The present disclosure relates to devices for making pressure or other measurements inside a living body, and in particular to a sensor/guide device having a guide wire and a distal sensor for pressure measurement in stenotic vessels.
Examples of such devices are described, for example, in Swedish Patents SE 441725, SE 453561, SE 454045, SE 460396, and SE 469454, in European Publication EP 0387453, in U.S. Pat. No. 6,167,763, and in U.S. Patent Publication No. 2016/0249821.
U.S. Pat. No. 6,167,763 describes a device in which a pressure sensor is mounted in a cantilevered configuration. In one embodiment, a tube extends around the pressure sensor. An opening is provided in the tube above the pressure sensor to allow the pressure sensor to be exposed to a surrounding medium, the pressure of which is to be measured.
U.S. Patent Publication No. 2016/0249821 explains that an unstable pressure column can form above the sensor transducer of the pressure sensor due to insufficient wetting when the device is immersed in a liquid. That publication hypothesized that instability in the pressure signal is caused by air pockets or bubbles trapped in or around the tube around the pressure sensor, and that this air influences the pressure column above the sensor transducer due to time dependent motion as a result of the inverse proportionality between capillary pressure and radius, as shown in the Young-Laplace equation, which describes the capillary pressure difference sustained across the interface between two static fluids due to surface tension. In other words, if the air pocket or bubble remained in place during the entire pressure measurement procedure, no problems would arise. But because the sensor guide wire is moved during the procedure, this can cause the air pocket or bubble to shift, which causes the pressure measurement to drift. To address this issue, U.S. Patent Publication No. 2016/0249821 describes various tube configurations that include multiple proximal openings and multiple distal openings extending through a circumferential wall of the tube surrounding the pressure sensor. These configurations provide certain benefits over prior tube designs.
However, the present inventors have discovered that there is a need for a further improved jacket design for sensor guide wires.
All references cited in this disclosure are hereby incorporated by reference in their entireties for the devices, techniques, and methods described therein, and for all disclosure relating to medical sensors and devices.
The present inventors have discovered that, while tube configurations that include multiple proximal openings and multiple distal openings may provide good drift characteristics, they can result in difficulties during assembly of the sensor guide wire. For example, as described in more detail below, during assembly of the sensor guide wire, the tube must be gripped while the tube is welded or otherwise attached to a core wire and/or an X-ray non-transparent distal coil. However, the tube is typically very small—about 2 mm in length and less than 1 mm in diameter. The present inventors have discovered that, if too many openings are included in the tube, the tube will be crushed as it is gripped during manufacturing. It was therefore necessary to determine a tube configuration that both prevents air pockets or bubbles from forming in the tube to reduce drift, but also allows for manufacturability. After substantial experimentation, the present inventors have discovered a tube design that results in an unexpectedly good combination of drift reduction and manufacturability.
In one embodiment, a guide wire for biological pressure measurement includes: a tube extending along an axial direction of the guide wire, wherein the tube comprises a circumferential wall and defines a proximal-end opening and a distal-end opening; and a pressure sensor configured for biological pressure measurement, wherein at least a portion of the pressure sensor is mounted within the tube, and wherein the pressure sensor comprises a pressure sensor transducer, wherein the circumferential wall of the tube includes exactly three openings configured for fluid and gas ingress and egress extending radially therethrough: a first elongated opening located at a location opposing the pressure sensor transducer such that the pressure sensor transducer is exposed via the first elongated opening, a second elongated opening located such that, in a cross-sectional view, a bisector of the second elongated opening is offset from a bisector of the first elongated opening in a first circumferential direction by an angle in a range of 95 to 115 degrees, and a third elongated opening located such that, in the cross-sectional view, a bisector of the third elongated opening is offset from the bisector of the first elongated opening in a second circumferential direction by an angle in a range of 95 to 115 degrees. Each of the first, second, and third elongated openings is elongated in the axial direction of the guide wire, wherein a majority of each of the first, second, and third elongated openings is located within a distal half of the tube. In the cross-sectional view, a circumferential angle over which the first elongated opening extends is greater than a circumferential angle over which the second elongated opening extends and a circumferential angle over which the third elongated opening extends.
In one aspect, in the cross-sectional view, the circumferential angle over which the first elongated opening extends is in a range of 65 to 75 degrees.
In one aspect, with is combinable with any combination of the above embodiments and aspects, in the cross-sectional view, the circumferential angle over which the second elongated opening extends and the circumferential angle over which the third elongated opening extends are each in a range of 35 to 45 degrees.
