another aspect, the handle shell is removable. According to another aspect, the frame is rotatable on a rotational axis aligned parallel to or generally aligned along the longitudinal axis. According to another aspect, a first pivot mount connects to a first end of the frame, a second pivot mount connects to a second end of the frame, and the first and second pivot mounts are aligned along the rotational axis. According to another aspect, the multiple lumens are attached to the multiple adapters by respective guidewires. According to another aspect, the base or table includes an upper surface for supporting the frame. According to another aspect, a patient bed supports the base or table.

[0011] According to another aspect, the frame includes a pair of rails extending parallel to the longitudinal axis, and the plurality of carriages are mounted on the pair of rails. According to another aspect, the carriage drive system includes a motor for each of the plurality of carriages. According to another aspect, the carriage drive system includes a rack mounted to the frame, and each of the motors includes a pinion gear meshed with the rack. According to another aspect, each of the plurality of carriages includes a limit switch or a proximity switch for homing the carriage relative to the frame. According to another aspect, the catheter system can be any catheter system from a set of catheter systems including a plurality of universal adapters. According to another aspect, the plurality of carriages are reconfigurable to accept any catheter system from the set of catheter systems in an initial pre-programmed spacing configuration. According to another aspect, the at least one control signal is further based on an autonomous or semi-autonomous control algorithm.

[0012] In another aspect, a method includes positioning an electronically controlled actuator system relative to a patient. The electronically controlled actuator system has a frame extending along a longitudinal axis, a carriage attached to the frame movable along the longitudinal axis relative to the frame, and a carriage drive system adjusting a position of the carriage along the longitudinal axis. The method includes making an incision to access the patient's vasculature. The method includes inserting a distal end of a catheter system through the incision into the patient's vasculature and advancing the distal end through the vasculature into or adjacent to an anatomical region of the patient. The method includes aligning a proximal end of the catheter system with the electronically controlled actuator system. The method includes coupling an adapter of the catheter system to the carriage. The method includes receiving at least one control signal at a control system of the electronically controlled actuator system. The method includes adjusting a position of the carriage along the longitudinal axis based on the at least one control signal, thereby actuating a lumen of the catheter system.

[0013] According to another aspect, the input signal is from a user interface, and the electronically controlled actuator system generates at least one control signal based on the input signal. According to another aspect, the method includes receiving a force signal from a load cell and generating at least one control signal further based on the force signal. According to another aspect, the method includes calculating an available range of motion of the lumen based on the force signal measured by the first load cell and an allowable force limit of the lumen. According to another aspect, the method includes adjusting a position of the carriage to an initial pre-programmed position before coupling an adapter of the catheter system with the carriage. According to another aspect, the catheter system includes multiple lumens and multiple corresponding adapters, and the electronically controlled actuator system includes multiple carriages.

[0014] The foregoing summary is illustrative only and is not intended to be limiting. Other aspects, features, and advantages of the systems, devices, and methods and / or other subject matter described in this application will become apparent in the teachings set forth below. This summary is provided to introduce some selected concepts of the disclosure. It is not intended to identify key or essential features of any subject matter described herein.

[0015] Various examples are shown in the accompanying drawings for illustrative purposes and should in no way be construed as limiting the scope of the embodiments. Various features of different disclosed embodiments may be combined to form additional embodiments that are part of this disclosure. [Brief explanation of the drawings]

[0016] [Figure 1] FIG. 1 illustrates a schematic of an electronically controlled actuator including multiple movable carriages for use with a catheter system. [Figure 2] FIG. 2 shows a perspective view of the electronically controlled actuator shown in FIG. [Figure 3]FIG. 3 shows a partial perspective view of another electronically controlled actuator. [Figure 4] 4 and 5 show partial perspective views of another electronically controlled actuator. [Figure 5] 4 and 5 show partial perspective views of another electronically controlled actuator. [Figure 6] FIG. 6 shows an adapter for connecting the lumen of a catheter system to the carriage of an electronically controlled actuator. [Figure 7] 7 and 8 show partial perspective views of another electronically controlled actuator. [Figure 8] 7 and 8 show partial perspective views of another electronically controlled actuator. [Figure 9] FIG. 9 shows another electronically controlled actuator. [Figure 10] 10-11 show a schematic implementation using two motors to cause translational and rotational movement of the lumen, respectively. [Figure 11] 10-11 show a schematic implementation using two motors to cause translational and rotational movement of the lumen, respectively. [Figure 12] FIG. 12 shows a schematic of another implementation using two motors, respectively, to cause translational and rotational movement of the lumen. [Figure 13] FIG. 13 illustrates a schematic implementation of converting translational movement into rotational movement. [Figure 14] FIG. 14 shows a schematic implementation in which a single motor is used to cause translational and rotational movement of the lumen. [Figure 15] FIG. 15 shows a control method for an electronically controlled actuator. DETAILED DESCRIPTION OF THE INVENTION

[0017] Various features and advantages of the systems, apparatus, and methods of the technology described herein will become more fully apparent from the following description of illustrative examples. These examples are intended to illustrate the principles of the disclosure, and the disclosure should not be limited to the merely illustrated examples. Features of the illustrated examples can be modified, combined, deleted, and / or substituted as would be apparent to one skilled in the art in light of the principles disclosed herein.

[0018] Transcatheter repair and native anatomy replacement procedures may require the use of complex catheter systems, dexterity to make fine adjustments to catheter control, and expert interpretation of fluoroscopy and / or echo imaging modalities to properly treat the patient. As additional functional demands are placed on catheter technology, new failure modes are likely to emerge. Mechanical systems are much more stable than the human hand and are capable of more precise and repeatable movements. Imaging software is currently being developed to create a better representation of the interaction between the catheter and the patient's anatomy using various imaging modalities. Systems that can operate catheter systems with these three points in mind will lead to safer, more repeatable, and more accurate procedures.

