WO2010031581A1

WO2010031581A1 - Guide wire fixing device

Info

Publication number: WO2010031581A1
Application number: PCT/EP2009/006797
Authority: WO
Inventors: Joop Meijer; Peter R. Stella
Original assignee: Joop Meijer; Stella Peter R
Priority date: 2008-09-22
Filing date: 2009-09-21
Publication date: 2010-03-25

Abstract

The invention relates to a guide wire fixing device for the endovascular treatment of a patient, comprising a holding body (2) which includes a holder for a hemostatic valve and at least one fixing unit (6) for a guide wire (15), wherein the holder comprises at least one elastic holding element (3, 4, 5) into which the hemostatic valve can be snapped. Each fixing unit (6) comprises a receptacle for the guide wire (15) and a fixing means (8) with which the guide wire (15) can be fixed. The fixing means (8) can be adjusted between an open and a closed position.

Description

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The invention relates to a guide wire fixation device for the endovascular treatment of a patient with a holding body, which has a holder for a hemostatic valve and at least one fixation for a guide wire.

In interventional treatment techniques, medical instruments, in particular catheters, guide wires, implants, dilating means and the like, are usually introduced into the patient via the groin. The introductory port is a hemostasis valve, which is usually equipped with a side arm and is often called a "Y-connector. The guide wires used in these interventional techniques serve, on the one hand, the placement of the catheter and, on the other hand, the guidance, placement and operation of the actual treatment agent, ie the implant or the dilatation balloon. In practice, it is necessary during the treatment to fix the guide wires so that they do not move unintentionally in the longitudinal direction. On the other hand, however, it is often necessary to make such a shift for readjustment.

Conventionally, the attending physician fixes the guide wires between two fingers of his hand. However, this complicates other manipulations, such as the handling of a dilatation balloon or detachment of an implant. For this reason, fixing devices have been developed. Such a fixing device is known, for example, from US Pat. No. 6,986,749 B2 /

DE 19948 409 C1. Although this fixing device allows the fixation

BESTATIGUNGSKOPIE However, the guide wires, without having to be held, but limits the ability to manipulate significantly by a rather complicated operation.

While the fixing device described above can be simply clipped onto a hemostatic valve, a fixation device directed to the same target according to WO 2005/072807 A1 is firmly connected to the hemostasis valve. For this purpose, the hemostatic valve is fixed in a bore of the holder and has proximally a clamping device for fixing two guide wires, which are pressed by a spring mechanism against a rail on. A disadvantage of this device is that the fixation device must be attached to the hemostatic valve before the start of the treatment and can not be removed from it during the treatment and that the fixation of the guide wires only knows a closed position. If the guide wires are to be moved again after the fixation, the doctor needs two hands, on the one hand to solve the clamping device, which must be kept in the open position and the other for the manipulation of the guide wires.

In view of this, there is a need for an easy to handle and attachable to a hemostatic valve at any time

Fixation device, in which the guide wire or wires from the treating

Doctor can be fixed in a simple manner or can be solved and moved. Such a fixing device should also the use of

Guidewires and medical instruments of different caliber allow and be adjustable so that even with strict fixation no

Injury or damage to the surface or a

Surface coating takes place.

This object is achieved with a guide wire fixing device of the type described above, in which the holder has at least one elastic retaining element, in which the hemostatic valve can be locked and each fixation has a receptacle for a guide wire and a fixing means with which the guide wire which can be Fixing means between an open and a closed position is adjustable.

The fixing device according to the invention is held on the integrated holding body on a commercial hemostatic valve and held in position. It has at least one fixation for a guide wire, preferably two fixations.

The holder is designed as an elastic holding element which can be snapped onto the hemostasis valve. The holder is such that guidewires exiting the hemostasis valve pass through the fixative. The fixing means has an open and a closed position, so that each wire can be fixed with a simple hand movement.

Preferably, each fixing means is continuously adjustable between an open and a closed position.

As a fixative, each fixation on a flexible tongue, with the help of each guided guide wire is set against a fixed inner wall. The determination is carried out for example via a continuously adjustable screw, in which the extreme positions can be adjusted with less than one revolution of the screw, preferably with less than half a turn of the screw.

The elastic holding elements of the holder of the device according to the invention are preferably elastic clips, in particular three elastic clips which are snapped onto the hemostatic valve. Such elastic clips, for example, consist of open rings whose opening is about 1/3, preferably about 1/4 of the circumference. The clips are preferably arranged so that the hemostatic valve is held immovably in the longitudinal direction. Nevertheless, a rotation about the longitudinal axis in the holder readily possible. In the embodiment with two fixations for one guidewire each, the fixations are expediently arranged on an inner wall of the device, the inner wall lying on the longitudinal axis of the fixation device. This allows the arrangement of the screws on the outside, with their effect is directed inwards against each other.

Each fixation expediently has a wire guide in which the respective guide wire is guided between the inner wall and the tongue. Preferably, there is still an outer boundary for each wire guide, so that the guide wire can not escape laterally from both sides.

In order to further improve the guidance of the guide wire in the fixing device, it is expedient to provide on the inner wall a projection, for example in the form of a nose, which prevents the guide wire from emerging or jumping out of the fixation.

As already stated, the fixing of the guide wire in the fixation is preferably carried out via a continuously adjustable screw which moves a flexible tongue against the guide wire. Such a screw has, for example, two mutually offset semicircular turns, engage in the complementarily arranged nubs of the associated screw socket. It allows a cost-effective production of the screw mechanism at the same time simple and safe handling. For safety reasons and to facilitate handling, each screw is self-locking.

Preferred embodiments are subject of the dependent claims.

