US20180050209A1 - Lead insertion tool - Google Patents

Lead insertion tool Download PDF

Info

Publication number
US20180050209A1
US20180050209A1 US15/241,866 US201615241866A US2018050209A1 US 20180050209 A1 US20180050209 A1 US 20180050209A1 US 201615241866 A US201615241866 A US 201615241866A US 2018050209 A1 US2018050209 A1 US 2018050209A1
Authority
US
United States
Prior art keywords
lead
tool
implantable
engagement mechanism
pathway
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US15/241,866
Inventor
Aaron Raines
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Advanced Neuromodulation Systems Inc
Original Assignee
Advanced Neuromodulation Systems Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Advanced Neuromodulation Systems Inc filed Critical Advanced Neuromodulation Systems Inc
Priority to US15/241,866 priority Critical patent/US20180050209A1/en
Assigned to ADVANCED NEUROMODULATION SYSTEMS, INC. DBA ST. JUDE MEDICAL NEUROMODULATION DIVISION reassignment ADVANCED NEUROMODULATION SYSTEMS, INC. DBA ST. JUDE MEDICAL NEUROMODULATION DIVISION ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: RAINES, AARON
Publication of US20180050209A1 publication Critical patent/US20180050209A1/en
Priority to US16/147,146 priority patent/US10933231B2/en
Abandoned legal-status Critical Current

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators
    • A61N1/375Constructional arrangements, e.g. casings
    • A61N1/3752Details of casing-lead connections
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/02Details
    • A61N1/04Electrodes
    • A61N1/05Electrodes for implantation or insertion into the body, e.g. heart electrode
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/36Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
    • A61N1/372Arrangements in connection with the implantation of stimulators

Definitions

  • aspects of the present invention relate to medical apparatus and methods. More specifically, the present invention relates to systems and methods for inserting a lead connector end of an implantable lead into an implantable pulse generator.
  • Implantable pulse generators include, for example, pacemakers, implantable cardioverter defibrillators (ICDs), and neuromodulators or neurostimulators.
  • Pacemakers and ICDs are used in the treatment of cardiac conditions, and neuromodulators or neurostimulators are used in chronic pain management or the actuation and control of other body systems.
  • Such IPGs commonly include a housing, circuitry, feedthrus, a connector assembly, and a header.
  • the circuitry includes a hybrid and/or other electronic components that control and assess any electrical sensing and electrical stimulation associated with the electrotherapy administered by the IPG.
  • the circuitry and a power source e.g., a battery are hermetically sealed in the housing.
  • the connector assembly is enclosed in the header, which is coupled to the housing.
  • the connector assembly includes many internal electrically conductive components such as, for example, wires, ribbon, antennas, blocks, rings, etc.
  • the header further includes one or more receptacles for receiving therein a lead connector end on a proximal end of an implantable lead. When a lead connector end is received in a receptacle, electrical contacts of the lead connector end are placed in electrical contact with electrical contacts (e.g., block and rings) of the connector assembly.
  • Implantable leads are becoming more flexible to address issues of lead fracture due the stiffness of implantable leads. Further, during revision cases where the implantable lead remains implanted while the IPG is replaced due to having reached its end of life or for an upgrade of the IPG, the lead becomes soft and flexible and can be hard to re-insert into the new IPG due to the lead having very little column strength. Similar issues are associated with leads employed in buried trials and then reused with a permanent IPG.
  • the physician pinches the lead very close to the header while trying to advance the lead by small incremental shifts of the lead towards the header.
  • the pinching may be via the physician's fingers or via forceps. In either case, the method takes the chance of damaging the lead. Lead damage necessitates lead replacement with a higher surgical risk, extended surgery times, and added monetary cost.
  • the tool includes a clamshell structure including a first portion, a second portion coupled to the first portion via a hinge, an engagement mechanism, and a lead pathway configured to receive the implantable lead.
  • Each portion of the clamshell structure includes a central structure, a leading projection extending from the central structure, and a part of a lead pathway.
  • the part of the lead pathway of the first portion combines with the part of the lead pathway of the second portion to form the lead pathway when the first portion and second portion are abutted together when the clamshell structure is in a closed state.
  • the lead pathway extends through the central portion and the leading projection to a free end of the leading projection.
  • the engagement mechanism is located on at least one of the portions of the clamshell structure and includes an engaged state and a self-biasing non-engaged state. When the engagement mechanism is self-biased into the non-engaged state, the implantable lead is free to displace along the lead pathway. When the engagement mechanism is forced into the engaged state, the lead cannot displace along the lead pathway.
  • the lead pathway includes a lumen.
  • the portions of the clamshell structure can be hinged apart to allow the implantable lead to be loaded into the lead pathway.
  • the engagement mechanism may include an engagement member on each of the portions of the clamshell structure, the implantable lead being compressed between the engagement members when the engagement mechanism is in the engaged state and the implantable lead is located in the lead pathway.
  • at least one of the engagement members may include a hard stop that inhibits excessive compression of the implantable lead by the engagement members.
  • a lead insertion tool for inserting a lead connector end of an implantable lead into a lead receptacle of a header of an implantable pulse generator, the implantable lead including a lead body extending distally from the lead connector end.
  • the tool includes a lead pathway and an engagement mechanism.
  • the lead pathway extends through the tool and is configured to receive the implantable lead.
  • the engagement mechanism includes an engaged state and a self-biasing non-engaged state. When the engagement mechanism is self-biased into the non-engaged state, the implantable lead is free to displace along the lead pathway. When the engagement mechanism is forced into the engaged state, the lead cannot displace along the lead pathway.
  • the lead pathway includes a lumen.
  • the tool may include a clamshell configuration that can be opened to allow the implantable lead to be loaded into the lead pathway.
  • the tool may include a leading projection through which the lead pathway extends.
  • the leading projection may have an outer diameter configured to be received in the lead receptacle.
  • the leading projection may include a tapered free end.
  • the tool may include a trailing projection, and the lead pathway may extend from a free end of the trailing projection to a free end of the leading projection.
  • the engagement mechanism when in the engaged state, interacts with the implantable lead along the lead pathway between the free end of the trailing projection and the free end of the leading projection.
  • the engagement mechanism may include at least one engagement member including an interior surface that compresses against the implantable lead when the engagement mechanism is forced into the engaged state.
  • the engagement member may be cantilevered from a surrounding structure of the tool.
  • the engagement member may be coupled to the surrounding tool via a living hinge.
  • the engagement mechanism includes a pair of opposed engagement members that compress the implantable lead between the engagement members when the engagement mechanism is forced into the engaged state.
  • at least one of the engagement members includes a hard stop that inhibits excessive compression of the implantable lead by the pair of engagement members.
  • Also disclosed herein is method of using a lead insertion tool to insert a lead connector end of an implantable lead into a lead receptacle of a header of an implantable pulse generator, the implantable lead including a lead body extending distally from the lead connector end.
  • the implantable lead extends through the tool such that the lead connector end projects out of a leading end of the tool and the lead body extends out of a trailing end of the tool.
