Handle design for a medical catheter

• US 7,331,958 B2
• Filed: 04/26/2002
• Issued: 02/19/2008
• Est. Priority Date: 04/27/2001
• Status: Expired due to Fees

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: C.R. Bard, Inc. (Becton, Dickinson & Co)
• Inventors: Falwell, Gary S., Gibson, Charles A., Burns, Steven J.
• Primary Examiner(s): Peffley; Michael
• Application Number:
  US10/475,941
• Publication Number:
  US 20040181140A1
• Time in Patent Office: 2,125 Days
• Field of Search: 604/95.01, 604/95.04, 606/41, 606 47- 50
• US Class Current: 606/41
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00839 Bioelectrical parameters, e.g. ECG, EEG
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/1435 Spiral

Abstract

A handle for use with a catheter, the handle including a housing, a cable, and a guide. The housing has a proximal end, a distal end, and a longitudinal axis that extends from the proximal end of the housing to the distal end of the housing. The cable is disposed in the housing and extends through the proximal end of the housing. A portion of the cable that is disposed in the housing is movable, under compression, in a first direction that is substantially aligned with the longitudinal axis of the housing. The guide is disposed in the housing and is adapted to prevent the portion of the cable from moving in a second direction that is transverse to the first direction when the portion of the cable is moved in the first direction. The handle is suitable for use with an electrophysiology catheter having an elongated shaft.

Claims

1. A catheter comprising:

a handle comprising;

a housing having a proximal end, a distal end, and a longitudinal axis that extends from the proximal end of the housing to the distal end of the housing;

a cable, disposed in the housing, that extends through the proximal end of the housing, a portion of the cable that is disposed in the housing being movable, under compression, in a first direction that is substantially aligned with the longitudinal axis of the housing; and

a guide, disposed in the housing, adapted to prevent the portion of the cable from moving in a second direction that is transverse to the first direction when the portion of the cable is moved in the first direction; and

an elongated shaft, a proximal end of the elongated shaft being attached to the distal end of the housing, wherein the cable extends through the distal end of the housing and into the elongated shaft;

wherein a distal end of the elongated shaft is coupled to a conductive braided mesh; and

wherein a distal end of the cable is coupled to a distal end of the braided mesh, and wherein the distal end of the braided mesh is movable distally in response to movement of the portion of the cable in the first direction.

2. The catheter of claim 1, wherein the guide includes:

a hollow mandrel formed from a material that is stiffer, in compression, than the cable, the cable being disposed within the mandrel; and

a retainer, attached to the housing and the mandrel, to retain the mandrel in a fixed position within the housing.

3. The catheter of claim 2, wherein the mandrel is cylindrically shaped.

4. The catheter of claim 2, wherein the mandrel has a length that is approximately twenty percent of a length of the portion of the cable.

5. The catheter of claim 1, wherein the guide is separate from the housing and removably attached thereto.

6. The catheter of claim 1, wherein the cable is approximately 0.011 inches in diameter.

7. The catheter of claim 1, wherein the catheter is an electrophysiology catheter.

8. The catheter of claim 1, wherein the portion of the cable that is disposed in the housing is movable, under compression, proximally relative to the housing in the first direction.

9. The catheter of claim 1, wherein the portion of the cable that is disposed in the housing is movable, under compression, distally relative to the housing in the first direction.

10. The catheter of claim 9, wherein the portion of the cable that is disposed in the housing is movable, under tension, proximally relative to the housing in a third direction that is opposite the first direction.

11. The catheter of claim 1, wherein the elongated shaft has a diameter of approximately 6 French.

12. The catheter of claim 1, wherein a distal end of the cable is attached to a distal end of the elongated shaft, and wherein the distal end of the elongated shaft is movable relative to a proximal end of the elongated shaft in response to movement of the portion of the cable in the first direction.

13. The catheter of claim 1, wherein the catheter for use with the handle comprises an elongate shaft, and wherein the guide is separate from the elongated shaft.

14. The catheter of claim 1, wherein the guide includes a mandrel having a through-hole occupied by a portion of the cable, wherein the through-hole is sized and shaped to prevent the portion of the cable occupying the through-hole from moving in any direction transverse to the first direction.

15. The catheter of claim 14, wherein the through-hole has a diameter that is 25 to 50 percent greater than an outer diameter of the cable.

