Embodiments of the present disclosure generally relate to methods and devices to secure an intracorporeal device to a device delivery system and release the device at a desired location within a body.
Implantable (e.g., intracorporeal) medical sensors are currently available to monitor certain physiologic conditions, such as blood pressure. The size of the implantable medical sensor is limited due to target implant locations within the patient, such as within blood vessels. One example of an implantable medical sensor is a pulmonary arterial (PA) pressure sensor. In some cases, the sensors can be passive, utilizing an external device located outside of the patient body for supplying energy to power the generation and/or communication of the physiological data. In other cases, the sensors may have an onboard battery capable of limited functionality.
Currently, when delivering an implantable sensor within a vessel, the sensor is held in parallel with the delivery catheter; in other words, the sensor is stacked on top of the delivery catheter. The delivery catheter systems utilize catheters that have a plurality of openings or skives, such as eight skives, along an outer surface of the catheter. Using the skives, the sensor to be delivered is tethered to the catheter at a plurality of points in the stacked configuration. Therefore, the total profile that must fit within an introducer sheath, which in some cases can have a 12 F introducer lumen, is the outer diameter of the catheter plus the height/width of the sensor. In many cases it is desirable to decrease the overall diameter of the sensor delivery system such that smaller introducer sheaths can be used and to facilitate the use with a wider variety of patients.
When removing the tether(s), the tether wire(s) must be pulled through the number of skives or openings, resulting in friction that can inhibit the pulling force. Further, due to the stacked configuration and tethering locations, when the sensor is released, catheter material can be located distal of the sensor and must still be removed which can increase difficulty of retraction.
A need remains for methods and devices that improve the delivery and release of the implantable device.
In accordance with embodiments herein an intracorporeal sensor delivery system comprises a push rod, a floss and a delivery sheath. The push rod is configured to deliver a sensor to a deployment location within a body. The floss is removably coupled to the push rod and the sensor. The delivery sheath has a shorter length than the push rod, wherein the delivery sheath comprises a hollow shaft configured to receive the push rod, the sensor, and the floss.
Optionally, the push rod further comprises a push shaft and a cutter tube positioned at a distal end of the push shaft. A window tube comprises an opening positioned distal to a distal end of the cutter tube. The floss extends within a hollow shaft of the window tube and through the opening. The floss further extends between an outer surface of the cutter tube and the delivery sheath. Optionally, the cutter tube includes a bevel that is configured to cut the floss when the bevel is advanced over the opening of the window tube.
Optionally, the floss extends through a hole in a proximal end of the sensor. Optionally, the floss is a full-length floss extending from a proximal end of the push rod, through the delivery sheath to the sensor, and back to the proximal end of the push rod. Optionally, the push rod comprises first and second lumens, and the full-length floss extends within the first and second lumens.
Optionally, the system further comprises a bumper, wherein a proximal end of the bumper is interconnected with a distal end of the push rod, and a distal end of the bumper is configured to face a proximal end of the sensor. Optionally, the system further comprises a ring interconnected with a proximal end of the sensor, and the floss extends though the ring. Optionally, the system further comprises an attachment feature configured to removably secure the floss to the sensor. The attachment feature is interconnected with the sensor through one or more holes or features extending through the sensor.
In accordance with embodiments herein an intracorporeal sensor delivery system comprises a push rod configured to deliver a sensor to a deployment location within a body. A release mechanism is provided at a distal end of the push rod. An attachment feature is provided at a proximal end of the sensor, the release mechanism and the attachment feature are removably coupled to each other. A delivery sheath has a shorter length than the push rod, and the delivery sheath comprises a hollow shaft configured to receive the push rod, the release mechanism, the attachment feature, and the sensor.
Optionally, the release mechanism comprises a threaded end at a distal end of the push rod. The attachment feature comprises a threaded hole configured to receive the threaded end of the push rod, and a shroud is configured to cover the threaded end when the push rod and the sensor are separated from each other.
Optionally, the system further comprises a sleeve extending over the push rod and a spring interfacing with the sleeve. The spring is compressed when the push rod and the attachment feature are removably coupled to each other, and the spring is configured to push the sleeve over the distal end of the push rod when the push rod and the attachment feature are decoupled. Optionally, the release mechanism comprises a threaded end at the distal end of the push rod, and the sleeve is configured to cover the threaded end when the release mechanism and the attachment feature are decoupled.
Optionally, the attachment feature comprises a protrusion extending proximally from the proximal end of the sensor. Optionally, the protrusion has i) triangle points, ii) a groove, iii) a ball-shape, or iv) a geometric shape.
Optionally, the release mechanism may comprise a snare configured to interface with the attachment feature. The snare is configured to extend from the distal end of the push rod when the snare and the attachment feature are removably coupled to each other. The snare is configured to be retracted into the push rod when the snare and the attachment feature are decoupled.
Optionally, the release mechanism further comprises a ball mounted on a distal end of the push rod and a sheath comprising detents at a distal end of the sheath. The detents are configured to expand outwardly to a first diameter when the ball or wedge is engaging with the detents, and the detents are configured to have a second diameter that is smaller than the first diameter when the ball is not engaging with the detents. Optionally, the attachment feature comprises a pocket configured to removably accept the ball when the ball is not engaging with the detents, and wherein the pocket is configured to retain the ball and detents when the ball is engaging with the detents.
Optionally, the release mechanism further comprises clamp arms formed of a shape memory material. The clamp arms are configured to interface with the attachment feature when the attachment feature is within the delivery sheath to retain the sensor. Distal portions of the clamp arms are configured to flex outwardly to release the sensor when the attachment feature and the clamp arms are advanced distally out of the delivery sheath. Optionally, the clamp arms further comprise paddles, balls, or jaws configured to interface with the attachment feature.
In accordance with embodiments herein an intracorporeal sensor delivery system comprises a delivery catheter comprising a lumen. The delivery catheter has a proximal end and a distal end. A guide wire lumen (GWL) is configured to receive a guide wire, and the GWL extends within the lumen of the catheter and protrudes beyond the distal end of the catheter. An intracorporeal sensor comprises a proximal end and a distal end. The proximal end of the sensor is positioned distal to the distal end of the catheter. A proximal coupling feature is coupled to the proximal end of the sensor. The proximal coupling feature is configured to removably couple the sensor to the delivery catheter. A distal coupling feature is coupled to the distal end of the sensor. The distal coupling feature is further removably coupled to an outer surface of the GWL at a position that is distally located with respect to the distal end of the sensor.
Optionally, the distal coupling feature comprises a loop that is interlaced around the outer surface of the GWL. In some cases, the loop comprises a first loop portion and a second loop portion. The first loop portion is attached to the sensor at a first attachment point. The second loop portion is attached to the sensor at a second attachment point. The first and second loop portions of the distal coupling feature are interlaced to form a first set of cross points along a first side of the GWL and a second set of cross points along a second side of the GWL. The first loop portion is outside of the second loop portion at the first set of cross points and the second loop portion is outside of the first loop portion at the second set of cross points.
