This application claims the benefit of U.S. Provisional Application No. 60/840,214 filed Aug. 25, 2006, which is incorporated by reference herein in its entirety.
1. Technical Field
This invention relates to wire guides used in the placement of medical devices, and more particularly to wire guides having a loop tip.
2. Background Information
Wire guides are elongate flexible members used to provide a path along which another medical device can be moved. The path provided by the wire guide can be used to navigate another medical device, such as a catheter through a body vessel. The use of wire guides to define such a path is known in the art. Briefly, a wire guide is navigated through a body lumen toward a point of treatment. Once positioned within the lumen, a therapeutic or diagnostic device, (i.e., a catheter) may be advanced over the wire guide to the target site and the desired therapeutic or diagnostic steps may be performed. The wire guide provides an established path for placing other devices and eliminates the need for performing delicate navigation procedures for each device passed into the body lumen, for example when additional procedures are performed.
During placement of the wire guide, an operator must navigate the wire guide through a tortuous pathway in the body lumen due to the presence of natural bends and/or curves, or unnatural impediments, such as tumors, build-ups, and/or strictures. The presence of a tortuous path may make navigation of a wire guide through the path difficult, for example, the tip of the wire guide may get bent away from the desired path or caught in a stricture, or in some cases even perforate the wall of the lumen, etc. making further navigation into the lumen difficult or impossible.
The prior art contains many examples of wire guides having straight, flexible tips intended to aid in navigation of tortuous body lumens. The presence of a straight tip, however, may make navigation more difficult. For example, upon encountering an impediment, the straight tip may bend (reflex) into the lumen wall and become caught. Contact of the straight tip with the lumen wall may prevent the wire guide from advancing further into the lumen as well as possibly damaging the lumen wall.
What is needed is an improved wire guide tip for navigating a tortuous body lumen where the improved wire guide includes a loop tip configured for facilitating navigation and reducing trauma to the lumen wall during advancement of the wire guide.
The various preferred embodiments provide significant improvements and advantages over conventional straight wire guide tips.
According to one aspect of the present invention, an elongate medical device configured for navigation through a bodily lumen is provided. The device includes an elongate shaft having a proximal portion and a distal portion. The distal portion includes a first interlocking connector. The device further includes a loop portion operably connected to the distal portion. The loop portion includes a second interlocking connector configured for connecting to the first interlocking connector.
According to another aspect of the present invention, an elongate medical system is provided. The system includes a catheter and a wire guide extending from a distal portion of the catheter. The wire guide includes an elongate shaft having a proximal portion and a distal portion. The distal portion of the shaft includes a first interlocking connector. The wire guide further includes a loop portion having a second interlocking connector configured for connecting to the first interlocking connector on the shaft.
In another aspect of the present invention, a method of manufacturing a wire guide having a loop tip is provided. The method includes forming an elongate shaft having a proximal portion and a distal portion. The distal portion has a first interlocking connector. The method further includes forming a loop structure having a second interlocking connector. The first interlocking connector of the shaft is connected to the second interlocking connector of the loop.
The foregoing paragraphs have been provided by way of general introduction, and are not intended to limit the scope of the following claims. The presently preferred embodiments, together with further advantages will be best understood by reference to the following detailed description taken in conjunction with the accompanying drawings.
Embodiments of the present invention will now be described by way of example with reference to the accompanying drawings, in which:
The invention is described with reference to the drawings in which like elements are referred to by like numerals. The relationship and functioning of the various elements of this invention are better understood by the following detailed description. However, the embodiments of this invention as described below are by way of example only, and the invention is not limited to the embodiments illustrated in the drawings. It should also be understood that the drawings are not to scale and in certain instances details have been omitted, which are not necessary for an understanding of the present invention, such as conventional details of fabrication and assembly.
As used in the specification, the terms proximal and distal should be understood as being in the terms of a physician using the wire guide. Hence the term distal means the portion of the wire guide which is farthest from the physician and the term proximal means the portion of the wire guide which is nearest to the physician.