16. The handle catheter of claim 14, wherein the through-hole has a diameter that is 10 to 20 percent greater than an outer diameter of the cable.

17. A catheter comprising:

a handle comprising;

a housing having a proximal end, a distal end, and a longitudinal axis that extends from the proximal end of the housing to the distal end of the housing;

a cable, disposed in the housing, that extends through the proximal end of the housing, a portion of the cable that is disposed in the housing being movable, under compression, in a first direction that is substantially aligned with the longitudinal axis of the housing; and

a guide, disposed in the housing, adapted to prevent the portion of the cable from moving in a second direction that is transverse to the first direction when the portion of the cable is moved in the first direction; and

an elongated shaft, a proximal end of the elongated shaft being attached to the distal end of the housing, wherein the cable extends through the distal end of the housing and into the elongated shaft;

wherein a distal end of the elongated shaft includes at least one electrode; and

wherein a distal end of the cable is attached to the at least one electrode, and wherein the at least one electrode is movable distally along the distal end of the elongated shaft in response to movement of the portion of the cable in the first direction.

18. The catheter of claim 17, wherein a distal end of the elongated shaft includes a tip assembly has an arcuate curve, wherein a distal end of the cable is attached to a distal end of the tip assembly, and wherein a radius of curvature of the arcuate curve is adjustable in response to movement of the portion of the cable in the first direction.

19. A catheter comprising:

a handle comprising;

a housing having a proximal end, a distal end, and a longitudinal axis that extends from the proximal end of the housing to the distal end of the housing;

a cable, disposed in the housing, that extends through the proximal end of the housing, a portion of the cable that is disposed in the housing being movable, under compression, in a first direction that is substantially aligned with the longitudinal axis of the housing; and

a guide, disposed in the housing, adapted to prevent the portion of the cable from moving in a second direction that is transverse to the first direction when the portion of the cable is moved in the first direction; and

an elongated shaft, a proximal end of the elongated shaft being attached to the distal end of the housing, wherein the cable extends through the distal end of the housing and into the elongated shaft;

wherein a distal end of the elongated shaft is coupled to a conductive braided mesh; and

wherein a distal end of the cable is attached to a proximal end of the braided mesh, and wherein the proximal end of the braided mesh is movable distally along the distal end of the elongated shaft in response to movement of the portion of the cable in the first direction.

20. A catheter comprising:

a handle comprising;

a housing having a proximal end, a distal end, and a longitudinal axis that extends from the proximal end of the housing to the distal end of the housing;

a cable, disposed in the housing, that extends through the proximal end of the housing, a portion of the cable that is disposed in the housing being movable, under compression, in a first direction that is substantially aligned with the longitudinal axis of the housing; and

means for preventing the portion of the cable from moving in a second direction that is transverse to the first direction when the portion of the cable is moved in the first direction;

wherein the portion of the cable that is disposed in the housing is movable, under compression, distally relative to the housing in the first direction; and

an elongated shaft, a proximal end of the elongated shaft being attached to the distal end of the housing, wherein the cable extends through the distal end of the housing and into the elongated shaft;

wherein a distal end of the elongated shaft is coupled to a conductive braided mesh, wherein a distal end of the cable is attached to one of a distal end and a proximal end of the braided mesh, and wherein the one of the distal end and the proximal end of the braided mesh is movable distally in response to movement of the portion of the cable in the first direction.

21. The catheter of claim 20, wherein the means for preventing includes:

a hollow mandrel formed from a material that is stiffer, in compression, than the cable, the cable being disposed within the mandrel; and

means for retaining the mandrel in a fixed position within the housing.

22. The catheter of claim 21, wherein the mandrel is cylindrically shaped.

23. The catheter of claim 21, wherein the mandrel has a length that is approximately twenty percent of a length of the portion of the cable.

24. The catheter of claim 20, wherein the means for preventing is removably attached within the housing.

25. The catheter of claim 20, wherein the catheter is an electrophysiology catheter.

26. The catheter of claim 20, wherein the portion of the cable that is disposed in the housing is movable, under compression, distally relative to the housing in the first direction.

27. The catheter of claim 26, wherein the portion of the cable that is disposed in the housing is movable, under tension, proximally relative to the housing in a third direction that is opposite the first direction.

