Patent Description:
Deflecting catheters, also referred to as steerable catheters are used in a variety of medical and non-medical procedures. In diagnostic and therapeutic medical procedures, a steerable catheter provides an operator (e.g., physician) with the ability to articulate the distal tip of the catheter in order to travel through constrained and/or tortuous anatomy, and/or to direct the distal catheter tip in a particular direction. Similar mechanisms are used in medical and nonmedical endoscopes to steer them to a target site and to orient a device portion (e.g., including a camera or other visualization means) in a desired direction.

In a typical design, control wires are manipulably attached at a proximal end of the device, and also attached at or near a distal end of the device. Such a configuration operates by manipulating one or more of the control wires to increase and/or decrease a generally longitudinal force on the distal device end that will deflect it in a desired direction. As described with reference to an existing steerable endoscopic camera device <NUM> of <FIG> , the control wires may be actuated by rotation of control wheels <NUM>, <NUM>. Each control wheel can be rotated to operate a control wire or pair of control wires in a manner exerting push/pull tension on a deflectable distal device portion (not shown, but well-known in the art) to deflect that portion along a first plane, while the other control wheel operates similarly to deflect that portion along a second plane intersecting (e.g., orthogonal to) the first plane. At times, it is desirable to lock that distal device portion into a particular deflected orientation (e.g., so that the operator may execute another task requiring releasing hand contact with one or both control wheels). The illustrated device <NUM> includes a first brake for the first control wheel <NUM>, with a twistable knob <NUM> for locking/unlocking an internal brake mechanism that operates along the central rotational axis of the first control wheel <NUM>. The illustrated device <NUM> includes a second brake for the second control wheel <NUM>, with a lever <NUM> for locking/unlocking an internal brake mechanism that operates by exerting a braking engagement along the central rotational axis of the second control wheel <NUM>. One or both brake controls <NUM>, <NUM> require a user to change his/her grip for actuation. Other examples of brake mechanisms are described and illustrated in, for example, <CIT>;<CIT>; <CIT>; <CIT>; <CIT>; <CIT>; and <CIT>.

It is be desirable to provide braking means that allow a user to "lock" into place the wire-operating elements within the control handle in a manner that will hold the distal end of the steerable catheter in a user-determined deflected or non-deflected orientation. Moreover, there is a need for such a braking means that is operable without a user needing to release other control elements of the steerable catheter, and which may simultaneously brake or even lock more than one control wheel/wire element to as to control (that is reduce or eliminate) deflection of the distal end portion through/along all planes. <CIT> describes an endoscope having bending mechanisms <NUM>, <NUM> for bending a bending part of the endoscope. The endoscope also has bending braking mechanisms <NUM>, <NUM> for applying braking to the bending operation mechanisms <NUM>, <NUM>, and a clicking mechanism <NUM>, <NUM> associated with the operation of the bending braking mechanisms <NUM>, <NUM> which can be locked.

The invention is set out in independent claims <NUM> and <NUM>.

In one aspect, embodiments disclosed herein may include a steerable catheter with a braking mechanism, where a frictionally-engaging braking element engages actuation/control spools of the steerable catheter in a lockable manner that will inhibit (up to and including preventing) movement of a distal end catheter portion out of a selected deflected conformation. The angle of force and the structures of the present embodiments differ from prior braking mechanisms including that the present embodiments use a brake-actuation axis that is orthogonal to (rather than coaxial or nearly coaxial with) a central rotational axis of control handles and spools of the steerable catheter.

In some embodiments of a steerable catheter with a braking mechanism, the steerable catheter includes a proximal handle body from which extends distally an elongate steerable catheter body with a deflectable distal catheter body end. The proximal handle body includes: at least a first control wheel in mechanical communication, via a first spool, with the distal catheter body end, where the at least a first control wheel and the first spool are rotatable around a common control wheel axis; a brake knob mounted rotatingly to the proximal handle body and configured to rotate around a brake knob axis that is non-coaxial with the control wheel axis; a brake arm in mechanical communication with the brake knob and disposed between the brake knob and the first spool, said brake arm including at least one spool-engagement surface; and ramped and planar handle body surfaces that complementarily interface with ramped and planar brake knob surfaces such that (i) in a first brake-actuation knob position the at least one spool-engagement surface does not contactingly engage the first spool, and (ii) in a second brake-actuation knob position the at least one spool-engagement surface does contactingly engage the first spool.