As shown in
Alternative configurations for the connector 29 are shown in
In some embodiments, the loop 30 may be externally connected to the distal portion 28 of the shaft 22. As shown in
In some embodiments, the loop 30 may be formed from a semi-circularly shaped member 82 where the curved portion 84 of the semicircle extends outward and the flattened portion 86 faces inward. The loop 30 may be formed by positioning end regions 88 of the semicircle member 82 with the flattened portions 86 against each other wherein the loop 30 extends between the end regions. As shown in
In some embodiments, the loop 30 may include a folding region 112 to facilitate folding of the loop 30, for example, for withdrawing the loop 30 into a catheter. As shown in
In some embodiments, the loop 30 may be provided as a helical coil configuration 140 as shown in
The loop 30 may also be formed as a die cut structure as shown in
In some embodiments, the loop 30 may be formed from tubing 170 that may be molded or extruded in the desired shape for the loop 30. For example, as shown in
Any method may be used to connect the connector 29 of the shaft 22 to the connector 33 of the loop 30. As described above, the connectors 29 and 33 may be sized and shaped to releasably interlock together the connectors 29 and 33 for example, by forming a snap-fit connection between the portions or by threading together the respective threads. In addition or as an alternative, the connectors 29 and 33 may be connected by bonding, including, but not limited to adhesive bonds and solder bonds, welding and molding. Combinations of these methods may also be used.
Any suitable material can be used for the wire guide 20 and portions thereof. The material chosen need only be biocompatible, or made biocompatible, and able to be formed into the structures described herein. Exemplary materials will also be compliant, elastic, resilient and have shape memory. Portions of the wire guide 20, such as the loop 30 and the shaft 22 may be made from different materials or the same materials. Examples of suitable materials include, but are not limited to stainless steel, tantalum, nitinol; gold, silver, tungsten, platinum, inconel, cobalt-chromium alloys and iridium, all of which are commercially available metals or alloys used in the fabrication of medical devices. Portions of the wire guide may be formed from a medically-acceptable polymer. For example, exemplary polymers include, but are not limited to, cellulose acetate, cellulose nitrate, silicone, polyethylene, high density polyethylene, polyethylene teraphthalate, polyurethane, polytetrafluoroethylene (PTFE), polyamide, polyester, polyorthoester, polyvinyl chloride (PVC), polypropylene, acrylonitrile-butadiene-styrene (ABS), polycarbonate, polyurethane, nylon silicone, and polyanhydride.
Portions of the wire guide 20 may also be made from a bioabsorbable material. A number of bioabsorbable homopolymers, copolymers, or blends of bioabsorbable polymers are known in the medical arts. These include, but are not necessarily limited to, polyesters including poly-alpha hydroxy and poly-beta hydroxy polyesters, polycaprolactone, polyglycolic acid, polyether-esters, poly(p-dioxanone), polyoxaesters; polyphosphazenes; polyanhydrides; polycarbonates including polytrimethylene carbonate and poly(iminocarbonate); polyesteramides; polyurethanes; polyisocyantes; polyphosphazines; polyethers including polyglycols polyorthoesters; expoxy polymers including polyethylene oxide; polysaccharides including cellulose, chitin, dextran, starch, hydroxyethyl starch, polygluconate, hyaluronic acid; polyamides including polyamino acids, polyester-amides, polyglutamic acid, poly-lysine, gelatin, fibrin, fibrinogen, casein, and collagen. For example, when the loop 30 is die-cut as described above, the loop 30 may be made from PTFE.
The wire guide 20, or portions thereof, may comprise a wire, a tubular member or a sheet of material. Further, the wire guide 20 or portions thereof may be formed from a series of layers, or as a coated core structure. For example, in one embodiment, the shaft 22 may comprise a nitinol core with a PTFE covering. The loop 30 may also be formed of nitinol and may include a PTFE covering. Portions of the loop 30 may also be reinforced for example, by providing additional layers of materials or stronger material from the list above, in or to prevent kinking. Any reinforcing materials will still allow the loop 30 to flex as it navigates through the lumen to the treatment site.
