Peel-away introducers are disposable medical devices used in a cardiac catheterization or other medical setting to deliver medical devices into the vasculature. Standard peel-away introducers include a proximal plastic hub coupled to a sheath. Medical devices can be inserted through the plastic hub and into the sheath, through which the device can be placed in a patient's body. Intravascular medical devices, such as intracardiac blood pumps, catheters, guidewires, or leads, can be introduced into a patient's vasculature through a peel-away introducer. Once the medical device has been positioned, the peel-away introducer can be removed. In one approach, the operator breaks the introducer by cracking the plastic introducer hub and peeling down the shaft of the sheath body. In order to break the peel-away introducer, the operator grasps the molded hub and breaks it at the proximal end of the sheath along axial notches or scorings. The sheath tears along perforations or scorings down one or both sides of the sheath and can be peeled axially. The peel-away introducer allows the introducer to be removed after a medical device is inserted into a patient through the introducer without disturbing or removing the medical device.
In a common manufacturing technique, peel-away introducers are formed from an extruded plastic tube with axial notches in a hub body. A hub body including notches and/or wings to facilitate breaking is overmolded onto an extruded plastic sheath or tube. The plastic tube is first assembled over a corepin or mandrel which defines and maintains the inner cavity of the hub and inner diameter and geometry of the sheath. The mandrel and extruded sheath are then placed into a mold cavity allowing for molten plastic to be injected and cooled, creating the plastic hub that the user breaks to initiate peeling.
In the overmolding technique, after the mandrel and extruded sheath are placed into a mold, molten plastic in injected into the mold. The plastic cools around the sheath in the shape of the mold, forming the hub body. The injected plastic is maintained at a high temperature when it is introduced to the mold, and the heat from the injected plastic surrounding the sheath may be sufficient to heat a top layer of the sheath plastic such that the plastic of the sheath may start to flow in a process called reflowing. The portion of the sheath disposed inside the hub of the assembly may lose its internal scoring or notching during the molding process if the heat of the injected plastic reflows into one or more of the scores/notches. As a result, the forces required to break the hub may be excessive or inconsistent because the sheath does not include a weakened section of one of the scores/notches. Furthermore, when the plastic of the sheath is reflowed and the scoring is removed in the section of the sheath within the hub, there is an increased risk that during the breaking of the hub the tear will not propagate to the scoring in the sheath body outside the section in the overmolded hub leading to a defective peel-away introducer sheath.
Described herein are methods and systems for producing a peel-away introducer including an overmolded hub while maintaining the scoring of the sheath. During overmolding, a mandrel designed with outer surface protrusions on which the sheath is assembled, maintains the inner scorings of the sheath through the injection molding process despite the application of extreme heat. With the internal scorings of the sheath maintained, when the hub is broken by an operator, the proximal section of the sheath tube in the overmolded hub breaks more easily and with less required force. Sheaths manufactured by the methods disclosed herein can also peel more easily.
In one aspect, a method for manufacturing a medical introducer includes placing an introducer sheath onto a mandrel, and overmolding an introducer hub onto a proximal end of the introducer sheath. The introducer sheath has one or more score lines formed on an inner surface. The mandrel has a number of surface protrusions so that when the introducer sheath is positioned on the mandrel, each of the surface protrusions contacts one of the score lines formed on the introducer sheath and prevents plastic material from the introducer hub from contacting the score lines.
In some implementations, the number of surface protrusions on the mandrel is equal to the number of score lines formed on the sheath. In some implementations, the introducer hub includes a number of notches. In some implementations, the number of notches in the introducer hub is equal to the number of score lines formed on the sheath and also equal to the number of surface protrusions on the mandrel. In some implementations, at least one of the number of notches is aligned with a score line formed on the sheath. In some implementations, at least two notches are aligned with a score line formed on the sheath. In some implementations, the introducer hub and introducer sheath are configured to be broken into at least two pieces along the notches and score lines.
In some implementations, the number of surface protrusions on the mandrel is not equal to the number of score lines formed on the sheath. In some implementations, at least one of the number of score lines formed on the inner surface of the introducer sheath is removed during the overmolding. In some implementations, the number of surface protrusions on the mandrel is equal to a desired number of score lines in the sheath.