  • the method includes causing the lead connector end to enter the lead receptacle by causing an engagement mechanism of the tool to engage the implantable lead while displacing the tool towards the lead receptacle with a free end of the lead connector end aligned with the lead receptacle.
  • the tool is displaced away from the lead receptacle and along the implantable lead with the engagement mechanism disengaged from the implantable lead and then again causing the engagement mechanism of the tool to engage the implantable lead while again displacing the tool towards the lead receptacle to further drive the lead connector end into the lead receptacle.
  • the engagement mechanism self-biases out of engagement with the implantable lead.
  • FIG. 1 is an isometric view of a lead insertion tool when its clamshell configuration is in a closed state.
  • FIG. 2 is an isometric view of the lead insertion tool when its clamshell configuration is in an open state and showing its exterior.
  • FIG. 3 is an isometric view of the lead insertion tool when its clamshell configuration is in the open state and showing its interior.
  • FIG. 4 is a similar view of lead insertion tool as depicted in FIG. 3 , except also depicting a proximal region of an implantable lead being located in one-half of a lead receiving channel of the lead insertion tool.
  • FIG. 5 is the same view as FIG. 4 , except the clamshell configuration of the lead insertion tool has been closed about the lead body such that the lead occupies the lead receiving channel of the lead insertion tool.
  • FIG. 6 shows the lead and lead insertion tool in the same relationship depicted in FIG. 5 , except the lead proximal end is being aligned with a lead receptacle of a header of an IPG.
  • FIG. 7 illustrates the lead proximal end received in the lead receptacle of the header via insertion by the lead insertion tool.
  • FIG. 8 depicts the lead insertion tool being distally withdrawn along the lead with the lead proximal end continuing to be received in the lead receptacle.
  • FIG. 9 shows the clamshell configuration of the lead insertion tool being opened and the lead insertion tool being removed from about the proximal region of the lead.
  • implementations of the present disclosure involve a lead insertion tool 10 and associated methods of inserting a proximal end 100 of an implantable lead 105 into a lead receptacle 200 of a header 205 of an implantable pulse generator (IPG) 210 such as, for example, a pacemaker, implantable cardioverter defibrillator (ICD), neuromodulator, neurostimulator, or etc.
  • IPG implantable pulse generator
  • the lead insertion tool 10 may be coupled to the lead body 110 near the proximal end 100 of the lead that is to be received in the header lead receptacle 200 .
  • the lead proximal end 100 includes, or may be in the form of, a lead connector end 115 having a number of electrical contacts 120 along the length thereof.
  • the tool 10 is free to slide along the lead body 110 until a lead body engagement mechanism 45 of the tool 10 is caused to engage the lead body 110 , thereby fixing the tool 10 relative to the lead body 110 as long as the lead body engagement mechanism 45 is activated.
  • the tool can then be used to insert the lead proximal end 100 into the header receptacle 200 .
  • Causing the lead connector end 120 to be fully received in the header lead receptacle 200 results in electrical contact being established between the electrical contacts 120 of the lead connector end 115 and corresponding electrical contacts inside the lead receptacle 200 that are part of a connector assembly in the IPG header 205 .
  • the connector assembly of the IPG header 205 is in electrical communication with the hybrid and other electronic components of the IPG 210 hermetically sealed in the housing 215 of the IPG 210 .
  • the lead insertion tool includes a leading projection 30 through which the lead body 110 extends.
  • the leading projection 30 is configured to facilitate guiding the lead 105 into the header lead receptacle 200 and also provide column strength to the lead body 110 to prevent its bending.
  • the leading projection 30 may serve to dilate the header lead receptacle 200 where the lead receptacle is compliant.
  • FIG. 1 is an isometric view of the lead insertion tool 10 in a closed condition.
  • FIGS. 2 and 3 are isometric views of the lead insertion tool in an open condition as viewed from the exterior and interior of the tool, respectively.
  • the lead insertion tool 10 has a clamshell configuration including a first half 15 and a second half 20 joined by a first living hinge 25 .
  • the tool 10 can be opened such that the first half 15 and second half 20 can be separated from each other yet maintained coupled together via the living hinge 25 extending between the bottom edges of each half 15 , 20 , as can be understood from FIGS. 2-3 .
  • the tool 10 can then be closed such that opposed interior faces 27 A, 27 B (see FIG. 3 ) of the respective halves 15 , 20 are abutted together, as indicated in FIG. 1 .
  • a living hinge 25 is depicted in the various figures, in some embodiments, the hinge 25 can be any other type of hinge.
  • the tool 10 further includes a central structure 28 , a leading projection 30 , a trailing projection 35 , a hollow cylindrical shaft or lumen 40 , and a lead body engagement mechanism 45 .
  • each of the central structure 28 , leading projection 30 , trailing projection 35 , lumen 40 , and lead body engagement mechanism 45 includes first and second portions respectively located on the first half 15 and the second half 20 .
  • the first half 15 includes a central structure first portion 28 A, a leading projection first portion 30 A, a trailing projection first portion 35 A, a lumen first portion 40 A, and lead body engagement mechanism first portion 45 A.
  • the second half 20 includes a central structure second portion 28 B, a leading projection second portion 30 B, a trailing projection second portion 358 , a lumen second portion 40 B, and lead body engagement mechanism second portion 45 B.
  • the lumen 40 may have an internal diameter of between approximately 0.03′′ and approximately 0.06′′.
  • the leading projection 30 may have an outer diameter of between approximately 0.06′′ and approximately 0.09′′.
  • the leading projection 30 extends from one side of the central structure 28 in a direction opposite the trailing projection 35 .
  • the leading projection 30 includes a cylindrical outer surface 50 and a tapered free end 55 . Moving along the free end 55 in a direction towards the trailing projection 35 , the tapered free end 55 increases in diameter to eventually match the outer diameter of the cylindrical outer surface 50 .
  • the outer diameter of the cylindrical outer surface 50 is slightly smaller than an internal diameter of the lead receptacle 200 of the IPG header 205 .
  • the leading projection 30 and its tapered free end 55 facilitate entry of the lead proximal end 100 into the header lead receptacle 200 .
  • the leading projection also gives column strength to the lead when the lead is being inserted into the header lead receptacle.
  • the trailing projection 35 extends from another side of the central structure 28 in a direction opposite the leading projection 30 .
  • the trailing projection 35 includes a cylindrical outer surface 60 and a flanged free end 65 .
  • the flanged free end 65 has a diameter that is substantially greater than the outer diameter of the cylindrical outer surface 60 and, as a result, the flanged free end 65 can be grasped to displace the tool 10 distally along the lead body 110 once the lead connector end 115 is fully received in the header lead receptacle 200 , as discussed below with respect to FIG. 8 .
  • the flanged free end 65 can be grasped to withdraw the tool along the lead without activating the engagement mechanism or otherwise pinching the lead.
  • the lumen 40 extends through the tool 10 to daylight at the free ends of each projection 30 , 35 .
  • the lumen 40 is made up of lumen portions 40 A, 40 B defined in each respective interior face 27 A, 27 B.
