Not Applicable
1. The Field of the Invention
The present invention relates generally to devices, systems, and methods for removing needles from devices or systems used to close openings in body lumens. More particularly, the present invention relates to devices, methods, and systems for removing needles from systems or devices used for closure of arterial and venous puncture sites accessed through a tissue tract.
2. The Relevant Technology
A number of diagnostic and interventional vascular procedures are now performed translumenally. A catheter is introduced to the vascular system at a convenient access location and guided through the vascular system to a target location using established techniques. Such procedures require vascular access, which is usually established using the well-known Seldinger technique. Vascular access is generally provided through an introducer sheath, which is positioned to extend from outside the patient's body into the vascular lumen. When vascular access is no longer required, the introducer sheath is removed and bleeding at the puncture site stopped.
One common approach for achieving hemostasis (the cessation of bleeding) is to apply external force near and upstream from the puncture site, typically by manual compression. However, the use of manual compression suffers from a number of disadvantages. For example, the manual compression procedure is time consuming, frequently requiring one-half hour or more of compression before hemostasis is achieved. Additionally, such compression techniques rely on clot formation, which can be delayed until anticoagulants used in vascular therapy procedures (such as for heart attacks, stent deployment, non-optical PTCA results, and the like) wear off. The anticoagulants may take two to four hours to wear off, thereby increasing the time required before completion of the manual compression procedure.
Further, the manual compression procedure is uncomfortable for the patient and frequently requires analgesics to be tolerable. Moreover, the application of excessive pressure can at times totally occlude the underlying blood vessel, resulting in ischemia and/or thrombosis. Following manual compression, the patient typically remains recumbent from four to as much as twelve hours or more under close observation to assure continued hemostasis. During this time, renewed bleeding may occur, resulting in blood loss through the tract, hematoma and/or pseudo-aneurysm formation, as well as arteriovenous fistula formation. These complications may require blood transfusions and/or surgical intervention.
The incidence of complications from the manual compression procedure increases when the size of the introducer sheath grows larger, and/or when the patient is anticoagulated. The compression technique for arterial closure can be risky, and is expensive and onerous to the patient. Although trained individuals can reduce the risk of complications, dedicating such personnel to this task is both expensive and inefficient. Nonetheless, as the number and efficacy of translumenally performed diagnostic and interventional vascular procedures increases, the number of patients requiring effective hemostasis for a vascular puncture continues to increase.
To overcome the problems associated with manual compression, the use of bioabsorbable sealing bodies is another example approach that has been proposed to achieve hemostasis. Generally, the use of bioabsorable sealing bodies relies on the placement of a thrombogenic and bioabsorbable material, such as collagen, at the superficial arterial wall over the puncture site. While potentially effective, the use of bioabsorbable material suffers from a number of drawbacks. For example, bioabsorbable sealing bodies may lack a solid mechanical attachment of the sealing body to the tissue. Due to the lack of a solid mechanical attachment, the sealing body can wander within the tissue tract or move out of the puncture site, thus causing late bleeds. Conversely, if the sealing body wanders and intrudes too far into the arterial lumen, due to the lack of a solid mechanical attachment, intravascular clots and/or collagen pieces with thrombus attached can form and embolize downstream, causing vascular occlusion.
In addition to not having a solid mechanical attachment to the tissue, the sealing bodies may rely upon expandable materials to achieve hemostasis. Again, the expandable materials lack the security of a hard mechanical closure, thus potentially causing late bleeds and prolonging hemostasis.
A further approach to achieving hemostasis is to use a suture to close a puncture site. Although difficult to suture manually, suture applying devices can be used to appropriately place a suture for closing a puncture site. One example suture applying device has a shaft carrying a pair of needles near its distal end. The needles are joined together by a length of suture. The shaft is used to introduce the needles into a lumen of a body structure and the needles pushed back through the lumen wall on either side of a puncture site. After the needles have passed back through the tissue, they are captured on the shaft and drawn proximally away from the body structure. Drawing the needles outward leaves a loop of suture behind to close the puncture site. The loop of suture can then be tied in a knot to complete the closure. Suture applying devices address many disadvantages associated with to use of external force (e.g., digital compression and with the use of bioabsorbable sealable bodies to achieve hemostasis.