Variations and modifications will occur to those of skill in the art after reviewing this disclosure. The disclosed features may be implemented, in any combination and subcombination (including multiple dependent combinations and subcombinations), with one or more other features described herein. The various features described or illustrated above, including any components thereof may be combined or integrated in other systems. Moreover, certain features may be omitted or not implemented.
The foregoing and other objects and advantages will be apparent upon consideration of the following detailed description, taken in conjunction with the accompanying drawings, in which like reference characters refer to like parts throughout, and in which:
Following below are more detailed descriptions of various concepts related to inventive methods of manufacturing a peel-away medical introducer. It should be appreciated that various concepts introduced above and discussed in greater detail below may be implemented in any number of ways, as the disclosed concepts are not limited to any particular manner of implementation. For example, though peel-away introducer sheaths are depicted herein having two axial notches which divide the introducer hub and underlying sheath into two sections, the introducer hub and sheath may be manufactured to have any number of axial notches or perforations so as to allow parting into any number of portions along an axial direction. Furthermore, although surface protrusions of a mandrel are described with reference to maintaining score lines on a sheath for use in a peel-away introducer, the surface protrusions on the mandrel may be used to protect other features of the internal geometry of a sheath during any overmolding or heat-treating process. Examples of implementations and applications are provided primarily for illustrative purposes.
The methods and systems described herein enable production of a peel-away introducer including an overmolded hub while maintaining the scoring of the sheath. The mandrel for holding the hub and the sheath can have one or more outer elongate protrusions formed along an outer surface thereof. A protrusion can contact each of the corresponding inner scorings of the sheath so that when heat is applied the score lines are maintained through the injection molding process rather than filled with material from the hub or the sheath (e.g., plastic that has melted during heat application). With the internal scorings of the sheath maintained, when the hub is broken by an operator, the proximal section of the sheath tube in the overmolded hub breaks more easily and with less required force than if this material had flowed into the score lines and hardened. Additionally, with the score lines in the introducer sheath maintained, the hub can be broken and the sheath peeled longitudinally to facilitate removal of the introducer hub assembly. The overmolding method described herein promotes appropriate breaking of the introducer hub and peeling of the sheath as designed.
The mandrel 101 with the first surface protrusion 102a and the second surface protrusion 102b is shaped to maintain the inner geometry of the introducer sheath 104. The introducer sheath 104 fits tightly over the mandrel 101 in preparation for overmolding of the introducer hub assembly 103. There may be some distance 106 between an outer surface 108 of the mandrel 101 and an inner surface 105 of the introducer sheath 104, but in most cases the distance 106 is minimized such that the outer surface 108 of the mandrel 101 is in contact with the inner surface 105 of the introducer sheath 104 in areas which are to be protected during overmolding, such as at the first score line 110a and the second score line 110b. In some implementations, the distance 106 between the outer surface 108 of the mandrel 101 and the inner surface 105 of the introducer sheath 104 in areas which are not protected during overmolding is e.g., 0 mm, 0.1 mm, 0.2 mm, 0.3 mm, or 0.4 mm or it can be structured at any other suitable distance. The surface protrusions 102a and 102b may be set at a desired height from the body of the mandrel 101. In some implementations, the surface protrusions 102a and 102b extend from the surface of the mandrel 101 by about 0.05 mm, 0.1 mm, 0.2 mm, 0.3 mm, or any suitable height. In certain embodiments, the distance between the outer surface 108 of the mandrel 101 and an inner surface 105 of the introducer sheath 104 is between about 0 mm and 0.4 mm, while the protrusions extend from the outer surface 108 of the mandrel 101 and have a height of about 0.05 mm to 0.3 mm. In some implementations, the surface protrusions have a shape which is square, rectangular, cylindrical, or any other suitable shape. In some implementations, the protrusions extend longitudinally along the mandrel. In some implementations, the protrusions extend in a helix along the mandrel.
With the introducer sheath 104 fit over the mandrel 101, the introducer hub assembly 103 can be formed onto the sheath 104 such as by being injection molded over the introducer sheath 104. The injection molding process exposes the proximal end of the introducer sheath 104 to high temperatures and/or pressures which can cause reflow of the plastic from which the introducer sheath 104 is formed. Reflowing plastic may cover or completely fill the first score line 110a and the second score line 110b in the introducer sheath 104 if the first score line 110a and the second score line 110b are not protected by a corresponding protrusion. The first surface protrusion 102a and the second surface protrusion 102b extend into the first score line 110a and the second score line 110b such that even if the introducer sheath 104 is heated and reflow occurs, the first score line 110a and the second score line 110b are maintained.
