Embodiments of this disclosure relate to systems, devices, and apparatuses for providing electrical circuits, leads, and/or electrodes on medical devices configured for stimulation of a body. Embodiments of this disclosure generally relate to medical devices (including systems) for the stimulation of nerves and/or muscles, including a flexible circuitry construction for use during the stimulation of muscles and/or nerves. In embodiments, systems may restore, enhance, and/or modulate diminished neurophysiological functions using electrical stimulation. Some embodiments provide a flexible layer disposed over a medical device for positioning electrodes external of the device and adjacent to one or more target nerves during a procedure.
Critical care patients, particularly those requiring invasive mechanical ventilation (MV), may generally experience higher levels of diaphragm, lung, brain, heart, and/or other organ injury. The respiratory muscles (e.g., diaphragm, sternocleidomastoid, scalenes, pectoralis minor, external intercostals, internal intercostals, abdominals, quadratus, etc.) may rapidly lose mass and strength during MV. A patient's lungs may suffer from ventilator-induced trauma, including high and low pressure injuries. Cognitive effects of MV may be caused by several factors, including aberrant neuro-signaling and inflammatory responses. Limiting a duration for which patients are subjected to MV may contribute toward minimizing such negative side effects. However, rapid respiratory muscle atrophy in MV patients makes it challenging to transition patients away from a dependency on MV. Options may be limited for strengthening the respiratory muscles of critical care patients, particularly for those that are on MV, so that they may regain an ability to breathe without external respiratory support.
Embodiments of the present disclosure relate to, among other things, systems, devices, and methods for applying stimulation to one or more anatomical targets. Embodiments of flexible circuitry apparatuses for the systems and devices described herein may be used with MV, such as, for example, stimulation of respiratory nerves and/or respiratory muscles. Each of the embodiments disclosed herein may include one or more of the features described in connection with any of the other disclosed embodiments.
In one example, a medical device may include a flexible body having a proximal end and a distal end and an electrode positioned on the body proximate the distal end. The electrode is configured to provide an electrical charge for stimulating tissue. The medical device may include an electrical connection positioned on the body proximate the proximal end. The electrical connection is configured to electrically couple the electrode to a power source. The medical device may include an electrical lead connecting the electrode to the electrical connection, wherein the lead is on or in the flexible body. The body is configured to have a first configuration prior to being secured to an exterior of a tube and a second configuration having a shape that conforms to a profile of the tube with the electrode secured to an exterior of the tube
Any of the systems or methods disclosed herein may include any of the following features. The medical device may include the tube. The flexible body is helically wound about the exterior of the tube in a plurality of winds, to achieve the second configuration. The medical device may include the tube, and securing the flexible body about the exterior of the tube causes the tube to have regions of varying flexibility at locations of the tube having the flexible body. The flexible body includes a dielectric substrate film disposed between the electrode and the electrical lead. The flexible body further includes a hole through the dielectric substrate film, and the hole is filled with a conductive material electrically connecting the electrode to the electrical lead. The medical device includes a sensor, an electronic chip, or an integrated circuit disposed within the dielectric substrate film and between the electrode and the electrical lead. The flexible body, in the first configuration, includes at least one segment having an enlarged width relative to an adjacent portion of the flexible body, wherein the at least one segment is less flexible than the adjacent portion of the flexible body. The flexible body, in the first configuration, includes at least one segment having a nonlinear configuration adjacent to a portion of the flexible body having a linear configuration, wherein the at least one segment is more flexible than the portion. The medical device includes the tube. The flexible body, in the first configuration, includes at least one bend between the proximal end and the distal end such that a longitudinal axis of a proximal portion proximal to the bend is transverse to a longitudinal axis of a distal portion distal to the bend. A flexibility of a segment of the medical device having the proximal portion differs from a flexibility of a segment of the medical device having the distal portion, due to the arrangements of the proximal and distal portions on the tube. The at least one bend causes a change in direction of a helical wind of the flexible body about the tube, when the flexible body is on the second configuration. The flexible body includes at least one segment having a stiffening structure that is configured to increase a stiffness of the flexible body relative to an adjacent portion of the flexible body. The flexible body includes at least one segment at the distal end having a plurality of branches, wherein each of the plurality of branches includes an array of electrodes. The at least one segment is angled relative to the proximal end such that such that a longitudinal axis of the plurality of branches is transverse to a longitudinal axis of the flexible body. The flexible body includes a second segment proximal of the distal end and having a plurality of second branches, wherein each of the plurality of second branches includes a second array of electrodes.
In another example, a medical device may include a tube having a longitudinal length and at least one lumen. The tube is configured to receive at least one of a device and a fluid in the at least one lumen. The medical device may include a flexible body having a stimulation array configured to provide an electrical charge for stimulating tissue. The flexible body includes a proximal portion and a distal portion separated from the proximal portion by at least one bend. The flexible body is configured to cover at least a portion of the longitudinal length of the tube such that the stimulation array is disposed about an exterior of the tubular body. The at least one bend is configured to arrange one of the proximal portion and the distal portion in a linear configuration and the other of the proximal portion and the distal portion in a nonlinear configuration relative to the tube, when the flexible body is wound about the exterior of the tube.