  • the lumen 40 is defined by a cylindrical inner surface, a portion of which is defined in each respective interior face 27 A, 27 B.
  • the cylindrical inner surface has an internal diameter that is slightly larger than an outer diameter of the lead body 110 , thereby allowing the lead body 110 to longitudinally displace within the lumen 40 such that the tool 10 can be moved along the lead body 110 when the lead body engagement mechanism 45 is not actuated to engage the lead body 110 , as discussed below with respect to FIGS. 5 and 8 .
  • each lead body engagement mechanism portion 45 A, 45 B may be in the form of a member 45 A, 45 B that is cantilevered off of the surrounding central structure portion 28 A, 28 B via a living hinge 70 A, 70 B.
  • each member 45 A, 45 B forms a peninsula from the respective central structure portion 28 , 28 B via the living hinge 70 A, 70 B, the rest of each member 45 A, 45 B being spaced apart from the surrounding central structure portion 28 A, 28 B via a void 75 A, 75 B defined in the surrounding central structure portion 28 A, 28 B.
  • Each member 45 A, 45 B is located within a respective void 75 A, 75 B.
  • hinges 70 A, 70 B are depicted in the various figures, in some embodiments, the hinges 70 A, 70 B can be any other type of hinge that may also have a biasing component (e.g., a spring) built into or supplementing the hinge.
  • a biasing component e.g., a spring
  • each member 45 A, 45 B has a contoured shape with a recess region 80 A, 80 B that is shaped and configured interface with a physician's thumb or index finger.
  • the physician may actuate the lead body engagement mechanism 45 by using a thumb and index finger to squeeze the opposed members 45 A, 45 B inwardly such that they deflect inwardly towards each other.
  • the members 45 A, 45 B deflecting inwardly cause the members to squeeze or compress the lead body 110 between the interior surfaces 85 A, 85 B (see FIG.
  • the lead body engagement mechanism 45 may be considered a lead body compression or squeezing mechanism 45 .
  • the Interior surfaces 85 A, 85 B of the respective lead body engagement members 45 A, 45 B are immediately adjacent the paths of the lumen portions 40 A, 40 B.
  • the members 45 A, 45 B assume or bias to their natural biased or non-deflected state and do not intersect the paths of the lumen portions 40 A, 40 B.
  • the tool 10 is free to be slid along the length of the lead body 110 with very little, if any, resistance, as discussed below with respect to FIGS. 5 and 8 .
  • the interior surfaces 85 A, 85 B of the respective lead body engagement members 45 A, 45 B Intersect and extend into the paths of the lumen portions 40 A, 40 B when the members 45 A, 45 B are being acted upon by an outside force, such as an Inwardly directed or pinching force of the physicians thumb and index finger.
  • the members 45 A, 45 B can be forced to deflect inwardly from their natural non-deflected state to intersect the paths of the lumen portions 40 A, 40 B, thereby pinching or compressing the lead body 110 , which is occupying the lumen 40 , between the interior surfaces 85 A, 85 B of the respective lead body engagement members 45 A, 45 B.
  • the tool 10 grasps the lead body 110 such that the tool cannot be slid along the length of the lead body 110 , thereby allowing the tool 10 to be used to insert the lead proximal end 100 into the header lead receptacle 200 , as discussed below with respect to FIGS. 6-7 .
  • the interior surfaces 85 A, 85 B of the members 45 A, 45 B may include hard stops 90 A, 90 B that contact each other when the interior surfaces 85 A, 85 B approach each other on account of the members 45 A, 45 B being inwardly deflected towards each other.
  • the hard stops 90 A, 90 B may be sized to prevent the interior surfaces 85 A, 85 B from contacting each other, thereby leaving a gap or space between the interior surfaces when the members are fully inwardly deflected towards each other such that the hard stops abut each other.
  • This hard stop feature helps to prevent the physician from overly pinching the lead body 110 between the member interior surfaces 85 A, 85 B and damaging the lead body.
  • the physician can be assured of sufficient compression on the lead body to assure desired displacement and manipulation of the of the lead body while minimizing the risk of lead body damage due to over compression of the lead body.
  • the Interior face 27 A of the first half 15 includes a male locking feature 95 A (e.g., a pin, tab, etc.) that is received in a female locking feature 95 B (e.g., hole, recess, etc.) of the interior face 27 B of the second half 20 in an interference fit arrangement such that the locking features 95 A, 95 B work together to keep the halves 15 , 20 in a closed state, as depicted in FIG. 1 .
  • the locking strength of the locking features 95 A, 95 B can easily be overcome by the physician intentionally prying the halves 15 , 20 apart by, for example, inserting a tool, finger nail, etc. between the interior faces 27 A, 27 B of the halves 15 , 20 .
  • male alignment features 97 A may also be present on the interior face 27 A of the first half 15 to be receive by corresponding female alignment features 97 B (e.g., slots, troughs, holes, etc.) defined in the interior face 27 B of the second half 20 .
  • These features 97 A, 97 B mating with each other will facilitate the locking features 95 A, 95 B aligning properly and the lumen portions 40 A, 40 B properly aligning to define a cylindrical lumen 40 from free end to free end of the projections 30 , 35 .
  • the tool 10 and its various components may be made from a variety of materials such as, for example, Polypropylene (PP), Polyethylene (PE), Acrylonitrile Butadiene Styrene (ABS), etc.
  • the tool 10 may be disposable or capable of being sterilized and reused.
  • FIG. 4 is an isometric view of the lead insertion tool 10 and proximal region 100 of the implantable lead 105 , wherein the lead is being loaded into the tool.
  • the clamshell configuration of the tool 10 is open such the opposed interior surfaces 27 A, 27 B of the halves 15 , 20 are spaced apart from each other and the halves 15 , 20 are nearly flat relative to each other.
  • the proximal end 100 of the implantable lead 105 is positioned relative to the tool 10 such that the lead body 110 just distal the distal edge of the lead connector end 115 is received in the lumen second portion 40 B.
  • FIG. 5 is the same view as FIG. 4 , except the clamshell configuration of the lead insertion tool 10 has been closed about the lead body 110 such that the lead 105 occupies the lead receiving channel or lumen 40 of the lead insertion tool 10 between the free ends of the projections 30 , 35 .
  • the entirety of the lead connector end 115 extends from the free end of the leading projection 30 .
  • the interior surfaces 27 A, 27 B abut each other, the alignment features 97 A, 97 B interface, and the locking features 95 A, 95 B are engaged to maintain the halves 15 , 20 in a closed state.
  • the interior surfaces 85 A, 85 B of the lead body engagement members 45 A, 45 B are located immediately adjacent the exterior surface of the lead body 110 . As explained above, the members 45 A, 45 B self-bias to a position where the interior surfaces 85 A, 85 B will not contact the exterior surface of the lead body 110 .
  • the interior surfaces 85 A, 85 B do not yet contact the exterior surface of the lead body 110 . Because the engagement members 45 A, 45 B have not been forced to engage the lead body 110 and, as noted above, the lumen 40 is of a greater diameter than the lead body 110 , the tool 10 can be freely displaced along the lead body 110 .