[0019] FIG. 1 illustrates a medical system including an electronically controlled actuator 100 and a catheter system 200 for use with a patient 1 positioned on a patient support 5. The electronically controlled actuator, or system 100, may include a frame 110. The frame 110 may extend along a longitudinal axis 101. The frame 110 may be supported by a base 105. The base 105 may rest on the floor, on the patient support 5, or on another structure. The base 105 may be movable and / or fixable in position relative to the patient support 5. The base 105 may position the frame 110 relative to the patient 1 for proper positioning of the catheter system 200.

[0020] The frame 110 can support multiple carriages 120 attached to the frame 110. The carriages 120 can be movable relative to the frame. For example, the carriages 120 can be movable along the frame 110 (e.g., the longitudinal axis 101). The carriages 120 can be aligned along the longitudinal axis 101. Each of the carriages 120 can include a slot or other mating feature configured to retain a lumen of a catheter. Each of the carriages can include a load cell for measuring a force associated with (e.g., applied to) each carriage.

[0021] Carriage drive system 130 may include actuators, motors, and / or other mechanisms for controlling the position of each of carriages 120 within frame 110. Each of carriages 120 may be independently movable relative to any of the other carriages or movable in subgroups (e.g., pairs) by drive system 130. Drive system 130 may include position sensors for tracking carriages 120 along frame 110 (e.g., along longitudinal axis 101). Drive system 130 may include limit switches and / or proximity switches for homing carriages 120 at positions along frame 110 (e.g., along longitudinal axis 101) and / or relative to other carriages.

[0022] The carriage drive system 130 may include a control system for adjusting the position of the carriage 120. The control system may include at least one computer-readable memory having executable instructions stored thereon and one or more processors in communication with the at least one computer-readable memory to execute the instructions. The executed instructions may receive input signals and generate at least one control signal based on the input signals. The input signals may include a set of instructions that adjust one or more positions of the carriage 120. The input signals may be transmitted manually, such as via a user interface 140 including one or more controls, or may be generated by an autonomous or semi-autonomous control algorithm. The user interface 140 may be local (e.g., on the base 105) or remote from the frame 110. The user interface 140 may communicate with the control system via wired or wireless communication.

[0023] The catheter system 200 can provide access to a work site within a body cavity for one or more instruments. Various types of catheter systems 200 are contemplated herein. In one embodiment, the catheter system 200 includes a deployable replacement heart valve, such as the delivery system described in U.S. Patent Publication No. 2019 / 0008640, the entire contents of which are incorporated herein by reference. The catheter system 200 can include a distal end (not shown) that can be attached to a handle distal end 201 and a proximal end 202. The distal end can be insertable into the vasculature of the patient 1 to access a remote work site, such as the patient's heart, through a transfemoral approach.

[0024] The catheter system 200 may include multiple lumens 250 extending between the distal end and the proximal end. As used herein, the term "lumen" may refer to a shaft, tube, or other physical structure having a lumen therein. The lumens 250 may be wrapped or nested together, meaning that a smaller lumen may be wrapped within a larger lumen, with all lumens having approximately the same length. In this manner, multiple lumens 250 may be wrapped or nested together as an assembly, allowing the lumens to move longitudinally relative to the other lumens. When each of the lumens 250 is held by one of the carriages 120 of the system 100, each of the lumens 250 can translate longitudinally independently. The lumens 250 may include an outer sheath assembly, a midshaft assembly, a rail assembly, and an inner shaft assembly. The lumens 250 may be actuated to deploy a prosthesis at a work site. The proximal end 202 of the catheter system 200 may include a handle for the lumens 250 and / or one or more control features. The proximal end 202 of the catheter system 200 may include a handle shell including one or more shell members. The shell members may completely or partially surround the control features. The shell members may be completely or partially removable to access the control features. The control features may include multiple adapters 260. Each of the adapters 260 may be attached to a lumen of the multiple lumens 250, such as through a guidewire. The adapters 260 may be coupled to a corresponding one of the carriages 120. In one embodiment, the adapters 260 may be received in a slot in the corresponding carriage 120. In another embodiment, the carriage 120 may include a clamp, a protrusion that engages with (e.g., inserts into) the respective adapter, or other coupling mechanism. Thus, adjusting the position of carriage 120 along frame 110 (eg, along axis 101 ) actuates attached bore 250 .

[0025] In certain implementations, an operator can interact with the system 100 and control the catheter system 200 through a user interface 140. The user interface 140 can include a selection interface for selecting one or more lumens 250 (e.g., individually or as a subgroup). The user interface 140 can include controls (e.g., controlled adjustment or manual adjustment) for adjusting the position of the selected one or more lumens 250.

[0026] The carriage drive system 130 can move the carriage 120 to one or more pre-programmed configurations. The pre-programmed configurations can correspond to initial and / or other operating positions of one or more control features of the catheter system 200. The initial configurations can be used to accommodate a variety of different catheter system designs or different medical procedures that may use different initial spacings for the adapter 260. The carriage drive system 130 can move the carriage 120 to a predetermined position based on input from an operator at the user interface 140. The user interface 140 can include a selection menu of various pre-programmed configurations of the system 100. The selection can be based on the type of catheter system and / or medical procedure.

[0027] System 100 may include automated controls for performing one or more steps of a medical procedure using catheter system 200. The steps of a medical procedure and the corresponding required movements of carriage 120 and lumen 250 may be preprogrammed into system 100. User interface 140 may include selections corresponding to each of the steps of the medical procedure. An operator can perform the steps of the medical procedure based on the selection of the appropriate sequence (e.g., step). Selection (e.g., execution) of a step can automatically move carriage 120 according to the preprogrammed movements and / or positions. For certain catheter systems, it may be important to release tension or compression on a first lumen for a first movement before applying tension or compression on a second lumen for a second movement to prevent malfunction of the catheter system. Thus, system 100 can automatically neutralize or return the drive lumen between or during steps of a medical procedure.

