MEDICAL GUIDEWIRES FOR TORTUOUS VESSELS

• US 20160199620A1
• Filed: 01/09/2015
• Published: 07/14/2016
• Est. Priority Date: 01/09/2015
• Status: Active Grant

• Current Assignee: Mivi Neuroscience, Inc.
• Original Assignee: Mivi Neuroscience, Inc.
• Inventors: Pokorney, James, Ogle, Matthew F.
• Granted Patent: US 10,518,066 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61M 2025/09083 having a coil around a core
• CPC Class Codes: A61M 2025/09166 having radio-opaque features
• CPC Class Codes: A61M 25/0136 Handles therefor
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/09 Guide wires
• CPC Class Codes: A61M 25/09033 with fixed mandrils, e.g. mandrils fixed to tip; Tensionable wires
• CPC Class Codes: A61M 25/09041 Mechanisms for insertion of guide wires
• CPC Class Codes: A61M 25/0905 extendable, e.g. mechanisms for extension

Abstract

Three groups of guidewire embodiments are described with particularly suitable structures for navigating circuitous vessels, especially blood vessels of the brain. Some of the guidewires have a hyperbolic taper that provides desired flexibility. In some embodiments, an integrated guide structure provides for extension in the blood vessel of a corewire to provide for extended reach of the guidewire. In further embodiments, the guidewire has a flexible tip that can be guided directly by the flow in the vessel.

Claims

1. An integrated guiding device comprising:

a corewire, and

an overtube with a lumen wherein the corewire extends through the lumen of the overtube,

the corewire comprising a flattened section along the distal half of the corewire, and the overtube comprising an indentation aligned with the flattened section with a fraction of the lateral extent of the flattened section of the corewire wherein the flattened section and indentation provide for torque coupling of the corewire and overtube and a defined amount of lateral motion of the corewire relative to the overtube,

wherein the corewire extends from a distal end of the overtube in a configuration with the overtube drawn in a proximal direction relative to the corewire to the extent provided by the aligned indentation of the overtube interfacing with the flattened section of the corewire and wherein the portion of the corewire extending from the overtube is unattached to the overtube.

2. The integrated guide structure of claim 1 wherein the corewire extends at least 2 centimeters from the distal end of the overtube in a configuration with the overtube drawn in a proximal direction relative to the corewire to the extent provided by the aligned indentation of the overtube interfacing with the flattened section of the corewire and wherein the extent of lateral motion of the corewire relative to the overtube is at least about 1 centimeter based on the constraints provided by the aligned indentation of the overtube interfacing with the flattened section of the corewire.

3. The integrated guiding device of claim 1 wherein the corewire has a low friction polymer coating over at least a portion of its outer surface.

4. The integrated guiding device of claim 1 wherein the flattened section is at least about 2 centimeters in length.

5. The integrated guiding device of claim 1 further comprising a second flattened section along the corewire and a second indentation in the overtube aligned with the second flattened section with a fraction of the lateral extent of the second flattened section wherein the second flattened section and the second indentation provide for torque coupling of the corewire and overtube.

6. The integrated guide device of claim 1 further comprising a distal coil attached to the distal end of the overtube.

7. The integrated guiding device of claim 1 wherein the distal coil is covered with a polymer.

8. The integrated guide device of claim 1 wherein the distal end of the overtube has cuts to increase flexibility.

9. A method for positioning a device for performing a therapeutic procedure in the vasculature of a patient, the method comprising:

extending a corewire relative to an overtube of an integrated guide structure to extend the distal reach of the device in a vessel; and

guiding a therapeutic treatment device over the integrated guide structure to a treatment position at least a portion of which extends beyond the distal end of the overtube.

10. The method of claim 9 wherein the vasculature is the neuro-arterial vasculature down stream from the carotid arteries.

11. The method of claim 9 wherein the therapeutic treatment device comprises an aspiration catheter or a device designed to engage a clot.

12. The method of claim 11 further comprising removing at least a portion of a clot using the therapeutic device.

13. The method of claim 9 wherein the integrated guide structure comprises a torque coupler comprising an indentation in the overtube and a flattened portion on the corewire, and wherein the distal end of the overtube comprises a resilient segment.

14. A guidewire comprising a solid wire of a biocompatible metal, having a length from about 90 cm to about 300 cm, a proximal diameter from about 0.0075 inches (in) about 0.03 in, and comprising an approximately hyperbolic taper along the distal third of the guidewire length forming a reduced diameter of the wire wherein the hyperbolic taper has a length form about 10 cm to about 60 cm.

15. The guidewire of claim 14 wherein the hyperbolic taper reduces the diameter over the length of the grind by about 20% to about 90% of the proximal diameter adjacent the taper.

16. The guidewire of claim 14 further comprising a coil secured over a portion of the hyperbolic taper section of the wire.

17. The guidewire of claim 16 further comprising a ball weld at the distal end of the wire securing the coil on the wire.

18. The guidewire of claim 16 further comprising a torque stabilizer, a proximal braze securing the proximal end of the coil to the wire or both.

19. The guidewire of claim 14 wherein the wire has a length from about 100 centimeters to about 250 centimeters, a diameter along the proximal section of the wire from about 0.025 inches to about 0.009 inches and a diameter at the distal tip of the wire from about 0.0015 inches to about 0.006 inches.

20. A guidewire comprising a metal wire having a length from about 10 cm to about 400 cm, a proximal diameter from about 0.05 mm to about 1.5 mm and a distal polymer tip having a flexible flattened section extending from the metal shaft.

21. The guidewire of claim 20 further comprising a radiopaque element at or near the distal end.

22. The guidewire of claim 20 wherein the distal polymer tip comprises nature rubber, polyisoprenes, polybutadiene, neoprene, butyl rubber, nitrile rubber, silicone, butyl rubber, ethylene propylene rubber, polyacrylic rubber, polyurethanes, mixtures thereof or the like.

23. The guidewire of claim 20 wherein the flexible flattened section of the distal polymer tip has a length from about 1 centimeter to about 20 centimeters.

24. A method comprising steering a guidewire within a blood vessel toward a selected branch wherein the guidewire comprises a distal polymer tip having a flattened section, the method comprising orienting a guidewire such that flow to the branch vessel steers the distal tip toward the selected branch.