The present invention generally relates to a medical device including a flexible elongate torque-transmitting member.
Medical diagnostic and treatment catheters may include a flexible elongate torque-transmitting member received in a body of the catheter to impart rotation to a functional element of the catheter. For example, debulking catheters, such as atherectomy and thrombectomy catheters, include a material-removing element, such as a cutting blade, that is rotated by a flexible driveshaft to remove material (e.g., tissue) from a body lumen of a subject.
Typically, the driveshaft of such a catheter has a structural driveshaft core including helical or coiled metal wires extending along a length of the driveshaft, and a polymer laminate circumferentially surrounding the driveshaft core. During some diagnostic and treatment procedures, the catheter is inserted in a tortuous path of a body lumen so that the catheter, and the driveshaft, is bent along an arc having a small radius of curvature. In such a case, the internal torsional resistance of the driveshaft may increase, which may negatively impact the performance of the catheter.
In one aspect, the present disclosure is related to a catheter including a torque-transmitting member operatively connected to a functional element of the catheter. The torque-transmitting member may include a flexible structural core, an inner radial layer, and an outer radial layer. The structural core has a plurality of adjacent core segments that move away from one another when the torque-transmitting member is bent along an arc. The inner radial layer has an inner surface secured to the plurality of core segments such that the inner layer experiences localized tensile strain when the core segments at the outer radius of the arc are urged away from one another during bending of the torque-transmitting member. The inner radial layer may comprise an elastomer. The driveshaft may have an internal torsional resistance from about 0.010 in-oz (0.007 N-cm) to about 0.10 oz-in (0.07 N-cm) when bent along an arc having a radius of curvature of about 0.5 in (1.27 cm). The outer layer may be heat shrunk around the inner layer and/or may have a low modulus of elasticity.
Other objects and features will be in part apparent and in part pointed out hereinafter.
Corresponding reference characters indicate corresponding parts throughout the drawings.
The present disclosure relates to a flexible elongate torque-transmitting member for a functional element of a medical device, and in one example, to a flexible elongate torque-transmitting member received in a lumen of a body of a catheter. Non-limiting examples of medical devices in which the torque-transmitting member may be incorporated in a body of a catheter, according to the principles of the present disclosure, include debulking catheters, including debulking catheters having a material-removing element (broadly, a functional element) rotated by the torque-transmitting member to remove material (e.g., tissue) from a body lumen of a subject; catheter and/or guidewire systems for treating chronic total occlusions; and visualization catheters having an imaging device, such as a camera, ultrasound transducer, etc. (broadly, a functional element) rotated by the torque-transmitting member. The torque-transmitting member may be incorporated in other types of medical devices without departing from the scope of the present invention.
Referring to
Referring still to
Referring to
As set forth above, the cutting element 24 is moveable longitudinally within the catheter body 12. Accordingly, as the cutting element 24 moves longitudinally within the body 12, it engages and moves longitudinally along the cam follower 40, causing the distal body portion 14b to pivot relative to the proximal body portion 14a of the catheter body 12 about the pivot axis P. In particular, in the illustrated embodiment moving the driveshaft 20 proximally, such as by moving the actuator 34 proximally, imparts proximal movement of the cutting element 24 along the cam follower 40, which causes the distal body portion 14b to pivot or deflect away from the proximal body portion 14a so that the cutting element 24 extends out the window 38. Moving the driveshaft 20 distally, such as by moving the actuator 34 distally, imparts distal movement of the cutting element 24 along the cam follower 40, which causes the distal body portion 14b to pivot or deflect toward the proximal body portion 14a so that the cutting element 24 is received in the cutting element housing 39. A suitable deployment mechanism for moving the cutting element 24 between its deployed and stored positions is disclosed in U.S. patent application Ser. No. 11/012,876, filed Dec. 14, 2004, which is hereby incorporated by reference in its entirety. It is understood that a catheter constructed according to the principles of the present disclosure may not include a deployment mechanism (e.g., the tissue-removing element or other functional element may always be deployed or may remain within the catheter body). The tissue-removing element 24 may comprise other devices, other than the illustrated cutting element, in other embodiments. For example, the tissue-removing element may comprise an abrasive element having an abrasive surface. Other tissue-removing elements do not depart from the scope of the present invention.