Any of the systems or methods disclosed herein may include any of the following features. The stimulation array includes a distal electrode array positioned on the flexible body proximate to the distal portion. The distal electrode array is configured to provide the electrical charge for stimulating tissue at a first location. The stimulation array includes a proximal electrode array positioned on the flexible body proximate to the proximal portion. The proximal electrode array is configured to provide the electrical charge for stimulating tissue at a second location that is different than the first location. The stimulation array includes an electrical connection positioned on the flexible body proximate to the proximal portion and configured to electrically couple the distal electrode array and the proximal electrode array to a power source. The at least one bend causes a change in direction of a helical wind of the flexible body about the tube, and a longitudinal axis of the proximal portion proximal to the at least one bend is transverse to a longitudinal axis of the distal portion distal to the at least one bend. A flexibility of a portion of the medical device having the proximal portion differs from a flexibility of a portion of the medical device having the distal portion, due to the arrangements of the proximal portion and distal portion on the tube.
In another example, a medical device may include a tube and a circuit having a flexible body including a proximal portion and a distal portion that is angled relative to the proximal portion. The distal portion having a plurality of branches each including an array of electrodes configured to provide an electrical charge for stimulating tissue. The flexible body is configured to engage the tube with the proximal portion disposed over the tube in a helical configuration, and the distal portion is disposed over the tube in a linear configuration, such that the plurality of branches is arranged substantially parallel to a longitudinal axis of the tube.
Any of the systems or methods disclosed herein may include any of the following features. The plurality of branches are positioned about a circumference of the tube at spaced intervals. The circuit is configured to modify a flexibility of the tube when the flexible body engages the tube, with the flexibility varying between a segment of the tube having the proximal portion and a segment of the tube having the distal portion.
It may be understood that both the foregoing general description and the following detail description are exemplary and explanatory only and are not restriction of the invention, as claimed.
The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate non-limiting embodiments of the present disclosure and together with the description serve to explain the principles of the disclosure.
Throughout the following description, specific details are set forth to provide a more thorough understanding to persons skilled in the art. The following description of examples of the technology is not intended to be exhaustive or to limit the system to the precise forms of any example embodiment. Accordingly, the description and drawings are to be regarded in an illustrative sense, rather than a restrictive sense.
All publications and patent applications mentioned in this specification are herein incorporated by reference in their entirety to the same extent as if each individual publication or patent application was specifically indicated to be incorporated by reference. For example, embodiments of the present disclosure may be used in combination with one or more systems, catheters, apparatuses, and electrodes described in U.S. Pat. Nos. 8,571,662, 9,242,088, 9,333,363, 9,776,005, 10,039,920, 10,293,164, U.S. Pat. Pub. 2015/0045810, U.S. Pat. Pub. 2019/0001126, U.S. Pat. Pub. 2019/0175908, U.S. Pat. Pub. 2019/0038894, and/or U.S. Pat. Pub. 2020/0147364; the disclosures of all of which are hereby incorporated by reference.
Further aspects of the disclosures and features of example embodiments are illustrated in the appended drawings and/or described in the text of this specification and/or described in the accompanying claims. It may be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed.
As used herein, the terms “comprises,” “comprising,” “including,” “having,” or other variations thereof, are intended to cover a non-exclusive inclusion such that a process, method, article, or apparatus that comprises a list of elements does not include only those elements, but may include other elements not expressly listed or inherent to such a process, method, article, or apparatus.
Additionally, the term “exemplary” is used herein in the sense of “example,” rather than “ideal.” As used herein, the term “proximal” means a direction closer to an operator and the term “distal” means a direction further from an operator. The term “approximately” or like terms (e.g., “about,” “substantially”) encompass values within 10% of the stated value.
Reference will now be made in detail to examples of the present disclosure described above and illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts.
Flexible body 102 may include a bend 108 adjacent to proximal end 106 such that proximal end 106 may have a transverse alignment relative to the intermediate portion of flexible body 102 and distal end 104 (the axis of end 106 is transverse to the axis of the intermediate portion). As described further herein, bend 108 may form an angle that aligns a longitudinal axis of proximal end 106 with a central axis of a medical device. Flexible body 102 may further include a proximal tab 110 at proximal end 106 that may have a width that is relatively greater than a width of flexible body 102 at distal end 104 and/or the intermediate portion. Proximal tab 110 may be sized and/or shaped to receive one or more circuitry components thereon, such as conductive pads 112.
Flexible body 102 may be formed of a flexible material having pliability properties such that circuit device 100 may be configured to deform a shape, geometry, and/or configuration of flexible body 102. For example, flexible body 102 may be formed of Liquid Crystal Polymer (LCP), thermoplastics, polyimide, PEEK polyester, silicone, other elastomers, and the like. Flexible body 102 may be construed of multiple layers of materials, such as, for example, electrically conductive and/or non-conductive materials. As described in further detail below, circuit device 100 may be configured to engage a medical device and flexible body 102 may be configured to conform to a profile of the medical device when attached thereto.
Still referring to
Conductive pads 112 may be configured to connect electrodes 114 to an ancillary device (e.g., a programmable energy delivery system, a power source, etc.) for transmission of an electric current thereto. Electrodes 114 may be configured to treat a target site of a subject (e.g., a patient) when receiving the electrical current from the ancillary device. For example, electrodes 114 may be operable to stimulate a target site (e.g., a nerve, ganglia, etc.), deliver energy to tissue (e.g., thermal, electrical, etc.), and/or sense a physiologic parameter from or at the target site when distal end 104 is positioned at the target site.