  • FIG. 6 shows the lead 105 and lead insertion tool 10 in the same relationship depicted in FIG. 5 , except the lead proximal end 100 is being aligned with the lead receptacle 200 of the header 205 of the IPG 210 , and the lead engagement mechanism 45 is being actuated to engage the lead body 110 .
  • inward forces are being applied (e.g., via a pinching action of the physician's thumb and index finger) to each engagement member 45 A, 45 B to drive the members 45 A, 45 B inward.
  • the interior surfaces 85 A, 85 B of the lead body engagement members 45 A, 45 B compress or pinch the lead body 110 , thereby preventing displacement of the tool 10 along the lead body 110 and allowing the tool 10 to be used to insert the lead connector end 115 into the appropriate header lead receptacle 200 .
  • FIG. 7 illustrates the lead proximal end 100 received in the lead receptacle 200 of the header 205 via insertion by the lead insertion tool 10 .
  • the leading projection 30 of the tool 10 has also been received in the header lead receptacle 200 .
  • the lead body engagement mechanism 45 of the tool 10 will have been in compressing or pinching engagement with the lead body 110 to allow the lead connector end 115 to be fully received in the header lead receptacle 200 as indicated in FIG. 7 .
  • the leading projection 30 has a tapered tip and an outer diameter that exceeds the inner diameter of the header lead receptacle 200 such that the leading projection 30 can dilate the header lead receptacle 200 where the receptacle 200 is of a compliant configuration.
  • this nature of the leading projection 30 can be employed to step-by-step and incrementally feed the lead connector end 115 into the receptacle 200 by starting out with the free end of the leading projection 30 being generally even with the free proximal end of the lead connector end 115 and inserting the lead connector end 115 the length of the leading projection 30 .
  • the engagement mechanism 45 of the tool 10 can then be released and the tool distally displace along the length of the lead body 110 until the leading projection 30 is outside the receptacle 200 .
  • the engagement mechanism 45 can then be reengaged with the lead body 110 and proximally displaced the length of the leading projection 30 to further incrementally insert the lead connector end 115 in to the header lead receptacle 200 . This process can be repeated over and over until the lead connector end 115 is fully received in the receptacle 200 as indicated in FIG. 7 .
  • a setscrew 220 on the IPG header 205 may be tightened down on the lead connector end 115 before the tool 10 is withdrawn from the header lead receptacle 200 and the fully inserted lead connector end. This will prevent the lead connector end from inadvertently being withdrawn from the header lead receptacle.
  • FIG. 8 depicts the lead Insertion tool 10 being distally withdrawn along the lead body 110 with the lead proximal end 100 continuing to be received in the lead receptacle 200 .
  • the physician no longer pushes the members 45 A, 45 B inward into engagement with the lead body 110 , instead allowing the members 45 A, 45 B to self-bias outwardly and out of engagement with the lead body 110 .
  • the tool 10 can be freely distally displaced along the lead body 110 such that the leading projection 30 is caused to exit the header lead receptacle 200 , leaving the lead connector end 115 fully received in the header lead receptacle 200 .
  • FIG. 9 shows the clamshell configuration of the lead insertion tool 10 being opened and the lead insertion tool 10 being removed from about the lead 105 .
  • the lead connector end 115 is still fully received in the header lead receptacle 200 .
  • the tool 10 can then be reused in a similar manner to insert a second lead connector end into the second header lead receptacle 200 illustrated in FIG. 9 .
  • the tool 10 provides column strength to the lead where it is most needed when the lead is being inserted into the header lead receptacle. Also, the tool grips the lead without crushing it. The tool can also slide along the lead when the engagement mechanism is self-biased into its non-engaged state, yet solidly engages the lead when forced out of the self-biased non-engage state into the engaged state by the physician squeezing together the engagement members.
  • the tool is inexpensive to manufacture.
  • the tool lumen can be sized to work with a wide variety of lead body diameters. Finally, the tool is simple and intuitive to use.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Electrotherapy Devices (AREA)

Abstract

Disclosed herein is a lead insertion tool for inserting a lead connector end of an implantable lead into a lead receptacle of a header of an implantable pulse generator, the implantable lead including a lead body extending distally from the lead connector end. The tool includes a lead pathway and an engagement mechanism. The lead pathway extends through the tool and is configured to receive the implantable lead. The engagement mechanism includes an engaged state and a self-biasing non-engaged state. When the engagement mechanism is self-biased into the non-engaged state, the implantable lead is free to displace along the lead pathway. When the engagement mechanism is forced into the engaged state, the lead cannot displace along the lead pathway.

Description

    FIELD OF THE INVENTION
  • Aspects of the present invention relate to medical apparatus and methods. More specifically, the present invention relates to systems and methods for inserting a lead connector end of an implantable lead into an implantable pulse generator.
  • BACKGROUND OF THE INVENTION
  • Implantable pulse generators (IPGs) include, for example, pacemakers, implantable cardioverter defibrillators (ICDs), and neuromodulators or neurostimulators. Pacemakers and ICDs are used in the treatment of cardiac conditions, and neuromodulators or neurostimulators are used in chronic pain management or the actuation and control of other body systems.
  • Such IPGs commonly include a housing, circuitry, feedthrus, a connector assembly, and a header. The circuitry includes a hybrid and/or other electronic components that control and assess any electrical sensing and electrical stimulation associated with the electrotherapy administered by the IPG. The circuitry and a power source (e.g., a battery) are hermetically sealed in the housing.
  • The connector assembly is enclosed in the header, which is coupled to the housing. The connector assembly includes many internal electrically conductive components such as, for example, wires, ribbon, antennas, blocks, rings, etc. The header further includes one or more receptacles for receiving therein a lead connector end on a proximal end of an implantable lead. When a lead connector end is received in a receptacle, electrical contacts of the lead connector end are placed in electrical contact with electrical contacts (e.g., block and rings) of the connector assembly.
  • When the lead connector assemblies of the respective implantable leads are plugged into respective receptacles of the header, electrical pathways are established that extend from the electronics in the housing to electrodes at the distal ends of the respective implantable leads. Thus, electrical stimulation originating in the housing is led to the connector assembly through feedthrus in the housing. The connector assembly serves to transmit electrical signals out of the IPG and to each lead electrically connected to the connector assembly, the lead transmitting electrical signals between the IPG and patient tissue. Similarly, but in reverse, tissue electrical signals sensed at the lead electrodes can be transmitted through the implantable leads, the connector assembly, the feedthrus and to the electronics in the housing.
  • Implantable leads are becoming more flexible to address issues of lead fracture due the stiffness of implantable leads. Further, during revision cases where the implantable lead remains implanted while the IPG is replaced due to having reached its end of life or for an upgrade of the IPG, the lead becomes soft and flexible and can be hard to re-insert into the new IPG due to the lead having very little column strength. Similar issues are associated with leads employed in buried trials and then reused with a permanent IPG.