Optionally, the loop comprises a first loop portion and a second loop portion. The first loop portion is attached to the sensor at a first attachment point. The second loop portion is attached to the sensor at a second attachment point. The first and second loop portions are interlaced to form a first set of cross points along a first side of the GWL and a second set of cross points along a second side of the GWL. The second loop portion is positioned between the first loop portion and the outer surface of the GWL at the first set of cross points and the first loop portion is positioned between the second loop portion and the outer surface of the GWL at the second set of cross points.
Optionally, the distal coupling feature comprises a loop that is twisted or wrapped around the outer surface of the GWL. Optionally, the proximal coupling feature comprises a loop that is twisted at least once around itself. Optionally, the GWL comprises a length, wherein a first portion of the length has a first stiffness, and a second portion of the length has a second stiffness that is different from the first stiffness. Optionally, the distal coupling feature comprises a loop that is wrapped around the outer surface of the GWL to allow, in response to the GWL being decoupled from the coupling feature, the loop to open laterally with no axial twisting, the opened loop configured to engage walls of a vessel to provide rotational stability of the sensor.
Optionally, the system further comprises a pressure sheath configured to removably cover a portion of the catheter and a portion of the proximal coupling feature. Optionally, the sensor is a pressure sensor.
Optionally, the catheter further comprises a second lumen extending parallel with respect to the lumen. Optionally, the catheter further comprises a skive into a lumen positioned proximal to the distal end of the catheter. The skive is configured to receive the proximal coupling feature, and the proximal coupling feature comprises a loop extending through the skive and between the GWL and the catheter.
Optionally, the catheter further comprises a skive positioned proximal to the distal end of the catheter. The skive is configured to receive the proximal coupling feature, and the proximal coupling feature comprises a loop interlaced around the outer surface of the GWL.
In accordance with embodiments herein, an intracorporeal sensor delivery system comprises a first lumen configured to receive a GWL. The GWL is configured to extend beyond a distal end of the first lumen. The GWL is configured to removably receive a distal coupling feature coupled to an outer surface of the GWL at a position that is distally located with respect to the distal end of the lumen, the distal coupling feature interconnected with a sensor. A second lumen is configured to convey a release mechanism. The release mechanism is configured to removably couple with a proximal end of the sensor, wherein the first and second lumens are positioned in parallel and held together.
Optionally, the release mechanism is a floss or a threaded fastener. Optionally, the system includes a cutter mechanism extending within the second lumen, the cutter mechanism configured to sever the release mechanism. Optionally, the system further comprises a pressure lumen positioned in parallel and held together with the first and second lumens. Optionally, the release mechanism is a floss, wherein the release mechanism is configured to extend through a hole or a ring in the proximal end of the sensor.
In accordance with embodiments herein, a method for forming a tandem delivery system configured to deliver an intracorporeal sensor comprises positioning a sensor and catheter in tandem wherein a proximal end of the sensor is located distal with respect to the catheter, and a GWL extending through the catheter is configured to extend beyond a distal end of the sensor. The method includes removably coupling a distal coupling feature around an outer surface of the GWL that extends beyond the distal end of the sensor, and the distal coupling feature is coupled to the sensor. The method further includes removably coupling a proximal coupling feature to the catheter, and wherein the proximal coupling feature is coupled to the sensor.
Optionally, the proximal coupling feature extends between the outer surface of the GWL and an inner portion of the catheter. Optionally, the removably coupling of the proximal coupling feature to the catheter further comprises removably retaining the proximal coupling feature within a skive formed in an outer surface of the catheter, wherein the GWL spans the skive, and the method further comprises capturing the proximal coupling feature between the outer surface of the GWL and the skive.
Optionally, the method further comprising interlacing the distal coupling feature around an outer surface of the GWL.
Optionally, the distal coupling feature includes first and second loop portions that are interlaced together to form first cross points on a first side of the GWL and second cross points on a second side of the GWL. The method further comprises positioning the first loop portion between the second loop portion and the GWL to form the first cross points on the first side of the GWL, and positioning the second loop portion between the first loop portion and the GWL to form the second cross points on the second side of the GWL.
In accordance with embodiments herein, an intracorporeal sensor delivery system comprises a catheter, a guide wire lumen (GWL), and a distal coupling feature. The delivery catheter comprises a lumen and the catheter has a proximal end and a distal end. The GWL is configured to receive a guide wire, and the GWL extends within the lumen of the catheter and protrudes beyond the distal end of the catheter. The distal coupling feature is coupled to a distal end of a sensor and is further removably coupled to an outer surface of the GWL at a position that is distally located with respect to the distal end of the catheter.
Optionally, the distal coupling feature comprises a loop that is interlaced around the outer surface of the GWL. Optionally, the distal coupling feature comprises a loop that is removably captured by a removable floss that is tethered to the outer surface of the GWL with at least one bumper. Optionally, the system further comprises a proximal coupling feature configured to removably couple at a proximal end of the sensor, wherein the proximal coupling feature is one of a floss, a threaded fastener, a snare, paddles, or detents. Optionally, the catheter comprises a second lumen, the system further comprising a torque cable extending through the second lumen, the torque cable comprising a proximal coupling feature configured to removably couple to a proximal end of the sensor.
Optionally, the catheter comprises a pressure sheath configured to measure pressure. Optionally, the catheter comprises a second lumen, and the system further comprises a push rod extending through the second lumen, the push rod further comprising a cutting element.
Optionally, a sensor comprises a proximal end and the distal end. A proximal coupling feature is coupled to the proximal end of the sensor. The proximal coupling feature is configured to removably couple the sensor to the delivery catheter. A pressure sheath is configured to removably cover a portion of the catheter and a portion of the proximal coupling feature.
Optionally, a sensor comprises a proximal end and the distal end. A proximal coupling feature coupled to i) the catheter or ii) the GWL, wherein the distal coupling feature and the proximal coupling feature, in response to the sensor being positioned within a vessel and being removably coupled from the GWL or catheter, are configured to interface with walls of the vessel to secure the sensor within the vessel.
Optionally, an intracorporeal sensor delivery system comprises a delivery catheter, a guide wire lumen (GWL), and a proximal external sleeve. The sleeve will act as a lumen to extract pressure readings from the anatomy. The sleeve is located from the proximal end of the catheter and extends up to the distal end of the catheter. The sleeve may be shorter than the shaft of the catheter so the sleeve can be advanced or retracted after sensor release.
It will be readily understood that the components of the embodiments as generally described and illustrated in the Figures herein, may be arranged and designed in a wide variety of different configurations in addition to the described example embodiments. Thus, the following more detailed description of the example embodiments, as represented in the Figures, is not intended to limit the scope of the embodiments, as claimed, but is merely representative of example embodiments.
Reference throughout this specification to “one embodiment” or “an embodiment” (or the like) means that a particular feature, structure, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, appearances of the phrases “in one embodiment” or “in an embodiment” or the like in various places throughout this specification are not necessarily all referring to the same embodiment.
