CN109069836A - 介入式医疗系统及其改进的组件及相关联的使用方法 - Google Patents
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Abstract
系统包括递送导管和独立包装的可植入医疗装置组件。该组件包括相对紧凑的可植入医疗装置、支承轴、系绳以及圈套芯轴。系绳在支承轴内延伸,并且该系绳具有远侧部和近侧部,该远侧部在支承轴的远端处联接至装置,该近侧部则从支承轴的近端伸出,以通过圈套芯轴的钩部进行接合。操作者可以利用接合后的圈套芯轴将支承轴拉入导管内轴的内腔中,使得联接后的装置与导管内轴的扩口端接合。然后,在将系绳的近侧部锁定在导管内后,操作者可以使导管的接纳部在装置上前进。
Description
技术领域
本发明涉及可植入医疗装置的递送,并且更具体地涉及一种有助于将相对紧凑的可植入心脏医疗装置固定至递送导管的系统、其改进的组件及相关联的方法。
背景
传统的可植入心脏起搏器包括脉冲发生器装置,一根或多根柔性细长引线联接于该脉冲发生器。该装置典型地远离心脏地植入于皮下囊袋中,并且一根或多根引线中的每根引线都从该脉冲发生器装置延伸至对应的电极、联接于该电极并定位在起搏部位处,即心内膜或心外膜处。有时与细长的引线相关联并且对于本领域技术人员而言众所周知的机械并发症和/或MRI兼容性问题激发了心脏起搏装置的发展,这些心脏起搏装置完全容纳在相对紧凑的包装内,用以紧邻于起搏位置地植入,例如在心脏的右心室RV内。
图1示意性地示出了植入后的相对紧凑的可植入医疗装置100的示例。图1示出了已经通过导管200递送的医疗装置100,操作者已经将该医疗装置100向上操作通过下腔静脉IVC和右心房RA进入到右心室RV中。装置100被示出为部署在右心室心尖内的植入部位处。另一潜在的心脏植入部位可位于右心房RA的附肢内或在管状静脉内。装置100和导管200可分别与在共同转让的美国专利申请US2015/0094668中描述的装置和工具相似。
图1还示出了装置100包括:气密密封的封壳105,该封壳105收容脉冲发生器电子器件和电源(未示出);起搏/感测电极111、112,该起搏/感测电极111、112形成在封壳105的外表面上;以及固定构件,该固定构件例如通过安装至封壳105的远端的可弹性变形的多个指状件115形成且靠近电极111,以用于将电极111固定或稳固抵靠在植入部位处的心内膜表面。封壳105较佳地由诸如钛之类的可生物相容且生物稳定的金属形成,除了形成有电极112以构成上述金属的露出部分的位置以外,该金属上覆盖有绝缘层、例如医用级聚氨酯或硅酮。诸如任何本领域技术人员已知的合适类型的气密馈通组件将电极111联接于容纳在封壳105内的脉冲发生器。
装置100被示出为通过该装置100的固定构件的指状件115固定在植入部位,但仍然通过柔性系绳280固定至导管200,该柔性系绳280从导管200的远侧开口203延伸出来并且连结至装置100的接合构件121。因此,操作者经由系绳280能够测试装置100在植入部位处的固定,以及/或者根据需要从植入部位移除装置100以将该装置100重新定位在更合适的部位处。一旦对装置100的植入感到满意,则操作者就能够通过释放系绳280的一长度281的端部而将系绳280从装置100分离,并且随后拉动系绳280的另一长度282以向近侧通过递送导管200抽出整个长度282,使得系绳的长度281向远侧被拉动并穿过接合构件121。
典型地通过将系绳280打成环穿过接合构件121的工序来实现利用系绳280将装置100固定至导管200,在上述工序后,系绳280的第一长度281和第二长度282穿过导管200的一个或多个内腔以使上述第一长度281和第二长度282的相对的端部从导管200的近侧开口201突出。由于上述工序可能有点繁琐,因而装置100和导管200的制造商可能将两者固定在一起作为一个系统,并且将该系统以单个消毒包装的方式提供给操作者。然而,由于考虑到保存期的缘故,因而可能优选的是上述装置与相关联的导管独立地包装,因此,可能期望用于将上述装置固定至导管的替代手段以增加操作者在植入手术时将上述装置固定至导管的容易程度。
概述
本文中公开的介入式医疗系统包括递送导管以及独立包装的可植入装置组件。根据一些示例,递送导管包括细长的内轴和接纳部,所述内轴具有包围该内轴的内腔的最远侧开口的扩口端,所述接纳部与内轴滑动接合;所述装置组件包括相对近侧的可植入医疗装置、支承轴以及系绳,所述系绳在支承轴内延伸,并且所述系绳的远侧部从支承轴的远端伸出且将装置联接至支承轴。装置组件还可包括细长的圈套芯轴,该圈套芯轴具有形成为钩部以与系绳的近侧部接合的远端,所述系绳的近侧部从至轴承的近端伸出,使得操作者可以利用圈套芯轴将支承轴拉入递送导管的内轴的内腔内并且使联接后的装置与内轴的扩口端接合。当联接后的装置由此接合时,操作者可以将系绳的近侧部锁定在递送导管内并随后使导管的接纳部在装置上前进以使装置收容在所述接纳部内。在一些示例中,可植入装置组件还包括能够附连至系绳的近侧部或从该系绳的近侧部卸下的系绳的保持件。
附图简介
下面的附图是对本发明的具体实施例的说明,并且因此不限制本发明的范围。各附图不按比例(除非指出)且旨在与下面的详细描述中的解释结合使用。下面将结合附图描述各示例,其中,相同的附图标记表示相同的元件,附图中:
图1示意性地示出了植入后的相对紧凑的可植入医疗装置的示例;
图2A是根据一些示例的介入式医疗系统的俯视图;
图2B是根据一些示例的通过图2A的剖面线B-B所取得的局部剖视图;
图3A是根据一些示例的图2A所示系统的医疗装置组件的立体图;
图3B是根据一些示例的医疗装置组件的各部件的俯视图;
图4A-4D是概述了用于将系统的相对紧凑的可植入医疗装置固定至系统的递送导管的图2A所示系统的各种俯视图;以及
图5是根据一些示例的导管的手柄的内部构造的俯视图。
详述
下面的详细描述在本质上仅仅是示例性的,但不意在以任何方式限制系统、组件或方法的范围、应用或构造。相反,下文描述提供的是实践性的示例,且本领域技术人员会认识到其中一些示例可具有合适的替代。
图2A是根据一些示例的介入式医疗系统3400的俯视图。图2A示出了系统3400的递送导管300,该系统3400包括手柄310、细长的外轴320以及联接至手柄310的冲洗组件315。图2B是通过图2A的剖面线B-B所取得的局部剖视图,该图2B示出了外轴320的最远侧部322,该最远侧部322限定具有最远侧开口303的接纳部321,其中,接纳部321的尺寸被设定成收容系统3400的诸如装置100之类的可植入医疗装置以,用于将该装置递送至植入部位。图2B示出了在外轴320的内腔302内延伸的导管300的内轴350,该内腔302与接纳部321流体连通。根据所示的实施例,接纳部321与内轴350滑动接合并且可借助于手柄310的第一控制构件311(图2A)相对于内轴350缩回和前进(以用于下文中进一步详细描述的目的),外轴320联接至其上。另外,轴320的内腔302可经由冲洗组件315冲洗。
