DEVICE FOR CATHETER SHEATH RETRACTION

• US 20100174290A1
• Filed: 07/10/2008
• Published: 07/08/2010
• Est. Priority Date: 07/11/2007
• Status: Active Grant

• Current Assignee: C.R. Bard, Inc. (Becton, Dickinson & Co)
• Original Assignee: C.R. Bard, Inc. (Becton, Dickinson & Co)
• Inventors: Wüebbeling, Martin, Vogel, Michael, Dorn, Jürgen
• Granted Patent: US 8,500,789 B2
• Time in Patent Office: Days
• US Class Current: 606/108
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/9517 handle assemblies therefor
• CPC Class Codes: A61F 2/966 with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
• CPC Class Codes: A61M 25/0136 Handles therefor

Abstract

There is disclosed herein a device (1) for moving an elongate member relative to an. elongate body through which it extends, the device comprising: a housing (10) connectable to the elongate body; a mover (20) associated with the housing and connectable to the elongate member for moving the elongate member relative to the housing and relative to a connected elongate body; and a pre-mover (40) for adjusting an elongate member connected to the mover relative to an elongate body connected to the housing in preparation for moving the elongate member with the mover. There is also disclosed a related surgical apparatus.

Claims

1. A device for moving an elongate member relative to an elongate body through which it at least partially extends, the device comprising:

a housing connectable to the elongate body;

a mover associated with the housing and connectable to the elongate member for moving the elongate member relative to the housing and relative to a connected elongate body; and

a pre-mover for adjusting the elongate member connected to the mover relative to the elongate body connected to the housing in preparation for moving the elongate member with the mover.

2. The device of claim 1, wherein the pre-mover resists movement of the elongate member by the mover prior to adjusting the elongate member.

3. The device of claim 1 or 2, wherein the pre-mover is configured for adjusting the elongate member relative to the elongate body to reduce slack between the elongate member and the elongate body to ensure direct subsequent relative movement therebetween by the mover.

4. The device of claim 1, 2 or 3, wherein the pre-mover is configured to adjust the mover relative to the housing so as to relatively adjust the elongate member and the elongate body respectively connected thereto.

5. The device of claim 1, 2, 3 or 4, wherein the pre-mover is configured to effect a predetermined relative adjustment between the elongate member and the elongate body.

6. The device of any preceding claim, wherein the pre-mover is configured to become inoperable following adjustment of the elongate member.

7. The device of any preceding claim, wherein the mover is operable to move the elongate member only in a first direction relative to the elongate body.

8. The device of any preceding claim, wherein the device is configured for the mover to move the elongate member towards the housing relative to the elongate body, which is fixedly connected to the housing.

9. The device of any preceding claim, wherein the device further comprises an accumulator, by which the elongate member is connectable to the mover and a portion of the elongate member is formed as an accumulation in the housing.

10. The device of any preceding claim, wherein the device further comprises a limiter for limiting the extent of movement of the elongate member relative to the elongate body.

11. The device of claim 10, wherein the limiter comprises a band of substantially inextensible material which is connected at one end to, and is wound on, a spool which is mounted to the housing, the band being connected at the other end to a winding member of the mover onto which the band is wound from the spool as the mover moves the elongate member, thereby permitting movement of the mover until the band is fully unwound from the spool and thereafter preventing further movement of the elongate member by the mover.

12. The device of any preceding claim, wherein:

the elongate body comprises a surgical catheter configured for insertion into a bodily lumen, and which includes a sheath which surrounds at least a distal end portion of the catheter;

the elongate member is a wire for moving the sheath relative to the catheter; and

the housing is connectable to a proximal end of the catheter.

13. The device of any preceding claim, wherein the mover comprises a take-up reel mounted to rotate relative to the housing onto which the elongate member is wound to effect movement thereof.

14. The device of any preceding claim, wherein the mover includes an actuator by which a user of the device may actuate the mover to move the elongate member.

15. The device of claim 14, wherein the actuator includes a trigger pivotally mounted to the housing to pivot between an extended position and a depressed position and configured to rotate a trigger gear by which to actuate the mover.