Furthermore, the described features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. In the following description, numerous specific details are provided to give a thorough understanding of embodiments. One skilled in the relevant art will recognize, however, that the various embodiments can be practiced without one or more of the specific details, or with other methods, components, materials, etc. In other instances, well-known structures, materials, or operations are not shown or described in detail to avoid obfuscation. The following description is intended only by way of example, and simply illustrates certain example embodiments.
Embodiments may be implemented in connection with concepts describe in the following patents, all of which are expressly incorporated in their entirety by reference: U.S. Pat. No. 10,653,859, titled “Delivery Catheter Systems and Methods” having an issue date of May 19, 2020, U.S. Pat. No. 10,894,144, titled “Apparatus and method for sensor deployment and fixation” having an issue date of Jan. 19, 2021, and U.S. patent Ser. No. 11/179,048, titled “System for deploying an implant assembly in a vessel” having an issue date of Nov. 23, 2021.
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No. 7,677,107 titled “Wireless pressure sensor and method for fabricating wireless pressure sensor for integration with an implantable device” having an issue date of Mar. 16, 2010; US Patent Application 20090007679 titled “WIRELESS PRESSURE SENSOR AND METHOD FOR FABRICATING WIRELESS PRESSURE SENSOR FOR INTEGRATION WITH AN IMPLANTABLE DEVICE” having a publication date of Jan. 18, 2009; US Patent Application 20090011117 titled “METHODS FOR TEXTURING A SURFACE OF AN ENDOVASCULAR IMPLANT” having a publication date of Jan. 8, 2009; US Patent Application 20150208929 titled “PRESSURE SENSOR, ANCHOR, DELIVERY” having a publication date of Jul. 30, 2015; US Patent Application 20090009332 titled “SYSTEM AND METHOD FOR MONITORING INGESTED MEDICATION VIA RF WIRELESS TELEMETRY” having a publication date of Jan. 8, 2009; and U.S. Pat. No. 8,382,677 titled “An anchored implantable pressure monitor” having an issue date of Feb. 26, 2013. The patents, applications and publications listed herein are expressly incorporated by reference in their entireties.
The term “skive” shall mean an area of removed material, such as an opening or notch in a catheter that is accessible from outside the catheter. The terms “skiving” and “skived” shall mean removing a portion of the catheter material, such as to expose a lumen within the catheter and/or to create an opening for a component (e.g., a portion of an anchor loop, a thread, floss, etc.) to pass through and/or be secured.
The term “tandem” shall mean one behind another and/or end to end in a locked manner. For example, a sensor and a delivery catheter can be held in tandem by locking the sensor to a “rail”, such as a guidewire lumen that extends through the delivery catheter.
The term “in parallel” and “parallel” shall mean one on top of the other and/or positioned side-by-side.
The term “intracorporeal sensor” shall mean any sensor configured to be inserted and fixed within a body. In some cases, the intracorporeal sensor is a pressure sensor.
The terms “push rod” and “push catheter” shall mean any wire, rod, and/or assembly of components such as rod(s), sheaths, and the like that push a sensor within a sheath (e.g., delivery sheath) to a delivery location within a body.
The term “attachment feature” shall mean any feature associated with and/or attached to and/or integral with the sensor that can be used to removably couple the sensor to one or more components of the delivery system.
The term “release mechanism” shall mean any feature associated with and/or attached to and/or integral with the delivery system that can be used to removably couple the one or more components of the delivery system to the sensor.
The terms “catheter” and “delivery catheter” shall mean any catheter or generally smooth cylindrical body that encloses one or more lumen and is configured to be inserted into a body. The catheter can include a single opening or lumen in which one or more features extend, multiple lumens in which each lumen includes zero features, such as a lumen used to measure pressure, or one or more features. The term catheter shall also mean a pressure sheath when a pressure sheath is used to enclose one or more features and is configured to be inserted into a body.
The catheter 102 can be a single lumen catheter or a multi-lumen catheter as discussed further below. A guidewire lumen (GWL) 112 extends within the catheter 102, such as within one lumen of the multi-lumen catheter or within the single lumen catheter. A guidewire 114 can extend within the GWL 112.
The sensor 106 can be a pressure sensor or can be a sensor 106 used to detect other indications within the body. In some embodiments, the pressure sensor 106 can be positioned within the pulmonary artery and be configured to be able to communicate with an implantable medical device, such as a pacemaker, etc., and/or communicate with an external device.
The sensor 106 can utilize one or more anchor mechanisms, such as loops, to secure the sensor 106 in place within the vessel when the sensor 106 is deployed at a deployment location. One or more of the anchor mechanisms can be used to removably couple the sensor 106 to the sensor delivery system 100. This provides an advantage over previous delivery systems as additional wires or other attachments are no longer needed to removably couple the sensor 106 to the sensor delivery system 100. A distal loop 116 and a proximal loop 118 can be attached to a body 119 of the sensor 106. The distal loop 116 (e.g., distal coupling feature) of the sensor 106 interfaces with an outer surface of the GWL 112. An interlacing weave pattern or other twisting, wrapping, etc., can be used to position the distal loop 116 around the outer surface of the GWL 112 as discussed further below. A portion of the proximal loop 118 (e.g., proximal coupling feature) can be retained between the GWL 112 and the catheter 102. For example, a first side of a proximal loop 118 extends into and/or through an opening or skive 122 in the catheter 102. The proximal loop 118 is positioned between the GWL 112 and an inner portion of the catheter 102 and/or the skive 122. A second side of the proximal loop 118 exits through the skive 122 on an opposite side of the GWL 112. Therefore, the sensor 106 is secured and/or interlocked to the catheter 102 while the GWL 112 is in place (e.g., while the GWL 112 extends through the portion of the catheter 102 coinciding with the skive 122 and the proximal loop 118). The distal and proximal loops 116, 118 (e.g., anchor loops) can be formed of Nitinol or other shape retaining material as is known in the art. Although the sensor 106 is shown as having two anchor loops, in some embodiments, the sensor 106 may include only the distal loop 116 or the proximal loop 118, or may include one or more additional loops.
A pressure sheath 120 can extend over the catheter 102 and portions of the GWL 112. In some embodiments a pressure sheath 120 is not utilized. In other embodiments, an introducer sheath (not shown) or other sheath (e.g., separate lumen) can extend over the catheter 102, sensor 106, GWL 112 and/or pressure sheath 120, and/or be integrated with or positioned alongside one or more of the catheter 102, sensor 106, GWL 112, and pressure sheath 120.
In some embodiments, the distal loop 116 and/or proximal loop 118 can be interlaced, wrapped, twisted together, combinations thereof, etc., around the outer surface of the GWL 112 to removably couple the distal and proximal loops 116, 118 to the GWL 112. Thus, in response to the GWL 112 being decoupled from the coupling feature, the distal and proximal loops 116, 118 will open to engage walls of a vessel. In some embodiments, the distal and/or proximal loops 116, 118 will open laterally with no axial twisting and the opened distal and proximal loops 116, 118 will engage walls of the vessel to provide rotational and axial stability of the sensor 106.
