The insertion of intravascular catheters through the skin and into the vasculature of a patient generally includes the use of a needle disposed within the lumen of the catheter. The needle provides a sharp tip and adds stiffness to the catheter to aid the insertion process. Catheters may come packaged with a needle already inserted or the clinician may insert the needle into the catheter at the point of use. In some instances, a clinician may reinsert a needle into a catheter after initial placement of the catheter. The rapid placement of larger catheters such a central venous catheters (CVC) may include inserting an introducer catheter through a lumen of the CVC. In such an instance, the introducer catheter may comprise a needle. The forgoing are just a few examples of many situations where a clinician may insert a needle through a catheter lumen. The tubular portions of the catheters are flexible and may be several inches in length. These characteristics pose difficulty when inserting a sharp needle through the lumen of the catheter. The insertion of the needle though the lumen of the catheter can also potentially pierce the catheter's tubular wall rendering the catheter unfit for use. As set forth above, there is a need to reduce the propensity of the needle tip to puncture a catheter wall upon insertion of the needle through the lumen of the catheter lumen. Disclosed herein are needle tip blunting guidewires and methods thereof that address the foregoing.
Disclosed herein are embodiments of a guidewire, including a flexible distal section, flexible proximal section, and a middle section disposed between the distal section and the proximal section. In some embodiments, the distal section is configured for insertion into a vasculature of a patient. In some embodiments, the middle section is less flexible than the distal section and the proximal section. The middle section may be stiff and a diameter of the middle section may be greater than a diameter of the distal section. In some embodiments, a tapered distal transition portion is disposed between the distal section and the middle section.
In some embodiments, the guidewire comprises a solid core wire extending a length of the guidewire. The solid core wire includes a first diameter extending along the distal section, a second diameter extending along the proximal section, and a third diameter extending along the middle section. The third diameter, which may be greater than the first diameter and the second diameter, defines an outside diameter of the guidewire along the middle section.
In some embodiments, the guidewire comprises a solid core wire extending a length of the guidewire and a coil disposed around the solid core wire along the length of the guidewire. The guidewire may further include a material applied around the guidewire along the middle section. The material may be a liquid during application and may transform into a solid after application.
In some embodiments, the guidewire comprises a solid core wire extending a length of the guidewire and a cannula threaded onto the solid core wire. The cannula is positioned along the middle section, and the cannula defines an outside diameter of the guidewire along the middle section.
In some embodiments, the guidewire comprises a flexible distal section, flexible proximal section, a stiff middle section disposed between the distal section and the proximal section; and a cannula threaded onto the guidewire. A distal tip of the cannula is positioned so that a proximal portion of the middle section is disposed within the cannula and a distal portion of the middle section extends distally beyond the distal tip of the cannula. An outside diameter of the middle section and an inside diameter of the cannula can: 1) define a longitudinal sliding fit between the middle section and the cannula, and 2) constrain the middle section to be parallel to the cannula.
In some embodiments, a method of using a guidewire comprises obtaining a guidewire including a flexible distal section, a flexible proximal section, and a stiff middle section disposed between the distal section and the proximal section; threading a cannula onto the guidewire; positioning a tip of the cannula between a distal end and a proximal end of the middle section; and inserting the cannula and the guidewire distally through a tubular member while maintaining the position of the cannula with respect to the guidewire. The method may further comprise contacting the tubular member with the middle section to constrain the tubular member away from a sharp point of the cannula.
In some embodiments, at least a portion of the proximal section may be disposed within the cannula after positioning the tip of the cannula between the distal end and the proximal end of the middle section. In some embodiments, the tubular member is a first intravascular catheter which may be at least partially inserted into a vasculature of a patient. In some embodiments, the method comprises inserting the guidewire and the cannula into a second intravascular catheter. In still other embodiments, the method comprises inserting the guidewire, the cannula, and the first intravascular catheter into a second intravascular catheter. In some embodiments, the method further comprises inserting the distal section of the guidewire into a vasculature and in some embodiments, the distal section is inserted into the vasculature before the cannula is threaded onto the guidewire.
These and other features of the concepts provided herein will become more apparent to those of skill in the art in view of the accompanying drawings and following description, which describe particular embodiments of such concepts in greater detail.
Before some particular embodiments are disclosed in greater detail, it should be understood that the particular embodiments disclosed herein do not limit the scope of the concepts provided herein. It should also be understood that a particular embodiment disclosed herein can have features that can be readily separated from the particular embodiment and optionally combined with or substituted for features of any of a number of other embodiments disclosed herein.