The fixation device according to the invention can be attached to a hemostasis valve at any time during an interventional treatment and removed again therefrom. The guide wires to be fixed with it can simply be inserted and fixed with a handle or released again. Even after the release or release of the fixation, the guide wires remain in the guide, unless they are removed from it. By the particular stepless adjustability of the fixing means, such as fixing screws, it is possible to reliably fix guide wires or micro-catheter of different caliber.

The invention is explained in more detail by the accompanying drawings. Show it:

1 shows a fixing device according to the invention in a lateral view;

Figure 2 shows the device of Figure 1 of the

Front side;

Figure 3 shows the device of Figure 1 in the

Top view;

Figure 4 shows the detail F of Figure 1 and

FIG. 5 shows an elastic holder of the device from FIG. 1.

The fixing device 1 according to Figure 1 consists of an elongated support member 2, at the distal end of three elastic supports 3, 4 and 5 are arranged for clipping on a hemostatic valve. Distal here refers to the side facing the patient, proximal to the side facing the attending physician. The elastic retaining clips have a substantially round reception, which is surrounded by a wall in the manner of a tongs and remains open at the top, the opening making up approximately ^Λ A of the circumference, see FIG. 5.

The retaining clips 3, 4 and 5 are arranged at such distances from one another that the branch usually provided on hemostatic valves (Y-connector) is positioned between the clips 2 and 3 and, after lateral twisting, a locking and fixing of the valve in the longitudinal direction leads. Embodiments with only two retaining elements are also possible. The guide wires protruding from the hemostatic valve, which the doctor requires for his manipulations, are fixed in the fixing device in the fixation 6 arranged proximally on a projection of the carrier element 2.

The fixation 6 has a fixed inner wall 7 and an elastic and displaceable tongue 8, between which the guide wire is both guided and fixed. The guide is further improved by two further outer boundaries in the form of lamellae 9 and 10. A nose 11 located distally on the inner wall 7 holds the inserted guide wire in position even when the fixation is not activated. The fixing device has two such guides, which are arranged in mirror image to the inner wall 7.

The movable tongue is actuated by a screw (not shown) which is guided in the screw socket 12. The screw socket 12 has two knobs 13, 14 (Figure 4), which engage in two threaded portions on the screw, so as to allow the screwing, but at the same time limit, since the screw in the preferred embodiments, only two each half guided around the screw body threaded portions exhibit. In this case, one stop represents the closed position, the other the open position of the fixation. Upon actuation of the screw, the tongue 8 is pressed in the direction of the inner wall 7 and thus clamps the guidewire extending therebetween. The thread pitch is such that the screws are self-locking.

FIG. 2 shows the fixing device from the proximal end side, with the fixation 6, two retaining elements for the screwed sockets 13, the screwed sockets 12, the guide slats 9 and the lugs 11. The position 5 designates the visible part of the elastic retaining clip 5.

Figure 3 shows the device according to the invention in plan view with the arrangement of the retaining clips 3, 4 and 5 to each other are open at the top, the fixation 6 with the two Schraubfassungen 12, the inner wall 7, the two tongues 8 and the guide plates 9, 10th and the noses 11. Figure 4 shows in detail the detail F of Figure 1 with the screw socket 8 and the two therein arranged knobs 13, 14, which cooperate with the threaded portions of the screws, not shown. An inserted guide wire 15 extends in front of the inner wall 7 below the nose 11 and behind the tongue 8 and behind the guide blades 9 and 10th

FIG. 5 shows the distal retaining clip 3 with its approximately four-circle-shaped upward-pointing opening.

- Claims -

Claims

claims

A guidewire fixation device for the endovascular treatment of a patient with a holding body, which has a holder for a hemostatic valve and at least one fixation for a guide wire, characterized in that the holder has at least one elastic holding element (3, 4, 5), in the hemostatic valve can be locked in place and each fixation (6) has a receptacle for a guide wire (15) and a fixing means (8) with which the guide wire (15) can be fixed, wherein the fixation means (8) between an open and a closed position is adjustable.

2. Fixing device according to claim 1, characterized dadurch.d ass the fixing means (8) is infinitely adjustable between an open and a closed position.

3. Fixing device according to claim 1 or 2, characterized in that each fixation (6) has a flexible tongue (8), which defines the respectively guided guide wire (15) against a fixed inner wall (7), wherein the determination of a continuously adjustable screw is done.

4. Fixing device according to claim 1, 2 or 3, characterized by three elastic clips (3, 4, 5) for receiving the hemostatic valve.

5. Fixing device according to claim 4, characterized in that the clips (3, 4, 5) consists of open rings whose opening makes up approximately ^Λ Λ of the circumference.

6. Fixing device according to one of claims 3 to 5, characterized by two fixings (6) for each guide wire (15).

7. Fixing device according to claim 6, characterized in that the two fixings (6) are arranged opposite each other on an inner wall (7), wherein the inner wall (7) on the longitudinal axis of the fixing device (1) is arranged.

8. Fixing device according to claim 6 or 7, characterized in that each fixation (6) has a wire guide, in which the respective guide wire (15) between the inner wall (7) and the tongue (8) is guided.

9. Fixing device according to claim 8, characterized by at least one further outer boundary (9, 10) of each wire guide.

10. Fixing device according to one of claims 6 to 9, characterized in that the inner wall (7) distally a nose (11) which retains the guide wire (15) after its introduction into the wire guide.

11. Fixing device according to claim 3, characterized in that the screw continuously between an open and a closed

Adjustable position, each screw in a screw socket (12) runs.

12. A fixing device according to claim 11, characterized in that each screw has two mutually offset semicircular turns, the complementarily arranged knobs (13, 14) engage the associated screw socket.

13. Fixing device according to claim 12, characterized in that each screw is designed to be self-locking.

- Summary -