The present invention relates to an introducer device for providing percutaneous access to a patient's vasculature for a transcatheter device delivery system, and, more particularly to an expandable introducer device having an expandable introducer sheath for accommodating passage of the transcatheter device delivery system therethrough.
An introducer device is used to provide percutaneous access to the vascular system of a patient and functions to permit the introduction and positioning of various minimally invasive delivery devices within the patient's vasculature. In general, having the smallest insertion profile is the most desirable and leads to less complications, less trauma, and improved patient outcomes. Some delivery devices, however, are large and require large sheaths to accommodate and help deliver them to the desired site within the body.
The present application is directed to introducers. Non-limiting examples of introducers include the following.
In a first example hereof, an expandable introducer comprises an introducer hub and an introducer sheath coupled to the introducer hub and extending distally therefrom. The introducer sheath includes a sheath wall having an interior surface defining a lumen of the introducer sheath and an exterior surface disposed radially outward from the interior surface. A portion of the sheath wall has a varying thickness around a circumference of introducer sheath.
In a second example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the introducer sheath is radially expandable from a folded, unexpanded state to an unfolded, expanded state, the introducer sheath includes a folded region and a non-folded region when the introducer sheath is in the folded, unexpanded state, and the varying thickness of the sheath wall includes a first thickness at the folded region and a second thickness at the unfolded region, wherein the second thickness is larger than the first thickness.
In a third example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the exterior surface of the sheath wall is textured to aid in hydro-coat retention or reduce surface contact area with a patient's anatomy, thereby reducing track forces during insertion and delivery.
In a fourth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the sheath wall includes a spine at the non-folded region of the introducer sheath.
In a fifth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the exterior surface of the sheath wall is wavy or ridged.
In a sixth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, an inner diameter of the introducer sheath remains constant along a length of the introducer sheath and a thickness of the sheath wall varies longitudinally such that the exterior surface is wavy or ridged.
In a seventh example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the exterior surface and the interior surface of the sheath wall are wavy or ridged.
In an eighth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, a thickness of the sheath wall is constant longitudinally, and wherein an inner diameter and an outer diameter of the introducer sheath varies longitudinally such that the exterior surface and the interior surface are wavy or ridged.
In a ninth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the interior surface of the sheath wall is circumferentially ridged.
In a tenth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, a thickness of the sheath wall varies circumferentially such that the interior surface of the sheath wall is circumferentially ridged.
In an eleventh example hereof, an expandable introducer comprises an introducer hub, and an introducer sheath coupled to the introducer hub and extending distally therefrom. The introducer sheath includes a sheath wall having an interior surface defining a lumen of the introducer sheath and an exterior surface disposed radially outward from the interior surface, and a spine coupled to the sheath wall and extending longitudinally along the sheath wall.
In a twelfth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the exterior surface of the sheath wall is textured to aid in hydro-coat retention or reduce surface contact area with a patient's anatomy, thereby reducing track forces during insertion and delivery.
In a thirteenth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, a portion of the sheath wall has a varying thickness around a circumference of introducer sheath.
In a fourteenth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the introducer sheath is radially expandable from a folded, unexpanded state to an unfolded, expanded state, the introducer sheath includes a folded region and a non-folded region when the introducer sheath is in the folded, unexpanded state, and the varying thickness of the sheath wall includes a first thickness at the folded region and a second thickness at the unfolded region, wherein the second thickness is larger than the first thickness.
In a fifteenth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the exterior surface of the sheath wall is wavy or ridged.
In a sixteenth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, an inner diameter of the introducer sheath remains constant along a length of the introducer sheath and a thickness of the sheath wall varies longitudinally such that the exterior surface is wavy or ridged.
In a seventeenth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the exterior surface and an interior surface of the sheath wall are wavy or ridged.
In an eighteenth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, a thickness of the sheath wall is constant longitudinally, and wherein an inner diameter and an outer diameter of the introducer sheath varies longitudinal that that the exterior surface and the interior surface are wavy or ridged.
In a nineteenth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the interior surface of the sheath wall is circumferentially ridged.
In a twentieth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, a thickness of the sheath wall varies circumferentially such that the interior surface of the sheath wall is circumferentially ridged.
In a twenty-first example hereof, an expandable introducer comprises an introducer hub and an introducer sheath coupled to the introducer hub and extending distally therefrom. The introducer sheath includes a sheath wall having an interior surface defining a lumen of the introducer sheath and an exterior surface disposed radially outward from the interior surface. The exterior surface of the sheath wall is wavy or ridged.
In a twenty-second example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, an inner diameter of the introducer sheath remains constant along a length of the introducer sheath and a thickness of the sheath wall varies longitudinally such that the exterior surface is wavy or ridged.
In a twenty-third example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the exterior surface of the sheath wall is textured to aid in hydro-coat retention or reduce surface contact area with a patient's anatomy, thereby reducing track forces during insertion and delivery.
