Modified guidewire for left ventricular access lead
First Claim
1. A method for installing an intravenous pacing lead within a patient, comprising:
- advancing a guide catheter through a vasculature until a distal end of the guide catheter is located in the coronary sinus of the heart;
advancing the pacing lead over at least a portion of a guidewire to position the pacing lead adjacent tissue to be stimulated, wherein at least a portion of the pacing lead is maintained within a lumen of the guide catheter and at least a portion of the guidewire is located within a lumen of the pacing lead;
removing the guidewire from the pacing lead lumen;
inserting a removal wire into the pacing lead lumen after removing the guidewire to secure the lead; and
removing the guide catheter from said portion of the pacing lead maintained within the lumen of the guide catheter while the removal wire is securing the lead.
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Accused Products
Abstract
An improved guidewire for assisting in implantation of a cardiac lead includes three sections. The most distal zone is sufficiently floppy to prevent trauma to the vessel walls through which the guidewire and lead are inserted. An intermediate zone is generally stiffer and has a cross-section less than or equal to the cross-section of the distal zone. The third zone is stiffer yet and is joined to the intermediate zone by a shoulder. The shoulder cooperates with protrusions on the lead to transfer forces between the guidewire and lead. A removal wire having temporary locking device to lock the removal wire to the lead is employed to remove the guide catheter without moving the lead from its desired location. Lubricious coatings are also provided to reduce friction between the lead and guidewire.
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Citations
49 Claims
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1. A method for installing an intravenous pacing lead within a patient, comprising:
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advancing a guide catheter through a vasculature until a distal end of the guide catheter is located in the coronary sinus of the heart;
advancing the pacing lead over at least a portion of a guidewire to position the pacing lead adjacent tissue to be stimulated, wherein at least a portion of the pacing lead is maintained within a lumen of the guide catheter and at least a portion of the guidewire is located within a lumen of the pacing lead;
removing the guidewire from the pacing lead lumen;
inserting a removal wire into the pacing lead lumen after removing the guidewire to secure the lead; and
removing the guide catheter from said portion of the pacing lead maintained within the lumen of the guide catheter while the removal wire is securing the lead. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A method for installing an intravenous pacing lead within a patient, comprising:
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advancing a guide catheter through a vasculature until a distal end of the catheter is located in the coronary sinus of the heart;
advancing the pacing lead to position the pacing lead adjacent tissue to be stimulated, wherein at least a portion of the pacing lead is maintained within a lumen of the guide catheter and at least a portion of a guidewire is located within a lumen of the pacing lead;
removing the guidewire from the pacing lead lumen;
inserting a removal wire into the pacing lead lumen after removing the guidewire to secure the lead; and
removing the guide catheter from said portion of the pacing lead maintained within the lumen of the guide catheter while the removal wire is securing the lead. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. An intravenous lead insertion assembly, comprising
a catheter having a proximal end and a distal end; -
an intravenous lead at least partially located within the catheter and having at least one electrode and a lumen extending from a proximal end of the lead to a distal end of the lead, the lumen having a first opening through the proximal end of the lead and a second opening through the distal end of the lead;
a guidewire for facilitating advancement of the intravenous lead into the coronary sinus, said guidewire sized to extend through the first and second openings in said lumen and past the distal end of the lead during implantation of the lead, and being removable from the lead after placement of the lead in the coronary sinus; and
a removal wire sized to extend through the first opening and into the lumen of the intravenous lead, the removal wire having a distal end portion including a lead contacting portion for contacting the lead to facilitate securing the lead during a removal of the catheter from around the lead. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37)
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38. An intravenous lead insertion assembly, comprising
a catheter having a proximal end and a distal end; -
an intravenous cardiac pacing lead at least partially located within the catheter and having at least one pacing electrode and a lumen extending from a proximal end of the lead to a distal end of the lead, the lumen having a first opening through the proximal end of the lead and a second opening through the distal end of the lead;
a guidewire for facilitating advancement of the intravenous lead into the coronary sinus, said guidewire sized to extend through the first and second openings in said lumen and past the distal end of the lead during implantation of the lead, and being removable from the lead after placement of the lead in the coronary sinus; and
a removal wire sized to extend through the first opening and into the lumen of the intravenous lead, the removal wire having a distal end portion including a lead contacting portion for contacting the lead to facilitate securing the lead during a removal of the catheter from around the lead. - View Dependent Claims (39, 40, 41, 42, 43)
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44. An intravenous lead insertion assembly, comprising
a catheter having a proximal end and a distal end; -
an intravenous cardiac lead at least partially located within the catheter and having at least one defibrillation electrode and a lumen extending from a proximal end of the lead to a distal end of the lead, the lumen having a first opening through the proximal end of the lead and a second opening through the distal end of the lead;
a guidewire for facilitating advancement of the intravenous lead into the coronary sinus, said guidewire sized to extend through the first and second openings in said lumen and past the distal end of the lead during implantation of the lead, and being removable from the lead after placement of the lead in the coronary sinus; and
a removal wire sized to extend through the first opening and into the lumen of the intravenous lead, the removal wire having a distal end portion including a lead contacting portion for contacting the lead to facilitate securing the lead during a removal of the catheter from around the lead. - View Dependent Claims (45, 46, 47, 48, 49)
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Specification