This application is related to copending U.S. patent application Ser. No. 10/841,069, filed on the same date, and expressly incorporated herein by reference.
The invention relates to the intravascular delivery of medical devices into a patient, and in particular, the intravascular implantation of stimulation and/or recording electrode leads into a patient.
There are certain circumstances in which it is desired to electrically stimulate tissue and/or record electrical signals received from such tissue via blood vessels. For example, U.S. patent application Ser. No. 10/744,319, which is expressly incorporated herein by reference, describes a method of treating neurological disorders by intravenously delivering stimulation leads within the brain, thereby obviating the need to invasively create a burr hole in the cranium of the patient.
Despite the minimally invasive benefits provided by these types of procedures, it is preferable that thrombosis formation caused by the blockage of blood flow through a vessel be prevented. It is also preferable that the electrical energy delivered by the vessel implanted electrode lead be as efficient as possible. For example, when treating a neurological disorder using electrical energy, it is desirable that the magnitude of the electrical energy be sufficient to cause sub-threshold stimulation of the targeted brain tissue. Due to the relatively low resistance of blood versus the relatively high resistance of vessel walls, however, the electrical energy is likely to follow the path of least resistance, i.e., through the blood stream, rather than the vessel wall. The gain of the implanted stimulation device could be increased in order to overcome the power losses through the bloodstream. Invariably, this may potentially cause poor sub-threshold stimulation of the target area, or worse, stimulation of a non-targeted region of the brain. Increasing the gain can also impact the system efficiency by reducing the battery life of the implanted stimulation source.
Thus, there remains a need to provide improved intravascular electrode leads that are capable of more efficiently transmitting electrical energy into vessel tissue and receiving electrical energy from vessel tissue, while minimizing the occlusion of blood flow.
In accordance with a first aspect of the present inventions, another expandable intravascular medical device is provided. The medical device comprises an electrode support structure, e.g., a non-tubular arcuate structure or a cylindrical member. The medical device further comprises at least one electrode associated with the support structure. For example, the electrode(s) can be discrete elements that are bonded to the support structure, electrically conductive layers disposed on the support structure, or the support structure, itself, can form the electrode(s). The medical device further comprises a plurality of resilient spring loops laterally extending from the support structure. The electrode(s) may optionally be formed from the spring loops. The medical device further comprises at least one lead electrically coupled to the electrode(s). Alternatively, if there are a plurality of electrodes, a plurality of leads can be electrically coupled to the respective electrodes.
In accordance with a second aspect of the present inventions, a method of performing a medical procedure on a patient is provided. The method comprises intravascularly introducing the afore-mentioned medical device into the patient while the medical device is in a collapsed geometry (e.g., by applying a compressive force to the spring loops), placing the medical device in an expanded geometry (e.g., by releasing the compressive force from the spring loops) to firmly contact the electrode(s) with the inner surface of a blood vessel, and transmitting and/or receiving electrical signals between the blood vessel and the electrode(s). In one preferred method, the medical device is implanted within the blood vessel.
Thus, although the present inventions should not be so limited in their broadest aspects, the firm placement of the electrode(s) against the inner surface of the vessel wall by the action of the spring loops allows the electrical energy to be more efficiently transmitted to and/or received from the vessel wall and surrounding tissue, while minimizing the occlusion of blood flow. In addition, due to their placement on one side of the vessel wall, the electrode(s) focus the transmission of the electrical energy into and/or the reception of the electrical energy from a targeted tissue site.
In accordance with a third aspect of the present inventions, an intravascular medical device is provided. The medical device comprises an elongated member and two resilient spring arms extending distally from the elongated member. The arms are configured to be laterally moved towards each other to place the medical device in a collapsed geometry, and configured to be laterally moved away from each into contact with an inner surface of a blood vessel to place the medical device an expanded geometry.
In one embodiment, the spring arms are pre-shaped to laterally move away from each other. The contact created between the respective arms and the blood vessel are sufficient to anchor the medical device within the blood vessel. The medical device further comprises an electrode associated with the distal end of one of the spring arms. For example, the electrode can be a discrete element that is bonded to the spring arm, an electrically conductive layer disposed on the spring arm, or the distal end of the arcuate spring, itself, can form the electrode. The medical device may comprise another electrode associated with the distal end of the other of the spring arms. The medical device further comprises a lead electrically coupled to the electrode. Alternatively, if there are two electrodes, a two leads can be electrically coupled to the respective electrodes.
In accordance with a fourth aspect of the present inventions, a method of performing a medical procedure on a patient is provided. The method comprises intravascularly introducing the afore-mentioned medical device into the patient while the medical device is in a collapsed geometry (e.g., by applying a compressive force to the spring arms), placing the medical device in an expanded geometry (e.g., by releasing the compressive force from the spring arms) to firmly contact the electrode with the inner surface of a blood vessel, and transmitting and/or receiving electrical signals between the blood vessel and the electrode. In one preferred method, the medical device is implanted within the blood vessel.
