The present disclosure relates generally to implantable medical leads. More specifically, the present disclosure relates to suture sleeves for anchoring medical leads to tissue of a patient.
Medical leads are secured to a patient's tissue in a variety of applications using anchoring devices, including those commonly referred to as suture sleeves. For example, in many applications, an electrical lead connected to a neural stimulation modulation or a cardiac rhythm management (CRM) device, such as a pacemaker, is secured to patient tissue at a vein entry site or other location to help prevent both acute and chronic lead migration and dislodgement. In particular, the leads are anchored in place by securing a suture sleeve about the insulation of the lead and suturing the suture sleeve to the patient's tissue.
Disclosed herein are various embodiments of suture sleeves and methods for making suture sleeves.
In Example 1, a suture sleeve for securing an implantable lead with a suture includes an elongate, tubular body having a proximal end portion with a proximal face, a distal end portion with a distal face, and an exterior surface. The suture sleeve also includes a lumen within the tubular body extending from the proximal end portion to the distal end portion, wherein the lumen is sized to receive the implantable lead. The suture sleeve also includes a nonlinear, inner transition region extending from the lumen to at least one of the proximal face and the distal face of the tubular body, wherein the inner transition region is adapted to control the radius of curvature of the implantable lead that bends along the inner transition region.
In Example 2, the suture sleeve according to Example 1, wherein the suture sleeve further comprises an outer transition region that extends between the exterior surface of the suture sleeve and at least one of the proximal face and the distal face of the suture sleeve.
In Example 3, the suture sleeve according to either Example 1 or 2, wherein the inner transition region includes at least one curvilinear surface.
In Example 4, the suture sleeve according to any of Examples 1-3, wherein the inner transition region includes at least one chamfered edge, and wherein each chamfered edge has an obtuse angle between adjacent surfaces thereof.
In Example 5, the suture sleeve according to any of Examples 1-4, wherein the suture sleeve further comprises the inner transition region extending from the lumen to the proximal face of the tubular body.
In Example 6, the suture sleeve according to any of Examples 1-5, wherein the suture sleeve further comprises the inner transition region extending from the lumen to the distal face of the tubular body.
In Example 7, the suture sleeve according to Example 6, wherein the suture sleeve further comprises a second inner transition region extending from the lumen to the proximal end of the tubular body.
In Example 8, the suture sleeve according to any of Examples 1-7, wherein the suture sleeve further comprises the inner transition region that controls bending of the lead to a radius of curvature in a range of about 0.010 inches to 0.250 inches.
In Example 9, the suture sleeve according to any of Examples 1-8, wherein the suture sleeve further comprises at least a portion of the tubular body made of a first material and at least a portion of the tubular body that includes the inner transition region made of a second material having a higher durometer than the first material.
In Example 10, the suture sleeve according to Example 9, wherein the first material comprises silicone or polyurethane.
In Example 11, the suture sleeve according to Example 10, wherein the second material comprises polyurethane, tecothane, polyether ether ketone (PEEK), stainless steel, MP35N, titanium or platinum.
In Example 12, a method of making a suture sleeve for securing an implantable lead includes forming a tubular body having a proximal end portion with a proximal face, a distal end portion with a distal face, an exterior surface, a lumen sized to receive the implantable lead, and an inner surface within the lumen. The method also includes forming a nonlinear, inner transition region extending from the lumen to at least one of the proximal face and the distal face of the tubular body, wherein the inner transition region is adapted to control a radius of curvature of the implantable lead that bends along the inner transition region.
In Example 13, the method according to Example 12, wherein forming a tubular body includes forming a channel around the circumference of the tubular body, wherein the channel is sized to accommodate a suture within the channel.
In Example 14, the method according to Example 12 or 13, the inner transition region includes at least one curvilinear surface or at least one chamfered edge having an obtuse angle between adjacent surfaces thereof.
In Example 15, the method according to according to any of Examples 12-14, wherein forming the inner transition region comprises using one of an injection molding, extrusion, sanding or a machining process.
In Example 16, an implantable system comprising a pulse generator, an implantable medical electrical lead having a lead body with a proximal end and a distal end, the proximal end coupled to the pulse generator, a suture sleeve for securing an implantable lead with a suture, and at least one anchoring element configured to be secured circumferentially about the tubular body to secure the suture sleeve at particular location within the patient's body. The suture sleeve includes an elongate, tubular body having a proximal end portion with a proximal face, a distal end portion with a distal face, and an exterior surface. The suture sleeve also includes a lumen having an inner surface that is within the tubular body and extends from the proximal end portion to the distal end portion, wherein the lumen is sized to receive the implantable lead. The suture sleeve also includes a non-linear, inner transition region extending from the lumen to at least one of the proximal face and the distal face of the tubular body, the inner transition region being a curvilinear surface or a chamfered edge having an obtuse angle between adjacent surfaces thereof, wherein the inner transition region is adapted to control a radius of curvature of the implantable lead that bends along the inner transition region.