In another aspect, embodiments disclosed herein may include a steerable catheter with a brake mechanism that includes a knob mounted to a catheter handle body, said knob being rotatable (relative to the handle body) around a knob axis; where the catheter handle body includes at least one steering control spool rotatable around a spool axis that is orthogonal to the knob axis; a handle ramped surface separated from a handle stop-surface, where a handle-contacting knob surface is movable across the handle ramped surface and is not movable past the handle stop-surface; and a frictional braking element in mechanical communication (along the knob axis) with the knob, said braking element disposed adjacent the at least one spool and actuatable into and out of contact with a contact surface of the at least one spool upon rotation of the knob around the knob axis.

Various embodiments are described below with reference to the drawings in which like elements generally are referred to by like numerals. The relationship and functioning of the various elements of the embodiments may better be understood by reference to the following detailed description. However, embodiments are not limited to those illustrated in the drawings. It should be understood that the drawings are not necessarily to scale, and in certain instances details may have been omitted that are not necessary for an understanding of embodiments disclosed herein, such as - for example -conventional fabrication and assembly.

Generally, embodiments disclosed herein relate to a structure and system for securely attaching the proximal ends of control wires (including any kind of control fiber, regardless of construction material) to the control spool(s) of a steerable catheter. In the most preferred embodiments, the structure and system include means for tuning - that is finely adjusting - relative tension of each of those control wires between the proximal end and a permanently/securely attached distal control wire end attached more distally within the steerable device. Too much or too little tension in each of the control wires (on its own, and more particularly in relation to the other control wire(s)) can cause premature or otherwise undesired deflection of the steerable device and/or may cause the steerable device to operate in a manner that is not desired or predictable. During assembly of a steerable catheter device, the system can be used to take up slackness one or all control wires.

The invention is defined by the claims, may be embodied in many different forms, and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey enabling disclosure to those skilled in the art. As used in this specification and the claims, the singular forms "a," "an," and "the" include plural referents unless the context clearly dictates otherwise.

The terms "proximal" and "distal" are used herein in the common usage sense where they refer respectively to a handle/doctor-end of a device or related object and a tool/patient-end of a device or related object. The terms "about," "generally," "substantially," and other generalizing terms, when used with reference to any volume, dimension, proportion, or other quantitative value is intended to communicate a definite and identifiable value within the standard parameters and variations that would be understood by one of skill in the art, and should be interpreted to include at least any legal equivalents (same or substantially similar function, manner of operation, and result at the element and assembly levels), minor but functionally-insignificant variants, and encompassing a numerical range that includes at least mathematically significant figures (although not required to be as broad as the largest range thereof), as well as including physical embodiments that encompass normal variations in manufacturing tolerances.

The term "control wire" (including just "wire") is used herein to denote the elongate members that connect a control surface of a steerable catheter with a deflectable distal portion of the catheter, and it may include metallic, polymeric, and/or other materials including - by way of nonlimiting example - ultrahigh molecular weight polyethylene (UHMWPE) yarn (e.g., Dyneema™), aramid fibers, monofilament line, multifilament/multifilar cable, and/or other materials that preferably have high tensile strength with low longitudinal stretch so as to provide predictable operation behavior. Metallic control wires can include stainless steel, NiTi, and/or high carbon steel alloy "music wire". Various other polymers may also be used within the scope of the present disclosure. The wire shape may be round (circular or non-circular in transverse section), flat (including rectilinear or with flat surfaces in transverse section). With regard to the physical construction, it may also be braided and/or twisted and optionally may be fused along at least some lengthwise portions. Also, the wires can be coated: for example a low friction polymer coating may be used over a substrate (or as a construction material) in order to reduce dynamic friction within the device's wire lumen(s) so as to provide a more controlled, repeatable response to actuation than higher-friction materials. One preferred material includes UHMWPE braided fiber. With regard to distal attachment of the control wire(s), a multifilar, braided, or other structure is preferred, which may be at least partially frayed or otherwise partially disaggregated (e.g., in order to provide greater surface area than a unitary aggregated wire structure, as described further below).