Regarding terms used herein, it should also be understood the terms are for the purpose of describing some particular embodiments, and the terms do not limit the scope of the concepts provided herein. Ordinal numbers (e.g., first, second, third, etc.) are generally used to distinguish or identify different features or steps in a group of features or steps, and do not supply a serial or numerical limitation. For example, “first,” “second,” and “third” features or steps need not necessarily appear in that order, and the particular embodiments including such features or steps need not necessarily be limited to the three features or steps. Labels such as “left,” “right,” “top,” “bottom,” “front,” “back,” and the like are used for convenience and are not intended to imply, for example, any particular fixed location, orientation, or direction. Instead, such labels are used to reflect, for example, relative location, orientation, or directions. Singular forms of “a,” “an,” and “the” include plural references unless the context clearly dictates otherwise.
With respect to “proximal,” a “proximal portion” or a “proximal end portion” of, for example, a catheter disclosed herein includes a portion of the catheter intended to be near a clinician when the catheter is used on a patient. Likewise, a “proximal length” of, for example, the catheter includes a length of the catheter intended to be near the clinician when the catheter is used on the patient. A “proximal end” of, for example, the catheter includes an end of the catheter intended to be near the clinician when the catheter is used on the patient. The proximal portion, the proximal end portion, or the proximal length of the catheter can include the proximal end of the catheter; however, the proximal portion, the proximal end portion, or the proximal length of the catheter need not include the proximal end of the catheter. That is, unless context suggests otherwise, the proximal portion, the proximal end portion, or the proximal length of the catheter is not a terminal portion or terminal length of the catheter.
With respect to “distal,” a “distal portion” or a “distal end portion” of, for example, a catheter disclosed herein includes a portion of the catheter intended to be near or in a patient when the catheter is used on the patient. Likewise, a “distal length” of, for example, the catheter includes a length of the catheter intended to be near or in the patient when the catheter is used on the patient. A “distal end” of, for example, the catheter includes an end of the catheter intended to be near or in the patient when the catheter is used on the patient. The distal portion, the distal end portion, or the distal length of the catheter can include the distal end of the catheter; however, the distal portion, the distal end portion, or the distal length of the catheter need not include the distal end of the catheter. That is, unless context suggests otherwise, the distal portion, the distal end portion, or the distal length of the catheter is not a terminal portion or terminal length of the catheter.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by those of ordinary skill in the art.
Any methods disclosed herein include one or more steps or actions for performing the described method. The method steps and/or actions may be interchanged with one another. In other words, unless a specific order of steps or actions is required for proper operation of the embodiment, the order and/or use of specific steps and/or actions may be modified. Moreover, sub-routines or only a portion of a method described herein may be a separate method within the scope of this disclosure. Stated otherwise, some methods may include only a portion of the steps described in a more detailed method.
The distal section 101 may be configured to be disposed within a vasculature of a patient. As such, the distal section 101 may comprise a flexibility sufficient to traverse a vasculature without causing injury to the vascular wall. In other words, the distal section 101 may flex during insertion to conform with the vasculature structure without kinking or plastically deforming. In some embodiments, the distal section 101 may comprise a flexibility that is consistent with medical guidewires configured to traverse a vasculature, as discussed further below. The distal section 101 may also comprise sufficient stiffness to facilitate insertion via a distally applied compression force without buckling within the vasculature. In some embodiments, the distal section 101 may include a length sufficient to extend from the vasculature insertion site to a desired location within the vasculature such as a location near or within the heart. As such, placement of intravascular devices may include use of the NTBG 100 as an intravascular guidewire. In other embodiments, the distal section 101 may be short, such that the distal section extends less than about 1 to 5 centimeters away from a cannula tip, for example.
The distal section 101 may comprise a round cross section having a diameter 111 consistent with insertion through the vasculature, a cannula and/or a catheter lumen. In some embodiments, the distal section 101 may comprise one or multiple preformed curves or shapes to aid insertion through the vasculature. Preformed shapes may be two-dimensional, such as the “J” shape illustrated in
The proximal section 103 may be configured to be manually inserted into a cannula of a needle. The proximal section 103 may comprise adequate stiffness to facilitate being manually grasped by a clinician and urged distally into the cannula without kinking or plastically deforming. The proximal section 103 may comprise a flexibility consistent with being coiled for placement in a package container without kinking or plastically deforming. In some embodiments, the proximal section 103 may be less flexible than the distal section 101. The proximal section 103 may comprise a round cross section having a diameter 113 consistent with disposition within the cannula. In some embodiments, the diameter 113 may be larger than the diameter 111. In some embodiments, the proximal section 103 may be configured to be disposed within the vasculature of a patient and therefore, the proximal section 103 may comprise similar physical properties as the distal section 101.