At 154, the guidewire 114 is pulled into the GWL 112, and then the GWL 112 is pulled in the proximal direction 108. As the practitioner pulls the GWL 112 (and guidewire 114 if still within GWL 112) in the proximal direction 108, the GWL 112 slides through the interlaced distal loop 116. The distal loop 116 is released from the sensor delivery system 100 and pops open to interface with walls of the patient's vessel. An advantage of the sensor delivery system 100 compared to previous delivery systems is that there is no catheter material distal with respect to the sensor 106 when the distal loop 116 is released.
At 156, the GWL 112 (and guidewire 114) are pulled in the proximal direction 108 to release the proximal loop 118 (e.g., coupling feature) from the catheter 102. When the proximal loop 118 is released, the sensor 106 is separated from the delivery system 100. In some embodiments, the proximal loop 118 may release from the delivery system 100 when less than the entire skive 122 is exposed.
At 158, the delivery catheter 102 is pulled in the proximal direction 108. When the GWL 112 is clear of the skive 122, the proximal loop 118 is released and will pop fully open to interface with the patient's vessel.
Further, the pressure sheath 120 and/or other sheaths can be retracted during the release of the sensor 106 or before the GWL 112 is pulled in the proximal direction 108 to release the distal loop 116. However, the pressure sheath 120 can remain near the deployed sensor 106 to allow pressure readings to be taken. In other embodiments, the catheter 102 can remain in place if the catheter 102 has its own pressure lumen (e.g., multi-lumen catheter). In still further embodiments, adequate clearance of e.g., approximately 0.04 square inch may be provided within the catheter 102 to facilitate pressure readings. Also, the steps of the method may occur in a different order. For example, the GWL 112 and guidewire 114 may be pulled to free the distal and proximal loops 116, 118 before the sheath(s) are retracted.
The multi-lumen catheter 306 includes first and second lumens 308, 310 extending therethrough. The first lumen 308 receives GWL 312, through which guidewire 322 is removably inserted. In the embodiment shown, the second lumen 310 can be empty or can receive other components not shown, such as to measure pressure (e.g., pulmonary arterial pressure (PAP)), etc. Although the first lumen 308 is shown as circular and the second lumen 310 is shown as having an approximate “D” shape, the first and second lumens 308, 310 can be other shapes to accommodate the uses of the lumen. Further, the first and second lumens 308, 310 can be different sizes than shown. For example, the first lumen 308 may encompass a larger cross-sectional area to accommodate a larger GWL 312 and/or the first and second lumens 308, 310 can be approximately the same size and/or same shape. The area of the multi-lumen catheter 306 around the first and second lumens 308, 310 can include catheter material, additional lumens, delivery or other passages, open space, etc. In other embodiments, the GWL 312 can extend through the second lumen 310, as discussed further below in
The sensor 106 is substantially in parallel with the GWL 312, which extends beyond the distal end 330 of the sensor 106. The sensor 106 remains distal with respect to the multi-lumen catheter 306. When the sensor delivery system 300 is inserted into an introducer sheath (not shown), the GWL 312 protrudes first, and the sensor 106 is positioned in the introducer sheath before the distal end 334 of the main catheter body. The multi-lumen catheter 306 holds the GWL 312 off center, and thus in some embodiments the GWL 312 and the multi-lumen catheter 306 are positioned to minimize vertical space (e.g., diameter D2), such as from an upper, outer surface of the multi-lumen catheter 306 and/or clearance needed for distal loop 324 to an opposite side of the sensor 106 or an opposite side of the multi-lumen catheter 306, whichever is greater. In some embodiments, the sensor 106 can, at least partially, overlap vertically with a pressure sheath (discussed further below) and inner shaft of the catheter 306. This ensures that the multi-lumen catheter 306 and the sensor 106 can be loaded together and moved through the introducer sheath without interference. Also, by arranging the multi-lumen catheter 306 and the sensor 106 in tandem, a size advantage can be realized as the introducer sheath can have a smaller diameter compared to systems that utilize arrangements that stack the catheter and the sensor on top of each other (e.g., catheter and sensor are held in parallel).
The GWL 312 may have a marker band (discussed further below in
In some embodiments, the variable stiffness GWL 312 can utilize a stiffer polymer for the proximal portion 386, 388 of the GWL 312 like the braided PI shafts, PEEK, vestamid, grilamid, 72 durometer (D) or 74D Pebax as a sleeve over a full length softer polymer shaft such as a 70D, 63D, 55D, 40D, Pebax distal or trilayer inner HDPE with soft outer layer. Alternatively, the stiffer polymer proximal portion 386, 388 of the GWL 312, such as a multilayer braided polyimide, vestamid, grilamid, 72D or 74D Pebax, etc., can be coaxially bonded to a softer polymer shaft such as a 70D, 63D, 55D, 40D, Pebax distal or trilayer inner HDPE with soft outer layer, etc., at the distal portion 390 of the GWL 312 which would include an optional bond of a third softer tip portion 392 for the distal portion 390 (e.g., 40 D, 55 D, Pebax, etc.). The markerband 394 can be swaged or bonded on the distal end of the distal soft GWL portion 390 either just proximal to (e.g., 1 mm) or under the proximal section of the soft tip portion 392. Suitable markerband materials are Platinum Iridium, Gold, or Silver, etc. It should be understood that although suitable materials as well as the stiffness or hardness thereof, are suggested herein, other materials not specifically named are also contemplated, and thus the embodiments are not limited to the listed materials and associated stiffnesses.
Returning to
The location of the skive 314 can be based on the length of the proximal loop 316, a desired tightness/looseness of the proximal loop 316 when extending between the GWL 312 and the catheter 306, and/or whether the proximal loop 316 is interlaced around an outer surface of the GWL 312 as discussed further below.
Distal loop 324 can have two attachment points that can be located within a region close to the distal end 330 of the sensor 106 (one attachment point 326 is shown). The distal loop 324 is removably coupled to the GWL 312, such as by being “woven” or interlaced around an outer surface of the GWL 312. In some embodiments, the distal loop 324 is twisted or pulled back and forth along the GWL 312 with deliberate alternating twist directions to keep each side of the distal loop 324 un-tangled with the other. The number of twists can be variable, depending on how tight the distal loop 324 should be against the outer surface of the GWL 312, the length of the distal loop 324, etc.
In comparison with previous systems, the interlacing of the distal loop 324 around the GWL 312 eliminates the need for sewing or tethering the distal loop 324 and/or proximal loop 316 to multiple skives of the delivery catheter. Accordingly, the assembly process is improved, and less friction is encountered when releasing the sensor 106. Further, the procedure is simplified compared to previous systems because no catheter material, or other delivery system material, is distal to the sensor 106 once the distal loop 324 is released from the GWL 312.
