This invention relates, generally, to catheters and, more particularly, to a single use deflectable stylet for use in a catheter, to a method of fabricating a stylet and to a catheter including the stylet.
In heart procedures, a catheter, be it a diagnostic catheter or a therapeutic catheter, is inserted via an introducer into the vasculature of a patient. Normally, the catheter is inserted through the femoral vein of a patient and is steered to a site in a patient's heart at which a diagnostic and/or therapeutic procedure is to be carried out. At the site, it is necessary to deflect a tip of the catheter to bring electrodes of the catheter into contact with heart wall tissue to effect diagnosis or therapy.
Thus, a tip of the catheter needs to be deflectable. This is achieved, in the case of the Applicant's catheter, by inserting a stylet into a lumen of an electrode sheath of the catheter. The electrode sheath is manufactured according to the Applicant's manufacturing technique and has an unimpeded lumen. This is due to the fact that electrical conductors for electrodes of the electrode sheath are generally embedded in a wall of the electrode sheath.
The catheter is also manufactured with a low-cost handle. The low-cost handle is achieved by not having electrical conductors or connectors arranged in the catheter. Rather, the electrical conductors pass through the body of the catheter and are connected directly to equipment for communicating with the electrodes of the catheter. It would therefore be beneficial to have a stylet which is also a low-cost item to enable it to be used once only without significantly increasing expenses of an institution using the catheters.
According to a first aspect of the invention, there is provided a single use, deflectable stylet for use in a catheter, the stylet including
a deflectable portion of a flexible material;
an actuator attached to the deflectable portion, manipulation of the actuator relative to the deflectable portion causing deflection of the deflectable portion; and
a stiffening element with the deflectable portion being associated with a distal region of the stiffening element, the stiffening element being sufficiently stiff in torsion to convert proximal rotation into substantially equivalent distal rotation.
Preferably, the deflectable portion is of a synthetic plastics material. Further, the stiffening element may be of metal. The metal may be a low cost steel material such as a stainless steel material or it may be aluminium, tungsten, or the like.
The deflectable portion may be an elongate tubular body member defining a passage. The tubular body member may define an axially extending cutaway region in a wall of the body member to facilitate deflection of a distal part of the body member.
The cutaway region may subtend an angle of greater than 90° but less than 270°. Typically the cutaway region may subtend an angle of approximately 170° to 190°.
In this specification, the term “subtend”, unless the context clearly indicates otherwise, is used in the sense of forming or marking the limits of the angle.
In an embodiment, the cutaway region may be closed off by a cage defined by a plurality of longitudinally spaced, transversely extending slots.
Instead of, or in addition to, the cutaway region, a plurality of longitudinally spaced, transversely extending slots may be defined in the distal part of the tubular body member to facilitate deflection of the distal part of the body member.
In one embodiment, the stiffening element may be a tube received in the passage of the tubular body member. In another embodiment, the stiffening element may be a sleeve received over the tubular body member.
In a further embodiment, the stiffening element may be a tube and the deflectable portion may constitute a tip portion mounted on a distal end of the tube. In this embodiment too, the deflectable portion may comprise an elongate tubular body member defining an axially extending cutaway region in a wall of the body member to facilitate deflection of the distal part of the body member.
The actuator may be a pull wire extending through the tube and the tubular body member, a distal end of the pull wire being fast with a distal end of the tubular body member.
In still a further embodiment, the deflectable portion may comprise an elongate, planar element having a mounting formation at its proximal end for mounting to the distal end of the tube. In this embodiment, the actuator may be a pull wire extending through the tube and over the planar element with a distal end of the pull wire being fast with a distal end of the planar element.
According to a second aspect of the invention, there is provided a single use, deflectable stylet for use in a catheter, the stylet including
an elongate, tubular body member of a synthetic plastics material, the plastics material being of a type which permits deflection of at least a part of the body member but which is sufficiently stiff in torsion to convert rotation at a proximal end of the body member into substantially equivalent rotation at a distal end of the body member, the body member defining a lumen;
an axially extending cutaway region defined in a wall of the body member at a distal part of the body member to facilitate deflection of the distal part of the body member, the cutaway region subtending an angle of greater than 90° but less than 270°; and
an actuator received in the lumen of the body member, a distal end of the actuator being fast with a distal end of the body member and relative displacement between the body member and the actuator causing deflection of the body member about the cutaway region of the body member.
The body member may be of a thermoplastic material. The thermoplastic material may be a polyetheretherketone (PEEK) material or a polyimide material.
The cutaway region may be formed with the actuator in position in the lumen of the body member. The cutaway region may be an inwardly crenated region formed in the wall of the body member. The cutaway region may be closed off by a cage comprising a plurality of longitudinally spaced, transversely extending slots.
The stylet may include a mounting assembly for mounting to a handle body of a catheter. The mounting assembly may include an anchoring element mountable to the handle body and a carrier displaceably arranged relative to the anchoring element, the actuator being mounted fast with one of the anchoring element and the carrier with another component being mounted fast with the other of the carrier and the anchoring element so that relative displacement of the actuator and the other component causes deflection of the deflectable portion.
Depending on the embodiment, the “other component” may be the tubular body member itself or, where the tubular body member is mounted on a distal end of the stiffening member, the stiffening member.
According to a third aspect of the invention, there is provided a method of fabricating a deflectable stylet the method including
providing an elongate tubular body member defining a lumen;
inserting an actuator into the lumen of the body member; and
using the actuator as a guide formation, forming an inwardly crenated, axially extending cutaway portion in a wall of the tubular member to form a bend-enhancing region about which the body member is able to deflect.