Thus, although the present inventions should not be so limited in its broadest aspects, the firm placement of the electrode(s) against the inner surface of the vessel wall by the action of the spring arms allows the electrical energy to be more efficiently transmitted to and/or received from the vessel wall and surrounding tissue, while minimizing the occlusion of blood flow.
In accordance with a fifth aspect of the present inventions, an expandable intravascular medical device is provided. The medical device comprises an arcuate spring configured to be expanded into firm contact with the inner surface of a blood vessel. The arcuate spring is non-tubular, i.e., it spans less than 360 degrees. In one embodiment, the arcuate spring spans greater than 180 degree. This allows the arcuate spring to more easily anchor the medical device to the inner surface of a blood vessel when expanded.
The medical device further comprises at least one electrode associated with the arcuate spring. For example, the electrode(s) can be discrete elements that are bonded to the arcuate spring, electrically conductive layers disposed on the arcuate spring, or the arcuate spring, itself, can form the electrode(s). The medical device further comprises at least one lead electrically coupled to the electrode(s). Alternatively, if there are a plurality of electrodes, a plurality of leads can be electrically coupled to the respective electrodes.
In accordance with a sixth aspect of the present inventions, a method of performing a medical procedure on a patient is provided. The method comprises intravascularly introducing the afore-mentioned medical device into the patient while the medical device is in a collapsed geometry (e.g., by applying a compressive force to the arcuate spring), placing the medical device in an expanded geometry (e.g., by releasing the compressive force from the arcuate spring) to firmly contact the electrode(s) with the inner surface of a blood vessel, and transmitting and/or receiving electrical signals between the blood vessel and the electrode(s).
Thus, although the present inventions should not be so limited in their broadest aspects, the firm placement of the electrode(s) against the inner surface of the vessel wall by the action of the arcuate spring allows the electrical energy to be more efficiently transmitted to and/or received from the vessel wall and surrounding tissue, while minimizing the occlusion of blood flow. Also, the non-tubular nature of the arcuate spring allows the medical device to adapt to various sizes of blood vessels as compared to tubular structures. In addition, due to the non-tubular nature of the arcuate spring, the electrode(s) can be more easily configured to focus the transmission of the electrical energy into and/or the reception of the electrical energy from a targeted tissue site.
In accordance with an eighth aspect of the present inventions, still another intravascular medical device is provided. The medical device comprises an arcuate structure with an inner electrically insulative surface. The arcuate structure may either be tubular or non-tubular. The medical device further comprises at least one electrode associated with the arcuate structure. In one embodiment, at least a portion of the arcuate structure forms the electrode(s). In another embodiment, the arcuate structure has an outer insulative surface, and the electrode(s) are disposed on the arcuate structure as a thin electrically conductive film. In either case, if the arcuate structure is resilient, the electrode(s) will be able to flex with the arcuate structure. In another embodiment, the arcuate structure is non-porous to enhance the electrical insulative nature of the arcuate structure. The medical device further comprises at least one lead electrically coupled to the electrode(s). Alternatively, if there are a plurality of electrodes, a plurality of leads can be electrically coupled to the respective electrodes.
In accordance with a ninth aspect of the present inventions, a method of performing a medical procedure on a patient is provided. The method comprises intravascularly introducing the afore-mentioned medical device into the patient while the medical device is in a collapsed geometry (e.g., by applying a compressive force to the arcuate structure), placing the medical device in an expanded geometry (e.g., by releasing the compressive force from the arcuate structure) to firmly contact the electrode(s) with the inner surface of a blood vessel, and transmitting and/or receiving electrical signals between the blood vessel and the electrode(s). In one preferred method, the medical device is implanted within the blood vessel.
Thus, although the present inventions should not be so limited in its broadest aspects, the existence of the inner insulative surface of the arcuate structure electrically insulates the blood from electrical energy transmitted and/or received by the electrode(s), while minimizing the occlusion of blood flow.
The drawings illustrate the design and utility of preferred embodiment(s) of the invention, in which similar elements are referred to by common reference numerals. In order to better appreciate the advantages and objects of the invention, reference should be made to the accompanying drawings that illustrate the preferred embodiment(s). The drawings, however, depict the embodiment(s) of the invention, and should not be taken as limiting its scope. With this caveat, the embodiment(s) of the invention will be described and explained with additional specificity and detail through the use of the accompanying drawings in which:
Referring now to
When the medical device 100 is in its expanded geometry, the electrode body 102 can be placed into firm contact with the target site and used to transmit to and/or receive electrical signals from the blood vessel and surrounding tissue, while minimizing blood occlusion. The leads 104, the proximal ends of which will extend from the intravascular access point in the patient (e.g., the femoral vein or jugular vein), are configured to be coupled to an implanted or external source and/or recorder of the electrical signals (not shown), as will be described in further detail below.