根据一些示例,可以采用相似于序列号14/039,937(代理案卷号C00005393.USU1)的共同未决且共同转让的美国专利申请2015/0094668中描述的工具的部署管的方式构造外轴320。例如,外轴320可以由不锈钢编织增强医用级聚合物形成,上述不锈钢编织增强医用级聚合物例如是布置成刚度从手柄310至最远侧部322递减的一个或多个合适等级的聚醚嵌段酰胺(例如,包括3533、6333、4033以及7233),并且接纳部321的直径可以达到大约0.3英寸(7.6mm)。最远侧部322可以具有根据本领域技术人员所知的方法混合在该远端322内的不透射线填充物、或粘结至该远端322的不透射线标记物(例如,填充钨的)。图2A进一步示出了包括第二控制构件312的手柄310,该第二控制构件312可联接至安装在内轴350内的牵引线,其中,牵引线能够经由该控制构件312操作以使内轴350和外轴320偏转,以将导管300如上文结合图1所描述的那样导向至植入部位。
图2B进一步示出了装置100固定至导管300并且收容在外轴320的接纳部321内,使得装置100的近端11与内轴350的扩口端352接合。根据所示的实施例,扩口端352限定有通入内轴350的内腔305内的最远侧开口35(参见图4A-4B),其中,如图3A-3B所示,内腔305的尺寸被设定成接纳系统3400的医疗装置组件400的支承轴450(应当注意的是,内轴350可包括沿着内腔305延伸并且接纳前述的牵引线的另一内腔)。根据示例性实施例,扩口端352可通过例如7233之类的聚醚嵌段酰胺形成,内轴350的其余部分则可通过例如挤出型聚醚嵌段酰胺、聚氨酯、硅橡胶或上述材料的复合物的管形成,该管包括由编织增强聚醚嵌段酰胺形成的覆盖物。
图3A是医疗装置组件400的立体图,根据一些示例,该医疗装置组件400构造成将诸如装置100之类的相对紧凑的医疗装置固定至导管300并且与导管300独立地包装。因此,如上所述,当导管300作为组件400的一部分独立地包装时,该导管300在其自身的包装内的保存期独立于装置100的保存期。这在制造装置100的电极111以使在该电极111内嵌入有抗炎类固醇时尤为重要。图3A示出了组件400,该组件包括装置100、支承轴450以及细长的系绳480,其中,系绳480联接至装置100并具有第一长度481和第二长度482,该第一长度481在支承轴450的内腔45内延伸,该第二长度482则沿着第一长度481在内腔45内、或在支承轴450的沿着内腔45延伸的另一内腔内(未示出)、或者邻近支承轴450的外表面延伸。图3A进一步示出了装置组件,该装置组件包括附连至系绳480的近侧部484(参见图3B)的可选的系绳的保持件460,该近侧部484靠近支承轴450的近端456。
图3B是根据一些示例的装置组件400的各部件的俯视图,其中,上述各部件彼此分开表示。图3B示出了组件400的部件还包括细长的圈套芯轴490,该圈套芯轴490具有形成为钩部的远端494。根据所示的实施例并且根据下文结合图4A-4C所描述的方法,远端494的钩部设计成与系绳480的近侧部484接合。图3B进一步示出了系绳480的近侧部484和远侧部483,该近侧部484和远侧部483分别在系绳480的相对的端部处将该系绳480的第一长度481和第二长度482连结在一起,并且当系绳480与支承轴450组装在一起时,如图3A所示,系绳的近侧部484从轴450的近端456伸出,而系绳的远侧部483则从轴450的远端457伸出。因此,系绳的近侧部484例如能够如图4A所示那样通过芯轴490接合,系绳的远侧部483例如能够如图4B所示那样联接至装置100的接合构件121。
进一步参照图3B,可选的系绳的保持件460被示出为处于该系绳的保持件460的第一部件460A、第二部件460B彼此分开的打开位置。图3B示出了包括成对的凹槽468和接纳部462,当保持件460例如如图3所示那样处于闭合位置时,上述成对的凹槽468用于接纳该凹槽468内的第一长度481和第二长度482,上述接纳部462用于接纳第一部件460A的突出部463并且与该突出部463互锁接合。根据示例性实施例,保持件460通过具有活动铰链特性的任意合适的医用级塑料(例如,聚丙烯Pro-faxTM 6523)形成,使得第一部件460A和第二部件460B可以通过铰链466连结在一起。
图4A-4D是概略地示出了用于将装置100固定在导管300的接纳部321内的一些方法的系统3400的各种俯视图。
参照图4A,操作者已将圈套芯轴490插入导管300的内轴350的内腔305内,使得形成在圈套芯轴490的远端494的钩部从内轴350的最远侧开口35伸出。图4A示出了通过相对于内轴350缩回接纳部321而暴露于该接纳部321的最远侧开口303处或远离该接纳部321的最远侧开口303的最远侧开口35,其中,例如通过沿箭头R移动第一控制构件311(图2)来相对于内轴350缩回接纳部321。返回参照图3B,圈套芯轴490的长度Lm充分大于导管的内轴350的长度,使得芯轴490的近端从导管300的近端、例如从图2A所示的近侧端口开口301伸出。图4A进一步示出了定向好的装置组件400,使得从支承轴的近端456伸出的近侧部484指向导管300的内轴350的最远侧开口35。因此,操作者能够如图4A所示那样将圈套芯轴490的远端494处的钩部与系绳的近侧部484接合,并且随后将拉力施加至插入后的圈套芯轴490的近端以如图4B所示那样沿箭头P将支承轴450拉入导管的内轴350的内腔305内。
在一些示例中,当导管的内轴的内腔305的直径为大约1.6mm时,圈套芯轴490和支承轴450的最大外径可分别不大于大约1.14mm,使得上述圈套芯轴490和支承轴450可分别以滑动接合的方式接纳在内腔305内。根据示例性实施例,圈套芯轴490由医用级不锈钢形成,系绳480通过具有诸如PTFE之类的含氟聚合涂层的聚酯纤维形成,并且支承轴450通过挤出型聚醚嵌段酰胺、聚氨酯、硅橡胶或上述材料的复合物形成。
参照图4C,操作可继续沿箭头P拉动支承轴450直到系绳的近侧部484从导管300的近侧端口开口301伸出,并且联接后的医疗装置100与导管的内轴350的扩口端352接合。根据一些方法,在使导管300的接纳部321相对于内轴350沿箭头A前进之前,使装置100如图2B所示那样收容在接纳部321内,操作者可例如通过安装在手柄310内的锁定构件318将系绳480锁定在导管300内。下文将结合图5对锁定构件318进行描述。最后,在包括系绳的保持件460的装置组件400的那些示例中,在将芯轴490与系绳的近侧部484接合之前已经从该系绳的近侧部484卸下保持件460,随后操作者在将系统3400导向至植入部位之前将保持件460重新附连至上述近侧部484。一旦操作者已将最远侧开口303导入至靠近目标植入部位附近,则操作者就可例如通过沿箭头R移动控制构件311(图2)相对于内轴350和被收容的装置100缩回外轴320,以便将装置100的固定构件的指状部350与上述部位处的组织接合。一旦固定构件的指状部115接合,除了对部位处的装置100的电气性能进行评估,操作者就还可以通过抓持保持件460并将拉力施加至系绳480来测试装置100的固定。若操作者确定装置100需要重新定位至更合适的部位,则操作者再次抓持保持件460并可施加充分大的拉力以使指状部115脱开。不过,若操作者对植入感到满意,则该操作者可卸下保持件460、切断系绳的近侧部484并且拉动系绳的长度481、482中的一个长度以通过递送导管200向近侧抽出整个长度,从而使另一长度通过装置的接合构件121向远侧拉出。
