SINUS ILLUMINATION LIGHTWIRE DEVICE

• US 20080228085A1
• Filed: 05/19/2008
• Published: 09/18/2008
• Est. Priority Date: 09/15/2006
• Status: Active Grant

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Jenkins, Thomas, Goldfarb, Eric, Vo, Tom Thanh, Wisted, Thomas J.
• Granted Patent: US 9,820,688 B2
• Time in Patent Office: Days
• US Class Current: 600/478
• CPC Class Codes: A61B 1/00071 Insertion part of the endoscope body A61B1/0055 takes precedence
• CPC Class Codes: A61B 1/0008 characterised by distal tip features
• CPC Class Codes: A61B 1/00117 Optical cables in or with an endoscope
• CPC Class Codes: A61B 1/00126 optical, e.g. for light supply cables
• CPC Class Codes: A61B 1/00128 mechanical, e.g. for tubes or pipes
• CPC Class Codes: A61B 1/233 for the nose, i.e. nasoscopes , e.g. testing of patency of Eustachian tubes
• CPC Class Codes: A61B 2017/246 for cleaning of the nose
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/411 Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• CPC Class Codes: A61M 2210/0618 Nose
• CPC Class Codes: A61M 2210/0681 Sinus (maxillaris)
• CPC Class Codes: A61M 25/0105 Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B

Abstract

An illuminating wire medical device may include an elongate flexible housing and an illuminating fiber and a core wire extending through at least part of the housing, the core wire providing desired pushability and torquability. The illuminating device may further include a connector assembly cooperating with the illuminating fiber to accommodate changes in length and to absorb forces applied during use of the device.

Claims

1. An illuminating guidewire device for use at a site within a patient'"'"'s body, the guidewire device comprising:

an elongate flexible housing having a proximal end, a distal end configured to be placed at the site within a patient'"'"'s body, and a lumen extending through the housing from the proximal end to the distal end;

at least one illuminating fiber extending through the lumen of the housing; and

a connector coupled with the proximal end of the elongate housing and a proximal end of the at least one illuminating fiber, the connector including a sliding member attached to the elongate housing so that the proximal end of the housing can move longitudinally within the connector;

wherein the proximal end of the at least one illuminating fiber is fixedly attached to the connector and extends into the proximal end of the housing such that the housing can slide over the at least one fiber as it moves longitudinally within the connector.

2. The device of claim 1, wherein the elongate housing has sufficient length so that its distal end may be passed into a nostril of the patient and through an opening into a paranasal sinus while its proximal end remains outside the patient.

3. The device of claim 1, wherein elongate housing comprises:

a proximal portion; and

a distal portion that is more flexible than the proximal portion.

4. The device of claim 3, wherein the proximal portion comprises a cable tube and the distal portion comprises a coil, and wherein a distal end of the cable tube is attached to a proximal end of the coil.

5. The device of claim 3, wherein the at least one illuminating fiber comprises at least two illuminating fibers.

6. The device of claim 5, further comprising a core wire disposed in the housing.

7. The device of claim 6, wherein the core wire is attached to the housing at two attachment points, one point located at or near the housing distal end and the other point located at or near a junction between the proximal and distal portions of the housing.

8. The device of claim 7, wherein the core wire extends proximally from the junction but does not extend all the way to the proximal end of the housing, and wherein a proximal end of the core wire is not attached to the housing.

9. The device of claim 1, wherein the sliding member comprises a cylindrical member configured to rotate within the connector, thus allowing the housing to rotate relative to the connector.

10. The device of claim 9, wherein the connector further comprises:

a proximal portion;

a distal portion; and

a bore extending through the proximal and distal portions and having a greater diameter in the proximal portion than in the distal portion,

wherein the sliding member is configured to slide and rotate within the bore in the proximal portion but is too large to slide into the bore in the distal portion of the connector, the distal portion thus acting as a stop for the sliding member.

11. The device of claim 10, wherein the proximal end of the illuminating fiber is attached to a centering grommet fixed within the connector.

12. The device of claim 10, wherein the sliding member comprises a keyed grommet configured to limit rotation of the elongate housing relative to the connector.