However, the use of suture applying devices also has a number of inefficiencies. Typically, to access a suture in manner that it can be tied off, the needle must be fully removed from the shaft and other components subsequently moved out of the way. However, after needle deployment, suture applying devices are often configured to draw needles proximally only to a point where they are partially exposed at the proximal end of the shaft. To remove needles from the shaft completely, an operator has to use manual force to individually grab the proximal end of the each needle (e.g., with a hemostat) and draw it further proximally while also securely holding the shaft. The amount of force required to further draw the needle proximally can sometimes be quite large (and potentially unacceptable).
Some suture applying devices have a separate internal needle holder that can be used to grab a partially exposed needle. The needle holder assists an operator in drawing the needle proximally until the distal end of the needle exits the proximal end of the shaft. However, needle holders often do not sufficiently grip a needle such that it can be efficiently drawn proximally. Additionally, the leverage obtained from using a needle holder is often insufficient to remove a needle from challenging (e.g., calcified or scarred) tissue anatomy.
For at least these reasons, it would be desirable to provide devices and methods for more efficiently removing needles from a suture applying device. It would be particularly desirable to provide devices and methods for efficiently removing needles form a suture applying device used to suture a puncture site associated with a percutaneous vascular procedure.
The present invention relates to methods and devices for removing needles from suturing systems and devices used to close openings in body lumens. In one embodiment, a suturing device has a guide body with a slidably mounted shaft. A plurality of needles is carried near the distal end of the shaft. One or more lengths of suture secured to and extending between the plurality of needles.
A plurality of need lumens, each having a distal end opening and corresponding proximal end opening on the guide body, is included in the guide body. Each needle lumen is configured to receive a corresponding one of the plurality of needles at a distal end opening and transfer the needle to the corresponding proximal end opening as the plurality of needles are drawn proximally by the shaft. Each of the distal end openings and proximal end openings are located outwardly from the center of the guide body. The proximal end openings are clustered together in closer proximity to one another relative to the distal opening. The pat of at least one needle lumen is partially circumferentially around the guide body to move at least one needle into a proximal end opening when the plurality of needles are drawn proximally by the shaft.
Other embodiments include need removal devices. Needle removal devices can include a body member configured to be positioned on one or more proximally exposed needles of a suturing system. The one or more needles are exposed from corresponding needle lumens on a proximal portion of a suturing system. One or more needle receptacles are at least partially defined by the body member. The one or more needle receptacles are positioned and configured to generally correspond to the needle lumens of the suturing device. The needle receptacles are further configured to selectively receive and grasp onto the proximally exposed one or more needles.
Accordingly, needle removal devices can be used to remove needles from a suturing system. A plurality of needles is drawn proximally through the suturing system until at least tips of the plurality of needles exit from the proximal end of the suturing system. A needle removal device is positioned substantial adjacent to a proximal end of the suturing system. At least the tips of one or more of the needles are received within needle receptacles formed within the needle removal device to secure the tips of the one or more needles within the needle receptacles. The need removal device is moved proximally relative to the suturing system to remove the one or more needles from the suturing system.
These and other objects and 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 the above and other advantages and features of the present invention, a more particular description of the invention 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 of the invention and are therefore not to be considered limiting of its scope. The invention will be described and explained with additional specificity and detail through the use of the accompanying drawings in which:
As used herein, the term “distal” is generally defined as in the direction of the patient or away from a user of a device. In the context of a medical device intervention with or through a vessel wall, “distal” herein refers to the interior or the lumen side of the vessel wall. Conversely, “proximal” generally means away from the patient or toward the user. In the context of a medical device intervention with or through a vessel wall, “proximal” herein refers to the exterior or outer side of the vessel wall.