A variety of shapes and sizes of the shaft 22 and the loop 30 may be used, and these can both be optimized based on particular applications. The dimensions of the shaft 22 and the loop 30 will depend upon various factors, including the intended use of the wire guide 20 and the body lumens into which the wire guide 20 will be positioned. For a wire guide 20 intended to cannulate the common bile duct, suitable dimensions include a shaft diameter 39 of between approximately 0.016 inches and approximately 0.038 inches, and preferably comprises a diameter 39 of approximately 0.035 inches. The distal portion diameter 37 forming the loop 30 of the wire guide 20 preferably has a diameter of between approximately 0.003 inches and approximately 0.010 inches, and preferably comprises a diameter of approximately 0.006 inches. When the loop 30 is ovoid in shape and delivered to the bile duct, the length of the loop 30 may be between approximately 4 and approximately 5 millimeters, and the width 34 at the widest portion of the loop 30 may be between approximately 2 and approximately 3 millimeters. One skilled in the art will recognize that other sizes and shapes are possible depending on the bodily location the wire guide 20 is configured to enter. For example, the loop 30 may also be configured to enter the colon, pancreas and esophagus that may require different sizes than described above. Any size and shape loop 30 may be used with the present invention.
Coatings may also be applied to at least a portion of the wire guide 20. The coating(s) may be applied by dipping, molding, spraying, heat shrinking or extrusion of a suitable coating material, such as PTFE, polyolefin, polyvinyl chloride (PVC), polyester (PET) and fluorinated ethylene propylene (FEP) and/or other polymeric coatings, directly to the wire guide 20 or portions thereof. Bioabsorbable coatings may also be used.
In some embodiments, a thin heat shrinkable material may be used for the coating, such as PTFE. The heat shrinkable materials facilitate manufacturing while providing a lubricious coating, which facilitates navigation. In preferred embodiments, the thickness of the coating is between approximately 0.001 and 0.010 inches. In particularly preferred embodiments, the thickness of the coating is between approximately 0.001 and 0.005 inches. In still more preferred embodiments, the thickness of the coating is between approximately 0.001 and 0.002 inches. These preferred thicknesses provide suitable coatings while not adding significantly to the overall thickness of the device.
Also, the wire guide 20 or portions thereof, with or without the coating described above, may be treated with a hydrophilic coating or hybrid polymer mixture, such as those based on polyvinyl puroladine and cellulose esters in organic solvent solutions. These solutions make the wire guide particularly lubricious when in contact with body fluids, which aids in navigation.
Radiopaque materials may be added in the coating. Also, radiopaque materials known in the art may be placed on the shaft 22 and the loop 30 and other portions of the wire guide 20. Several examples of suitable radiopaque materials and markers are known in the art, and any suitable material and/or marker can be utilized in the present invention. Common radiopaque materials include barium sulfate, bismuth subcarbonate, and zirconium dioxide. Other radiopaque elements include: cadmium, tungsten, gold, tantalum, bismuth, platinum, iridium, and rhodium. In one embodiment, iodine may be employed for its radiopacity and antimicrobial properties. Radiopacity is typically determined by fluoroscope or x-ray film. Radiopaque, physiologically compatible materials include metals and alloys selected from the Platinum Group metals, especially platinum, rhodium, palladium, rhenium, as well as tungsten, gold, silver, tantalum, and alloys of these metals. These metals have significant radiopacity and in their alloys may be tailored to accomplish an appropriate blend of flexibility and stiffness. They are also largely biocompatible. For example, a platinum/tungsten alloy, e.g., 8% tungsten and the remainder platinum may be used.
Operation of the wire guide 20 of the present invention is similar to conventional wire guides known in the art. The wire guide 20 may be provided to the operator preassembled with the wire guide 20 loaded into a catheter, such as the catheter 40 shown in FIGS. 10A and 10B-C. The catheter may be any catheter known to one skilled in the art, including, but not limited to, dual lumen, triple lumen catheters, balloon catheters, stent delivery catheters, cannulae, papillotomes and sphincterotomes, and the like. In some embodiments, the wire guide 20 may be back loaded into the lumen 52 so that the distal portion 28 including the loop 30 of the wire guide 20 extends distally from the catheter 40. Back loading refers to introduction of the proximal portion 26 of the wire guide 20 into the catheter 40 until the distal portion 26 extends out of a proximal guide wire exit (
The wire guide 20 may be advanced through the tortuous body lumen to the desired location and the catheter 40 may be advanced over the wire guide 20 following standard procedures known to one skilled in the art.