The method may include forming the cutaway portion with a subtended angle greater than 90° but less than 270°.
Further, the method may include securing a distal end of the actuator fast with a distal end of the body member.
The method may include providing a stiffening member for the stylet. The stiffening member may be a tube and the method may include mounting the tubular body member on a distal end of the tubular member. Instead, the stiffening member may be a tube and the method may include inserting the tube into the lumen of the body member. Still further, the stiffening member may be a tube and the method may include inserting the body member into a passage of the tube.
According to a fourth aspect of the invention, there is provided a catheter which includes
a catheter handle having a handle body;
an electrode sheath extending from a distal end of the handle, the electrode sheath defining a lumen; and
a single use, deflectable stylet, as described above, received in the lumen of the electrode sheath.
The catheter may include a deflection control mechanism which is displaceably carried on the handle body, the carrier of the mounting assembly being secured to the displacement control mechanism and the anchoring formation being secured to a proximal end of the handle body.
A projection control mechanism may be carried on the handle body, the electrode sheath being carried on the projection control mechanism and the projection control mechanism being operable to extend and retract the electrode sheath relative to the stylet.
In
The stylet 10 includes a stiffening element in the form of a tube 16. In this embodiment, the deflectable portion 12, which comprises an elongate tubular member 18, is mounted on a distal end of the tube 16. The tube 16 is of metal such as stainless steel.
The tubular body member 18 of the deflectable portion 12 is of a thermoplastics material. For example, the tubular body member 12 can be made of a polyetheretherketone (PEEK) plastics or a polyimide plastics material.
The tubular body member 18 defines a bend-enhancing region 20. The bend-enhancing region 20 is formed by an inwardly directed, axially extending crenation 22 which is cut into a wall of the tubular body member 18 to a depth sufficient to expose the pull wire 14. The crenation 22 subtends an angle of greater than 90° but less than 270°. Preferably the crenation 22 subtends an angle slightly less than 180° which, because the deflectable portion 12 is of a plastics material should be sufficient to permit bending in a plane passing through the longitudinal axis of the deflectable portion 12.
The stylet 10 further includes a mounting assembly 23. The mounting assembly 23 comprises an anchoring formation 24 and a mounting member, or carrier, 26 displaceably arranged relative to the anchoring formation 24 to be displaceable in the direction of arrows 28.
A proximal end of the pull wire 14 is mounted fast with the anchoring formation 24. A proximal end of the tube 16 is mounted fast with the carrier 26 so that relative displacement between the carrier 26 and the anchoring formation 24 results in deflection of the deflectable portion 12 in a plane passing through the longitudinal axis of the deflectable portion. More particularly, when the tube 16 is urged distally relative to the anchoring formation 24, deflection of the deflectable portion 12 occurs about the bend-enhancing region 20.
Referring now to
Referring to
The elongate tubular body member 36 defines a passage 38 through which the pull wire 14 passes. Once again, a distal end 14.1 of the pull wire 14 is fast with a distal end at 12.1 of the deflectable portion 12 of the body member 36. As in the case of the embodiment illustrated in
To form the crenation 22 in the case of the embodiment shown in
Once the pull wire 14 has been secured in position, a scalpel or other cutting implement is used to form the crenation 22. A wall of the body member 18, 36 is cut away to the depth of the pull wire 14 and the pull wire 14 is used as a guide in forming the crenation 22.
In
In the formation of this embodiment, the pull wire 14 is again inserted into the passage 38 and is used as a guide in the cutting of the slots 39 to the required depth.
Referring to
The catheter 40 includes an electrode sheath 46 extending from the handle body 42. A distal end of the electrode sheath carries a plurality of axially spaced electrodes 48. The distal end of the electrode sheath 46 is deflectable into the position shown in dotted lines using the stylet 10, as will be described in greater detail below.
The anchoring formation 24 of the mounting assembly 23 includes an attachment formation in the form of a pair of opposed, radially outwardly extending pins 50 (
The handle body 42 of the catheter 40 further includes a projection control mechanism 60. The projection control mechanism 60 comprises a projection control knob 62 arranged distally of the deflection control knob 56. The electrode sheath 46 is fast with the deflection control mechanism 60. The deflection control mechanism 60 is used to extend the distal end of the electrode sheath 46 relative to a distal of the stylet 10. With such an arrangement, hard to reach places in a patient's heart can be accessed by extending the distal end of the electrode sheath 46 relative to the distal end of the stylet 10.
It is a particular advantage of the invention that a low-cost, single use, deflectable stylet 10 is provided. This renders the catheter 40, in its entirety, disposable as it is made of low-cost materials. Generally, the stylet 10, in order to be deflectable is made from high cost material such as nitinol. However, the Applicant has determined that, surprisingly, by making the stylet out of suitable plastics materials and metals, instead of the high cost material, adequate deflection of the distal end of the electrode sheath 46 can still be obtained and provide the necessary deflectability.
It will be appreciated by persons skilled in the art that numerous variations and/or modifications may be made to the invention as shown in the specific embodiments without departing from the scope of the invention as broadly described. The present embodiments are, therefore, to be considered in all respects as illustrative and not restrictive.
The present application claims priority from United States of America Provisional Patent Application No. 60/934,844 filed on Jun. 15, 2007, the contents of which are incorporated herein by reference in its entirety.
Number | Date | Country | |
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60934844 | Jun 2007 | US |