The term “hemostasis” is herein used to mean the arrest of bleeding or substantially blocking flow of blood outwardly from a vessel lumen while the vessel lumen is pressurized or sustaining physiological blood flow. This amount of blockage or occlusion to flow is further defined such that the blood loss which is experienced is less than an amount which would affect procedural methods or outcomes according to a physician user of a device of ordinary skill in the art. In other words, “hemostasis” is not intended to mean only “total hemostasis” such that there is a total lack of blood loss. Rather, the term is used to also mean “procedural hemostasis” as a relative term in its use among physicians of ordinary skill.
The term “suturing” is herein intended to include the process of joining two surfaces or edges together with a suture such as a thread of material (either polymeric or natural), gut, wire, or the like or so as to close an aperture, opening, or wound, or join tissues.
Handle assembly 114 may include interlock wings 116 and handle 118. Interlock wings 116 can each include a detent 144 for engaging a pair of grooves 146 in hub 148 of sheath 120. Interlock wings 116 may be constructed of a resilient material (e.g., polycarbonate) so that interlock wings 116 may be pressed together to remove the detents 144 from grooves 146. Upon removal of the detents 144 from grooves 146, sheath 120 may be rotated relative to guide body 102 by maintaining a grip on interlock wings 116 with one hand and rotating hub 148 with the other hand. In other embodiments, interlock wings 116 and hub 148 may allow a physician or other user to hold and manipulate suturing system 10. For example, a physician can hold on to hub 148 when inserting and withdrawing suturing system 10 from a puncture site.
Flexible tube 106 may be formed from a flexible plastic, polymer, metal, combinations thereof, or any other suitable material. Flexible tube 106 may be generally circular in cross-sectional geometry and may include a guide wire lumen (not shown) and the central lumen (not shown) configured to house the support holster (not shown) and a plurality of needles 108 (hereinafter referred to as needles 108). Flexible tube 106 may further include guide wire exit port 134 configured to allow a guide wire that is advanced proximally through a guide wire lumen (not shown) to exit from a side of flexible tube 106. Optionally, flexible tube 106 may include distal J-tip 139 for atraumatic tracking through vessels or other body lumens. In other embodiments, distal J-tip 139 may be omitted.
Still referring to
At the distal end of sheath 120, each of needle lumens 136A, 136B, 136C, and 136D may be axially aligned and circumferentially spaced about the periphery of guide body 102. For example, each of the distal end openings needle lumens 136A, 136B, 136C, and 136D can be located outwardly from the center of guide body 102 and spaced essentially equidistant from one another on the distal end of guide body 102. Each of the proximal end openings of needle lumens 136A, 136B, 136C, and 136D can also be located outwardly from the center of guide body 102. Within guide body 102, needle lumens 136A and 136B can be configured to transfer corresponding needles 108 circumferentially when corresponding needles 108 are drawn proximally.
One or more blood detection lumens 124 may be configured for receiving blood from the vessel to assist in positioning suturing system 10. One or more suture lumens 126 may be configured to receive suture lengths 128 attached to needles 108. In other embodiments, blood detection lumen 124 may be omitted. As depicted in
Central axial lumen 122 may extend from flexible tube 106, through needle guide 104, through guide body 102 and into stem 138 (see
In one embodiment, suture lengths 128 may be configured in the form of the loop with the free ends being attached to needles 108 and with the looped end passing outside suturing system 10 through the tube (not shown). Such a configuration facilitates management of suture lengths 128 during insertion of suturing system 10 to a puncture site and during movement of needles 108 to suture the vessel wall. As needles 108 are proximally advanced through guide body 102, suture lengths 128 are drawn distally through suture lumen 126 where they are completely removed from suture lumen 126 upon full deployment of needles 108 wherein the tips of needles 108 exit hub 148
Referring now more specially to
Suturing system 10 may then be introduced over the guide wire by passing the guide wire proximally through flexible tube 106 until the guide wire exits at exit port 134 (e.g., as depicted in
Turning to
Handle assembly 114 may be securely attached to guide body 102 so that sheath 120 may be rotated relative to guide body 102 when holding handle assembly 114. Handle assembly 114 may be securely fastened to guide body 102 by gluing, molding, and the like. In other embodiments, handle assembly 114 may be formed as an integral part of guide body 102. Handle assembly 114 may also include a plurality of tubes (not shown) aligned with blood detection lumen 124 and one or more suture lumens 126. At least a portion of the suture lengths may pass through one or more of the tubes.