In some embodiments, the proximal section 103 may include indicia 110. The indicia 110 may be indicative of a distance to the middle section 102. In some instances, the distal tip of the cannula may not be visible to a clinician. A location of indicia 110 with respect to a proximal end of the cannula may indicate a position of the middle section 102 with respect to a distal tip of the cannula. The indicia 110 may also be indicative of a distance to the distal end 104 of the NTBG 100. In some instances, a clinician may observe the indicia 110 to determine the position of the distal end 104 along the vasculature of the patient.
The middle section 102 is disposed between the distal section 101 and the proximal section 103. In the illustrated embodiment, the middle section 102 may be straight to correspond with a straight cannula. In some embodiments, the middle section 102 may comprise a curve to correspond with a curved cannula. The middle section 102 may remain straight during use. As is known, catheters, guidewires and other elongated medical devices have varying levels or degrees of stiffness (or flexibility), which is often referred to as flexural stiffness or flexural rigidity. Flexural stiffness is understood as the product of the elastic modulus (E) of a material and the area moment of inertia (I) where the flexural stiffness (EI) has the SI units of Newtons (N)·meters2 (m2) or N·m2.
In certain situations, a particular medical procedure may require a medical device have a particular degree of stiffness. As is further known, the degree of stiffness of a medical device may be determined by the materials from which it is comprised, the shape and dimensions of the medical device, and any braiding utilized in its construction. The middle section 102 may comprise a round cross section having a diameter 112 that, in some embodiments, may be larger than the diameter 111 of the distal section 101 and the proximal section 103. The middle section 102 may include a tight diametral tolerance. In some embodiments, the diametral tolerance of the diameter 112 may be about ±0.002 inches, ±0.001 inches, ±0.0005 inches, ±0.0002 inches, or tighter.
The middle section 102 may comprise a distal transition portion 106. The distal transition portion 106 may define a smooth transition of physical properties between the distal section 101 and the middle section 102. The distal transition portion 106 may comprise a taper to transition the diameter 111 of the distal section 101 to the diameter 112 of the middle section 102. The distal transition portion 106 may also be constructed to transition the flexibility of the distal section 101 to the stiffness of the middle section 102. In some embodiments, the distal transition portion 106 may define a strain relief. In a similar fashion, the middle section 102 may comprise a proximal transition portion 107. The proximal transition portion 107 may define a smooth transition of physical properties between the proximal section 103 and the middle section 102. In some embodiments, the middle section 102 may be configured to be disposed within the vasculature of a patient. More specifically, the length of the middle section 102 may be sufficiently short to traverse curved portions of an intended vasculature.
As shown in
The tip 510 of the cannula 500 may be a sharp tip such as a tip consistent with piercing skin and/or a vascular wall. In other embodiments, the tip 510 may be a configured insertion through a septum. In some embodiments, the tip 510 may include a sharp point 517 disposed on the outside surface 518 of the cannula 500. In other embodiments, the tip 510 may include a facet 516 that is cut to displace the point 517 inward away from the outside surface 518 of the cannula 500.
The NTBG 100 may be provided in multiple configurations. For example, in some embodiment configurations, the distal section 101 may include a length consistent with placement of an intravascular device. Similarly, configurations of NTBG 100 may be sized for use with specific cannula gauges. For example, an embodiment of the NTBG 100 may be configured for use with a variety of cannulas of a specified gauge. As may be appreciated by one of ordinary skill, configurations of NTBG 100 may be provided with any combination of physical properties for each of the distal, middle, and proximal sections (101, 102, 103), such as length, diameter, and flexibility.
In some instances, the tubular member 600 may comprise flexibility and stiffness characteristics to cause a curvature of the tubular member 600 to extend proximally beyond the catheter tip 510 when the tubular wall 611 is in contact with the distal portion 522 at the contact point 622. In this instance, the curvature of the tubular member 600 may displace the tubular wall 611 radially away from the outside surface 518 of the cannula 500 which may at least partially define the separation distance 630. In such an instance, piercing of the tubular member 600 may be prevented in the event that the tip 517 is disposed on the outside surface 518 of the cannula 500.
