The present disclosure relates to intravascular devices, systems, and methods. In some embodiments, a guidewire includes a transition tube to facilitate electrical interconnection between a pressure sensor and electrical contacts at the proximal portion of the guidewire.
Heart disease is very serious and often requires emergency operations. A main cause of heart disease is the accumulation of plaque inside the blood vessels, which eventually occludes the blood vessels. Common treatment options available to open up the occluded vessel include balloon angioplasty, rotational atherectomy, and intravascular stents. Traditionally, surgeons have relied on X-ray fluoroscopic images that are planar images showing the external shape of the silhouette of the lumen of blood vessels to guide treatment. Unfortunately, with X-ray fluoroscopic images, there is a great deal of uncertainty about the exact extent and orientation of the stenosis responsible for the occlusion, making it difficult to find the exact location of the stenosis. In addition, though it is known that restenosis can occur at the same place, it is difficult to check the condition inside the vessels after surgery with X-ray.
A currently accepted technique for assessing the severity of a stenosis in a blood vessel, including ischemia causing lesions, is fractional flow reserve (FFR). FFR is a calculation of the ratio of a distal pressure measurement (taken on the distal side of the stenosis) relative to a proximal pressure measurement (taken on the proximal side of the stenosis). FFR provides an index of stenosis severity that allows determination as to whether the blockage limits blood flow within the vessel to an extent that treatment is required. The normal value of FFR in a healthy vessel is 1.00, while values less than about 0.80 are generally deemed significant and require treatment.
Often intravascular guidewires are utilized to measure the pressure within the blood vessel. For a guidewire equipped with a pressure sensor, segments of electrical contacts are usually arranged at the proximal portion of the guidewire. Proper electrical connection between the pressure sensor and the electrical contacts is necessary for communication of signals between the pressure sensor and the electrical contacts.
Embodiments of the present disclosure provide an improved intravascular guidewire. The guidewire includes a pressure sensor at a distal portion. Electrical signals are transmitted between the pressure sensor and electrical contacts at the proximal portion of the guidewire via multiple metallic, conductive components. For example, electrical wires are connected to the pressure sensor. The proximal portion of the guidewire can include conductive members embedded within a polymer. A transition tube is positioned along a length of the guidewire. Conductive members are embedded within the transition tube. The electrical wires are directly connected to the conductive members of the transition tube. The conductive members at the proximal portion of the guide wire are directly connected to the conductive members of the transition tube. Accordingly, the pressure sensor is in electrical communication with the electrical contacts the proximal portion of the guidewire via the electrical wires, the conductive members of the transition tube, and the conductive members at the proximal portion of the guide wire. Utilizing the transition tube to establish electrical communication advantageously allows the electrical connections to be made while maintaining a small outer diameter of the guidewire, which makes it easier for the guidewire to more easily traverse tortuous vasculature of the patient.
Exemplary aspects of the present disclosure provide an intravascular guidewire, comprising: a flexible elongate member configured to be positioned within a vessel of a patient, the flexible elongate member comprising a proximal portion and a distal portion; an electronic component secured to the distal portion of the flexible elongate member; a first conductive member in communication with the electronic component; a second conductive member disposed at the proximal portion of the flexible elongate member; a tube disposed along a length of the flexible elongate member, the tube comprising a third conductive member, wherein the third conductive member is in electrical communication with the first and second conductive members.
In some aspects, the tube comprises a first polymer. In some aspects, the third conductive member is embedded within the first polymer. In some aspects, the flexible elongate member comprises a metal core, and wherein the tube is positioned around the metal core. In some aspects, the guidewire further includes a fourth conductive member disposed at the proximal portion of the flexible elongate member, wherein the fourth conductive member is directly in communication to the second conductive member. In some aspects, the first conductive member is directly in communication with the electronic component; the third conductive member is directly in communication with the first and second conductive members; and the electronic component is in communication with the fourth conductive member via the first, second, and third conductive members. In some aspects, the tube is disposed distally of the fourth conductive member. In some aspects, the tube is disposed distally of the third conductive member. In some aspects, the first conductive member comprises an electrical wire. In some aspects, the proximal portion of the flexible elongate member comprises a second polymer, and wherein the second conductive member is embedded within the second polymer. In some aspects, the guidewire further comprises: a plurality of first conductive members; a plurality of second conductive members; and a plurality of third conductive members. In some aspects, the flexible elongate member comprises a metal core, and a first of the plurality of conductive members is directly in communication with a first of the plurality of third conductive members; and a second of the plurality of conductive members is directly in communication with the metal core. In some aspects, a proximal portion of the tube comprises a first diameter less than a second diameter of a distal portion of the tube.
