1. The Field of the Invention
The present disclosure relates to various medical devices deliverable and deployable within a lumen. More particularly, the invention relates to devices for shielding a medical device and methods for delivering a medical device into a subject's body while minimizing or preventing contamination of or damage to the medical device.
2. The Relevant Technology
Stents, grafts, and a variety of other endoprostheses are used in interventional procedures, such as for treating aneurysms, lining or repairing vessel walls, filtering or controlling fluid flow, and expanding or scaffolding occluded or collapsed vessels. Such endoprostheses may be delivered and used in virtually any accessible body lumen of a human or animal, and may be deployed by any of a variety of recognized means. One recognized use for a vascular endoprosthesis is for the treatment of atherosclerotic stenosis in blood vessels. For example, after a patient undergoes a percutaneous transluminal coronary angioplasty, or similar interventional procedure, a stent is often deployed at the treatment site to improve the results of the medical procedure and reduce the likelihood of restenosis.
Typically, a vascular endoprosthesis, such as a stent, is delivered by a delivery sheath, such as a catheter, to a desired location or deployment site inside a body lumen or other tubular organ. In order to deliver a stent or other medical device to a desired location, a guide wire or other device may be used to add steering and support. The guide wire is generally threaded through and/or over the delivery system. Therefore, systems and methods for loading a guide wire may be desirable.
This Summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This Summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter. Embodiments disclosed herein relate to medical devices and in particular to device shields and methods of use.
The present disclosure is related to protective covers or device shields for packaging and protecting medical devices (e.g., stents, filters, shunts, other implantable devices, or other medical devices) during storage and deployment. Stent retention, surface integrity, and crossing profile are exemplary characteristics of a stent or another medical device that may be important to positive clinical outcomes. At least one of these characteristics may be positively impacted by at least one of the embodiments of a device shield disclosed herein. For example, a device shield may constrain the dimensions of the stent and/or balloon during the storage process and/or at least a portion of the delivery process, which may impact the overall profile and/or stent retention by limiting expansion during storage. It may be possible for a stent and/or balloon to expand slightly during storage due to residual stresses and/or fluctuations in humidity and/or temperature. Even slight expansions of the stent may negatively affect stent retention and/or crossing profile.
Furthermore, a device shield may reduce or prevent the adhesion of free particulates in the surrounding environment or on a surgeon's gloves from contacting a sensitive area of the medical device (e.g. the stent, filter, or other implantable device, or other medical device) and/or the delivery device (e.g. the balloon catheter or other delivery device). Without a device shield, a guide wire or other delivery device may scratch the medical device and/or contaminants may deposit on the medical device. Either of these events may adversely impact product performance and/or clinical outcome.
In one embodiment, a device shield is described. The device shield includes a storage portion, an expanded portion, and one or more distal arms. The storage portion is configured to maintain a medical device within the device shield such that exposure of the medical device to the environmental particulates and the damage is minimized. The expanded portion is designed to direct a guide wire into a guide wire lumen of a medical device positioned within the storage portion. The one or more distal arms are configured to selectively flex to expand the expanded portion to facilitate passage of the medical device from the storage portion through the expanded portion.
The device shield may provide at least one of the following: easier guide wire insertion into a catheter lumen, minimization of surface damage of the stent and/or balloon before and/or during guide wire loading, maintaining the stent and/or balloon in a pre-deployed configuration, minimizing contamination of the stent and/or balloon surfaces before insertion into a patient, facilitating insertion into an access device, simplifying removal of the loading device, restraining the loading device from insertion into a patient's anatomy, insertion without a need for removal of the sheath in a separate step, or combinations thereof.
In another embodiment, a device shield for a medical device is disclosed. The device shield includes a body having a storage portion therein configured to have a medical device disposed therein to limit exposure of the medical device to environmental particulates or damage. The body includes a plurality of distal arms that are selectively movable between a first position and a second position. The plurality of distal arms are configured in the first position to retain the medical device within the storage portion to ensure that the medical device is not exposed to damage or environmental particulates. The plurality of distal arms are configured in the second position to permit movement of the medical device out of the storage portion once the risk of exposure to environmental particulates and damage is minimized.
In yet another embodiment, a kit is disclosed. The kit includes a medical device, a medical device delivery apparatus associated with the medical device, and a device shield. The device shield includes a body and one or more distal arms. The body is configured to maintain the medical device and at least a portion of the medical device delivery apparatus associated with the medical device within the body such that exposure of the medical device to the environmental particulates and the damage is minimized. The one or more distal arms are configured to constrain the medical device and/or the portion of the medical device delivery apparatus associated with the medical device in the body in at least one dimension such that exposure of the medical device to the environmental particulates and the damage is minimized.
Additional features and advantages of the disclosure will be set forth in the description which follows, and in part will be obvious from the description, or may be learned by the practice of the invention. The features and advantages of the invention may be realized and obtained by means of the instruments and combinations particularly pointed out in the appended claims. These and other features of the present invention will become more fully apparent from the following description and appended claims, or may be learned by the practice of the invention as set forth hereinafter.
