The present disclosure relates to elongated catheters and, more specifically, to methods of manufacturing elongated catheters including a sensor and an extended working channel.
A common interventional procedure in the field of pulmonary medicine is bronchoscopy, in which a bronchoscope is inserted into the airways through the patient's nose or mouth. The structure of a bronchoscope generally includes a long, thin, flexible tube that typically contains three elements: an illumination assembly for illuminating the region distal to the bronchoscope's tip via an optical fiber connected to an external light source; an imaging assembly for delivering back a video image from the bronchoscope's distal tip; and a lumen or working channel through which instruments may be inserted, including but not limited to placement (e.g., guide wires), diagnostic (e.g., biopsy tools) and therapeutic (e.g., treatment catheters or laser, cryogenic, radio frequency, or microwave tissue treatment probes) instruments.
During particular procedures (e.g., microwave ablation and biopsy) a catheter having an extended working channel may be inserted through a working channel to enable navigation to sites too remote and having luminal diameters too small for the bronchoscope. Generally, a locatable guide is positioned at a distal end of the extended working channel to guide the catheter to targeted tissue. When the distal end of the extended working channel is positioned adjacent targeted tissue, the locatable guide is removed from the extended working channel. Then, an instrument may be inserted through the extended working channel in order to act on the targeted tissue (e.g., perform a biopsy or ablation of the targeted tissue).
There is a need for a catheter having an extended working channel that includes a sensor for locating a distal end of the catheter within the anatomy of a patient with the extended working channel open for insertion of an instrument.
In an aspect of the present disclosure, a flexible catheter includes an elongated body, and a sensor. The elongated body has proximal and distal end portions and defines a working channel therethrough. The sensor is disposed in the distal end portion of the elongated body and is adapted for detecting the position of a distal end of the elongated body within the anatomy of a patient. The sensor is formed from a wire that forms a first layer of wraps about the distal end portion of the elongated body and that includes first and second leads that form a twisted pair proximal to the first layer of wraps. The twisted pair of the first and second leads extends to the proximal end portion of the elongated body. The wire may be continuous from the first lead, through the first layer of wraps, and to the second lead.
In aspects, the elongated body includes a braid that defines the working channel and an outer coating that is disposed over the braid for isolating the working channel from an environment that surrounds the flexible catheter. The braid may be formed of cords that define channels therebetween. The twisted pair of the wire is disposed within one of the channels of the braid between the first layer of wraps and the proximal end portion of the elongated body. The elongated body may include an inner liner that is disposed within the braid. The outer coating may be bonded to the braid and may be formed from a reflowed polymer tube. The wire may be disposed within the outer coating between the distal and proximal end portions of the elongated body.
In some aspects, the first layer of wraps is transverse to a longitudinal axis of the elongated body. The wire may also form a second layer of wraps about the distal end portion over the first layer of wraps. The first layer of wraps may be in a first direction about the braid and the second layer of wraps is in a second direction about the distal end portion opposite the first direction.
In another aspect of the present disclosure, a catheter system includes a flexible catheter and a handle. The flexible catheter includes an elongated body that has proximal and distal end portions and defines a working channel therethrough. The sensor is disposed in the distal end portion of the elongated body and is adapted for detecting the position of a distal end of the elongated body within the anatomy of a patient. The sensor is formed from a wire has a first layer of wraps about the distal end portion. The wire including first and second leads that form a twisted pair proximal to the first layer of wraps and that extends to a proximal end portion of the elongated body. The handle is disposed over the proximal end portion of the elongated body. The handle is longitudinally and rotatably fixed to the flexible catheter. The handle includes an adapter that is in electrical communication with the sensor.
In aspects, the catheter system includes a telescopic channel that is disposed over a portion of the elongated body and that is coupled to a distal end of the handle.
In another aspect of the present disclosure, a method of manufacturing a flexible catheter includes wrapping a wire about a distal end portion of a braid, positioning first and second leads of the wire in a channel defined about the braid between the first layer of wraps and the proximal end portion of the braid, and forming an outer coating over the braid and the wire from a distal end of the braid to a proximal end portion of the braid. Wrapping the wire about the distal end portion of the braid forms a first layer of wraps transverse to a longitudinal axis defined by the braid. The wire may be continuous from the first lead, through the first layer of wraps, and to the second lead.
In aspects the method includes twisting the first and second leads together to form a twisted pair. Positioning the first and second leads in the channel may include positioning the twisted pair in the channel. Twisting and positioning the first and second leads may occur simultaneously.
