Tissue slitting methods and systems

• US 10,531,891 B2
• Filed: 03/14/2013
• Issued: 01/14/2020
• Est. Priority Date: 09/14/2012
• Status: Active Grant

• Current Assignee: Spectranetics Corporation (Koninklijke Philips N.V.)
• Original Assignee: Spectranetics Corporation (Koninklijke Philips N.V.)
• Inventors: Bowe, Wade A., Burton, George Woodrow, Dalby, Paul Joseph, Grace, Kenneth P., Sotak, Ryan Michael, Schneider, Blaine Andrew
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Pahakis, Manolis
• Application Number:
  US13/828,383
• Publication Number:
  US 20140081252A1
• Time in Patent Office: 2,497 Days
• Field of Search: None
• CPC Class Codes: A61B 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61B 17/32037 for removing obstructions from inner organs or blood vessels, e.g. for atherectomy
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 17/50 Instruments, other than pincettes or toothpicks, for removing foreign bodies from the human body locating otherwise A61B5/06; locating by radiation A61B6/00; removing calculi A61B17/22; from the eyes A61F9/00709
• CPC Class Codes: A61B 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/320044 Blunt dissectors
• CPC Class Codes: A61B 90/02 Devices for expanding tissue, e.g. skin tissue implements for holding wounds open, surgical tractors A61B17/02; implantable mammary prosthesis A61F2/12; dilators A61M29/00
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/057 Anchoring means; Means for fixing the head inside the heart
• CPC Class Codes: A61N 2001/0578 having means for removal or extraction
• CPC Class Codes: F04C 2270/041 Controlled or regulated
• CPC Class Codes: G10L 21/00 Speech or voice signal processing techniques to produce another audible or non-audible signal, e.g. visual or tactile, in order to modify its quality or its intelligibility G10L19/00 takes precedence
• CPC Class Codes: H04L 65/403 Arrangements for multi-party communication, e.g. for conferences data switching systems for conference H04L12/18; arrangements for connecting several subscribers to a common circuit, i.e. affording conference facilities H04M3/56; television conferencing systems H04N7/15
• CPC Class Codes: H04M 3/568 audio processing specific to telephonic conferencing, e.g. spatial distribution, mixing of participants echo suppression in two-way loud-speaking telephone systems H04M9/02; sound field processing per se H04S7/30

Abstract

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Claims

1. A tissue slitting apparatus comprising:

a laser light source configured to generate light energy;

a shaft configured to be coupled to the laser light source, wherein the shaft is flexible, the shaft having;

a proximal end;

a distal end;

a first inner lumen running from the proximal end to the distal end and configured to receive at least one implanted object;

an axis running along the first inner lumen of the shaft;

a second inner lumen disposed radially outward of the first inner lumen; and

at least one optical fiber carried by the shaft and exposed distally to the distal end of the shaft, the at least one optical fiber being configured to receive the light energy from the laser light source, and wherein the at least one optical fiber, upon being exposed distally to the distal end of the shaft, comprises a predetermined structure comprising;

a first section extending through the second inner lumen and parallel to the axis running along the first inner lumen of the shaft;

an elbow section, wherein the elbow section comprises a first leg having a first end and a second leg having a second end, wherein the first end is coupled to and extending from the first section and disposed distally relative to the distal end of the shaft, wherein the first leg and the second leg form an acute angle such that the first end of the elbow and the second end of the elbow are oriented in a proximal direction, wherein the first end is directed toward the second inner lumen; and

a second section coupled to the second end of the elbow and disposed proximally relative to the elbow, the second section partially disposed within the first inner lumen of the shaft, the second section extending at the acute angle relative to the first section and toward the axis running along the first inner lumen of the shaft, the second section configured to emit the light energy transversely toward the axis to slit tissue at least partially surrounding the implanted object while the implanted object is disposed in the first inner lumen.

2. The tissue slitting apparatus of claim 1, wherein the laser light source is configured to output one or more wavelengths of laser light.

3. The tissue slitting apparatus of claim 1, wherein the laser light source is an XeCl Excimer laser and the light energy has a wavelength of 308 nm.

4. The tissue slitting apparatus of claim 1, further comprising:

a second laser light source configured to generate light energy, wherein the light energy generated by the second laser light source has a wavelength other than 308 nm.

5. The tissue slitting apparatus of claim 1, further comprising:

at least one optical component disposed between the at least one optical fiber and the laser light source, wherein the at least one optical component is configured to alter a characteristic associated with the light energy.

6. The tissue slitting apparatus of claim 5, wherein the at least one optical component is one or more of a filter, lens, prism, coating, film, and deposited layer of optically transmissive material.

7. The tissue slitting apparatus of claim 1, wherein the tissue slitting apparatus is configured to subject a tissue growth to a slitting action only about a partial periphery of an internal diameter of the tissue growth surrounding the implanted object at any point along the implanted object.

8. The tissue slitting apparatus of claim 1, wherein the at least one optical fiber is configured to move relative to the distal end from a first position to a second position as the tissue slitting apparatus contacts a tissue growth.

9. The tissue slitting apparatus of claim 8, wherein the at least one optical fiber moves against a spring, and wherein the spring is configured to exert a force against the at least one optical fiber and maintain the first position of the at least one optical fiber when the tissue slitting apparatus moves past the tissue growth.

10. A tissue slitting apparatus comprising:

a laser light source configured to generate light energy;

a shaft configured to be coupled to the laser light source, wherein the shaft is flexible, the shaft having;

a proximal end;

a distal end;

a first inner lumen running from the proximal end to the distal end and configured to receive at least one implanted object;

an axis running along the first inner lumen of the shaft;

a second inner lumen disposed radially outward of the first inner lumen, wherein the first inner lumen and the second inner lumen terminate at the distal end of the shaft; and

at least one optical fiber carried by the shaft and exposed distally to the distal end of the shaft, the at least one optical fiber being configured to receive the light energy from the laser light source, and wherein the at least one optical fiber, upon being exposed distally of the distal end of the shaft, comprises a predetermined structure comprising;

a first section extending through the second inner lumen and parallel to the axis running along the first inner lumen of the shaft;

an elbow comprising a first end and a second end, wherein the first end is coupled to the first section and disposed distally relative to the distal end of the shaft, wherein the elbow comprises an acute angle relative to the first section; and

a second section coupled to the second end of the elbow and disposed proximally relative to the elbow, the second section partially disposed within the first inner lumen of the shaft, the second section extending at the acute angle relative to the first section and toward the axis running along the first inner lumen of the shaft, the second section configured to emit the light energy transversely toward the axis to slit tissue at least partially surrounding the implanted object while the implanted object is disposed in the first inner lumen.