If the first score line 110a and the second score line 110b are altered or removed by reflow of the plastic during construction, the introducer sheath 104 may not separate properly during breaking of the introducer hub assembly 103 after use. The hub body 112 may break as designed at first notch 114a and second notch 114b when an outward or downward force is applied to the first wing 116a and second wing 116b. However, if the first score line 110a and the second score line 110b have been damaged, the separation may not propagate to the introducer sheath 104, or from a proximal portion of the introducer sheath 104 to a more distal portion not in contact with the introducer hub assembly 103. As a result, it may be difficult or uncomfortable for an operator to apply the additional or excessive force required in order to initiate the breaking of the introducer hub assembly 103.
Though the introducer sheath 104 is depicted here having two score lines, the first score line 110a and the second score line 110b, the introducer sheath 104 may be configured with any number of score lines. In some implementations, the introducer sheath is configured with one score line, two score lines, three score lines, four score lines, six score lines, ten score lines, or any other suitable number of score lines. The score lines may be formed as perforations, scorings, indentations or by any other suitable means.
The mandrel 101 is depicted here having two surface protrusions, the first surface protrusion 102a and the second surface protrusion 102b, but may have any suitable number of surface protrusions. In some implementations, the mandrel 101 has one surface protrusion, two surface protrusions, three surface protrusions, four surface protrusions, six surface protrusions, or any other suitable number of surface protrusions. The mandrel 101 may have a number of surface protrusions equal to the number of score lines on the introducer sheath 104. Alternatively, the mandrel 101 may have a number of surface protrusions which is less than the number of score lines on the introducer sheath 104. If the number of surface protrusions is less than the number of score lines on the introducer sheath 104, any additional score lines on the introducer sheath 104 may be removed by reflow of material during the manufacture of the introducer hub assembly 103 overlay. For example, if an introducer sheath 104 has three score lines, but only two are desired for an introducer hub assembly a mandrel with only two surface protrusions may be used to protect two of the three score lines on the introducer sheath during overmolding. Alternatively, the mandrel 101 may have a number of surface protrusions that is greater than the number of score lines on the introducer sheath 104 such that only some of the total surface protrusions contact the score lines. This can allow, for example, the mandrel 101 to be configured to assemble sheaths having varying number of score lines.
The surface protrusions on the mandrel 101 may be matched to the type of score lines on the introducer sheath 104, as shown in
Although two surface protrusions 402, the first surface protrusion 402a and the second surface protrusion 402b, are shown in
The first surface protrusion 402a and the second surface protrusion 402b shown in
A medical device or catheter may be inserted into a patient through the throughgoing cavity 524 in the introducer hub assembly 503. After the device or catheter has been inserted, an operator can break the introducer hub assembly 503 by applying a force to the first wing 516a and the second wing 516b, breaking the introducer hub assembly 503 into two or more pieces. The introducer hub assembly 503 is designed to break at the first notch 514a and the second notch 514b upon the application of this force on the first wing 516a and the second wing 516b. The alignment of the first notch 514a and the second notch 514b with the first score line 510a and the second score line 510b, respectively, allows the break force applied by the operator to break the hub body 512 to propagate from the first notch 514a to the first score line 510a and from the second notch 514b to the second score line 510b to allow the introducer hub assembly 503 to be broken into two pieces and the introducer sheath 504 to be peeled away. Good alignment of the notches with the score lines that have been protected from damage during the overmolding of the hub body 512 allows the introducer hub assembly to be easily broken and peeled with a nominal breaking force applied.
If the score line 610 of the introducer sheath 604 has been damaged or removed by the reflow of plastic material from the introducer sheath 604 during overmolding, the introducer sheath 604 may not easily split apart at the hub body 612 or below the hub body 612. This may require additional or excessive force to be applied to the hub body 612 or to the introducer sheath 604 in order to break the hub body 612 and introducer sheath. Alternatively, the malfunction of the introducer hub assembly 603 due to damaged score lines in the introducer sheath 604 may result in a defective introducer hub assembly which cannot be peeled away as designed. Alternative or suboptimal methods for removal may then be used which may require additional tools.