In Example 17, the implantable system according to Example 16, wherein at least a portion of the tubular body of the suture sleeve comprises silicone or polyurethane.
In Example 18, the implantable system according to Example 16 or 17, wherein the suture sleeve further comprises an anchor receiving area along the tubular body, the anchor receiving area defining an exterior surface within a channel that extends around a circumference of the tubular body.
In Example 19, the implantable system according to according to any of Examples 16-18, wherein the suture sleeve further comprises a protruding lip feature along the exterior surface of the tubular body at the distal end portion or the proximal end portion.
In Example 20, a suture sleeve for securing an implantable lead with a suture includes an elongate, tubular body having a proximal end portion with a proximal face, a distal end portion with a distal face, and an exterior surface. The suture sleeve also includes a lumen within the tubular body extending from the proximal end portion to the distal end portion, wherein the lumen is sized to receive the implantable lead. The suture sleeve also includes a nonlinear, inner transition region extending from the lumen to at least one of the proximal face and the distal face of the tubular body, wherein the inner transition region is a curvilinear surface or a chamfered edge having an obtuse angle between adjacent surfaces thereof and is adapted to control the radius of curvature of the implantable lead that bends along the inner transition region.
In Example 21, the suture sleeve according to Example 20, wherein the suture sleeve further comprises an outer transition region that extends between the exterior surface of the suture sleeve and at least one of the proximal face and the distal face of the suture sleeve.
In Example 22, the suture sleeve according to Example 20 or 21, wherein the inner transition region further comprises multiple curvilinear surfaces.
In Example 23, the suture sleeve according to according to any of Examples 20-22, wherein the inner transition region further comprises two or more chamfered edges, and wherein each chamfered edge has an obtuse angle between adjacent surfaces thereof.
In Example 24, the suture sleeve according to according to any of Examples 20-23, wherein the suture sleeve further comprises the inner transition region extending from the lumen to the proximal face of the tubular body.
In Example 25, the suture sleeve according to according to any of Examples 20-24, wherein the suture sleeve further comprises a second inner transition region extending from the lumen to the proximal face of the tubular body.
In Example 26, the suture sleeve according to according to Example 25, wherein the suture sleeve further comprises a second inner transition region extending from the lumen to the proximal end of the tubular body.
In Example 27, the suture sleeve according to according to any of Examples 20-26, wherein the suture sleeve further comprises the inner transition region that controls bending of the lead to a radius of curvature in a range of about 0.010 inches to 0.250 inches.
In Example 28, the suture sleeve according to according to any of Examples 20-26, wherein the suture sleeve further comprises at least a portion of the tubular body made of a first material and at least a portion of the tubular body that includes the inner transition region made of a second material having a higher durometer than the first material.
In Example 29, the suture sleeve according to according to Example 28, wherein the first material comprises silicone or polyurethane.
In Example 30, the suture sleeve according to according to Example 28, wherein the second material comprises a polyurethane, tecothane, polyether ether ketone (PEEK), stainless steel, MP35N, titanium and platinum.
In Example 31, a method of making a suture sleeve for securing an implantable lead includes forming a tubular body having a proximal end portion with a proximal face, a distal end portion with a distal face, an exterior surface, a lumen sized to receive the implantable lead and an inner surface within the lumen. The method also includes forming a nonlinear, inner transition region extending from the lumen to at least one of the proximal face and the distal face of the tubular body, wherein the inner transition region is a curvilinear surface or a chamfered edge having an obtuse angle between adjacent surfaces thereof and is adapted to control a radius of curvature of the implantable lead that bends along the inner transition region.
In Example 32, the method according to Example 31, wherein forming the tubular body includes forming a channel around the circumference of the tubular body, wherein the channel is sized to accommodate a suture within the channel.
In Example 33, the method according to Example 31 or 32, wherein forming the tubular body comprises using an injection molding process or an extrusion process.
In Example 34, the method according to according to any of Examples 31-33, wherein forming the inner transition region comprises using one of an injection molding, extrusion, sanding or a machining process.
In Example 35, the method according to according to any of Examples 31-34, wherein forming the tubular body includes forming the tubular body of silicone or polyurethane.
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.
While the invention is amenable to various modifications and alternative forms, specific embodiments have been shown by way of example in the drawings and are described in detail below. The intention, however, is not to control the invention to the particular embodiments described. On the contrary, the invention is intended to cover all modifications, equivalents, and alternatives falling within the scope of the invention as defined by the appended claims.
