# US 12,178,973 B2 · Apparatus for the introduction and manipulation of multiple telescoping catheters > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 12,178,973 B2 - Document ID: US12178973B2 - Status: Granted - Kind: B2 - Application number: 17/992,427 - Filed: 2022-11-22 - Published: 2023-03-16 - Granted: 2024-12-31 - Earliest claimed: 2016-11-07 - Assignees: Edwards Lifesciences Corporation - Applicants: Edwards Lifesciences Corporation - Inventors: Matthew T. Winston; Christopher J. Olson; Asher L. Metchik; Tri D. Tran; Alexander J. Siegel - Web page: https://patentgrep.com/patent/US12178973B2 ## CPC - A61M 25/0147: {with movable mechanical means, e.g. pull wires} - A61F 2/2427: {Devices for manipulating or deploying heart valves during implantation} - A61F 2/2436: {Deployment by retracting a sheath} - A61M 25/0052: {Localized reinforcement, e.g. where only a specific part of the catheter is reinforced, for rapid exchange guidewire port} - A61M 25/0133: {Tip steering devices} - A61M 25/0662: {Guide tubes} - A61F 2/2433: {using balloon catheter} - A61M 25/005: {with embedded materials for reinforcement, e.g. wires, coils, braids} - A61M 2025/0059: {having means for preventing the catheter, sheath or lumens from collapsing due to outer forces, e.g. compressing forces, or caused by twisting or kinking} - A61M 2025/015: {Details of the distal fixation of the movable mechanical means} - 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)} - A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C) ## Abstract A delivery apparatus includes a steerable guide sheath. The steerable guide sheath has a steerable portion, a pull ring located in the distal portion, and a pull wire coupled at one end to the pull ring and coupled at the opposite end to a control handle. The pull wire extends longitudinally through a pull-wire conduit. The steerable guide sheath further includes a compression-resistance portion made of metal and located in the distal portion. ## Claims ### Claim 1 A steerable guide sheath, comprising: a steerable portion configured to flex and unflex to adjust the curvature of a distal portion of the guide sheath; a pull ring located in the distal portion; a first pull wire coupled at one end to the pull ring and coupled at the opposite end to a control handle, wherein the first pull wire extends longitudinally through a first pull-wire conduit; and a compression-resistance portion made of metal and located in the distal portion. ### Claim 2 (depends on 1) The steerable guide sheath of claim 1, wherein the metal is stainless steel, titanium, nickel titanium alloy, or cobalt chromium. ### Claim 3 (depends on 1) The steerable guide sheath of claim 1, further comprising an adjustment knob located on the control handle, wherein rotating the adjustment knob applies a pulling force on the first pull wire to cause the steerable portion to bend. ### Claim 4 (depends on 1) The steerable guide sheath of claim 1, wherein the compression resistance portion is disposed opposite the first pull wire conduit. ### Claim 5 (depends on 1) The steerable guide sheath of claim 1, wherein the compression resistance portion has a thickness less than a thickness of the distal portion. ### Claim 6 (depends on 1) The steerable guide sheath of claim 1, further comprising a second pull wire coupled at one end to the pull ring and coupled at the opposite end to the control handle, wherein the second pull wire extends longitudinally through a second pull-wire conduit. ### Claim 7 (depends on 6) The steerable guide sheath of claim 6, wherein a plane bisecting the distal portion and passing between the first and second pull-wire conduit bisects the compression-resistance portion. ### Claim 8 (depends on 1) The steerable guide sheath of claim 1, further comprising an atraumatic tip portion located distally of the steerable portion. ### Claim 9 A delivery apparatus for a prosthetic device, comprising: a steerable guide sheath; a steerable catheter disposed within the guide sheath; an implant catheter coaxially disposed within the steerable catheter, wherein the prosthetic device is mounted on a distal end of the implant catheter; wherein the steerable guide sheath comprises: a steerable portion configured to flex and unflex to adjust the curvature of a distal portion of the guide sheath; a pull ring located in the distal portion; a first pull wire coupled at one end to the pull ring and coupled at the opposite end to a control handle, wherein the first pull wire extends longitudinally through a first pull-wire conduit; and a compression-resistance portion made of metal and located in the distal portion. ### Claim 10 (depends on 9) The delivery apparatus of claim 9, wherein the metal is stainless steel, titanium, nickel titanium alloy, or cobalt chromium. ### Claim 11 (depends on 9) The delivery apparatus of claim 9, further comprising an adjustment knob located on the control handle, wherein rotating the adjustment knob applies a pulling force on the first pull wire to cause the steerable portion to bend. ### Claim 12 (depends on 9) The delivery apparatus of claim 9, wherein the compression resistance portion is disposed opposite the first pull wire conduit. ### Claim 13 (depends on 9) The delivery apparatus of claim 9, wherein the compression resistance portion has a thickness less than a thickness of the distal portion. ### Claim 14 (depends on 9) The delivery apparatus of claim 9, further comprising a second pull wire coupled at one end to the pull ring and coupled at the opposite end to the control handle, wherein the second pull wire extends longitudinally through a second pull-wire conduit. ### Claim 15 (depends on 14) The delivery apparatus of claim 14, wherein a plane bisecting the distal portion and passing between the first and second pull-wire conduit bisects the compression-resistance portion. ### Claim 16 (depends on 9) The delivery apparatus of claim 9, further comprising an atraumatic tip portion located distally of the steerable portion. ### Claim 17 A steerable guide sheath, comprising: a steerable portion configured to flex and unflex to adjust the curvature of a distal portion of the guide sheath; a pull ring located in the distal portion; a first pull wire coupled at one end to the pull ring and coupled at the opposite end to an adjustment knob located on a control handle, wherein the first pull wire extends longitudinally through a first pull-wire conduit; a second pull wire coupled at one end to the pull ring and coupled at the opposite end to the adjustment knob, wherein the second pull wire extends longitudinally through a second pull-wire conduit; and a compression-resistance portion made of metal and located in the distal portion opposite the first and second pull wire conduits, wherein a plane bisecting the distal portion and passing between the first and second pull-wire conduit bisects the compression-resistance portion. ### Claim 18 (depends on 17) The steerable guide sheath of claim 17, wherein the metal is stainless steel, titanium, nickel titanium alloy, or cobalt chromium. ### Claim 19 (depends on 17) The steerable guide sheath of claim 17, wherein the compression resistance portion has a thickness less than a thickness of the distal portion. ### Claim 20 (depends on 17) The steerable guide sheath of claim 17, further comprising an atraumatic tip portion located distally of the steerable portion.