图5是根据一些和示例的导管的手柄310的内部构造的俯视图,其中,手柄310的外表面或壳体510A的第一部分被移除以与壳体510B的第二部分分离。图5示出了在锁定构件318内延伸的系绳的长度481、482以及从近侧端口开口301伸出的系绳的近侧部484。锁定构件318可以是本领域技术人员已知的旋塞式阀,其中,当该阀的杆件沿箭头S1旋转时,关闭该阀以夹紧系绳的长度481、482并将该系绳的长度481、482固定在手柄310内。根据所示的实施例,当手柄的壳体的部分510A、510B被固定在一起时,锁定构件318的杆件可延伸通过形成在手柄的壳体的第一部分510A的凹陷表面内的相应的孔。图5进一步示出了根据一些示例的、在手柄310内延伸的支承轴450的近端456。
前述的详细描述中,已经参考具体的示例描述了本发明。但是,可理解的是在不背离所附权利要求书所阐述的本发明的范围的情况下,可进行各种修改和改变。
Claims (5)
1.一种用于将可植入医疗装置固定在递送导管的接纳部内的方法,所述方法包括:
相对于所述递送导管的内轴缩回所述递送导管的所述接纳部,使得所述内轴的细长的内腔的最远侧开口暴露于所述接纳部的最远侧开口处或远离所述接纳部的最远侧开口;
将细长的圈套芯轴插入所述递送导管的所述内轴的所述内腔内,使得所述圈套芯轴的钩部从所述内腔的露出的最远侧开口伸出,并且使所述圈套芯轴的近端从所述递送导管的近侧端口开口伸出;
将所述圈套芯轴的所述钩部与系绳的近侧部接合,所述系绳的所述近侧部从所述系绳的支承轴的近端伸出,所述系绳在所述支承轴的内腔内延伸,并且所述系绳的远侧部从所述支承轴的远端伸出并联接至所述医疗装置;
在接合所述圈套芯轴的所述钩部后,将拉力施加至插入后的所述圈套芯轴的所述近端,以便将所述支承轴拉入所述递送导管的所述内腔内,从而使联接后的所述医疗装置与所述递送导管的所述内轴的扩口端接合,所述扩口端包围所述内轴的所述内腔的所述最远侧开口;
在施加所述拉力后,将所述系绳的所述近侧部锁定在所述递送导管内;以及
在锁定所述系绳的所述近侧部后,使所述递送导管的所述接纳部相对于所述递送导管的所述内轴在所述医疗装置上前进,以使所述医疗装置收容在所述接纳部内。
2.如权利要求1所述的方法,其特征在于,所述方法还包括:
在将所述圈套芯轴的所述钩部与所述系绳接合之前,从所述系绳的所述近侧部卸下系绳的保持件;以及
在施加所述拉力后,将所述系绳的所述保持件重新附连至所述系绳的所述近侧部。
3.如权利要求2所述的方法,其特征在于,卸下所述保持件包括:打开所述保持件的相对的第一部件和第二部件并使所述第一部件和所述第二部件彼此远离以从所述第一部件和所述第二部件之间的压配合释放所述系绳的所述近侧部的长度;并且重新定位所述保持件包括:将相对的所述第一部件和所述第二部件朝向彼此闭合以在所述第一部件和所述第二部件之间的压配合中获得所述系绳的所述近侧部的长度,并使相对的所述第一部件和所述第二部件彼此互锁。
4.一种介入式医疗系统,所述系统包括递送导管以及与所述递送导管独立地包装的可植入医疗装置组件,所述递送导管包括细长的内轴以及与所述内轴滑动接合的接纳部,所述接纳部的尺寸设定成使所述医疗装置收容在该接纳部内并且所述接纳部具有最远侧开口,并且所述内轴包括细长的内腔,所述内轴的所述内腔从所述内轴的扩口的远端处的远侧开口延伸至所述递送导管的扩口的远端的近侧端口开口处的近侧开口,所述组件包括:
相对紧凑的可植入医疗装置,该医疗装置包括脉冲发生器、收容所述脉冲发生器的气密的封壳以及形成在所述封壳的端部的接合构件;
细长的支承轴,所述支承轴从所述支承轴的近端延伸至所述支承轴的远端,所述支承轴包括沿着所述支承轴的长度延伸的内腔,所述内腔包括在所述支承轴的所述近端处的近侧开口以及在所述支承轴的所述远端处的远侧开口,整个所述支承轴的尺寸设定成以滑动接合的方式装配在所述内轴的所述内腔内;
细长的系绳,所述系绳包括第一长度、第二长度、远侧部以及近侧部,所述远侧部和所述近侧部分别在所述系绳的相对端部处连结所述第一长度和所述第二长度,所述第一长度在所述支承轴的所述内腔内延伸,所述近侧部从所述支承轴的所述近端伸出,所述远侧部从所述支承轴的所述远端伸出,所述远侧部联接至所述医疗装置的所述接合构件;以及
细长的圈套芯轴,所述圈套芯轴在从所述圈套芯轴的近端到所述圈套芯轴的远端的长度上延伸,所述远端形成为钩部,所述钩部构造成与所述系绳的所述近侧部接合,所述圈套芯轴的长度大于所述递送导管的所述内轴的长度,并且所述圈套芯轴的尺寸设定成与滑动接合的方式装配在所述内轴的所述内腔内。
5.如权利要求4所述的系统,其特征在于,所述组件还包括所述系绳的保持件,所述保持件构造成附连至所述系绳的所述近侧部和从所述系绳的所述近侧部卸下,所述系绳的所述保持件包括相对的第一部件和第二部件,所述第一部件和所述第二部件构造成彼此互锁,并且当彼此互锁时,将所述系绳的所述近侧部保持在所述第一部件和所述第二部件之间的压配合中。
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Families Citing this family (17)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11198013B2 (en) | 2016-11-21 | 2021-12-14 | Cardiac Pacemakers, Inc. | Catheter and leadless cardiac devices including electrical pathway barrier |
EP3541460B1 (en) | 2016-11-21 | 2020-12-23 | Cardiac Pacemakers, Inc. | Delivery devices and wall apposition sensing |
CN110114114B (zh) | 2016-12-27 | 2023-05-02 | 心脏起搏器股份公司 | 用于无引线心脏装置的递送装置和方法 |
US10485981B2 (en) | 2016-12-27 | 2019-11-26 | Cardiac Pacemakers, Inc. | Fixation methods for leadless cardiac devices |