In a twenty-fourth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the introducer sheath is radially expandable from a folded, unexpanded state to an unfolded, expanded state, and the introducer sheath includes a folded region and a non-folded region when the introducer sheath is in the folded, unexpanded state.
In a twenty-fifth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the introducer sheath includes a spine coupled to the sheath wall and extending longitudinally.
In a twenty-sixth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the interior surface of the sheath wall is circumferentially ridged.
In a twenty-seventh example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, a thickness of the sheath wall varies circumferentially such that the interior surface of the sheath wall is circumferentially ridged.
In a twenty-eighth example hereof, an expandable introducer comprises an introducer hub and an introducer sheath coupled to the introducer hub and extending distally therefrom. The introducer sheath includes a sheath wall having an interior surface defining a lumen of the introducer sheath and an exterior surface disposed radially outward from the interior surface. The exterior surface of the sheath wall is wavy or ridged and the interior surface of the sheath wall is wavy or ridged.
In a twenty-ninth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, a thickness of the sheath wall is constant longitudinally, and an inner diameter and an outer diameter of the introducer sheath varies longitudinal such that the exterior surface and the interior surface are wavy or ridged.
In a thirtieth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the exterior surface of the sheath wall is textured to aid in hydro-coat retention or reduce surface contact area with a patient's anatomy, thereby reducing track forces during insertion and delivery.
In a thirty-first example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the introducer sheath is radially expandable from a folded, unexpanded state to an unfolded, expanded state, the introducer sheath includes a folded region and a non-folded region when the introducer sheath is in the folded, unexpanded state, and a first thickness of the folded region of the sheath wall is less than a second thickness of the non-folded region of the sheath wall.
In a thirty-second example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the introducer sheath further includes a spine coupled to the sheath wall, the spine extending longitudinally.
In a thirty-third example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the spine extends along the non-folded region of the introducer sheath.
In a thirty-fourth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the interior surface of the sheath wall is circumferentially ridged.
In a thirty-fifth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, a thickness of the sheath wall varies circumferentially such that the interior surface is circumferentially ridged.
In a thirty-sixth example hereof, an expandable introducer comprises an introducer hub and an introducer sheath coupled to the introducer hub and extending distally therefrom. The introducer sheath includes a sheath wall having an interior surface defining a lumen of the introducer sheath and an exterior surface disposed radially outward from the interior surface. The interior surface of the sheath wall is circumferentially ridged such that inner radius of the introducer sheath varies circumferentially.
In a thirty-seventh example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, an outer radius of the introducer sheath is constant, wherein a thickness of the sheath wall varies such that the inner radius varies circumferentially.
In a thirty-eighth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the exterior surface of the sheath wall is textured to aid in hydro-coat retention or reduce surface contact area with a patient's anatomy, thereby reducing track forces during insertion and delivery.
In a thirty-ninth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the introducer sheath is radially expandable from a folded, unexpanded state to an unfolded, expanded state.
In a fortieth example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the introducer sheath includes a folded region and a non-folded region when the introducer sheath is in the folded, unexpanded state.
In a forty-first example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the introducer sheath further includes a spine disposed coupled to the sheath wall, wherein in the spine extends longitudinally.
In a forty-second example hereof, in the expandable introducer of any of the previous or subsequent examples hereof, the spine is coupled to the non-folded region of the introducer sheath.
The details of one or more aspects of the disclosure are set forth in the accompanying drawings and the description below. Other features, objects, and advantages of the techniques described in this disclosure will be apparent from the description and drawings, and from the claims.
The foregoing and other features and advantages of the present disclosure will be apparent from the following description of embodiments hereof as illustrated in the accompanying drawings. The accompanying drawings, which are incorporated herein and form a part of the specification, further serve to explain the principles of the present disclosure and to enable a person skilled in the pertinent art to make and use the embodiments of the present disclosure. The drawings may not be to scale.
It should be understood that various embodiments disclosed herein may be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. It should also be understood that, depending on the example, certain acts or events of any of the processes or methods described herein may be performed in a different sequence, may be added, merged, or left out altogether (e.g., all described acts or events may not be necessary to carry out the techniques). In addition, while certain aspects of this disclosure are described as being performed by a single device or component for purposes of clarity, it should be understood that the techniques of this disclosure may be performed by a combination of devices or components associated with, for example, a delivery system. The following detailed description is merely exemplary in nature and is not intended to limit the invention of the application and uses of the invention. Furthermore, there is no intention to be bound by any expressed or implied theory presented in the preceding field of the invention, background, summary or the following detailed description.
As used in this specification, the singular forms “a”, “an” and “the” specifically also encompass the plural forms of the terms to which they refer, unless the content clearly dictates otherwise. The term “about” is used herein to mean approximately, in the region of, roughly, or around. When the term “about” is used in conjunction with a numerical range, it modifies that range by extending the boundaries above and below the numerical values set forth. In general, the term “about” is used herein to modify a numerical value above and below the stated value by a variance of 5%. It should be understood that use of the term “about” also includes the specifically recited number of value.