Exemplary aspects of the present disclosure provide a method of fabricating an intravascular guidewire, the method comprising: obtaining an electronic component and a first conductive member in communication with the electronic component; obtaining a flexible elongate member comprising a second conductive member; positioning a tube around at least a portion of the flexible elongate member, the tube comprising a third conductive member; and establishing communication between the electronic component and the second conductive member by electrically connecting the first conductive member to the third conductive member and electrically connecting the second conductive member to the third conductive member.
In some aspects, the flexible elongate member comprises a metal core, and wherein the positioning comprises positioning the tube around the metal core. In some aspects, the method further comprises exposing the third conductive member. In some aspects, the flexible elongate member further comprises a polymer surrounding the metal core, wherein the third conductive member is embedded within the polymer, and wherein the exposing comprises ablating the polymer. In some aspects, the method further includes reducing a diameter of a proximal portion of the tube. In some aspects, the exposing the third conductive member comprises exposing a proximal portion and a distal portion of the third conductive member, wherein the first conductive member is electrically connected to the distal portion of the third conductive member, and wherein the second conductive member is electrically connected to the proximal portion of the third conductive member. In some aspects, the electrically connecting comprises soldering.
Additional aspects, features, and advantages of the present disclosure will become apparent from the following detailed description.
Illustrative embodiments of the present disclosure will be described with reference to the accompanying drawings, of which:
For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to the embodiments illustrated in the drawings, and specific language will be used to describe the same. It is nevertheless understood that no limitation to the scope of the disclosure is intended. Any alterations and further modifications to the described devices, systems, and methods, and any further application of the principles of the present disclosure are fully contemplated and included within the present disclosure as would normally occur to one skilled in the art to which the disclosure relates. In particular, it is fully contemplated that the features, components, and/or steps described with respect to one embodiment may be combined with the features, components, and/or steps described with respect to other embodiments of the present disclosure. For the sake of brevity, however, the numerous iterations of these combinations will not be described separately.
As used herein, “flexible elongate member” or “elongate flexible member” includes at least any thin, long, flexible structure that can be inserted into the vasculature of a patient. While the illustrated embodiments of the “flexible elongate members” of the present disclosure have a cylindrical profile with a circular cross-sectional profile that defines an outer diameter of the flexible elongate member, in other instances all or a portion of the flexible elongate members may have other geometric cross-sectional profiles (e.g., oval, rectangular, square, elliptical, etc.) or non-geometric cross-sectional profiles. Flexible elongate members include, for example, intravascular catheters and intravascular guidewires. In that regard, intravascular catheters may or may not include a lumen extending along its length for receiving and/or guiding other instruments. If the intravascular catheter includes a lumen, the lumen may be centered or offset with respect to the cross-sectional profile of the device.
In most embodiments, the flexible elongate members of the present disclosure include one or more electronic, optical, or electro-optical components. For example, without limitation, a flexible elongate member may include one or more of the following types of components: a pressure sensor, a flow sensor, a temperature sensor, an imaging element, an optical fiber, an ultrasound transducer, a reflector, a mirror, a prism, an ablation element, a radio frequency (RF) electrode, a conductor, and/or combinations thereof. Generally, these components are configured to obtain data related to a vessel or other portion of the anatomy in which the flexible elongate member is disposed. Often the components are also configured to communicate the data to an external device for processing and/or display. In some aspects, embodiments of the present disclosure include imaging devices for imaging within the lumen of a vessel, including both medical and non-medical applications. However, some embodiments of the present disclosure are particularly suited for use in the context of human vasculature. Imaging of the intravascular space, particularly the interior walls of human vasculature can be accomplished by a number of different techniques, including ultrasound (often referred to as intravascular ultrasound (“IVUS”) and intracardiac echocardiography (“ICE”)) and optical coherence tomography (“OCT”). In other instances, infrared, thermal, or other imaging modalities are utilized. Further, in some instances the flexible elongate member includes multiple electronic, optical, and/or electro-optical components (e.g., pressure sensors, temperature sensors, imaging elements, optical fibers, ultrasound transducers, reflectors, mirrors, prisms, ablation elements, RF electrodes, conductors, etc.).