28. The catheter of claim 26, wherein the catheter further comprises an elongated shaft, a proximal end of the elongated shaft being attached to the distal end of the housing, and wherein the cable extends through the distal end of the housing and into the elongated shaft.

29. The catheter of claim 28, wherein the elongated shaft has a diameter of approximately 6 French, and wherein the cable is approximately 0.011 inches in diameter.

30. The catheter of claim 20, wherein a distal end of the cable is attached to a distal end of the elongated shaft, and wherein the distal end of the elongated shaft is movable relative to a proximal end of the elongated shaft in response to movement of the portion of the cable in the first direction.

31. The catheter of claim 20, wherein the handle further comprises:

actuator means, attached to the housing, for applying a compressive force to the portion of the cable to move the portion of the cable in the first direction in response to movement of the actuator means.

32. The catheter of claim 20, wherein the means for preventing is separate from the elongated shaft.

33. A catheter comprising:

a handle comprising;

a housing having a proximal end, a distal end, and a longitudinal axis that extends from the proximal end of the housing to the distal end of the housing;

a cable, disposed in the housing, that extends through the proximal end of the housing, a portion of the cable that is disposed in the housing being movable, under compression, in a first direction that is substantially aligned with the longitudinal axis of the housing; and

means for preventing the portion of the cable from moving in a second direction that is transverse to the first direction when the portion of the cable is moved in the first direction;

wherein the portion of the cable that is disposed in the housing is movable, under compression, distally relative to the housing in the first direction; and

an elongated shaft, a proximal end of the elongated shaft being attached to the distal end of the housing, wherein the cable extends through the distal end of the housing and into the elongated shaft;

wherein a distal end of the elongated shaft includes at least one electrode, wherein a distal end of the cable is attached to the at least one electrode, and wherein the at least one electrode is movable distally along the distal end of the elongated shaft in response to movement of the portion of the cable in the first direction.

34. The catheter of claim 33, wherein a distal end of the elongated shaft includes a tip assembly has an arcuate curve, wherein a distal end of the cable is attached to a distal end of the tip assembly, and wherein a radius of curvature of the arcuate curve is adjustable in response to movement of the portion of the cable in the first direction.

35. A method of using a catheter having a handle, the handle having walls defining a cavity, a proximal end, a distal end, and a longitudinal axis that extends from the proximal end of the handle to the distal end of the handle, the method comprising acts of:

applying a compressive force to a portion of a cable that is disposed in the cavity to move the portion of the cable in a first direction that is substantially aligned with the longitudinal axis of the handle; and

within the cavity, constraining the portion of the cable such that the portion of the cable is prevented from moving in a second direction that is transverse to the first direction in response to the act of applying;

wherein the catheter includes an elongated shaft having a proximal end that is attached to the distal end of the handle, wherein the cable extends through the distal end of the handle and into the elongated shaft, wherein a distal end of the elongated shaft is coupled to a conductive braided mesh, and wherein a distal end of the cable is attached to one of a distal end and a proximal end of the braided mesh, the method further comprising an act of moving the one of the distal end and the proximal end of the braided mesh distally in response to movement of the portion of the cable in the first direction.

36. The method of claim 35, further comprising an act of:

applying a rotational force to an actuator that is disposed on the handle and attached to the portion of the cable to apply the compressive force to the portion of the cable.

37. The method of claim 35, further comprising an act of:

applying a linear force to an actuator that is disposed on the handle and attached to the portion of the cable to apply the compressive force to the portion of the cable.

38. The method of claim 35, wherein the catheter includes an elongated shaft having a proximal end that is attached to the distal end of the handle, wherein the cable extends through the distal end of the handle and into the elongated shaft, and wherein a distal end of the cable is attached to a distal end of the elongated shaft, the method further comprising an act of moving the distal end of the elongated shaft relative to the proximal end of the elongated shaft in response to movement of the portion of the cable in the first direction.

39. The method of claim 35, wherein the act of constraining comprises constraining the portion of the cable with a mandrel having a through-hole occupied by a portion of the cable, wherein the through-hole is sized and shaped to prevent the portion of the cable occupying the through-hole from moving in any direction transverse to the first direction.

40. The method of claim 39, wherein the through-hole has a diameter that is 25 to 50 percent greater than an outer diameter of the cable.