US10806931B2 (en) | 2016-12-27 | 2020-10-20 | Cardiac Pacemakers, Inc. | Delivery devices and methods for leadless cardiac devices |
WO2018125791A1 (en) | 2016-12-27 | 2018-07-05 | Cardiac Pacemakers, Inc. | Leadless delivery catheter with conductive pathway |
CN110225779B (zh) | 2017-01-26 | 2023-04-04 | 心脏起搏器股份公司 | 用于无引线心脏装置的递送装置 |
WO2018165377A1 (en) | 2017-03-10 | 2018-09-13 | Cardiac Pacemakers, Inc. | Fixation for leadless cardiac devices |
US10737092B2 (en) | 2017-03-30 | 2020-08-11 | Cardiac Pacemakers, Inc. | Delivery devices and methods for leadless cardiac devices |
US11577085B2 (en) | 2017-08-03 | 2023-02-14 | Cardiac Pacemakers, Inc. | Delivery devices and methods for leadless cardiac devices |
EP3843833B1 (en) * | 2018-08-27 | 2024-05-29 | BIOTRONIK SE & Co. KG | A delivery system for implanting a medical device |
US11446510B2 (en) | 2019-03-29 | 2022-09-20 | Cardiac Pacemakers, Inc. | Systems and methods for treating cardiac arrhythmias |
CN113660977A (zh) | 2019-03-29 | 2021-11-16 | 心脏起搏器股份公司 | 用于治疗心律失常的系统和方法 |
US11504528B2 (en) | 2019-05-03 | 2022-11-22 | Pacesetter, Inc. | Biostimulator transport system having weldless bearing retainer |
US11571582B2 (en) | 2019-09-11 | 2023-02-07 | Cardiac Pacemakers, Inc. | Tools and systems for implanting and/or retrieving a leadless cardiac pacing device with helix fixation |
CN114364431A (zh) | 2019-09-11 | 2022-04-15 | 心脏起搏器股份公司 | 用于植入和/或取回具有螺旋固定件的无导线心脏起搏装置的工具和系统 |
CN113384803A (zh) * | 2021-06-11 | 2021-09-14 | 湖南埃普特医疗器械有限公司 | 一种导引延伸导管 |
Citations (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20080091247A1 (en) * | 2006-08-30 | 2008-04-17 | Med-El Elektromedizinische Geraete Gmbh | System, Apparatus, and Method for Facilitating Interface with Laryngeal Structures |
US20120165827A1 (en) * | 2010-12-13 | 2012-06-28 | Alexander Khairkhahan | Pacemaker Retrieval Systems and Methods |
US20130131591A1 (en) * | 2011-11-17 | 2013-05-23 | Medtronic, Inc. | Delivery system assemblies and associated methods for implantable medical devices |
US20130253342A1 (en) * | 2012-03-26 | 2013-09-26 | Medtronic, Inc. | Pass-through implantable medical device delivery catheter |
US20150039069A1 (en) * | 2013-07-31 | 2015-02-05 | Medtronic, Inc. | Fixation for implantable medical devices |
US20150094668A1 (en) * | 2013-09-27 | 2015-04-02 | Medtronic, Inc. | Interventional medical systems, tools, and assemblies |
CN105073024A (zh) * | 2012-06-06 | 2015-11-18 | 艾博特心血管系统公司 | 用于医疗装置膨胀的设备、系统及方法 |
US20160015968A1 (en) * | 2014-07-17 | 2016-01-21 | Medtronic, Inc. | Interventional medical systems, tools, and methods of use |
CN105358212A (zh) * | 2013-07-31 | 2016-02-24 | 美敦力公司 | 用于可植入医疗装置的固定 |
Family Cites Families (81)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3835864A (en) | 1970-09-21 | 1974-09-17 | Rasor Ass Inc | Intra-cardiac stimulator |
US3814104A (en) | 1971-07-05 | 1974-06-04 | W Irnich | Pacemaker-electrode |
US4103690A (en) | 1977-03-21 | 1978-08-01 | Cordis Corporation | Self-suturing cardiac pacer lead |