The electronic, optical, and/or electro-optical components of the present disclosure are often disposed within a distal portion of the flexible elongate member. As used herein, “distal portion” of the flexible elongate member includes any portion of the flexible elongate member from the mid-point to the distal tip. As flexible elongate members can be solid, some embodiments of the present disclosure will include a housing portion at the distal portion for receiving the electronic components. Such housing portions can be tubular structures attached to the distal portion of the elongate member. Some flexible elongate members are tubular and have one or more lumens in which the electronic components can be positioned within the distal portion.
The electronic, optical, and/or electro-optical components and the associated communication lines are sized and shaped to allow for the diameter of the flexible elongate member to be very small. For example, the outside diameter of the elongate member, such as a guidewire or catheter, containing one or more electronic, optical, and/or electro-optical components as described herein are between about 0.0007″ (0.0178 mm) and about 0.118″ (3.0 mm), with some particular embodiments having outer diameters of approximately 0.014″ (0.3556 mm) and approximately 0.018″ (0.4572 mm)). As such, the flexible elongate members incorporating the electronic, optical, and/or electro-optical component(s) of the present application are suitable for use in a wide variety of lumens within a human patient besides those that are part or immediately surround the heart, including veins and arteries of the extremities, renal arteries, blood vessels in and around the brain, and other lumens.
“Connected” and variations thereof as used herein includes direct connections, such as being glued or otherwise fastened directly to, on, within, etc. another element, as well as indirect connections where one or more elements are disposed between the connected elements.
“Secured” and variations thereof as used herein includes methods by which an element is directly secured to another element, such as being glued or otherwise fastened directly to, on, within, etc. another element, as well as indirect techniques of securing two elements together where one or more elements are disposed between the secured elements.
Referring initially to
Referring now to
The intravascular device 102 also includes a connection portion 114 adjacent the proximal portion 109 of the device. In that regard, the connection portion 114 can be spaced from the proximal end 110 of the flexible elongate member 106 by a distance 116. Generally, the distance 116 is between 0% and 50% of the total length of the flexible elongate member 106. While the total length of the flexible elongate member can be any length, in some embodiments the total length is between about 1300 mm and about 4000 mm, with some specific embodiments having a length of 1400 mm, 1900 mm, and 3000 mm. In some instances the connection portion 114 is spaced from the proximal end 110 between about 0 mm and about 1400 mm. In some specific embodiments, the connection portion 114 is spaced from the proximal end by a distance of 0 mm, 300 mm, and 1400 mm. Accordingly, in some instances the connection portion 114 is positioned at the proximal end 110. In some such embodiments, one or more aspects of the engagement and alignment features of the intravascular device 102 discussed below are positioned distal of the of the connection portion 114 instead of proximal of the connection portion 114 as shown in the embodiment of
In the illustrated embodiment of
As shown, the connection portion 114 has a diameter 122 (or other similar measurement for outer cross-section profiles for non-circular cross-sectional embodiments) while locking section 118 has a diameter 124 (again, or other similar measurement for outer cross-section profiles for non-circular cross-sectional embodiments). The diameter 124 of locking section 118 is different than the diameter 122 of connection portion 114. In that regard, the different sizes of the diameters 122, 124 create a structure that is configured to facilitate alignment and/or connection of the intravascular device 102 to a connector, such as connector 104. In the illustrated embodiment, the diameter 124 of locking section 118 is less than the diameter 122 of the connection portion 114. In some embodiments, the diameter 124 of locking section 118 is between about 40% and about 80% of diameter 122, with some particular embodiments being about 42%, 64%, and/or other percentage of diameter 122. In that regard, in some embodiments the diameter 122 of connection portion 114 is between about 0.0178 mm and about 3.0 mm, with some particular embodiments being 0.3556 mm (0.014″) and 0.4572 mm (0.018″). Accordingly, in some embodiments the diameter 124 of locking section 118 is between about 0.007 mm and about 2.4 mm, with some particular embodiments being 0.15 mm, 0.19 mm, 0.23 mm, and 0.29 mm. In the illustrated embodiment, section 120 has a diameter that is approximately equal to diameter 122 and, therefore, greater than diameter 124. However, in other embodiments, section 120 has a diameter that is greater than diameter 122, less than diameter 122, greater than diameter 124, equal to diameter 124, and/or less than diameter 124. In some embodiments, locking section 118 is a section of a core wire extending through the connection portion 114. Locking section 118 and section 120 together can sometimes to be referred to as the locking feature.