In some aspects, forming the outer coating includes reflowing a distal polymer tube that is disposed over the braid and the wire from the distal end of the braid to the proximal end portion of the braid. Forming the outer coating may include reflowing a proximal polymer tube that is disposed over the proximal end portion of the braid proximal of the wire before reflowing the distal polymer tube. Forming the outer coating may include positioning an outer sleeve over the reflowed proximal polymer tube and wrapping the wire over the outer sleeve before reflowing the distal polymer tube. Reflowing the distal polymer tube may include reflowing the distal polymer tube into a portion of the reflowed proximal polymer tube over the wire.
In particular aspects, the method may include positioning an inner liner over a mandrel and forming a braid over the inner liner and the mandrel before wrapping the wire. Forming the braid over the braid may include weaving cords to form the braid. Forming the outer coating may include reflowing a distal polymer tube and the inner liner together from the distal end of the braid to the proximal end portion of the braid. The distal polymer tube may be disposed over the braid and the wire.
In certain aspects, the method of manufacturing includes trimming the braid after forming the outer coating. Trimming the braid may include cutting the distal end portion of the braid distal to the layer of wraps of the wire and cutting the proximal end portion of the braid.
Further, to the extent consistent, any of the aspects described herein may be used in conjunction with any or all of the other aspects described herein.
Various aspects of the present disclosure are described hereinbelow with reference to the drawings, which are incorporated in and constitute a part of this specification, wherein:
This disclosure relates generally to a catheter having an Extended Working Channel (EWC) and a sensor positioned at a distal end of the EWC for locating the distal end of the EWC within the anatomy of a patient. Such a catheter eliminates the need for a separate locatable guide to be inserted through the EWC to locate the distal end of the catheter within the anatomy of a patient. In addition, such a catheter eliminates the need to remove the locatable guide before insertion of an instrument through the EWC to treat targeted tissue. Further, such a catheter is locatable during an entire procedure such that the changes in the location of the distal end of the catheter are detectable and/or the catheter is repositionable during the procedure when an instrument positioned within the EWC.
Embodiments of the present disclosure are now described in detail with reference to the drawings in which like reference numerals designate identical or corresponding elements in each of the several views. As used herein, the term “clinician” refers to a doctor, a nurse, or any other care provider and may include support personnel. Throughout this description, the term “proximal” refers to the portion of the device or component thereof that is closest to the clinician and the term “distal” refers to the portion of the device or component thereof that is farthest from the clinician.
Referring now to
Examples of methods of marking the location of and registering a pathway to targeted tissue may be found in commonly assigned U.S. Patent Publication No. 2016/0000414, filed Jun. 29, 2015, entitled “Methods for Marking Biopsy Location,” and U.S. Pat. No. 10,772,532, filed Jul. 2, 2015, entitled “Real-time Automatic Registration Feedback.” Examples of guiding a catheter to and treating targeted tissue may be found in commonly assigned U.S. Pat. Nos. 9,459,770 and 9,247,992. Examples of bronchoscopes, handles, and support systems for microwave ablation catheters may be found in commonly assigned U.S. Pat. No. 9,867,665. The entire contents of each of these disclosures are incorporated herein by reference.
With additional reference to
With particular reference to
The inner liner 60 and the outer coating 68 are formed from polymer tubes, as detailed below, which are made from of a reflowable polymer material (e.g., Arnitel®, Hytrel®, Pebax®, polytetrafluoroethylene (PTFE)) which may bond to the braid 64, the wire 71, and to one another. The braid 64 is constructed of a mesh of between 16 and 32 of similar or varying material cords woven together (e.g., stainless steel, Dacron®, polyethylene naphthalate (PEN), polyethylene terephthalate (PET), and/or insulated electrical wire). The wire 71 is a solid core magnetic wire with a thin dielectric coating (e.g., a copper wire with a polyimide coating).
Referring now to
With particular reference to
The braid 64 is formed by helically weaving cords 66 of material over a cylinder (e.g., the inner liner 60 and the mandrel 100. The cords 66 define channels 67 therebetween that follow the helical pattern of the cords 66. The pitch of the cords 66 is in a range of about 0.125 to about 0.225 (e.g., about 0.177). The braid 64 may compress the inner liner 60 over the mandrel 100. The braid 64 has an outer diameter in a range of about 0.052 to about 0.102 inches (e.g., 0.092 inches). It is contemplated that the inner liner 60, the braid 64, and the mandrel 100 may be supplied as a preassembled unit.
With reference to
As shown, the sensor 58 includes two layers of wraps 72a, 72b; however, it is contemplated that the sensor 58 may include a single layer of wraps 72 or may include more than two layers of wraps 72. The number of wraps 72 of the wire 71 is proportional to signal strength of the sensor 58. That is, as the number of wraps 72 increases, the signal strength of the sensor 58 increases. As the number of layers of wraps 72 is increased, the flexibility of the catheter 50 in the area of the wraps 72 is reduced and the diameter of the catheter 50 in the area of the wraps 72 is increased.