  • To address the lead's lack of column strength, the physician pinches the lead very close to the header while trying to advance the lead by small incremental shifts of the lead towards the header. The pinching may be via the physician's fingers or via forceps. In either case, the method takes the chance of damaging the lead. Lead damage necessitates lead replacement with a higher surgical risk, extended surgery times, and added monetary cost.
  • There is a need in the art for improved systems and methods of inserting a lead connector end of an implantable lead into the receptacle of an IPG header.
  • BRIEF SUMMARY OF THE INVENTION
  • Disclosed herein is lead insertion tool for inserting a lead connector end of an implantable lead into a lead receptacle of a header of an implantable pulse generator, the implantable lead including a lead body extending distally from the lead connector end. In one embodiment, the tool includes a clamshell structure including a first portion, a second portion coupled to the first portion via a hinge, an engagement mechanism, and a lead pathway configured to receive the implantable lead. Each portion of the clamshell structure includes a central structure, a leading projection extending from the central structure, and a part of a lead pathway. The part of the lead pathway of the first portion combines with the part of the lead pathway of the second portion to form the lead pathway when the first portion and second portion are abutted together when the clamshell structure is in a closed state. The lead pathway extends through the central portion and the leading projection to a free end of the leading projection. The engagement mechanism is located on at least one of the portions of the clamshell structure and includes an engaged state and a self-biasing non-engaged state. When the engagement mechanism is self-biased into the non-engaged state, the implantable lead is free to displace along the lead pathway. When the engagement mechanism is forced into the engaged state, the lead cannot displace along the lead pathway.
  • Depending on the embodiment, the lead pathway includes a lumen. The portions of the clamshell structure can be hinged apart to allow the implantable lead to be loaded into the lead pathway.
  • In one embodiment, the engagement mechanism may include an engagement member on each of the portions of the clamshell structure, the implantable lead being compressed between the engagement members when the engagement mechanism is in the engaged state and the implantable lead is located in the lead pathway. In one embodiment, at least one of the engagement members may include a hard stop that inhibits excessive compression of the implantable lead by the engagement members.
  • Also disclosed herein is a lead insertion tool for inserting a lead connector end of an implantable lead into a lead receptacle of a header of an implantable pulse generator, the implantable lead including a lead body extending distally from the lead connector end. In one embodiment, the tool includes a lead pathway and an engagement mechanism. The lead pathway extends through the tool and is configured to receive the implantable lead. The engagement mechanism includes an engaged state and a self-biasing non-engaged state. When the engagement mechanism is self-biased into the non-engaged state, the implantable lead is free to displace along the lead pathway. When the engagement mechanism is forced into the engaged state, the lead cannot displace along the lead pathway.
  • Depending on the embodiment, the lead pathway includes a lumen. The tool may include a clamshell configuration that can be opened to allow the implantable lead to be loaded into the lead pathway. The tool may include a leading projection through which the lead pathway extends. The leading projection may have an outer diameter configured to be received in the lead receptacle. The leading projection may include a tapered free end. The tool may include a trailing projection, and the lead pathway may extend from a free end of the trailing projection to a free end of the leading projection.
  • In one embodiment, the engagement mechanism, when in the engaged state, interacts with the implantable lead along the lead pathway between the free end of the trailing projection and the free end of the leading projection. The engagement mechanism may include at least one engagement member including an interior surface that compresses against the implantable lead when the engagement mechanism is forced into the engaged state. The engagement member may be cantilevered from a surrounding structure of the tool. The engagement member may be coupled to the surrounding tool via a living hinge.
  • In one embodiment, the engagement mechanism includes a pair of opposed engagement members that compress the implantable lead between the engagement members when the engagement mechanism is forced into the engaged state. In one embodiment, at least one of the engagement members includes a hard stop that inhibits excessive compression of the implantable lead by the pair of engagement members.
  • Also disclosed herein is method of using a lead insertion tool to insert a lead connector end of an implantable lead into a lead receptacle of a header of an implantable pulse generator, the implantable lead including a lead body extending distally from the lead connector end. The implantable lead extends through the tool such that the lead connector end projects out of a leading end of the tool and the lead body extends out of a trailing end of the tool. In one embodiment, the method includes causing the lead connector end to enter the lead receptacle by causing an engagement mechanism of the tool to engage the implantable lead while displacing the tool towards the lead receptacle with a free end of the lead connector end aligned with the lead receptacle.
  • In one embodiment, the tool is displaced away from the lead receptacle and along the implantable lead with the engagement mechanism disengaged from the implantable lead and then again causing the engagement mechanism of the tool to engage the implantable lead while again displacing the tool towards the lead receptacle to further drive the lead connector end into the lead receptacle. In one embodiment, the engagement mechanism self-biases out of engagement with the implantable lead.
  • While multiple embodiments are disclosed, still other embodiments of the present disclosure will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the disclosure. As will be realized, the invention is capable of modifications in various aspects, all without departing from the spirit and scope of the present disclosure. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is an isometric view of a lead insertion tool when its clamshell configuration is in a closed state.
  • FIG. 2 is an isometric view of the lead insertion tool when its clamshell configuration is in an open state and showing its exterior.
  • FIG. 3 is an isometric view of the lead insertion tool when its clamshell configuration is in the open state and showing its interior.
  • FIG. 4 is a similar view of lead insertion tool as depicted in FIG. 3, except also depicting a proximal region of an implantable lead being located in one-half of a lead receiving channel of the lead insertion tool.
  • FIG. 5 is the same view as FIG. 4, except the clamshell configuration of the lead insertion tool has been closed about the lead body such that the lead occupies the lead receiving channel of the lead insertion tool.
  • FIG. 6 shows the lead and lead insertion tool in the same relationship depicted in FIG. 5, except the lead proximal end is being aligned with a lead receptacle of a header of an IPG.
  • FIG. 7 illustrates the lead proximal end received in the lead receptacle of the header via insertion by the lead insertion tool.
  • FIG. 8 depicts the lead insertion tool being distally withdrawn along the lead with the lead proximal end continuing to be received in the lead receptacle.
  • FIG. 9 shows the clamshell configuration of the lead insertion tool being opened and the lead insertion tool being removed from about the proximal region of the lead.
  • DETAILED DESCRIPTION
  • As can be understood from FIGS. 6-9 and discussed in detail below, implementations of the present disclosure involve a lead insertion tool 10 and associated methods of inserting a proximal end 100 of an implantable lead 105 into a lead receptacle 200 of a header 205 of an implantable pulse generator (IPG) 210 such as, for example, a pacemaker, implantable cardioverter defibrillator (ICD), neuromodulator, neurostimulator, or etc.
  • In one embodiment, the lead insertion tool 10 may be coupled to the lead body 110 near the proximal end 100 of the lead that is to be received in the header lead receptacle 200. The lead proximal end 100 includes, or may be in the form of, a lead connector end 115 having a number of electrical contacts 120 along the length thereof.