Still referring to
As needles 108 are drawn through vessel wall 272, suture lengths 128 will be fed distally through one or more suture lumens 126 (e.g., as depicted in
Thus, lumens 136A, 136B, 136C, 136D can be arranged on the distal end of guide body 102 for effective hole closure. Due at least in part to the circumferential path of needle lumens 136A and 136B, needles 108 exit hub 148 in closer proximity to one another than when needles 108 were captured into the distal end of guide body 102. Since needles 108 are in closer proximity to one another, needles 108 can be more easily removed from suturing system 10. Advantageously, suturing system 10 provides effective hole closure together with more efficient needle removal.
Turning to
Once needles 108 are removed from guide body 102, slack may be removed from suture lengths 128 by pulling them to evenly matched lengths and tensioning until resistance is felt. Suture lengths 128 may then be cut substantially close to needles 108 and needles 108 may be disposed of. Suturing system 10 may then be removed from access tract 270 to allow closure of puncture site 266. Such a configuration of suturing system 10 may allow a user to safely and securely close a puncture site.
In other embodiments, suturing system 10 may be readily adapted for use with punctures made to a variety of hollow body organs and lumens. It may, however, be necessary to modify the dimensions and other particular aspects of suturing system 10 to accommodate the different usage environments. For example, the distance between needle guide 104 and guide body 102 may be configured to allow transapical insertion of suturing system 10 into a heart ventricle as described in U.S. patent application, entitled “Apparatus and Method for Suturing Body Lumens,” attorney docket number 16497.229, the disclosure of which is incorporated herein in its entirety.
Suturing system 30 may include guide body 302, a needle guide (not shown) secured to a distal end of guide body 302, and a flexible tube (not shown) secured to a distal end of the needle guide. A plurality of needles 308 (depicted in
Subsequently, force (somewhat radially and distally) can be applied near the proximal end of needle removal tool 323 to push needle removable tool 323 into contact with hub 348. After contacting hub 348, force can continue to be applied to needle removal tool 323. Leverage on hub 348 can be used to provide sufficient initial force for further proximal movement of needles 308. After the sufficient initial force, needle removal tool 323 can be squeezed (e.g. with a user's hand or hemostat) to grab and lock needles 308 in corresponding capture receiving slots 347. Turning to
Needle removal tool 323 may allow a user to exert an initial force (somewhat radially and distally) and/or further force (proximally) of about one quarter (0.25) pound-force to seventy (70) pound-force; about one (1) pound-force to sixty (60) pound-force; or about five (5) pound-force to forty (40) pound-force on needles 108 to overcome an initial resistance to proximal movement of needles 108 from guide body 102. In other embodiments, the needle removal tool 323 may allow a user to exert larger or smaller forces on needles 308. At least a portion of the sidewalls of capture receiving slots 347 may include gripping features such as ridges, textured surfaces, adhesives, magnets, or other features suitable to help grip needles 308. In other embodiments, the gripping features may be omitted.
Needle removal tool 323 may be made from polymers, polymeric composites, titanium, stainless steel, metal alloys, combinations thereof, or any other suitable materials
U-shaped body 472 is wide enough to fit over needle deployment shaft 412. Thus, needle deployment shaft 412 may selectively be drawn proximally even after needle remove device has captured needles 408. Accordingly, needle deployment shaft 412 and needle removal device 452 may be configured to move axially relative to one another. Needle removal device 452 may be positioned at least partially within hub 448. In other embodiments, needle removal device 452 may be positioned proximal hub 448 or substantially within hub 448.