US5327905A (en) | 1992-02-14 | 1994-07-12 | Boaz Avitall | Biplanar deflectable catheter for arrhythmogenic tissue ablation |
US5184625A (en) | 1992-04-16 | 1993-02-09 | Cordis Corporation | Biopsy forceps device having improved handle |
US5492119A (en) | 1993-12-22 | 1996-02-20 | Heart Rhythm Technologies, Inc. | Catheter tip stabilizing apparatus |
US5609601A (en) | 1994-09-23 | 1997-03-11 | United States Surgical Corporation | Endoscopic surgical apparatus with rotation lock |
WO1996034646A1 (en) | 1995-05-01 | 1996-11-07 | Medtronic Cardiorhythm | Dual curve ablation catheter and method |
US5624736A (en) | 1995-05-12 | 1997-04-29 | Milliken Research Corporation | Patterned conductive textiles |
US6152144A (en) | 1998-11-06 | 2000-11-28 | Appriva Medical, Inc. | Method and device for left atrial appendage occlusion |
US6783510B1 (en) | 1999-07-08 | 2004-08-31 | C.R. Bard, Inc. | Steerable catheter |
US7949395B2 (en) | 1999-10-01 | 2011-05-24 | Boston Scientific Neuromodulation Corporation | Implantable microdevice with extended lead and remote electrode |
US7497844B2 (en) | 2000-03-31 | 2009-03-03 | Medtronic, Inc. | System and method for positioning implantable medical devices within coronary veins |
US6733500B2 (en) | 2000-03-31 | 2004-05-11 | Medtronic, Inc. | Method and system for delivering a medical electrical lead within a venous system |
US6582443B2 (en) | 2000-12-27 | 2003-06-24 | Ams Research Corporation | Apparatus and methods for enhancing the functional longevity and for facilitating the implantation of medical devices |
EP1365702A2 (en) | 2001-03-08 | 2003-12-03 | Atritech, Inc. | Atrial filter implants |
US20020183824A1 (en) | 2001-05-09 | 2002-12-05 | Medtronic, Inc. | Co-extruded, multi-lumen medical lead |
US6716238B2 (en) | 2001-05-10 | 2004-04-06 | Scimed Life Systems, Inc. | Stent with detachable tethers and method of using same |
JP2005508208A (ja) | 2001-06-04 | 2005-03-31 | アルバート・アインシュタイン・ヘルスケア・ネットワーク | 血栓フィルターおよび心房ペースメーカーを備えた心臓刺激装置 |
US7546166B2 (en) | 2001-11-29 | 2009-06-09 | Medtronic, Inc. | Medical lead designs for lead placement through tissue |
US20040147973A1 (en) | 2002-06-27 | 2004-07-29 | Hauser Robert G. | Intra cardiac pacer and method |
US7149587B2 (en) | 2002-09-26 | 2006-12-12 | Pacesetter, Inc. | Cardiovascular anchoring device and method of deploying same |
US8303511B2 (en) | 2002-09-26 | 2012-11-06 | Pacesetter, Inc. | Implantable pressure transducer system optimized for reduced thrombosis effect |
US7715900B2 (en) | 2002-12-19 | 2010-05-11 | University Of Washington | Quadruple inversion recovery for quantitative contrast-enhanced black blood imaging |
US20050004602A1 (en) | 2003-07-02 | 2005-01-06 | Applied Medical Resources Corporation | Interlocking suture clinch |
EP1670360B1 (en) | 2003-09-12 | 2007-10-17 | NMT Medical, Inc. | Device for preventing formation of thrombi in the left atrial appendage |
US7566336B2 (en) | 2003-11-25 | 2009-07-28 | Cardia, Inc. | Left atrial appendage closure device |
