Tissue slitting methods and systems

• US 9,949,753 B2
• Filed: 03/14/2013
• Issued: 04/24/2018
• Est. Priority Date: 09/14/2012
• Status: Active Grant

• Current Assignee: Spectranetics Corporation (Koninklijke Philips N.V.)
• Original Assignee: Spectranetics Corporation (Koninklijke Philips N.V.)
• Inventors: Bowe, Wade A., Burton, George Woodrow, Dalby, Paul Joseph, Sotak, Ryan Michael
• Primary Examiner(s): JENNESS, NATHAN JAY
• Application Number:
  US13/828,231
• Publication Number:
  US 20140081303A1
• Time in Patent Office: 1,867 Days
• CPC Class Codes: A61B 17/3203 Fluid jet cutting instruments
• CPC Class Codes: A61B 17/32037 for removing obstructions from inner organs or blood vessels, e.g. for atherectomy
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• 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 17/3211 Surgical scalpels, knives; Accessories therefor
• CPC Class Codes: A61B 17/50 Instruments, other than pincettes or toothpicks, for removing foreign bodies from the human body locating otherwise A61B5/06; locating by radiation A61B6/00; removing calculi A61B17/22; from the eyes A61F9/00709
• CPC Class Codes: A61B 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61B 2017/320004 abrasive
• CPC Class Codes: A61B 2017/320044 Blunt dissectors blunt suture needles A61B2017/06085
• CPC Class Codes: A61B 90/02 Devices for expanding tissue, e.g. skin tissue implements for holding wounds open, surgical tractors A61B17/02; implantable mammary prosthesis A61F2/12; dilators A61M29/00
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• 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
• CPC Class Codes: F04C 2270/041 Controlled or regulated
• CPC Class Codes: G10L 21/00 Speech or voice signal processing techniques to produce another audible or non-audible signal, e.g. visual or tactile, in order to modify its quality or its intelligibility G10L19/00 takes precedence
• CPC Class Codes: H04L 65/403 Arrangements for multi-party communication, e.g. for conferences data switching systems for conference H04L12/18; arrangements for connecting several subscribers to a common circuit, i.e. affording conference facilities H04M3/56; television conferencing systems H04N7/15
• CPC Class Codes: H04M 3/568 audio processing specific to telephonic conferencing, e.g. spatial distribution, mixing of participants echo suppression in two-way loud-speaking telephone systems H04M9/02; sound field processing per se H04S7/30

Abstract

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

Claims

1. A tissue slitting apparatus comprising:

a shaft, wherein the shaft is flexible, the shaft having a proximal and a distal end, and wherein the shaft includes an inner lumen running from the proximal end to the distal end to receive at least one of an implanted object and mechanical traction device, and a central axis running along the inner lumen of the shaft; and

a laser member carried by the inner lumen of the shaft, the laser member comprising;

a plurality of optical fibers exposed adjacent to the distal end of the shaft, the plurality of optical fibers being aligned along only one direction perpendicular to the central axis of the shaft, wherein the plurality of optical fibers are configured to receive light energy from a laser light source and emit the light energy at the distal end in a distal direction; and

an engagement feature comprising a surface forming an arc extending less than 360 degrees, wherein the surface is configured to engage the at least one of the implanted object and the mechanical traction device, the surface disposed between the central axis of the shaft and the plurality of optical fibers.

2. A tissue slitting apparatus comprising:

a shaft, wherein the shaft is flexible, the shaft having a proximal and a distal end, and wherein the shaft includes an inner lumen running from the proximal end to the distal end to receive at least one of an implanted object and mechanical traction device, and a central axis running along the inner lumen of the shaft, and wherein the distal end comprises a wall disposed radially outwardly relative to the inner lumen; and

a laser member carried by the inner lumen of the shaft, the laser member comprising;

a plurality of optical fibers exposed adjacent to the distal end of the shaft, the plurality of optical fibers being aligned along only one radial direction perpendicular to the central axis of the shaft, wherein one of the plurality of optical fibers is disposed radially outwardly of the wall at the distal end, and another one of the plurality of optical fibers is disposed radially inwardly of the wall at the distal end, wherein the plurality of optical fibers are configured to receive light energy from a laser light source and emit the light energy at the distal end in a distal direction; and

an engagement feature comprising an arcuate surface, wherein the arcuate surface is configured to engage the at least one of the implanted object and the mechanical traction device, the arcuate surface disposed between the central axis of the shaft and the plurality of optical fibers.

3. The tissue slitting apparatus of claim 2, further comprising the laser light source.

4. The tissue slitting apparatus of claim 3, wherein the laser light source is configured to output one or more wavelengths of laser light.

5. The tissue slitting apparatus of claim 3, wherein the laser light source is an XeCl Excimer laser and the light energy has a wavelength of 308 nm.

6. The tissue slitting apparatus of claim 3, further comprising a second laser light source configured to generate light energy, wherein the light energy generated by the second laser light source has a wavelength other than 308 nm.

7. The tissue slitting apparatus of claim 3, further comprising at least one optical component disposed between the plurality of optical fibers and the laser light source, wherein the at least one optical component is configured to alter a characteristic associated with the light energy.

8. The tissue slitting apparatus of claim 7, wherein the at least one optical component is one or more of a filter, lens, prism, coating, film, and deposited layer of optically transmissive material.

9. The tissue slitting apparatus of claim 3, wherein the tissue slitting apparatus is configured to subject a tissue growth to a slitting action only about a partial periphery of an internal diameter of the tissue growth adjacent to and at least substantially surrounding the implanted object at any point along the implanted object.

10. The tissue slitting apparatus of claim 3, wherein each of the plurality of optical fibers comprises a terminating end, wherein the terminating end of the plurality of optical fibers are disposed to emit light energy at an angle relative to the central axis of the shaft.

11. The tissue slitting apparatus of claim 3, wherein each of the plurality of optical fibers comprises a terminating end, wherein the terminating end of the plurality of optical fibers are disposed to emit light energy parallel to the central axis of the shaft.