As depicted, body 472 includes a plurality of needle receptacles 462 formed in a bottom surface of body 472. Needle receptacles 462 may at least partially define lumens extending through the bottom surface of body 472 toward an upper surface of body 472. The lumen of needle receptacles 462 may have a circular, oval, triangular, or other suitable cross-sectional geometric shape. The lumens of one or more of needle receptacles 462 may have a constant diameter or a varying diameter. Needle receptacles 462 may be configured and positioned in body 472 to generally correspond to proximal ends of needle lumens 436 (in
This corresponding configuration may allow needles 408 to be selectively received within needle receptacles 462 when needle removal device 452 is positioned over needles 408. As depicted, four needle receptacles 462 may be formed in body 472. In other embodiments, three, five, six, or any other suitable numbers of needle receptacles 462 may be formed in body 472 in any suitable configuration. Generally, subsequently to capturing needs 408 in needle receptacles 462, ends 478 and 479 can be pressed towards one another causing needles 408 to be pinched within needle receptacles 462. Needle removal device 452 can then be moved proximally to remove needles 408 from guide body 402. Generally, ends 478 and 479 are spaced such that a user's hand or a hemostat can manipulate needle removal device with sufficient force to retain needles 408 within needle receptacles 462.
Needles 408 can include notches 484 formed in the shaft portion of needs 408. Notches 484 may be formed circumferentially about the shaft portion, on one side of the shaft portion, or in any other part of the shaft portion of needles 408. Notches 484 may be configured to selectively lock into corresponding slots 483. For example, once needles 408 are received within needle receptacles 462, the edges of slots 483 may engage notches 484. Once engaged, needles 408 are locked in needle receptacles 462.
In various embodiments of needle removal device 452, needle receptacles 462 have a proximal end located within a solid portion of body 472. As such, the tips of needles 408 are housed within body 472 during needle removal. Keeping the tips of needles 408 within body 472 significantly reduces the chance of accidental sticks.
To facilitate removal of needles 408 from guide body 402, handle 418 (depicted in
As depicted in
Turning to
With needles captured in slots 462, needle removal device 452 may allow a user to exert a force in the proximal direction of about one quarter (0.25) pound-force to seventy (70) pound-force; about one (1) pound-force to sixty (60) pound-force; or about five (5) pound-force to forty (40) pound-force on needles 408. In other embodiments, needle removal device 452 may allow a user to exert larger or smaller forces on needles 408.
Turning to
Suturing system 50 may include guide body 502, a needle guide (not shown) secured to a distal end of guide body 502, and a flexible tube (not shown) secured to a distal end of the needle guide. A plurality of needles may be mounted with their distal ends in a support holster (not shown) and attached to a movable needle deployment shaft 512 (
Once needles 508 emerge within hub 548, needles 508 may be received within needle removal device 552. While one needle removal device 552 is shown, suturing system 50 may include two, three, or any suitable number of needle removal devices 552. For example, the suturing system 50 may include two needle removal devices 552 located on opposites sides of the guide body 502. Alternately, the suturing system 50 may include two needle removal devices 552 in tandem on the same side of guide body 502. Thus, a total of four needles may be received within the needle removal devices 552.
Body member 580 may include a pair of tabs 598. Tabs 598 may be connected to body member 580 by hinges. The hinges permit tabs 598 to be positioned toward or away from one another. Tabs 598 can be attached via adhesives, threadedly attaching, fastening with a fastener, welding, combinations of the foregoing, or another suitable technique. Tabs 598 may be configured to allow a user to move needle removal device 552 between the receiving and grasping positions. For example, a user may push tabs 598 apart to transition needle removal device 552 into the receiving position. On the other hand, a user may push or squeeze tabs 598 together to transition needle removal device 552 into the grasping position. The user may push or squeeze tabs 598 together with a user's fingers, a hemostat, or other suitable means. In the grasping position, teeth 557 can assist in securing needles within needle removal device 552.