In addition, previous catheter delivery systems having multiple skives required a lubricious coating to be added to portions of the catheter to reduce the friction. By reducing the number of skives, such as by using only one skive 314, to secure the sensor 106 to the catheter 306, the outer surface of the catheter 306 is “smoother”. The release is better controlled by one component being pulled through a smoother sheath, rather than through the multiple skives of the catheter. For example, the GWL 312 can be constructed with low friction polymers (e.g., HDPE, PTFE). Therefore, in some cases the additional lubricious coating can be eliminated. In other cases, the materials used for the catheter 306 can be compounded to include lubricious material such as Pebax with Mobilize or Propel, etc.
The proximal loop 316 extends in the proximal direction 108, outside the catheter 306, and through the opening created by the skive 314b between the GWL 312 and the catheter material. For example, both portions of the proximal loop 316 can extend between the GWL 312 and the catheter material, such as to enter and exit the skive 314b along the same side as each other. Additionally or alternatively, the proximal loop 316 can be twisted to retain the proximal loop 316, such that the side portions of the proximal loop 316 enter and exit the skive 314b along opposite side of the GWL 312 as each other.
The proximal loop 316 exits a proximal end 354 of the skive 314b and can be crossed or twisted outside of the catheter 306. In some embodiments, the proximal loop 316 is crossed to form an X 352. The proximal loop 316 then further extends into the skive 314a and is captured between the GWL 312 and the skive 314a.
In some embodiments, a distance D6 from a proximal end 354 of the skive 314b and the distal end 334 of the catheter 306 (or the proximal end 328 of the sensor 106) is less than 10 mm. In some embodiments, the distance D6 is approximately 2 mm. An advantage of the additional skive 314b is that the distal skive 314b keeps the proximal loop 316 from moving up and over the catheter shaft, and the proximal skive 314a locks the remaining length of the proximal loop 316, keeping the sensor 106 from sliding axially.
An advantage of the tandem design is the ability to tether/removably couple the sensor 106 to the GWL 312 that has a smaller diameter than the entire catheter 306, allowing the sensor 106 to lie more concentric with the delivery system and save vertical space, thus fitting through smaller introducer sheaths.
In some embodiments, the tandem design can fit within an 11 F sheath (e.g., introducer), which is smaller than the currently used 12 F sheath. This provides an advantage wherein the sensor deliver system 100, 300 can be used in smaller vessels and thus a greater variety of patients. In addition, the smaller size can allow for reduced push forces through the 12 F or larger sheath, and/or the size of the guidewire 322 could be increased to possibly eliminate a guide wire exchange step in the implantation procedure. In general, a benefit is realized as smaller sized components reduce the risk of patient harm.
The GWL 312 is in parallel with the sensor 106, and the sensor 106 can overlap portions of the multi-lumen catheter 306 vertically and/or horizontally. Also, the sensor 106 may be different shapes, such as substantially rectangular as shown in
A funnel or bumper (not shown) can be attached to, for example, either an inner shaft of the catheter 306 or a pressure jacket (not shown) to help center the sensor 106 during one or more of i) loading the sensor 106 and catheter 306 in another sheath, ii) during deployment, and iii) retrieval of the sensor 106 into the catheter 306 if the procedure is aborted. The funnel may prevent sensor damage, allowing the sensor 106 to be re-used. In some embodiments, the funnel can be located to envelop the proximal end 328 of the sensor 106 to keep the sensor 106 taut with the GWL 312 and closer to a concentric position.
For example, the multi-lumen catheter 306 or a single lumen catheter can include a tapered portion adjacent to the sensor 106, such as to flare outwardly along all or portion(s) of the outer diameter of the catheter.
At the distal end of the catheter 307, in some cases, the GWL lumen 309 can have marker band 394a. The GWL 312 extends from the GWL lumen 309 and can optionally have a marker band 394b. Optionally or alternatively the pressure lumen 313 can have marker band 394c.
The distal loop 324 of the sensor 106 can be twisted, interlaced or otherwise wrapped around the GWL 312 as discussed herein. The proximal loop 316 of the sensor 106 may be unattached.
The torque cable 321 includes a threaded fastener 323 that is accepted by a hole 325 in the proximal end 328 of the sensor 106. The threaded fastener 323 is shown in this view as aligned with and outside the hole 325. In some embodiments the threaded fastener 323 can be accepted by a nut at the proximal end 328 of the sensor 106 as discussed further below with respect to
By way of example, the torque cable 321 can be used during deployment to support the sensor 106 in addition to the GWL 312. The torque cable 321 will hold the sensor 106 in place while the GWL 312 is retracted. This may enable various benefits, such as to test the anchoring of the sensor 106, provide the ability to interrogate the sensor 106 with no interference, final positioning of the sensor 106, and/or repositioning of the sensor 106 when the sensor 106 is still attached to the torque cable 321.
When the physician or practitioner is ready to release the sensor 106, the torque cable 321 can be rotated counterclockwise and the threaded fastener 323 unscrews from the hole 325 in the sensor 106 while the sensor 106 is held in the vessel with the distal loop 324. In some embodiments, the torque cable 321 can move in the proximal direction 108 and/or the distal direction 110 independently of the torque cable lumen 311 to adjust the position of the sensor 106. If, in some cases, the torque cable 321 is turned in the clockwise direction, or opposite the direction used to separate the threaded fastener 323 from the sensor 106, the torque cable can be used to radially position the sensor 106 within the vessel.
Additionally, similar to the discussion above with respect to
Referring to
In
Referring specifically to
Again, one of the loop portions, in this example the distal loop portion 408, is always in front of the distal loop portion 406, or in the “out of page” direction. In other words, on the “into page” side or back side of the GWL 312, one of the distal loop portions (e.g., distal loop portion 406) is always on top or on an outside of the cross points 404, while on the “out of page” side of the GWL 312, the other distal loop portion (e.g., distal loop portion 408) is always on top or on the outside of the cross points 402. This allows each side of the distal loop 324, the distal loop portions 406 and 408, to “pop” into place without twisting rotationally (e.g., around each other) when the GWL 312 is removed.
Therefore, when viewed as shown in
Although six cross points 402, 404 are shown in
Therefore, although the interlace pattern 400 of the distal loop 324 is illustrated as loosely positioned around the outer surface of the GWL 312 for ease of description, at least portions of the interlace pattern 400 may be flush and/or in contact with an outer surface of the GWL 312 while still providing a level of friction that allows the GWL to be easily removable. For example, in some cases a level of friction force that inhibits the pulling force of the GWL 312 is not desirable. In some embodiments, the interlace pattern 400 may not have a uniform tightness along the GWL 312, wherein a tip portion L1 of the interlace pattern 400 may be looser than a body portion L2 of the interlace pattern 400.
Some advantages of interlacing the distal loop 324 to the GWL 312 include keeping the distal loop 324 at a low profile for easy navigation and preventing the distal loop 324 from inverting proximally due to insertion/navigation forces through the body. The specific weave pattern 400 prevents any twisting of each side of the distal loop 324, which allows for long term loop form stability and prevention of tangling of the distal loop 324 once released.