Methods of use of the NTBG may include the following steps or processes. A method may include a step of inserting the NTBG through the cannula. The NTBG may be inserted distally, i.e., inserting the distal end first, or proximally, i.e., inserting the proximal end first. Threading the cannula onto the NTBG may be analogous to inserting the NTBG through the cannula. In some embodiments, the NTBG may be partially inserted so that the distal end or the proximal end of the NTBG is disposed within the cannula.
A method may include a step of positioning the middle section of the NTBG adjacent the cannula tip, so that the tip is disposed between the distal end and the proximal end of the middle section and, so that the distal portion may effectively blunt the sharp tip of the cannula.
A method may include a step of visually observing indicia disposed on the proximal section of the NTBG in relation to a proximal end of the cannula to determine the position of the middle section with respect to the cannula tip. In some instances, the cannula tip may not be visible to the clinician and therefore, the position of the middle section with respect to the cannula tip may not be observable. The location of an indicium with respect to the proximal end of the cannula may provide a visual indication to the clinician that the middle section is positioned adjacent the cannula tip.
A method may include a step of contacting the tubular member (catheter) with the middle section, i.e. the distal portion of the middle section, to constrain the tubular member away from the sharp point of the cannula. More specifically, the distal portion contacts an inside surface of the tubular wall of the tubular member, so that the sharp point of the cannula does not gouge or pierce the tubular wall.
A method may include a step of inserting the NTBG through a catheter. The NTBG may be inserted distally, i.e., inserting the distal section first, or proximally, i.e., inserting the proximal section first. Threading the catheter onto the NTBG may be analogous to inserting the NTBG through the catheter. In some embodiments, the NTBG may be partially inserted so that a distal end of the NTBG is disposed within the catheter. The NTBG may be inserted through the catheter before or after the catheter has been inserted into a patient.
A method may include a step of inserting the cannula and the NTBG through a catheter in a single step. This step may be performed after the NTBG is inserted through the cannula and after the middle section is positioned adjacent the cannula tip. During this step, the position of the NTBG with respect to the cannula may be constrained so that the middle section remains positioned adjacent the cannula tip.
A method may include a step of inserting the NTBG and the cannula through a catheter in a single step. This step may be performed after the NTBG is inserted through the cannula and after the middle section is positioned adjacent the cannula tip. During this step, the position of the NTBG with respect to the cannula may be constrained so that the middle section remains positioned adjacent the cannula tip.
A method may include a step of inserting the NTBG, the cannula, and the catheter through a second catheter in a single step. This step may be performed after the NTBG is inserted through the cannula, after the middle section is positioned adjacent the cannula tip, and after the NTBG and the cannula are inserted though the first catheter. During this step, the position of the NTBG with respect to the cannula may be constrained so that the middle section remains positioned adjacent the cannula tip.
A method may include a step of inserting the NTBG into the vasculature of the patient. In some embodiments, only the distal section of the NTBG is inserted into the patient. In other embodiments, the distal section and at least a portion of the middle section is inserted into the patient. Still in other embodiments, the distal section, the middle section and at least a portion of proximal section is inserted into the patient.
A method may include a step of removing the cannula from the catheter. In this step, the cannula is displaced proximally relative to the catheter until no portion of the cannula is inserted into the catheter. In some embodiments, the NTBG may remain inserted through the cannula.
A method may include a step of removing the cannula from the NTBG. Removing the cannula from the NTBG includes displacing the cannula proximally off the proximal end of the NTBG. In some embodiments, a catheter may remain threaded onto the NTBG.
A method may include a step of threading a catheter onto the NTBG in the absence of the cannula. In other words, the NTBG may be inserted into the patient and the catheter may be threaded onto the NTBG from the proximal end. The NTBG may serve as a guidewire as the catheter is inserted through the vasculature of the patient.
A method may include a step of visually observing indicia disposed on the proximal section of the NTBG in relation to the vascular insertion site. The location of an indicium with respect to the vascular insertion site may provide a visual indication to the clinician as to the position of the distal end of the NTBG along the vasculature of the patient.
While some particular embodiments have been disclosed herein, and while the particular embodiments have been disclosed in some detail, it is not the intention for the particular embodiments to limit the scope of the concepts provided herein. Additional adaptations and/or modifications can appear to those of ordinary skill in the art, and, in broader aspects, these adaptations and/or modifications are encompassed as well. Accordingly, departures may be made from the particular embodiments disclosed herein without departing from the scope of the concepts provided herein.
This application claims the benefit of priority to U.S. Provisional Application No. 63/120,913, filed Dec. 3, 2020, which is incorporated by reference in its entirety into this application.
Number | Date | Country | |
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63120913 | Dec 2020 | US |