  • The tool 10 is free to slide along the lead body 110 until a lead body engagement mechanism 45 of the tool 10 is caused to engage the lead body 110, thereby fixing the tool 10 relative to the lead body 110 as long as the lead body engagement mechanism 45 is activated. The tool can then be used to insert the lead proximal end 100 into the header receptacle 200. Causing the lead connector end 120 to be fully received in the header lead receptacle 200 results in electrical contact being established between the electrical contacts 120 of the lead connector end 115 and corresponding electrical contacts inside the lead receptacle 200 that are part of a connector assembly in the IPG header 205. Via feedthrus of the IPG 210, the connector assembly of the IPG header 205 is in electrical communication with the hybrid and other electronic components of the IPG 210 hermetically sealed in the housing 215 of the IPG 210.
  • In one embodiment, the lead insertion tool includes a leading projection 30 through which the lead body 110 extends. The leading projection 30 is configured to facilitate guiding the lead 105 into the header lead receptacle 200 and also provide column strength to the lead body 110 to prevent its bending. In some embodiments, the leading projection 30 may serve to dilate the header lead receptacle 200 where the lead receptacle is compliant. These features, and others as described below, allow a lead proximal end 100 to be inserted into a lead receptacle 200 of an IPG header 205 in a rapid fashion with little risk of damage to the implantable lead 105 and despite the lead body 110 being highly flexible.
  • A. Features of the Lead Insertion Tool
  • To begin a detailed discussion of an embodiment of the lead insertion tool 10, reference is made to FIGS. 1-3. FIG. 1 is an isometric view of the lead insertion tool 10 in a closed condition. FIGS. 2 and 3 are isometric views of the lead insertion tool in an open condition as viewed from the exterior and interior of the tool, respectively.
  • As illustrated in FIGS. 1-3, in one embodiment, the lead insertion tool 10 has a clamshell configuration including a first half 15 and a second half 20 joined by a first living hinge 25. Thus, the tool 10 can be opened such that the first half 15 and second half 20 can be separated from each other yet maintained coupled together via the living hinge 25 extending between the bottom edges of each half 15, 20, as can be understood from FIGS. 2-3. The tool 10 can then be closed such that opposed interior faces 27A, 27B (see FIG. 3) of the respective halves 15, 20 are abutted together, as indicated in FIG. 1. While a living hinge 25 is depicted in the various figures, in some embodiments, the hinge 25 can be any other type of hinge.
  • As shown in FIG. 1, the tool 10 further includes a central structure 28, a leading projection 30, a trailing projection 35, a hollow cylindrical shaft or lumen 40, and a lead body engagement mechanism 45. In one embodiment and as Indicated in FIGS. 2-3, each of the central structure 28, leading projection 30, trailing projection 35, lumen 40, and lead body engagement mechanism 45 includes first and second portions respectively located on the first half 15 and the second half 20. Specifically, the first half 15 includes a central structure first portion 28A, a leading projection first portion 30A, a trailing projection first portion 35A, a lumen first portion 40A, and lead body engagement mechanism first portion 45A. Similarly, the second half 20 includes a central structure second portion 28B, a leading projection second portion 30B, a trailing projection second portion 358, a lumen second portion 40B, and lead body engagement mechanism second portion 45B.
  • The lumen 40 may have an internal diameter of between approximately 0.03″ and approximately 0.06″. The leading projection 30 may have an outer diameter of between approximately 0.06″ and approximately 0.09″.
  • As depicted in FIG. 1, the leading projection 30 extends from one side of the central structure 28 in a direction opposite the trailing projection 35. The leading projection 30 includes a cylindrical outer surface 50 and a tapered free end 55. Moving along the free end 55 in a direction towards the trailing projection 35, the tapered free end 55 increases in diameter to eventually match the outer diameter of the cylindrical outer surface 50. The outer diameter of the cylindrical outer surface 50 is slightly smaller than an internal diameter of the lead receptacle 200 of the IPG header 205. As discussed below with respect to FIGS. 6-7, the leading projection 30 and its tapered free end 55 facilitate entry of the lead proximal end 100 into the header lead receptacle 200. The leading projection also gives column strength to the lead when the lead is being inserted into the header lead receptacle.
  • As illustrated in FIG. 1, the trailing projection 35 extends from another side of the central structure 28 in a direction opposite the leading projection 30. The trailing projection 35 includes a cylindrical outer surface 60 and a flanged free end 65. The flanged free end 65 has a diameter that is substantially greater than the outer diameter of the cylindrical outer surface 60 and, as a result, the flanged free end 65 can be grasped to displace the tool 10 distally along the lead body 110 once the lead connector end 115 is fully received in the header lead receptacle 200, as discussed below with respect to FIG. 8. Thus, the flanged free end 65 can be grasped to withdraw the tool along the lead without activating the engagement mechanism or otherwise pinching the lead.
  • As can be understood from FIGS. 1-3, the lumen 40 extends through the tool 10 to daylight at the free ends of each projection 30, 35. The lumen 40 is made up of lumen portions 40A, 40B defined in each respective interior face 27A, 27B. The lumen 40 is defined by a cylindrical inner surface, a portion of which is defined in each respective interior face 27A, 27B. The cylindrical inner surface has an internal diameter that is slightly larger than an outer diameter of the lead body 110, thereby allowing the lead body 110 to longitudinally displace within the lumen 40 such that the tool 10 can be moved along the lead body 110 when the lead body engagement mechanism 45 is not actuated to engage the lead body 110, as discussed below with respect to FIGS. 5 and 8.
  • As can be understood from FIGS. 1-3, in one embodiment, each lead body engagement mechanism portion 45A, 45B may be in the form of a member 45A, 45B that is cantilevered off of the surrounding central structure portion 28A, 28B via a living hinge 70A, 70B. As a result, each member 45A, 45B forms a peninsula from the respective central structure portion 28, 28B via the living hinge 70A, 70B, the rest of each member 45A, 45B being spaced apart from the surrounding central structure portion 28A, 28B via a void 75A, 75B defined in the surrounding central structure portion 28A, 28B. Each member 45A, 45B is located within a respective void 75A, 75B. While living hinges 70A, 70B are depicted in the various figures, in some embodiments, the hinges 70A, 70B can be any other type of hinge that may also have a biasing component (e.g., a spring) built into or supplementing the hinge.
  • As shown in FIGS. 1-2, the exterior of each member 45A, 45B has a contoured shape with a recess region 80A, 80B that is shaped and configured interface with a physician's thumb or index finger. Thus, the physician may actuate the lead body engagement mechanism 45 by using a thumb and index finger to squeeze the opposed members 45A, 45B inwardly such that they deflect inwardly towards each other. As discussed in detail below, the members 45A, 45B deflecting inwardly cause the members to squeeze or compress the lead body 110 between the interior surfaces 85A, 85B (see FIG. 3) of the members 45A, 45B such that the tool 10 cannot be displaced along the length of the lead body 110, thereby allowing the tool 10 to be used to insert the lead proximal end into the header lead receptacle. Thus, in one embodiment, the lead body engagement mechanism 45 may be considered a lead body compression or squeezing mechanism 45.
