Steerable device having a corewire within a tube and combination with a functional medical component

• US 20060200047A1
• Filed: 03/04/2005
• Published: 09/07/2006
• Est. Priority Date: 03/06/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Ganesan, Kavitha, Wlodarski, Grace, Galdonik, Jason A., Ogle, Matthew F., Pokorney, James
• Granted Patent: US 8,092,483 B2
• Time in Patent Office: Days
• US Class Current: 600/585
• CPC Class Codes: A61M 25/0054 with regions for increasing flexibility
• CPC Class Codes: A61M 25/0133 Tip steering devices
• CPC Class Codes: A61M 25/0138 having flexible regions as a result of weakened outer material, e.g. slots, slits, cuts, joints or coils

Abstract

An integrated guiding device has a tube and a corewire within the tube and a torque coupler. The torque coupler can couple the rotational motion of the tube with the rotational motion of the corewire. The wire can be moved longitudinally at least some amount relative to the tube. The device can further comprise a functional medical structure, such as an embolism protection structure. The device can be used in medical procedures, such as less invasive procedures within the cardiovascular system. Improved fiber based embolism protection devices comprise fiber bundles that are twisted prior to delivery.

Claims

1. A biocompatible integrated guiding device comprising a tube and a corewire within the lumen of the tube, the tube having at least one slot within the tube material, wherein the slot is positioned along the distal half of the tube.

2. The biocompatible integrated guiding device of claim 1 wherein the tube comprises a plurality of slots.

3. The biocompatible integrated guiding device of claim 2 wherein the plurality of slots are oriented transverse to the axis of the tube.

4. The biocompatible integrated guiding device of claim 2 further comprising one or more torque couplers that can couple the rotational motion of the tube with the rotational motion of the corewire.

5. The biocompatible integrated guiding device of claim 2 wherein the plurality of slots are located along a slotted portion at the distal end of the catheter.

6. The biocompatible integrated guiding device of claim 2 wherein the plurality of slots have two configurations that are mirror images of each other through a plane passing perpendicular to the axis of the tube.

7. The biocompatible integrated guiding device of claim 6 wherein the different configurations alternate with respect to adjacent slots.

8. The biocompatible integrated guiding device of claim 1 wherein the slot penetrates through the tube to the inner lumen.

9. The biocompatible integrated guiding device of claim 1 wherein the tube comprises a key way within the lumen having a surface with an asymmetrical cross section and the corewire comprises a key having a surface with an asymmetrical cross section complimentary to the asymmetrical cross section of the key way surface.

10. A method of forming a catheter, the method comprising:

cutting slots along a tubular member wherein the slots have a transverse component to the slot orientation.

11. The method of claim 10 wherein the cutting is performed with a laser.

12. The method of claim 10 wherein the cutting is performed with electrostatic discharge machining.

13. A medical system comprising:

a corewire;

a tube over at least a portion of the corewire;

a medical device operably connected to the corewire and tube at or near their distal end; and

a pull element operably connected to the corewire and tube at or near their respective proximal ends, the pull element comprising a slide wherein the position of the slide controls the relative position of the corewire within the tube over a range of motion,

wherein relative position of the corewire and the tube actuates the medical device and wherein the relative position of the corewire within the tube has at least one stable position effectively locking the relative position between the end points of the range of motion.

14. The medical system of claim 13 wherein the corewire has a bend that provides friction against the tube wherein the friction provides the effective locking of the corewire.

15. The medical system of claim 13 wherein the pull element comprises a spring loaded button that provided continuous locking of the corewire over the allowed range of motion of the corewire to provide the effective locking of the corewire

16. The medical system of claim 13 wherein the medical device comprises a fiber-based embolism protection device.

17. The medical system of claim 16 wherein the fiber-based embolism protection device comprises a plurality of fibers in a bundle.

18. The medical system of claim 17 wherein the position of the corewire relative to the tube controls the degree of flaring of the center of the fibers outward from the corewire.

19. The medical system of claim 18 wherein the pull element has markings that indicate a desired positioning of the corewire for a particular vessel size.

20. The medical system of claim 13 wherein the pull element jackets the corewire interfacing with the pull element.

21. A surgical system comprising:

a guide structure;

a filter element attached to the distal end of the guide structure; and

an aspiration catheter mounted over the guide structure, the aspiration catheter having a central lumen and comprising a suction element attached near the distal end of the aspiration catheter,

wherein the aspiration catheter has a length no more than about ¾

of the length of the guide structure.

22. The surgical system of claim 21 wherein the guide structure comprises a corewire and a tube over the core wire.

23. The surgical system of claim 22 wherein the guide structure further comprises a backend tool that controls the relative position of the corewire relative to the tube.

24. The surgical system of claim 22 wherein the relative position of the corewire and the tube control the deployment of the filter element from a low profile configuration to an expanded configuration that extends further outward from the axis of the guide structure relative to the low profile configuration.

25. The surgical system of claim 24 wherein the filter element comprises a plurality of fibers in a bundle wherein the fibers are attached to the corewire and the tube with the fibers bending in the expanded configuration.

26. The surgical, system of claim 21 wherein the filter element comprises a plurality of fibers in a bundle.

27. The surgical system of claim 26 wherein the guide structure has a length of no more than about 100 centimeters.

28. The surgical system of claim 26 wherein the suction device comprises a syringe that is attached at a port to a tubular component of the aspiration catheter.

29. The surgical system of claim 21 further comprising a cannula having a central lumen and a pointed tip.

30. The surgical system of claim 29 wherein the cannula has a slit to provide for placement and removal from a position with the guide structure within the central lumen of the cannula.

31. The surgical system of claim 29 wherein the cannula has an adjustable diameter with an outer diameter within the range of adjustable diameters less than the inner diameter of the aspiration catheter.

32. A method for delivering a filter into an exposed vessel of a patient, the method comprising:

inserting a filter element into the exposed vessel wherein the filter element is attached to a guide structure; and

applying aspiration during at least a portion of the process of removal of the filter element.

33. The method of claim 32 wherein the filter element comprises a plurality of fibers in a bundle and wherein the guide structure comprises a corewire and a tube over the corewire wherein the relative position of the corewire and the tube control the deployment of the filter element from a low profile configuration to an expanded configuration that extends further outward from the axis of the guide structure relative to the low profile configuration.

34. The method of claim 33 further comprising actuating the filter to the expanded configuration following insertion of the filter.

35. The method of claim 34 further comprising performing a procedure within the vessel after the filter is in an expanded configuration prior to the application of suction.

36. The method of claim 33 wherein the removal of the device comprises withdrawing the filter element at least part way into the aspiration catheter.

37. The method of claim 36 wherein suction is applied during the transition of the filter element from an expanded configuration to a removal configuration and during withdrawal of the filter at least part way into the aspiration catheter.

38. The method of claim 32 wherein the filter element is inserted to capture emboli generated during an anastimosis procedure.

39. The method of claim 32 wherein the filter element is inserted to capture emboli generated during a carotid endartorectomy.