Any other undisclosed or incidental details of the construction or composition of the various elements of the disclosed embodiment of the present invention are not believed to be critical to the achievement of the advantages of the present invention, so long as the elements possess the attributes needed for them to perform as disclosed. The selection of these and other details of construction are believed to be well within the ability of one of even rudimentary skills in this area, in view of the present disclosure. Illustrative embodiments of the present invention have been described in considerable detail for the purpose of disclosing a practical, operative structure whereby the invention may be practiced advantageously. The designs described herein are intended to be exemplary only. The novel characteristics of the invention may be incorporated in other structural forms without departing from the spirit and scope of the invention. Unless otherwise indicated, all ordinary words and terms used herein shall take their customary meaning as defined in The New Shorter Oxford English Dictionary, 1993 edition. All technical terms shall take on their customary meaning as established by the appropriate technical discipline utilized by those normally skilled in that particular art area. All medical terms shall take their meaning as defined by Stedman's Medical Dictionary, 27th edition.
It is therefore intended that the foregoing detailed description be regarded as illustrative rather than limiting, and that it be understood that it is the following claims, including all equivalents, that are intended to define the spirit and scope of this invention.
Number | Name | Date | Kind |
---|---|---|---|
3791387 | Itoh | Feb 1974 | A |
3890977 | Wilson | Jun 1975 | A |
4176662 | Frazer | Dec 1979 | A |
4207872 | Meiri et al. | Jun 1980 | A |
4281660 | Fujiwara | Aug 1981 | A |
4310789 | Mank et al. | Jan 1982 | A |
4326530 | Fleury, Jr. | Apr 1982 | A |
4447227 | Kotsanis | May 1984 | A |
4545390 | Leary | Oct 1985 | A |
4729384 | Bazenet | Mar 1988 | A |
4800890 | Cramer | Jan 1989 | A |
4824435 | Giesy et al. | Apr 1989 | A |
5003990 | Osypka | Apr 1991 | A |
5037391 | Hammerslag et al. | Aug 1991 | A |
5054501 | Chuttani et al. | Oct 1991 | A |
5069217 | Fleischhacker, Jr. | Dec 1991 | A |
5078716 | Doll | Jan 1992 | A |
5109867 | Twyford, Jr. | May 1992 | A |
5114402 | McCoy | May 1992 | A |
5131407 | Ischinger et al. | Jul 1992 | A |
5133364 | Palermo et al. | Jul 1992 | A |
5211636 | Mische | May 1993 | A |
5221270 | Parker | Jun 1993 | A |
5246009 | Adams | Sep 1993 | A |
5247942 | Prather et al. | Sep 1993 | A |
5271415 | Foerster et al. | Dec 1993 | A |
5282478 | Fleischhaker et al. | Feb 1994 | A |
5300048 | Drewes, Jr. et al. | Apr 1994 | A |
5334168 | Hemmer | Aug 1994 | A |
5337732 | Grundfest et al. | Aug 1994 | A |
5345925 | Allred, III et al. | Sep 1994 | A |
5349964 | Imran et al. | Sep 1994 | A |
5357978 | Turk | Oct 1994 | A |
5358479 | Wilson | Oct 1994 | A |
5365943 | Jansen | Nov 1994 | A |
5376083 | Mische | Dec 1994 | A |
5387219 | Rappe | Feb 1995 | A |
5398670 | Ortiz et al. | Mar 1995 | A |
5421348 | Larnard | Jun 1995 | A |
5433200 | Fleischhacker, Jr. | Jul 1995 | A |
5490845 | Racz | Feb 1996 | A |
5498249 | Quinn | Mar 1996 | A |