In one aspect, with is combinable with any combination of the above embodiments and aspects, in the cross-sectional view, a length of a chord extending between opposing edges of the first elongated opening is in a range of 0.18 to 0.22 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, in the cross-sectional view, a length of a chord extending between opposing edges of the second elongated opening and a length of a chord extending between opposing edges of the third elongated opening are each in a range of 0.07 to 0.17 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, an outer diameter of the tube is in a range of 0.33 to 0.39 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, an inner diameter of the tube is in a range of 0.26 to 0.32 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, a thickness of the circumferential wall is in a range of 0.030 to 0.040 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, portions of the tube form a first strut located between the first elongated opening and the second elongated opening, and a second strut located between the first elongated opening and the third elongated opening, and in the cross-sectional view, the circumferential angle over which the first strut extends and the circumferential angle over which the second strut extends are each in a range of 40 to 50 degrees.
In one aspect, with is combinable with any combination of the above embodiments and aspects, in the cross-sectional view, a length of a chord extending between opposing edges of the first strut and a length of a chord extending between opposing edges of the second strut are each in a range of 0.08 to 0.22 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, proximal ends of the first, second, and third elongated openings are aligned in a circumferential direction, and distal ends of the first, second, and third elongated openings are aligned in a circumferential direction.
In one aspect, with is combinable with any combination of the above embodiments and aspects, an axial distance between a distal end of the tube and each of the distal ends of the first, second, and third elongated openings is in a range of 0.18 to 0.28 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, an axial distance between the distal end of the tube and each of the proximal ends of the first, second, and third elongated openings is in a range of 0.84 to 0.94 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, an axial length of the tube is in a range of 1.8 to 2.2 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, an axial length of the first elongated opening, an axial length of the second elongated opening, and an axial length of the third elongated opening are each in a range of 27 to 37% of a length of the tube.
In one aspect, with is combinable with any combination of the above embodiments and aspects, an axial length of the first elongated opening, an axial length of the second elongated opening, and an axial length of the third elongated opening are each in a range of 0.55 to 0.75 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, in a top view, an axial distance between a proximal end of the pressure sensor transducer and a proximal end of the first elongated opening is in a range of 0.23 to 0.53 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, wherein the first elongated opening has a shape of a rectangle with rounded corners.
In one aspect, with is combinable with any combination of the above embodiments and aspects, each of the second and third elongated openings has a shape of a rectangle with circular segments at proximal and distal ends thereof.
In one aspect, with is combinable with any combination of the above embodiments and aspects, a radius of the rounded corners and a radius of the circular segments are each in a range of 0.04 to 0.06 mm.
In one aspect, with is combinable with any combination of the above embodiments and aspects, in the cross-sectional view, the bisector of the second elongated opening is offset from the bisector of the first elongated opening in the first circumferential direction by an angle in a range of 95 to 105 degrees, and in the cross-sectional view, the bisector of the third elongated opening is offset from the bisector of the first elongated opening in the second circumferential direction by an angle in a range of 95 to 105 degrees.
In one aspect, with is combinable with any combination of the above embodiments and aspects, an entirety of each of the first, second, and third elongated openings is located within the distal half of the tube.
Referring generally to the figures, a guide wire used for biological pressure measurements is shown and described.
Referring to
A pressure sensor element 19 is mounted on the wire 16. The pressure sensor element 19 may be an absolute pressure sensor, such as the one disclosed in Swedish patent application No. 9600334-8. The pressure sensor element 19 may include a transducer 29 such as the membrane shown in
The transducer of the pressure sensor element 19 may be mounted such that bending artifacts are minimized or eliminated (e.g., ensuring that the edges of the pressure sensor element 19 do not come into contact with the surrounding tube).
The pressure sensor element 19 is protected by a short section of a tube 21, having an aperture 22 through which a surrounding medium interacts with the pressure sensor element 19. The guide wire 1 further includes, at the very distal end of the guide wire, an X-ray non-transparent distal coil 23 (also referred to as a “radiopaque coil”), made, for example, of platinum, and used for location purposes, and a safety wire 24 for securing the distal part of the coil 23.
In one embodiment, the wire 16 is made of stainless steel. In other embodiments, the wire 16 may be made of a shape memory metal. The proximal tubing 17 and the proximal coil 18 may be coupled so as to be utilized as an electrical shield.
Referring to
The groove may have two portions. A first portion of the groove may serve as a shelf 27 for receiving the proximal part of the sensor chip and holding the sensor in place. The second portion 28 may be an open space over which the cantilever extends, which allows the distal part of the sensor chip to protrude freely, even in a case where the wire tip is bent or deflected.