Still referring to
Electrodes 114 may be positioned along exterior surface 101 in various complex arrangements relative to one another to form high current densities along flexible body 102. It should be appreciated that flexible body 102 may be configured to permit enhanced variety in positioning electrodes 114 axially and radially along a circumference of a medical device (e.g., a catheter) when circuit device 100 is attached thereto. Stated differently, a position of electrodes 114 may not be limited by a structure of a medical device, such as, for example, a geometry of an inner lumen of the medical device, due to the incorporation of electrodes 114 on circuit device 100 in lieu of the medical device.
Electrodes 114 may be configured to deliver stimulation as monopolar, bipolar, tripolar, or other multipolar electrodes. As used herein, a stimulation transmitted by electrodes 114 may refer to an electrical signal transmitted by a single electrode 114 (anode) to the ground reference (cathode) that is positioned away from the anode to generate a larger electrical field (monopolar electrical stimulation); an electrical signal transmitted from an anode electrode 114 to a cathode electrode 114 (bipolar stimulation); or an electrical signal transmitted from one or more electrodes 114 to one or more other electrodes 114 (multipolar electrical stimulation) (e.g., from a cathode to two anodes, from two cathodes to an anode, or from a cathode to three or more anodes, or from two cathodes to two anodes, etc.). As any of these electrode combinations and configurations are contemplated, for clarity when referring to one or more processes, methods, or modes of operation, such types of electrical signal transmission may all be referred to as a stimulation transmitted by one electrode 114 or a combination of electrodes 114.
Referring now to
Conductive leads 116 may be configured to negate a necessity of including wires to connect electrodes 114 to a power source, thereby simplifying a circuitry construction of circuit device 100. Each conductive lead 116 may include a distal end positioned adjacent to distal end 104 at a location of electrode 114, and a proximal end positioned adjacent to proximal end 106 at a location of conductive pad 112.
It should be understood that conductive pads 112 and electrodes 114 may be patterned on exterior surface 101 opposite of conductive leads 116 on interior surface 103. Circuit device 100 may include at least one conductive lead 116 for each corresponding pair of conductive pads 112 and electrodes 114 on flexible body 102. An electrical current received by circuit device 100 from an ancillary device (e.g., a power source, etc.) at conductive pads 112 may be delivered to electrodes 114 via conductive leads 116.
In some embodiments, flexible body 102 may include a shape memory alloy wire (not shown) disposed along exterior surface 101 and/or interior surface 103. The wire may be configured to selectively manipulate a shape of flexible body 102, such as, for example, in response to receiving a current and/or an increase in temperature (e.g., from a subject's body, etc.). As described in further detail below, the wire may be operable to adjust a shape of a medical device when circuit device 100 is attached thereto. Control of a shape and/or orientation of the medical device may allow for control of a stimulation field generated by electrodes 114. As noted above, a shape and intensity of a stimulation field may be further controlled by a shape, size, charge, and/or arrangement of electrodes 114 relative to one another along flexible body 102.
Referring to
In some examples, tubular body 12 may be formed of an extruded polymer having homogenous properties (e.g., a constant thickness, etc.) between distal tip 14 and proximal tip 16 such that tubular body 12 may include a substantially consistent flexural strength along the longitudinal length. In other embodiments, circuit device 100 may be configured to increase a material thickness along certain portions of tubular body 12 and/or include one or more structures that modify the properties of tubular body 12 (e.g., increase or decrease rigidity or flexibility, affect shape memory, etc.) when flexible body 102 is attached thereto.
Tubular device 12 may include one or more lumens (see
Circuit device 100 may be disposed about medical device 10 and secured to an outer surface of tubular body 12. Flexible body 102 is configured to have a first configuration prior to being secured to an exterior of tubular body 12 and a second configuration having a shape that conforms to a profile of the tubular body 12 with electrodes 114 secured to an exterior of tubular body 12. Accordingly, flexible body 102 may be configured to conform to a geometry of tubular body 12 (e.g., cylindrical). In the example, distal end 104 may be secured to a distal portion of tubular body 12 adjacent to and proximal of distal tip 14. Proximal end 106 may be secured to a proximal portion of tubular body 12 adjacent to and distal of proximal tip 16.
Circuit device 100 may be attached to medical device 10 at one or more locations and by various methods, including, for example, bonding flexible body 102 to an exterior of tubular body 12 (e.g., thermal bonding, thermal welding, thermal lamination, ultrasonic welding, laser welding, RF welding, adhesive bonding, solvent bonding, chemical reaction, and/or solvent bonding). It should be appreciated that a resulting flexural property of tubular body 12 may vary based on various factors, including but not limited to, the method of bonding flexible body 102 thereto, a configuration/arrangement of flexible body 102 relative to tubular body 12, and/or a material composition of flexible body 102. In some embodiments, circuit device 100 may be treated to modify the surface properties of flexible body 102 prior to limitation or bonding onto tubular body 12. Examples of surface treatments may include, but are not limited to, micro-blasting, sand blasting, plasma treatment, chemical etching, filing, grinding, electroplating, thermal spraying, physical vapor deposition, electron beam heating, and more.
The resulting flexural properties of the combined assembly of medical device 10 and circuit device 100 may influence the performance of tubular body 12 during a procedure. For example, the flexural properties may be decreased in specific regions along a longitudinal length of tubular body 12 to influence where tubular body 12 may bend during a procedure, such as when navigating through anatomical structures of a subject. The flexural properties may be decreased to further reduce stress along specific regions of tubular body 12 that may be maintained in a bent configuration when positioned at a target site within a subject. In some embodiments, the flexural properties may be configured to influence a direction of bending tubular body 12.
