The present disclosure relates to a device used to facilitate the intravascular delivery of a medical device. More specifically, the disclosure relates to percutaneous circulatory support systems having a cannula and a device to facilitate delivery of the cannula through delivery sheathing.
Certain medical devices, such as circulatory support devices, are delivery intravascularly. The introduction of such devices to the vasculature often involves passing the devices through one or more delivery sheaths, and then guiding the device through the patient's vasculature to its final position. In the case of a circulatory support device to be placed in the left side of the heart, the device is commonly introduced into the femoral artery and passed through the vasculature until device enters the aorta. The cannula incorporated into the device is then passed through the aortic valve and into the left ventricle. Due to the size and construction of the such devices, and in particular the cannulas incorporated into circulatory support devices, passage of the devices through delivery sheaths may be difficult.
In Example 1, a percutaneous circulatory support system includes a device including a housing and a cannula coupled to the housing, a cannula delivery tool configured for receiving and radially compressing the cannula, the cannula delivery tool having a proximal portion positioned adjacent a tapered portion, and a distal portion positioned adjacent the tapered portion.
In Example 2, the system of Example 1 further includes wherein the cannula delivery tool is a laser cut tube and the cannula delivery tool comprises a plurality of closed cells.
In Example 3, the system of Example 1 further includes wherein the percutaneous circulatory support system includes a starter tube for receiving the cannula delivery tool and the cannula, wherein the cannula delivery tool is configured to compress when inserted into the starter tube.
In Example 4, the system of Example 3 further includes wherein the percutaneous circulatory support system further includes an introducer sheath, wherein the introducer sheath comprises an inner diameter, and when the cannula delivery tool is compressed, the cannula delivery tool is defined by an outer diameter that is less than the inner diameter of the introducer sheath.
In Example 5, the system of Example 1 further includes wherein the cannula delivery tool is composed of nitinol.
In Example 6, the system of Example 1 further includes wherein the proximal portion of the cannula delivery tool comprises a curved plate that extends on a first side of the cannula delivery tool, and wherein a tether extends from the curved plate and extends proximally to couple with the introducer sheath.
In Example 7, the system of Example 1 further includes wherein the cannula delivery tool includes a surface coating along the surface of the cannula delivery tool.
In Example 8, the system of Example 4 further includes wherein a coefficient of friction between the cannula and the introducer sheath is greater than a coefficient of friction between the cannula delivery tool and the introducer sheath.
In Example 9, the system of Example 6 further includes wherein the system further comprises a guidewire that extends within the cannula delivery tool and the cannula, and wherein the guidewire extends through a second side of the cannula delivery tool, the second side being opposite the first side relative to a longitudinal axis of the cannula delivery tool.
In Example 10, a method of deploying a percutaneous device includes providing a percutaneous support system including the percutaneous device having at least a housing coupled to a cannula, a handle for actuation of the percutaneous support system, a starter tube loaded on a catheter of the percutaneous support system, a cannula delivery tool loaded onto the catheter, and an introducer sheath. The method further includes extending the cannula delivery tool over the cannula, retracting the cannula delivery tool and the percutaneous support device into the starter tube and inserting the starter tube at least partially into the introducer sheath. The method further includes extending the cannula delivery tool out of a distal portion of the starter tube and at least partially out of a distal portion of the introducer sheath and extending the cannula out of the cannula delivery tool.
In Example 11, the method of Example 10 further includes wherein retracting the delivery tool into the starter tube compresses cannula delivery tool such that the cannula delivery tool comprises an outer diameter that is less than an inner diameter of the introducer sheath.
In Example 12, the method of Example 10 further includes wherein the percutaneous support system further includes a guidewire, and wherein the method further includes extending the guidewire through the cannula delivery tube and the percutaneous support device prior to extending the cannula delivery tool over the cannula.
In Example 13, the method of Example 12 further includes wherein the percutaneous support system further comprises a tether coupled to the introducer sheath and the cannula delivery tool, such that a length of the tether dictates how far the cannula delivery tool extends out of the introducer sheath.
In Example 14, the method of Example 10 further includes wherein the method further comprises retracting the tether in order to retract the cannula delivery tool through the introducer sheath and into the starter tube.
In Example 15, the method of Example 11 further includes wherein the cannula delivery tool comprises a tapered portion and a surface treatment, both configured to allow the cannula delivery tool to compress when retracted into the start tube.
In Example 16, a percutaneous circulatory support system includes a percutaneous circulatory support device including an impeller disposed within an impeller housing, the impeller being rotatable relative to the impeller housing to cause blood flow through the impeller housing. The system further includes a cannula coupled to the impeller housing, a cannula delivery tool configured for receiving and radially compressing the cannula, the cannula delivery tool having a proximal portion positioned adjacent a tapered portion, and a distal portion positioned adjacent the tapered portion.
In Example 17, the system of Example 16 further includes wherein the cannula delivery tool is a laser cut tube and the cannula delivery tool comprises a plurality of closed cells.
In Example 18, the system of Example 16 further includes wherein the percutaneous circulatory support system includes a starter tube for receiving the cannula delivery tool and the cannula, wherein the cannula delivery tool is configured to compress when inserted into the starter tube.
