The invention relates generally to sensors mounted on guide wires for intravascular measurements of physiological variables in a living body, and in particular to the design of such sensor guide wires.
Sensor and guide wire assemblies in which a sensor, adapted for measurements of physiological variables in a living body, such as blood pressure and temperature, is mounted at a distal portion of a guide wire are known.
For example, the U.S. Pat. No. Re. 35,648, which is assigned to the present assignee, and whose entire contents are incorporated herein by reference for details as to sensors, guide wires, and associated techniques, discloses a sensor and guide wire assembly comprising a sensor element, an electronic unit, signal transmitting cables connecting the sensor element to the electronic unit, a flexible tube having the signal cables and the sensor element disposed therein, a solid metal wire, and a coil attached to the distal end of the solid wire. The sensor element comprises a pressure sensitive device, e.g. a membrane, with piezoresistive elements electrically connected in a Wheatstone bridge-type of arrangement mounted thereon.
One physiological parameter that can be determined by use of a guide wire mounted pressure sensor is the so-called fractional flow reserve (FFR), which is used to assess the severity of a stenosis located somewhere in a coronary artery (see, e.g., “Coronary Pressure” by N. H. J. Pijls and B. De Bruyne, 2nd edition, Kluwer Academic Publishers, The Netherlands, 2000, whose entire contents are incorporated herein by reference). The clinical value of FFR as a diagnostic tool is gaining increasing acceptance within the medical society, something which, in turn, has created a desire to apply the method in ever narrower arteries, i.e. further out in the coronary tree.
To measure a physiological parameter such as blood pressure at a measurement site located far out in a small and tortuous vessel put, however, very high requirements on the mechanical characteristics of the guide wire that carries the pressure sensor. In, for example, the U.S. Pat. No. 5,226,423, which is assigned to the assignee of the present patent specification, and whose entire contents are incorporated herein by reference for details as to sensors, guide wires, and associated techniques, a sensor guide wire is disclosed, in which a solid wire, which constitutes the core of the sensor guide, has been divided into a plurality of sections and each of the sections has a different thickness and thereby a different flexibility. A large flexibility of the sensor guide is advantageous in that it allows the sensor guide to be introduced into small and tortuous vessels. It should, however, also be recognized that if the core wire is too flexible, it would be impossible to push the sensor guide forward into the vessels, i.e. the sensor guide wire must possess a certain stiffness, torqueability, and “pushability”.
To summarize: the desire to measure physiological variables such as blood pressure and temperature further out in the coronary tree has put the manufacturers of guide wire mounted sensors in a dilemma, because this urge implies that the torqueability and stiffness of the guide wire should be increased, which most easily can be accomplished if the diameter of a core wire arranged inside the sensor guide wire is increased. The core wire diameter is, however, limited by the outer diameter of the sensor guide wire, and this outer diameter cannot be increased without jeopardizing the compatibility with other interventional devices, such as different kinds of catheters which are threaded over the sensor guide wire in order to treat the stenosis that was diagnosed by the sensor and guide wire assembly. Ultimately, the diameters of all interventional devices are, however, apparently limited by the diameters of the narrow arteries of the peripheral coronary tree—if anything there is consequently a desire to reduce the outer diameter of a sensor guide wire. On the other hand, increasing the core wire diameter without a corresponding increase of the outer diameter of the sensor guide would leave less space available for the signal transmitting cables that extend in the interior of the sensor guide.
The electrical signal cables, which provide the sensor with the electrical excitation energy necessary to operate the Wheatstone bridge and which transfer the output signals from the sensor to an external display unit, are thin and sensitive members, each of which requires its own electrical insulation. An alternative arrangement for transmitting the sensor signals is described in the U.S. Pat. No. 6,106,486, which is assigned to the present assignee, and whose entire contents are incorporated herein by reference for details as to sensors, guide wires, and associated techniques, and wherein it is suggested to transmit the sensor signals in conductors which in the form of layers of electrically conductive material extend concentrically over the circumference of the guide wire, and wherein the outermost conductive layer is covered with an insulating layer. In the published U.S. Patent application 2003/0028128 A1, a sensor guide is described wherein a signal conductor is disposed concentrically in the central lumen of a thick-walled tube; and the published U.S. Patent application 2003/0220588 A1 discloses a similar arrangement, comprising at least two signal conductors arranged within the central lumen of a thick-walled tube. These two applications, which are assigned to the present assignee, and whose entire contents are incorporated herein by reference for details as to sensors, guide wires, and associated techniques, state that the advantage of substituting a thick-walled tube for a core wire is, inter alia, that the conductors, when arranged in the lumen of the thick-walled tube, are better protected against damages caused by the handling of the sensor guide. Damage on an electrical signal cable or, perhaps more likely, on the electrical insulation surrounding the cable can lead to unreliable performance or even short-circuit of the sensor. It can further be noted that the sensor guides disclosed in the two applications are provided with outer insulating layers which can be made from different kinds of polymers. Sensor guide wires comprising a thick-walled tube having a lumen in which a number of signal conductors are arranged, or sensor guide wires comprising a number of concentric conductive layers are, however, considered to represent very special designs of sensor guide wires; and those types fall outside the scope of the present invention as defined by the claims.