Still referring to
In the present example, flexible body 102 may be attached to tubular body 12 at an angle that is transverse to a central axis of tubular body 12 such that circuit device 100 is secured to medical device 10 in a helical configuration. Flexible body 102 may be wound about the central axis of tubular body 12 in a plurality of helical winds 115 (i.e., helix turns). A pair of adjacent helical winds 115 may form a gap 117 therebetween. Electrodes 114 may be wrapped around a circumference of tubular body 12 and flexible body 102 may conform to a profile of tubular body 12.
Still referring to
A substantial length of tubular body 12 may be disposed underneath flexible body 102. As described above, bend 108 may form an angle between an intermediate portion of flexible body 102 and proximal end 106 to align proximal end 106 with the central axis of tubular body 12. Accordingly, the plurality of helical winds 115 may terminate at bend 108 such that proximal end 106 may extend substantially parallel to tubular body 12. Stated differently, the helical configuration of flexible body 102 may extend from distal end 104 to bend 108 such that proximal portion 106 may be maintained in a non-helical (e.g., linear) configuration that is parallel to the central axis of tubular body 12.
Still referring to
In some examples, base layer 120 may have a thickness ranging from about 12 microns to about 125 microns. The one or more dielectric substrate films forming base layer 120 may comprise polymer materials, such as, for example, polyimides, polyesters, liquid crystal polymer (LCP), polyethylene naphthalate, polyvinyliden fluoride, polyetherimide, various fluoropolymers (FEP), etc. In some examples, the polymer materials comprising base layer 120 may be biocompatible with tissue.
Still referring to
For example, the electrically conductive layer forming conductive lead 116 may be patterned using additive processes (e.g., spraying, sputtering, sputter coating, screen printing, stenciling, electrodeposition, electroplating, atomic layer deposition, and/or digital printing, etc.) and/or subtractive processes (e.g., chemical etching, laser etching, and/or laser machining, etc.). Stated differently, flexible body 102 may include the desired electrical circuit traces and/or other electrical circuit elements by selectively removing a portion of conductive lead 116 via one or more of the additive and/or subtractive processes described above.
Still referring to
In some embodiments, an exterior surface of electrode 114 and/or conductive lead 116 may have one or more materials and/or finishes included thereon, such as, for example, via additive processing (e.g., electrodeposition, electroplating, electroless plating, sputtering, sputter coating, etc.). The one or more materials and/or finishes included on electrode 114 and/or conductive lead 116 may include, for example, nickel, silver, gold, platinum, platinum iridium, titanium nitride, and the like. The one or more materials and/or finishes may be operable to enhance a conductivity, corrosion resistance, and/or a biocompatibility of circuit device 100.
Additionally, an insulative or non-conductive substrate, layer, coating, film, and/or finish may be attached (e.g., bonded, soldered, etc.) to flexible body 102 to provide insulation of electrode 114, conductive lead 116, and/or base layer 120. Such materials may include, for example, tetrafluoroethylene (TFE), polytetrafluoroethylene (PTFE), polyimide, polyetheretherketone (PEEK) polyester, silicon, and other various flexible substrates.
Still referring to
Referring now to
Each electrode 114 may be interconnected with conductive lead 116 by a respective via 124 that extends through the plurality of base layers 120 disposed therebetween. Each via 124 may be filled with a conductive material configured to connect the conductive materials (e.g., electrode 114 and conductive lead 116) to one another through the plurality of base layers 120 and adhesive layers 126 positioned therebetween. In the present example, flexible body 102 may include three base layers 120 and one coverlay film 122 disposed beneath base layers 120.
Still referring to
Device component 130 may include various systems, including, for example, a sensor, an electronic chip, an integrated circuit, and the like. In some embodiments, device component 130 may be fully enclosed between the plurality of base layers 120; while in other embodiments, at least a portion of device component 130 may be exposed from the plurality of base layers 120. In this instance, device component 130 may be accessible to a subject's tissue and/or fluids during use of circuit device 100 in a procedure. For example, device component 130 may include a sensing system configured to detect a signal (e.g., cardiac signal, impedance, temperature, flow, pressure, chemical composition, blood gas, etc.) from a subject (i.e., a patient) to facilitate determining a position of circuit device 100 therein, and/or to detect stimulation of an anatomical target based on a physical response of the subject.
Although not shown in
In other embodiments, device component 130 may include flex detection circuitry that may be configured to detect the flexure of flexible body 102 during a procedure at various regions along the longitudinal length of tubular body 12. Such information may guide a placement of tubular body 12 and/or provide anatomical information to an operator of medical device 10. For example, device component 130 may include a strain circuit, a piezo circuit, and/or various other sensors configured to measure a compression and/or expansion (e.g., lateral extension, longitudinal elongation, etc.) of opposite surfaces of tubular body 12 to determine a two or three-dimensional spatial orientation (e.g., distance, rotation, etc.) of tubular body 12 relative to a subject.
