# US 10,245,072 B2 · Extravascular medical access tools having boring tip and methods of using such tools > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 10,245,072 B2 - Document ID: US10245072B2 - Status: Granted - Kind: B2 - Application number: 15/139,546 - Filed: 2016-04-27 - Published: 2017-01-12 - Granted: 2019-04-02 - Earliest claimed: 2015-07-10 - Assignees: Medtronic, Inc. - Applicants: Medtronic, Inc. - Inventors: Ronald A. Drake; Lester O. Stener; John A. Lange; Mitchell R. MacIver - Web page: https://patentgrep.com/patent/US10245072B2 ## CPC - A61B 17/3468: {for implanting or removing devices, e.g. prostheses, implants, seeds, wires (devices for implanting seeds A61M37/0069)} - A61B 17/1691: {for the sternum} - A61B 17/32002: {with continuously rotating, oscillating or reciprocating cutting instruments} - A61N 1/05: for implantation or insertion into the body, e.g. heart electrode (A61N1/06 takes precedence) - A61N 1/0504: {Subcutaneous electrodes} - A61B 18/14: Probes or electrodes therefor - A61B 2017/00243: {cardiac} - A61B 2017/0046: {with a releasable handle; with handle and operating part separable} - A61B 2017/320044: {Blunt dissectors} - A61B 2017/320056: {Tunnelers} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61N: ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY (measurement of bioelectric currents A61B; surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body A61B18/00; anaesthetic apparatus in general A61M; incandescent lamps H01K; infrared radiators for heating H05B) ## Abstract This disclosure describes various tools and associated methods suitable for gaining access to extravascular spaces. The various tools and associated methods utilize a boring tip that may rotate to aid in safely and effectively crossing diaphragmatic attachments. The boring tip may, in some instances not have any sharp edge. For example, the boring tip may have a dome shape but including at least one surface recessed and offset from a summit of the dome shape. Various mechanisms may be used to control rotation of the boring tip as described herein. ## Claims ### Claim 1 A tool for creating a sub-sternal tunnel in a patient, the tool comprising a handle and a tunneling assembly, the tunneling assembly comprising: a relatively rigid tubular member including a proximal portion and a distal portion, the proximal portion being attached to the handle such that the distal portion extends distally from the handle; an elongate inner member extending within the tubular member and comprising: a proximal portion protruding out from the proximal portion of the tubular member and being attached to the handle, the proximal portion of the inner member including an interface for receiving a force that rotates the inner member relative to the tubular member; and a boring tip without any sharp edge, the tip protruding out from the distal portion of the tubular member and generally conforming to a dome shape but including at least one surface recessed from the dome shape, each of the at least one surface being offset from a summit of the dome shape, the summit of the dome shape coinciding with a distal-most edge of the boring tip. ### Claim 2 (depends on 1) The tool of claim 1, wherein a distal-most segment of the distal portion of the tubular member of the tunneling assembly extends at an angle relative to the proximal portions of the tubular member and the inner member. ### Claim 3 (depends on 1) The tool of claim 1, wherein each of the at least one surface of the boring tip of the tunneling assembly has a concave curvature. ### Claim 4 (depends on 3) The tool of claim 3, wherein the at least one surface comprises three surfaces, and each surface has an elliptical perimeter. ### Claim 5 (depends on 1) The tool of claim 1, wherein each of the at least one surface of the boring tip of the tunneling assembly is relatively flat. ### Claim 6 (depends on 5) The tool of claim 5, wherein each of the at least one surface has a circular perimeter. ### Claim 7 (depends on 1) The tool of claim 1, wherein the handle comprises a lock-and-release mechanism by which the tunneling assembly is attached to the handle, the mechanism being operable to detach the handle from the tunneling assembly. ### Claim 8 (depends on 7) The tool of claim 7, wherein the proximal portion of the inner member of the tunneling assembly extends proximally from the interface of the proximal portion and from the handle. ### Claim 9 (depends on 1) The tool of claim 1, wherein the handle comprises a knob that interlocks with the interface of the proximal portion of the inner member of the tunneling assembly, the knob being configured for engagement by fingers of an adult hand to apply the force to the interface that rotates the inner member. ### Claim 10 (depends on 9) The tool of claim 9, wherein the handle includes a looped gripping portion extending laterally from the knob. ### Claim 11 (depends on 1) The tool of claim 1, wherein the handle comprises a relatively straight and longitudinally extending alignment horn spaced laterally apart from the tunneling assembly, and extending parallel to, and coplanar with the distal portion of the tunneling assembly tubular member. ### Claim 12 (depends on 11) The tool of claim 11, wherein the horn has a relatively flat profile. ### Claim 13 (depends on 11) The tool of claim 11, wherein the horn includes a radiopaque coil mounted therein, the coil extending longitudinally in the horn.