[0028] The system 100 and the automated procedural steps performed by the catheter system 200 may be based on the detected position of the catheter system 200. Imaging modalities can be used to provide images of the anatomical structures and the catheter system 200 during a successful medical procedure. Advances in imaging modalities continue to improve the resolution of such images. Software, including machine learning techniques, can be used to interpret these images and reliably recognize when the catheter system 200 is in the proper position for a procedural step or when the catheter system 200 is not in the proper position for a procedural step. This determination can be linked to the system 100 and / or provided to the operator. The operator, or the system 100, then has the opportunity to manually adjust the catheter system 200 or approve an automated adjustment. When implemented by the system 100, the process can provide a high level of accuracy and speed to the procedure. Desirably, the system 100 can be fully autonomous or allow the operator to accept recommended procedural moves.

[0029] The system 100 can measure a force feedback signal. The force feedback signal can be generated from a sensor, such as a load cell, mounted on the carriage 120, based on the current of a motor of the carriage drive system 130, and / or other means. The carriage drive system 130 can move the carriage 120 based on the force feedback signal in a manner that prevents one or more force thresholds of the system (e.g., the threshold for each particular lumen) from being exceeded. Optionally, the user interface 140 can include a warning that the system has prevented / exceeded any such threshold. Optionally, the user interface 140 can provide a manual override of one or more safety thresholds. In one embodiment, a load cell measures the force applied by a carriage of the plurality of carriages 120 to a lumen of the plurality of lumens 150. The load cell can be mounted on a first carriage and, when coupled with the carriage, contact an adapter of the plurality of adapters 260. The user interface 140 can display the force measured by the load cell and / or compare the force to an allowable force limit associated with the lumen. The user interface 140 can display the available range of motion of the lumens based on the force measured by the load cell and the allowable force limit. Optionally, the allowable force limit can be exceeded based on operator input. Having the ability to measure force live, move multiple lumens at once, and have full knowledge of where each lumen is relative to the others can advantageously enable additional features that are difficult to implement with conventional handle designs. For example, these features can be used to mitigate safety risks and procedural operations.

[0030] The carriage drive system 130 can move the carriage 120 based on limits on the translational speed of either the lumen or the carriage. Each lumen can have a target translation speed or a range of speeds (upper and lower speed limits). The target translation speed can vary depending on the step of the medical procedure being performed. The translational speed and / or force threshold can be based on fault testing of the catheter system. The translational speed and / or force threshold can be set to overcome any internal friction of the catheter system without overshooting the desired location. Irregularities such as imperfect operation or malfunctions such as binding of lumens within the catheter system during any step of the medical procedure can be detected using the force feedback signal. The range of force required to move any carriage for a given configuration of the catheter system can be known based on modeling and / or testing. Therefore, deviations from the expected range can be automatically recognized. Warnings can be provided to the operator through the user interface.

[0031] Fluid pressure sensors can also be implemented within electronically controlled actuator systems to provide information to an operator or control system during a procedure. Connecting tubing to a flush port that may be present on the catheter allows access to the pressure directly surrounding the catheter inside the body. One exemplary use case may be for heart valve replacement. The act of pinning the valve leaflets can result in a pressure drop that can be harmful to the patient. The fluid pressure sensor can provide feedback to the operator or automatically provide feedback to the motor to reverse or stop the catheter movement in a time-sensitive manner.

[0032] FIG. 2 shows further details of the system 100. The system 100 may include a frame 110 supported by a base 105. The base 105 may include a lower support 106. The lower support 106 may be configured to rest on a bed or floor. The base 105 may include an upper support 107 extending vertically upward from the lower support 106. A joint 144, or pivot mechanism, or other rotation mechanism may be disposed between the lower support 106 and the upper support 107. The joint 144 may be a general-purpose joint or the like, and may allow the upper support 107 to rotate, pivot, or bend in a direction 146 so that the catheter system 200 can tilt up and down. The joint 144 may also allow the upper support 107 to rotate in a direction 148 so that the catheter system 200 can move laterally. In this manner, the distal end of the catheter system 200 can be moved to precisely aim (e.g., accommodate an angle on a patient) at a work site within a body cavity to perform a medical or diagnostic procedure (e.g., a medical procedure described above) without moving the base 105. After adjustment, the joint 144 can be locked via a locking mechanism to prevent inadvertent movement of the catheter system 200 during a procedure. The upper support 107 can include first and second pivot controls 108, 109. The pivot controls 108, 109 can be pivotally coupled to a frame 110. The pivot controls 108, 109 can be aligned along the longitudinal axis 101. The pivot controls 108, 109 can rotate along a direction 152 to enable rotation of the frame 110 about the longitudinal axis 101 to control the rotational position of the catheter system 200 during a medical procedure. The upper support 107 may include a mounting location for a user interface 140 (or a portion thereof). The user interface 140 may include a display screen 141 and / or input / control devices 142.

[0033] The frame 110 may include a lid 111. The lid 111 may enclose a cavity that houses the carriage 120. The carriage 120 may include multiple carriages, e.g., first through seventh carriages 121-127, as shown in FIG. 2 . One or more of the carriages 120 may include a motor controller, e.g., first through seventh motor controllers 131a-137a, as described above. The motor controllers 131a-137a may be mounted on the carriages 121-127, respectively, and operable to move the carriages along the longitudinal axis 101. One or more of the carriages 120 may include a load cell, as described above. The load cell may be mounted on the carriages 121-127, respectively, and may be operable to measure a force applied to the catheter system 200 by the carriage.

