# US 2021/0330355 A1 · Puncture device associated with medical assembly > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 2021/0330355 A1 - Document ID: US20210330355A1 - Status: Published application - Kind: A1 - Application number: 17/231,077 - Filed: 2021-04-15 - Published: 2021-10-28 - Earliest claimed: 2020-04-22 - Assignees: Baylis Medical Company Inc. - Applicants: Baylis Medical Company Inc. - Inventors: Jackie Leung; Eduardo Moriyama; Gareth Davies; Kaylie Lau - Web page: https://patentgrep.com/patent/US20210330355A1 ## CPC - A61B 17/3478: {Endoscopic needles, e.g. for infusion (biopsy needles A61B10/0233; catheters with injection needles A61M25/0067)} - A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)} - A61B 17/00: Surgical instruments, devices or methods (A61B18/00 takes precedence; dental tools A61C3/00; eye surgery A61F9/007; ear surgery A61F11/20) - A61B 17/06066: {Needles, e.g. needle tip configurations} - A61B 17/221: Gripping devices in the form of loops or baskets {for gripping calculi or similar types of obstructions (surgical snare instruments A61B17/32056)} - A61B 18/1206: {Generators therefor} - A61B 18/14: Probes or electrodes therefor - A61B 18/1477: {Needle-like probes} - A61B 18/1492: {having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence)} - A61B 2017/00017: {Electrical control of surgical instruments} - A61B 2017/00026: {Conductivity or impedance, e.g. of tissue} - A61B 2017/00243: {cardiac} - A61B 2017/00247: {Making holes in the wall of the heart, e.g. laser Myocardial revascularization} - A61B 2017/00296: {mounted on an endoscope} - A61B 2017/003: {Steerable} - A61B 2017/00318: {Steering mechanisms} - A61B 2017/00358: {Snares for grasping} - A61B 2017/00867: {shape memory effect} - A61B 2017/0237: {for heart surgery} - A61B 2017/06071: {with an abrupt angle formed between two adjacent sections} - A61B 2017/22044: {with a pointed tip} - A61B 2017/22097: {Valve removal in veins} - A61B 2017/2212: {having a closed distal end, e.g. a loop} - A61B 2017/2217: {single wire changing shape to a gripping configuration} - A61B 2018/00071: {Electrical conductivity} - A61B 2018/00184: {Moving parts} - A61B 2018/00273: {Anchoring means for temporary attachment of a device to tissue} - A61B 2018/00279: {deployable} - A61B 2018/00577: {Ablation} - A61B 2018/00601: {Cutting} - A61B 2018/1407: {Loop} - A61B 2018/1412: {Blade} - A61B 2018/1425: {Needle} - A61B 2018/1432: {curved} - A61B 2018/144: {Wire} - A61B 2018/1452: {including means for cutting (A61B2018/146 takes precedence)} - A61B 2018/1475: {Electrodes retractable in or deployable from a housing} - A61F 2/0022: {placed deep in the body opening (occluding blood vessels by internal devices A61B17/12022)} - A61F 2/24: Heart valves {; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body} - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - 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 An elongated medical assembly has a distal-assembly tip. The distal-assembly tip is, at least in part, selectively maneuverable along an assembly-tip movement path terminating proximate to a first biological feature of a biological structure of a patient. An elongated puncture device has a distal puncture tip. The distal puncture tip is, at least in part, selectively deployable along a puncture-tip movement path extending from the elongated medical assembly and into, at least in part, the first biological feature, and also extending from the first biological feature toward a second biological feature of the patient. ## Claims ### Claim 1 An apparatus, comprising: an elongated medical assembly having a distal-assembly tip being, at least in part, selectively maneuverable along an assembly-tip movement path terminating proximate to a first biological feature of a biological structure of a patient; and an elongated puncture device having a distal puncture tip being, at least in part, selectively deployable along a puncture-tip movement path extending from the elongated medical assembly and into, at least in part, the first biological feature, and then extending from the first biological feature toward a second biological feature of the patient, wherein said elongated puncture device is configured to form a puncture site extending through the second biological feature once the elongated puncture device is deployed, at least in part, along the puncture-tip movement path, and becomes located at the second biological feature. ### Claim 2 (depends on 1) The apparatus of claim 1, wherein: the elongated puncture device is selectively maneuverable from, and selectively retractable toward, the elongated medical assembly. ### Claim 3 (depends on 1) The apparatus of claim 1, wherein: the puncture-tip movement path is, at least in part, configured to be spatially aligned to face the assembly-tip movement path after deployment of the elongated puncture device. ### Claim 4 (depends on 1) The apparatus of claim 1, wherein: the puncture-tip movement path is, at least in part, spatially aligned to intersect the assembly-tip movement path. ### Claim 5 (depends on 1) The apparatus of claim 1, wherein: the assembly-tip movement path and the puncture-tip movement path intersect orthogonally with each other. ### Claim 6 (depends on 1) The apparatus of claim 1, wherein: the assembly-tip movement path and the puncture-tip movement path are configured to selectively intersect each other, with an obtuse angle being subtended between the assembly-tip movement path and the puncture-tip movement path. ### Claim 7 (depends on 1) The apparatus of claim 1, wherein: the assembly-tip movement path and the puncture-tip movement path are configured to selectively intersect each