The electrode body 102 comprises a plurality of electrically conductive sub-structures 106 (in this case, three), which together, form an integrated support structure. In the preferred embodiment, the conductive sub-structures 106 are self-expanding (i.e., they automatically expand in the absence of a radially compressive force). Alternatively, the conductive sub-structures 106 expand only in the presence of a radially expanding force, such with a stent balloon (not shown). In any event, once expanded, the rigidity of the conductive sub-structures 106 will allow them to remain in their expanded geometry until a radially compressive force is applied.
In the preferred embodiment, the conductive sub-structures 106 are distinct in that they are separately formed, and then they are linked together to form the integrated structure. In the illustrated embodiment, the conductive sub-structures 106 are cylindrical structures that are axially aligned along the length of the electrode body 102. In this case, the conductive sub-structures 106 act as three ring electrodes that extend along the electrode body 102. Alternatively, as illustrated in
In any event, each conductive sub-structure 106 is skeletal in nature, and is formed by fashioning a wire or wires into an undulating shape, as illustrated in
In whichever manner fashioned, the material used to form each conductive sub-structure 106 is both biocompatible and electrically conductive. Preferably, such material is also radiopaque and allows for electrolytic detachable linkages to the proximal end of the electrode body 102, as will be described in further detail below. Suitable metals and alloys for the composition of the support structure include Platinum Group metals, especially platinum, rhodium, palladium, rhenium, as well as tungsten, gold, silver, tantalum, and alloys of these metals, such as a platinum/tungsten alloy. Each conductive sub-structure 106 can also be composed of a wide variety of stainless steels if some sacrifice of radiopacity can be tolerated. Certain super-elastic alloys, such as nickel/titanium alloys, nickel/titanium alloys, or nickel/aluminum alloys, can also be used. Especially preferred is the titanium/nickel alloy known as “nitinol,” which is a very sturdy alloy that will tolerate significant flexing. If desired, the wire used to form the conductive sub-structure 106 can be further coated with platinum-iridium, gold, or silver to improve its conduction properties, biocompatibility, and radiopacity. Each conductive sub-structure 106 can be coated with additives, such as a non-thrombogenic agent to prevent blood coating, or a therapeutic agent.
The portions of the conductive sub-structures 106 that are mechanically linked together (i.e., the loops 108 at the edges of the conductive sub-structures 106) are electrically isolated from each other. In the embodiments illustrated in
Although each insulative element 110 is shown as only connecting a pair of loops 108 together, an insulative element 110 can connect a series of loop pairs. For example,
In the embodiment illustrated in
In an alternative embodiment illustrated in
As illustrated in
In whichever manner the conductive sub-structures 106 are linked and electrically isolated, the leads 104 are connected to the electrode body 102 using suitable means, such as welding or soldering. Each lead 104 comprises an electrically conductive core with an outer insulative layer. The length of the lead 104 is preferably sized to extend from intravascular access point in the patient to the selected target site within the blood vessel where the electrode body 102 will be implanted. If the medical device 100 is to be connected to the implanted stimulator or recorder, the length of the lead 104 should be sized to extend from the implantation site of the stimulator and/or recorder to the selected target site when routed through the intravascular access point. For example, if the target site is in the patient's brain, the implantation site of the stimulator or recorder is in the chest region of the patient, and the intravascular access point is the patient's jugular vein, then the length of the lead 104 may be in the range of 50 cm to 100 cm. If, however, the target site is in the patient's brain, the implantation site of the source or recorder is in the abdominal region of the patient, and the intravascular access point is the patient's femoral vein, then the length of the lead 104 may be in the range of 150 cm to 300 cm.
The leads 104 can be coupled to the electrode body 102 in a variety of manners to achieve different electrode functionalities. For example, in the illustrated embodiment, the leads 104 are coupled to the respective conductive sub-structures 106, so that the conductive sub-structures 106 are completely electrically isolated from one another. In this manner, the electrode body 102 can have a multiple-channel and/or multi-polar capability. That is, if operating as a multi-channel device, the conductive sub-structures 106 can simultaneously receive multiple signals (if connected to a recorder) or can simultaneously transmit multiple signals (if connected to a stimulation source). If operated as a multi-polar device, electrical signals can be transmitted between one or more conductive sub-structures 106 (as anodes) and one or more other conductive sub-structures (as cathodes). Of course, the conductive sub-structures 106 can be electrically combined to make a single-channel and/or monopolar device if the proximal ends of the leads 104 are electrically connected together at the stimulator and/or recorder. In an alternative embodiment, a single lead 104 can be coupled to one of the conductive sub-structures 106, preferably the proximal-most conductive sub-structure 106, in which case, the conductive sub-structures 106 can be electrically coupled together in series, e.g., by directly or indirectly electrically coupling a pair of respective loops 108 together.
It should be noted that electrode body 102 may alternatively have a wireless transmitter and/or receiver in order to provide the electrode body 102 with the capability of wirelessly communicating with a remote stimulator and/or recorder. In this case, the leads will be routed from the electrodes on the electrode body 102 to the transmitter and/or receiver.
