Sampling catheter devices, methods, and systems

Abstract

A sampling catheter encloses a sampling brush which can be selectively extended and retracted from and into the catheter assembly to allow insertion and movement of the catheter while presenting a smooth surface to the body lumen. The selective extension and retraction of the brush allows it to be withdrawn while limiting contamination by contact with tissue outside of the sampled region. The catheter may simultaneously or separately house a cutting tool for slice sampling tissue.

1 . A biopsy device, comprising:
 an elongate outer sheath with one or more distal ports at a distal end thereof;   an inner sheath with one or more ports alignable with the distal ports;   a brush enclosed within the inner sheath;   the inner sheath being movable relative to the outer sheath and the brush to permit bristles thereof to extend through the distal ports.   
     
     
         2 . The device of  claim 1 , wherein the inner sheath is rotatable and/or translatable within the outer sheath. 
     
     
         3 . The device of  claim 1 , wherein the inner or outer sheath has at least one cutting edge to permit tissue projecting into the ports to be sliced. 
     
     
         4 . The device of  claim 1 , wherein the inner sheath comprises a cutting portion at a distal end thereof, the brush and the inner sheath being configured such that each can be independently manipulated at a respective proximal end thereof. 
     
     
         5 . The device of  claim 1 , wherein:
 the inner sheath has a longitudinal axis extending from a proximal end to a distal end thereof,   the inner sheath comprises a cutting portion at the distal end thereof,   at least one of the ports of the inner sheath extends along and parallel to said longitudinal axis, and   the inner sheath is rotatable relative to the outer sheath such that when one of the distal ports of the outer sheath is aligned with a respective port of the inner sheath, the bristles of the brush can radially extend through the aligned outer sheath port and inner sheath port.   
     
     
         6 . A catheter, comprising:
 a catheter device having an outer sheath with a longitudinal aspect, generally cylindrical in shape, and presenting a smooth surface over an outer radius of said outer sheath;   the catheter device being configured such that bristles may be selectively directed from said catheter device at a distal end thereof such that at least some bristle tips extend to a radius greater than said outer sheath outer radius;   at least some of the bristles being positioned proximal of a distal end of the outer sheath such that the bristles receive mechanical support from the catheter device outer sheath;   the catheter device being configured such that the bristles may be selectively repositioned such that they are confined within the outer sheath outer radius;   the catheter device outer sheath having at least one opening, the catheter device having a cutting tool movable within the outer sheath to move across at least a portion of the at least one opening.   
     
     
         7 . The catheter of  claim 6 , wherein the catheter device outer sheath is sized to permit insertion in a human bile duct. 
     
     
         8 . The catheter of  claim 6 , wherein the catheter device outer sheath has an outer diameter of no more than 20 mm. 
     
     
         9 . The catheter of  claim 6 , wherein the cutting tool is movable axially within the outer sheath. 
     
     
         10 . The catheter of  claim 9 , wherein the bristles are supported on a shaft housed within the outer sheath and are selectively extendable through said at least one opening. 
     
     
         11 . The catheter of  claim 10 , wherein the bristles are attached to the cutting tool. 
     
     
         12 . The catheter of  claim 6 , wherein the bristles are supported on a shaft housed within the outer sheath and are selectively extendable through said at least one opening. 
     
     
         13 . The catheter of  claim 6 , further comprising an endoscope configured to support the catheter at a proximal end thereof and provide actuators for causing the selective repositioning of the bristles. 
     
     
         14 . A brush catheter, comprising:
 a brush on the end of a shaft;   an outer sheath encasing the brush and the shaft;   the shaft being movable between a brushing position and an insertion position;   the insertion position being such that the brush is entirely encased within the outer sheath such that the outer sheath presents a smooth outer surface for insertion in a body lumen;   the brushing position being such that bristles of the brush extend through one or more openings in the outer sheath;   wherein, in both the brushing and insertion positions, the brush remains proximal to a distal end of the outer sheath.   
     
     
         15 . The catheter of  claim 14 , further comprising a cutting tool, the cutting tool and brush being movable within the outer sheath such that they can switch places, whereby the cutting tool can be used for cutting tissue extending through the one or more openings and the brush can be used for brushing the body lumen into which the catheter is inserted without fully removing either from the outer sheath. 
     
     
         16 . The catheter of  claim 15 , wherein the brush is attached to the cutting tool. 
     
     
         17 . The catheter of  claim 16 , wherein:
 the cutting tool is selectively reconfigurable between a cutting configuration and a brushing configuration;   in the cutting configuration, the bristles are radially retracted; and   in the brushing configuration, the bristles are radially extended such that they can extend through the one or more openings.   
     
     
         18 . The catheter of  claim 15 , wherein the cutting tool is a cylindrical member attached to an inner sheath, within said outer sheath, that can be rotated or moved axially from a proximal end of the outer sheath to move a cutting edge of the cutting tool. 
     
     
         19 . The catheter of  claim 14 , wherein at least one of the one or more openings has a length that permits bristles of the brush to be moved axially in a brushing motion while extended therethrough. 
     
     
         20 . The catheter of  claim 14 , wherein the bristles are attached to the shaft which extends to a proximal end of the outer sheath and is enclosed within the sheath.