[0034] FIG. 3 shows a partial perspective view of an electronically controlled actuator, or system 100a, as one implementation of the system 100. The system 100a may include a frame 310. A front wall of the frame 310 may include a cutout 310a that receives a portion of the catheter system 200 when assembled therewith. The system 100a may include a carriage 320. The carriage 320, such as the carriage 120 illustrated in FIG. 1, may be movable along the frame 310. The carriage 320 may include multiple carriages, e.g., first through eighth carriages 321 through 328. As can be seen in FIG. 3, the outer prongs of the carriages (e.g., 321, 322, 323, 326, 327, and 328) may be shaped (e.g., U-shaped) and configured to nest within adjacent carriages. Each carriage 320 may include a slot for receiving an adapter of the catheter system 200. For example, the first carriage 321 has a slot defined between side walls 321a, 321b for receiving an adapter. Each carriage 320 may include a carriage drive system motor, such as first through eighth motors 331-338. Each motor may include a pinion gear (e.g., gear 331a) that can mesh with a rack 330 extending along the frame 310 in the direction of movement. The carriage 320 can move along the rack 330 upon activation of the motor. One or more of the carriages 320 may include limit switches or proximity switches 331b for homing the carriage relative to the frame and / or other carriages. Each carriage 320 may include one or more mounts for securing ports, such as a flush port. Alternatively, or in addition to providing linear motion, one or more carriages may be included that provide different types of motion. In one embodiment, the carriages may include rotary drivers, as further described below. The rotational driver may be used to deploy and / or retract an elongated member such as a suture or tether.

[0035] 4-5 show partial perspective views of an electronically controlled actuator 100b as another implementation of system 100. System 100b may include a frame 410 including first and second side rails 411, 412. A carriage 420 may be mounted on and movable along rails 411, 412 by slots 421, 422, respectively. A motor 431 may be coupled to carriage 420. Motor 431 may engage rack 430 through pinion gear 431a in the manner described above for system 100a.

[0036] FIG. 6 illustrates an exemplary adapter 560, such as the adapter 260 of the catheter system 200 described in connection with FIG. 1 . The adapter 560 may include a body 563 that may be insertable into (e.g., within a slot in) a carriage. The slot in the carriage may open vertically (e.g., as shown in FIG. 3 ), and the adapter 560 may be inserted into the slot along the vertical direction. The adapter 560 may include protrusions 561, 562 extending from the body. The adapter 560 may be coupled (e.g., attached) to the lumen 250 of the catheter system 200 through a guidewire 565. The guidewire 565 may be attached to the body 563 through the slot and / or a plate 564. The body 563 may include an opening through which the lumen 550 of the catheter system 200 can pass. The lumen 550 may include multiple lumens that are wrapped or nested together, as described above. Of the multiple lumens 550, the lumen 250 may be the only one attached to the adapter 560. The protrusions 561, 562 may engage opposing walls of the carriage, allowing the system 100 to actuate the lumen 250 of the catheter system. In this manner, moving the carriage engaged with the adapter 560 moves the lumen 250 attached to the adapter 560. The shape of the adapter 560 may vary as long as there is sufficient material to mechanically secure the adapter to the carriage. The shape of the adapter 560 may be standardized for the catheter system to limit the number of unique nesting designs of the carriage. The catheter system 200 may include a handle shell at its proximal end. The handle shell may be permanent and allow the adapter to be secured to the actuator, platform, or system 100, 200, or the handle shell may be a temporary package that maintains the orientation of the lumen and adapter and is removed when the catheter system is placed within the actuator, platform, or system 100, 200. In this case, the adapter 560 may reside within the handle shell and couple to the bore 250, and the handle shell may include openings that allow the protrusions 561, 562 to pass through and engage the carriage.In other embodiments, the catheter system 200 does not have a handle shell.

[0037] 7-8 illustrate an electronically controlled actuator, or system 100c, as one implementation of system 100 and catheter system 200c. System 100c can include multiple carriages 620, including, for example, first through seventh carriages 621-627. Carriages such as carriage 120 shown in FIGS. 1-2 can be movable along support rails 675. Each carriage 620 can include a slot (e.g., slots 651-657) for receiving a corresponding adapter from multiple adapters 660 of catheter system 200c. Adapters 660 can include first through seventh adapters 661-667. Adapters 661-667 can be received or nested within the slots of corresponding carriages 621-627, which can be vertically open. Lateral protrusions 695 of adapters 660 can engage sides of the slots, allowing the carriage to apply force to catheter system 200c through the adapters. Alternatively, the catheter system 200c may have a handle including a shell to provide a gripping surface. The shell may be removed before the adapter 660 is coupled to the carriage 620. Alternatively, the shell is not included in the system 200c. The adapters 660 may each be coupled to a component of the catheter system 200c, such as one of a plurality of control features or lumens 650. The plurality of lumens 650 may include an outer shaft, a midshaft, a rail assembly, a primary flex, a secondary flex, an inner shaft, and / or a guidewire lumen, as described in U.S. Patent Publication No. 2019 / 0008640.

[0038] The carriages 620 may be mounted on support rails 675 and movable along their longitudinal axes. The carriages 620 may be attached to side rails 673 extending along the support rails 675. Bolts and nuts 674 may be used to selectively couple (e.g., attach) the carriages 620 to the side rails 673. The carriages 620 may be attached to the side rails 673 either singly or in groups. The carriages 620 may move along the support rails 675 by rotation of worm gears 672 controlled by a motor control system. The side rails 673 may be attached to the worm gears 672 by slides 671. Alternatively, each carriage 620 may include a motor for the carriage drive system. Each motor may include a pinion gear (not shown) that may mesh with a rack extending in the direction of carriage movement. The carriages 620 may move along the rack by actuation of the motor.

[0039] Each carriage 620 may include a load cell, such as load cells 631-637. The load cells 631-637 may form a "floating bridge" between the front plate 681 and the rear plate 682 on each carriage. Each load cell may be attached to both the front plate 681 and the rear plate 682. The front plate 681 and the rear plate 682 may also form slots that receive their respective adapters (e.g., their lateral protrusions). Thus, tension and / or compression applied by and through the carriage to the catheter system may be measured by the load cells 631-637. In some implementations, a treatment movement is performed (e.g., by turning a knob) to return the load of a particular lumen to zero. This may be performed as a best guess when balancing the load. Using load cells 631-637 implemented as described herein, one for each carriage, as shown in FIG. 8, returning the load to zero can be advantageously performed automatically and accurately. The front and / or rear plates 681, 682 may include one or more protruding rails 691. The protruding rails 691 may be oriented vertically along the insertion direction of the adapter. The adapter 660 may include alignment slots 692 that correspond to the size and position of the protruding rails 691.