other, with an obtuse angle being subtended between the assembly-tip movement path and the puncture-tip movement path once the elongated puncture device, in use, is selectively maneuvered, at least in part, from an exit portal of the elongated medical assembly, and the distal puncture tip is selectively maneuvered, at least in part, along the puncture-tip movement path. ### Claim 8 (depends on 1) The apparatus of claim 1, wherein: a bent section is positioned along the elongated puncture device; and the bent section is configured to be inserted into the first biological feature. ### Claim 9 (depends on 1) The apparatus of claim 1, wherein: the elongated medical assembly includes an exit portal, in which the assembly-tip movement path is extendable, at least in part, from the exit portal; and the elongated puncture device is selectively maneuverable, at least in part, away from the exit portal of the elongated medical assembly. ### Claim 10 (depends on 1) The apparatus of claim 1, wherein: the elongated puncture device includes a radio frequency wire with a radio frequency electrode fixedly positioned at the distal puncture tip. ### Claim 11 (depends on 1) The apparatus of claim 1, wherein: the biological structure incudes the heart of the patient; and the first biological feature includes the right coronary artery of the heart; and the second biological feature includes a valve leaflet of the heart. ### Claim 12 (depends on 1) The apparatus of claim 1, wherein: the elongated medical assembly includes: a medical sheath assembly having a distal exit section leading to a lumen defined along, at least in part, a length of the medical sheath assembly; and the elongated puncture device is configured to be receivable in, and movable, along, at least in part, the lumen of the medical sheath assembly. ### Claim 13 (depends on 1) The apparatus of claim 1, wherein: the elongated puncture device is configured to provide a first elongated member extending along the right coronary artery once the elongated puncture device is deployed from the elongated medical assembly. ### Claim 14 (depends on 13) The apparatus of claim 13, wherein: the elongated puncture device is also configured to provide a second elongated member extending from the first elongated member located, at least in part, in the right coronary artery and toward the valve leaflet obstructing the right coronary artery, with the distal puncture tip extending from the second elongated member toward the valve leaflet in such a way that the distal puncture tip is positioned to puncture through the valve leaflet to form a puncture site through the valve leaflet. ### Claim 15 (depends on 13) The apparatus of claim 13, wherein: the distal puncture tip is positioned to be snared and pulled away from a puncture site that extends through the valve leaflet and toward the elongated medical assembly after the distal puncture tip is further maneuvered to protrude, at least in part, from the puncture site. ### Claim 16 (depends on 1) The apparatus of claim 1, wherein: the distal puncture tip is configured to protrude and extend, at least in part, beyond a puncture site, and is also configured to be maneuvered away from the puncture site. ### Claim 17 (depends on 1) The apparatus of claim 1, wherein: the distal puncture tip is configured to protrude and extend, at least in part, beyond a puncture site, and is also configured to be snared and pulled away from the puncture site by a tip-snare device, in which the tip-snare device is configured to be maneuvered proximate to the distal puncture tip in such a way that the tip-snare device, in use, snares and then moves the distal puncture tip. ### Claim 18 (depends on 1) The apparatus of claim 1, wherein: the elongated puncture device includes: a first cutting element positioned at the distal puncture tip, and the first cutting element being configured to form a puncture site through the second biological feature; and a second cutting element being spaced apart from the first cutting element, and the second cutting element being configured to form a laceration along, at least in part, the second biological feature starting from the puncture site after the first cutting element, in use, forms the puncture site through the second biological feature. ### Claim 19 An apparatus for an elongated medical assembly having a distal-assembly tip being, at least in part, selectively maneuverable along an assembly-tip movement path terminating proximate to a first biological feature of a biological structure of a patient, and the apparatus comprising: an elongated puncture device having a distal puncture tip; and the distal puncture tip being, at least in part, selectively deployable along a puncture-tip movement path extending from the elongated medical assembly and into, at least in part, the first biological feature, and then extending from the first biological feature toward a second biological feature of the patient. ### Claim 20 A method of operating an elongated medical assembly having a distal-assembly tip and an elongated puncture device having a distal puncture tip, the method comprising: selectively maneuvering, at least in part, the distal-assembly tip, of the elongated medical assembly, along an assembly-tip movement path terminating proximate to a first biological feature of a biological structure of a patient; and selectively deploying, at least in part, the distal puncture tip, of the elongated puncture device, along a puncture-tip movement path extending from the elongated medical assembly and into, at least in part, the first biological feature, and then extending from the first biological feature toward a second biological feature of the patient.