US20050165456A1 (en) | 2003-12-19 | 2005-07-28 | Brian Mann | Digital electrode for cardiac rhythm management |
US7410480B2 (en) | 2004-04-21 | 2008-08-12 | Acclarent, Inc. | Devices and methods for delivering therapeutic substances for the treatment of sinusitis and other disorders |
US20050267555A1 (en) | 2004-05-28 | 2005-12-01 | Marnfeldt Goran N | Engagement tool for implantable medical devices |
US20080057100A1 (en) | 2004-06-22 | 2008-03-06 | Williams Michael S | Implantable device for delivery of therapeutic agents |
US20060247753A1 (en) | 2005-04-29 | 2006-11-02 | Wenger William K | Subcutaneous lead fixation mechanisms |
US7623899B2 (en) | 2005-09-16 | 2009-11-24 | Biosense Webster, Inc. | Catheter with flexible pre-shaped tip section |
US10143456B2 (en) | 2005-10-07 | 2018-12-04 | Alex Javois | Left atrial appendage occlusion device |
US7647124B2 (en) | 2005-11-15 | 2010-01-12 | Medtronic, Inc. | Delivery catheter |
US8679097B2 (en) | 2005-12-20 | 2014-03-25 | Orthodynamix Llc | Method and devices for minimally invasive arthroscopic procedures |
US20070156114A1 (en) | 2005-12-29 | 2007-07-05 | Worley Seth J | Deflectable catheter with a flexibly attached tip section |
WO2009099464A1 (en) | 2008-02-05 | 2009-08-13 | Cvdevices, Llc | Steering engagement catheter devices, systems and methods |
CA2723810C (en) | 2008-05-07 | 2015-06-30 | Guided Delivery Systems, Inc. | Deflectable guide |
WO2010042857A1 (en) | 2008-10-10 | 2010-04-15 | Guided Delivery Systems Inc. | Tether tensioning devices and related methods |
US8795328B2 (en) | 2009-01-08 | 2014-08-05 | Coherex Medical, Inc. | Medical device for modification of left atrial appendage and related systems and methods |
US20100274227A1 (en) | 2009-02-13 | 2010-10-28 | Alexander Khairkhahan | Delivery catheter handle cover |
US8500733B2 (en) | 2009-02-20 | 2013-08-06 | Boston Scientific Scimed, Inc. | Asymmetric dual directional steerable catheter sheath |
US8968381B2 (en) | 2009-04-15 | 2015-03-03 | Cook Medical Technologies Llc | Everting deployment system and handle |
DE102009037827A1 (de) | 2009-08-10 | 2011-02-17 | Epflex Feinwerktechnik Gmbh | Medizinisches Katheterinstrument |
US8532790B2 (en) | 2010-04-13 | 2013-09-10 | Medtronic, Inc. | Slidable fixation device for securing a medical implant |
EP2394695B1 (fr) | 2010-06-14 | 2012-09-26 | Sorin CRM SAS | Capsule intracardiaque autonome et son accessoire d'implantation |
WO2012082735A1 (en) | 2010-12-13 | 2012-06-21 | Nanostim, Inc. | Delivery catheter systems and methods |
US10112045B2 (en) | 2010-12-29 | 2018-10-30 | Medtronic, Inc. | Implantable medical device fixation |
US9775982B2 (en) | 2010-12-29 | 2017-10-03 | Medtronic, Inc. | Implantable medical device fixation |
US8504156B2 (en) | 2011-08-26 | 2013-08-06 | Medtronic, Inc. | Holding members for implantable cardiac stimulation devices |
US8945145B2 (en) | 2011-09-22 | 2015-02-03 | Medtronic, Inc. | Delivery system assemblies for implantable medical devices |