[0040] FIG. 9 shows an electronically controlled actuator, or system 100d, and a handle 703 of a catheter system 200d as another implementation of system 100. Most catheter designs rely on a user-actuated slide or knob to move the catheter's lumen(s). For system 100d, the lumen may be actuated by a member, or nest 722, connected to a carriage 720 that is driven by an alternative to manual operation (e.g., electromechanical, hydraulic, pneumatic). The lumen of catheter system 200d may be attached to an adapter, such as adapter 560 shown in FIG. 6, that has a protrusion that protrudes from the shell of the catheter handle 703. The protrusion is fastened by a nest component 722 on the carriage 720, which is driven by a motor 721. The shell of the handle 703 is not necessary if there is sufficient support from the member that drives the lumen, but a basic handle shell may be desirable for preparation and insertion of the device into a patient.

[0041] FIG. 10 shows a schematic front view of two nests 810 coupled with a lumen 812. The two nests 810 may be part of a plurality of nests that engage with the lumen 812. Each of the nests 810 may be coupled with a carriage, similar to the coupled nest 722 and carriage 720 shown in FIG. 9, where the carriage 720 is part of the electronically controlled actuator 100d. The nest 810 may also be coupled to the carriage 120 of the electronically controlled actuator 100 shown in FIGS. 1 and 2, the carriage 320 of the electronically controlled actuator 100a shown in FIG. 3, the carriage 420 of the electronically controlled actuator 100b shown in FIGS. 4 and 5, or the carriage 620 of the electronically controlled actuator 200c shown in FIGS. 7 and 8. Each of the nests 810 shown in FIG. 10 engages or is engaged with a rack 814 attached to an individual lumen of the plurality of lumen 812. The coupling of each respective nest 810 to the rack 814 may be through an adapter (e.g., adapter 560 described above). Also shown in Figure 10 is that each nest 810 has gear teeth 820 for engaging a gear 822 actuated by a motor 824.

[0042] FIG. 11 shows a schematic perspective view of one of the nest-to-lumen engagements shown in FIG. 10 . A rack 814 can be seen attached to one of the lumens 812. The rack 814 is driven by a pinion gear 818, which is actuated by a motor 816. Rotation of the pinion gear 818 can translate the rack 814 about the longitudinal axis 815 of the lumen 812. As described in connection with FIG. 1 , this translational movement of the lumen-attached rack 814 can be independent of the translational movement of the other lumens. The implementation of the pinion gear 818 and rack 814 for translating the lumen is an alternative to the pinion gear 331 a and rack 330 engagement shown in FIG. 3 . Gear 822, in turn, can be actuated by motor 824 to rotate nest 810 in rotational direction 817 when the teeth of gear 824 engage with teeth 820 of nest 810. As constructed in FIG. 11 , nest 810 can rotate about longitudinal axis 815, causing lumen 812 to rotate as well. Each lumen can be locked in a rotational position through a locking or stop mechanism (not shown). In this manner, the implementation shown in FIGS. 10 and 11 can allow the lumens to independently translate along and rotationally about longitudinal axis 815. These translational and rotational movements of the lumens are independent of the movements of the other lumens of multiple lumens 812. Nest 810 is coupled to the carriage in a manner that allows translational and rotational movement of the lumen it carries.

[0043] Another embodiment for driving a lumen translationally and rotationally using two motors is shown in FIG. 12. Carriage 830 is coupled to gears for translational movement, as described above with respect to FIGS. 2, 3, 4, 7, and 9. As shown in FIG. 12, motor 836 is coupled to carriage 830. Motor 836 has a worm gear 838 mounted thereon that engages gear 844 mounted on lumen 832. Lumen 832 may be one of multiple lumens nested together. Lumen 832 is rotatably coupled to carriage 830 through adapter 834, which may be held in the correct gear-engagement position by a mechanism (not shown). Carriage 830 carries load cell 846 for measuring the force associated with lumen 832. As can be seen in FIG. 12, when motor 836 is actuated, worm gear 838 is driven, causing gear 844, and therefore lumen 832, to rotate. 12 can cause translational and rotational movement to the lumen 832. When movement stops, the rotational position of the lumen 832 can be locked by a retention mechanism (not shown).

[0044] The implementation of Figures 10-12 requires two motors 816, 824 to provide translational and rotational movement to the lumen. However, in some implementations, the number of motors can be reduced to one, reducing cost, increasing the compactness of the electronically controlled actuation system, and simplifying operation. Figure 13 illustrates such an implementation schematically. The lumen 852 is coupled to the nest 850 in a manner that allows the lumen 852 to translate with the nest 850 along a longitudinal axis 855 when the nest 850 is translated by a motor (not shown) such as those described above with respect to Figures 2, 3, 4, 7, and 9. The coupling of the lumen 852 to the nest 850 also allows the lumen 852 to rotate about the longitudinal axis 855. By a "clutch" action, the same motor can be engaged with a shaft 858 attached to a bevel gear 854. The engagement of bevel gears 854 , 856 can allow shaft 858 to transmit rotational movement to bevel gear 856 and thus to bore 852 .

[0045] An implementation of the bevel gear arrangement shown in FIG. 13 is shown schematically in FIG. 14. Motor 870 is attached to pinion gear 874 and bevel gear 862 via shaft 872. Pinion gear 874 engages rack 876, which may be attached to bore 877, as described above in FIGS. 10-11. In other embodiments, the attached bore may also be disposed parallel to rack 876. When motor 870 is actuated, rotation of shaft 872 causes pinion gear 874 to translate rack 876 in direction 878. This translational movement of rack 876 can correspondingly move attached bore 877. When rotational movement of the bore is required, the assembly of motor 870, pinion gear 874, and bevel gear 882 can be moved upward, for example, by a clutch, and bevel gear 882 engages another bevel gear 884 attached to shaft 886. Alternatively, pinion gear 874 can be disengaged from rack 876. In this case, actuation of motor 870 can cause bevel gears 882, 884 to transfer the rotational movement of shaft 872 to the rotational movement of shaft 886. The rotational movement of shaft 886 can cause lumen 877 to rotate (e.g., via gears or a belt / pulley mechanism).