To further clarify at least some of the advantages and features of the present disclosure, a more particular description will be rendered by reference to specific embodiments thereof, which are illustrated in the appended drawings. It is appreciated that these drawings depict only illustrated embodiments and are therefore not to be considered limiting of its scope. The disclosure will be described and explained with additional specificity and detail through the use of the accompanying drawings in which:
FIGS. 18 and 19A-19B illustrate an embodiment of a device shield that is adapted to fold or refold a balloon;
The present disclosure is related to device shields for packaging and protecting medical devices (e.g., balloon expandable, self-expanding, or other stents; luminal filters; or other implantable devices, or other medical devices) and/or at least a portion of a delivery device (e.g. balloon catheters, self-deploying stent catheters, vena cava filter delivery catheters, or other delivery devices) during storage and deployment. Stent retention, surface integrity, and crossing profile are exemplary characteristics of a stent or other medical device that may be important to positive clinical outcomes. At least one of these characteristics may be positively impacted by at least one embodiment of a device shield described herein. For example, a device shield may constrain the dimensions of the stent and/or balloon during the storage process, which may impact the overall profile and/or stent retention by limiting expansion during storage. It may be possible for a stent and/or balloon to expand slightly during storage due to residual stresses and/or fluctuations in humidity and/or temperature. Even slight expansions of the stent may negatively affect stent retention and/or crossing profile.
Furthermore, a device shield may limit the adhesion of free particulates in the surrounding environment or on a surgeon's gloves from contacting the medical device and/or a portion of the delivery device. Without a device shield, a guide wire or other device may scratch the medical device and/or delivery device. Additionally, contaminants may deposit on the medical device and/or delivery device. Either of these events may adversely impact product performance and/or clinical outcome.
Referring now to
Further discussion of the data and study can be found in Catheterization and Cardiovascular Diagnosis 40:238-332 (1997). D. M. Whelan, BSc, H. M. M. van Beusekom, PhD, and W. J. van der Giessen, MD, PhD. “Foreign Body Contamination During Stent Implantation,” the entirety of which is incorporated herein by reference.
While the data from
In contrast, according to some embodiments of the present invention, the implantable devices are not uncovered or exposed prior to insertion into an access device. As a result, the implantable devices are shielded from contamination or damage from the time the packaging is opened, through the loading of the guide wire, and until the implantable device is inserted into the access device. Thus, according to some embodiments of the present invention, the implantable devices remains covered and protected from contamination and damage until the implantable device is inserted into the access device, which may provide even further improved clinical outcomes than those described shown in
The data illustrated in
The device shield 100 may include an expanded portion 102. The expanded portion 102 may be fluted and/or flared to receive a guide wire 50. The expanded portion 102 may further guide the guide wire 50 into a guide wire lumen (shown as 32 in
In some embodiments, the device shield 100 may include a limit element 106 that may prevent the stent and/or balloon (shown as 10 and 20, respectively in
Thus, the expanded portion 102 of the device shield 100 may be inserted at least partially into the RHV 290 as shown in
As shown in
As shown in
Referring now to
In the closed position 706a illustrated in
The limit element 706 may include multiple components. For example, as shown in
Referring now to
Referring to
The first half 800a and second half 800b may be joined during assembly, storage, guide wire loading, and deployment of a stent and/or may be split open after advancement of the catheter into the patient anatomy. The first half 800a and second half 800b of the device shield 800 each include a body portion 812, a storage portion 804 formed in the body portion 812 that is configured to store and protect a medical device and a medical device delivery apparatus during storage and delivery, and a limit element 806 configured to constrain the medical device and the medical device delivery apparatus. For example, the limit element 806 may prevent distal longitudinal translation toward an insertion stem 810. The first half 800a and second half 800b of the device shield 800 further include a hinged portion 820 that facilitates transition of the limit element 806 from a constraining position to a releasing position. The hinged portion 820 may include a living hinge or other hinge mechanism. The first half 800a and second half 800b of the device shield 800 may include an expanded portion 808 at the distal end of the body portion 812. In other embodiments, storage portion 804 and the limit element 806 may be flexible.
The insertion stem 810 includes an interior lumen 818 that can be used to insert a stent delivery system, a catheter device, or other medical devices through the device shield 800 into an access device. The insertion stem 810 may be used to insert the device shield 800 into an access device, such as RHV 290 described above. The expanded portion 808 may be used as a grip to facilitate insertion and/or maintain the position of the stem 810 within the access device.
As can be further seen in
In one embodiment, the first half 800a and/or second half 800b may be at least partially formed of clear plastic, which may facilitate verification of contents within the device shield 800. In some embodiments, a lens may be formed into the device shield 800 in order to facilitate visual inspection of the contents of the device shield 800.
In the present embodiment, the storage portion 804 and the limit element 806 are shown deflected outward. This deflection may be accomplished by biasing the limit element 806 toward an outward position. For example, a living hinge may be formed in such a way to accomplish this bias, a biasing element, such as a spring, may be used, or other features or processes may be utilized to outwardly bias the limit element 806. The storage portion 804 and the limit element 806 may be deflected inward when a constraining device such as a retaining member 850 is placed over the body 812, the storage portion 804, and the limit element 806, as will be explained further herein below.