Referring again to
In other embodiments, the distal loop 324 can be twisted or wrapped around the GWL 312 in other patterns. For example, the distal loop portions 406 and 408 may be positioned next to, near each other, not touching, etc., and wrapped around the outer surface of the GWL 312 one or more times, such as without being interlaced. In further embodiments, the distal loop portions 406 and 408 can be twisted around each other one or more times before being wrapped one or more times around the outer surface of the GWL 312. In still further embodiments the distal loop portions 406, 408 can be twisted in the same direction, alternating which portion is on the outside of either side of the GWL 312. It should be understood that the twisting, wrapping, and/or interlacing can be accomplished in any order and in any combination. Advantages of twisting the distal loop include increased stiffness and/or stability to help retain the distal loop in the desired position.
In
Skive 506 provides space for the interlace pattern 500 of the proximal loop 316 to be held within the single lumen catheter 508. The skive 506, in some cases, can be larger or more extensive than the skive 314 of
In some embodiments, as discussed above in
Referring also to
When the pressure sheath 600 is positioned over the skive 314 (
In some embodiments the pressure sheath 600 can be used to take pressures before and/or after release of the sensor 106 without an added step of removing the delivery sheath (e.g., introducer sheath) and reinserting a pressure catheter. Instead, pressures can be taken through the pressure sheath 600. In some cases, the multi-lumen catheter 306 is removed while the pressure sheath 600 remains in place, and then pressures are taken through the pressure sheath 600. By way of example only, the pressure sheath 600 can be a column of fluid, wherein blood of the patient applies pressure at the end of the body. A pressure transducer (not shown) can be connected to the pressure sheath 600 outside of the body to measure the pressure of the column of fluid.
In some embodiments, a lumen of sufficient diameter within the multi-lumen catheter 306 could contain an available channel (e.g., second lumen 310 of
Further, the pressure sheath 600 can be used with proximal interleaving/interlacing as discussed in
At 672, the sensor 106 and catheter 306 are positioned in tandem and the sensor 106 and the GWL 312 are positioned in parallel with each other. For example, the proximal end 328 of the sensor 106 can be located distal with respect to the distal end 334 of the catheter 306.
At 674, the distal loop 324 (e.g., distal coupling feature) of the sensor 106 can be removably coupled to the GWL 312 by arranging the distal loop 324 around an outer surface of the GWL 312, such as in the interlace pattern 400 discussed in
At 676, the sensor 106 is removably coupled to the catheter 306. In some embodiments, the proximal loop 316 (e.g., proximal coupling feature) of the sensor 106 can be arranged around the outer surface of the GWL 312, such as in the interlace pattern 500 discussed in
The interlocking embodiments of 674 and 676 may require access to a proximal end (not shown) of the GWL 312 and the distal tip 320 of the GWL 312, as well as manipulation of the position of the GWL 312 along the catheter 306.
At 678, in some embodiments, the pressure sheath 600 or other sleeve can be positioned over the catheter 306 and the skive 314, providing the benefit of taking pressures with the pressure sheath 600 as well as more securely locking the sensor 106 and catheter 306 to each other. The assembly provides an additional advantage wherein the practitioner does not need to handle the sensor 106 separately from the catheter 306 or interconnect the sensor 106 with the catheter 306. In other embodiments, a lumen in a multi-lumen catheter (e.g., two lumen, three lumen, etc.) can be used to take pressure readings, which can eliminate the need for the pressure sheath 600.
The tandem delivery, wherein the sensor 106 and the catheter 306 are positioned in tandem with respect to each other and the sensor 106 and the GWL 312 are in parallel with each other, can be utilized with release mechanisms other than, or in combination with, the proximal loop interlocking and the proximal and distal loop interlacing discussed herein.
To release the sensor 106 from the catheter 102, the floss 700 can be pulled by the practitioner in the proximal direction 108. The distal loop 116 is released from the delivery system 701 when the floss 700 has been pulled in the proximal direction 108 and releases the distal loop 116 within the attachment area 706 closest to the sensor 106. The proximal loop 118 is similarly released.
In some embodiments the floss 700 can be a full floss, wherein the floss is a full-length tether connection. The practitioner pulls the floss 700 at least as far as needed to release the distal loop 116 and the proximal loop 118. Once the GWL 112 and the floss 700 are proximal with respect to the distal loop 116, the distal loop 116 will deploy to its predetermined shape and engage the walls of the vessel. Similarly, the proximal loop 118 will deploy when released from the floss 700 and the catheter 102 and GWL 112 are proximal with respect to the proximal loop 118.
In other embodiments, the floss 700 can be a hybrid floss, wherein the practitioner pulls the floss and/or actuates a cutter to cut the floss which releases the proximal loop 118. The distance the floss 700 needs to be pulled is much shorter compared with the full floss. The operation of the hybrid floss and cutter are described further below.
In coronary cases for various interventions, the practitioner inserts a guide catheter that has a dilator on the distal end that transitions down to a guidewire. This process places a hollow tube or sheath extending from the proximal end (e.g., the practitioner) to the distal end (e.g., location where implantable device is to be positioned in the vessel). The insertion of the delivery sheath can be as shown and discussed above in
The delivery sheath 902 is a shaft construction that typically includes a liner, braid, and polymer jackets. The delivery sheath 902 passes through an introducer sheath over the guidewire and dilator (not shown). After placement, the dilator and guidewire can be removed from the delivery sheath 902 so it is ready for the sensor delivery.
The sensor 106 and push rod 904 can be preloaded in a loader tube that connects directly to the delivery sheath 902.
Accordingly, the sensor 106 and the push rod 904 (e.g., threaded delivery cable 1002) can be preloaded in the loader tube 1000 that connects directly to the delivery sheath 902. The loader tube 1000 aids in keeping the distal and proximal loops 116, 118 (e.g., anchor loops) of the sensor 106 compressed and in the correct orientation for proper anchoring post-delivery. The diameter of the distal and proximal loops 116, 118 is larger than an inner diameter of the delivery sheath 902, and thus the distal and proximal loops 116, 118 will not enter the deliver sheath 902 without manipulation. Advantages of using the loader tube 1000 is that the loader tube 1000 eliminates this compression step for practitioners and minimizes contact with the sensor 106, as this step could be accomplished, for example, during an assembly process in advance of use by the physician.
Embodiments disclosed herein include features that allow alternate securement options, delivery techniques, and release mechanisms that can be used to deliver the sensor 106. Once the sensor 106 is advanced distally out of the delivery sheath 902, the sensor 106 is released, such as by disengaging the release mechanism of the push rod 904 from the attachment feature of the sensor 106. After release, the push rod 904 and release mechanism are removed. An advantage of the system is that the delivery sheath 902 remains proximal to the deployed sensor 106, enabling pressure readings to be taken without removing the delivery sheath 902 and reinserting a separate device, as has previously been standard practice.
An additional benefit of the sheathed delivery system 900 is that it can be delivered over any standard size guidewire the practitioner wishes to use. Currently, a 0.018 inch guidewire is used. The sheathed delivery system 900 can accommodate guidewires that are 0.018-0.035 inch in diameter without requiring the size of the introducer sheath to be changed (e.g., 12 F).