Additionally and/or alternatively, one or more integrated circuits may be directly attached to flexible body 102 to provide further localized smart circuitry. For example, as shown in
Circuit device 100 may include a circuit trace 134 along interior surface 103 for each device component 130 included on flexible body 102. Circuit traces 134 may interconnect device components 130 with a corresponding conductive pad 112 at proximal end 106 (
Referring now to
Flexible body 102 may be secured to tubular body 12 such that device component 130 may be aligned with and received in slot 15. Thus, interior surface 103 may be flush against an exterior surface of tubular body 12. It should be appreciated that flexible body 102 may cover and/or encapsulate a majority of tubular body 102. Accordingly, slot 115 may be covered when flexible body 102 is attached to tubular body 12, thereby sealing lumen 13 with interior surface 103. Device component 130 may include, for example, a thermistor sensor, an electronic chip, a resistor, a diode, a capacitor, a strain gauge, a piezoelectric sensor, an integrated circuit, and various other electronic devices.
By way of example, device component 130 may be configured to measure a temperature of a fluid, such as, for example, a fluid disposed within one of the plurality of lumens 11, 13 and/or positioned external of medical device 10. Circuit device 100 may be configured to measure a change in temperature based on the temperature data detected by device component 130. In some examples, circuit device 100 may be configured to measure a flow rate and/or other characteristics of the fluid based on the temperature data sensed by device component 130. In other examples, device component 130 may be configured to heat fluid (e.g., blood, etc.) located external of circuit device 100 and measure a temperature change of the fluid at one or more locations along a longitudinal length and/or lateral width of circuit device 100. For example, at least one location for measuring a temperature change of the fluid may be positioned relatively distal to the heat source (e.g., distal component 130) for determining a flow rate or other properties of the fluid.
In some embodiments, as seen in
Proximal end 106 may be printed on sheet 10 with various configurations, sizes, and/or shapes. For example, proximal end 106 may be printed to include bend 108 having a desired angle. It should be appreciated that bend 108 may define a plurality of angles and/or degrees of curvature between proximal end 106 and an intermediate portion of flexible body 102. Further, proximal end 106 may be printed to include a squared end defining proximal tab 110 (
Still referring to
Referring now to
Extension tubes 150 may include a coupling mechanism 152 (e.g., a luer connector, a female adapter, a fitting, and/or other fluid tight connector assemblies) at a distal end of each extension tube 150 for securely coupling an ancillary device (e.g., a tool, a sensor, a cable, a fiber, etc.). Extension tubes 150 may facilitate receipt of the one or more ancillary devices into lumens 11 via hub 140. In some examples, extension tubes 150 may be configured to couple hub 140 to a fluid source for delivering a fluid (e.g., drug, therapeutic agent, etc.) to lumens 11. Extension tubes 150 may be further configured to extract a fluid sample (e.g., blood) collected from medical device 10 and received at hub 140 via lumens 11.
In other examples, extension tubes 150 may receive an ancillary device for monitoring a pressure and/or a temperature (e.g., a sensor) and/or for positioning tubular body 12 within a patient (e.g., a guidewire). Other ancillary devices, such as, for example, optical fibers, ultrasound cameras, intravascular imagers, filters, lasers, lights, and the like may be introduced into lumens 11 through hub 140 and from extension tubes 150.
Still referring to
It should be appreciated that proximal hub 140 may incorporate one or more features for facilitating an electrical connection to wires 118. The one or more wires 118 may be connected to conductive pads 112 to thereby establish electrical communication between wires 118 and electrodes 114 (e.g., via conductive leads 116). An electrical junction between conductive pads 112 and wires 118 may be formed by various suitable attachment methods, including, for example, solder, laser weld, conductive adhesive, hot bar, interference, friction fits, and/or various other mechanical connection methods.
Further, the electric junction may be reinforced with potting, overmolding, encapsulating, mechanical fasteners, and/or combinations thereof. Each wire 118 may extend through protective sheath 154 and may terminate at electrical connector 156. Electrical connector 156 may be selectively coupled to a power source configured to supply electrodes 114 with electrical power.
Still referring to
Referring now to
Stated differently, each conductive pad 112 is formed about at least one aperture 111 such that conductive pads 112 may contact a device received through aperture 111. Internal components of electrical connector 156 are depicted with an outer housing of electrical connector 156 omitted for illustrative purposes. Electrical connector 156 may include a socket 158 having a plurality of openings, and a plurality of pins 159 extending through the plurality of openings. Each of the plurality of pins 159 may have a proximal end extending proximally out of socket 158 and a distal end extending distally out of socket 158.
Still referring to
Each of the plurality of apertures 111 may be sized and shaped to receive at least one of the plurality of pins 159. It should be appreciated that a quantity and position of apertures 111 relative to proximal tab 110′ may be based on a number and position of pins 159 on socket 158. Circuit device 100 may establish connection with the power source in response to conductive pads 112 contacting pins 159. In some examples, proximal tab 110′ may be soldered to socket 158 thereby securing an electrical connection between conductive pads 112 and pins 159.
In other embodiments, referring now to
Electronic component 135 may include various suitable devices, including, for example, computer readable storage media such as various types of volatile and non-volatile storage media, including but not limited to, static memory, dynamic memory, a read-only memory chip, a read-write memory chip, an electrically erasable programmable read-only memory (EEPROM), random access memory, flash memory, and the like. In other embodiments, electronic component 135 may include a sensing circuit, a radio-frequency identification (RFID) tag, and other various devices.
For example, electronic component 135 may be configured to store product specific data relating to circuit device 100, such as a serial number, lot number, product configuration, expiration date, calibration constants for device component 130, etc. By way of further example, electronic component 135 may be configured to record use data of circuit device 100 and/or medical device 10, such as dates of activation, variable data from therapy procedure sessions, control unit function algorithms, sensor data of device component 130, etc.