In Example 19, the system of Example 18 further includes wherein the percutaneous circulatory support system further includes an introducer sheath, wherein the introducer sheath comprises an inner diameter, and when the cannula delivery tool is compressed, the cannula delivery tool is defined by an outer diameter that is less than the inner diameter of the introducer sheath.
In Example 20, the system of Example 16 further includes wherein the cannula delivery tool is composed of nitinol.
In Example 21, the system of Example 16 further includes wherein the proximal portion of the cannula delivery tool comprises a curved plate that extends on a first side of the cannula delivery tool, and wherein a tether extends from the curved plate and extends proximally to couple with the introducer sheath.
In Example 22, the system of Example 21 further includes wherein the system further comprises a guidewire that extends within the cannula delivery tool and the cannula, and wherein the guidewire extends through a second side of the cannula delivery tool, the second side being opposite the first side relative to a longitudinal axis of the cannula delivery tool.
In Example 23, the system of Example 16 further includes wherein the cannula delivery tool comprises a surface coating along the surface of the cannula delivery tool.
In Example 24, the system of Example 23 further includes wherein the surface coating is silicone.
In Example 25, the system of Example 19 further includes wherein a coefficient of friction between the cannula and the introducer sheath is greater than a coefficient of friction between the cannula delivery tool and the introducer sheath.
In Example 26, a cannula delivery tool configured for delivering a cannula includes a proximal portion opposite a distal portion and a body portion extending therebetween, wherein the body portion comprises a tapered portion, a curved plate extending from the proximal portion configured for easing the introduction of the cannula delivery tool into a sheath, and a plurality of closed cells along the body portion formed by laser cutting a tube that forms the cannula delivery tool.
In Example 27, the cannula delivery tool of Example 26 further includes herein a tether is coupled to the curved plate and extends proximally from the curved plate of the cannula delivery tool, and wherein the tether is welded to the curved plate.
In Example 28, the cannula delivery tool of Example 26 further includes wherein the cannula delivery tool is composed of one of nitinol and stainless steel, and wherein the cannula delivery tool comprises a surface treatment.
In Example 29, the cannula delivery tool of Example 26 further includes wherein the cannula delivery tool is configured to compress from an expanded configuration having an expanded outer diameter to a compressed configuration have a compressed outer diameter.
In Example 30, a method of deploying a percutaneous support device includes providing a percutaneous support system including the percutaneous support device having at least an impeller housing coupled to a cannula, a handle for actuation of the percutaneous support system, a starter tube loaded on a catheter of the percutaneous support system, a cannula delivery tool loaded onto the catheter, and an introducer sheath. The method further includes extending the cannula delivery tool over the cannula, retracting the cannula delivery tool and the percutaneous support device into the starter tube and inserting the starter tube at least partially into the introducer sheath. The method further includes extending the cannula delivery tool out of a distal portion of the starter tube and at least partially out of a distal portion of the introducer sheath and extending the cannula out of the cannula delivery tool.
In Example 31, the method of Example 30 further includes wherein retracting the delivery tool into the starter tube compresses cannula delivery tool such that the cannula delivery tool comprises an outer diameter that is less than an inner diameter of the introducer sheath.
In Example 32, the method of Example 30 further includes wherein the percutaneous support system further includes a guidewire, and wherein the method further includes extending the guidewire through the cannula delivery tube and the percutaneous support device prior to extending the cannula delivery tool over the cannula.
In Example 33, the method of Example 32 further includes wherein the percutaneous support system further comprises a tether coupled to the introducer sheath and the cannula delivery tool, such that a length of the tether dictates how far the cannula delivery tool extends out of the introducer sheath.
In Example 34, the method of Example 30 further includes wherein the method further comprises retracting the tether in order to retract the cannula delivery tool through the introducer sheath and into the starter tube.
In Example 35, the method of Example 31 further includes wherein the cannula delivery tool comprises a tapered portion and a surface treatment, both configured to allow the cannula delivery tool to compress when retracted into the start tube.
While multiple embodiments are disclosed, still other embodiments of the present invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.
Various modifications and additions can be made to the exemplary embodiments discussed without departing from the scope of the present invention.
For example, while the embodiments described above refer to particular features, the scope of this invention also includes embodiments having different combinations of features and embodiments that do not include all of the above described features.
