Guidewire and catheter with rotating and reciprocating symmetrical or asymmetrical distal tip

• US 6,183,432 B1
• Filed: 11/13/1997
• Issued: 02/06/2001
• Est. Priority Date: 11/13/1997
• Status: Expired due to Term

• Current Assignee: Cardinal Health Switzerland 515 GmbH (Cardinal Health, Inc.)
• Original Assignee: LuMend, Inc. (Cardinal Health, Inc.)
• Inventors: Milo, Charles F.
• Primary Examiner(s): Dawson, Glenn K.
• Assistant Examiner(s): Hayes, Michael J.
• Application Number:
  US08/969,814
• Time in Patent Office: 1,181 Days
• Field of Search: 604/20, 604/22, 604/96, 606/1, 606/159, 606/167, 606/171, 606/180, 606/169, 606/170, 606/178, 600/463, 600/471, 600/585
• US Class Current: 604/22
• CPC Class Codes: A61B 17/22012 in direct contact with, or very close to, the obstruction or concrement for removing obstructions in blood vessels by laser A61B18/245
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61M 25/0105 Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B
• CPC Class Codes: A61M 25/0116 self-propelled, e.g. autonomous robots A61M25/0122 takes precedence
• CPC Class Codes: A61M 25/09041 Mechanisms for insertion of guide wires

Abstract

A guidewire or a catheter for crossing vascular occlusions comprises a shaft having a proximal end and a distal end, and a drive member having a proximal and a distal end, the drive member being rotatably disposed within and along a longitudinal axis of the guidewire shaft. An actuator is connected to the proximal end of the drive member, the actuator imparting a rotation to the drive member. An asymmetrical rotating tip is attached to the distal end of the drive member and driven in rotation about the longitudinal axis of the shaft by the drive member. The rotating tip may include a protruding portion that projects from a plane defined by an outer surface of the guidewire shaft to render the rotating tip asymmetrical with respect to the longitudinal axis of the shaft. The protruding portion creates a volume of revolution as the asymmetrical tip rotates, which facilitates crossing a vascular occlusion by displacing and exerting pressure on stenotic material causing the occlusion. Alternatively, the rotating tip may be symmetrical. A coupling member may be attached to the distal end of the shaft and may include a distal angled surface. When the tip includes a mating angled surface, rotation of the drive member causes the tip to undergo both a reciprocal and a rotational motion along and about the longitudinal axis of the shaft.

Claims

1. A guidewire for crossing vascular occlusions comprising:

a guidewire shaft having a proximal end and a distal end, the distal end being perpendicular to an outer surface of the guidewire shaft such that the outer surface of the guidewire shaft and the distal end define a right cylinder;

a drive member having a proximal and a distal end, the drive member being rotatably disposed within and along a longitudinal axis of the guidewire shaft;

an actuator connected to the proximal end of the drive member, the actuator capable of imparting rotational movement to the drive member, and

an asymmetrical and atraumatic rotating tip attached to the distal end of the drive member, the asymmetrical and atraumatic rotating tip comprising,

a planar proximal end and a rounded distal end, wherein the planar proximal end is substantially parallel to and in very close proximity to the distal end of the guidewire shaft;

a smooth, rounded outer surface comprising,

a portion that substantially conforms to the right cylinder defined by the guidewire shaft; and

a protruding portion that locally projects radially from the longitudinal axis of the guidewire shaft beyond the right cylinder; and

at least one image transducer mounted in the asymmetrical and atraumatic tip for obtaining guidance information as the guidewire advances through a patient'"'"'s vasculature, wherein the at least one image transducer is mounted in a recess in the portion of the atraumatic rotating tip that substantially conforms to the right cylinder defined by the guidewire shaft.

2. A guidewire for crossing vascular occlusions, comprising:

a guidewire shaft having a proximal end and a distal end, the distal end being perpendicular to an outer surface of the guidewire shaft such that the outer surface of the guidewire shaft and the distal end define a right cylinder;

a drive member having a proximal and a distal end, the drive member being rotatably disposed within and along a longitudinal axis of the guidewire shaft, rein the drive member is a shaft having a lumen therethrough to accommodate at least one electrical lead coupled to an imaging device near the proximal end of the guidewire shaft;

an actuator connected to the proximal end of the drive member, the actuator capable of imparting rotational movement to the drive member, and

an asymmetrical and atraumatic rotating tip attached to the distal end of the drive member, the asymmetrical and atraumatic rotating tip comprising,

a planar proximal end and a rounded distal end, wherein the planar proximal end is substantially parallel to and in very close proximity to the distal end of the guidewire shaft;

a smooth, rounded outer surface comprising,

a portion that substantially conforms to the right cylinder defined by the guidewire shaft; and

a protruding portion that locally projects radially from the longitudinal axis of the guidewire shaft beyond the right cylinder; and

at least one image transducer mounted in the asymmetrical and atraumatic tip for obtaining guidance information as the guidewire advances trough a patient'"'"'s vasculature, wherein the at least one image transducer is mounted in a recess in the portion of the atraumatic rotating tip that substantially conforms to the right cylinder defined by the guidewire shaft, and wherein the at least one image transducer is coupled to the at least one electrical lead.