As shown in
The connection portion 114 is configured to facilitate communication between the intravascular device 102 and another device. More specifically, in some embodiments the connection portion 114 is configured to facilitate communication of data obtained by the component 112 to another device, such as a computing device or processor. Accordingly, in some embodiments, the connection portion 114 includes one or more conductive portions. In some implementations, the connection portion 114 can include conductive bands, rings, coatings, coils, etc. In some instances, the connection portion 114 includes one or more electrical connectors, or conductive portions, as described in U.S. patent application Ser. No. 13/931,052, titled “INTRAVASCULAR DEVICES, SYSTEMS, AND METHODS,” filed Jun. 28, 2013, which is hereby incorporated by reference in its entirety. In other embodiments, the connection portion 114 includes an optical connector. In such instances, the connection portion 114 provides an optical connection to one or more optical communication pathways (e.g., fiber optic cable) that extend along the length of the flexible elongate member 106 and are optically coupled to the component 112. Further, in some embodiments the connection portion 114 provides both electrical and optical connections to both electrical conductor(s) and optical communication pathway(s) coupled to the component 112. In that regard, it should again be noted that component 112 can be comprised of a plurality of elements in some instances. In some instances, the connection portion 114 can be configured to provide a physical connection to another device, either directly or indirectly. In other instances, the connection portion 114 can be configured to facilitate wireless communication between the intravascular device 102 and another device. Generally, any current or future developed wireless protocol(s) may be utilized. In yet other instances, the connection portion 114 facilitates both physical and wireless connection to another device.
As noted above, in some instances the connection portion 114 provides a connection between the component 112 of the intravascular device 102 and an external device. Accordingly, in some embodiments one or more electrical conductors, one or more optical pathways, and/or combinations thereof extend along the length of the flexible elongate member 106 between the connection portion 114 and the component 112 to facilitate communication between the connection portion 114 and the component 112. Generally, any number of electrical conductors, optical pathways, and/or combinations thereof can extend along the length of the flexible elongate member 106 between the connection portion 114 and the component 112. In some instances, between one and ten electrical conductors (or conductive portions) and/or optical pathways extend along the length of the flexible elongate member 106 between the connection portion 114 and the component 112. For the sake of clarity and simplicity, the embodiments of the present disclosure described below include three electrical conductors and, therefore, the connection portion 114 is described as having three separate conductive portions corresponding to the three electrical conductors.
In some embodiments, the flexible elongate member 106 includes multiple core wires. For example, the flexible elongate member 106 can include a proximal core wire (or proximal metal core) and a distal core wire (or distal metal core) that are attached to one another. The components associated with the proximal portion of the intravascular device 102 (e.g., including the proximal core wire) can be referred to a proximal subassembly, and the components associated with the distal portion of the intravascular device 102 (e.g., including the distal core wire) can be referred to a distal subassembly. The flexible elongate member can refer to one or more components of the proximal subassembly and/or the distal subassembly. In some embodiments, the flexible elongate member 106 includes features as described in U.S. patent application Ser. No. 13/931,052, titled “INTRAVASCULAR DEVICE, SYSTEMS, AND METHODS” and filed Jun. 28, 2013, which is hereby incorporated by reference in its entirety.