In some embodiments, the device shield 800 and storage portion 804 may be integrally formed. For example, storage portion 804 may be formed into an outer surface (not shown) of the device shield 800. The storage portion 804 may then be deformed from an undeformed state to a deformed state. For example, the storage portion 804 may be deformed away from a longitudinal axis (not shown) of the device shield 800. The storage portion 804 may be restricted from returning to the undeformed state. For example, the storage portion 804 may be strained past its yield limit as it is deformed to the deformed state, may be heat set while in the deformed state, may be otherwise restricted, or combinations thereof. In the present embodiment, the hinge 820 may be a flexible hinge.
Referring now to
In some embodiments, the retaining member 850 may include a device receiving aperture 852. The device shield 800 may be inserted into the device receiving aperture 852. In the present embodiment, the retaining member 850 may include a lateral aperture 854. In some embodiments, the lateral aperture 854 may provide access to the device shield 800 during use.
As the device shield 800 is inserted through the device receiving aperture 852, at least one of the storage portions 804 and/or the limit elements 806 may be deflected towards the longitudinal axis of the device 800, i.e., into the constraining state. With at least one storage portion 804 and/or the limit element 806 in the constraining state, the stent delivery catheter may be generally restrained within the device shield.
In this constraining state, as shown in
Constraining the stent and/or balloon may be beneficial because the physician may not have to strain his eyesight to find a relatively small guide wire lumen of the stent delivery device but need only insert the guide wire into the relatively large lumen 818 of the insertion stem 810 and advance it smoothly.
Once the guide wire is associated with the device shield, i.e., the guide wire has exited a proximal end of the device shield, the insertion stem 810 may be inserted into an access device, such as an open RHV.
Referring now to
Once the distal portion of the medical device is fully within the access device, the entire device shield 800 may be retracted over the stent deployment device. The retaining member 850 may be fully removed from device shield 800. In split device shield embodiments, first half 800a and second half 800b may be separated by pulling them apart or simply allowing one portion to fall away from the other. The physician is left with the stent delivery device advanced into the patient.
Referring now to
In the closed position 906a illustrated in
Referring now to
The device shield 1000 may include an expanded portion 1002. The expanded portion 1002 may include a necked funnel 1094 that may facilitate insertion of the guide wire into a stent delivery device (shown as 30, in
At least some embodiments may ease guide wire loading by, for example, positioning the distal end of the stent delivery device adjacent to the necked portion 1094 such that insertion of a guide wire into the stent delivery device may guide the guide wire. For example, the expanded portion 1002 may deflect the guide wire toward the center of the stent delivery device as it passes through the necked portion 1094 thereby inserting the guide wire into the distal end of the stent delivery device that may be located adjacent the necked portion 1094.
The distal end of the device shield 1000 may have a varied length. In some embodiments, it may have sufficient length for a physician to easily identify the opening and/or to facilitate guide wire insertion along the axial direction. For example, a length of approximately 10 mm beyond the necked portion 1094 may be sufficient in some instances.
In some embodiments, the expanded portion 1002 and/or the necked portion 1094 may be expandable or otherwise configured to facilitate insertion of the stent delivery device through the necked portion 1094 into an access device, such as an RHV. For example, the necked portion 1094 may include at least one expansion aperture 1096, such as a slit, channel, or other feature, to facilitate expansion of the expanded portion 1002 when a device, such as the stent delivery device, having a larger axial dimension is inserted through the necked portion 1094.
Expansion apertures 1096 may have various configurations. For example, at least one expansion aperture 1096 may be spiraled around the device shield 1000, the at least one expansion aperture 1096 may span the entire length of the expanded portion 1002, the at least one expansion aperture 1096 may be staggered along the length to facilitate use of multiple expansion apertures 1096 that do not span the entire length of the expanded portion 1002. The at least one expansion aperture 1096 may extend between a proximal end of the device shield 1000 and the distal end of the device shield 1000. In some embodiments, the at least one expansion aperture 1096 may extend between a proximal end of the expanded portion 1002 and a distal end of the expanded portion 1002. In further embodiments, the at least one expansion aperture 1096 may extend from a proximal end of the device shield 1000 and/or the expanded portion 1002 to a distal end of the device shield 1000 and/or the expanded portion 1002. In another example, the expanded portion 1002 may include an elastomeric portion.
Other configurations are contemplated to facilitate a lower profile, guide wire insertion, an expanded configuration that allows the stent delivery device to advance through the expanded portion 1002 without damaging the stent coating and/or causing the stent to be displaced on the stent delivery device, or other features.
In a further embodiment, the distal end of the device shield 1000 may include a colored tip that may provide greater visibility for a physician. The color may be provided by an ink, which may be bright colored, fluorescent, and/or glow-in-the-dark. A removable portion 1090 may be positioned near a proximal portion of the device shield 1000 that may facilitate removal of the device shield 1000 by the physician by grasping the removable portion 1090 while advancing the stent delivery device and/or proximally retracting the device shield 1000. In a further embodiment, a separation aperture 1092 may be provided that may create an opening in a side of the device shield 1000 to facilitate removal of the device shield 1000 from the stent delivery device.