At step 704, the surface protrusions of the mandrel are aligned with the score lines of the introducer sheath. The introducer sheath fits tightly over the mandrel and the score lines on the interior of the introducer sheath are in contact with the surface protrusions of the mandrel. In some implementations, the surface protrusions of the mandrel may be aligned with the score lines of the introducer sheath before the mandrel is inserted into the introducer sheath, or simultaneous to insertion. The shape, size, and height of the surface protrusions may be matched to the score lines in the introducer sheath. In some implementations, the surface protrusions may be a continuous raised section configured as a ridge with an angled top, a squared top or a rounded top. The surface protrusions on the mandrel may be a variety of heights from the body of the mandrel to match the score lines in the introducer sheath. In some implementations, the surface protrusions extend from the surface of the mandrel by 0.05 mm, 0.1 mm, 0.2 mm, 0.3 mm, or any suitable height. In some implementations, there is some distance between an outer surface of the mandrel and an inner surface of the introducer sheath, but in most cases the distance is minimized such that the outer surface of the mandrel is in contact with the inner surface of the introducer sheath at least in regions which are to be protected from reflow during further manufacture. In some implementations, the distance between the outer surface of the mandrel and the inner surface of the introducer sheath in areas which are not to be protected is 0 mm, 0.1 mm, 0.2 mm, 0.3 mm, 0.4 mm or any other suitable distance. In some implementations, the surface protrusions 102a and 102b extend from the surface of the mandrel 101 by about 0.05 mm, 0.1 mm, 0.2 mm, 0.3 mm, or any suitable height. In certain implementations, the distance between the outer surface of the mandrel and an inner surface of the introducer sheath is between about 0 mm and 0.4 mm, while the protrusions extend from the outer surface of the mandrel and have a height of about 0.05 mm to 0.3 mm.
At step 706, the method includes overmolding an introducer hub onto a proximal end of the introducer sheath. The overmolding process uses heating, which may cause the plastic material of the introducer sheath to melt and reflow. The areas of the score lines which are protected by their contact with the surface protrusions of the mandrel are not covered by reflowing plastic and are maintained throughout the overmolding process. Areas which are not protected by the surface protrusions on the mandrel may reflow and fill in any additional score lines.
The overmolding of the introducer hub may also include overmolding one or more wings onto the introducer hub to aid in the breaking of the hub after use. After the introducer hub is overmolded onto the proximal end of the sheath the introducer hub and introducer sheath are removed from the mandrel. The introducer sheath includes a number of score lines which have been maintained by the mandrel during the overmolding of the introducer hub and introducer hub body. The score lines correspond to notches in the overmolded introducer hub. The introducer hub may be separated into two or more pieces at the notches and score lines after use with the application of a nominal force on the wings. Once the introducer hub has been separated at the notches and score lines, the introducer sheath may be peeled away along the score lines to remove the introducer hub assembly.
The foregoing is merely illustrative of the principles of the disclosure, and the methods and systems can be practiced other than the described implementations, which are represented for purposes of illustration and not of limitation. It is to be understood that the methods and systems disclosed herein, while shown for use in manufacture of a peel-away introducer hub and sheath, may be applied to other systems in which internal geometries of a sheath must be maintained during heat treatment.
Variations and modifications will occur to those of skill in the art after reviewing this disclosure. For example, the geometries and orientations of the surface protrusions of the mandrel can be beneficially chosen to match an internal geometry of the introducer sheath, or to complement an internal geometry or desired internal geometry. The disclosed features may be implemented, in any combination and subcombination (including multiple dependent combinations and subcombinations), with one or more other features described herein. The various features described or illustrated above, including any components thereof, may be combined or integrated in other systems. Moreover, certain features may be omitted or not implemented.
Examples of changes, substitution, and alterations are ascertainable by one skilled in the art and could be made without departing from the scope of the information disclosed herein.
The present application is a continuation of U.S. patent application Ser. No. 15/834,783, filed Dec. 7, 2017, which claims the benefit of the filing date of U.S. Provisional Patent Application No. 62/431,671, filed on Dec. 8, 2016, the entire disclosures of which are hereby incorporated herein by reference.
