Guide wire with releaseable barb anchor

• US 5,728,122 A
• Filed: 06/07/1995
• Issued: 03/17/1998
• Est. Priority Date: 01/18/1994
• Status: Expired due to Term

• Current Assignee: St Jude Medical Incorporated (Abbott Laboratories)
• Original Assignee: Datascope Corporation (Getinge AB)
• Inventors: Leschinsky, Boris, Follman, Mark, Urbanski, Jeffrey
• Primary Examiner(s): Rimell, Sam
• Application Number:
  US08/484,911
• Time in Patent Office: 1,014 Days
• Field of Search: 128/772, 606/213, 606/215, 606/217, 606/222, 606/223, 606/224, 606/225, 606/226, 606/227, 606/228, 606/229, 606/232, 606/233, 604/164, 604/282, 604/96
• US Class Current: 606/213
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00654 entirely comprised between the two sides of the opening
• CPC Class Codes: A61B 2017/00672 Locating means therefor, e.g. bleed back lumen
• CPC Class Codes: A61M 2025/018 Catheters having a lateral opening for guiding elongated means lateral to the catheter
• CPC Class Codes: A61M 2025/09075 having a core without a coil possibly combined with a sheath
• CPC Class Codes: A61M 2025/09083 having a coil around a core
• CPC Class Codes: A61M 2025/09091 where a sheath surrounds the coil at the distal part
• CPC Class Codes: A61M 2025/09125 Device for locking a guide wire in a fixed position with respect to the catheter or the human body
• CPC Class Codes: A61M 2025/09175 having specific characteristics at the distal tip
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/09 Guide wires

Abstract

An insertion guide wire with an anchor formed in the distal end for precisely locating a subcutaneous arterial wound and guiding a plug of hemostatic material thereto. When the hemostatic material is properly placed, the anchor can be released and the guide wire removed, leaving no foreign object in the lumen of the artery.

Claims

1. A method for inserting hemostatic material into a wound in a patient wherein said wound is comprised of a puncture in the patient'"'"'s skin, a puncture in one of the patient'"'"'s arteries and a wound channel between said punctures, said method comprising the steps of

inserting into said wound a guide wire having a proximal end, a distal end, a medial portion and a longitudinal axis, said distal end having been formed into an anchor, said insertion continuing until said anchor has passed through said arterial puncture and said proximal end is outside the patient'"'"'s body,

pulling back on said guide wire until said anchor catches on the inside of said artery,

inserting said hemostatic material over said guide wire and along said medial portion thereof until said hemostatic material is in said wound channel adjacent said arterial puncture, and

releasing said anchor and removing said guide wire from said wound.

2. The method as claimed in claim 1, further comprising the steps of inserting a sheath and a dilator over said guide wire and removing said dilator before inserting said hemostatic material through said sheath.

3. The method as claimed in claim 2, wherein said hemostatic material is housed in a preloaded canister and is inserted into said wound channel through said sheath.

4. The method as claimed in claim 2, wherein locating means are provided for determining when said sheath is properly located in said wound channel with respect to said arterial puncture, said method further comprising the step of inserting said sheath until said locating means indicates that said sheath is located at a predetermined position relative to said arterial puncture.

5. A method for inserting hemostatic material into a wound in a patient wherein said wound is comprised of a puncture in the patient'"'"'s skin, a puncture in one of the patient'"'"'s arteries and a wound channel between said punctures and wherein a procedural sheath is in situ with its distal tip inside said artery and its proximal end outside of the patient, said method comprising the steps of

inserting a guide wire into said procedural sheath, said guide wire having a proximal end, a distal end, a medial portion and a longitudinal axis, said distal end having been formed into an anchor, said insertion continuing until said anchor has emerged from the distal end of said procedural sheath,

removing said procedural sheath from the patient,

pulling back on said guide wire until said anchor catches on the inside of said artery,

inserting said hemostatic material over said guide wire and along said medial portion thereof until said hemostatic material is in said wound channel adjacent said arterial puncture and,

releasing said anchor and removing said guide wire from said wound.