One example of a control wire may include a 4x-<NUM> Denier ultrahigh tenacity polyethylene braid having a very small outer diameter of about <NUM> (measured in accordance with ASTM D-<NUM>); high strength (about <NUM>, and at least equal to or greater than <NUM>, measured in accordance with ASTM D-<NUM>); low longitudinal stretch/ elongation (about <NUM>%, ±<NUM>%, measured in accordance with ASTM D-<NUM>) (e.g., as available from Textile Development Associates Inc. of Brookfield, Conn. Certain preferred control wire embodiments include or may even consist of high modulus fiber material that is nonconductive and/or substantially nonstretching. In one embodiment, a high modulus fiber control wire material may be braided. One such high modulus fiber material can be a High Molecular Density Polyethylene, a melt spun liquid crystal polymer fiber rope, or a spun para-aramid fiber polymer, or a high strength ceramic fiber. In some embodiments, a high modulus fiber control wire material may have a tensile strength in a range of about <NUM> ksi (<NUM>,<NUM> MPa) to <NUM>,<NUM> ksi (<NUM>,<NUM> MPa), and/or a tensile modulus in the range of about <NUM>,<NUM> ksi (<NUM>,<NUM> MPa) to about <NUM>,<NUM> ksi (<NUM>,<NUM> MPa).

One embodiment of a steerable catheter device <NUM> is described with reference to <FIG>. The steerable catheter device <NUM> includes a proximal control handle body <NUM> with a steerable catheter body <NUM> extending distally therefrom (which may have a default straight linear configuration, and for which is illustrated only a deflected distal end terminal lengthwise portion). Various embodiments may include one or more different steering control means known in the art. This illustrated embodiment includes a pair of control wheels, with an outer control wheel <NUM> and an inner control wheel <NUM>. As set forth in greater detail below (including with reference to <FIG>), the outer control wheel <NUM> is disposed in mechanical communication with a pair of control wires that are operable, upon wheel rotation, to deflect at least the end portion <NUM> of the catheter body <NUM> along a first plane, and the inner control wheel <NUM> is disposed in mechanical communication with another pair of control wires that are operable, upon wheel rotation, to deflect the catheter body <NUM> along a second plane that may be generally orthogonal to the first plane, and is at least somewhat offset from that first plane. Simultaneous or sequential operation of the outer and inner wheels <NUM>, <NUM> preferably can deflect the distal end portion <NUM> of the catheter body <NUM> in any direction around a <NUM>-degree circle defined generally by a circumference of the catheter.

Steering mechanisms using control wires are well-known in the art including in <CIT> to Williams.

The overall control structure described is also well known in the steerable device art, including particularly the endoscope art, but those devices lack the currently disclosed finely-controlled mechanism for efficient and effective tensioning of control wires. Certain embodiments in keeping with the present disclosure may include at least one visualization element (as well as supporting hardware and/or software, not shown - but well-known in the art and readily understandable as using electrical and/or optical devices such as CCD, fiber optic, CMOS, etc.) for use of such embodiments as endoscopic devices including, for example, as a cholangioscope configured for use with and through a larger endoscope.

A sagittal (vertical plane) section view of <FIG> taken along line 2B-2B is shown in <FIG> to illustrate the physical arrangement of components, from which those of skill in the art will understand the structures and functions described herein. A partially disassembled view of the control handle portion of the steerable catheter device <NUM> is shown in <FIG>, where a portion of the body <NUM>, outer control wheel <NUM>, and the inner control wheel <NUM> are removed, and the spool assemblies therein are shown in more detail. The outer control wheel <NUM> engages a shaft <NUM> of, and controls rotation of, an outer spool <NUM> around a common central rotational axis (that preferably is orthogonal to the generally circular handle and spool). The outer spool <NUM> includes a circumferential groove <NUM> around its outer circumferential surface, which groove <NUM> receives a tube <NUM> through which extend the proximal end regions of opposed first and second control fibers <NUM>, <NUM>. The outer spool <NUM> includes two gear-mounting apertures 121a, 121b, each of which receives and forms a rotation-permitting engagement with the split mounting end <NUM> of a gear <NUM>. Each spool includes at least one face surface intersecting the spool axis (preferably having the major face congruent with a plane that is orthogonal to that spool rotational axis) and at least one circumferential surface that includes or is included by a contact surface that may frictionally be contacted by a brake mechanism.

The inner control wheel <NUM> engages a shaft <NUM> of, and controls rotation of, an inner spool <NUM>. The inner spool <NUM> includes a circumferential groove <NUM> around its outer circumferential surface, which groove <NUM> receives a tube <NUM> through which extend the proximal end regions of opposed third and fourth control fibers <NUM>, <NUM>. The proximal end terminus of each control wire (not shown) is secured to its respective spool. Those of skill in the art will appreciate that rotary actuation of the outer control wheel <NUM> effects corresponding rotary actuation of the outer spool <NUM>, while rotary actuation of the inner control wheel <NUM> effects corresponding rotary actuation of the outer spool <NUM>, and that respective distal attachments of each control fiber to/in the distal end lengthwise portion <NUM> of the catheter body <NUM> will provide for controllable deflection.