Number | Name | Date | Kind |
---|---|---|---|
4317445 | Robinson | Mar 1982 | A |
4380252 | Gray et al. | Apr 1983 | A |
4402685 | Buehler et al. | Sep 1983 | A |
4569347 | Frisbie | Feb 1986 | A |
4651751 | Swendson et al. | Mar 1987 | A |
4699611 | Bowden | Oct 1987 | A |
4798594 | Hillstead | Jan 1989 | A |
4895565 | Hillstead | Jan 1990 | A |
5069674 | Fearnot et al. | Dec 1991 | A |
5139486 | Moss | Aug 1992 | A |
5180372 | Vegoe et al. | Jan 1993 | A |
5221255 | Mahurkar et al. | Jun 1993 | A |
5234425 | Fogarty et al. | Aug 1993 | A |
5250033 | Evans et al. | Oct 1993 | A |
5279596 | Castaneda et al. | Jan 1994 | A |
5304142 | Liebl et al. | Apr 1994 | A |
5312355 | Lee | May 1994 | A |
5320611 | Bonutti et al. | Jun 1994 | A |
5380304 | Parker | Jan 1995 | A |
5395341 | Slater | Mar 1995 | A |
5397310 | Chu et al. | Mar 1995 | A |
5397311 | Walker et al. | Mar 1995 | A |
5405338 | Kranys | Apr 1995 | A |
5407430 | Peters | Apr 1995 | A |
5409463 | Thomas et al. | Apr 1995 | A |
5409469 | Schaerf | Apr 1995 | A |
5488960 | Toner | Feb 1996 | A |
5492530 | Fischell et al. | Feb 1996 | A |
5536255 | Moss | Jul 1996 | A |
5573517 | Bonutti et al. | Nov 1996 | A |
5599326 | Carter | Feb 1997 | A |
5653697 | Quiachon et al. | Aug 1997 | A |
5713867 | Morris | Feb 1998 | A |
5752937 | Otten et al. | May 1998 | A |
5795341 | Samson | Aug 1998 | A |
5827242 | Follmer et al. | Oct 1998 | A |
5911702 | Romley et al. | Jun 1999 | A |
5935122 | Fourkas et al. | Aug 1999 | A |
5971993 | Hussein et al. | Oct 1999 | A |
6042578 | Dinh et al. | Mar 2000 | A |
6068622 | Sater et al. | May 2000 | A |
6080141 | Castro et al. | Jun 2000 | A |
6165163 | Chien et al. | Dec 2000 | A |
6197014 | Samson et al. | Mar 2001 | B1 |
6197016 | Fourkas et al. | Mar 2001 | B1 |
6217565 | Cohen | Apr 2001 | B1 |
6258080 | Samson | Jul 2001 | B1 |
6290692 | Klima et al. | Sep 2001 | B1 |
6319244 | Suresh et al. | Nov 2001 | B2 |
6338730 | Bonutti et al. | Jan 2002 | B1 |
6363273 | Mastrorio et al. | Mar 2002 | B1 |
6379346 | McIvor et al. | Apr 2002 | B1 |
6423052 | Escano | Jul 2002 | B1 |
6428556 | Chin | Aug 2002 | B1 |
6454744 | Spohn et al. | Sep 2002 | B1 |
6508966 | Castro et al. | Jan 2003 | B1 |
6544270 | Zhang | Apr 2003 | B1 |
6562049 | Norlander et al. | May 2003 | B1 |
6589227 | Soenderskov | Jul 2003 | B2 |
6613038 | Bonutti et al. | Sep 2003 | B2 |
6652508 | Griffin et al. | Nov 2003 | B2 |
6692462 | Mackenzie et al. | Feb 2004 | B2 |
6702972 | Markle | Mar 2004 | B1 |
6740073 | Saville | May 2004 | B1 |
6749600 | Levy | Jun 2004 | B1 |
6814715 | Bonutti et al. | Nov 2004 | B2 |
6824553 | Samson et al. | Nov 2004 | B1 |
6827710 | Mooney et al. | Dec 2004 | B1 |
6852261 | Benjamin | Feb 2005 | B2 |
6866660 | Garabedian et al. | Mar 2005 | B2 |
6881211 | Schweikert et al. | Apr 2005 | B2 |