6. The method as claimed in claim 5, further comprising the step of using a funnel to insert said anchor into said procedural sheath.

7. The method as claimed in claim 5, further comprising the step of inserting a guide sheath over said guide wire after said removal of said procedural sheath.

8. The method as claimed in claim 7, wherein said hemostatic material is inserted through said guide sheath.

9. The method as claimed in claim 8, wherein said hemostatic material is housed in a preloaded canister, said method further comprising the step of forcing said hemostatic material from said canister into said guide sheath.

10. An insertion guide wire having a distal end and a proximal end, comprising:

a sheath having a proximal end, a distal end and a lumen therein, said distal end of said sheath being comprised of a wire coil and being formed into a loop having a total arc of greater than 360°

so that said wire coil overlaps upon itself in an overlapping portion, at least some of said coils in said overlapping portion being interleaved; and

a core wire in said lumen, said core wire having a proximal end and a distal end, said distal end of said core wire being bent back upon itself to form a hook, said hook retaining said overlapping coils in said interleaved condition.

11. An insertion guide wire according to claim 10, wherein said core wire is slidable within said lumen.

12. An insertion guide wire according to claim 10, further comprising means for moving said core wire axially within said lumen.

13. An insertion guide wire according to claim 12, wherein said core wire is slidable toward said distal end of said sheath so as to release said overlapping coils from said interleaved condition thereby to enable said loop to straighten out.

14. An insertion guide wire according to claim 12, wherein said core wire moving means enables control of said axial movement of said core wire from said proximal end of said insertion guide wire.

15. An insertion guide wire according to claim 12 wherein said wire coil is comprised of two adjoined coils of opposite hand thread and wherein said overlapping coils are of opposite hand thread.

16. An insertion guide wire according to claim 10, further comprising a safety wire.

17. An insertion guide wire according to claim 12, further comprising means for temporarily resisting axial movement in the distal direction of said core wire.

18. An insertion guide wire according to claim 17, wherein said resisting means is comprised of a split sleeve.

19. A guide wire, comprising

a sheath having a longitudinal axis, a proximal end, a distal end and a lumen extending from said proximal end toward said distal end;

an aperture formed in an intermediate portion of said sheath at a spaced distance from said distal end, said aperture delimiting a distal portion of said sheath between said distal end and said aperture;

a core wire slideably arranged in said sheath and having a proximal end and a distal end, said core wire being movable between a first position in which an intermediate portion of said core wire between said proximal and distal ends protrudes from said sheath through said aperture and a second position in which said distal end of said core wire is positioned between said proximal end of said sheath and said aperture;

said distal portion of said sheath being held between said intermediate portion of said sheath and said intermediate portion of said core wire with said core wire in said first position to define an anchor having a component projecting in a direction transverse to said longitudinal axis, whereby movement of said core wire from said first position to said second position releases said anchor.

20. A guide wire as claimed in claim 19, wherein said anchor includes a bended region in said guide wire, said guide wire having a greater degree of bendability in said bended region than in a region proximal of said bended region.

21. A guide wire as claimed in claim 20, wherein said core wire extends through said sheath in said bended region, and said greater degree of bendability is achieved by providing said core wire with a reduced diameter in said bended region.

22. A guide wire as claimed in claim 21, further comprising a wire spring wrapped around said reduced diameter of said core wire.

23. A guide wire as claimed in claim 20, wherein said core wire includes a proximal portion and a distal portion separated by a space, said space being located in said bended region.

24. A guide wire as claimed in claim 20, further comprising a cannula arranged around a portion of said core wire distally of said bended region.

25. A guide wire as claimed in claim 24, wherein said distal end of said sheath is separated from a remaining portion of said sheath by a predetermined distance, said distal end and said remaining portion being joined together by said cannula.