As shown in <FIG> and <FIG>, the outer spool shaft <NUM> extends through and beyond a central passage of the inner spool <NUM> and its shaft <NUM>. A brake assembly is also depicted, including a brake-actuation knob <NUM> with cap <NUM>, brake arm <NUM> including brake shoes <NUM> (which may be structurally and compositionally integral with or different than the rest of the arm),and a biasing element (illustrated here as a coil spring <NUM>), elements of which are shown in <FIG>. In both <FIG> and <FIG>, the illustrated brake assembly is shown as having two brake shoes <NUM> that serve as spool-engaging surfaces, where each one is shown in engaging contact with a respective one of the spools <NUM>, <NUM>. The biasing element <NUM> biases the brake arm <NUM> away from an inward-facing surface of the housing <NUM> toward/into this engaging contact, which preferably provides sufficient force to resist (up to and including to prevent) rotation of the spools relative to the brake arm <NUM> when fully engaged. More particularly, the spring (or other biasing element known or developed in the art) is selected and/or configured to exert a predetermined force when assembled. The contact shown is between the brake shoes <NUM> and an outer circumferential surface of the respective spools <NUM>, <NUM>. The axial direction of the biasing contact force preferably is at least substantially orthogonal to the central rotational axis of the spools <NUM>, <NUM> and control wheels <NUM>, <NUM>, and is not coaxial with that central rotational axis (being at least, or greater than, about <NUM>° off that central rotational axis).

In other embodiments, a single brake shoe, or an integrated same-material portion of the brake arm <NUM> may serve as the spool-engaging surface(s). In other embodiments, more or fewer elements may be used to contact and inhibit (up to and including preventing) movement of the spools by providing a predetermined force of the brake arm toward the spool - and preferably toward, and orthogonal with, the common rotational axis of the spool(s) and control wheel(s). This structure and functionality provides an operator of a steerable catheter to deflect the distal end portion to a desired conformation, then actuate the brake mechanism to inhibit spool movement and thereby hold that conformation while the operator frees up his/her hands to perform other tasks.

In the illustrated embodiment, a rotating knob <NUM> interfaces with the housing body <NUM> of the steerable catheter in order to actuate (that is, to engage and/or disengage) the brake mechanism relative to the spools. In this embodiment, the central rotational axis of the knob <NUM> is coaxial with the engagement/disengagement axis of the brake arm <NUM> and is orthogonal relative to the central rotational axis of the spools <NUM>, <NUM> and control wheels <NUM>, <NUM>. The brake mechanism is configured so that rotation of the knob <NUM> in a first direction advances the brake arm toward the spools, and rotation in a second/opposite direction retracts the brake arm away from the spools. In the illustrated embodiment, the coil spring <NUM> provides biasing force against the brake arm <NUM> toward the spools. The knob <NUM> is attached to the brake arm <NUM> in a manner allowing the knob to rotate around the brake arm, but providing for fixed attachment and connected movement of the brake arm together with the knob along the longitudinal axis of the brake arm away from the spools. This attachment may be effected by a threaded connector (<NUM> in <FIG>, disposed through a knob aperture <NUM>) or other means that preferably allow for adjustment/tuning during assembly (in coordination with the biasing means <NUM>, which may be a coil spring, leaf spring, or any other appropriate biasing means).

This operation for engagement/disengagement of the brake arm <NUM> with the spools is effected by a complementary interface between the underside of the knob <NUM> (shown in <FIG>) and a recessed portion of the handle body housing <NUM> (shown in <FIG>). As will be appreciated by those of skill in the art, these complementary surfaces are contoured and dimensioned to provide a path of motion that will selectably direct the brake arm into contact with, and retract the brake arm from contact with, the spools. Changes in the contours and/or dimensions may be used to increase or decrease the amount of force directed into full-contact engagement between the brake arm and the spools. In the illustrated embodiment, the contact provided by the complementary interface (described in more detail below) may be characterized as light contact, which is enhanced by the bias of the biasing element <NUM>.