The latter two patent applications as well as several other known sensor guide wires, e.g. the sensor guide wire disclosed in the U.S. Pat. No. 5,715,827 to Corl et al., exhibit a design that includes a distal coil spring extending from the distal tip of the sensor guide to a sensor housing, inside which the sensor element is arranged, and a proximal coil spring extending between the housing and a proximal tube. The proximal coil spring is provided for improving the manoeuvrability of the sensor guide wire, but may also put further limitations on the maximum dimensions of a core wire disposed therein.
A general object of the present invention is to provide an improved design for a sensor and guide wire assembly, which enhances the manoeuvrability of the sensor guide wire and, at the same time, reduces the risk of electrical failure of the signal transmitting cable(s) arranged in the sensor guide wire.
Embodiments of the present invention are directed to a sensor and guide wire assembly comprising a sensor element arranged in a sensor guide wire having a distal tip and comprising a core wire, a proximal tube, and at least one electrical signal transmitting cable. The sensor element is mounted at a distal portion of the core wire, and is connected to the one or more electrical signal cables, which extend from the sensor element to the proximal end portion of the sensor guide wire, where each electrical cable is connected to a conductive member. The conductive members are electrically insulated from each other by insulating members, and are arranged longitudinally spaced from each other at the proximal end portion of the sensor guide wire, so as to form a male connector for further connection to a corresponding female connector of an external signal conditioning and display unit. Although not necessary prerequisites for the present invention, the sensor guide wire can further be fitted with a jacket as well as a distal coil, which surrounds the distal portion of the core wire and extends between the distal tip and the jacket. The sensor element is disposed inside the jacket, and is through a window in the jacket in fluid communication with the surrounding medium, e.g. blood.
According to embodiments of the present invention, a sensor guide wire comprises a polymer layer, which is provided in the vicinity of a sensor element and encloses a portion of a core wire and a number of signal transmitting cables. If the sensor guide wire is equipped with a sensor housing in the form of a jacket or sleeve, the polymer layer extends preferably between the jacket and a proximal tube. If no jacket is present, the polymer layer can extend from the proximal tube to a distal coil, or, if no distal coil is provided, all the way to the distal tip of the sensor guide wire.
From one aspect, a polymer layer can be regarded as a replacement for a proximal coil spring, and has the advantage that it easily can be made thinner than a conventional coil spring, thereby providing the possibility to increase the outer diameter of the core wire portion enclosed by this polymer layer. As previously discussed, a larger core wire diameter implies a higher torqueability and thereby improved manoeuvrability of the sensor guide wire. On the other hand, if the core wire diameter is left unchanged, more space can be provided for the signal transmitting cables, which, in turn, may involve the possibility of taking different kinds of measures to protect the electrical signal cables. The thickness of the electrical insulation surrounding the cables can, for example, be increased.
Further, in contrast to a coil spring, which inherently is permeable to bodily fluids such as blood, a polymer layer can easily be made essentially impermeable to bodily fluids. An impermeable outer layer entails the advantage that the insulating requirements on the thin signal transmitting cables can be reduced as no electrically conductive fluid will be present between the cables.
A soft polymer layer will also be very unlikely to damage the thin and sensitive signal cables, because, for example, there is no risk that the cables are squeezed between a core wire and an inelastic outer member such as a proximal coil spring.
A polymer layer can be provided as a tube or sleeve that encloses a portion of a core wire and a number of signal transmitting cables extending along this portion of the core wire, or a polymer layer can be coated onto a core wire, with the signal cables being embedded in the polymer layer.