5513650 | Johansen | May 1996 | A |
5522819 | Graves et al. | Jun 1996 | A |
5531685 | Hemmer et al. | Jul 1996 | A |
5595565 | Treat et al. | Jan 1997 | A |
5604531 | Iddan et al. | Feb 1997 | A |
5613973 | Jackson et al. | Mar 1997 | A |
5643281 | Suhocki et al. | Jul 1997 | A |
5685312 | Yock | Nov 1997 | A |
5728122 | Leschinsky et al. | Mar 1998 | A |
5730704 | Avitall | Mar 1998 | A |
5800453 | Gia | Sep 1998 | A |
5813405 | Montano et al. | Sep 1998 | A |
5824031 | Cookston et al. | Oct 1998 | A |
5836947 | Fleischman et al. | Nov 1998 | A |
5879295 | Li et al. | Mar 1999 | A |
5885381 | Mitose et al. | Mar 1999 | A |
5885741 | Akamastu et al. | Mar 1999 | A |
5891130 | Palermo et al. | Apr 1999 | A |
5904648 | Arndt et al. | May 1999 | A |
6007482 | Madni et al. | Dec 1999 | A |
6056743 | Ellis et al. | May 2000 | A |
6059719 | Yamamoto et al. | May 2000 | A |
6099546 | Gia | Aug 2000 | A |
6102918 | Kerr | Aug 2000 | A |
6162171 | Ng et al. | Dec 2000 | A |
6190382 | Ormsby et al. | Feb 2001 | B1 |
6193708 | Ken et al. | Feb 2001 | B1 |
6203525 | Whayne et al. | Mar 2001 | B1 |
6203547 | Nguyen et al. | Mar 2001 | B1 |
6206852 | Lee | Mar 2001 | B1 |
6259938 | Zarychta et al. | Jul 2001 | B1 |
6277139 | Levinson et al. | Aug 2001 | B1 |
6290693 | Jung et al. | Sep 2001 | B1 |
6348045 | Malonek et al. | Feb 2002 | B1 |
6371970 | Khosravi et al. | Apr 2002 | B1 |
6379319 | Garibotto et al. | Apr 2002 | B1 |
6454758 | Thompson et al. | Sep 2002 | B1 |
6464699 | Swanson | Oct 2002 | B1 |
6500167 | Webster, Jr. | Dec 2002 | B1 |
6530913 | Giba et al. | Mar 2003 | B1 |
6551302 | Rosinko et al. | Apr 2003 | B1 |
6591144 | Pigott | Jul 2003 | B2 |
6592581 | Bowe | Jul 2003 | B2 |
6602208 | Jafari | Aug 2003 | B2 |
6616617 | Ferrera et al. | Sep 2003 | B1 |
6620179 | Boock et al. | Sep 2003 | B2 |
6720402 | Langer et al. | Apr 2004 | B2 |
6730058 | Hayzelden | May 2004 | B2 |
6824543 | Lentz | Nov 2004 | B2 |
7288074 | Swain et al. | Oct 2007 | B2 |
7371249 | Douk et al. | May 2008 | B2 |
7993329 | Howell et al. | Aug 2011 | B2 |
20010031970 | Heuser et al. | Oct 2001 | A1 |
20020010426 | Clayman et al. | Jan 2002 | A1 |
20020016604 | Boock et al. | Feb 2002 | A1 |
20020032455 | Boock et al. | Mar 2002 | A1 |
20020087100 | Onuki et al. | Jul 2002 | A1 |
20020123698 | Garibotto et al. | Sep 2002 | A1 |
20040006311 | Shchervinsky | Jan 2004 | A1 |
20040016849 | Jakubowski et al. | Jan 2004 | A1 |
20040030259 | Dae et al. | Feb 2004 | A1 |
20040030350 | Griego et al. | Feb 2004 | A1 |
20040082859 | Schaer | Apr 2004 | A1 |
20040082881 | Grewe et al. | Apr 2004 | A1 |
20040106897 | Thompson et al. | Jun 2004 | A1 |
20040111020 | Long | Jun 2004 | A1 |
20040111082 | Howell et al. | Jun 2004 | A1 |
20040125139 | Beck et al. | Jul 2004 | A1 |
20040193032 | Mogul | Sep 2004 | A1 |
20040193205 | Burgermeister | Sep 2004 | A1 |
20040199087 | Swain et al. | Oct 2004 | A1 |
20040199088 | Bakos et al. | Oct 2004 | A1 |
20040215208 | Foushee et al. | Oct 2004 | A1 |
20040225233 | Frankowski et al. | Nov 2004 | A1 |
20040236346 | Parker | Nov 2004 | A1 |
20040243168 | Ferrera et al. | Dec 2004 | A1 |
20050027243 | Gibson et al. | Feb 2005 | A1 |
20050038412 | Rabiner et al. | Feb 2005 | A1 |
20050043779 | Wilson | Feb 2005 | A1 |