The terms “proximal” and “distal” herein when used with respect to a delivery system are used with reference to the clinician using the devices. Therefore, “proximal” and “proximally” mean in the direction toward the clinician, and “distal” and “distally” mean in the direction away from the clinician.
As used herein, the term “generally” and “substantially” mean approximately. When used to describe angles such as “substantially parallel” or “substantially perpendicular” the term “substantially” means within 10 degrees of the angle. When used to describe shapes such as “substantially” or “generally” cylindrical or “substantially” or “generally” tube-shaped or “generally” or “substantially” conical, the terms mean that the shape would appear cylindrical or tube-shaped or conical to a person of ordinary skill in the art viewing the shape with a naked eye.
The introducer hub 106 includes the distal end 107, a proximal end 108, and a passageway 109 extending from the proximal end 108 to the distal end 107 of the introducer hub 106. The passageway 109 is sized and shaped to accommodate a delivery system therethrough, as described in more detail below. An exterior surface of the introducer hub 106 tapers in a distal direction, as shown in
The introducer sheath 110 is a substantially flexible, plastic tube defining a lumen 122 of the introducer sheath 110. The sheath 110 includes a distal end 112, a proximal end 114, and a sheath wall 115. The sheath wall 115 includes an interior or inner surface 116 defining the lumen 122 and an exterior or outer surface 118, as best shown in
At least a portion of the introducer sheath 110 is configured to be folded into a folded or unexpanded configuration during insertion within a vessel of a patient and can be unfolded to an unfolded or expanded configuration via advancement of a dilator or delivery system through the lumen 122 of the introducer sheath 110, as shown and explained with reference to
In the embodiment shown in
As explained above, advancement of a dilator or delivery system through the lumen 122 of the introducer sheath 110 causes the introducer sheath 110 to unfold or expand to the expanded configuration.
In another embodiment, as shown in
In another embodiment, which may be in combination with the embodiments shown and described with respect to
In another embodiment, which may be in combination with embodiments shown and described with respect to
The ridged exterior surface 118 of the sheath wall 115 reduces track force, as it reduces the amount of contact surface the introducer sheath 110 has with the anatomy. This reduces the need for a coating, as the ridged exterior surface 118 reduces the coefficient of friction, compared to an introducer sheath that includes a constant outer diameter around the outer surface of the introducer sheath. The ridged or waved interior surface 116 of the sheath wall 115 reduces surface contact area between the interior surface 116 of the sheath wall 115 and the dilator and/or delivery system that advances through the lumen 122 of the introducer sheath 110. This, in turn, results in reduced insertion forces when advancing the dilator or delivery system therethrough. In the embodiment shown, the wavy interior surface 116 of the sheath wall 115 extends along the entire longitudinal length of the introducer sheath 110, i.e. from the proximal end 114 to the distal end 112 of the introducer sheath 110. However, this is not meant to be limiting, as the wavy interior surface 116 of the sheath wall 115 may be present only along a portion of the introducer sheath 110, such as, for example, only the distal end 112, or only proximal end 114, or only sections of the introducer sheath 110 that have high insertion forces. Similarly, in the embodiment shown, the wavy exterior surface 118 extends along the entire longitudinal length of the introducer sheath 110, i.e. from the proximal end 114 to the distal end 112 of the introducer sheath 110. However, this is not meant to be limiting, as the wavy exterior surface 118 may be present only along a portion of the introducer sheath 110, such as, for example, only the distal end 112, or only proximal end 114, or only sections of the introducer sheath 110 that have high tracking forces. In an embodiment, the thickness of the introducer sheath wall 115 may be about 0.005 inch to about 0.015 inch. As can be seen, the lumen 122 of the introducer sheath 110, defined by the interior surface 116 of the sheath wall 115, is sized and shaped to accommodate passage of a dilator or a delivery system therethrough.
In any of the embodiments disclosed herein, the exterior surface 118 of the introducer sheath wall 115 may be textured, as shown in
In another embodiment, which may be combined with any of the embodiments described herein, the introducer sheath 110 includes a circumferentially ridged or ribbed interior surface 116, as shown in
In another embodiment, which may be combined with any of the embodiments described above, the exterior surface 118 of the introducer sheath wall 115 is textured, examples of which are shown in
While the devices and methods have been disclosed herein as used for delivery of a heart valve prosthesis, they may be used for delivery of any catheter-based device (e.g., stent graft, stent, balloon, etc.) and may be used in any suitable blood vessel.
As noted above, it should be understood that various embodiments disclosed herein may be combined in different combinations than the combinations specifically presented in the description and accompanying drawings. For example, the embodiments with wavy inner or outer surface may also include the spine 128 of
The present application claims the benefit of U.S. Provisional Application No. 63/498,841, filed Apr. 28, 2023, the contents of which are incorporated by reference herein in their entirety.
Number | Date | Country | |
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63498841 | Apr 2023 | US |