As shown in
The prior art embodiments of
Referring to
In the embodiments described below, the guide wire 300 may further include a pressure sensor element 19, a proximal tubing portion 17, a proximal coil 18, an X-ray non-transparent distal coil 23, leads 30, etc., as generally described with respect to
According to one embodiment, a guide wire 300 for biological pressure measurement includes a tube 31 extending along an axial direction of the guide wire 300, as shown in all of
The circumferential wall of the tube includes exactly three openings configured for fluid and gas ingress and egress extending radially therethrough: a first elongated opening 35, a second elongated opening 36, and a third elongated opening 37. The first elongated opening 35 is located at a position opposing the pressure sensor transducer 29 such that the pressure sensor transducer 29 is exposed via the first elongated opening 35. As shown in
Each of the first, second, and third elongated openings 35, 36, 37 is elongated in the axial direction of the guide wire 300. By making the openings 35, 36, 37 elongated, air can more easily escape the tube 31 via the openings 35, 36, 37.
A majority of each of the first, second, and third elongated openings 35, 36, 37 is located within a distal half of the tube 31. Because a majority of the openings 35, 36, and 37 are located within a distal half of the tube 31, the strength of the tube 31 is increased over those in which the openings are also included in the proximal half of the tube. Preferably an entirety of each of the first, second, and third elongated openings 35, 36, 37 is located within a distal half of the tube 31, which can provide even more strength to the tube.
As shown in
In the cross-sectional view, the circumferential angle φO1 over which the first elongated opening 35 extends may be in a range of 60 to 80 degrees, and preferably in a range of 65 to 75 degrees.
In the cross-sectional view, the circumferential angle φO2 over which the second elongated opening 36 extends and the circumferential angle φO3 over which the third elongated opening 37 extends may be each in a range of 30-50 degrees, and preferably in a range of 35 to 45 degrees.
In the cross-sectional view, a length of a chord CO1 extending between opposing edges of the first elongated opening 35 may be in a range of 0.16 to 0.24 mm, and preferably in a range of 0.18 to 0.22 mm.
In the cross-sectional view, a length of a chord CO2 extending between opposing edges of the second elongated opening 36 and a length of a chord CO3 extending between opposing edges of the third elongated opening 37 may be each in a range of 0.05 to 0.19 mm, and preferably in a range of 0.07 to 0.17 mm.
An axial length of the tube may be in a range of 1.8 to 2.2 mm. An outer diameter DO of the tube 31 may be in a range of 0.30 to 0.42 mm, and preferably in a range of 0.33 to 0.39 mm. An inner diameter D1 of the tube 31 may be in a range of 0.23 to 0.35 mm, and preferably in a range of 0.26 to 0.32 mm.
A thickness TW of the circumferential wall 32 may be in a range of 0.017 to 0.047 mm.
In the cross-sectional view, the circumferential angle φS1 over which the first strut 38 extends and the circumferential angle φS2 over which the second strut 39 extends may be each in a range of 35 to 55 degrees, and preferably in a range of 40 to 50 degrees.
In the cross-sectional view, a length of a chord CS1 extending between opposing edges of the first strut 38 and a length of a chord CS2 extending between opposing edges of the second strut 39 may be each in a range of 0.08 to 0.22 mm, and preferably in a range of 0.12 to 0.16 mm.
Proximal ends 35a, 36a, 37a of the first, second, and third elongated openings 35, 36, 37 are aligned in a circumferential direction, and distal ends 35b, 36b, 37b of the first, second, and third elongated openings 35, 36, 37 are aligned in a circumferential direction.
The tube 31 has a proximal end 31a and a distal end 31b, as shown in
Axial lengths LO of the fi first, second, and third elongated openings 35, 36, 37 may be each in a range of 22% to 42% of a length LT of the tube 31, and preferably in a range of 27 to 37% of a length LT of the tube 31. Axial lengths LO of the first, second, and third elongated openings 35, 36, 37 may be each in a range of 0.55 to 0.75 mm.
As shown in
The first elongated opening 35 may have a shape of a rectangle with rounded corners. Each of the second and third elongated openings 36, 37 may have a shape of a rectangle with circular segments at proximal and distal ends 36a, 36b, 37a, 37b thereof.
A radius RO1 of the rounded corners of the first elongated opening 35 and a radius RO2, RO3 of the circular segments may be each in a range of 0.04 to 0.06 mm.