US8945146B2 (en) | 2011-10-24 | 2015-02-03 | Medtronic, Inc. | Delivery system assemblies and associated methods for implantable medical devices |
US8781605B2 (en) | 2011-10-31 | 2014-07-15 | Pacesetter, Inc. | Unitary dual-chamber leadless intra-cardiac medical device and method of implanting same |
US9216293B2 (en) | 2011-11-17 | 2015-12-22 | Medtronic, Inc. | Delivery system assemblies for implantable medical devices |
US9220906B2 (en) * | 2012-03-26 | 2015-12-29 | Medtronic, Inc. | Tethered implantable medical device deployment |
US20140018818A1 (en) | 2012-07-12 | 2014-01-16 | Pacesetter, Inc. | System and method of implanting a medical device |
US9168379B2 (en) | 2012-09-26 | 2015-10-27 | Medtronic, Inc. | Therapy delivery method and system for implantable medical devices |
US9238145B2 (en) | 2012-11-27 | 2016-01-19 | Biotronik Se & Co. Kg | Leadless implantable device delivery apparatus |
US20140172034A1 (en) | 2012-12-18 | 2014-06-19 | Pacesetter, Inc. | Intra-cardiac implantable medical device with ic device extension for lv pacing/sensing |
US8634919B1 (en) | 2012-12-20 | 2014-01-21 | Pacesetter, Inc. | Intracardiac implantable medical device for biatrial and/or left heart pacing and method of implanting same |
US10668270B2 (en) | 2013-05-06 | 2020-06-02 | Medtronic, Inc. | Substernal leadless electrical stimulation system |
US9717923B2 (en) | 2013-05-06 | 2017-08-01 | Medtronic, Inc. | Implantable medical device system having implantable cardioverter-defibrillator (ICD) system and substernal leadless pacing device |
EP2801341A1 (de) | 2013-05-06 | 2014-11-12 | Biotronik AG | Freigabevorrichtung zum Lösen eines medizinischen Implantats von einer Einführvorrichtung sowie Einführvorrichtung mit einer Freigabevorrichtung |
US10556117B2 (en) | 2013-05-06 | 2020-02-11 | Medtronic, Inc. | Implantable cardioverter-defibrillator (ICD) system including substernal pacing lead |
US9155882B2 (en) | 2013-07-31 | 2015-10-13 | Medtronic, Inc. | Implantable medical devices including tine fixation component having hook segment |
US10842993B2 (en) * | 2013-08-16 | 2020-11-24 | Cardiac Pacemakers, Inc. | Leadless cardiac pacing devices |
US10722723B2 (en) | 2013-08-16 | 2020-07-28 | Cardiac Pacemakers, Inc. | Delivery devices and methods for leadless cardiac devices |
US9492674B2 (en) * | 2013-08-16 | 2016-11-15 | Cardiac Pacemakers, Inc. | Leadless cardiac pacemaker with delivery and/or retrieval features |
ES2666373T3 (es) | 2013-08-16 | 2018-05-04 | Cardiac Pacemakers, Inc. | Dispositivos de administración para dispositivos cardiacos sin cables |
US10300286B2 (en) * | 2013-09-27 | 2019-05-28 | Medtronic, Inc. | Tools and assemblies thereof for implantable medical devices |
US9336169B2 (en) | 2013-10-02 | 2016-05-10 | International Business Machines Corporation | Facilitating resource use in multicycle arbitration for single cycle data transfer |
US9861815B2 (en) * | 2014-04-01 | 2018-01-09 | Medtronic, Inc. | Interventional medical systems, tools, and subassemblies |