26. A guide wire as claimed in claim 19, wherein said anchor is in the form of a loop defining an are of at least 360°

, one portion of said loop being positioned on one side of said longitudinal axis and another portion of said loop being positioned on another side of said longitudinal axis.

27. A guide wire as claimed in claim 19, wherein said intermediate portion of said core wire forms an angle of less than about 180°

with said longitudinal axis.

28. A guide wire as claimed in claim 19, further comprising locating means for indicating a predetermined distance from said aperture.

29. A system for stanching the flow of blood from an internal wound wherein there is communication between the internal wound and the external world through a wound channel and a skin puncture, said system comprising

a guide wire including a sheath having a longitudinal axis, a proximal end, a distal end and a lumen extending from said proximal end toward said distal end, an aperture formed in an intermediate portion of said sheath at a spaced distance from said distal end, said aperture delimiting a distal portion of said sheath between said distal end and said aperture, and a core wire slideably arranged in said sheath and having a proximal end and a distal end, said core wire being movable between a first position in which an intermediate portion of said core wire between said proximal and distal ends protrudes from said sheath through said aperture and a second position in which said distal end of said core wire is positioned between said proximal end of said sheath and said aperture, said distal portion of said sheath being held between said intermediate portion of said sheath and said intermediate portion of said core wire with said core wire in said first position to define an anchor having a component projecting in a direction transverse to said longitudinal axis, whereby movement of said core wire from said first position to said second position releases said anchor;

a plug of hemostatic material sized to pass through the wound channel, said plug having a through lumen for slideably receiving said guide wire; and

means for advancing said hemostatic material through the wound channel to the internal wound.

30. A system as claimed in claim 29, further comprising a placement sheath sized for insertion in the wound channel and having a lumen for receiving and advancing said plug of hemostatic material through the wound channel.

31. A system as claimed in claim 29, further comprising means for indicating when said plug of hemostatic material is positioned adjacent the internal wound.

32. A system as claimed in claim 29, further comprising a funnel to facilitate insertion of said distal end of said guide wire into the wound channel.

33. A guide wire, comprising

a sheath having a longitudinal axis, a proximal end, a distal end and a lumen extending from said proximal end toward said distal end;

an aperture formed in an intermediate portion of said sheath at a spaced distance from said distal end;

a core wire slideably arranged in said sheath and having a proximal end and a distal end; and

a barb having one end attached to said core wire, another end and an intermediate portion between said one end and said another end;

said core wire being movable between a first position in which said intermediate portion of said barb protrudes from said sheath through said aperture and a second position in which said intermediate portion of said barb is positioned entirely within said lumen of said sheath.

34. A guide wire as claimed in claim 33, wherein said distal end of said sheath includes a flexible tip.

35. A guide wire as claimed in claim 33, wherein said distal end of said core wire includes a flexible tip.

36. A guide wire as claimed in claim 33, wherein said another end of said barb includes a J-tip.

37. A guide wire as claimed in claim 33, wherein said sheath is formed from a wire coil.

38. A guide wire as claimed in claim 33, wherein said sheath is formed from a biocompatible plastic.

39. A guide wire as claimed in claim 33, wherein said sheath includes a distal portion and a proximal portion separated by a predetermined distance, said aperture defining said predetermined distance.

40. A guide wire as claimed in claim 39, further comprising at least one safety wire for supporting said proximal and said distal portions of said sheath separated by said predetermined distance.

41. A guide wire as claimed in claim 39, further comprising an intervening plastic filler between said proximal and distal portions of said sheath.

42. A guide wire as claimed in claim 33, further comprising a safety wire assembled in said lumen of said sheath.

43. A guide wire as claimed in claim 33, further comprising means for temporarily resisting axial movement of said core wire in a direction toward said distal end of said sheath.

44. A guide wire as claimed in claim 43, wherein said resisting means includes a split sleeve assembled on said core wire between said proximal end of said core wire and said proximal end of said sheath.