The exact quantitative measurements of the frictional and other forces will vary depending upon the materials of the brake arm (including brake shoes, if present), the spools, the control wires, and the catheter body. However, those of skill in the art will be able to provide and fine-tune this mechanism with reference to the present disclosure. At the very least, locked-in engagement of the brake mechanism will hold the spools in place when they are oriented in a manner that deflects the catheter distal end portion <NUM>, resisting any implicit/natural tendency of the catheter or other elements to straighten the catheter body or otherwise move. In certain preferred embodiments, an operator may still rotate one or both control wheels <NUM>, <NUM> in a manner moving one or both spools - even while engaged with the brake - without damaging any components, but such an operation will require exerting greater force than operating the wheels and spools without the brake engaged. For example, this may allow a user to deflect the catheter, lock in the brake (e.g., as shown in <FIG>), direct a tool through a working channel of the catheter, then -with the brake engaged- move (e.g., "fine tune") the location of the deflected catheter end to a desired location. However, in preferred embodiments the locked-in deflected end will not move unless the operator actuates one or both control wheels with sufficient force to overcome the frictional engagement of the brake mechanism with the spool(s).

The brake mechanism's operation, including by complementary interaction of ramped surfaces, may be understood with reference to <FIG>, <FIG>, <FIG>, <FIG>, and <FIG>. The brake arm <NUM> shown in <FIG> includes a post 182a, a foot 182b, and the brake shoes <NUM>, where the illustrated embodiment shows the foot and shoes as being curved to conform in a matching complementary manner with the outer circumferential surface of the spools so as to fully frictionally engage therewith. The brake arm post 182a passes through a central opening <NUM> of the knob-receiving recess <NUM> and is received rotatably into the knob <NUM> so that movement of the knob along the post's longitudinal central axis will move the arm reciprocally along that axis (which is also the central rotational axis of the knob).

The recess <NUM> of the housing <NUM> includes an outer track, a channel <NUM>, and an inner annulus <NUM>, which allow transit interface therewith, respectively, of a camming tab <NUM>, a ring <NUM>, and an inner track within the ring. When the knob <NUM> is engaged into the recess <NUM>, the camming tab <NUM> rides along a ramped surface 166c and planar surface 166b of the outer track between end termini 166a, 166d. At the same time ramped and planar surfaces of the inner annulus <NUM> will complementarily engage ramped and planar surfaces of the knob's inner track. The inner annulus <NUM> includes radially-opposite lower planar surfaces 164w that are separated from higher planar surfaces 164y by intervening ramped surfaces 164x. This structure provides a stop-surface 164z that are shown as substantially or exactly perpendicular to the lower planar surfaces 164w. On the ring <NUM>, the inner track includes radially-opposite lower planar surfaces 194w that are separated from higher planar surfaces 194y by intervening ramped surfaces 194x. This structure provides a stop-surface 194z that are shown as substantially or exactly perpendicular to the lower planar surfaces 194w.

In a first, unlocked/unbraked, state, with the knob <NUM> in the position shown in <FIG>, the brake arm (including its brake shoe(s), if present) is not contacting the spools, so that the operator can freely rotate the control wheels and spools to deflect the catheter. An advantage of the present embodiments is also shown in <FIG>, where the operator can use a single finger to actuate/rotate the knob <NUM> without releasing or changing grip on the control wheels <NUM>, <NUM>. Stated differently, the knob is located and oriented to be reachable by a single digit of a user's hand, other digits of which are simultaneously operably grasping one or both control wheel(s). Internally, in the unlocked/ unbraked state, the camming tab <NUM> contacts both the housing's planar surface 166b and the unbraked terminal end 166a of the housing's outer track, where - in this position - the knob holds the attached brake arm away from the spools (where the knob's cap <NUM> is at its greatest distance from the housing <NUM>). This unbraked state is aided or at least complemented by the interaction of the opposed, but complementary engagement of ramped and planar surfaces of the knob's inner track with ramped and planar surfaces of the housing's inner annulus. Specifically, the knob's higher planar surfaces 194y contact the inner annulus higher surfaces 164y. An externally visible portion of the housing may include visual indicia (e.g., showing an image and/or wording for unbraked/unlocked) corresponding to the position of the exterior knob tab <NUM> in this unbraked state.