16. The device of claim 15, wherein the trigger includes a planetary gear by which to rotate the trigger gear.

17. The device of claim 15 or 16, wherein the trigger gear is coupled to a drive shaft of the mover by a one-way clutch so as to enable the trigger gear to rotate the drive shaft when depressed towards the depressed position but preventing the trigger gear from rotating the drive shaft when returned towards the extended position, the trigger being biased towards the extended position.

18. The device of any preceding claim, wherein the mover includes:

a toothed gear mounted to rotate relative to the housing; and

a leaf spring fixedly mounted to the housing and arranged so that one end thereof engages with the teeth of the toothed gear at a non-radial angle of incidence to the gear, the leaf spring being resiliently flexible to disengage from the gear teeth and allow rotation of the toothed gear in one direction and to engage the gear teeth and substantially resist rotation of the gear in the other direction, so as to effect a ratchet arrangement to permit actuation of the mover to move the elongate member only in one direction relative to the elongate body.

19. The device of any preceding claim, wherein the pre-mover includes a rack gear configured to engage initially with a pinion gear of the mover, so that adjustment of the elongate member relative to the elongate body is effected by actuation of the rack gear to rotate the pinion gear of the mover.

20. The device of claim 19, wherein the rack gear is mounted to a slider arm which is connected at one end to a button which is mounted to slide relative to the housing and is arranged to be actuated by a user to effect actuation of the rack gear.

21. The device of any preceding claim, wherein the housing forms a sealed unit in which the mover and pre-mover are mounted to be actuated by a user.

22. The device of claim 21, wherein the housing is sized and configured, and an actuator of the mover and of the pre-mover are arranged, so as to facilitate operation of the device with a single hand by a user.

31. A surgical apparatus including the device according to any preceding claim and having an elongate body connected to the housing and an elongate member connected to the mover.

23. A device for moving an elongate member by a predetermined distance relative to an elongate body through which it at least partially extends, thereby to release a stent at the distal end of the elongate body, the device comprising:

a take-up reel onto which the elongate member is wound when it is moved; and

a limiter that is configured to limit further rotation of the take-up reel after a length of the elongate member has been taken up on the reel to move the elongate member said pre-determined distance,

wherein the limiter comprises a tethered line, which is configured to be progressively consumed when the take-up reel is rotated until the tethered line anchors the take-up reel against further rotation, one end of the tethered line being provided with a line connector by which it may be attached to a limiter reel on which it is to be taken up to be consumed, and

wherein the limiter reel is provided with plural reel connectors to which the line connector may be connected to attach the tethered line to the limiter reel.

24. The device of claim 23, wherein the line connector is a male connector and the reel connectors are female connectors into which the male connectors can be connected.

25. The device of claim 23 or 24, wherein the line connector is a ball or cylinder joined onto the end of the tethered line.

26. The device of claim 23, 24 or 25, wherein the tethered line has a total length, of which a consumable length corresponding to the length of said elongate member to be taken up may form all or a portion, the limiter being adjustable to set the consumable length to correspond to the length of said elongate member to be taken up prior to use of the device for effecting the predetermined relative movement between the elongate body and the elongate member, preferably during manufacture-and-assembly of the device.

29. The device of any one of claims 23 to 28, wherein the tethered line is carried on a tether spool, and is unspooled from the tether spool while being progressively consumed during rotation of the take-up reel.

30. The device of any one of claims 23 to 29, wherein the elongate body is a catheter and the elongate member is a sheath retraction wire for proximally retracting a sheath that surrounds the abluminal surface of the stent to be released at the catheter distal end.

32. The surgical apparatus according to claim 30, further including a stent carried by the elongate body for delivery to a target site of a patient and releasable from the elongate body at the target site by movement of the elongate member relative to the elongate body.