In preferred embodiments of the present invention, a polymer layer can comprise a low-friction material and/or a hydrophilic agent for reducing the friction between the outer surface of the sensor guide wire and a vessel wall as the sensor guide wire is advanced through sharp bends in narrow and tortuous vessels. The low-friction material and/or the hydrophilic agent can be applied as a coating on the surface of the polymer layer, or can be incorporated in the polymer layer itself. Another possibility is that the polymer layer comprises or consists of a low-friction and/or hydrophilic polymeric material.
From
When a guide wire like sensor guide wire 3 is manoeuvred through the tortuous arteries of a patient's coronary system, a coil spring, like proximal coil spring 7, will be bent, which means that small gaps will appear between the consecutive windings of the coil spring at the outer bending radius of the guide wire. Consequently, the sensor guide wire 3 is inherently permeable to the medium, e.g. blood, surrounding the sensor guide wire 3. In other words, bodily fluids such as blood will penetrate into the interior of the sensor guide 3, and will in particular be in contact with the signal cables 11. Each of the signal cables 11 is therefore individually insulated by a thin tubing or coating of an electrically non-conductive material that encloses the signal cable along its length. Any damage on this insulating layer will lead to unreliable performance of the sensor and guide wire assembly 1, and can also cause a short-circuit of the sensor element 2. Needless to say, the requirements on these insulating layers are consequently severe.
In
A comparison between the sensor and guide wire assembly 1 of
First, a thin-walled coil spring having, for example, an outer diameter of about 0.36 mm (0.014 inches) and an inner diameter of about 0.25 mm (0.010 inches) has a bending rigidity which is negligible in comparison with the bending rigidity of a polymer layer in the form of a nylon or polyimide tube with approximately the same dimensions. As previously discussed, a rather high bending rigidity and thereby kink resistance of an outer member, such as a polymer tube, of a sensor guide wire is necessary, or at least advantageous, in certain intravascular medical procedures such as balloon catheterizations, and contributes also significantly to the overall stiffness, torqueability and pushability of the sensor guide wire. Consequently, as also is to be seen from a comparison between
Second, a coil spring like proximal coil spring 7 of the sensor guide wire 3 of
In
Thus, the essential difference between the second embodiment of
A fourth embodiment of a sensor and guide wire assembly according to the present invention comprises a sensor guide wire 63 having a cross-section which is schematically illustrated in
The present invention relates to sensor and guide wire assemblies, which typically have a length ranging from 1 m to 3 m. The most common commercially available sensor guide wires have an outer diameter of about 0.36 mm (0.014 inches), and core wire diameters between 0.1 mm to 0.25 mm, typically with tapered distal portions. The core wires can be made from stainless steel or a super-elastic alloy, e.g. a NiTi-alloy, or a shape-memory metal such as Nitinol. A polymer layer, which can be applied as a tubing, can have a wall thickness between about 0.025 mm and about 0.075 mm, and one or several polymers can be combined into one tubing. Examples of suitable polymers are polyimide and nylon. A signal transmitting cable or lead, having one or several strands, can have a diameter between about 0.02 mm and 0.04 mm, with a polymer insulation having a thickness of about 0.002 mm to about 0.012 mm. As used herein, a signal (transmitting) cable or lead is considered to be a thin electrically conductive thread, which can be arranged along the length of a core wire. To exemplify, a conductor provided in the form of a concentric layer of electrically conductive material is not considered to fall within the present definition of a signal (transmitting) cable or lead; and a sensor and guide wire assembly comprising such a conductor falls consequently outside the scope of the present invention. Further, as used herein, a core wire is considered to be a solid wire which generally is arranged in the centre of a sensor guide wire and whose mechanical properties, e.g. torqueability and stiffness, determine the general mechanical properties of the sensor guide wire. To exemplify, a hollow core having a lumen in which electrical leads can be arranged is not considered to fall within the present definition of a core wire; and a sensor and guide wire assembly comprising such a core wire falls consequently outside the scope of the present invention.
As was discussed above, the bending resistance of a polymer tube, which can serve as a polymer layer in a sensor guide wire, is much higher than the bending resistance of a corresponding coil spring, which typically can be arranged as a proximal coil spring in the manner shown in
In all of the embodiments described and discussed in conjunction with
Although the present invention has been described with reference to specific embodiments, also shown in the appended drawings, it will be apparent for those skilled in the art that many variations and modifications can be done within the scope of the invention as described in the specification and defined with reference to the claims below.