A method of forming the expanded portion 1002 of the device shield 1000 may include inserting a tapered mandrel in one end that approximates the dimensions of the distal end of the stent delivery device. A second tapered mandrel, such as a hypotube, may be inserted through the device shield 1000 in an opposite direction such that the second mandrel extends over an end of the first mandrel. This overlap may facilitate the forming of a double-taper between the first and second mandrels and/or may vary the length of the expanded portion 1002 by moving the first and second mandrels relative to each other.
With the mandrels positioned within the device shield 1000 as described (e.g., inserted through opposing ends so the ends of the mandrels meet), the device shield 1000 can be further processed or undergo further process steps. Having the mandrels so positioned within the device shield 1000, the mandrels can maintain the desired shape of the device shield 1000, and the expanded portion 1002 in particular, as further processing takes place. For instance, with the mandrels so positioned within device shield 1000, the body of the device shield 1000 can undergo a heat shrink formation process to form expanded portion 1002. Likewise, in other embodiments, a necking operation can also be used to reduce the diameter of the body of the device shield 1000 to conform to the mandrel profile, thereby forming the expanded portion 1002. Furthermore, a combination of heating, heat shrinking, and/or necking can be used to form the tapered profile of the expanded portion 1002.
An exemplary method of using a guide wire loading tool, such as device shield 1000, may include positioning the device shield 1000 over a stent delivery device so that a distal end of the stent delivery device may be positioned adjacent the expanded portion 1002. The guide wire loading tool 1000 and stent delivery device may be removed from its packaging. A guide wire may be inserted into the device shield 1000 through its distal end until the guide wire is directed into and/or through a lumen of the stent delivery device. The guide wire loading tool 1000, with the stent delivery device, may be inserted into an access device, such as an RHV.
In embodiments with a removable portion 1090, the guide wire loading tool 1000, with the stent delivery device, may be inserted into an access device until the removable portion 1090 abuts the access device which may prevent the guide wire loading tool 1000 from advancing into the patient anatomy. In embodiments without a removable portion 1090, the guide wire loading tool 1000, with the stent delivery device, may be inserted into an access device until the expanded portion 1002 abuts the access device which may prevent the guide wire loading tool 1000 from advancing into the patient anatomy.
The stent delivery device may be advanced further, which may cause a distal portion of the guide wire loading tool 1000 to expand. For example, the expanded portion 1002 may expand as the stent delivery device passes through it. The stent delivery device may continue to advance until the device shield 1000 reaches a desired location with respect to the access device. For example, the desired location may include having the device shield 1000 positioned over a catheter shaft. The device shield 1000 may be grasped by the removable portion 1090. The practitioner may remove the device shield 1000 by retracting the removable portion 1090. In embodiments with a separation aperture 1092, removal of the device shield 1000 may include expanding the separation aperture 1092 while retracting the device shield 1000. Some embodiments of the device shield 1000 may be disposable.
The device shield 1100 may include an outer sheath 1180. The outer sheath 1180 may enclose at least a portion of the stent 10 and/or balloon 20. The outer sheath 1180 may include a separation aperture 1192, which may be similar to separation aperture 1092 shown in
The stent 10 and/or balloon 20 may be transitioned from the device shield 1100 by removing the outer sheath 1180 from about the stent 10 and/or balloon 20. For example, as shown in
The device shield 1110 may be positioned relative to an access device before removal of the outer sheath 1180. For example, the outer sheath 1180 may be removed after at least a portion of the stent 10 has been inserted into the access device. In other words, the device shield 1100 may be positioned such that it abuts the access device before applying a load to split the outer sheath 1180.
The stent 10 may be advanced into the access device relative to the removal of the outer sheath 1180. For example, as the outer sheath 1180 is split, the stent 10 may be simultaneously advanced into the access device. In another example, the stent 10 may be independently advanced into the access device.
The device shield 1200 may include a storage portion 1204 that may be configured to store the stent and/or balloon (shown as stent 10 and balloon 20 above). In the present embodiment, the storage portion 1204 may include a retaining mechanism 1205 that may restrain longitudinal motion of the working element. The device shield 1200 may be split into an upper and lower portion, which may be connected by, for example, a hinge or other mechanism.
The device shield 1300 may include an outer sheath 1380. The outer sheath 1380 may enclose at least a portion of the stent 10 and balloon 20. The outer sheath 1380 may overlap itself. By overlapping the sheath 1380, the stent 10 and/or balloon 20 may be generally protected from scratches and/or contamination. In addition, the outer sheath 1380 may reduce significant tangential loads to the working element (i.e. stent 10 and/or balloon 20). For example, as the sheath 1380 is removed, the overlapping feature may minimize loads to the working element.