[0046] In some embodiments, two or more lumens (e.g., two, three, four, five, or all of the lumens) can be controlled to move translationally and / or rotationally simultaneously and independently. This facilitates performing procedures that require simultaneous movement of two lumens. Additionally, simultaneous movement of lumens in opposite directions is difficult to implement with conventional handles but is facilitated in the disclosed embodiments. This movement of two lumens in opposite directions can be beneficial for eliminating undesirable instability (e.g., drift) at the distal end of the catheter system. Another item that is easier to implement with the setup of Figures 10-14 is independent clocking control of the lumens, as each of the lumens can rotate independently and be locked when rotational movement is stopped.

[0047] According to some embodiments, an independent accessory motor is included in (e.g., operatively and mechanically coupled to) the actuator or catheter system 100, 200. The independent accessory motor may be mounted in a stationary position or may be translatable, rotatable, and / or otherwise movable along the actuator platform or catheter system 100, 200 depending on the use case. In some implementations, an adapter is operatively and / or mechanically attached or otherwise coupled to the motor that allows the motor to interact with different catheter features, such as spooling / translating a suture or wire, torquing a member, or pinning a member. The actuator or catheter system 100, 200 may include a clamp or other mechanical feature for pinning or attachment (e.g., guidewire pinning).

[0048] According to some embodiments, the actuator platform, or catheter system 100, 200, can include an internal pump (e.g., a peristaltic pump) configured and adapted to irrigate and / or aspirate one or more lumens of the catheter system. In some embodiments, the pump is configured and adapted for inflation of one or more balloons associated with the catheter system. One or more ports on the pump may be accessible to facilitate exchange of saline, contrast, or aspirate, as desired or needed.

[0049] According to some embodiments, a sheath holder is provided to secure or hold the introducer, or sheath of the catheter system, in a desired area prior to the patient access point when the system 100, 200 performs its delivery steps. The sheath holder can be used to prevent the sheath from translating when the catheter (e.g., one or more internal lumens of the catheter system 200) translates.

[0050] FIG. 15 illustrates a method for controlling a medical system including an electronically controlled actuator system, such as system 100, and a catheter system, such as catheter system 200. The method can be utilized with a variety of different types of catheter systems to complete various types of medical procedures. In step 1005, the method can include positioning the electronically controlled actuator system of the medical system relative to a patient. The electronically controlled actuator system can include a base and a frame extending along a longitudinal axis. A carriage, or carriages, can be mounted with the frame and movable along the longitudinal axis relative to the frame. A carriage drive system can adjust the position of the carriage along the longitudinal axis to an initial configuration.

[0051] An incision may be made to access the patient's vasculature in step 1015. In one example, a transfemoral approach to the heart may be used.

[0052] The distal end of the catheter system may be advanced into the patient's vasculature in step 1025. The distal end may be advanced into or adjacent to an anatomical region of the patient to conduct a medical procedure.

[0053] In step 1035, the proximal end of the catheter system can be aligned with the electronically controlled actuator system. Optionally, the handle shell can be removed and / or an adapter can be attached to one or more lumens of the catheter system at the proximal end.

[0054] In step 1045, the adapter or adapters of the catheter system may be nested or otherwise coupled with the carriage(s). The adapters may be received within slots in the carriage.

[0055] In step 1055, the carriage drive system can receive at least one control signal. The control signal can be based on a user input at a user interface. The control signal can be based on a force feedback system of the actuator system (e.g., comparing a force signal measured by a load cell to an allowable force limit of the lumen). The control signal can also be based on an automated procedure. The automated procedure can be based on analysis of one or more images related to the position of the catheter system within the patient's anatomical region.

[0056] In step 1065, the actuator system can adjust the position of the carriage along the longitudinal axis of the frame. The adjustment can be based on at least one control signal. The adjustment can actuate one or more lumens of the catheter system to facilitate the medical procedure.

[0057] In some embodiments, specific anatomical or procedural dimensions, measurements, and / or maneuvers for a particular patient based on pre-screening or pre-planning may be pre-entered and entered into the actuator or control system prior to the procedure, and the electronically controlled actuator system 100 may be configured to automatically perform initial advancement and positioning operations (e.g., primary and secondary flex operations, depth and / or height translation operations) of one or more lumens of the catheter system (e.g., for a replacement heart valve delivery system, where the initial advancement and positioning operations can get the replacement heart valve into a desired general location within the heart). A clinical professional can then perform fine-tuning advancement and positioning operations.

[0058] Specific Terms Orientation terms used herein, such as "top," "bottom," "proximal," "distal," "longitudinal," "lateral," and "end," are used in the context of illustrative examples. However, the present disclosure should not be limited to the orientations shown. Indeed, other orientations are possible and within the scope of the present disclosure. It should be understood that terms related to circular shapes used herein, such as diameter or radius, do not require a perfectly circular structure, but rather should apply to any suitable structure having a cross-sectional area that can be measured side to side. In general, shape-related terms such as "circular," "cylindrical," "semicircular," or "semi-cylindrical," or any related or similar term, need not strictly conform to the mathematical definition of a circle, or cylinder, or other structure, but can include structures that are a reasonably close approximation.

[0059] Conditional language such as "may," "could," "could be," "could be," and the like, unless specifically stated otherwise or understood otherwise within the context in which it is used, is generally intended to convey that a particular example includes or does not include certain features, elements, and / or steps. Thus, such conditional language is not generally intended to imply that features, elements, and / or steps are in any way required with respect to one or more embodiments.