41. The method of claim 39, wherein the through-hole has a diameter that is 10 to 20 percent greater than an outer diameter of the cable.

42. A method of using a catheter having a handle, the handle having walls defining a cavity, a proximal end, a distal end, and a longitudinal axis that extends from the proximal end of the handle to the distal end of the handle, the method comprising acts of:

applying a compressive force to a portion of a cable that is disposed in the cavity to move the portion of the cable in a first direction that is substantially aligned with the longitudinal axis of the handle; and

within the cavity, constraining the portion of the cable such that the portion of the cable is prevented from moving in a second direction that is transverse to the first direction in response to the act of applying;

wherein the catheter includes an elongated shaft having a proximal end that is attached to the distal end of the handle, wherein the cable extends through the distal end of the handle and into the elongated shaft, and wherein a distal end of the elongated shaft includes at least one electrode that is movably attached to a distal end of the cable, the method further comprising an act of moving the at least one electrode distally along the distal end of the elongated shaft in response to movement of the portion of the cable in the first direction.

43. The method of claim 42, wherein the catheter includes an elongated shaft having a proximal end that is attached to the distal end of the handle, wherein the cable extends through the distal end of the handle and into the elongated shaft, wherein a distal end of the elongated shaft includes a tip assembly having an arcuate curve, and wherein a distal end of the cable is attached to a distal end of the tip assembly, the method further comprising an act of adjusting a radius of curvature of the arcuate curve in response to movement of the portion of the cable in the first direction.

44. A catheter comprising:

an elongated shaft; and

a handle comprising;

a housing having a proximal end and a distal end, the distal end of the housing being attached to a proximal end of the elongated shaft;

a cable, disposed in the housing, that extends through the distal end of the housing and into the elongated shaft;

an actuator, attached to the housing and the cable, the actuator being movable between a first position in which the cable extends a first distance into the elongated shaft and a second position in which the cable extends a second distance into the elongated shaft, the second distance being less than the first distance; and

a guide, disposed in the housing and separate from the elongated shaft, adapted to maintain a portion of the cable that is disposed between the distal end of the housing and the actuator when the actuator is in the second position in a substantially fixed lateral position when the actuator is moved toward the first position;

wherein a distal end of the elongated shaft is coupled to a conductive braided mesh; and

wherein a distal end of the cable is coupled to a distal end of the braided mesh, and wherein the distal end of the conductive braided mesh is movable proximally and distally in response to movement of the actuator.

45. The catheter of claim 44, wherein the guide includes:

a hollow mandrel formed from a material that is stiffer, in compression, than the cable, the cable being disposed within the mandrel; and

a retainer, attached to the housing and the mandrel, to retain the mandrel in a fixed position within the housing.

46. The catheter of claim 45, wherein the mandrel is cylindrically shaped.

47. The catheter of claim 45, wherein the mandrel has a length that is approximately twenty percent of a length of the portion of the cable that is disposed between the distal end of the elongated shaft and the actuator when the actuator is in the second position.

48. The catheter of claim 46, wherein the housing has a longitudinal axis that is aligned with the proximal end of the elongated shaft, and wherein the actuator is a slide actuator that is movable along the longitudinal axis of the housing.

49. The catheter of claim 48, wherein the substantially fixed lateral position is aligned with the longitudinal axis of the housing.

50. The catheter of claim 44, wherein the guide is separate from the housing and removably attached thereto.

51. The catheter of claim 44, wherein the guide is further adapted to maintain the portion of the cable that is disposed between the distal end of the housing and the actuator when the actuator is in the second position in the substantially fixed lateral position when the actuator is moved toward the second position.

52. The catheter of claim 44, wherein the actuator is a thumb wheel actuator.

53. The catheter of claim 44, wherein the cable is movable distally with respect to the housing in compression, and proximally with respect to the housing in tension.

54. The catheter of claim 44, wherein the cable is approximately 0.011 inches in diameter.

55. The catheter of claim 44, wherein the elongated shaft has a diameter of approximately 6 French.

56. The catheter of claim 44, wherein the catheter is an electrophysiology catheter.

57. The catheter of claim 44, wherein a distal end of the cable is attached to a distal end of the elongated shaft, and wherein the distal end of the elongated shaft is movable relative to a proximal end of the elongated shaft in response to movement of the actuator.