In some embodiments the push rod 1100 is configured to be longer than the delivery sheath 902, such as a few centimeters longer depending upon a length of the sensor 106 and the distal and proximal loops 116, 118. In some cases, the push rod 1100 may extend a distance out the proximal end of the delivery sheath 902 before the push rod 1100 is pushed to advance the sensor 106. The extra length ensures that the sensor 106 will exit the delivery sheath 902.
In some embodiments, the push rod 1100 is a composite of a braided push shaft 1101 and one or more tubes or mandrels (e.g., hypotubes). The floss 1102 is threaded through a window tube 1108. In other embodiments the floss 1102 extends outside the cutter tube 1110 and into an opening 1124 in the window tube 1108. The cutter tube 1110 has a bevel 1112 that is configured to cut the floss 1102 when the bevel 1112 of the cutter tube 1110 and the opening 1124 of the window tube 1108 are in a predetermined relationship with each other.
The hybrid suture floss cut release can also be used with the sensor 106 and the GWL 312, and/or in the tri-lumen catheter 307 configuration, such as for extra stability and to improve positioning/repositioning. A further advantage of combining the push rod 1100 and cutter assembly in the tandem configuration as discussed below is the smaller overall profile (e.g., diameter) of the assembly. Additionally, the assemblies can be used to deliver the sensor 106 without an additional delivery sheath, e.g., such as delivery sheath 902 of
The GWL 312 extends through the lumen 1140 and can contain a guidewire (not shown). The proximal loop 118 can be free-floating or unrestrained. In other embodiments, the proximal loop 118 can be retained inside the pressure sheath 600, inside the lumen 1140, and/or wrapped/interleaved around an outside surface of the GWL lumen 312 as discussed herein.
The GWL 312 extends beyond the distal end 330 of the sensor 106. The distal loop 116 is interleaved, wrapped around, etc., the GWL 312 as discussed further herein. The GWL 312 can be pulled in the proximal direction 108 to release the distal loop 116. The pressure sheath 600 can be pulled in the proximal direction 108 to release the proximal loop 118, if needed. Once the distal loop 116 is released, the floss 1102 can be pulled as discussed herein to release the sensor 106.
Although not shown, the distal end of one or more of the GWL lumen 1152, pressure lumen 1156, and GWL 312 can have marker band (see markerbands 394 for
The GWL 312 extends from the GWL lumen 1152 in the distal direction 110. The distal loop 324 of the sensor 106 can be twisted, interlaced or otherwise wrapped around the GWL 312 as discussed herein. The proximal loop 118 of the sensor 106 may be free floating, or alternatively, can be captured in any manner discussed herein. In other embodiments, the sensor 106 has no proximal loop 118
In some cases, the floss 1102 extends within the cutter lumen 1156 proximate the push rod 110 and cutter tube 1110, enters the window tube 1108 (see
The push rod 1200 extends a length L7 beyond the proximal end 910 of the delivery sheath 902 such that the push rod 1200 is longer than the delivery sheath 902 to ensure sensor exit when the push rod 1200 is pushed in the distal direction 110. When the sensor 106 is pushed out of the delivery sheath 902 at the desired deployment location, the practitioner pulls the floss 1102 a length L6 of the delivery system. In some embodiments, the practitioner may pull the floss 1102 approximately 60-120 cm, such as to pull the floss 1102 completely out of the hole 1206. In other embodiments, the practitioner may pull the floss 1102 completely out of the system, doubling the length of pulling (e.g., 120-240 cm).
In some cases, the floss 1102 can be a polymer suture (Polyester, Polyethylene, nylon, bioabsorbable, etc.) or Nitinol. Although a multi-lumen push rod 1200 is shown in
Alternative shapes of rings and/or other attachment features/fasteners can be used to removably couple with the floss 1102.
Although the detent paddles 1422 are shown as having a circular or round opening with which to grasp the protrusion 1404, the opening can be shaped differently to accommodate differently shaped protrusions 1404. Also, the detent paddles 1422 can be substantially flat, have distal tips that curve outward or inward, and the like.
The nut 1506 can have an opening 1508 that accepts diameters associated with the detents 1502 and the ball 1504 when the detents 1502 and the ball 1504 are not engaged, as shown in view 1510. Therefore, the ball 1504 and detents 1502 can be separately advanced into the pocket 1507. The opening 1508 is not wide enough to allow the diameter of the expanded detents 1502 holding the ball 1504 to pass through, as shown in view 1512, thus capturing the locking feature.
Jaws, Paddles, and/or Slides Release
The embodiments of 16A-16H utilize a nut (attachment feature) bonded onto the sensor 106 that has one or more recess/hole specifically designed to interface with an attachment mechanism (e.g., jaw, paddle, or slide) of a push rod to form a locking feature in accordance with embodiments herein. In some cases, the one or more recess can be provided in the sensor 106 itself. In some embodiments the jaws and paddles are made from shape memory material(s) such as Nitinol so that when the sensor 106 is advanced out of the sheath(s) or the sheath compressing the paddles/jaws is retracted, the arms of the paddles/jaws open up and release the sensor 106. In some cases, a flat Nitinol ribbon can be cut into a desired shape, such as a paddle, clamp arm, etc., extending at the end of a wire that can also be Nitinol. Some embodiments may not require self-expanding materials, while some may require a second action, such as pulling action in the proximal direction 108 to release the sensor 106.
All of the sheathed delivery release mechanisms described herein can be combined with some form of bumper on the push rod/catheter so that if a case is ever aborted, the bumper CAN help make the sensor 106 coaxial and easier to retrieve into the delivery sheath or introducer. In some embodiments, the bumper can have a flared shape that interfaces with the sensor 106.
To retrieve the sensor 106, the bumper 1800 can be positioned against the proximal side of the sensor 106. The shape of the distal end 1806 of the bumper 1800, which in some cases can be flared and/or shaped to match a particular sensor geometry and/or size, can assist with holding the sensor 106 coaxial with the delivery sheath or introducer. Known retrieval methods can be used, which is some cases can be a reversal of the release mechanism, or by inserting a different tool.
The IMD 1900 includes a housing 1906 that is joined to a header assembly 1908 that holds receptacle connectors connected to a right ventricular lead 1930 and an atrial lead 1920, respectively. The atrial lead 1920 includes a tip electrode 1922 and a ring electrode 1923. The right ventricular lead 1930 includes an RV tip electrode 1932, an RV ring electrode 1934, an RV coil electrode 136, and an SVC coil electrode 1938. The leads 1920 and 1930 detect intracardiac electrogram (IEGM) signals that are processed and analyzed, and also deliver therapies.
The IMD 1900 may be implemented as a full-function biventricular pacemaker, equipped with both atrial and ventricular sensing and pacing circuitry for four chamber sensing and stimulation therapy (including both pacing and shock treatment). Optionally, the IMD 1900 may further include a coronary sinus lead with left ventricular electrodes. The IMD 1900 may provide full-function cardiac resynchronization therapy. Alternatively, the IMD 1900 may be implemented with a reduced set of functions and components. For instance, the IMD may be implemented without ventricular sensing and pacing.