For example, as shown in
The intravascular device 102 includes a distal core 210 and a proximal core 220. The distal core 210 and the proximal core 220 are metallic components forming part of the body of the intravascular device 102. For example, the distal core 210 and the proximal core 220 are flexible metallic rods that provide structure for the flexible elongate member 106. The diameter of the distal core 210 and the proximal core 220 can vary along its length.
In some embodiments, the intravascular device 102 comprises a distal assembly and a proximal assembly that are electrically and mechanically joined together, which results in electrical communication between the electronic component 112 and the conductive portions 132, 134, 136. For example, pressure data obtained by the pressure sensor 112 can be transmitted to the conductive portions 132, 134, 136. Control signals from a computer in communication with the intravascular device 102 can be transmitted to the electronic component 112 via the conductive portions 132, 134, 136. The distal subassembly can include the distal core 210. The distal subassembly can also include the electronic component 112, the conductive members 230, and/or one or more layers of polymer/plastic 240 surrounding the conductive members 230 and the core 210. For example, the polymer/plastic layer(s) can protect the conductive members 230. The proximal subassembly can include the proximal core 220. The proximal subassembly can also include one or more layers of polymer/plastic 250 surrounding the core 220 and/or conductive members 260 embedded within the one or more layers of polymer/plastic 250. In some embodiments, the proximal subassembly and the distal subassembly can be separately manufactured. During the assembly process for the intravascular device 102, the proximal subassembly and the distal subassembly can be electrically and mechanically joined together.
The intravascular device 102 includes one or more conductive members 230 in communication with the electronic component 112. For example, the conductive members 230 can be one or more electrical wires that are directly in communication with the electronic component 112. In some instances, the conductive members 230 are electrically and mechanically coupled to the electronic component 112 by, e.g., soldering. In some instances, the conductive members 230 comprise two or three electrical wires (e.g., a bifilar cable or a trifilar cable). An individual electrical wire can include a bare metallic conductor surrounded by one or more insulating layers. The conductive members 230 can extend along the length of the distal core 210. For example, at least a portion of the conductive members 230 can be spirally wrapped around the distal core 210.
The intravascular device 102 includes one or more conductive members 260 at the proximal portion of the flexible elongate member 106. The conductive members 260 are embedded within polymer/plastic layer(s) 250. The conductive members 260 are directly in communication with the conductive portions 132, 134, and/or 136. In some instances, the conductive members 230 are electrically and mechanically coupled to the electronic component 112 by, e.g., soldering. In some instances, the conductive portions 132, 134, and/or 136 comprise conductive ink (e.g., metallic nano-ink, such as silver or gold nano-ink) that is deposited or printed directed over the conductive members 260.
As described herein, electrical communication between the conductive members 230 and the conductive members 260 can be established at the connection region 270 of the flexible elongate member 106. By establishing electrical communication between the conductive members 230 and the conductive members 260, the conductive portions 132, 134, 136 can be in electrically communication with the electronic component 112.
The tube 300 can be generally cylindrical with an annular cross-sectional shape. The tube 300 can be formed of one or more layers of polymer and/or plastic. For example, the tube 300 can be formed of polyimide. The tube 300 includes a distal portion 302 and a proximal portion 304. Note that the orientation of
The tube 300 can fabricated in a continuous process and then cut into small component lengths. An individual length is illustrated in the
Different amounts of material from the tube 300 can be removed at the distal portion 302 and the proximal portion 304. For example, ablation of the polyimide at the proximal portion 304 completely exposes a short section 324 of both ribbons 320 and also thins out or reduces the diameter of the proximal portion 304. The reduced diameter 309 of the proximal portion 304 can be between 0.007″ and 0.020″, includes values such as 0.010″, 0.013″, 0.016″, 0.020″, 0.023″, and/or other suitable values. The reduced diameter 309 of the proximal portion 304 allows expansion as the tube 300 is pushed onto the core wire 220. For example, the core wire 220 can transition from a smaller diameter to a larger diameter, and the tube 300 can expand as the tube 300 is pushed onto the transition. Narrow ablation slots 322 are also made along the distal portion 302 and are contained within a width of each ribbon 320. The slots 322 allow for soldering of the trifilar 230 to the exposed ribbon 320 in the slot 322. The portions of the conductive members 320 that are indicated by dashed marks in
In some embodiments, the tube 300 is disposed distally of the fourth conductive member (e.g., the conductive portions 132, 134, 136). In some embodiments, the tube is disposed distally of the third conductive member (e.g., the conductive members 260).