In some embodiments, electronic component 135 may further include a computer system, such as, for example a processor (e.g., a central processing unit (CPU), a graphics processing unit (GPU), or both) in conjunction with the memory described above. For example, the processor may be part of a standard personal computer or a workstation. The processor may be one or more general processors, digital signal processors, application specific integrated circuits, field programmable gate arrays, servers, networks, digital circuits, analog circuits, or combinations thereof, for analyzing and processing data. The processor may implement a software program, such as programmable code. In other embodiments, the memory may be an external storage device or database separate from electronic component 135.
Still referring to
For example, the controller may accept information from the system and system components, process the information according to various algorithms, and produce information signals that inform a user of circuit device 100 of a procedure status or other information that is being monitored by circuit device 100. The controller may be a digital IC processor, analog processor, or any other suitable logic or control system that carries out control algorithms. Electronic component 135 may be powered by a battery, a direct wire energy, or other suitable power devices. In some examples, electronic component 135 may be configured to communicate with the controller or other components of circuit device 100 via a wired and/or wireless connection.
According to an exemplary method of using circuit device 100 during a procedure, flexible body 102 may be initially bonded to tubular body 12 in one of a plurality of configurations as shown and described above. Proximal tab 110 may be received within hub 140 and coupled to a power source from a connection of conductive pads 114 with electrical connector 156. With circuit device 100 secured to medical device 10, tubular body 12 may be received within a subject (e.g., patient) and navigated toward a target treatment site.
Medical device 10 may be configured to traverse through blood vessels located relatively proximate to one or more nerves (e.g., phrenic nerves, vagus nerves, etc.), muscles, and/or other tissues. A flexibility (or lack thereof) of tubular body 12 may be at least partially determined by the flexural properties of circuit device 100 based on an attachment configuration of flexible body 102 and/or a material composition of flexible body 102. In other words, a geometry and arrangement of circuit device 100 may influence the flexural properties of medical device 10. Medical device 10 may be guided to a target treatment site using one or more devices received within lumens 11 (
Accordingly, tubular member 12 may be configured to guide placement of circuit device 100 relative to the target treatment site. Upon arriving at the target treatment site, tubular body 12 may be moved (e.g., translated, rotated, etc.) to position electrodes 114 at a desired location relative to a target object (e.g., a nerve, a muscle, a tissue, etc.). With electrodes 114 positioned adjacent to the target object, activation of the power source may deliver an electrical current through wires 118, conductive pads 112, and to electrodes 114 via conductive leads 116. Electrodes 114 may be configured to stimulate the target object (e.g., a stimulation sufficient to cause a desired physiological result) upon receiving the electrical current from conductive leads 116.
Electrodes 114 may generate therapeutic effects for specific anatomical targets (e.g., nerve stimulation) and a relative position of electrodes 114 to one another on exterior surface 101 may generate one or more charge fields along tubular body 12 for certain therapeutic effects (e.g., asymmetric charge fields). Electrodes 114 may generate a sufficient charge to cause contraction of a diaphragm or other lung-accessory. In some embodiments, electrodes 114 may be positioned along tubular body 12 to form a sensor array antenna configured and operable to detect various forms of stimulation, including, for example, nerve stimulation, muscle stimulation, cardiac stimulation, phrenic nerve activation, diaphragm muscle activation, and more.
In examples where circuit device 100 includes device component 130 (e.g., a sensor, etc.), device component 130 (
It should be understood that with circuit device 100 secured to an exterior of medical device 10, lumens 11 may be utilized to receive other devices than those included in circuit device 100. Stated differently, circuit device 100 may be operable to maximize an available space within lumens 11 to receive other ancillary devices. For example, circuit device 100 may omit a necessity to route wires internally through tubular body 12 for connecting electrodes 114 to a power source, thereby allowing tubular body 12 to be sized with a smaller minimum diameter.
Further, circuit device 100 includes conductive leads 116 such that use of wires to connect electrodes 114 to a power source may be omitted entirely, whether received within and/or disposed over tubular body 12, thereby further reducing a complexity of medical device 10. Accordingly, tubular body 12 may include a smaller cross-sectional profile than other medical devices (e.g., catheters) sized and shaped to accommodate electrical components (e.g., wires) for including one or more electrodes on the device.
In some embodiments, medical device 10 may sense physiologic parameters of the target treatment site using one or more devices (e.g., intravascular ultrasound (IVUS)) received within lumens 11 (
Referring specifically to
Flexible body 102 may include layers having a greater thickness along widened segments 203 relative to intermediate segment 205. Widened segments 203 may be configured to impart reduced flexibility on flexible body 102. In the example, widened segments 203 have a relatively smaller longitudinal length than intermediate segment 205, however, it should be understood that various other relative lengths and/or configurations of segments 203, 205 may be included without departing from a scope of this disclosure. In other embodiments, additional and/or fewer widened segments 203 and/or intermediate segments 205 may be included along flexible body 102.
Still referring to
Referring now to
In the present example, irregular segment 303 includes a pair of convex waves 305 and a pair of concave waves 307, however, it should be understood that additional and/or fewer waves 305, 307 may be included on irregular segment 303. In other embodiments, flexible body 102 may include additional irregular segments 303 between distal end 104 and proximal end 106. In the present example, irregular segment 303 may be formed along flexible body 102 adjacent to distal end 104 and may include a constant width with a remaining portion of flexible body 102. Further, irregular segment 303 may be configured to increase a flexibility of flexible body 102 relative to the remaining portion of flexible body 102
Still referring to
Referring now to
In the present example, a distal segment 404 is positioned adjacent to distal end 104, a proximal segment 408 is positioned adjacent to proximal end 106, and an intermediate segment 406 is disposed between distal segment 404 and proximal segment 408. Flexible body 102 may include a pair of bends 410, at least one of which is disposed between distal segment 404 and intermediate segment 406 and another of which is disposed between intermediate segment 406 and proximal segment 406.