Although the previously described electrode body 102 has been described as having discrete conductive sub-structures, the electrode body 102 can be formed from a unibody support structure. In particular,
Like the previously described conductive sub-structures 106, the unibody support structure 124 is skeletal in nature and, in this case, is formed as a tubular mesh. The wires used to form the unibody support structure 124, however, comprises an electrically conductive core 130 and an insulative layer 132 disposed over the conductive core 130, as best shown in
The conductive and insulative regions 126/128 of the electrode body 102 can be formed into other shapes besides cylindrical shapes. For example, as illustrated in
Referring now to
The pusher element 156 is mechanically coupled to the electrode body 102, and is axially rigid, so that the electrode body 102 can be introduced through the catheter 152, yet laterally flexible to allow the pusher element 156 to bend around the natural curves within the patient's vasculature. In the illustrated embodiment, the pusher element 156 can be selectively detached from the electrode body 102 (once properly placed) using an electrolytic arrangement.
In particular, as illustrated in
In alternative embodiments, pusher wires with mechanical detachment mechanisms can be used to selectively detach the electrode body 102. For example, U.S. Pat. Nos. 5,234,437, 5,250,071, 5,261,916, 5,304,195, 5,312,415, and 5,350,397, which are expressly incorporated herein by reference, disclose such mechanically detachable means.
The delivery catheter 152 comprises an elongate, flexible, catheter body 164, and a delivery lumen 166 (shown in
The catheter body 164 is composed of a medically acceptable material, preferably a nondistensible polymer having the appropriate mechanical properties. Preferred materials include polyethylene, polyester, polypropylene, polyimide, polyvinyl chloride, ethylvinyl acetate, polyethylene terephthalate, polyurethane, Pebax®, fluoropolymers, silicone, and their mixtures and block or random copolymers. The catheter body 164 preferably has a relatively stiff proximal segment, which makes up between 70%–95% of the total length of the catheter body 164, and a relatively flexible distal segment, which makes up the remaining 5%–30% of the length of the catheter body 164.
The delivery lumen 166 of the catheter 152 preferably has a diameter of between 2–50 mils, but ultimately will be sized to allow the guidewire 154 and medical device 100 to be respectively introduced therethrough. Alternatively, as shown in
Referring back to
It should be noted that the kit illustrated in
Having described the structure of the intravascular lead kit 150, a preferred method of installing the medical device 100 within a patient's body in order to perform a therapeutic or diagnostic procedure will now be described, with reference to
Next, the delivery catheter 152 is introduced over the guidewire 154 until the distal end of the catheter 152 is just proximal to the target site 182 (
After the medical device 100 has been deployed within the patient, the delivery catheter 152 is removed from the patient's body. Depending on the nature of the disorder and goals of the operation, the medical device 100 may be left within the patient either acutely (i.e., only during an operation and then removed after the operation has been completed), chronically, or sub-chronically (i.e., less than six months). In any event, the proximal ends of the leads 104 of the medical device 100 will remain outside of the patient's body after the deployment process is completed, and in particular, will extend from the vascular access point, e.g., the internal jugular vein or femoral vein. The exposed ends of the leads 104 can be subcutaneously routed a short distance to the clavical or chest region or behind the ear of the patient (in this case where the jugular vein is the access point) or the abdominal or groin region of the patient (in the case where the femoral vein is the access point), where they can be coupled to the implanted stimulation/recording device. Alternatively, the stimulation/recording device 100 may not be implanted, but rather located exterior to the patient, e.g., during a non-chronic procedure.
Referring now to
In its collapsed geometry, the electrode body 202 can be intravascularly delivered to a target site within a vessel using a standard stent delivery apparatus. In order to maintain the electrode body 202 in its collapsed geometry, a removable sheath or covering 203 is disposed over the collapsed electrode body 202, as shown in
The electrode body 202 comprises an arcuate resilient spring 206 and a plurality of electrodes 208 (in this case, three) disposed on the spring 206. The resilient spring 202 is non-tubular, i.e., its arcuate shape spans less than 360 degrees. In this manner, unlike tubular electrode structures, the electrode body 202 is more adaptable to variously sized blood vessels. In addition, the transmitted and/or recorded electrical energy is more focused. Preferably, the arcuate shape of the arcuate spring 206 spans greater than 180 degrees, so that it is capable of being frictionally adhered to the inner surface of a blood vessel.
The spring 206 is pre-shaped to assume its arcuate shape in the absence of an external force, but can be collapsed, e.g., by rolling the spring 206. Thus, the electrode body 202 can be placed and maintained in its collapsed geometry by applying a compressive force on the spring 206 and placing it within the sheath 203. In contrast, the electrode body 202 can be placed in its expanded geometry by releasing the compressive force to unfurl the spring 206, which naturally occurs when the sheath 203 is removed.
