Locally flexible dilator sheath

• US 5,507,751 A
• Filed: 06/08/1994
• Issued: 04/16/1996
• Est. Priority Date: 11/09/1988
• Status: Expired due to Term

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Pacemaker Corporation (Cook Group Incorporated)
• Inventors: Lui, Chun K., Goode, Louis
• Primary Examiner(s): Kamm, William E.
• Assistant Examiner(s): SCHAETZLE, KENNEDY
• Application Number:
  US08/255,602
• Time in Patent Office: 678 Days
• Field of Search: 607/1, 607/2, 607/126, 606/108, 606/167, 606/170, 606/180, 606/184, 606/185, 606/159, 604/158, 604/164, 604/264
• US Class Current: 606/108
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/320708 Curettes, e.g. hollow scraping instruments
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 17/3468 for implanting or removing devices, e.g. prostheses, implants, seeds, wires devices for implanting seeds A61M37/0069
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61N 1/056 Transvascular endocardial electrode systems
• 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

Abstract

A locally flexible dilator sheath (10) for separating encapsulating tissue from an implanted cardiac electrical lead. The dilator sheath includes an elongated tubular member (11) of a rigid stainless steel material, which is sized for placement of the tubular member over a cardiac lead that is implanted in the vascular system of a patient. The distal end (13) of the rigid tubular member is beveled to ease the separation of extremely tough tissue that encapsulates an implanted cardiac lead. To ease insertion around curves in the vascular system of the patient, the elongated tubular member includes a relieved portion (14). The relieved portion includes a relief pattern (15) of apertures (16,17,19,23) in the elongated tubular member. The relief apertures preferably include diametrically opposed slots (24,25) that extend perpendicularly into the tubular member. Adjacent pairs (44,45) of slots are circumferentially offset a 90° angle (26) to add further lateral flexibility to the relieved portion. A polyester shrink tube (41) surrounds the relief apertures to provide integrity to the tubular member should the tubular member fracture when separating encapsulating tissue from the implanted lead.

Claims

1. A locally flexible dilator sheath (10) comprising:

an elongated tubular member (11) of a rigid material having a passage (12) extending longitudinally therethrough and sized for placement of said elongated tubular member over a cardiac electrical lead that is implanted in a vessel, a distal end (13) shaped for separation of encapsulating tissue from an implanted lead, and a relieved portion (14), whereby said relieved portion is flexible for laterally bending around vessel curves in which a cardiac electrical lead is implanted.

2. The dilator sheath of claim 1 wherein said relieved portion (14) includes a relief pattern (15) formed in said elongated tubular member.

3. The dilator sheath of claim 2 wherein said relief pattern includes a plurality of relief apertures (23) positioned in said elongated tubular member.

4. The dilator sheath of claim 2 wherein said relief pattern includes a plurality of main apertures (16), a plurality of distal apertures (17) proximate a distal end (18) of said relief pattern, and a plurality of proximal apertures (19) proximate a proximal end (20) of said relief pattern.

5. The dilator sheath of claim 4 wherein said distal and said proximal apertures have an aperture area (46) less than a main aperture area (47) of said main apertures.

6. The dilator sheath of claim 2 wherein said relief pattern includes pairs of diametrically opposed slots (24,25).

7. The dilator sheath of claim 6 wherein adjacent pairs (44, 45) of said pairs of diametrically opposed slots are circumferentially offset a prescribed angle (26,27).

8. The dilator sheath of claim 6 wherein slots in a pair (44) of said pairs of diametrically opposed slots are laterally separated from each other a prescribed distance (28).

9. The dilator sheath of claim 6 wherein adjacent pairs of said pairs of diametrically opposed slots are longitudinally spaced a prescribed distance (29) apart.

10. The dilator sheath of claim 6 wherein a first slot (24) in a pair (44) of said pairs of diametrically opposed slots extends into said tubular member a first depth (37).

11. The dilator sheath of claim 10 wherein a second slot (25) in said pair (44) of said pairs of diametrically opposed slots extends into said tubular member a second depth (38).

12. The dilator sheath of claim 1 wherein said relieved portion includes a plurality (30) of at least one of rectangular (31), round (32), square (33), elliptical (34), and teardrop-shaped (35) apertures or a combination (36) thereof.

13. The dilator sheath of claim 1 wherein said relieved portion includes a plurality of unopposed apertures (39) positioned in said relieved portion of said tubular member.

14. The dilator sheath of claim 1 further comprising a coating (40) extending over said relieved portion.

15. The dilator sheath of claim 14 wherein said coating includes a plastic tube (41).

16. The dilator sheath of claim 15 wherein said plastic tube comprises at least one from a group consisting of polytetrafluoroethylene, polyamides, and polyester.

17. The dilator sheath of claim 1 wherein said rigid material includes at least one from a group consisting of stainless steel, titanium, nitinol, nickel-based alloys, and a reinforced liquid crystal polymer.

18. A locally flexible dilator sheath (10) comprising:

an elongated tubular member (11) of a rigid material having a passage (12) extending longitudinally therethrough and sized for placement of said elongated tubular member over a cardiac electrical lead implanted in a vessel, a distal end (13) shaped for separation of encapsulating tissue from an implanted lead, and a relieved portion (14) having a relief pattern (15) formed therein; and

a flexible plastic coating material (40) positioned over said relieved portion of said elongated tubular member, whereby said relieved portion is flexible for laterally bending around vessel curves in which a cardiac electrical lead is implanted.

19. The dilator sheath of claim 18 wherein said relief pattern includes pairs of diametrically opposed slots (24,25), adjacent pairs (44,45) of said pairs of said diametrically opposed slots being circumferentially offset a prescribed angle (26,27).

20. A locally flexible dilator sheath (10) comprising:

an elongated tubular member (11) of a rigid stainless steel material having a passage (12) extending longitudinally therethrough and sized for placement of said elongated tubular member over a cardiac electrical lead implanted in a vessel, a distal end (13) beveled and shaped for separation of encapsulating tissue from an implanted lead, and a relieved portion (14) having a relief pattern (15) of main pairs (16) of diametrically opposed slots (24,25) formed therein, adjacent pairs (44,45) of said diametrically opposed slots being longitudinally spaced a prescribed distance apart (29) and circumferentially offset a 90°

angle (26), slots of said pairs of diametrically opposed slots being laterally separated from each other a first separation distance (28), said relief pattern also having distal pairs (17) and proximal pairs (19) of diametrically opposed slots, each pair of slots being laterally separated from each other a second separation distance (22) greater than said first separation distance;

a tube (41) of polyester material heat shrunk over said relieved portion including said relief pattern of said elongated tubular member; and

a flange (42) positioned proximal said relieved portion on said elongated tubular member, whereby said relieved portion is flexible for laterally bending around vessel curves in which a cardiac electrical lead is implanted.