[0060] Conjunctive language such as the phrase "at least one of X, Y, and Z," unless specifically stated otherwise, is to be understood in conjunction with the context as being generally used to convey that an item, term, etc. can be either X, Y, or Z. Thus, such conjunctive language is not generally intended to imply the necessity of the presence of at least one X, at least one Y, and at least one Z in a particular embodiment.

[0061] As used herein, the terms "approximately," "about," and "substantially" refer to an amount close to the stated amount that still performs a desired function or achieves a desired result. For example, in some embodiments, as the context may indicate, the terms "approximately," "about," and "substantially" may refer to an amount that is within 10% or less of the stated amount. As used herein, the term "generally" refers to a value, amount, or characteristic that primarily includes or tends toward a particular value, amount, or characteristic. As an example, in certain embodiments, as the context may indicate, the term "generally parallel" may refer to deviations from strict parallelism by 20 degrees or less. All ranges include their endpoints.

[0062] summary Several exemplary embodiments of electronically controlled actuators have been disclosed. While the present disclosure has been described in terms of certain exemplary embodiments and uses, other embodiments and uses, including embodiments and uses that do not provide all of the features and advantages described herein, are within the scope of the present disclosure. Components, elements, features, operations, or steps may be arranged or implemented differently than described, and components, elements, features, operations, or steps may be combined, merged, added, or omitted in various embodiments. All possible combinations and subcombinations of the elements and components described herein are intended to be included in the present disclosure. No single feature or group of features is necessary or essential.

[0063] Certain features that are described in this disclosure in the context of separate implementations can also be implemented in combination in a single implementation. Conversely, various features that are described in the context of a single implementation can also be implemented in multiple implementations individually or in any suitable subcombination. Moreover, while features may be described above as functioning in a particular combination, in some cases, one or more features from a claimed combination can be excluded from that combination, and the combination may be claimed as a subcombination or as a variation of the subcombination.

[0064] Any portion of any of the steps, processes, structures, and / or apparatus disclosed or illustrated in one embodiment of the present disclosure may be combined or used in conjunction with (or in place of) any other portion of any of the steps, processes, structures, and / or apparatus disclosed or illustrated in a different embodiment or flow chart. The embodiments described herein are not intended to be discrete and separate from one another. Combinations, variations, and partial implementations of the disclosed features are within the scope of the present disclosure.

[0065] Although operations may be illustrated in the drawings or described in the specification in a particular order, such operations need not be performed in the particular order shown or in sequential order to achieve desirable results, and not all operations need be performed. Other operations not shown or described may be incorporated into the illustrated methods and processes. For example, one or more additional operations may be performed before, after, concurrently with, or between any of the described operations. Furthermore, operations may be rearranged or reordered in some implementations. Also, the separation of various components in the above-described implementations should not be understood as requiring such separation in all implementations, and it should be understood that the described components and systems may generally be integrated together in a single product or packaged into multiple products. Additionally, some implementations are within the scope of this disclosure.

[0066] Additionally, although exemplary embodiments are described, any embodiments having equivalent elements, modifications, omissions, and / or combinations are also within the scope of the present disclosure. Moreover, although certain aspects, advantages, and novel features have been described herein, not necessarily all such advantages may be achieved in accordance with any particular embodiment. For example, some embodiments within the scope of the present disclosure may achieve one advantage or a group of advantages as taught herein without necessarily achieving other advantages taught or suggested herein. Furthermore, some embodiments may achieve advantages different from those taught or suggested herein.

[0067] Several embodiments are described in connection with the accompanying drawings. While the figures are drawn and / or shown to scale, such scale is not limiting, as dimensions and proportions other than those shown are contemplated and are within the scope of the disclosed invention. Distances, angles, and the like are merely illustrative and do not necessarily bear a precise relationship to the actual dimensions and layout of the devices shown. Components can be added, removed, and / or rearranged. Furthermore, disclosure herein of any particular feature, aspect, method, property, attribute, quality, attribute, element, or the like, related to various examples can be used in all other embodiments described herein. Additionally, any method described herein can be practiced using any apparatus suitable for performing the described steps.

[0068] For purposes of summarizing the disclosure, certain aspects, advantages, and features of the invention are described herein. Not all advantages will necessarily be achieved, or even any such advantages, in accordance with any particular embodiment of the invention disclosed herein. No aspect of the disclosure is essential or required. In many embodiments, the devices, systems, and methods may be configured differently from that shown in the figures or described herein. For example, various functions provided by the illustrated modules may be combined, rearranged, added, or deleted. In some implementations, additional or different processors or modules may perform some or all of the functions shown in the figures and described with reference to the illustrated embodiments. Many implementation variations are possible. Any of the features, structures, steps, or processes disclosed herein may be included in any embodiment.

[0069] In summary, various embodiments of electronically controlled actuators and related methods are disclosed. The disclosure extends beyond the specifically disclosed embodiments to other alternative embodiments and / or other uses of the embodiments, as well as certain modifications and equivalents. Moreover, the disclosure expressly contemplates that various features and aspects of the disclosed embodiments can be combined with or substituted for one another. Accordingly, the scope of the disclosure should not be limited by the particular disclosed embodiments described above, but should be determined solely by a fair reading of the claims.

Claims

1. 1. A healthcare system comprising:

1. An electronically controlled actuator system, comprising: a frame extending along a longitudinal axis; a plurality of carriages attached to the frame and movable relative to the frame along the longitudinal axis; an electronically controlled actuator system including a carriage drive system configured to adjust the position of each of the plurality of carriages along the longitudinal axis based on at least one control signal; 1. A catheter system for providing access into a body cavity, comprising: a distal end; a proximal end; a plurality of lumens extending between the distal end and the proximal end; a plurality of adapters, each adapter attached to a lumen of the plurality of lumens; and a catheter system, wherein each of the adapters of the plurality of adapters is configured to be coupled to a corresponding carriage of the plurality of carriages such that adjusting the position of the corresponding carriage along the longitudinal axis actuates the attached lumen.

2. The medical system of claim 1 , wherein each of the plurality of carriages is independently movable along the longitudinal axis.