When expanded within a blood vessel, the resiliency of the spring 206 continuously urges it against the inner surface of the blood vessel with a force sufficient to hold the electrode body 202 in place within the selected blood vessel without moving as a result of the repetitive blood pulsing within the vascular system, but without distending the vessel wall. In the illustrated embodiment, the spring 206 is non-porous, but can alternatively be skeletal in nature, such as a coil, mesh, or braid. The surface of the arcuate spring 206 is preferably both biocompatible and electrically insulative. The arcuate spring 206 can be entirely composed of a resilient insulative material, such as polyimide, polytetrafluoroethylene (PTFE), Fluorinated Ethylene Propylene (FEP), polyethylene, or silicone, or can be composed of a core of electrically conductive material, such as one or more of the various materials from which the previously described conductive sub-structures 106 are composed, and an insulative layer disposed over the core.
In the illustrated embodiment, the electrodes 208 are applied to the spring 206 as a layer of highly electrically conductive and biocompatible material, such as gold, silver, or platinum. Deposition techniques include sputtering, vapor deposition, ion beam deposition, electroplating over a deposited seed layer, or a combination of these processes. Alternatively, the electrodes 208 may be discrete and flexible elements, such as mesh or braid, that is suitably bonded to the spring 206. In other alternative embodiments, the spring 206, itself, may form the electrodes 208. For example, any of the previously described techniques, such as forming electrodes from electrically conductive sub-structures, or removing insulative material to expose portions of an electrically conductive core, can be used.
The leads 204, the proximal ends of which will extend from the intravascular access point in the patient (e.g., the femoral vein or jugular vein), are configured to be coupled to an implanted or external source and/or recorder of the electrical signals (not shown), as will be described in further detail below. The conductive leads 204, which are of similar construction and length as leads 104, are suitably coupled to the electrodes 208 using means, such as welding or soldering.
Using the delivery catheter 152, with the associated guidewire 154 and electrolytic pusher wire 156, the medical device 200 can be delivered to a target site 182 within a selected blood vessel in the same manner as that described above, so that the electrode body 202 is expanded into firm contact with the blood vessel 180, as illustrated in
Referring now to
The electrode body 212 comprises an arcuate structure 216, a plurality of electrodes 218 (in this case, three) disposed on the structure 216, and a plurality of resilient spring loops 215 mounted to the arcuate structure 216. The spring loops 215 can be mounted to the arcuate structure 216 in any suitable manner, including welding or soldering. The spring loops 215 are pre-shaped to extend laterally from the arcuate structure 216 in the absence of a compressive force, but can be collapsed, e.g., by applying a compressive force to the spring loops 215. Thus, the electrode body 212 can be placed in its collapsed geometry by applying a compressive force to hinge the spring loops 215, which naturally occurs when the electrode body 212 is introduced within the delivery catheter 152. In contrast, the electrode body 212 can be placed in its expanded geometry by releasing the compressive force in order to hinge the spring loops 215 into their laterally extending position, which naturally occurs when the electrode body 212 exits the delivery catheter 152. The resiliency of the spring loops 215 continuously urges the arcuate structure 216 against the opposing vessel wall into firm contact with the target site with a force sufficient to hold the electrode body 212 in place within the selected blood vessel without moving as a result of the repetitive blood pulsing within the vascular system, but without distending the vessel wall.
Like the previously described arcuate spring 206, the arcuate structure 216 is non-tubular, i.e., its arcuate shape spans less than 360 degrees, thereby providing the electrode body 212 with the same advantages as the electrode body 202. Unlike the previously described electrode body 202, however, the electrode body 212 can advantageously span less than 180 degrees, since the electrode body 212 need not have the capability, by itself, to adhere to the vessel walls. That is, the force applied by the spring loops 215 is sufficient to place the electrode body 212 firmly against the vessel wall. In this manner, the electrode body 212 may be even more adaptable to a variety of blood vessel shapes, and the electrical stimulation and/or recording energy more focused, than that of the previously described arcuate electrode body 202.
Like the previously described arcuate spring 206, the surface of the arcuate structure 216 is preferably both biocompatible and electrically insulative, and thus can be constructed in a similar manner as the spring 206, with the exception that the arcuate structure 216 need not be resilient. Optionally, however, the arcuate structure 216 may be composed of a resilient material, so that it acts as a spring much like the resilient spring 206 of the electrode body 202. In this manner, the frictional engagement created by the resiliency of the spring, in addition to the lateral forces created by the resiliency of the spring loops 215, will place the electrodes 218 firmly in contact with the vessel wall.
The electrodes 218 can be composed of the same material and be disposed on the arcuate structure 216 in the same manner as the previously described electrodes 208. In addition to the electrodes 218, the resilient spring loops 215 can be composed of an electrically conductive material, so that they can also serve as electrodes. In this case, the spring loops 215 can be directly mounted to the electrodes 218. Alternatively, the spring loops 215 can act as electrodes, obviating the need for separate electrodes 218 on the arcuate structure 216.