  • As indicated in FIG. 3, the Interior surfaces 85A, 85B of the respective lead body engagement members 45A, 45B are immediately adjacent the paths of the lumen portions 40A, 40B. When the members 45A, 45B are not being acted upon by an outside force, such as an inwardly directed or pinching force of the physicians thumb and index finger, the members 45A, 45B assume or bias to their natural biased or non-deflected state and do not intersect the paths of the lumen portions 40A, 40B. As a result, the tool 10 is free to be slid along the length of the lead body 110 with very little, if any, resistance, as discussed below with respect to FIGS. 5 and 8.
  • Conversely, as can be understood from FIG. 3, the interior surfaces 85A, 85B of the respective lead body engagement members 45A, 45B Intersect and extend into the paths of the lumen portions 40A, 40B when the members 45A, 45B are being acted upon by an outside force, such as an Inwardly directed or pinching force of the physicians thumb and index finger. In other words, the members 45A, 45B can be forced to deflect inwardly from their natural non-deflected state to intersect the paths of the lumen portions 40A, 40B, thereby pinching or compressing the lead body 110, which is occupying the lumen 40, between the interior surfaces 85A, 85B of the respective lead body engagement members 45A, 45B. As a result, the tool 10 grasps the lead body 110 such that the tool cannot be slid along the length of the lead body 110, thereby allowing the tool 10 to be used to insert the lead proximal end 100 into the header lead receptacle 200, as discussed below with respect to FIGS. 6-7.
  • As shown in FIG. 3, in one embodiment, the interior surfaces 85A, 85B of the members 45A, 45B may include hard stops 90A, 90B that contact each other when the interior surfaces 85A, 85B approach each other on account of the members 45A, 45B being inwardly deflected towards each other. The hard stops 90A, 90B may be sized to prevent the interior surfaces 85A, 85B from contacting each other, thereby leaving a gap or space between the interior surfaces when the members are fully inwardly deflected towards each other such that the hard stops abut each other. This hard stop feature helps to prevent the physician from overly pinching the lead body 110 between the member interior surfaces 85A, 85B and damaging the lead body. Thus, in part due to the hard stops, the physician can be assured of sufficient compression on the lead body to assure desired displacement and manipulation of the of the lead body while minimizing the risk of lead body damage due to over compression of the lead body.
  • As illustrated in FIG. 3, in one embodiment, the Interior face 27A of the first half 15 includes a male locking feature 95A (e.g., a pin, tab, etc.) that is received in a female locking feature 95B (e.g., hole, recess, etc.) of the interior face 27B of the second half 20 in an interference fit arrangement such that the locking features 95A, 95B work together to keep the halves 15, 20 in a closed state, as depicted in FIG. 1. The locking strength of the locking features 95A, 95B can easily be overcome by the physician intentionally prying the halves 15, 20 apart by, for example, inserting a tool, finger nail, etc. between the interior faces 27A, 27B of the halves 15, 20.
  • As shown in FIG. 3, male alignment features 97A (e.g., ridges, pins, etc.) may also be present on the interior face 27A of the first half 15 to be receive by corresponding female alignment features 97B (e.g., slots, troughs, holes, etc.) defined in the interior face 27B of the second half 20. These features 97A, 97B mating with each other will facilitate the locking features 95A, 95B aligning properly and the lumen portions 40A, 40B properly aligning to define a cylindrical lumen 40 from free end to free end of the projections 30, 35.
  • Depending on the embodiment, the tool 10 and its various components may be made from a variety of materials such as, for example, Polypropylene (PP), Polyethylene (PE), Acrylonitrile Butadiene Styrene (ABS), etc. Depending on the embodiment, the tool 10 may be disposable or capable of being sterilized and reused.
  • With the preceding understanding of the various aspects of the lead insertion tool 10, the discussion will now turn towards methods of employing the tool.
  • B. Method of Using the Lead Insertion Tool
  • FIG. 4 is an isometric view of the lead insertion tool 10 and proximal region 100 of the implantable lead 105, wherein the lead is being loaded into the tool. As shown in FIG. 4, the clamshell configuration of the tool 10 is open such the opposed interior surfaces 27A, 27B of the halves 15, 20 are spaced apart from each other and the halves 15, 20 are nearly flat relative to each other. Also, the proximal end 100 of the implantable lead 105 is positioned relative to the tool 10 such that the lead body 110 just distal the distal edge of the lead connector end 115 is received in the lumen second portion 40B.
  • FIG. 5 is the same view as FIG. 4, except the clamshell configuration of the lead insertion tool 10 has been closed about the lead body 110 such that the lead 105 occupies the lead receiving channel or lumen 40 of the lead insertion tool 10 between the free ends of the projections 30, 35. The entirety of the lead connector end 115 extends from the free end of the leading projection 30.
  • As can be understood from FIGS. 3 and 5, when the clamshell configuration of the tool 10 is in the closed state about the lead body 110, the interior surfaces 27A, 27B abut each other, the alignment features 97A, 97B interface, and the locking features 95A, 95B are engaged to maintain the halves 15, 20 in a closed state. Also, the interior surfaces 85A, 85B of the lead body engagement members 45A, 45B are located immediately adjacent the exterior surface of the lead body 110. As explained above, the members 45A, 45B self-bias to a position where the interior surfaces 85A, 85B will not contact the exterior surface of the lead body 110. Thus, since the members 45A, 45B have not yet been subjected to an inward force (e.g., via being pressed inward by the physician's thumb and index finger), the interior surfaces 85A, 85B do not yet contact the exterior surface of the lead body 110. Because the engagement members 45A, 45B have not been forced to engage the lead body 110 and, as noted above, the lumen 40 is of a greater diameter than the lead body 110, the tool 10 can be freely displaced along the lead body 110.
  • FIG. 6 shows the lead 105 and lead insertion tool 10 in the same relationship depicted in FIG. 5, except the lead proximal end 100 is being aligned with the lead receptacle 200 of the header 205 of the IPG 210, and the lead engagement mechanism 45 is being actuated to engage the lead body 110. Specifically, inward forces are being applied (e.g., via a pinching action of the physician's thumb and index finger) to each engagement member 45A, 45B to drive the members 45A, 45B inward. As a result, the interior surfaces 85A, 85B of the lead body engagement members 45A, 45B compress or pinch the lead body 110, thereby preventing displacement of the tool 10 along the lead body 110 and allowing the tool 10 to be used to insert the lead connector end 115 into the appropriate header lead receptacle 200.
  • FIG. 7 illustrates the lead proximal end 100 received in the lead receptacle 200 of the header 205 via insertion by the lead insertion tool 10. As can be understood from FIG. 7, the leading projection 30 of the tool 10 has also been received in the header lead receptacle 200. The lead body engagement mechanism 45 of the tool 10 will have been in compressing or pinching engagement with the lead body 110 to allow the lead connector end 115 to be fully received in the header lead receptacle 200 as indicated in FIG. 7. As noted above, in one embodiment, the leading projection 30 has a tapered tip and an outer diameter that exceeds the inner diameter of the header lead receptacle 200 such that the leading projection 30 can dilate the header lead receptacle 200 where the receptacle 200 is of a compliant configuration. In one embodiment, this nature of the leading projection 30 can be employed to step-by-step and incrementally feed the lead connector end 115 into the receptacle 200 by starting out with the free end of the leading projection 30 being generally even with the free proximal end of the lead connector end 115 and inserting the lead connector end 115 the length of the leading projection 30. The engagement mechanism 45 of the tool 10 can then be released and the tool distally displace along the length of the lead body 110 until the leading projection 30 is outside the receptacle 200. The engagement mechanism 45 can then be reengaged with the lead body 110 and proximally displaced the length of the leading projection 30 to further incrementally insert the lead connector end 115 in to the header lead receptacle 200. This process can be repeated over and over until the lead connector end 115 is fully received in the receptacle 200 as indicated in FIG. 7.