In use, the outer sheath 1380 of the device shield 1300 can extend around a portion or the entirety of the outer surface of the working element (i.e. stent 10 and/or balloon 20) while a guide wire (not shown) is loaded into the working element. Once the guide wire has been loaded and the working element is ready to be removed from the device shield 1300, an end 1382 of the outer sheath 1380 that is positioned on the outside of device shield 1300 can be peeled away from the working element as shown in
Referring now to
In the present embodiment, the device shield 1400 may have a split design. For example, the device shield 1400 may have an upper portion 1400a and a lower portion 1400b. In other embodiments, the device shield 1400 may be formed as a generally unitary body. For example, the majority of the device shield 1400 may be integrally formed.
Whether the device shield 1400 is formed in a split or unsplit configuration, the device shield 1400 may include a storage portion 1402 which may include a generally cylindrical body and/or generally cylindrical inner surface that may approximate the dimension of a stent delivery device, a balloon, and/or a crimped stent, individually and collectively identified as medical device 1404. In other embodiments, the upper portion 1400a and lower portion 1400b may differ. For example, only one of the upper portion 1400a or lower portion 1400b may include a storage portion 1402. The medical device can be similar or identical to the stent 10, the balloon 20, and/or the stent delivery device 30 illustrated in
It will be appreciated that the device shield 1400, as well as the other device shields described herein, may be configured to receive other types of guide wire receiving devices therein. For instance, rather than receiving a stent and/or stent delivery device, the guide wire loading devices described herein may be adapted to receive a balloon catheter for performing angioplasty procedures and the like.
As seen in
As illustrated in
With specific reference to
The lens 1410 can also be formed in other ways while still providing the desired magnification benefits. By way of non-limiting example, a separate magnifying lens may be overmolded or bonded to the device shield 1400 to provide the desired magnification. Depending on the type of lens used and/or the material used to form the lens, the optical quality of the magnified image may be tailored as desired.
The lens 1410 feature allows the medical device 1404 that is positioned within the storage portion 1402 to be viewed under magnification. For example, medical device 1404 appears larger in
Magnification of the medical device 1404 can be beneficial for a number of reasons. For instance, magnification allows a physician to view the stent struts and determine whether they are bent, scratched, or otherwise damaged or compromised. Likewise, any coatings on the medical device 1404 may be more easily observed and potential scratches or other defects can be identified. Furthermore, in some embodiments, the lens 1410 may enable a physician to more easily view a lumen in the medical device (such as guide wire lumen 32 of stent delivery device 30 illustrated in
It will be appreciated that variations of this design are possible that will allow the number of components to be reduced while retaining at least some of the main features and/or benefits. For example, the upper portion 1400a and lower portion 1400b may be associated with each other through a lateral living hinge or other connection along their edge. Several other embodiments may be contemplated that may incorporate the main features of the present disclosure.
Attention is now directed to
With reference to
The outer sheath 1510 can engage or be mounted on the inner sheath 1508 in a variety of ways. As illustrated in
When the flex sections 1514a-1514n are moved inward as shown in
In order to form the tapered lumen 1516, the flex sections 1514a-1514n are moved inward toward the central axis of the device shield 1500. The flex sections 1514a-1514n are moved inward with the aid of the outer sheath 1510. As the outer sheath 1510 moves over the distal portion 1512 of the inner sheath 1508, the outer sheath 1510 engages and compresses the flex sections 1514a-1514n inward, as shown in
After loading the guide wire 1502 into the medical device 1504 as described above, it may be desirable to enlarge the lumen 1516 to enable the medical device 1504 to be advanced over the guide wire 1502 and into an access device. More specifically, once the guide wire 1502 has been inserted into the medical device 1504, the device shield 1500 can be associated with an access device, such as an access catheter or RHV, and the lumen 1516 can be opened wide enough to allow the medical device 1504 to pass therethrough into the access device.
Referring to
Alternatively, in other embodiments, the outer sheath 1510 may be associated with or mounted on the inner sheath 1508 in other ways. By way of non-limiting example, the outer sheath 1510 may simply be sized so as to be slidably mounted on the inner sheath 1508. In this configuration, the outer sheath 1510 could simply be retracted off of the flex sections 1514a-1514n by sliding or pulling back on the outer sheath 1510 in the direction of arrow A. When the outer sheath 1510 is refracted, the flex sections 1514a-1514n of the inner sheath 1508 will return to their natural outwardly flexed configuration, which will cause the lumen 1516 to open as described above.
With the guide wire 1502 loaded into the medical device 1504 and the lumen 1516 opened up, the device shield 1500 can be associated with an access device (not shown). For instance, the flex sections 1514a-1514n can be aligned with or inserted into an opening in an access device, such as an access catheter or RHV. Once the device shield 1500 is properly positioned relative to the access device, the medical device 1504 can be advanced into the access device for deployment into the patient. Notably, the device shield 1500 allows for both the insertion of the guide wire 1502 into the medical device 1504 without the risk of damaging the medical device 1504, and the advancement of the medical device 1504 into an access device without exposing the medical device 1504 to the surrounding environment where the medical device 1504 could be contaminated.
