Devices and methods for accessing the vasculature of a patient
Inventors
Rosenman, Daniel C. • Kayser, Daniel • Altman, Peter A.
Assignees
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Publication Number
US-10874831-B2
Publication Date
2020-12-29
Expiration Date
Abstract
A steerable guide sheath system adapted for delivery into a patient's vasculature. The pull wire which is used to tension the deflectable portion of the sheath is wrapped or twisted around the axis of the sheath.
Core Innovation
The invention relates to a steerable guide sheath system adapted for delivery into a patient's vasculature. The system includes a main tubular body having a distal deflectable portion that extends to a distal end and a main body portion extending to a proximal end, with a lumen extending therebetween. Deflection of the distal deflectable portion is controlled using a pull wire that is routed through a pull wire tube arrangement positioned with respect to a main tubular body axis.
A pull wire tube includes a portion twisted or rotated around the main tubular body, with the twisted or rotated portion spaced distally from the proximal end of the main tubular body. The pull wire tube further includes a distal straight segment extending distally from the twisted or rotated portion and a proximal straight segment extending along the main tubular body to the proximal end of the sheath. The pull wire itself includes a twisted or rotated pull wire portion corresponding to the pull wire tube portion and distal and proximal straight pull wire segments, where the distal straight pull wire segment is secured to the distal deflectable portion to control deflection.
The pull wire tube portion and the pull wire portion that are twisted or rotated are configured such that translation of the pull wire through the twisted or rotated portion evens out the pull wire length and moment of inertia of the main tubular body with respect to a main axis of the guide while the guide is being rotated by the user. This functional arrangement is applied as part of steerable guide sheath delivery into various vasculature targets described in the disclosed embodiments.
Claims Coverage
The document provides two independent claims (clm-00001 and clm-00002). Both claims share the same core inventive concept: a steerable guide sheath with a distal deflectable portion actuated by a pull wire routed through a pull wire tube having a twisted or rotated portion, together with a functional outcome during user rotation related to evening out pull wire length and moment of inertia.
Steerable guide sheath with distal deflectable portion and pull-wire actuated deflection
A main tubular body having a distal deflectable portion and a main body portion with a lumen, together with a pull wire secured to the distal deflectable portion to control deflection of the distal deflectable portion.
Twisted or rotated pull wire tube around the main tubular body
A pull wire tube with a proximal end, a distal end, and a pull wire lumen, wherein a portion of the pull wire tube is twisted or rotated around the main tubular body and is spaced distally from the proximal end of the main tubular body.
Distal and proximal straight segments of the pull wire tube
The pull wire tube having a distal straight segment extending distally from the twisted or rotated portion and a proximal straight segment extending along the main tubular body to the proximal end of the sheath.
Twisted or rotated pull wire portion with distal and proximal straight pull-wire segments
A pull wire extending through the pull wire tube between the proximal and distal ends, where the pull wire has a twisted or rotated pull wire portion and a distal straight pull wire segment extending distally from the twisted or rotated pull wire portion, and a proximal straight pull wire segment extending proximally toward the proximal end of the sheath.
Evening out pull wire length and moment of inertia during rotation by translating through the twisted or rotated portion
Wherein translation of the pull wire through the twisted or rotated portion of the pull wire tube evens out the pull wire length and moment of inertia of the main tubular body with respect to a main axis of the guide while the guide is being rotated by the user.
Across the independent claims, the inventive coverage centers on the use of a pull wire and pull wire tube with twisted or rotated portions spaced distally from the proximal end, coupled with distal and proximal straight segments and a distal attachment to the distal deflectable portion, where translating the pull wire through the twisted or rotated portion evens out pull wire length and the main tubular body’s moment of inertia during user rotation.
Stated Advantages
Evening out pull wire length and moment of inertia of the main tubular body with respect to a main axis of the guide while the guide is being rotated by the user.
Documented Applications
Carotid artery stenting.
Renal artery access.
Abdominal aortic aneurysm stent graft crossing at an aneurysm bifurcation.
Left internal mammary artery (LIMA) access.
Coronary sinus and cardiac venous sub-selection.
Coronary ostium access.
Intracardiac echography (ICE) imaging.
Neurological interventions.
Additional percutaneous procedures.
MRI compatibility considerations via material choices/contrast concepts (as discussed in the embodiments).
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