The tube 31 provides a surprisingly good combination of drift reduction and manufacturability when included in a sensor guide wire 300. These unexpected results are demonstrated by experimental testing performed on sensor guide wires with tubes having various hole configurations. The tested tubes included (i) a first tube having a single opening extending through a circumferential wall of the tube, (ii) a second tube having two openings extending through the circumferential wall of the tube, (iii) a third tube having three openings extending through the circumferential wall of the tube (according to an embodiment of the present invention), and (iv) a fourth tube having four openings extending through the circumferential wall of the tube. The specific designs of the tested tubes are shown in the insets in
The first tube was a one-opening tube having exactly one opening extending through the circumferential wall of the tube, as in the prior art guide wire shown in
The second tube was a two-opening tube having a distal opening an a top distal side of the tube, to be located opposing the sensor membrane of a pressure sensor element, and a proximal opening on a top proximal side of the tube, to be located opposing a silicone coating on the pressure sensor element.
The third tube was a tube 31 having exactly three openings as described above with respect to embodiments of the present invention.
The fourth tube was a four-opening tube having a distal opening an a top distal side of the tube, to be located opposing the sensor membrane of a pressure sensor element, a proximal opening on a top proximal side of the tube, to be located opposing a silicone coating on the pressure sensor element, and two side openings located near a middle of the tube.
Atty. Dkt. No.: 030481-0605
First, manufacturability of sensor guide wires using the two-opening, three-opening, and four-opening tubes was tested.
Substantial manufacturing difficulties arose during manufacturing with the two-opening tube. Specifically, the separation of the windows between the proximal and distal ends of the tube made it difficult to clean joints during a joint cleaning process after the tube was bonded to other portions of the guide wire.
Further, in both the two-opening tube and the four-opening tube, it was difficult to remove adhesive particles left on the silicone coating that was exposed via the proximal opening. And in all tubes with proximal openings, including the two-opening tube and the four opening tube, it was difficult to clamp the tube during assembly, because bending occurred at much lower clamping forces.
Second, sensor guide wires using all four of the tube designs were tested for drift performance. For each tested guide wire, 25 tests were performed. The test method and apparatus was designed to simulate human blood pressure and flow rates. The pressure for systolic and diastolic pressure were set for test purposes at 120/80 mmHg. Pressure was not varies once the test was started. The devices were positioned at the same spot for all devices and left there for the duration of the test. In each test, pressure was measured continuously for 60 minutes. Drift reduces the accuracy of the intravascular pressure measurement. Reduction of drift improves accuracy, and thus improves a doctor's ability to evaluate the stenosis and determine the best course of treatment for a patient.
The results of the drift testing are shown in
The guide wires with one-opening, two-opening, and four-opening tubes all experienced substantial pressure drift during the testing, with a mean pressure drift of 6.40 mmHg, 4.01 mmHg, and 1.87 mmHg, respectively. The three-opening tube design yielded a mean pressure drift of only 0.77—an 81% improvement over the two-hole design. This alone is a surprising improvement. But even more surprising was the fact that the three-opening design yielded a 59% reduction in drift relative to the four-opening design.
As demonstrated above, the three-opening design described in the present application yields a surprisingly good combination of manufacturability and pressure drift reduction. The present inventors believe that these results are an effect of the specific configuration of the tube 31 in which the first elongated opening 35 is located at a location opposing the pressure sensor membrane 29 such that the pressure sensor membrane 29 is exposed via the first elongated opening 35, the second elongated opening 36 is located such that, in a cross-sectional view, a bisector B2 of the second elongated opening 36 is offset from a bisector B1 of the first elongated opening 35 in a first circumferential direction by an angle θ1 in a range of 95 to 115 degrees, the third elongated opening 37 is located such that, in the cross-sectional view, a bisector B3 of the third elongated opening 37 is offset from the bisector B1 of the first elongated opening 35 in a second circumferential direction by an angle θ2 in a range of 95 to 115 degrees, each of the first, second, and third elongated openings 35, 36, 37 is elongated in the axial direction of the guide wire 300, a majority of each of the first, second, and third elongated openings 35, 36, 37 is located within a distal half of the tube 31, and in the cross-sectional view, a circumferential angle φ1 over which the first elongated opening 35 extends is greater than a circumferential angle φ2 over which the second elongated opening 36 extends and a circumferential angle φ3 over which the third elongated opening 37 extends.
The embodiments set forth above are merely a few examples of the invention and many variations and modifications within the spirit and scope of the invention are possible, depending on the specific situation or application at hand. The invention is thus not limited to the embodiments described above. The invention is therefore defined with reference to the following claims.
This application claims benefit of priority to U.S. Provisional Application No. 62/658,677, filed on Apr. 17, 2018, the contents of which is hereby incorporated by reference.
Number | Date | Country | |
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62658677 | Apr 2018 | US |