In some embodiments, tabs 598 are configured to move the needle removal device between a receiving position and a grasping position. In the receiving position, any needles are moveable within one or more needle receptacles. In the grasping position, tabs 598 flex body member 580 such that one or more grooves (e.g., of teeth 557) grasp any needles between opposing sidewalls of the one or more grooves to secure the needles within the plurality of needle receptacles.
Thus, needle removal device 552 may include locking features configured to selectively lock needle removal device 552 in the grasping position. For example, one of tabs 598 may include one or more locking arms configured to rotate over other tab 598 when needle removal device 552 is in the grasping position to hold tabs 598 together. Other tab 598 may include one or more grooves (e.g., teeth 557) configured to receive and/or secure the one or more locking arms on other tab 598. In other embodiments, locking features may include a hook member configured to hold tabs 598 together in the grasping position. In other embodiments, the locking features may be omitted.
As depicted in
In addition, body member 580 may be substantially rigid to improve compliance of needle removal device 552 and to enhance the grip of needle removal device 552 on needles 508. Such a configuration may allow a user to exert a force in the proximal direction on needles 508 to overcome an initial resistance to removal of needles 508 from guide body 502. For example, in the grasping position, needle removal device 552 may allow a user to exert a force in the proximal direction of about one quarter (0.25) pound-force to seventy (70) pound-force; about one (1) pound-force to sixty (60) pound-force; or about five (5) pound-force to forty (40) pound-force on needles 508. In other embodiments, needle removal device 552 may allow a user to exert larger or smaller forces on needles 508.
A method for removing needles 508 from suturing system 50 is described with respect to
Referring now to
Turning to
Turning to
Attachment ring 582 may be removed from stem 538 by moving the attachment ring 582 axially or substantially traverse relative to stem 538. Proximal movement of needle removal device 552, in turn, may continue to remove needles 508 from guide body 502. Once needles 508 are removed from guide body 502, suture lengths (not shown) attached to needles 508 may be cut and needles 508 may be disposed of.
Referring now to
Turning to
Turning to
Attachment rings 582 may be removed from stem 538 by moving attachment ring 582 axially or substantially traverse relative to stem 538. Proximal movement of needle removal devices 552A and 552B, in turn, may continue to remove needles 508 from guide body 502. Once needles 508 are removed from guide body 502, suture lengths (not shown) attached to needles 508 may be cut and needles 508 may be disposed of.
Subsequently, force (somewhat radially and distally) can be applied near the proximal end of needle removal tool 652 to push needle removable tool 652 into contact with hub 648. After contacting hub 648, force can continue to be applied to needle removal tool 652. Leverage on hub 648 can be used to provide sufficient initial force for further proximal movement of needle 608. After the sufficient initial force, a user can then pull proximally to remove needle removal tool 652 and needle 608 from suturing system 60. Removal of needle 608 makes suture lengths available to the user.
Needle removal tool 652 can be configured to remove one or more needles 608 at a time. For example, in configurations similar to
Subsequently, pressure applied to members 753 and 754 proximal of hinge 762 can be removed. In response, the force of spring 763 causes ends 756 and 757 to close on needle 708. In some embodiments, the force of spring 763 is sufficient to hold needle 708 without slipping. In other embodiments, members 653 and 654 can be squeezed or pushed together distal of hinge 762 (e.g., with a user's fingers, a hemostat, or any other suitable means) to assist in gripping needle 708. In either embodiment, members 753 and 754 are squeezed or pushed together captured needle 708 in ends 756 and 757.
Subsequently, force (somewhat radially and distally) can be applied near the proximal end of needle removal tool 752 to push needle removable tool 752 into contact with hub 748. After contacting hub 748, force can continue to be applied to needle removal tool 752. Leverage on hub 748 can be used to provide sufficient initial force for further proximal movement of needle 708. After the sufficient initial force, a user can then pull proximally to remove needle removal tool 752 and needle 708 from suturing system 70. Removal of needle 708 makes suture lengths available to the user.