Referring to
Referring to
The driveshaft core 46 may be of other configurations. For example, in other embodiments within the scope of the present invention, the driveshaft core 46 may comprise at least one layer of braided strands, with each strand being a core segment of the driveshaft core. In yet other embodiments, the driveshaft core 46 or the outer layer of the core may comprise at single coiled strand, with each turn of the strand being a core segment or the driveshaft core. In yet other embodiments, the driveshaft core 46 may comprise at least one slit tube having one or more slits (e.g., spaced apart radial slits or a helical slit) to allow for bending along the length of the tube, with each portion adjacent the one or more slits being a core segment of the driveshaft core.
To explain the forces involved when a helically wound or coiled torque-transmitting member (e.g., the driveshaft 36), among other torque-transmitting members, is bent along an arc (see,
The gaps G between adjacent strands 48 of the outer filar layer 46d increase (and decrease) when the driveshaft is bent along an arc, such as when the catheter is moving through or disposed within a tortuous path in a body lumen. Turning to
When the bent portion of the driveshaft 20 is rotated 180 degrees about its axis LA, the adjacent strands 48 that were at the outer radius of the arc (as shown in
As can be understood, if the inner layer 50 does not have a suitable elastic yield strain, as determined at least in part by the gap change ΔG when the driveshaft 20 is bent along an arc, then the bridge portions 60 at the outer radius of the arc (as shown in
According to the teachings of the present disclosure, to inhibit plastic deformation of the bridge portions 60 of the inner layer 50 due to the gap change ΔG between adjacent strands 48, a material (e.g., a polymer) used to form the inner layer of a particular driveshaft 20 is chosen based on the elastic yield strain of the material and the potential gap change between adjacent strands experienced when the driveshaft is bent along an arc having a selected minimum radius of curvature and rotated about its rotational axis. For example, if adjacent strands experience a 0.1 mm change in gap ΔG when the driveshaft is bent at a predetermined arc (e.g., 0.5 in ((1.27 cm)) and the initial gap is 0.5 mm, then the material chosen to form the inner layer should have a minimum elastic yield strain of 20% so that the inner layer does not, at least theoretically, undergo plastic deformation when the driveshaft is bent at the predetermined arc having a minimum radius of curvature.
In the illustrated example, the inner radial layer 50 comprises an elastomer, such as silicone, latex, and thermoplastic elastomers, among others. Suitable thermoplastic elastomers include styrenic block copolymers, polyolefin blends, elastomeric alloys (TPE-v or TPV), thermoplastic polyurethanes, thermoplastic copolyester, and thermoplastic polyamides. Suitable commercially available thermoplastic elastomers derived from block copolymers include ARNITEL® (available from DSM), ENGAGE® (available from The Dow Chemical Company), HYTREL® (available from DUPONT) DRYFLEX® and MEDIPRENE® (available from ELASTO), KRATON® (available from Shell chemical division), and PEBAX® (available from Arkema), which is a PEBA (polyether block amide) thermoplastic elastomer.
In the illustrated example, the elastomer (e.g., thermoplastic elastomer) of the inner radial layer 50 of the driveshaft 20 has an elastic yield strain from at least about 25%, or from at least about 50%, or from at least about 100%, or from at least about 150%, or from at least about 200%. For example, the inner radial layer 50 may have an elastic yield strain of from about 25% to about 2000%, or from about 25% to about 1000%, or from about 25% to about 500%, or from about 25% to about 300%, or from about 25% to about 200%, or from about 25% to about 150%, or from about 25% to about 100%, or from about 50% to about 2000%, or from about 50% to about 1000%, or from about 50% to about 500%, or from about 50% to about 200%, or from about 50% to about 150%, or from about 75% to about 2000%, or from about 75% to about 1000%, or from about 75% to about 500%, or from about 75% to about 200%, or from about 75% to about 100%, or from about 100% to about 2000%, or from about 100% to about 500%, or from about 150% to about 2000%, or from about 150% to about 500%.