The conductive leads 214, the proximal ends of which will extend from the intravascular access point in the patient (e.g., the femoral vein or jugular vein), are configured to be coupled to an implanted or external source and/or recorder of the electrical signals (not shown), as will be described in further detail below. The conductive leads 214, which are of similar construction and length as leads 104, are suitably coupled to the electrodes 218 using means, such as welding or soldering.
Using the delivery catheter 152, with the associated guidewire 154 and electrolytic pusher wire 156, the medical device 210 can be delivered to a target site 182 within a selected blood vessel in the same manner as that described above, so that the electrode body 212 is placed into firm contact with the blood vessel 180, as illustrated in
Referring now to
The electrode body 222 comprises an elongated cylindrical member 226, a plurality of electrodes 228 (in this case, three) disposed on the cylindrical member 226, and a plurality of resilient spring loops 225 mounted to the cylindrical member 226. The spring loops 225 can be mounted to the cylindrical member 226 in any suitable manner, including welding, soldering, or tying the spring loops 225 to the cylindrical member 226. Like the previously described spring loops 225, the spring loops 225 are pre-shaped to extend laterally from the cylindrical member 226 in the absence of a compressive force, but can be collapsed, e.g., by applying a compressive force to the spring loops 225. The resiliency of the spring loops 225 continuously urges the cylindrical member 226 against the opposing vessel wall into firm contact with the target site with a force sufficient to hold the electrode body 222 in place within the selected blood vessel without moving as a result of the repetitive blood pulsing within the vascular system, but without distending the vessel wall.
The cylindrical member 226 can be composed of any flexible and insulative material, such as Pebax®, nylon, silicone, or urethane. In the illustrated embodiment, the electrodes 228 take the form of a ring electrodes that axially extend along the member 226. The electrodes 228 may be discrete elements that are mounted to the cylindrical member 226 in an interference relationship, or may be suitably formed on the cylindrical member 226 as a layer of material. The electrodes 228 may be composed of the same material as the previously described electrodes 208. Like the previously described spring loops 225, the resilient spring loops 225 can also be composed of an electrically conductive material in order to serve as electrodes, in which case, the spring loops 225 can be directly mounted to the electrodes 228, or alternatively, the spring loops 225 can act as electrodes, obviating the need for separate electrodes 228 on the cylindrical member 226.
The conductive leads 224, the proximal ends of which will extend from the intravascular access point in the patient (e.g., the femoral vein or jugular vein), are configured to be coupled to an implanted or external source and/or recorder of the electrical signals (not shown), as will be described in further detail below. The conductive leads 224, which are of similar construction and length as leads 104, extend through the cylindrical member 226 where they are suitably coupled to the electrodes 228 using means, such as welding or soldering.
Using the delivery catheter 152, with the associated guidewire 154 and electrolytic pusher wire 156, the medical device 220 can be delivered to a target site 182 within a selected blood vessel in the same manner as that described above, so that the electrode body 222 is placed into firm contact with the blood vessel 180, as illustrated in
Referring now to
The electrode body 232 comprises a central support member 236, a pair of resilient spring arms 235 extending from the distal end of the support member 234, and a pair of electrodes 238 disposed on the distal ends of the respective spring arms 235. The support member 236 can be composed of any suitable rigid or semi-rigid insulative material, such as Pebax®, nylon, urethane, silicone, or polyimide.
The spring arms 235 can be mounted to the support member 236 in any suitable manner, including welding or soldering. The spring arms 235 are pre-shaped to laterally extend away from each other in the absence of a compressive force to place the electrode body 232, but can be collapsed, e.g., by applying a compressive force to the spring arms 235. Thus, the electrode body 232 can be placed and maintained in its collapsed geometry by applying a compressive force to move the spring arms 235 towards each other, which naturally occurs when the electrode body 232 is introduced within the delivery catheter 152. A sheath (not shown) can be optionally used to maintain the electrode body 232 in its collapsed geometry as it is introduced through the delivery catheter 152. In contrast, the electrode body 232 can be placed in its expanded geometry by releasing the compressive force to allow the spring arms 235 to move away from each other, which naturally occurs when the electrode body 232 exits the delivery catheter 152. When the spring arms 235 expand against the vessel wall, they will create an anchoring force sufficient to hold the electrode body 232 in place within the selected blood vessel without moving as a result of the repetitive blood pulsing within the vascular system, but without distending the vessel wall.
In the illustrated embodiment, the electrodes 238 are discrete elements that are suitably bonded onto the resilient arms 235, although the electrodes 238 can be formed onto the spring arms 235 in other suitable manners. With the exception of their distal ends, the spring arms 235 are preferably coated with an electrically insulative material. Alternatively, the exposed distal ends of the spring arms 235 can act as electrodes, thereby obviating the need to bond separate discrete electrodes 238 onto the spring arms 235.