Still referring to
In other embodiments, circuit device 400 may include additional and/or fewer segments along flexible body 102 that may be separated by additional and/or fewer bends 410, respectively. Each of the plurality of segments 404, 406, 408 may include one or more electrodes 114; while in some embodiments, segments 404, 406, 408 may omit electrodes 114 entirely.
Referring now to
By way of further example, the pitch or angle that flexible body 102 helically winds about tubular body 12 may be relatively smaller along intermediate segment 406 such that flexible body 102 may be substantially rigid along intermediate segment 406. It should be appreciated that segments 404, 406, 408 may include various other angles and pitches of helical wrap than those shown and described herein, and relative to one another, than those shown and described herein dependent on a desired configuration of circuit device 400.
Still referring to
Circuit device 400 may be configured to form a gap 405 between adjacent segments 404, 406, 408 that change direction relative to one another when flexible body 102 is attached to tubular body 12. Circuit device 400 may not cover at least a portion of tubular body 12 when the helical wrap of flexible body 102 changes directions, thereby exposing a portion of tubular body 12 disposed beneath flexible body 102.
It should be appreciated that the flexural properties of tubular body 12 may vary along the portions that are exposed along gaps 405 relative to other portions that receive flexible body 102. For example, tubular body 12 may have a relatively decreased rigidity (i.e., an increased flexibility) along regions that omit flexible body 102 thereon. Further, an assembly of medical device 10 and circuit device 100 may provide areas having a greater material thickness along portions where flexible body 102 is attached to tubular body 12, thereby providing asymmetric properties along the longitudinal length of tubular body 12.
Still referring to
It should be appreciated that an angle and/or a pitch of helical wrap of each the plurality of segments 404, 406, 408 may remain constant and/or vary relative to one another when a direction of the helical wind changes. In some embodiments, bend 410 may match an angle of the helical wrap of flexible body 102. In this instance, at least one of the plurality of segments 404, 406, 408 may have an elongated length extending along a longitudinal axis that is transverse to the remaining segments of flexible body 102.
For example, as seen in
As seen in
It should be understood that bend angle C and helix angle D of the present example are merely illustrative such that bend 410 and the plurality of helical winds along intermediate segment 406 may have various other suitable relationships relative to one another than those shown and described herein. Additionally, a helical pitch of intermediate segment 406 (e.g., see
Flexible body 102, and the portion of the medical device corresponding to it, may have varying flexural properties along distal segment 404 and intermediate segment 406 based on a respective geometry of each segment 404, 406. In the present example, distal segment 404 may be oriented parallel to a central axis of tubular body 12 such that the portion of the medical device corresponding to it distal segment 104 may have radial asymmetric flexural properties. Medical device 10 may experience greater deflection along a portion corresponding to distal segment 404 when a force that is transverse to a longitudinal axis of flexible body 102 and parallel to a central axis of tubular body 12 is applied, than when the force is perpendicular to both flexible body 102 and tubular body 12.
Still referring to
Referring now to
The stiffening structures may include components (e.g., additional layers, adhesive used for lamination, stiffening wires, etc.) made of materials of varying stiffness and/or thickness and that may be incorporated into regions of flexible body 102 to increase and/or decrease a stiffness of circuit device 500. Stiffeners may include glass-reinforced epoxy laminate materials (FR4), polyimide, polyester, polymers, and/or stainless steel. The stiffening structures may be formed of materials having a relatively high stiffness to increase a rigidity of tubular body 12 in the specific areas aligned with stiffening segments 504 when flexible body 102 is attached thereto.
Stated differently, flexible body 102 may be configured to reduce a flexibility of tubular body 12 along areas aligned with stiffening segments 504. The stiffening structures may provide additional layers on tubular body 12, thereby varying a width of the assembly of medical device 10 and circuit device 500 along a longitudinal length of tubular body 12. Accordingly, the flexural properties of tubular body 12 may vary at the selective regions corresponding to a location of stiffened segments 504 thereon. In other embodiments, a stiffening structure may be disposed between an exterior surface of tubular body 12 and interior surface 103 of flexible body 102 prior to attaching circuit device 100 to medical device 10. In this instance, the stiffening structure may be encapsulated between tubular body 12 and flexible body 102.
Referring now to
Still referring to
Distal segment 604 and/or intermediate segment 606 may include one or more (e.g., a plurality) of electrodes 114. In the present example, each of the pair of branch segments 608 may define an array of electrodes 114 along distal segment 604, thereby providing a complex circuit density at distal segment 604. It should be appreciated that circuit device 600 may be configured to generate greater current and/or fields of coverage with the array of electrodes 114 on branch segments 608 for providing enhanced treatment therapies to a target site. The array of electrodes 114 may provide medical device 10 with complex electrode geometries capable of selectively generating greater current densities and/or concentrated density fields.