It may also be beneficial for the elastomer (e.g., thermoplastic elastomer) of the inner radial layer 50 to have, in addition to a suitable elastic yield strain, a low modulus of elasticity relative to the outer radial layer 52. For example, in the illustrated example the ratio of the modulus of elasticity of outer radial layer 52 to the inner radial layer may be from at least about 1.5:1, or from at least about 2:1, or from at least about 5:1, or from at least about 10:1, or from at least about 20:1, or from at least about 50:1. In one example, the ratio of the modulus of elasticity of outer radial layer 52 to the inner radial layer may be from 1.5:1 to about 50:1, or from about 2:1 to about 50:1, or from about 1.5:1 to about 25:1. In this way, the transmission of tensile strain (i.e., elongation) of the bridge portions 60 to the outer radial layer 52 is reduced because the bridge portions will readily deform at the interface of the inner and outer radial layers without causing significant strain (i.e., elongation) of the outer layer at the interface. Moreover, by having a low modulus of elasticity, the driveshaft 20 is more axially flexible and more readily bendable into an arc. The modulus of elasticity of the inner radial layer 50 may be from about 5 MPa to about 100 MPa, or from about 5 MPa to about 50 MPa, or from about 5 MPa to about 20 MPa, or from about 5 MPa to about 10 MPa.
In the illustrated example, the outer radial layer 52 applies a radially compressive force to the inner radial layer 50 and the driveshaft core 46 to retain the strands 48 in their respective orientations relative to one another and inhibit shifting of the strands. Also in the illustrated example, the outer radial layer 52 has a low coefficient of friction (i.e., has a high lubricity) and high abrasion-resistance so as to respectively inhibit energy loss in the form of friction and inhibit deterioration of the outer layer when the driveshaft 20 rubs against the wall of the body lumen 16 as the driveshaft rotates. Suitable material for the outer radial layer 52 includes, for example, PTFE, FEP, or Polyolefin, among others. As disclosed above, the outer radial layer 52 may comprise a heat-shrink tube that is heat-shrunk over the inner radial layer 50. The heat-shrink tube binds onto the inner radial layer 50 with sufficient radial force so that the outer radial layer does not move or shift longitudinally relative to the inner radial layer.
As disclosed above, in the illustrated example the outer radial layer 52 of the driveshaft 20 may have a modulus of elasticity that is greater than the modulus of elasticity of the inner radial layer 50. Again, this configuration reduces the transmission of strain from the inner radial layer 50 to the outer radial layer 52. Moreover, by having a greater modulus of elasticity, the outer radial layer 52 maintains the driveshaft core 46 (e.g., the strands 48) in its proper configuration (e.g., maintains the strands in proper arrangement relative to one another). Without a suitable outer radial layer having a sufficiently high modulus of elasticity, the strands 48 of the driveshaft core 46 may shift relative to one another and become disorganized, which may lead to buckling of the driveshaft 20.
Although the outer radial layer 52 does not experience the strain (or at least a significant portion thereof) imparted by the gap change ΔG between adjacent strands 48, the outer radial layer will experience some strain when the driveshaft 20 is bent along an arc. Accordingly, to inhibit plastic deformation of the outer radial layer 52, the material of the outer radial layer may have an elastic yield strain greater than one half the ratio of the diameter of the laminated driveshaft 20 divided by the minimum radius of curvature to which the driveshaft will be subjected. For example, with a 0.025 in (0.064 cm) diameter driveshaft subjected to minimum of 0.25 in (0.64 cm) radius of curvature, the yield strain of the outer radial layer 52 should be greater than 0.025/0.25/2=5%. In other examples, the elastic yield strain of the outer layer may be from about 2% to about 50%, or from about 2% to about 20%, or from about 2% to about 10%, or from about 5% to about 20%.
Because in the illustrated embodiment the driveshaft 20 is received in the lumen 16 of the catheter body 12 and rotates therein, the outer radial layer (which is the outermost layer in the illustrated embodiment) may have an outer surface having a high lubricity and high abrasion-resistance. The high lubricity reduces energy lost due to friction between the rotating driveshaft 20 and the catheter body 12. As an example, the outer radial layer (or another outmost radial layer) may have a low coefficient of friction, such as from about 0 to about 0.25, or from about 0.05 to about 0.1.
The internal torsional resistance of a driveshaft constructed according to the principles of the present invention was measured and compared to the internal torsional resistance of drive shafts constructed according to conventional methods. The internal torsional resistance is the resistant force that opposes rotation of a driveshaft about its longitudinal axis. Each of four tested drive shafts had identical driveshaft cores (i.e., a 0.020 in (0.051 cm)) diameter driveshaft core comprising 304V stainless steel wires arranged in four filar layers. An innermost filar layer included a single wire running along the longitudinal axis; an inner intermediate filar layer included six wires helically wound in a first direction around the innermost wire; an outer intermediate filar layer including nine wires helically wound in a second direction around the inner intermediate layer; and an outermost filar layer including twelve wires helically wound in the first direction around the outer intermediate layer. The four tested drive shafts had the following layers over the core: i) no layers; ii) inner radial layer of PEBAX® 3533 and an outer radial layer of PTFE (the “PEBAX®/PTFE driveshaft”); iii) a single radial layer of Grilamid L25 (an extrudable, nylon 12 material) having a thickness of 0.003 in (0.008 cm) (the “thick Grilamid L25 driveshaft”); and iv) a single radial layer of Grilamid L25 having a thickness of 0.001 in (0.003 cm) (the “thin Grilamid L25 driveshaft”).