The implantable sensor 1950 is configured to be implanted at a location remote from the electrodes of the leads 1920 and 1930. The implantable sensor 1950 may be implanted in a blood vessel, such as an artery or vein. In an embodiment, the sensor 1950 is implanted within the pulmonary artery (PA). The sensor 1950 may be anchored to the vessel wall of a blood vessel using one or more expandable loop wires. The diameter of each loop should be larger than the diameter of target blood vessel in order to provide adequate anchoring force. Optionally, instead of the loop wire, the sensor 1950 may be attached to the end of a self-expandable stent and deployed into the blood vessel through a minimally invasive method.
Alternatively, the implantable sensor 1950 may be secured to tissue outside of blood vessels. The sensor 1950 may be secured in place by using a fixation screw (e.g., helix) attached to the housing. The screw may anchor the sensor 1950 to patient heart tissue, such as cardiac tissue of the left or right ventricle. The sensor 1950 is configured to sense a physiologic parameter of interest (PPOI) and to generate signals indicative of the PPOI. In a non-limiting example, when the sensor 1950 is disposed within the PA, the sensor 1950 may sense, as the PPOI, blood pressure.
In some embodiments, the sensor 1950 can be powered by, and communicate with, the external device 1904. In other embodiments, the sensor 1950 can communicate with the IMD 1900. The sensor 1950 can communicate information about the physiologic parameter, for example.
All references, including publications, patent applications and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein.
It should be clearly understood that the various arrangements and processes broadly described and illustrated with respect to the Figures, and/or one or more individual components or elements of such arrangements and/or one or more process operations associated of such processes, can be employed independently from or together with one or more other components, elements and/or process operations described and illustrated herein. Accordingly, while various arrangements and processes are broadly contemplated, described and illustrated herein, it should be understood that they are provided merely in illustrative and non-restrictive fashion, and furthermore can be regarded as but mere examples of possible working environments in which one or more arrangements or processes may function or operate.
As will be appreciated by one skilled in the art, various aspects may be embodied as a system, method or computer (device) program product. Accordingly, aspects may take the form of an entirely hardware embodiment or an embodiment including hardware and software that may all generally be referred to herein as a “circuit,” “module” or “system.” Furthermore, aspects may take the form of a computer (device) program product embodied in one or more computer (device) readable storage medium(s) having computer (device) readable program code embodied thereon.
Any combination of one or more non-signal computer (device) readable medium(s) may be utilized. The non-signal medium may be a storage medium. A storage medium may be, for example, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any suitable combination of the foregoing. More specific examples of a storage medium would include the following: a portable computer diskette, a hard disk, a random access memory (RAM), a dynamic random access memory (DRAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or Flash memory), a portable compact disc read-only memory (CD-ROM), an optical storage device, a magnetic storage device, or any suitable combination of the foregoing.
Program code for carrying out operations may be written in any combination of one or more programming languages. The program code may execute entirely on a single device, partly on a single device, as a stand-alone software package, partly on single device and partly on another device, or entirely on the other device. In some cases, the devices may be connected through any type of network, including a local area network (LAN) or a wide area network (WAN), or the connection may be made through other devices (for example, through the Internet using an Internet Service Provider) or through a hard wire connection, such as over a USB connection. For example, a server having a first processor, a network interface, and a storage device for storing code may store the program code for carrying out the operations and provide this code through its network interface via a network to a second device having a second processor for execution of the code on the second device.
Aspects are described herein with reference to the Figures, which illustrate example methods, devices and program products according to various example embodiments. These program instructions may be provided to a processor of a general purpose computer, special purpose computer, or other programmable data processing device or information handling device to produce a machine, such that the instructions, which execute via a processor of the device implement the functions/acts specified. The program instructions may also be stored in a device readable medium that can direct a device to function in a particular manner, such that the instructions stored in the device readable medium produce an article of manufacture including instructions which implement the function/act specified. The program instructions may also be loaded onto a device to cause a series of operational steps to be performed on the device to produce a device implemented process such that the instructions which execute on the device provide processes for implementing the functions/acts specified.
The units/modules/applications herein may include any processor-based or microprocessor-based system including systems using microcontrollers, reduced instruction set computers (RISC), application specific integrated circuits (ASICs), field-programmable gate arrays (FPGAs), logic circuits, and any other circuit or processor capable of executing the functions described herein. Additionally or alternatively, the modules/controllers herein may represent circuit modules that may be implemented as hardware with associated instructions (for example, software stored on a tangible and non-transitory computer readable storage medium, such as a computer hard drive, ROM, RAM, or the like) that perform the operations described herein. The above examples are exemplary only, and are thus not intended to limit in any way the definition and/or meaning of the term “controller.” The units/modules/applications herein may execute a set of instructions that are stored in one or more storage elements, in order to process data. The storage elements may also store data or other information as desired or needed. The storage elements may be in the form of an information source or a physical memory element within the modules/controllers herein. The set of instructions may include various commands that instruct the modules/applications herein to perform specific operations such as the methods and processes of the various embodiments of the subject matter described herein. The set of instructions may be in the form of a software program. The software may be in various forms such as system software or application software. Further, the software may be in the form of a collection of separate programs or modules, a program module within a larger program or a portion of a program module. The software also may include modular programming in the form of object-oriented programming. The processing of input data by the processing machine may be in response to user commands, or in response to results of previous processing, or in response to a request made by another processing machine.
It is to be understood that the subject matter described herein is not limited in its application to the details of construction and the arrangement of components set forth in the description herein or illustrated in the drawings hereof. The subject matter described herein is capable of other embodiments and of being practiced or of being carried out in various ways. Also, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having” and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items.
It is to be understood that the above description is intended to be illustrative, and not restrictive. For example, the above-described embodiments (and/or aspects thereof) may be used in combination with each other. In addition, many modifications may be made to adapt a particular situation or material to the teachings herein without departing from its scope. While the dimensions, types of materials and coatings described herein are intended to define various parameters, they are by no means limiting and are illustrative in nature. Many other embodiments will be apparent to those of skill in the art upon reviewing the above description. The scope of the embodiments should, therefore, be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. In the appended claims, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects or order of execution on their acts.
This application claims priority to U.S. Provisional Application No. 63/412,003, titled “TANDEM INTERLACE DELIVERY CATHETER FOR DELIVERING AN INTRACORPOREAL SENSOR” which was filed on Sep. 30, 2022, and U.S. Provisional Application No. 63/427,122, titled “SHEATHED DELIVERY SYSTEMS FOR DELIVERING AN INTRACORPOREAL SENSOR” which was filed on Nov. 22, 2022, the complete subject matter of which are expressly incorporated herein by reference in their entirety.
Number | Date | Country | |
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63412003 | Sep 2022 | US | |
63427122 | Nov 2022 | US |