Needle removal tool 752 can be configured to remove one or more needles 708 at a time. For example, in configurations similar to
For either of needle removal tools 752 and 792, ends 756 and 757 can include gripping features configured to help grasp the needles 708 such as adhesives, ridges, textured surfaces, magnets, or other suitable means (including those in
Accordingly, needle removal tools 652 and 752 may allow a user to exert an initial force (somewhat radially and distally) and/or further force (proximally) of about one quarter (0.25) pound-force to seventy (70) pound-force; about one (1) pound-force to sixty (60) pound-force; or about five (5) pound-force to forty (40) pound-force on the needles 108 to overcome an initial resistance to proximal movement of needles from a guide body 102. In other embodiments, needle removal tools 652 and 752 may allow a user to exert larger or smaller forces on needles.
In some embodiments of the invention, needle removal devices may be configured to secure needles for removal from suturing systems by at least partially deforming the needles as described in U.S. patent application, entitled “Needle Harvesting Devices, Systems and Methods,” attorney docket number 16497.245, filed on the same day, the disclosure of which is incorporated herein in its entirety.
Any embodiments of suturing devices, needle removal devices, and the like may include a material made from any of a variety of known suitable biocompatible materials, such as a biocompatible shape memory material (SMM). For example, the SMM may be shaped in a manner that allows for the needle removal device to automatically move from the receiving position to the grasping position when needles are received within the needle receptacles. SMMs have a shape memory effect in which they may be made to remember a particular shape. Once a shape has been remembered, the SMM may be bent out of shape or deformed and then returned to its original shape by unloading from strain or heating. Typically, SMMs may be shape memory alloys (SMA) comprised of metal alloys, or shape memory plastics (SMP) comprised of polymers. The materials may also be referred to as being superelastic.
Usually, an SMA may have an initial shape that may then be configured into a memory shape by heating the SMA and conforming the SMA into the desired memory shape. After the SMA is cooled, the desired memory shape may be retained. This allows for the SMA to be bent, straightened, twisted, compacted, and placed into various contortions by the application of requisite forces; however, after the forces are released, the SMA may be capable of returning to the memory shape. The main types of SMAs are as follows: copper-zinc-aluminum; copper-aluminum-nickel; nickel-titanium (NiTi) alloys known as nitinol; nickel-titanium platinum; nickel-titanium palladium; and cobalt-chromium-nickel alloys or cobalt-chromium-nickel-molybdenum alloys known as elgiloy alloys. The temperatures at which the SMA changes its crystallographic structure are characteristic of the alloy, and may be tuned by varying the elemental ratios or by the conditions of manufacture.
For example, the primary material of needle removal device may be of a NiTi alloy that forms superelastic nitinol. Also, additional materials may be added to the nitinol depending on the desired characteristic. The alloy may be utilized having linear elastic properties or non-linear elastic properties.
An SMP is a shape-shifting plastic that may be fashioned into the needle receptacles of the base member in accordance with the present disclosure. Also, it may be beneficial to include at least one layer of an SMA and at least one layer of an SMP to form a multilayered body; however, any appropriate combination of materials may be used to form a multilayered device. When an SMP encounters a temperature above the lowest melting point of the individual polymers, the blend makes a transition to a rubbery state. The elastic modulus may change more than two orders of magnitude across the transition temperature (Ttr). As such, an SMP may be formed into a desired shape of an endoprosthesis by heating it above the Ttr, fixing the SMP into the new shape, and cooling the material below Ttr. The SMP may then be arranged into a temporary shape by force and then resume the memory shape once the force has been released. Examples of SMPs include, but are not limited to, biodegradable polymers, such as oligo(ε-caprolactone)diol, oligo(ρ-dioxanone)diol, and non-biodegradable polymers such as, polynorborene, polyisoprene, styrene butadiene, polyurethane-based materials, vinyl acetate-polyester-based compounds, and others yet to be determined. As such, any SMP may be used in accordance with the present disclosure.