6887417 | Gawreluk et al. | May 2005 | B1 |
6939327 | Hall et al. | Sep 2005 | B2 |
6939337 | Parker et al. | Sep 2005 | B2 |
7018372 | Casey et al. | Mar 2006 | B2 |
7025746 | Tal | Apr 2006 | B2 |
7037295 | Tiernan et al. | May 2006 | B2 |
7101353 | Lui et al. | Sep 2006 | B2 |
7144411 | Ginn et al. | Dec 2006 | B2 |
7169118 | Reynolds et al. | Jan 2007 | B2 |
7226433 | Bonnette et al. | Jun 2007 | B2 |
7357794 | Makower et al. | Apr 2008 | B2 |
7367967 | Eidenschink | May 2008 | B2 |
7422571 | Schweikert et al. | Sep 2008 | B2 |
7438712 | Chouinard | Oct 2008 | B2 |
7497844 | Spear et al. | Mar 2009 | B2 |
7524305 | Moyer | Apr 2009 | B2 |
7540865 | Griffin et al. | Jun 2009 | B2 |
7628769 | Grandt et al. | Dec 2009 | B2 |
7637903 | Lentz et al. | Dec 2009 | B2 |
7645273 | Lualdi | Jan 2010 | B2 |
7704245 | Dittman et al. | Apr 2010 | B2 |
7713260 | Lessard et al. | May 2010 | B2 |
7722567 | Tal | May 2010 | B2 |
7731694 | Becker et al. | Jun 2010 | B2 |
7744571 | Fisher et al. | Jun 2010 | B2 |
7749185 | Wilson et al. | Jul 2010 | B2 |
7766820 | Core | Aug 2010 | B2 |
7833218 | Lunn et al. | Nov 2010 | B2 |
7837671 | Eversull et al. | Nov 2010 | B2 |
7871398 | Chesnin et al. | Jan 2011 | B2 |
7905877 | Jimenez et al. | Mar 2011 | B1 |
7909798 | Osypka | Mar 2011 | B2 |
7963948 | Melsheimer | Jun 2011 | B2 |
7968038 | Dittman et al. | Jun 2011 | B2 |
7985213 | Parker | Jul 2011 | B2 |
7989042 | Obara et al. | Aug 2011 | B2 |
7993305 | Ye et al. | Aug 2011 | B2 |
8021409 | Aggerholm | Sep 2011 | B2 |
8070898 | Eversull et al. | Dec 2011 | B2 |
8123726 | Searfoss et al. | Feb 2012 | B2 |
8147452 | Nardeo et al. | Apr 2012 | B2 |
8206375 | Snow | Jun 2012 | B2 |
8231551 | Griffin et al. | Jul 2012 | B2 |
8246574 | Jacobs et al. | Aug 2012 | B2 |
8257298 | Hamboly | Sep 2012 | B2 |
8273059 | Nardeo et al. | Sep 2012 | B2 |
8292827 | Musbach et al. | Oct 2012 | B2 |
8298189 | Fisher et al. | Oct 2012 | B2 |
8303570 | Gregorich et al. | Nov 2012 | B2 |
8317754 | Leeflang et al. | Nov 2012 | B2 |
8343136 | Howat et al. | Jan 2013 | B2 |
8366720 | Mitelberg et al. | Feb 2013 | B2 |
8377035 | Zhou et al. | Feb 2013 | B2 |
8398696 | Buiser et al. | Mar 2013 | B2 |
8475431 | Howat | Jul 2013 | B2 |
8529719 | Pingleton et al. | Sep 2013 | B2 |
8591495 | Fischell et al. | Nov 2013 | B2 |
8597277 | Lenker et al. | Dec 2013 | B2 |
8636270 | Ostrovsky | Jan 2014 | B2 |
8672888 | Tal | Mar 2014 | B2 |
8684963 | Qiu et al. | Apr 2014 | B2 |
8728055 | Stehr et al. | May 2014 | B2 |
8758402 | Jenson et al. | Jun 2014 | B2 |
8821510 | Parker | Sep 2014 | B2 |
8974420 | Searfoss et al. | Mar 2015 | B2 |
9095684 | Martinez-Arraras | Aug 2015 | B2 |
9168359 | Rowe et al. | Oct 2015 | B2 |
9295809 | Sheetz | Mar 2016 | B2 |
9320873 | Okamura | Apr 2016 | B2 |
9352116 | Guo et al. | May 2016 | B2 |
9427551 | Leeflang et al. | Aug 2016 | B2 |