13. An illuminating guidewire assembly, comprising:

a connector including a proximal portion, a distal portion and a sliding member disposed in the proximal portion;

an elongate flexible body coupled with the sliding member and extending through and distally from the distal portion of the connector, the body having a lumen;

an illuminating fiber fixedly attached to the connector and extending through the lumen of the elongate body; and

a core wire disposed in the lumen of the elongate body, wherein the core wire is shorter than the elongate body, and wherein the core wire is disposed nearer a distal end of the elongate body than a proximal end of the elongate body.

14. The assembly of claim 13, wherein the elongate body comprises:

a proximal portion; and

a distal portion that is more flexible than the proximal portion.

15. The assembly of claim 14, wherein the core wire is attached to an inner wall of the elongate body lumen at or near the distal end of the elongate body and at or near a junction between the proximal portion and the distal portion, wherein a proximal end of the core wire is not directly attached to the inner wall of the elongate body.

16. The assembly of claim 15, wherein the illuminating fiber comprises a proximal end attached to the connector and extends into and through the lumen of the elongate body to the distal end of the body.

17. The assembly of claim 16, wherein the illuminating fiber comprises two illuminating fibers, and wherein the elongate body lumen is sufficiently large to allow the body to slide over the fibers.

18. The assembly of claim 13, wherein the connector further comprises a stop to prevent the sliding member from sliding distally out of the connector.

19. An illuminating guidewire, comprising:

an elongate flexible housing including an inner passage, a distal end, a mid-section and a proximal end; and

a core wire disposed within the inner passage, wherein the core wire commences at the mid-section and extends to the distal end of the housing.

20. The device of claim 19, further comprising a connector slidably attached to the proximal end of the housing.

21. The device of claim 20, further comprising at least one illuminating fiber fixedly attached to the connector and extending from the connector through the housing to the distal end of the housing such that the housing can slide over the fiber.

22. The device of claim 21, wherein the housing is configured to rotate relative to the connector.

23. A method for visually confirming the positioning of a distal end of a device placed within a patient, said method comprising:

inserting a distal end of an illuminating device into a patient,

injecting a light activated drug through the illuminating device into the patient;

emitting light from the distal end portion of the illuminating device;

observing transillumination resulting from the light emitted from the distal end portion of the illuminating device that occurs on an external surface of the patient as enhanced by the light activated drug; and

correlating the location of the observed transillumination on the external surface of the patient with an internal location of the patient that underlies the location of observed transillumination, to confirm positioning of the distal end of the illuminating device.

24. The method of claim 23, wherein the illuminating device comprises an illuminating guidewire.

25. The method of claim 23, wherein the illuminating device comprises an ostium seeker device.

26. The method of claim 23, wherein the illuminating device comprises a sinus suction instrument.

27. The method of claim 23, wherein the illuminating device comprises an integrated wire dilatation catheter, wherein an integrated illuminating guidewire extends distally of a distal end of a dilatation catheter of said integrated wire dilatation catheter.

28. The method of claim 23, wherein the observing is performed by direct line of sight human observation, without the need for any visualization equipment.

29. The method of claim 23, wherein the distal end is inserted into a paranasal sinus of the patient.

30. The method of claim 29, wherein the distal end portion is inserted through an ostium of the paranasal sinus and into the sinus.

31. The method of claim 30, wherein the distal end is initially inserted through a nostril of the patient and then advanced through the ostium and into the paranasal sinus.

32. The method of claim 31, further comprising:

inserting a scope through the nostril of the patient, wherein the illuminating device is inserted adjacent the scope; and

visualizing advancement of the distal end portion of the illuminating device via the scope as the distal end portion is advanced toward an ostium of the sinus.

33. The method of claim 23, further comprising observing motion of the transillumination resulting from the light emitted from the distal end of the illuminating device as the distal end is moved relative to the patient.

34. The method of claim 23, further comprising inserting a guide within the patient prior to inserting the illuminating device, and wherein the distal end of the illuminating device is inserted through the guide.

35. The method of claim 23, wherein the illuminating device is preloaded in a guide, and wherein the method further comprises:

inserting the guide and preloaded illuminating device within the patient; and

advancing the illuminating device relative to the guide to extend a distal end of the illuminating device distally out of a distal end of the guide.

36. The method of claim 23, wherein the illuminating device comprises an illuminating guidewire, and wherein the method further comprises:

advancing a working device over the illuminating guidewire to position a working end of the working device at a target location;

performing a procedure with the working device at the target location; and

removing the working device from the patient.