The proximal end portion 112 of the lead 106 can extend subcutaneously or submuscularly from the pulse generator 104 to the vascular entry site. At least a portion of the lead 106 can be secured by a securing means, such as suturing the lead 106 to subcutaneous tissue. The lead 106 can be secured by one or more sutures extending around the body of the lead 106 at a location proximal to the vascular entry site. In particular, the one or more sutures can wrap around a suture sleeve 108, also described as a lead anchor, which extends around the body of the lead 106, as will be discussed further herein.
Generally, suture sleeves 108 are used to secure the implantable lead 106 to body tissue to minimize chronic loading, movement and migration of the electrode. Suture sleeves 108 may also be used to secure a formation of a strain relief loop 116 to prevent loading to the electrode or delicate tissues and structures within the patient's body to minimize potential tissue damage or to reduce patient pain. For example, the formation of the strain relief loop 116 is commonly used in non-cardiac applications such as cervical vagus nerve stimulation or carotid sinus stimulation to prevent loading the nerves or carotid artery.
Although the lead 106 shown in
The suture sleeve 200 may include at least one anchor receiving area 216, 218 along the tubular body 202, according to various embodiments. As shown in
A plurality of anchoring means, such as sutures, can extend around the suture sleeve 200 and engage tissue, in some embodiments. Each suture can comprise a flexible string that can be wrapped around the suture sleeve 200 and threaded through tissue at an implant site. A knot can be tied in each suture after the suture is firmly wrapped around the suture sleeve 200 and thread through tissue at an implant site to anchor the suture sleeve 200 and the lead 106 (
In various embodiments, the suture sleeve 200 may include at least one slot 220 formed in the tubular body 202. In some embodiments, the slot 220 extends longitudinally along at least a portion of the anchoring device. In some embodiments, the slot 220 extends longitudinally along an entire length of the tubular body 202, from the proximal end portion 204 to the distal end portion 206. The slot 220 facilitates compression of the tubular body 202 of the suture sleeve 200 under the tying force of the sutures. Described differently, the slot 220 allows the tubular body 202 to collapse inwardly when the sutures are tightened about the body 202. As shown in
Described differently, in some embodiments, the inner transition region 222, 224 is a curve that connects two orthogonal surfaces at an angle other than a right angle. The curve may be defined as a straight curve or a radiused curve. For example, the inner transition region 222, 224 may be a curvilinear surface (or also described as a convex radius edge or rounded edge) having a suitable radius of curvature adapted to control the radius of curvature of the lead 106 of
The inner transition region 222, 224 optionally comprises multiple obtuse angles or rounded curves. In some embodiments, the multiple non-linear curves are successive, connected regions. In other embodiments, the multiple non-linear curves are discrete, separate regions.
A benefit of using the suture sleeve 200 featuring an inner transition region 222, 224 includes eliminating a relatively sharp edge between the inner surface 215 and the adjacent face of the suture sleeve 200 to help minimize kinking of the lead 106 of
Another benefit of using a suture sleeve 200 with a transition region is to minimize damaging the exterior surface 212 of the lead body when the lead body rubs against the inner edges of the suture sleeve 200. The curvilinear surface is the preferred embodiment for minimizing surface damage that might be caused by interaction between the suture sleeve inner edges and the lead body.
In various embodiments, the suture sleeve 200 has one or two inner transition regions 222, 224. For example, in
The inner transition region 222, 224 may generally form a radius of curvature in a range of about 0.010 inches to 0.250 inches, for example. In some embodiments, the radius of curvature formed may be about 0.062 inches, for example. Other examples of suitable radii of curvature ranges may include about 0.010 inches to 0.020 inches, about 0.020 inches to 0.025 inches or about 0.025 inches to 0.065 inches. In still further suitable examples, the radius of curvature range may be about 0.065 inches to about 0.100 inches, about 0.1 inches to 0.2 inches or about 0.20 inches to 0.25 inches. In some embodiments, a suitable radius of curvature for the suture sleeve 200 may be any radius greater than the minimum bend radius of the implantable lead body portion that interacts with the suture sleeve 200.
In some embodiments, the suture sleeve 200 includes an outer transition region 226, 228 along at least a portion of the exterior surface 212, in some embodiments. The outer transition region 226, 228 may share features that are similar to the inner transition portion, except that the outer transition region 226, 228 defines a transition located between the exterior surface 212 of the suture sleeve 200 and at least one face of the suture sleeve 200. In various embodiments, the outer transition region 226, 228 is a non-linear profile that extends from the exterior surface 212 of the tubular body 202 to one of the faces 208, 210 of the tubular body 202.