33. The surgical apparatus according to claim 32, wherein the stent is a self-expanding stent suitable to be implanted at a treatment location in a bodily lumen, and wherein the device is configured to effect a pre-movement adjustment of the elongate member relative to the elongate body, said adjustment including a preliminary movement of the elongate member relative to the elongate body insufficient to release any portion of said stent to an expanded diameter permitting circumferential engagement with the inner wall of the bodily lumen at the intended treatment location.

34. The surgical apparatus according to claim 33, wherein said preliminary movement is insufficient to release any portion of said stent from the elongate body.

35. The surgical apparatus according to claim 32, wherein the stent is a self-expanding stent, and wherein the device is configured to effect a pre-movement adjustment of the elongate member relative to the elongate body, said adjustment including a preliminary movement of the elongate member relative to the elongate body insufficient to release any portion of the stent to an expanded diameter of more than 110% of the stent unreleased diameter, preferably 105% or less of the stent unreleased diameter.

27. A device for moving an elongate member by a predetermined distance relative to an elongate body through which it at least partially extends, thereby to release a stent at the distal end of the elongate body, the device comprising:

a take-up reel onto which the elongate member is wound when it is moved; and

a limiter that is configured to limit further rotation of the take-up reel after a length of the elongate member has been taken up on the reel to move the elongate member said pre-determined distance,

wherein the limiter comprises a tethered line, which is configured to be progressively consumed when the take-up reel is rotated until the tethered line anchors the take-up reel against further rotation,

wherein the tethered line to be consumed has a consumable length corresponding to the length of said elongate member to be taken up, and

wherein (i) a plurality of tether lines are provided having different respective consumable lengths, from which the tethered line to be consumed is selected having a consumable length which corresponds to the length of said elongate member to be taken up, or (ii) a tether line is provided having reference markings along its length indicating different consumable lengths corresponding to different lengths of said elongate member which can be taken up, the consumable length being set by the tether line being consumed, prior to moving the elongate member, up to the reference marking which indicates a remaining consumable length corresponding to the length of said elongate member to be taken up.

28. The device of claim 27, wherein the tethered line is consumed by being taken up on a limiter reel.

36. A stent delivery device, comprising:

a housing connectable to an elongate body;

a mover coupled to a housing and connected to an outer sheath disposed over a stent compressed about a distal end of the elongate body; and

a pre-mover associated with the housing having a locked position engaging the mover and an unlocked position in which the mover is released, wherein movement of the pre-mover from the locked position to the unlocked position prepares the outer sheath for deployment of the stent.

37. A stent delivery device, comprising:

a take-up reel onto which a sheath retraction line is wound when an outer sheath which surrounds a compressed stent at a distal portion of the delivery device is retracted; and

a limiter which limits the length of the sheath retraction line which may be taken up on the reel so as to limit retraction of the outer sheath,

wherein the limiter comprises a limiter reel and a tethered line which is progressively consumed by the limiter reel when the take-up reel is rotated and which anchors the take-up reel against further rotation when fully consumed, one end of the tethered line being provided with a line connector attached to the limiter reel, and

wherein the line connector is connected to one of plural reel connectors disposed around the limiter reel.

38. A stent delivery device, comprising:

a take-up reel onto which a sheath retraction line is wound when an outer sheath which surrounds a compressed stent at a distal portion of the delivery device is retracted; and

a limiter which limits the length of the sheath retraction line which may be taken up on the reel so as to limit retraction of the outer sheath,

wherein the limiter comprises a limiter reel and a tethered line connected to the limiter reel, which is progressively consumed by the limiter reel when the take-up reel is rotated,

wherein the tethered line has a consumable length corresponding to the retraction limit of the outer sheath, and

wherein (i) one or more further tether lines are provided having respective consumable lengths different from the length of the tethered line connected to the limiter reel, or (ii) the tether line connected to the limiter reel has reference markings along its length indicating different available consumable lengths, the consumable length which corresponds to the retraction limit of the outer sheath being indicated by one said reference marker.

39. A device substantially as described hereinbefore with reference to the accompanying drawings.

40. A surgical apparatus substantially as described hereinbefore with reference to the accompanying drawings.