The conductive leads 234, the proximal ends of which will extend from the intravascular access point in the patient (e.g., the femoral vein or jugular vein), are configured to be coupled to an implanted or external source and/or recorder of the electrical signals (not shown), as will be described in further detail below. The conductive leads 234, which are of similar construction and length as leads 104, extend through the support member 236 and are suitably coupled to the proximal ends of the spring arms 235 using means, such as welding or soldering.
Using the delivery catheter 152, with the associated guidewire 154 and electrolytic pusher wire 156, the medical device 230 can be delivered to a target site 182 within a selected blood vessel in the same manner as that described above, so that the electrode body 232 is placed into firm contact with the blood vessel 180, as illustrated in
Although particular embodiments of the present invention have been shown and described, it should be understood that the above discussion is not intended to limit the present invention to these embodiments. It will be obvious to those skilled in the art that various changes and modifications may be made without departing from the spirit and scope of the present invention. Thus, the present invention is intended to cover alternatives, modifications, and equivalents that may fall within the spirit and scope of the present invention as defined by the claims.
Number | Name | Date | Kind |
---|---|---|---|
4141365 | Fischell et al. | Feb 1979 | A |
4285347 | Hess | Aug 1981 | A |
4519403 | Dickhudt | May 1985 | A |
4608985 | Crish et al. | Sep 1986 | A |
4658835 | Pohndorf | Apr 1987 | A |
4739768 | Engelson | Apr 1988 | A |
4813934 | Engelson et al. | Mar 1989 | A |
4869255 | Putz | Sep 1989 | A |
4884579 | Engelson | Dec 1989 | A |
5005587 | Scott | Apr 1991 | A |
5010894 | Edhag | Apr 1991 | A |
5170802 | Mehra | Dec 1992 | A |
5224491 | Mehra | Jul 1993 | A |
5234437 | Sepetka | Aug 1993 | A |
5239999 | Imran | Aug 1993 | A |
5250071 | Palermo | Oct 1993 | A |
5261916 | Engelson | Nov 1993 | A |
5263488 | Van Veen et al. | Nov 1993 | A |
5304195 | Twyford, Jr. et al. | Apr 1994 | A |
5312415 | Palermo | May 1994 | A |
5350397 | Palermo et al. | Sep 1994 | A |
5365926 | Desai | Nov 1994 | A |
5391200 | KenKnight et al. | Feb 1995 | A |
5397341 | Hirschberg et al. | Mar 1995 | A |
5411551 | Winston et al. | May 1995 | A |
5417719 | Hull et al. | May 1995 | A |
5423864 | Ljungstroem | Jun 1995 | A |
5501703 | Holsheimer et al. | Mar 1996 | A |
5509411 | Littmann et al. | Apr 1996 | A |
5531779 | Dahl et al. | Jul 1996 | A |
5534007 | St. Germain et al. | Jul 1996 | A |
5543864 | Hirschman et al. | Aug 1996 | A |
5603731 | Whitney | Feb 1997 | A |
5647870 | Kordis et al. | Jul 1997 | A |
5683422 | Rise | Nov 1997 | A |
5702438 | Avitall | Dec 1997 | A |
5707354 | Salmon et al. | Jan 1998 | A |
5713922 | King | Feb 1998 | A |
5716377 | Rise et al. | Feb 1998 | A |
5752979 | Benabid | May 1998 | A |
5782239 | Webster, Jr. | Jul 1998 | A |
5792187 | Adams | Aug 1998 | A |
5800474 | Benabid et al. | Sep 1998 | A |
5814062 | Sepetka et al. | Sep 1998 | A |
5833709 | Rise et al. | Nov 1998 | A |
5846238 | Jackson et al. | Dec 1998 | A |
5860974 | Abele | Jan 1999 | A |
5871483 | Jackson et al. | Feb 1999 | A |
5891136 | McGee et al. | Apr 1999 | A |
5902236 | Iversen | May 1999 | A |
5908385 | Chechelski et al. | Jun 1999 | A |
5925070 | King et al. | Jul 1999 | A |
5938689 | Fischell et al. | Aug 1999 | A |
5954761 | Machek et al. | Sep 1999 | A |
5967986 | Cimochowski et al. | Oct 1999 | A |
6015387 | Schwartz et al. | Jan 2000 | A |
6016449 | Fischell et al. | Jan 2000 | A |