After the medical device 1504 is inserted into the access device, it may be desirable for the device shield 1500 to be removed from the catheter body 1522. This may be accomplished in a variety of ways, but one exemplary method of doing so is described here. Referring to
Other embodiments of device shield 1500 may be created by one of skill in the art. By way of non-limiting example, there is no need for the slots 1524, 1526 to align if the outer sheath 1510 can be retracted fully off of the inner sheath 1508 and each sheath 1508, 1510 is independently removed over the catheter body 1522. Thus, device shield 1500 allows the guide wire to be inserted into a medical device without damaging the medical device and allows the medical device to be delivered directly into an access device without the medical device being exposed to the surrounding environment in a significant manner.
Turning now to
In the present embodiment, the device shield 1600 has a split design. Specifically, the device shield 1600 has an upper portion 1600a and a lower portion 1600b. In
Whether the device shield 1600 is formed in a split or unsplit configuration, the device shield 1600 may include a storage portion 1602 which may include a generally cylindrical body and/or generally cylindrical inner surface that may approximate the dimension of a balloon 1604. In other embodiments, the upper portion 1600a and lower portion 1600b may differ. For example, only one of the upper portion 1600a or lower portion 1600b may include a storage portion 1602.
As seen in
In addition to facilitating insertion of a guide wire into the balloon 1604, device shield 1600 also facilitates the folding or refolding of the balloon 1604. The folding or refolding of the balloon 1604 can be accomplished either as the balloon 1604 is inserted into the storage portion 1602 or as the balloon 1604 is deployed from the storage portion 1602.
The folding or refolding of the balloon 1604 is achieved with grooves that are formed in the device shield 1600 at the end of the of storage portion 1602 opposite from the lumen 1606. Referring to
The rifled portion 1612 is adapted to fold or refold the balloon 1604 as the balloon 1604 is inserted into or deployed from the device shield 1600 through the rifled portion 1612. More specifically, as illustrated in
In an alternative embodiment, a balloon 1604 could be placed in the storage portion 1602 while the balloon is unfolded. After inserting a guide wire into the unfolded balloon 1604, the balloon 1604 could be deployed (i.e., passed into an access device, for example) through the rifled portion 1612. As the unfolded balloon 1604 passes through the rifled portions 1612, the spiral grooves 1610 in the rifled portion 1612 create one or more folds in the balloon 1604 such that the balloon 1604 is folded as the balloon 1604 exits the rifled portion 1612.
It will be appreciated that the rifled portion 1612 may be formed with one or more rifling grooves, depending on the number of folds that are desired. For example, two grooves would create two folds in the balloon, three folds would form three folds, and so on. Furthermore, the grooves in the rifled portion may be axially aligned instead of being spiraled grooves. Axially aligned grooves will create folds that align axially with the balloon. Further, a reduction in profile in the device shield will cause a reduction in profile of the balloon as it is advanced, thereby causing the folds to compress to a lower profile.
In yet another embodiment, the grooves in the rifled portion 1612 may have an axially aligned portion and a spiral portion. Including bother axially aligned and spiraled grooved portions would allow the folds in the balloon to first be formed axially and then to be rotated to reach a lower profile. It will be appreciated that a number of different configurations and groove profiles may likewise be used to fold or refold an expanded balloon prior to insertion within a patient's body. Thus, the device shield 1600 both allows for the insertion of a guide wire into a balloon without risk of damaging the balloon as well as being able to easily fold or refold the balloon prior to insertion into a patient.
Turning now to
The device shield 1700 may include a generally cylindrical body or housing with a storage portion 1702 therein. The storage portion 1702 may be sized and configured to maintain or package a medical device 1704 (e.g., a stent), a balloon 1706 associated with the medical device 1704, and at least a portion of a medical device delivery apparatus 1708 until the medical device 1704 is deployed int a patient's body. The storage portion 1702 may include a generally cylindrical inner surface that may approximate the dimension of the medical device 1704. For example, the inner diameter of the storage portion 1702 may be substantially similar to, or only slightly larger than, the diameter of a crimped stent (e.g. for a 0.040 inch diameter crimped stent diameter the inner diameter of at least a part of the storage portion 1702 may be approximately 0.042 inches in diameter). The storage portion 1702 may have a diameter or length that can fully encompass the medical device 1704 and/or balloon 1706 during packaging and/or delivery.
The device shield 1700 may include an expanded portion 1710. The expanded portion 1710 may be fluted, flared, or funnel-shaped to facilitate insertion of a guide wire 1712 into the medical delivery device apparatus 1708. For instance, the expanded portion 1710 may include one or more interior surfaces, identified at reference numbers 1714a-d, that collectively taper from a first diameter at the distal end of the device shield to a smaller diameter adjacent a passageway 1716. The collective taper of interior surfaces 1714a-d directs the guide wire 1712 into the passageway 1716.
Passageway 1716 extends between the expanded portion 1710 and the storage portion 1702 to facilitate the loading of the guide wire 1712 into the medical device delivery apparatus 1708. As shown in
In some embodiments, the distal end of the storage portion 1702 and/or the passageway 1716 may act to limit the distal movement of the medical device 1704, the balloon 1706, and/or the medical device delivery apparatus 1708. For instance, as can be seen in
The device shield 1700 may be expandable or otherwise configured to facilitate the deployment of the medical device 1704, the balloon 1706, and/or the medical device delivery apparatus 1708 through the passageway 1716 and the expanded portion 1710, such as for insertion into an access device (e.g., an RHV). For instance, the device shield 1700 may include one or more expansion slots that enable the distal end of device shield 1700, and particularly passageway 1716 or expanded portion 1710, to expand to allow the medical device 1704, the balloon 1706, and/or the medical device delivery apparatus 1708 to pass therethrough.