The PEBAX®/PTFE driveshaft was constructed according to the principles of the present invention, using a reflow process. It was determined that when the driveshaft was bent along an arc having a radius of curvature r of about 0.5 in (1.27 cm), the strands at the outer radius of the arc experience a gap change percentage (% ΔG) of about 75%. The gap change percentage (% ΔG) was calculated by measuring (or estimating) the gap change (ΔG) and dividing that value by the initial gap measurement (Ginitial). This calculation is represented by following formula:
% ΔG=((Gbent−Ginitial)/Ginitial)×100
PEBAX® 3533 was selected as the inner layer based on the calculated gap change percentage (% ΔG) of about 75%.
A PTFE heat-shrink tube was selected as the outer radial layer because of its low coefficient of friction (i.e., its lubricity), its abrasive-resistance, its ability to contract to a relatively small diameter to apply a suitable radial compressive force to retain the organization of the driveshaft strands, and its elastic yield strain being sufficient to inhibit plastic deformation when the driveshaft is bent along the selected arc. The selected PTFE heat-shrink tube was configured to have a 0.040 in (0.102 cm) expanded inner diameter, a 0.015 in (0.038 cm) recovered (i.e., contracted) inner diameter, and a wall thickness of 0.003 in (0.008 cm) when recovered. The PTFE heat-shrink tube had a coefficient of friction from 0.04 to 0.1.
In forming the driveshaft, a sleeve formed from PEBAX® 3533 was provided, and the driveshaft core was inserted into the sleeve. The PEBAX® 3533 sleeve had an inner diameter measuring 0.021 in (0.533 mm) +/−0.001 in (0.0254 mm), and a wall thickness of 0.0012 in (0.003 cm)+/−0.0003 in (0.0008 cm). The PTFE heat-shrink tube was sleeved over the PEBAX® sleeve that was received on the driveshaft core, and the driveshaft assembly was reflowed using a hot box. After reflowing, the outer diameter of the PEBAX®/PTFE driveshaft measured from about 0.0248 in (0.0630 cm) to about 0.0252 in (0.0640 cm). Accordingly, the thickness of the PEBAX®/PTFE laminate was from about 0.0024 in (0.0610 mm) to about 0.0026 in (0.0660 mm).
The two Grilamid L25 drive shafts were constructed according to conventional methods, including reflowing the Grilamid L25 layer using a large upright over and an FEP heat-shrink tube. The FEP heat-shrink tube was removed after reflowing. Grilimad L25 has an elastic yield strain of 6%, and a high tensile modulus of 110 MPa. Theoretically, an elastic yield strain of 6% should be sufficient to inhibit plastic deformation due solely to the driveshaft being bent along the arc, without accounting for the strain caused by adjacent core segments moving apart. In other words, Grilimad L25 has elastic yield strain (i.e., 6%) greater than one half the ratio of the diameter of the laminated driveshaft 20 divided by the minimum radius of curvature to which the driveshaft will be subjected.
Referring to
To set-up the test, the following steps were performed for each of the driveshafts:
The following steps are steps taken to perform the test:
Table I (below) shows the results of the testing. A graph showing these results of the testing is presented in
As can be seen from Table I and
Having described the invention in detail, it will be apparent that modifications and variations are possible without departing from the scope of the invention defined in the appended claims.
When introducing elements of the present invention or the preferred embodiments(s) thereof, the articles “a”, “an”, “the” and “said” are intended to mean that there are one or more of the elements. The terms “comprising”, “including” and “having” are intended to be inclusive and mean that there may be additional elements other than the listed elements. In view of the above, it will be seen that the several objects of the invention are achieved and other advantageous results attained.
As various changes could be made in the above constructions, products, and methods without departing from the scope of the invention, it is intended that all matter contained in the above description and shown in the accompanying drawings shall be interpreted as illustrative and not in a limiting sense.