6018682 | Rise | Jan 2000 | A |
6027456 | Feler et al. | Feb 2000 | A |
6053873 | Govari et al. | Apr 2000 | A |
6066163 | John | May 2000 | A |
6074407 | Levine et al. | Jun 2000 | A |
6074507 | Sukenik | Jun 2000 | A |
6091980 | Squire et al. | Jul 2000 | A |
6094596 | Morgan | Jul 2000 | A |
6119044 | Kuzma | Sep 2000 | A |
6122548 | Starkebaum et al. | Sep 2000 | A |
6128538 | Fischell et al. | Oct 2000 | A |
6136021 | Tockman et al. | Oct 2000 | A |
6141576 | Littmann et al. | Oct 2000 | A |
6161029 | Spreigl et al. | Dec 2000 | A |
6161047 | King et al. | Dec 2000 | A |
6170488 | Spillman, Jr. et al. | Jan 2001 | B1 |
6179858 | Squire et al. | Jan 2001 | B1 |
6205361 | Kuzma et al. | Mar 2001 | B1 |
6216045 | Black et al. | Apr 2001 | B1 |
6231516 | Keilman et al. | May 2001 | B1 |
6249707 | Kohnen et al. | Jun 2001 | B1 |
6263248 | Farley et al. | Jul 2001 | B1 |
6266568 | Mann et al. | Jul 2001 | B1 |
6319251 | Tu et al. | Nov 2001 | B1 |
6330477 | Casavant | Dec 2001 | B1 |
6353762 | Baudino et al. | Mar 2002 | B1 |
6360122 | Fischell et al. | Mar 2002 | B1 |
6361528 | Wilson et al. | Mar 2002 | B1 |
6370427 | Alt et al. | Apr 2002 | B1 |
6391052 | Buirge et al. | May 2002 | B2 |
6393325 | Mann et al. | May 2002 | B1 |
6397109 | Cammilli et al. | May 2002 | B1 |
6402746 | Whayne et al. | Jun 2002 | B1 |
6408214 | Williams et al. | Jun 2002 | B1 |
6415187 | Kuzma et al. | Jul 2002 | B1 |
6418344 | Rezai et al. | Jul 2002 | B1 |
6438427 | Rexhausen et al. | Aug 2002 | B1 |
6442413 | Silver | Aug 2002 | B1 |
6442435 | King et al. | Aug 2002 | B2 |
6445953 | Bulkes et al. | Sep 2002 | B1 |
6463328 | John | Oct 2002 | B1 |
6466822 | Pless | Oct 2002 | B1 |
6480743 | Kirkpatrick et al. | Nov 2002 | B1 |
6484059 | Gielen | Nov 2002 | B2 |
6516227 | Meadows et al. | Feb 2003 | B1 |
6519488 | KenKnight et al. | Feb 2003 | B2 |
6522932 | Kuzma et al. | Feb 2003 | B1 |
6529774 | Greene | Mar 2003 | B1 |
6539263 | Schiff et al. | Mar 2003 | B1 |
6547788 | Maguire et al. | Apr 2003 | B1 |
6547870 | Griessmann et al. | Apr 2003 | B1 |
6562063 | Euteneuer et al. | May 2003 | B1 |
6584358 | Carter et al. | Jun 2003 | B2 |
6587733 | Cross, Jr. et al. | Jul 2003 | B1 |
6589230 | Gia et al. | Jul 2003 | B2 |
6591138 | Fischell et al. | Jul 2003 | B1 |
6597953 | Boling | Jul 2003 | B2 |
6600954 | Cohen et al. | Jul 2003 | B2 |
6606521 | Paspa et al. | Aug 2003 | B2 |
6647296 | Fischell et al. | Nov 2003 | B2 |
6658302 | Kuzma et al. | Dec 2003 | B1 |
6662055 | Prutchi | Dec 2003 | B1 |
6665562 | Gluckman et al. | Dec 2003 | B2 |
6690974 | Archer et al. | Feb 2004 | B2 |
6697676 | Dahl et al. | Feb 2004 | B2 |
6714822 | King et al. | Mar 2004 | B2 |
6842648 | Partridge et al. | Jan 2005 | B2 |
6895283 | Erickson et al. | May 2005 | B2 |
6999820 | Jordan | Feb 2006 | B2 |
20010025192 | Gerber et al. | Sep 2001 | A1 |
20010041821 | Wilk | Nov 2001 | A1 |
20010053885 | Gielen et al. | Dec 2001 | A1 |
20020111661 | Cross, Jr. et al. | Aug 2002 | A1 |
20020151948 | King et al. | Oct 2002 | A1 |
20020151949 | Dahl et al. | Oct 2002 | A1 |
20020188207 | Richter | Dec 2002 | A1 |
20030014016 | Purdy | Jan 2003 | A1 |
20030040785 | Maschino et al. | Feb 2003 | A1 |
20030199962 | Struble et al. | Oct 2003 | A1 |
20030204135 | Bystritsky | Oct 2003 | A1 |
20030204228 | Cross, Jr. et al. | Oct 2003 | A1 |
20040015193 | Lamson et al. | Jan 2004 | A1 |
Number | Date | Country |
---|---|---|
0 861 676 | Sep 1998 | EP |
0 865 800 | Sep 1998 | EP |
0 865 800 | Dec 1999 | EP |
0 864 800 | Sep 2004 | EP |
WO 0185094 | Nov 2001 | WO |
WO 03077986 | Sep 2003 | WO |
Number | Date | Country | |
---|---|---|---|
20050251239 A1 | Nov 2005 | US |