As discussed elsewhere herein, expansion slots may have various configurations. For example, an expansion slot: i) may be spiraled around the device shield 1700, ii) may span the entire length of the expanded portion 1710 and/or the passageway 1716, iii) may be staggered along the length and/or around the expanded portion 1710, the passageway 1716, and/or the entire device shield 1700, or iv) combinations thereof.
By way of example, the illustrated embodiment of device shield 1700 includes four expansion slots 1720, 1722, 1724, 1726, but may include fewer or more than four expansion slots. The expansion slots 1720, 1722, 1724, 1726 are radially offset from one another by about 90 degrees, but may be offset by other angles as well. Furthermore, in the illustrated embodiment, the expansion slots 1720, 1722, 1724, 1726 extend through the wall of the device shield 177, from an outer surface to an inner surface of device shield 1770. Nevertheless, at least some of the expansion slots 1720, 1722, 1724, 1726 may extend only partially through the wall of device shield 1700. For example, at least some the expansion slots 1720, 1722, 1724, 1726 may be scores or areas of reduced wall thickness formed in the wall of device shield 1700. Likewise, at least some the expansion slots 1720, 1722, 1724, 1726 may comprise perforations formed in the wall of device shield 1700. The perforations may be designed to allow device shield 1700 to expand either with the perforations remaining intact or preferentially failing.
According to the present embodiment, the expansion slots 1720, 1722, 1724 extend from the distal end of device shield 1700 along about half of the length of device shield 1700. In contrast, and for additional reasons discussed below, the expansion slot 1726 extends from the distal end of device shield 1700 along the entire length of the generally cylindrical body portion of device shield 1700. The expansion slots 1720, 1722, 1724, 1726 at least partially define four distal arms 1728, 1730, 1732, 1734. Furthermore, the expansion slots 1720, 1722, 1724, 1726 allow the distal arms 1728, 1730, 1732, 1734 to pivot or flex outwardly. The outward pivoting or flexing of the distal arms 1728, 1730, 1732, 1734 expands the passageway 1716 and/or the expanded portion 1710 as shown in
While the present embodiment has been illustrated with four expansion slots (three of which extend along about half the length of the device shield 1700), thereby creating four distal arms, this is but one exemplary implementation. For example, a device shield may include one or more slots that define one or more distal arms. Furthermore, the one or more expansion slots may extend along any portion of the length of the device shield so long has the one or more slots allow for the one or more distal arms to flex or pivot sufficiently to allow the medical device to pass through the passageway or the expanded portion.
As noted above, the expansion slot 1726 extends along the entire length of the generally cylindrical body portion of the device shield 1700. In addition to facilitating the movement of the distal arms 1728, 1730, 1732, 1734, the expansion slot 1726 facilitates the removal of the device shield 1700 from the medical device delivery apparatus 1708. More specifically, once medical device 1704, balloon 1706, and/or a portion of the medical device delivery apparatus 1708 have been deployed from the distal end of device shield 1700, device shield 1700 may be removed from off of a shaft of the medical device delivery apparatus 1708. That is, the shaft of the medical device delivery apparatus 1708 may be passed laterally through the expansion slot 1726 to separate the device shield 1700 from the medical device delivery apparatus 1708.
As can be seen in the Figures, the expansion slot 1726 may include a removal notch 1736 formed in the proximal end thereof. The removal notch 1736 may facilitate the alignment of the shaft of the medical device delivery apparatus 1708 with the expansion slot 1726. That is, as a radial or lateral load is applied to the device shield 1700, the removal notch 1736 will guide the shaft of the medical device delivery apparatus 1708 into the expansion slot 1726, thereby allowing the medical device delivery apparatus 1708 to pass through the expansion slot 1726.
A removal tab 1738 may be positioned near a proximal portion of the device shield 1700 to facilitate removal of the device shield 1700 from the medical device delivery apparatus 1708. The removal tab 1738 may be grasped by a physician and a lateral force may be applied thereto to remove the device shield 1700 from the medical device delivery apparatus 1708.
In addition to facilitating the removal of the device shield 1700, the removal tab 1738 also acts as a stop. Specifically, as shown in
An exemplary method of using a device shield, such as device shield 1700, may include positioning the device shield 1700 over the medical device delivery apparatus 1708 so that a distal end of the medical device delivery apparatus 1708 may be positioned adjacent the passageway 1716, which is in communication with the expanded portion 1710. The device shield 1700 and the medical device delivery apparatus 1708 may be removed from its packaging. A guide wire 1712 may be inserted into the device shield 1700 through the expanded portion 1710 and into the passageway 1716, which directs the guide wire 1712 into and/or through a lumen of the medical device delivery apparatus 1708. The device shield 1700, with the medical device delivery apparatus 1708, may be inserted into an access device, such as an RHV.