9492636 | Heideman et al. | Nov 2016 | B2 |
9517323 | Kimmel et al. | Dec 2016 | B2 |
9539368 | Haslinger et al. | Jan 2017 | B2 |
9539411 | Cully et al. | Jan 2017 | B2 |
9545496 | Hiroshige et al. | Jan 2017 | B2 |
9597481 | Ishikawa | Mar 2017 | B2 |
9616195 | Lippert et al. | Apr 2017 | B2 |
9622892 | Baker et al. | Apr 2017 | B2 |
9629978 | Eversull et al. | Apr 2017 | B2 |
9707373 | Nielsen | Jul 2017 | B2 |
9884169 | Bierman et al. | Feb 2018 | B2 |
9901706 | Storbeck et al. | Feb 2018 | B2 |
9937319 | Leeflang et al. | Apr 2018 | B1 |
9980710 | Seifert et al. | May 2018 | B2 |
9981115 | Merk et al. | May 2018 | B2 |
9987460 | Brustad et al. | Jun 2018 | B2 |
10065015 | Leeflang et al. | Sep 2018 | B2 |
10076639 | Guo et al. | Sep 2018 | B2 |
10086172 | Okamura | Oct 2018 | B2 |
10124151 | Okamura et al. | Nov 2018 | B2 |
20020058910 | Hermann et al. | May 2002 | A1 |
20020072712 | Nool et al. | Jun 2002 | A1 |
20030083623 | Berg et al. | May 2003 | A1 |
20040059296 | Godfrey | Mar 2004 | A1 |
20040122360 | Waldhauser et al. | Jun 2004 | A1 |
20040267202 | Potter | Dec 2004 | A1 |
20040267203 | Potter et al. | Dec 2004 | A1 |
20050090802 | Connors et al. | Apr 2005 | A1 |
20050149105 | Leeflang et al. | Jul 2005 | A1 |
20050182387 | Webler | Aug 2005 | A1 |
20060052749 | Moyer | Mar 2006 | A1 |
20060095050 | Hartley et al. | May 2006 | A1 |
20060111614 | Saadat et al. | May 2006 | A1 |
20060135981 | Lenker et al. | Jun 2006 | A1 |
20060161135 | Vanderwoude | Jul 2006 | A1 |
20060200110 | Lentz et al. | Sep 2006 | A1 |
20060287574 | Chin | Dec 2006 | A1 |
20080046005 | Lenker et al. | Feb 2008 | A1 |
20080051734 | Bonutti et al. | Feb 2008 | A1 |
20080051821 | Gephart | Feb 2008 | A1 |
20080082165 | Wilson et al. | Apr 2008 | A1 |
20080306442 | Bardsley et al. | Dec 2008 | A1 |
20090043285 | Stehr et al. | Feb 2009 | A1 |
20090192463 | Nardeo et al. | Jul 2009 | A1 |
20090240202 | Drasler et al. | Sep 2009 | A1 |
20100082000 | Honeck et al. | Apr 2010 | A1 |
20100228178 | McGraw | Sep 2010 | A1 |
20100268196 | Hastings et al. | Oct 2010 | A1 |
20100305509 | Osypka et al. | Dec 2010 | A1 |
20120245527 | Stephens et al. | Sep 2012 | A1 |
20130018309 | Ewing et al. | Jan 2013 | A1 |
20130131718 | Jenson et al. | May 2013 | A1 |
20130317438 | Ellingwood et al. | Nov 2013 | A1 |
20130317481 | Ellingwood et al. | Nov 2013 | A1 |
20140031843 | Rottenberg et al. | Jan 2014 | A1 |
20150051541 | Kanemasa et al. | Feb 2015 | A1 |
20150174364 | Kennelly et al. | Jun 2015 | A1 |
20150201963 | Snow | Jul 2015 | A1 |
20150352330 | Wasdyke et al. | Dec 2015 | A1 |
20160001042 | Worley et al. | Jan 2016 | A1 |
20160051798 | Weber et al. | Feb 2016 | A1 |
20160058976 | Okamura et al. | Mar 2016 | A1 |
20160066948 | Ellingwood et al. | Mar 2016 | A1 |
20160096000 | Mustapha | Apr 2016 | A1 |