The total length of the layers 72a, 72b of the wraps 72 is in a range of about 0.04 to about 0.36 inches (e.g., about 0.18 inches). As the total length of the layers 72a, 72b is increased, the flexibility of the catheter 50 in the area of the wraps 72 is reduced. Thus, the number of layers of wraps 72, the length of the wraps 72, and the total number of wraps 72 is a compromise between the signal strength of the sensor 58 and the flexibility and size of the catheter 50.
The wraps 72 are formed by ends or leads 76a, 76b of the wire 71 being wrapped around about the braid 64. The inner and outer layers 72a, 72b may be formed simultaneously by beginning at a distance spaced away from a distal end 65b of the braid 64. The inner layer 72a is formed by a first lead 76a being wrapped around the braid 64 in a first direction substantially transverse to a longitudinal axis of the braid 64 while proximally traversing an outer surface of the braid 64. The outer layer 72b is formed by a second lead 76b being wrapped around the braid 64 and the inner layer 72a in a second direction, opposite to the first direction, substantially transverse to a longitudinal axis of the braid 64 while proximally traversing the inner layer 72a. The wrapping of the second lead 76b trails the wrapping of the first lead 76a in a range of about 1 to about 5 wraps 72 of the wire 71 (e.g., 2 wraps) to allow the inner layer 72a to form before being covered by the outer layer 72b. The wraps 72 are started spaced away from the distal end 65b of the braid 64 a distance in a range of about 0.0 to about 3.0 inches (e.g., about 0.5 inches). The wraps 72 are spaced away a distance from the distal end 65b of the braid 64 large enough to ensure that the inner liner 60 and the braid 64 are substantially cylindrical in shape in the region of the wraps 72 while minimizing the distance the wraps 72 are space away from the distal end 65b to reduce wasted materials.
In embodiments where the sensor 58 includes an odd number of wraps 72, one lead exits the sensor 58 at a proximal end of the sensor 58 and the other lead exits the sensor at a distal end of the sensor 58. The lead that exits the sensor 58 at the distal end is placed under or over the wraps 72 prior to wrapping the leads 76a, 76b over the braid 64 as detailed below.
Additionally, a support tube or layer may be positioned over the braid 64 before the wire 71 is wrapped over the braid 64 to form the sensor 58 or may be placed over the sensor 58 after the wire 71 is wrapped over the braid to form the sensor 58. The support layer may be a ferro-metallic tube or a powder with resin that is configured to strengthen or support the sensor 58 to prevent the sensor 58 from deforming when used. The support layer may increase the signal strength of the sensor 58 such that the length and/or number of wraps 72 required to achieve a desired signal strength for the sensor 58 may be reduced.
With particular reference to
It is contemplated that a single device or a combination of devices may be used to wrap the wire 71 about the braid 64 to form the wraps 72, twist the pair of leads 76a, 76b of the wire 71 together, and wrap the twisted pair of leads 76a, 76b of the wire 71 about the braid 64. Alternatively, it is contemplated that the wraps 72 and the twisted pair of leads 76a, 76b may be preformed apart from the braid and then positioned or loaded over the braid 64. Once the wraps 72 are loaded over the braid 64, the twisted pair of leads 76a, 76b are wrapped about the braid 64 as detailed above.
Referring now to
With reference to
Referring to
With particular reference to
Referring to
Still referring to
With particular reference to
With continued reference to
The point 77 at which the twisted pair of the leads 76a, 76b exits through the outer coating 68 of the catheter 50 is positioned within the cavity 27 of the connector portion 26. The leads 76a, 76b are untwisted from one another and electrically coupled (e.g., soldered) separately to the internal connector 92. The internal connector 92 is in electrical communication with the external connector 94 such that an adapter (not shown) may be coupled to the external connector 94 to supply electrical energy to the sensor 58 (
With particular reference to
While several embodiments of the disclosure have been shown in the drawings, it is not intended that the disclosure be limited thereto, as it is intended that the disclosure be as broad in scope as the art will allow and that the specification be read likewise. Any combination of the above embodiments is also envisioned and is within the scope of the appended claims. Therefore, the above description should not be construed as limiting, but merely as exemplifications of particular embodiments. Those skilled in the art will envision other modifications within the scope of the claims appended hereto.
This application is a continuation of U.S. patent application Ser. No. 16/805,940, filed on Mar. 2, 2020, which is a continuation of U.S. patent application Ser. No. 15/228,321, filed on Aug. 4, 2016, now U.S. Pat. No. 10,575,754, which claims the benefit of the filing date of provisional U.S. Patent Application No. 62/222,449, filed on Sep. 23, 2015, the entire contents of each of which being incorporated by reference herein.
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Child | 17165104 | US | |
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