The needle receptacles and the like may have at least one layer made of an SMM or suitable superelastic material and other suitable layers that can allow the needle receptacles to automatically grasp onto the needles.
Also, the needle removal devices, the needle receptacles or other aspects or components of the system may be comprised of a variety of known suitable deformable materials, including stainless steel, silver, platinum, tantalum, palladium, nickel, titanium, nitinol, nitinol having tertiary materials (U.S. 2005/0038500, which is incorporated herein by reference, in its entirety), niobium-tantalum alloy optionally doped with a tertiary material (U.S. 2004/0158309, 2007/0276488, and 2008/0312740, which are each incorporated herein by reference, in their entireties) cobalt-chromium alloys, or other known biocompatible materials. Such biocompatible materials may include a suitable biocompatible polymer in addition to or in place of a suitable metal. The polymeric needle removal device may include biodegradable or bioabsorbable materials.
In one embodiment, the needle removal device and/or needle receptacles may be made from a superelastic alloy such as nickel-titanium or nitinol, and includes a ternary element selected from the group of chemical elements consisting of iridium, platinum, gold, rhenium, tungsten, palladium, rhodium, tantalum, silver, ruthenium, or hafnium. The added ternary element improves the radiopacity of the nitinol knot replacement element. The nitinol needle removal device has improved radiopacity yet retains its superelastic and shape memory behavior and further maintains a thin body thickness for high flexibility.
In one embodiment, the needle removal device and/or the needle receptacles may be made at least in part of a high strength, low modulus metal alloy comprising Niobium, Tantalum, and at least one element selected from the group consisting of Zirconium, Tungsten, and Molybdenum.
In further embodiments, the needle removal device and/or the needle receptacles may be made from or be coated with a biocompatible polymer. Examples of such biocompatible polymeric materials may include hydrophilic polymer, hydrophobic polymer, biodegradable polymers, bioabsorbable polymers, and monomers thereof. Examples of such polymers may include nylons, poly(alpha-hydroxy esters), polylactic acids, polylactides, poly-L-lactide, poly-DL-lactide, poly-L-lactide-co-DL-lactide, polyglycolic acids, polyglycolide, polylactic-co-glycolic acids, polyglycolide-co-lactide, polyglycolide-co-DL-lactide, polyglycolide-co-L-lactide, polyanhydrides, polyanhydride-co-imides, polyesters, polyorthoesters, polycaprolactones, polyesters, polyanydrides, polyphosphazenes, polyester amides, polyester urethanes, polycarbonates, polytrimethylene carbonates, polyglycolide-co-trimethylene carbonates, poly(PBA-carbonates), polyfumarates, polypropylene fumarate, poly(p-dioxanone), polyhydroxyalkanoates, polyamino acids, poly-L-tyrosines, poly(beta-hydroxybutyrate), polyhydroxybutyrate-hydroxyvaleric acids, polyethylenes, polypropylenes, polyaliphatics, polyvinylalcohols, polyvinylacetates, hydrophobic/hydrophilic copolymers, alkylvinylalcohol copolymers, ethylenevinylalcohol copolymers (EVAL), propylenevinylalcohol copolymers, polyvinylpyrrolidone (PVP), combinations thereof, polymers having monomers thereof, or the like.
The coatings can also be provided on the system or components thereof to facilitate the loading or delivery of beneficial agents or drugs, such as therapeutic agents, pharmaceuticals and radiation therapies.
The invention is susceptible to various modifications and alternative means, and specific examples thereof have been shown by way of example in the drawings and are herein described in detail. It should be understood, however, that the invention is not to be limited to the particular systems or methods disclosed, but to the contrary; the invention is to cover all modifications, equivalents, and alternatives falling within the spirit and scope of the claims.
The present invention 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 invention 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.