20050070821 | Deal et al. | Mar 2005 | A1 |
20050080356 | Dapolito et al. | Apr 2005 | A1 |
20050096590 | Gullickson et al. | May 2005 | A1 |
20050165277 | Carrillo et al. | Jul 2005 | A1 |
20050228222 | Furumi | Oct 2005 | A1 |
20050261663 | Patterson et al. | Nov 2005 | A1 |
20050288545 | Matsumoto et al. | Dec 2005 | A1 |
20060100544 | Ayala et al. | May 2006 | A1 |
20060100545 | Ayala et al. | May 2006 | A1 |
20060189975 | Whayne et al. | Aug 2006 | A1 |
20070060997 | De Boer | Mar 2007 | A1 |
20070083253 | Fischell et al. | Apr 2007 | A1 |
20070135825 | Binmoeller | Jun 2007 | A1 |
20070162047 | Gasche | Jul 2007 | A1 |
20070185414 | Urbanski et al. | Aug 2007 | A1 |
20070185416 | Melsheimer | Aug 2007 | A1 |
20070299367 | Melsheimer et al. | Dec 2007 | A1 |
20080051676 | Melsheimer | Feb 2008 | A1 |
20080051721 | Carter et al. | Feb 2008 | A1 |
20080064988 | Carter et al. | Mar 2008 | A1 |
20090012475 | Onuki et al. | Jan 2009 | A1 |
20110257476 | Belafsky | Oct 2011 | A1 |
Number | Date | Country |
---|---|---|
0 667 115 | Jan 1995 | EP |
0 827 712 | Nov 1999 | EP |
1 346 747 | Sep 2003 | EP |
1 532 999 | Nov 2004 | EP |
2511600 | Feb 1983 | FR |
2625437 | Jul 1989 | FR |
2 103 936 | Mar 1983 | GB |
62-116746 | May 1987 | JP |
07088191 | Apr 1995 | JP |
2006-192294 | Jul 2006 | JP |
WO 9405200 | Mar 1994 | WO |
WO 9731677 | Sep 1997 | WO |
WO 9811896 | Mar 1998 | WO |
WO 9819608 | May 1998 | WO |
WO 9930610 | Jun 1999 | WO |
WO 9934726 | Jul 1999 | WO |
WO 9953827 | Oct 1999 | WO |
WO 0022975 | Apr 2000 | WO |
WO 0044275 | Aug 2000 | WO |
WO 0103764 | Jan 2001 | WO |
WO 0108548 | Feb 2001 | WO |
WO 0108742 | Feb 2001 | WO |
WO 0167967 | Sep 2001 | WO |
WO 02070061 | Sep 2002 | WO |
WO 2004050161 | Jun 2004 | WO |
WO 2004089456 | Oct 2004 | WO |
WO 2006039216 | Apr 2006 | WO |
WO 2006039217 | Apr 2006 | WO |
Entry |
---|
International Search Report mailed Jan. 17, 2008 for International Application No. PCT/US2007/076305. |
International Search Report mailed Feb. 15, 2008 for International Application No. PCT/US2007/077072. |
Long, Gary, Ph.D., et al.; “The Cath-Cam: a new concept in colonoscopy;” Gastrointestinal Endoscopy, vol. 64, No. 6, Dec. 2006, pp. 997-1001. |
Mosse, C.A., Ph.D., et al., “Technical Advances and Experimental Devices for Enteroscopy;” Gastrointest Endosc Clin N Am., vol. 9, No. 1, Jan. 1999, pp. 145-161. |
Hodgson et al., Shape memory alloys, [online], [retrieved on Dec. 9, 2009]. Retrieved from Johnson Matthey database using Internet <URL: http://www.jmmedical.com/html/—shape—memory—alloys—.html>. |
Lin, Shape memory alloys and Their Applications (1996, 1998), [online], [retrieved on Dec. 5, 2005]. Retrieved from Stanford University database using Internet <URL: http://www stanford.edu/˜richlin/sma/sma.html>. |
Shape memory alloys (2001), [online], [retrieved on Dec. 9, 2005]. Retrieved from University of Alberta database using Internet <URL: http://www.cs.ualberta.ca/˜database/MEMS/sma—mems/sma.html>. |
Two-Way Memory, [online], [retrieved on Dec. 9, 2005]. Retrieved from Johnson Matthey database using Internet <URL: http://www.jmmedical.com/html/2—way—memory.html>. |
Number | Date | Country | |
---|---|---|---|
20080051721 A1 | Feb 2008 | US |
Number | Date | Country | |
---|---|---|---|
60840214 | Aug 2006 | US |