As shown in
The outer transition region 226, 228 may comprise a curve that extends smoothly and continuously from the inner transition region 222, 224, in some embodiments, as illustrated in
In
In various embodiments, the inner transition region 222, 224 or the outer transition region 226, 228 comprises multiple curvilinear surfaces, wherein each curvilinear surface has a specific radius of curvature. For example, in some embodiments, the multiple curvilinear surfaces of the outer transition region 226, 228 can have varying radii of curvature. Alternatively, in some embodiments, the multiple curved transitions can have equivalent or similar radii of curvature.
Suitable materials for the suture sleeve 200 include various polymeric, ceramic and metallic materials. Some examples of suitable polymer materials for the suture sleeve 200 include, but are not limited to, silicone, polyurethane, polycarbonate, tecothane, polyether, polyester, polyisobutylene (PIB) polyurethane, polyamide, nylon 6, nylon 12, polyetherimide and/or combinations thereof. Some examples of suitable metallic materials include, but are not limited to, stainless steel, MP35N titanium, platinum and/or combinations thereof.
In various embodiments, the suture sleeve 200 comprises multiple suitable materials including various polymeric, ceramic and metallic materials. In some embodiments, at least a portion of the suture sleeve 200 is formed from a first material and a second material. The second material, in various embodiments, has different material or mechanical properties than the first material, e.g., durometer, tensile strength, and lubricity. In some embodiments, an inner portion of the suture sleeve 200 may be made of the first material, while an outer portion of the suture sleeve 200 is made of the second material. For example, in some embodiments, a portion of the tubular body 202 of the suture sleeve 200 comprising the exterior surface 212 can be made a low durometer material, e.g., silicone, while a portion of the tubular body 202 that includes the inner transition region 222, 224 can be made of a second material with high durometer, e.g. PEEK.
Furthermore, as shown in
As shown in
The protruding lip feature 432, 532 may allow for the increase or decrease of a maximum radius of curvature of an inner transition region 422, 424, 522, 524. In some embodiments, the protruding lip feature 432, 532 having an outer diameter that is larger than the nominal outer diameter (i.e. the outer diameter at the middle portion 405, 505) allows for a larger maximum radius of curvature of the inner transition region 422, 424, 522, 524. In other embodiments, the protruding lip feature 432, 532 having an outer diameter that is smaller than the nominal outer diameter reduces or limits the maximum radius of curvature of the inner transition region 422, 424, 522, 524.
The protruding lip feature 432, 532 can provide several benefits for medical electric leads. The protruding lip feature 432, 532 may provide support to and control the bend radius of the medical lead 106 that is bending or curling along the exterior surface 412, 512 of the suture sleeve 400. In some embodiments, the protruding lip feature can provide support to a lead 106 bending greater than about 90 degrees. For example, the suture sleeve 400 with the protruding lip feature 432, 532 may provide support to the medical lead 106 bending between about 90 degrees and 180 degrees or between about 90 degrees and about 120 degrees. The term “about” may be used to define an angle value that is within 1 to 5 degrees from the specified value.
Other benefits of using a suture sleeve 400, 500 with the protruding lip feature 432, 532 include providing an outer transition region 426, 428, 526, 528, that minimizes an abrasive edge that might damage the exterior surface 412, 512 of the lead body when the lead body rubs against the exterior surface 412, 512 of the protruding lip feature 432, 532.
Similarly, the suture sleeve 800 includes an inner transition region 822 at the proximal end portion 804 of the tubular body 802, but no inner transition region at the distal end portion 806. In some embodiments, the inner transition region 822 at the proximal end portion 804 can be larger or smaller than the radii or curved profile of the inner transition region at the distal end portion 806.
The various embodiments of the suture sleeves described herein can be made using a range of manufacturing techniques. For example, one method of making a suture sleeve comprises forming the tubular body that includes the proximal end portion with the proximal end and the distal end portion with the distal end, in some embodiments. The tubular body also includes the exterior surface and the lumen with an inner surface, wherein the lumen is sized to receive the implantable lead. In some embodiments, forming a tubular body includes forming a channel around the circumference of the tubular body, wherein the channel is sized to accommodate a suture within the channel. In some embodiments, forming the tubular body comprises using an injection molding process or an extrusion process.
The method of making a suture sleeve further comprising forming the nonlinear, inner transition region extending from the lumen to at least one of the proximal face and the distal face of the tubular body, wherein the inner transition region is a curvilinear surface or a chamfered edge having an obtuse angle between adjacent surfaces thereof and is adapted to control a radius of curvature of the implantable lead that bends along the inner transition region, in some embodiments. In some embodiments, forming the inner transition region comprises using one of an injection molding, extrusion, sanding or a machining process.
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 that fall within the scope of the claims, together with all equivalents thereof.
This application claims priority to Provisional Application No. 62/008,310, filed Jun. 5, 2014, which is herein incorporated by reference in its entirety.
Number | Date | Country | |
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62008310 | Jun 2014 | US |