With continued reference to
As illustrated in
The impeller assembly housing 140 carries an impeller assembly 144 therein. The impeller assembly 144 includes an impeller shaft 146 and an impeller 148 that rotates relative to the impeller assembly housing 140 to drive blood through the blood pump 102. More specifically, the impeller 148 causes blood to flow from a blood inlet 150 formed on the impeller assembly housing 140, through the impeller assembly housing 140, and out of a blood outlet 152 formed on the impeller assembly housing 140. In some embodiments the impeller shaft 146 and the impeller 148 may be integrated, and in other embodiments the impeller shaft 146 and the impeller 148 may be separate components. As shown in
With continued reference to
In some embodiments, a controller (not shown) may be operably coupled to the motor 154 and configured to control the motor 154. In some embodiments, the controller may be disposed within the motor housing 142. In other embodiments, the controller may be disposed outside of the motor housing 142 (for example, in a catheter handle, an independent housing, etc.). In some embodiments, the controller may include multiple components, one or more of which may be disposed within the motor housing 142. According to embodiments, the controller may be, may include, or may be included in one or more Field Programmable Gate Arrays (FPGAs), one or more Programmable Logic Devices (PLDs), one or more Complex PLDs (CPLDs), one or more custom Application Specific Integrated Circuits (ASICs), one or more dedicated processors (e.g., microprocessors), one or more central processing units (CPUs), software, hardware, firmware, or any combination of these and/or other components. Although the controller is referred to herein in the singular, the controller may be implemented in multiple instances, distributed across multiple computing devices, instantiated within multiple virtual machines, and/or the like. In other embodiments, the motor 154 may be controlled in other manners.
With continued reference to
Further,
At block 202, the method first comprises providing a percutaneous support system, for example, the percutaneous circulatory support system 100. Further, at block 204, the method 200 includes extending the cannula delivery tool 170 over the cannula 116 of the illustrative percutaneous circulatory support system 100. Extending the cannula delivery tool 170 over the cannula 116 may include positioning the cannula delivery tool 170 such that the entire cannula 116 is enclosed by the cannula delivery tool 170. During this step, the cannula delivery tool 170 is in an expanded configuration such that the cannula delivery tool 170 has the expanded outer diameter 196 (
Additionally, the method 200 comprises the step illustrated at block 206 of retracting the cannula delivery tool 170 and the percutaneous circulatory support device 102 into the starter tube 108. As such, the cannula delivery tool 170, the cannula 116 and the percutaneous circulatory support device 102 are retracted into the starter tube 108 to prepare for insertion into the body of a patient. During this step, the cannula delivery tool 170 is configured to compress from the expanded outer diameter 196 (
At block 208, the method 200 includes inserting the starter tube 108, which includes the cannula delivery tool 170 and circulatory support device 102, into the introducer sheath 134. In various embodiments, the introducer sheath 134 has already been positioned at least partially into an artery of the patient, for example the femoral artery, of the patient.
At block 210, the method 200 further includes extending the cannula delivery tool 170 out of the starter tube 108 and partially out of the introducer sheath 134. This step further includes wherein the starter tube 108 is not extended entirely out of a distal portion of the introducer sheath 134, such that when the cannula delivery tool 170 is pushed out of the starter tube 108, the cannula delivery tool 170 is in direct contact with the interior of the introducer sheath 134, for example as shown in
With reference again to
The method 200 then comprises the step at block 212, including extending the cannula 116 out of the cannula delivery tool 170. During this step, the cannula 116 and thus the percutaneous circulatory support device 102 that is coupled with the cannula 116, are released from the cannula delivery tool 170. The circulatory support device 102 can then be deployed through the patient's vasculature and into the heart of the patient. Once the circulatory support device 102 passes out of the cannula delivery tool 170, the cannula delivery tool 170 may be retracted into the introducer sheath 134 and further into the starter tube 108. When retracted into the introducer sheath 134, the diameter of the cannula delivery tool 170 is compressed down, as described further herein.
Further, in various embodiments, the illustrative percutaneous circulatory support system 100 may include the guidewire 120 for use in deploying the cannula 116 and the 102. For example, in these embodiments, prior to extending the cannula delivery tool over the cannula, the method 200 includes extending the guidewire 120 through the cannula delivery tool 170, specifically through the first side 186 as discussed with reference to
Additionally, in embodiments, the method 200 may include retracting the tether 184 to retract the cannula delivery tool 170 through the introducer sheath 134 and into the starter tube 108 for removal. This step is optimized by the curved shape of the plate 182 of the cannula delivery tool 170, specifically in that the curved shape of the plate 182 allows for the cannula delivery tool 170 to be more easily captured back into the introducer sheath 134 and compressed back down to the compressed outer diameter 196 (
While the cannula delivery tool 170 and the cannula 116 are described throughout as begin used with a percutaneous circulatory support system 100 for delivering the percutaneous circulatory support device 102, the cannula delivery tool 170 and the cannula 116 may be used with a variety of different systems. Specifically, the cannula delivery tool 170 may also be used with a variety of the different medical devices, such as devices including balloon, stents, or other radially compressible and expandable devices that are introduced intravascularly. The embodiments described herein are not meant to be limiting and are provided as an example thereof.
Various modifications and additions can be made to the exemplary embodiments discussed without departing from the scope of the present invention. For example, while the embodiments described above refer to particular features, the scope of this invention also includes embodiments having different combinations of features and embodiments that do not include all of the described features. Accordingly, the scope of the present invention is intended to embrace all such alternatives, modifications, and variations as fall within the scope of the claims, together with all equivalents thereof.
This application claims priority to Provisional Application No. 63/280,357, filed Nov. 17, 2021, which is herein incorporated by reference in its entirety.
Number | Date | Country | |
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63280357 | Nov 2021 | US |