The device shield 1700, with the medical device delivery apparatus 1708, may be inserted into an access device until the removable tab 1738 abuts the access device, which may prevent the device shield 1700 from advancing into the patient anatomy. Once the device shield 1700 and the medical device delivery apparatus 1708 are positioned within the access device, the medical device delivery apparatus 1708 may be advanced further, which may cause the distal arms 1728, 1730, 1732, 1734 of the device shield 1700 to expand. The distal arms 1728, 1730, 1732, 1734 may expand sufficiently to allow the medical device delivery apparatus 1708 to pass through the passageway 1716 and the expanded portion 1710.
A practitioner may remove the device shield 1700 from the access device by grasping the removal tab 1738 and drawing the device shield proximally. The practitioner may also remove the device shield 1700 from the medical device delivery apparatus 1708 by applying a lateral force to the removal tab 1738. As the device shield 1700 moves laterally, the removal notch 1736 aligned the shaft of the medical device delivery apparatus 1708 with the expansion slot 1726. As the practitioner continues to apply a lateral force to the removal tab 1738, the shaft of the medical device delivery apparatus 1708 may pass through the expansion slot 1726, thereby removing the device shield 1700 from the medical device delivery apparatus 1708.
The various embodiments are described herein with respect to a stent and/or balloon. The present disclosure may also be used with other medical devices. For example, the device shield may be used with lumen filters, closure devices, graft materials, other medical devices, or combinations thereof. Medical devices of all types are advanced over guide wires. In addition, various stents may be used with the present disclosure. For example, drug eluting stents, bare metal stents, bioabsorbable stents, stents of varying sizes and/or structures, other stents, or combinations thereof with or without their accompanying balloons or other deployment devices may be used. Furthermore, self-expanding stents may be used with embodiments of the present disclosure. For example, the storage portions (described as 104, 204, 704 above) may store a self-expanding stent without a balloon. In another example, the self-expanding stent may be stored within a catheter that may be stored within a storage portion.
An embodiment of a method for delivering a medical device into a patient's body may include using any of the devices described above, in order to reduce and/or prevent contamination and/or damage of a medical device and/or delivery device surface prior to device insertion within the patient anatomy. The method may include packaging a device with a protective covering. After opening the surrounding package in a procedural environment, such as the catheter lab, a guide wire may be inserted into the device through the protective covering and the covering will be advanced with the enclosed device into, or adjacent to, an access device, such as an RHV.
A mechanism may be actuated on the protective covering to allow the device to be inserted into the anatomy through the access device, although it is also possible in some embodiments to use a protective covering that requires no actuation before device insertion. Following insertion, the protective covering may be removed and/or discarded. It will be appreciated that according to this method, the surface of the device that is disposed within the protective covering may be shielded from contamination by particulates within the surrounding environment until it is inserted through the access device or at the very least the device may be shielded from contamination or damage until just before insertion through the access device. As shown in
In another embodiment, a method for delivering a medical device into a patient body includes (1) positioning an introducer apparatus in the patient body and (2) positioning at least a portion of a device shield into the introducer apparatus. In one embodiment, the device shield includes (a) a housing that includes a medical device and at least a portion of a medical device delivery apparatus associated with the medical device, and (b) a limit element having a first position configured to constrain the medical device and/or the portion of the medical device delivery apparatus associated with the medical device.
The method for delivering a medical device into a patient body further includes (3) transitioning the limit element to a second position, wherein the second position is configured to permit delivery of the medical device into the patient body, and (4) delivering the medical device from the device shield and into the patient body via the introducer apparatus.
In one embodiment, the method for delivering a medical device into a patient body further includes inserting a guide wire into a guide wire lumen of the medical device delivery apparatus prior to positioning the device shield into the introducer apparatus.
In another embodiment, positioning at least the portion of the device shield into the introducer apparatus triggers an actuator for transitioning the limit element from the first position to the second position. In another embodiment, the method for delivering a medical device into a patient body further includes removing a retaining member from the housing to transition the limit element from the first position to the second position. In yet another embodiment, the method for delivering a medical device into a patient body further includes tearing or peeling at least a portion of the housing away from the medical device to transition the limit element from the first position to the second position.
The present disclosure may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrative and not restrictive. The scope of the disclosure is, therefore, indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.
This application is a continuation-in-part of U.S. App. Ser. No. 13/037,008, filed 28 Feb. 2011, entitled MEDICAL DEVICE SHIELD AND METHODS FOR DELIVERY A MEDICAL DEVICE, which claims the benefit of and priority to U.S. Provisional App. Ser. No. 61/309,359, filed 1 Mar. 2010, entitled SYSTEMS AND METHODS FOR LOADING A GUIDE WIRE, and U.S. Provisional App. Ser. No. 61/348,597, filed May 26, 2010, entitled SYSTEMS AND METHODS FOR LOADING A GUIDE WIRE, the entirety of each of which is incorporated herein by reference.
Number | Date | Country | |
---|---|---|---|
61309359 | Mar 2010 | US | |
61348597 | May 2010 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 13037008 | Feb 2011 | US |
Child | 13220123 | US |