# US 11,998,238 B2 · Methods and devices for puncturing tissue > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 11,998,238 B2 - Document ID: US11998238B2 - Status: Granted - Kind: B2 - Application number: 17/474,415 - Filed: 2021-09-14 - Published: 2021-12-30 - Granted: 2024-06-04 - Earliest claimed: 2013-08-07 - Assignees: Boston Scientific Medical Device Limited - Applicants: Boston Scientific Medical Device Limited - Inventors: Gareth Davies; John Paul Urbanski; Ferryl Alley; Bogdan Beca - Web page: https://patentgrep.com/patent/US11998238B2 ## CPC - A61B 17/3478: {Endoscopic needles, e.g. for infusion (biopsy needles A61B10/0233; catheters with injection needles A61M25/0067)} - A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)} - A61B 90/39: {Markers, e.g. radio-opaque or breast lesions markers} - A61B 2017/00247: {Making holes in the wall of the heart, e.g. laser Myocardial revascularization} - A61B 2017/003: {Steerable} - A61B 2017/22042: {Details of the tip of the guide wire} - A61B 2017/22044: {with a pointed tip} - A61B 2017/3488: {Fixation to inner organ or inner body tissue} - A61B 2018/00351: {Heart} - A61B 2018/00363: {Epicardium} - A61B 2018/00601: {Cutting} - A61B 2018/144: {Wire} - A61B 2090/3966: {Radiopaque markers visible in an X-ray image} - A61M 25/0041: {pre-formed, e.g. specially adapted to fit with the anatomy of body channels (urethral catheters A61F2/04)} - A61M 25/09: Guide wires - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)} ## Abstract Novel and unique medical devices and associated methods are disclosed, for a medical device for puncturing tissue at a tissue site. The medical device is an elongate member having a proximal section, a distal section, and a rail section therebetween. The medical device includes an active tip at a distal end of the distal section and is operable to deliver energy to create a puncture through the tissue. The rail section is configured to both act as a rail for supporting installation of one or more tubular members thereupon, as well as be maneuverable for enabling access to the tissue site. ## Claims ### Claim 1 A medical device for puncturing tissue at a tissue site, the medical device comprising: an elongate member having a proximal section, a distal section, and a rail section between the proximal and distal sections; and, an active tip at a distal end of the distal section, the active tip operable to deliver energy to create a puncture through the tissue; and the rail section being configured to both act as a rail for supporting installation of one or more tubular members thereupon, as well as to be maneuverable for enabling access to the tissue site; wherein the distal section defines a distal section curved portion and a distal section straight portion, the distal section straight portion being distal to the distal section curved portion; and further wherein the distal section straight portion has a reverse taper with an outer diameter of the distal section straight portion increases in a distal direction, such that a distal end of the distal section straight portion has a diameter greater than a proximal end of the distal section straight portion. ### Claim 2 (depends on 1) The medical device of claim 1, wherein the distal section curved portion is configured to automatically form a distal coil in a deployed state for anchoring the distal section upon the distal section being advanced through the puncture. ### Claim 3 (depends on 2) The medical device of claim 2, wherein the coil is configured such that, upon deployment from a confined state, along an axis of advancement, the active tip curves away from the axis of advancement. ### Claim 4 (depends on 2) The medical device of claim 2, wherein the distal coil is configured as a double pigtail curve. ### Claim 5 (depends on 1) The medical device of claim 1, wherein the distal section straight portion has a length of about 3 mm to 10 mm. ### Claim 6 (depends on 1) The medical device of claim 1, wherein the elongate member comprises an electrically conductive guidewire. ### Claim 7 (depends on 6) The medical device of claim 6, wherein the electrically conductive guidewire is substantially covered by a layer of electrical insulation with a distal tip of the electrically conductive guidewire exposed. ### Claim 8 (depends on 7) The medical device of claim 7, wherein the electrically conductive guidewire further comprises an exposed portion on the proximal section, wherein the exposed portion allows for coupling to a source of electrical energy. ### Claim 9 (depends on 1) The medical device of claim 1, wherein the active tip is substantially atraumatic. ### Claim 10 (depends on 1) The medical device of claim 1, wherein the medical device further comprises a radiopaque marker positioned on the distal section. ### Claim 11 (depends on 10) The medical device of claim 10, wherein the radiopaque marker comprises a helical coil surrounding the elongate member at the distal section. ### Claim 12 (depends on 11) The medical device of claim 11, wherein the helical coil has a length of about 15 mm to about 100 mm. ### Claim 13 (depends on 1) The medical device of claim 1, wherein the active tip comprises an electrode. ### Claim 14 (depends on 13) The medical device of claim 13, wherein the electrode is dome shaped. ### Claim 15 (depends on 14) The medical device of claim 14, wherein the active tip further comprises a radiopaque marker band. ### Claim 16 (depends on 1) The medical device of claim 1, wherein the active tip is configured to deliver radiofrequency energy. ### Claim 17 (depends on 1) The medical device of claim 1, wherein the distal section defines a J-shaped distal section.