Utilizing the tube 300 to establish electrical communication between the conductive members 230 and the conductive members 260 advantageously allows the electrical connections to be made in the minimal space that is available, as a result of the large core wire 220, while ensuring sealing against fluid ingress and maintaining a small outer diameter of the intravascular device 102. For example, the transition composite tube 300 provides a space-saving electrical connection to the proximal composite core ribbons 260 while also providing increased space for the electrical connection to the trifilar 230 from the distal core 210. The more difficult, space-sensitive connection to the composite core ribbons 260 can be accomplished and verified as a subassembly on the composite core 220 prior to attaching the distal subassembly. The polyimide of the tube 300 acts as an insulating material that also withstands the high heat required for soldering connections.
Referring now to
At step 410, the method 400 includes obtaining an electronic component and a first conductive member in communication with the electronic component. The electronic component can be the electronic component 112, such as a pressure sensor, in some embodiments. The first conductive member can be an electrical wire of the trifilar cable 230, for example. In some embodiments, the method 400 includes obtaining all or portions of the distal subassembly. For example, the method 400 can include obtaining the electronic component mounted to the distal core wire 210. The method 400 can include assembling one or more components of the distal subassembly, such as securing the electronic component 112 to the distal core wire 210, wrapping the conductive members 230 around the distal core wire, etc.
At step 420, the method 400 includes obtaining a flexible elongate member comprising a second conductive member. For example, the flexible elongate member can be a proximal subassembly, including the proximal core wire 220, the polymer/plastic layer(s) 250, and the one or more embedded conductive members 230. The second conductive member can be the conductive member 230. The method 400 can include assembling one or more components of the proximal subassembly.
At step 430, the method 400 includes positioning a tube around at least a portion of the flexible elongate member, the tube comprising a third conductive member. The tube can be the tube 300 including the one or more embedded conductive member 320. The third conductive member can be the conductive member 320.
At step 440, the method 400 includes establishing communication between the electronic component and the second conductive member by electrically connecting the first conductive member to a third conductive member and electrically connecting the second conductive member to the third conductive member. For example, the method 400 includes electrically connecting the first conductive member to the exposed distal portion of the third conductive member. The method 400 includes electrically connecting the second conductive member to the proximal portion of the third conductive member.
The method 400 can include forming the fourth conductive members at the proximal portion of the flexible elongate member. For example, the fourth conductive members can be directly in communication with the conductive members 260. For example, the conductive members 260 can be mechanically and/or electrically coupled to the fourth conductive members. In some embodiments, the fourth conductive members can be rings that are slid over the flexible elongate members. In some embodiments, the fourth conductive members are conductive ink that is deposited or printed around the flexible elongate member. The method 400 can include joining the proximal and distal subassemblies in some embodiments.
Persons skilled in the art will also recognize that the apparatus, systems, and methods described above can be modified in various ways. Accordingly, persons of ordinary skill in the art will appreciate that the embodiments encompassed by the present disclosure are not limited to the particular exemplary embodiments described above. In that regard, although illustrative embodiments have been shown and described, a wide range of modification, change, and substitution is contemplated in the foregoing disclosure. It is understood that such variations may be made to the foregoing without departing from the scope of the present disclosure. Accordingly, it is appropriate that the appended claims be construed broadly and in a manner consistent with the present disclosure.
Number | Date | Country | |
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62543818 | Aug 2017 | US |