58. The catheter of claim 44, wherein the guide includes a mandrel having a through-hole occupied by a portion of the cable, and wherein the through-hole has a diameter that is 25 to 50 percent greater than an outer diameter of the cable.

59. The catheter of claim 44, wherein the guide includes a mandrel having a through-hole occupied by a portion of the cable, and wherein the through-hole has a diameter that is 10 to 20 percent greater than an outer diameter of the cable.

60. A handle for use with a catheter having an elongated shaft, the handle comprising:

a housing having a proximal end and a distal end, the distal end of the housing being attached to a proximal end of the elongated shaft;

a cable, disposed in the housing, that extends through the distal end of the housing and into the elongated shaft;

an actuator, attached to the housing and the cable, the actuator being movable between a first position in which the cable extends a first distance into the elongated shaft and a second position in which the cable extends a second distance into the elongated shaft, the second distance being less than the first distance; and

a guide, disposed in the housing and separate from the elongated shaft, adapted to maintain a portion of the cable that is disposed between the distal end of the housing and the actuator when the actuator is in the second position in a substantially fixed lateral position when the actuator is moved toward the first position;

wherein the actuator is a thumb wheel actuator; and

wherein the thumb wheel includes an arcuate wall, disposed on a proximal portion of the thumb wheel actuator, that prevents the cable from bowing in a lateral direction as the thumb wheel is rotated toward the first position.

61. The handle of claim 60, wherein the arcuate wall spans less than one hundred and eighty degrees.

62. A catheter comprising:

an elongated shaft; and

a handle, the handle comprising;

a housing having a proximal end and a distal end, the distal end of the housing being attached to a proximal end of the elongated shaft;

a cable, disposed in the housing, that extends through the distal end of the housing and into the elongated shaft;

an actuator, attached to the housing and the cable, the actuator being movable between a first position in which the cable extends a first distance into the elongated shaft and a second position in which the cable extends a second distance into the elongated shaft, the second distance being less than the first distance; and

a guide, disposed in the housing and separate from the elongated shaft, adapted to maintain a portion of the cable that is disposed between the distal end of the housing and the actuator when the actuator is in the second position in a substantially fixed lateral position when the actuator is moved toward the first position;

wherein a distal end of the elongated shaft includes at least one electrode; and

wherein a distal end of the cable is attached to the at least one electrode, and wherein the at least one electrode is movable proximally and distally along the distal end of the elongated shaft in response to movement of the actuator.

63. The catheter of claim 62, wherein a distal end of the elongated shaft includes a tip assembly has an arcuate curve, wherein a distal end of the cable is attached to a distal end of the tip assembly, and wherein a radius of curvature of the arcuate curve is adjustable in response to movement of the actuator.

64. A handle for use with a catheter having an elongated shaft, the handle comprising:

a housing having a proximal end and a distal end, the distal end of the housing being attached to a proximal end of the elongated shaft;

a cable, disposed in the housing, that extends through the distal end of the housing and into the elongated shaft;

an actuator, attached to the housing and the cable, the actuator being movable between a first position in which the cable extends a first distance into the elongated shaft and a second position in which the cable extends a second distance into the elongated shaft, the second distance being less than the first distance; and

a guide, disposed in the housing and separate from the elongated shaft, adapted to maintain a portion of the cable that is disposed between the distal end of the housing and the actuator when the actuator is in the second position in a substantially fixed lateral position when the actuator is moved toward the first position;

wherein the cable is a first cable, the actuator is a first actuator, the guide is a first guide, and wherein the substantially fixed lateral position is a first substantially fixed lateral position, the handle further comprising;

a second cable, disposed in the housing, that extends through the distal end of the housing and into the elongated shaft;

a second actuator, attached to the housing and the second cable, the second actuator being movable between a third position in which the second cable extends a third distance into the elongated shaft and a fourth position in which the second cable extends a fourth distance into the elongated shaft, the fourth distance being less than the second distance; and

a second guide, disposed in the housing, adapted to maintain a portion of the second cable that is disposed between the distal end of the housing and the second actuator when the second actuator is in the fourth position in a second substantially fixed lateral position when the second actuator is moved toward the third position.

65. The handle of claim 64, wherein the second cable is movable distally with respect to the housing in compression, and proximally with respect to the housing in tension.