20160220358 | Wilson et al. | Aug 2016 | A1 |
20160346507 | Jackson et al. | Dec 2016 | A1 |
20160346508 | Williams et al. | Dec 2016 | A1 |
20160354583 | Ellingwood et al. | Dec 2016 | A1 |
20160375222 | Wada | Dec 2016 | A1 |
20170043135 | Knutsson | Feb 2017 | A1 |
20170056063 | Ellingwood et al. | Mar 2017 | A1 |
20170072165 | Lim et al. | Mar 2017 | A1 |
20170087331 | Cully et al. | Mar 2017 | A1 |
20170113018 | Shimizu et al. | Apr 2017 | A1 |
20170120008 | Burkholz et al. | May 2017 | A1 |
20170238965 | Murphy | Aug 2017 | A1 |
20170252535 | Ganske et al. | Sep 2017 | A1 |
20170274179 | Sullivan et al. | Sep 2017 | A1 |
20170281908 | Ellingwood et al. | Oct 2017 | A1 |
20170296777 | Heisel et al. | Oct 2017 | A1 |
20170333682 | Nardeo | Nov 2017 | A1 |
20170340860 | Eberhardt et al. | Nov 2017 | A1 |
20180001061 | Okamura et al. | Jan 2018 | A1 |
20180015254 | Cragg et al. | Jan 2018 | A1 |
20180043138 | Chu | Feb 2018 | A1 |
20180056037 | Shimizu | Mar 2018 | A1 |
20180228502 | Shaffer et al. | Aug 2018 | A1 |
20180250498 | Stern et al. | Sep 2018 | A1 |
20180256847 | Lareau et al. | Sep 2018 | A1 |
20180344987 | Lancette et al. | Dec 2018 | A1 |
20180361116 | Quick et al. | Dec 2018 | A1 |
Number | Date | Country |
---|---|---|
104623790 | May 2015 | CN |
77827 | May 1983 | EP |
1053039 | Nov 2000 | EP |
1212185 | Jun 2002 | EP |
1444000 | Aug 2004 | EP |
1631343 | Mar 2006 | EP |
1656963 | May 2006 | EP |
1853331 | Nov 2007 | EP |
2068994 | Jun 2009 | EP |
2335764 | Jun 2011 | EP |
2429628 | Mar 2012 | EP |
2473123 | Jul 2012 | EP |
2703069 | Mar 2014 | EP |
3132823 | Feb 2017 | EP |
3311873 | Apr 2018 | EP |
3347079 | Jul 2018 | EP |
3395301 | Oct 2018 | EP |
252863 | Jun 1926 | GB |
19968257128 | Oct 1996 | JP |
2004357847 | Dec 2004 | JP |
2008543440 | Dec 2008 | JP |
4695878 | Jun 2011 | JP |
5581139 | Aug 2014 | JP |
04326702 | Sep 2020 | JP |
93008986 | May 1993 | WO |
93015872 | Aug 1993 | WO |
97037713 | Oct 1997 | WO |
2000048659 | Aug 2000 | WO |
2001041858 | Jun 2001 | WO |
2006138356 | Dec 2006 | WO |
2009114556 | Sep 2009 | WO |
2017094697 | Jun 2017 | WO |
2018191547 | Oct 2018 | WO |
Entry |
---|
Decision to Grant received in corresponding Japanese Application No. 2019-551498 dated Sep. 1, 2021, 6 pp. |
International Search Report and Written Opinion in International Application No. PCT/US2017/065046 dated Mar. 22, 2018 (5 pages). |
Office Action received in corresponding Indian Application No. 201917026180 dated Sep. 15, 2021, 7 pp. |
Written Opinion for corresponding Singapore Application No. 11201905183X dated Sep. 7, 2020 (4 pages). |
Number | Date | Country | |
---|---|---|---|
20220339400 A1 | Oct 2022 | US |
Number | Date | Country | |
---|---|---|---|
62431671 | Dec 2016 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 15834783 | Dec 2017 | US |
Child | 17741627 | US |