Circuit device 600 may be assembled onto medical device 10 such that the longitudinal axis of each branch segment 608 may be parallel to a center, longitudinal axis of tubular body 12. Stated differently, distal segment 604 may be secured onto a distal portion of tubular body 12 in a linear arrangement such that branch segments 608 extend parallel to the center axis of tubular body 12. Further, an axis of intermediate segment 606 may be transverse to the center axis of tubular body 12 such that flexible body 102 may be helically wound about an exterior of tubular body 12 along intermediate segment 606. Accordingly, circuit device 600 may be configured to impart different flexural properties onto tubular body 12 along a portion receiving distal segment 604 and intermediate segment 606, respectively.
Still referring to
It should be appreciated that branch segments 608 may be selectively spaced apart from one another at various other relative degrees and/or distances dependent on a desired therapeutic effect to be provided by circuit device 600 and medical device 10. In other embodiments, circuit device 600 may include additional branch segments 608 at distal segment 604, intermediate segment 606, and/or at various other portions of flexible body 102.
For example, as shown in
Each branch segment 609 may include one or more (e.g., a plurality) of electrodes 114, thereby defining an array of electrodes 114 on each branch segment 609. In some examples, electrodes 114 may be arranged along each branch segment 609 to be longitudinally aligned with one another, and longitudinally offset from the plurality of electrodes 114 along branch segments 608.
Still referring to
For example,
Referring now to
First intermediate segment 704 may extend distally relative to second intermediate segment 706 such that first intermediate segment 704 may be disposed between distal segment 702 and second intermediate segment 706. First intermediate segment 704 may have a longitudinal length (an axis) extending transverse to the longitudinal axes of each of distal segment 702 and second intermediate segment 706. In some examples, first intermediate segment 704 may include one or more (e.g., a plurality) of electrodes 114; while in other examples, first intermediate segment 704 may exclude electrodes 114 thereon.
Still referring to
Accordingly, the pair of branch segments 609 may be positioned proximal to, and at angle from, the pair of branch segments 608. Thus, each branch segment 609 may have a longitudinal axis that is transverse to an axis of the pair of branch segments 608. Second intermediate segment 706 may extend distally relative to proximal intermediate segment 708 such that second intermediate segment 706 may be disposed between first intermediate segment 704 and proximal segment 708. Second intermediate segment 706 may have a longitudinal length (an axis) extending transverse to a longitudinal axis of each of first intermediate segment 704 and proximal segment 708. In some examples, first intermediate segment 704 may have an axis that is parallel to an axis of proximal segment 708.
Still referring to
Distal segment 702 and second intermediate segment 706 may extend parallel to each other and to a central longitudinal axis of tubular body 12, and first intermediate segment 704 and proximal segment 708 may be helically wrapped about tubular body 12, when circuit device 700 is attached to medical device 10. Accordingly, varying flexural properties may be imparted on tubular body 12 along those portions receiving segments 702, 706 thereon compared to segments 704, 708.
The pair of branches 608 may be secured to tubular body 12 along a similar or different radial location about the axis of body 12 than the pair of branches 609 (i.e., either spaced 180 degrees or 90 degrees apart, respectively, or any other suitable angle apart). An angular change of flexible body 102 at bends 710, 712, 714 may be determinative of an angle of a helical wrap of first intermediate segment 704 and proximal segment 708 about tubular body 12 when circuit device 700 is secured to medical device 10 (see, e.g.,
Referring now to
Outlet connector 164 may extend proximally outward from housings 160A, 160B when electrical connector 156 is in a fully assembled state. Outlet connector 164 may define a connector interface of electrical connector 156 for connection with a power source and may be configured to receive proximal tab 110″. Proximal tab 110″ may be disposed about an exterior of outlet connector 164 with the plurality of conductive pads 112 facing radially outward. Outlet connector 164 may include a keying feature 166 configured to facilitate an alignment and attachment of proximal tab 110″ to outlet connector 164. For example, keying feature 166 may engage the terminal ends of proximal tab 110″ and/or designate a starting and ending point for wrapping proximal tab 110″ about a circumference of outlet connector 164.
Still referring to
Each of the aforementioned systems, devices, assemblies, and methods may be used to provide electrical circuitry at a target treatment site in a subject (e.g., a patient) that may be capable of providing diagnostic or therapeutic effects. By providing a medical device including a circuit device disposed at the exterior of the medical device (over the sheath or tube), a user may utilize the lumens of the medical device for receipt of others devices and/or materials. With the circuit device having a minimal size and flexible electrical circuitry, the circuit device may minimize an overall physical profile of the medical device while maximizing a selective positioning of the electrical components at various locations along the medical device. In this instance, a user may increase efficiency of procedures, reduce overall procedure time, and/or avoid unnecessary harm to a subject's body caused by the medical device having an invasive profile for accommodating electrical circuitry devices within the lumens.
It will be apparent to those skilled in the art that various modifications and variations may be made in the disclosed devices and methods without departing from the scope of this disclosure. Other aspects of the disclosure will be apparent to those skilled in the art from consideration of eth specification and practice of the features disclosed herein. It is intended that the specification and examples be considered as exemplary only.
This application claims priority to U.S. Provisional Application No. 62/860,452, filed on Jun. 12, 2019, which is hereby incorporated by reference in its entirety. All publications, patent applications, and patents mentioned in this specification are herein incorporated by reference in their entirety to the same extent as if each individual document was specifically individually indicated to be incorporated by reference.
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Number | Date | Country | |
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20200391027 A1 | Dec 2020 | US |
Number | Date | Country | |
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62860452 | Jun 2019 | US |