In a second, locked/braked, state, with the knob <NUM> in the position shown in <FIG>, the brake arm (including its brake shoe(s), if present) is contacting the spools in the manner shown in <FIG>, so that the control wheels and spools are held in place and a deflected position of the catheter is retained without the operator having to hold one or both control wheels in place. Internally, in the locked/braked state, the camming tab <NUM> contacts both the housing's ramped surface 166c and the braked terminal end 166d of the housing's outer track. In this position, the knob <NUM> moves the attached brake arm <NUM> toward the spools (so that the knob's cap <NUM> is at its nearest distance from the housing <NUM>, and the biasing means <NUM> operates to press/bias the brake arm toward/against the spool(s)). This braked state is aided or at least complemented by the interaction of the opposed, but complementary engagement of ramped and planar surfaces of the knob's inner track with ramped and planar surfaces of the housing's inner annulus. Specifically, the knob's higher planar surfaces 194y contact the inner annulus lower planar surfaces 164w. An externally visible portion of the housing may include visual indicia (e.g., showing an image and/or wording for braked/locked) corresponding to the position of the exterior knob tab <NUM> in this braked state, where <FIG> shows - by way of nonlimiting example - an iconographic image of a closed lock that is aligned with the outer knob tab <NUM> in <FIG>, and the locked/unlocked icons 187p/187q in <FIG>.

The combination of contact between the knob <NUM> and housing recess <NUM> with the biasing means <NUM> may also provide, in certain embodiment, tactile and/or auditory feedback for braking/locking engagement and/or for unbraking/unlocking disengagement. For example, as an operator actuates the knob <NUM> by rotation from the position shown in <FIG> to the position shown in <FIG>, the operator may feel and/or hear a "click" as the tab <NUM> moves into seated contact against the braked terminal end 166d of the housing's outer track. Similarly, when an operator disengages the brake mechanism by rotating the knob <NUM> from the position shown in <FIG> to the position shown in <FIG>, the operator may feel and/or hear a "click" as the tab <NUM> moves into seated contact against the unbraked terminal end 166a of the housing's outer track. One or more of the visual, tactile, and auditory indicia will provide an operator with increased confidence and security regarding the operative state of the distal catheter end portion <NUM> (e.g., whether it is freely moving/deflectable, or is substantially locked into a particular conformation). As noted above, being substantially locked into place by frictional contact of the brake arm with the spool(s) may still -in some embodiments- permit an operator to exert extra force and still move the control wheels in a limited manner that may be used to fine-tune position/conformation of the distal catheter end portion <NUM>.

With regard to particular construction materials those of skill in the art, when informed by the present disclosure, will appreciate that many variant options are possible for exact dimensions and construction materials of the brake arm, biasing means, brake shoe(s)(if present), spool outer circumferential surfaces, etc. An effective brake mechanism assembly according to the presently disclosed inventive embodiments will provide a combination of normal force and dynamic friction that offer the braking functionality described herein. In one embodiment, the brake arm <NUM> may be constructed of polycarbonate, and the brake shoe(s) <NUM> may be constructed of an elastic high-friction moldable polymer (e.g., Versaflex™ OM 1040X, available from PolyOne of Avon Lake, Ohio). The spools contacted by the brake shoe(s) may be made of HOPE (highdensity polyethylene) or nylon (e.g., Hylon™ 1000N), which will provide good braking contact as well as provide the mechanical strength and other properties needed for fine control of the control wires. The surface of the spool(s) and/or brake shoe(s) may also be textured to enhance frictional contact.

Claim 1:
A steerable catheter (<NUM>) with braking mechanism, the steerable catheter comprising:
a proximal handle body (<NUM>) from which extends distally an elongate steerable catheter body (<NUM>) including a deflectable distal catheter body end;
where the proximal handle body includes:
at least a first control wheel (<NUM>) in mechanical communication, via a first spool (<NUM>), with the distal catheter body end, where the at least a first control wheel and the first spool are rotatable around a common control wheel axis;
a brake knob (<NUM>) mounted rotatingly to the proximal handle body and configured to rotate around a brake knob axis that is orthogonal to the control wheel axis;
a brake arm (<NUM>) in mechanical communication with the brake knob and disposed between the brake knob and the first spool, said brake arm including at least one spool-engagement surface (<NUM>); and
ramped and planar handle body surfaces (164w-y, 166b-c) that complementarily interface with ramped and planar brake knob surfaces (194w-y) such that
in a first brake-actuation knob position the at least one spool-engagement surface does not contactingly engage the first spool, and
in a second brake-actuation knob position the at least one spool-engagement surface does contactingly engage the first spool.