3. The medical system of claim 2 , wherein each of the plurality of carriages includes a nest coupled thereto, the nest configured to rotate about the longitudinal axis.

4. The medical system of claim 3 , wherein each of the nests is configured to independently rotate about the longitudinal axis.

5. 1. A control system comprising: at least one computer-readable memory having executable instructions stored thereon; one or more processors in communication with the at least one computer readable memory, the processors executing the instructions to provide the system with at least: receiving an input signal; and generating the at least one control signal based on the input signal.

6. The medical system of claim 5 , further comprising a user interface for providing the input signal.

7. The medical system of claim 6 , wherein the user interface is located remotely from the actuator system and in wired or wireless communication with the control system.

8. 10. The medical system of any preceding claim, wherein the multiple lumens of the catheter system include an outer sheath assembly, a midshaft assembly, a rail assembly, and an inner shaft assembly.

9. 7. The medical system of claim 6, further comprising a first load cell configured to measure a force applied by a first carriage of the plurality of carriages to a first lumen of the plurality of lumens.

10. 10. The medical system of claim 9, wherein the first load cell is mounted on the first carriage and contacts a first adapter of the plurality of adapters when coupled with the first load cell.

11. 10. The medical system of claim 9, further comprising a user interface configured to display the force measured by the first load cell relative to an allowable force limit associated with the first lumen.

12. 12. The medical system of claim 11, wherein the user interface is further configured to display an available range of motion of the first lumen based on the force measured by the first load cell and the allowable force limit.

13. Executing the instructions further comprises: receiving a force signal from the first load cell; generating the at least one control signal further based on a comparison of the force signal to the allowable force limit; 13. The medical system of claim 11 or claim 12, wherein the at least one control signal is configured to prevent the tolerable force limit from being exceeded.

14. 7. The medical system of claim 6, further comprising a load cell configured to measure a force applied to each lumen of the plurality of lumens by a corresponding carriage of the plurality of carriages.

15. 10. The medical system of any preceding claim, wherein the at least one control signal is configured to adjust the positions of at least two of the plurality of carriages as a first group along the longitudinal axis.

16. 10. The medical system of any preceding claim, wherein each of the carriages of the plurality of carriages includes a receiving slot configured to receive one of the plurality of adapters therein.

17. 17. The medical system of claim 16, wherein each of the plurality of adapters includes one or more lateral protrusions extending perpendicular to the longitudinal axis, and each of the receiving slots includes one or more upward protrusions configured to engage with the one or more lateral protrusions.

18. 10. The medical system of any preceding claim, wherein the proximal end of the catheter system includes a handle shell including one or more shell members.

19. The medical system of claim 18 , wherein the plurality of adapters project laterally outward from within the handle shell.

20. The medical system of claim 18 , wherein the handle shell is removable.

21. 10. The medical system of any preceding claim, wherein the frame is rotatable on an axis of rotation aligned parallel to or generally along the longitudinal axis.

22. 22. The medical system of claim 21, further comprising a first pivot mount connected to a first end of the frame and a second pivot mount connected to a second end of the frame, the first and second pivot mounts aligned along the axis of rotation.

23. 10. The medical system of any preceding claim, wherein the plurality of lumens are attached to the plurality of adapters by respective guidewires.

24. 10. The medical system of any preceding claim, further comprising a base, or table, including an upper surface configured to support the frame.

25. 25. The medical system of claim 24, further comprising a patient bed configured to support the base or table.

26. 10. The medical system of any preceding claim, wherein the frame comprises a pair of rails extending parallel to the longitudinal axis, the plurality of carriages being mounted on the pair of rails.

27. 10. The medical system of any preceding claim, wherein the carriage drive system comprises a motor for each of the plurality of carriages.

28. 28. The medical system of claim 27, wherein the carriage drive system comprises a rack mounted to the frame, and each of the motors includes a pinion gear meshed with the rack.

29. 10. A medical system according to any preceding claim, wherein each of the plurality of carriages includes a limit switch or proximity switch for homing the carriage relative to the frame.

30. 10. The medical system according to any of the preceding claims, wherein the catheter system can be any catheter system from a set of catheter systems that includes a plurality of universal adapters.

31. 31. The medical system of claim 30, wherein the plurality of carriages are reconfigurable to receive any catheter system from the set of catheter systems in an initial pre-programmed spacing configuration.

32. 10. The medical system of any preceding claim, wherein the at least one control signal is further based on an autonomous or semi-autonomous control algorithm.

33. 1. A method of controlling a medical system, comprising: positioning an electronically controlled actuator system of the medical system relative to a patient, the electronically controlled actuator system comprising: a frame extending along a longitudinal axis; a carriage attached to the frame and movable relative to the frame along the longitudinal axis; a carriage drive system configured to adjust the position of the carriage along the longitudinal axis; making an incision to access the patient's vasculature; inserting a distal end of a catheter system through the incision into the patient's vasculature and advancing the distal end through the vasculature into or adjacent to an anatomical region of the patient; aligning a proximal end of the catheter system with respect to the electronically controlled actuator system; coupling an adapter of the catheter system to the carriage; receiving at least one control signal at a control system of the electronically controlled actuator system; and adjusting a position of the carriage along the longitudinal axis based on at least one control signal, thereby actuating a lumen of the catheter system.

34. 34. The method of claim 33, further comprising receiving an input signal from a user interface and generating the at least one control signal based on the input signal.

35. 35. The method of claim 33 or 34, further comprising receiving a force signal from a load cell and generating the at least one control signal further based on the force signal.

36. 36. The method of claim 35, further comprising calculating an available range of motion of the lumen based on the force signal measured by the load cell and an allowable force limit of the lumen.

37. The method of any of claims 33 to 36, further comprising adjusting the position of the carriage to an initial pre-programmed position before coupling the adapter of the catheter system with the carriage.

38. The method of any of claims 33 to 37, wherein the catheter system comprises multiple lumens and multiple corresponding adapters, and the electronically controlled actuator system includes multiple carriages.

Images