3. An instrument comprising:

a shaft having a proximal end and a distal end, the distal end being perpendicular to an outer surface of the shaft such that the outer surface of shaft and the distal end define a right cylinder;

an asymmetrical and atraumatic tip adjacent to the distal end of the shaft for crossing a vascular occlusion, wherein the asymmetrical and atraumatic tip comprises,

a rounded and smooth distal end;

a planar proximal end; and

a circumference between the rounded and smooth distal end and the planar proximal end, comprising,

a portion that substantially conforms to the right cylinder; and

a protruding portion that protrudes radially from a longitudinal axis of the shaft beyond the right cylinder; and

at least one of an ultrasonic transducer and an optical fiber device for obtaining guidance information as the instrument advances through a patient'"'"'s vasculature, wherein the at least one of an ultrasonic transducer and an optical fiber is positioned in the portion that substantially conforms to the right cylinder;

a drive member having a proximal and a distal end, the asymmetrical and atraumatic tip being attached to the distal end of the drive member such that the planar proximal end of the asymmetrical and atraumatic tip is in close proximity to and substantially parallel to the distal end of the shaft; and

an actuator coupled to the proximal end of the drive member, wherein the actuator actuates the drive member to cause a rotational movement of the asymmetrical and atraumatic tip relative to the longitudinal axis of the shaft.

4. An instrument for crossing a vascular occlusion, comprising:

a shaft having a proximal end and a distal end, the distal end being perpendicular to an outer surface of the shaft such that the outer surface of shaft and the distal end define a right cylinder;

an asymmetrical and atraumatic tip adjacent to the distal end of the shaft for crossing a vascular occlusion, wherein the asymmetrical and atraumatic tip comprises,

a rounded and smooth distal end;

a planar proximal end; and

a circumference between the rounded and smooth distal end and the planar proximal end, comprising,

a portion that substantially conforms to the right cylinder; and

a protruding portion that protrudes radially from a longitudinal axis of that shaft beyond the right cylinder; and

at least one of an ultrasonic transducer and an optical fiber for obtaining guidance information as the instrument advances through a patient'"'"'s vasculature, wherein the at least one of an ultrasonic transducer and an optical fiber is positioned in the portion that substantially conforms to the right cylinder;

a drive member having a proximal and a distal end, the asymmetrical and atraumatic tip being attached to the distal end of the drive member such that the planar proximal end of the asymmetrical and atraumatic tip is in close proximity to and substantially parallel to the distal end of the shaft the drive member including a lumen which houses electrical leads for the ultrasonic transducer, the electrical leads and the optical fiber being connected to an imaging device near the proximal end of the shaft; and

an actuator coupled to the proximal end of the drive member, wherein the actuator actuates the drive member to cause a rotational movement of the asymmetrical and atraumatic tip relative to the longitudinal axis of the shaft.

5. A guidewire for crossing vascular occlusions, comprising:

a guidewire shaft having a proximal end and a distal end, the distal end being perpendicular to an outer surface of the guidewire shaft such that the outer surface of the guidewire shaft and the distal end define a right cylinder;

a drive member having a proximal and a distal end, the drive member being rotatably disposed within and along a longitudinal axis of the guidewire shaft;

an actuator connected to the proximal end of the drive member, the actuator capable of imparting rotational movement to the drive member, and

an asymmetrical and atraumatic rotating tip attached to the distal end of the drive member, the asymmetrical and atraumatic rotating tip comprising,

a planar proximal end and a rounded distal end, wherein the planar proximal end is substantially parallel to and in very close proximity to the distal end of the guidewire shaft;

a smooth, rounded outer surface comprising,

a portion that substantially conforms to the right cylinder defined by the guidewire shaft; and

a protruding portion that locally projects radially from the longitudinal axis of the guidewire shaft beyond the right cylinder; and

at least one image transducer comprising one of an ultrasonic transducer and an optical fiber device, the at least one image transducer mounted in the asymmetrical and atraumatic tip for obtaining guidance information as the guidewire advances through a patient'"'"'s vasculature, wherein the at least one image transducer is mounted in a recess in the portion of the atraumatic rotating tip that substantially conforms to the right cylinder defined by the guidewire shaft.