US9283382B2 (en) | 2014-04-01 | 2016-03-15 | Medtronic, Inc. | Interventional medical systems, tools, and associated methods |
US20150306375A1 (en) | 2014-04-25 | 2015-10-29 | Medtronic, Inc. | Implantable extravascular electrical stimulation lead having improved sensing and pacing capability |
US9446248B2 (en) * | 2014-07-17 | 2016-09-20 | Medtronic, Inc. | Interventional medical systems, tools, and methods of use |
US10478620B2 (en) | 2014-08-26 | 2019-11-19 | Medtronic, Inc. | Interventional medical systems, devices, and methods of use |
US10716931B2 (en) * | 2014-09-09 | 2020-07-21 | Pacesetter, Inc. | Systems and methods for implanting a medical device |
US10441777B2 (en) * | 2014-09-09 | 2019-10-15 | Pacesetter, Inc. | Implantable medical device having restrained tether device |
US11207530B2 (en) * | 2015-02-03 | 2021-12-28 | Medtronic, Inc. | Relatively compact implantable medical devices and associated methods for loading the devices into a delivery catheter |
US9468773B1 (en) * | 2015-05-07 | 2016-10-18 | Medtronic, Inc. | Interventional medical systems and implantable medical devices including tethering features, and associated methods |
-
2016
- 2016-04-29 US US15/142,009 patent/US10143823B2/en active Active
-
2017
- 2017-04-27 WO PCT/US2017/029865 patent/WO2017189858A1/en active Application Filing
- 2017-04-27 CN CN201780026001.5A patent/CN109069836B/zh active Active
- 2017-04-27 EP EP17724964.6A patent/EP3448510B1/en active Active
Patent Citations (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20080091247A1 (en) * | 2006-08-30 | 2008-04-17 | Med-El Elektromedizinische Geraete Gmbh | System, Apparatus, and Method for Facilitating Interface with Laryngeal Structures |
US20120165827A1 (en) * | 2010-12-13 | 2012-06-28 | Alexander Khairkhahan | Pacemaker Retrieval Systems and Methods |
US20130131591A1 (en) * | 2011-11-17 | 2013-05-23 | Medtronic, Inc. | Delivery system assemblies and associated methods for implantable medical devices |
US20130253342A1 (en) * | 2012-03-26 | 2013-09-26 | Medtronic, Inc. | Pass-through implantable medical device delivery catheter |
CN105073024A (zh) * | 2012-06-06 | 2015-11-18 | 艾博特心血管系统公司 | 用于医疗装置膨胀的设备、系统及方法 |
US20150039069A1 (en) * | 2013-07-31 | 2015-02-05 | Medtronic, Inc. | Fixation for implantable medical devices |
CN105358212A (zh) * | 2013-07-31 | 2016-02-24 | 美敦力公司 | 用于可植入医疗装置的固定 |
US20150094668A1 (en) * | 2013-09-27 | 2015-04-02 | Medtronic, Inc. | Interventional medical systems, tools, and assemblies |
US20160015968A1 (en) * | 2014-07-17 | 2016-01-21 | Medtronic, Inc. | Interventional medical systems, tools, and methods of use |
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EP3448510A1 (en) | 2019-03-06 |
EP3448510B1 (en) | 2020-02-12 |
US10143823B2 (en) | 2018-12-04 |
CN109069836B (zh) | 2022-02-25 |
WO2017189858A1 (en) | 2017-11-02 |
US20170312479A1 (en) | 2017-11-02 |
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