Method and apparatus for separating a coiled structure from biological tissue

• US 4,988,347 A
• Filed: 11/09/1988
• Issued: 01/29/1991
• Est. Priority Date: 11/09/1988
• Status: Expired due to Term

• Current Assignee: Cook Pacemaker Corporation Route
• Original Assignee: Cook Pacemaker Corporation (Cook Group Incorporated)
• Inventors: Goode, Louis, Shipko, Frederick J.
• Primary Examiner(s): Howell, Kyle L.
• Assistant Examiner(s): Schaetzle, Kennedy J.
• Application Number:
  US07/269,771
• Time in Patent Office: 811 Days
• Field of Search: 128/783, 128/784, 128/785, 128/786, 128/419 P, 128/642, 128/328 V, 606/99
• US Class Current: 606/1
• 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: A61N 2001/058 Fixing tools

Abstract

Heart lead removal apparatus is disclosed for removing a heart lead from the wall of a heart through a blood vessel leading to the heart. The apparatus comprises a flexible stylet wire with an expandable wire coil attached to the distal end for engaging the coiled structure of the heart lead. The stylet wire is inserted in the longitudinal passageway of the coiled structure to the distal end of the heart lead where the tip is typically secured to the heart wall with a number of tines formed from the insulating material surrounding the coiled structure. When inserted, the stylet wire is rotated in a direction to unwind and expand the wire coil and engage the heart lead coiled structure, thereby securing the stylet wire to the heart lead. A separator tube is inserted over the proximal end of the stylet wire and the heart lead and moved along the entire length of the heart lead to first separate the restricted heart lead from the blood vessel leading to the heart cavity. When fully inserted, the separator tube is positioned against the heart cavity wall, and the stylet wire is pulled while the separator tube is rotated back and forth to separate the heart lead tip from the heart wall. The separator tube, stylet wire, and heart lead are then removed from the heart cavity and blood vessel without causing any significant injury to the heart cavity wall.

Claims

1. Apparatus for separating a length of a coiled structure having a longitudinal passageway therein from biological tissue, comprising:

wire means having a distal end for inserting in said longitudinal passageway of said coiled structure;

coil means attached about said distal end of said wire means for radially expanding and securing said wire means to said coiled structure; and

tube means positionable about said wire means and said length of said coiled structure for separating said coiled structure from said biological tissue when said wire means is secured to said coiled structure.

2. The apparatus of claim 1 further comprising control means positionable about a proximal end of said wire means for rotating said radially expandable means to engage said coiled structure.

3. The apparatus of claim 1 wherein a distal end of said tube means has a cutting edge.

4. The apparatus of claim 1 wherein said radially expandable means includes turns of wire.

5. Method of separating a coiled structure from biological tissue, comprising the steps of:

inserting a wire in a longitudinal passageway of said coiled structure,

securing said wire to said coiled structure with a coil attached about a distal end of said wire, and

separating a length of said coiled structure restricted in said tissue with a tube positioned about and moved along said length of said coiled structure when said wire is secured to said coiled structure.

6. The method of claim 5 further comprising the steps of moving said tube to a distal end of said coiled structure adjacent other tissue, engaging said distal end of said coiled structure against said distal end of said tube 1 and separating said distal end of said coiled structure from said other tissue.

7. The method of claim 6 wherein the step of engaging said distal end of said coiled structure against said distal end of said tube includes pulling said wire secured to said distal end of said coiled structure.

8. The method of claim 7 further comprising the step of removing said coiled structure from said tissue when said distal end of said coiled structure is separated from said other tissue.

9. The method of claim 6 wherein the step of separating includes rotating said tube and dislodging said distal end of said coiled structure from said other tissue.

10. The method of claim 5 further comprising the steps of unsecuring said wire from said coiled structure when said coiled structure is inseparable from said tissue and removing said wire from said passageway.

11. Apparatus for separating a blood vessel and a length of an electrical lead restricted in said blood vessel, said lead having a proximal end and including a coiled structure wound in a first direction and having a longitudinal passageway therein, comprising:

limiting means for inserting into said longitudinal passageway of said electrical lead;

expandable means attached to said limiting means for securing said limiting means to said electrical lead at a predetermined distance away from said proximal end of said electrical lead; and

separator means positionable about said limiting means and said length of said electrical lead and movable therealong for separating said blood vessel and said electrical lead restricted in said blood vessel when said limiting means is secured to said electrical lead.

12. The apparatus of claim 11 wherein a distal end of said separator means includes an edge for separating said lead from said blood vessel as said separator means is moved along said length of said electrical lead.

13. The apparatus of claim 11 wherein said expandable means includes a wire coil positioned about said distal end of said limiting means and wound in a second direction opposing said first direction of said coiled structure of said heart lead.

14. Apparatus for removing a heart lead having a longitudinal passageway therein and a distal end secured to heart tissue, said passageway having a predetermined dimension, comprising:

a stylet wire having distal end means for inserting into said longitudinal passageway of said heart lead;

a wire coil attached to said distal end means of said stylet wire and including expandable means for securing said distal end means of said stylet wire to said distal end of said heart lead, said expandable means in a first state having an outside dimension within a predetermined tolerance of said predetermined dimension and in an expanded state engaging said heart lead when in said passageway; and

a tube including distal tube end means for separating said distal end of said heart lead secured to said heart tissue when said tube is positioned about said stylet wire and said distal end of said heart lead, and said stylet wire is secured to said distal end of said heart lead.

15. The apparatus of claim 14 wherein said expandable means comprises a plurality of turns of wire positioned about said distal end of said stylet wire.

16. The apparatus of claim 14 wherein said distal end tube means includes cutting edge means for separating said distal end of said heart lead from said heart tissue as said distal end tube means is engaged against said heart tissue when said stylet wire is secured to said distal end of said heart lead.

17. The apparatus of claim 14 wherein said tube comprises semi-rigid material means for sliding over said heart lead and through a blood vessel leading to said heart tissue.

18. The apparatus of claim 14 wherein said predetermined tolerance is less than two one thousandths of an inch.

19. Apparatus for separating a coiled structure from biological tissue, said structure having a longitudinal passageway therein and a proximal end, comprising:

flexible means insertable in said longitudinal passageway of said coiled structure for limiting movement of said coiled structure,

expandable means attached to said flexible means for securing said flexible means to said coiled structure at a position within said passageway away from said proximal end of said coiled structure, and

separator means positionable about said flexible means and said coiled structure for separating said coiled structure from said biological tissue when said flexible means is secured to said coiled structure.

20. The apparatus of claim 19 wherein said flexible means comprises a flexible stylet wire.

21. The apparatus of claim 19 wherein said expandable means comprises a wire coil.

22. The apparatus of claim 19 wherein said separator means comprises a hollow tube.

23. Apparatus for removing a coiled structure from biological tissue, said structure including a longitudinal passageway having a predetermined dimension therein, comprising:

a wire having distal end means for inserting in said longitudinal passageway of said coiled structure;

a coil attached about said distal end means of said wire and including expandable means for securing said wire to said coiled structure at a position within said passageway distal from said proximal end of said coiled structure, said expandable means in a first state having an outside dimension within a predetermined tolerance of said predetermined dimension and in an expanded state engaging said coiled structure when in said passageway; and

control means positioned about a proximal end of said wire for removing said coiled structure from said tissue when said wire is secured to said coiled structure.

24. The apparatus of claim 23 further comprising tube means positionable about said wire and said coiled structure for separating said coiled structure from said biological tissue when said wire is secured to said coiled structure.