  • As can be understood from FIG. 7, a setscrew 220 on the IPG header 205 may be tightened down on the lead connector end 115 before the tool 10 is withdrawn from the header lead receptacle 200 and the fully inserted lead connector end. This will prevent the lead connector end from inadvertently being withdrawn from the header lead receptacle.
  • FIG. 8 depicts the lead Insertion tool 10 being distally withdrawn along the lead body 110 with the lead proximal end 100 continuing to be received in the lead receptacle 200. Specifically, the physician no longer pushes the members 45A, 45B inward into engagement with the lead body 110, instead allowing the members 45A, 45B to self-bias outwardly and out of engagement with the lead body 110. Because the engagement members 45A, 45B are no longer being forced to engage the lead body 110 and, as noted above, the lumen 40 is of a greater diameter than the lead body 110, the tool 10 can be freely distally displaced along the lead body 110 such that the leading projection 30 is caused to exit the header lead receptacle 200, leaving the lead connector end 115 fully received in the header lead receptacle 200.
  • FIG. 9 shows the clamshell configuration of the lead insertion tool 10 being opened and the lead insertion tool 10 being removed from about the lead 105. The lead connector end 115 is still fully received in the header lead receptacle 200. The tool 10 can then be reused in a similar manner to insert a second lead connector end into the second header lead receptacle 200 illustrated in FIG. 9.
  • As can be understood from the preceding discussion, the tool 10 provides column strength to the lead where it is most needed when the lead is being inserted into the header lead receptacle. Also, the tool grips the lead without crushing it. The tool can also slide along the lead when the engagement mechanism is self-biased into its non-engaged state, yet solidly engages the lead when forced out of the self-biased non-engage state into the engaged state by the physician squeezing together the engagement members. The tool is inexpensive to manufacture. The tool lumen can be sized to work with a wide variety of lead body diameters. Finally, the tool is simple and intuitive to use.
  • The foregoing merely illustrates the principles of the invention. Various modifications and alterations to the described embodiments will be apparent to those skilled in the art in view of the teachings herein. It will thus be appreciated that those skilled in the art will be able to devise numerous systems, arrangements and methods which, although not explicitly shown or described herein, embody the principles of the invention and are thus within the spirit and scope of the present invention. From the above description and drawings, it will be understood by those of ordinary skill in the art that the particular embodiments shown and described are for purposes of illustrations only and are not intended to limit the scope of the present invention. References to details of particular embodiments are not intended to limit the scope of the invention.

Claims (20)

What is claimed is:
1. A lead insertion tool for inserting a lead connector end of an implantable lead into a lead receptacle of a header of an implantable pulse generator, the implantable lead including a lead body extending distally from the lead connector end, the tool comprising:
a clamshell structure including a first portion, a second portion coupled to the first portion via a hinge, an engagement mechanism, and a lead pathway configured to receive the implantable lead,
wherein each portion of the clamshell structure includes a central structure, a leading projection extending from the central structure, and a part of a lead pathway, the part of the lead pathway of the first portion combining with the part of the lead pathway of the second portion to form the lead pathway when the first portion and second portion are abutted together when the clamshell structure is in a closed state,
wherein the lead pathway extends through the central portion and the leading projection to a free end of the leading projection,
wherein the engagement mechanism is located on at least one of the portions of the clamshell structure and includes an engaged state and a self-biasing non-engaged state,
wherein, when the engagement mechanism is self-biased into the non-engaged state, the implantable lead is free to displace along the lead pathway, and when the engagement mechanism is forced into the engaged state, the lead cannot displace along the lead pathway.
2. The tool of claim 1, wherein the first portion of the clamshell structure includes a first alignment feature and the second portion of the clamshell structure includes a second alignment feature, the alignment features interfacing with each other to facilitate proper alignment of the first and second portions of the clamshell structure when the first and second portions of the clamshell structure are abutted together.
3. The tool of claim 2, wherein the first portion of the clamshell structure includes a first lock feature and the second portion of the clamshell structure includes a second lock feature, the lock features Interfacing with each other to maintain the first and second portions of the clamshell structure in a closed state.
4. The tool of claim 3, wherein the engagement mechanism includes an engagement member on each of the portions of the clamshell structure, the implantable lead being compressed between the engagement members when the engagement mechanism is in the engaged state and the implantable lead is located in the lead pathway.
5. The tool of claim 4, wherein at least one of the engagement members includes a stop that inhibits excessive compression of the implantable lead by the engagement members.
6. The tool of claim 5, further comprising a trailing projection, and the lead pathway extends from a free end of the trailing projection to a free end of the leading projection.
7. A lead insertion tool for inserting a lead connector end of an implantable lead into a lead receptacle of a header of an implantable pulse generator, the implantable lead including a lead body extending distally from the lead connector end, the tool comprising:
a lead pathway through the tool that is configured to receive the implantable lead; and
an engagement mechanism including an engaged state and a self-biasing non-engaged state,
wherein, when the engagement mechanism is self-biased into the non-engaged state, the implantable lead is free to displace along the lead pathway, and when the engagement mechanism is forced into the engaged state, the lead cannot displace along the lead pathway.
8. The tool of claim 7, wherein the tool includes a clamshell configuration that can be opened to allow the implantable lead to be loaded into the lead pathway, and wherein the clamshell configuration includes an alignment arrangement that facilitates proper alignment of the clamshell configuration when assuming a closed state.
9. The tool of claim 8, wherein the clamshell configuration includes a lock arrangement that maintains the clamshell configuration in a closed state.
10. The tool of claim 9, the tool further comprising a leading projection through which the lead pathway extends and wherein the leading projection has an outer diameter configured to be received in the lead receptacle.
11. The tool of claim 10, wherein the leading projection includes a tapered free end.
12. The tool of claim 11, further comprising a trailing projection, and the lead pathway extends from a free end of the trailing projection to a free end of the leading projection.
13. The tool of claim 12, wherein the engagement mechanism, when in the engaged state, interacts with the implantable lead along the lead pathway between the free end of the trailing projection and the free end of the leading projection.
14. The tool of claim 13, wherein the engagement mechanism includes at least one engagement member including an interior surface that compresses against the implantable lead when the engagement mechanism is forced into the engaged state.
15. The tool of claim 14, wherein the engagement member is cantilevered from a surrounding structure of the tool.
16. The tool of claim 15, wherein the engagement member is coupled to the surrounding tool via a living hinge.
17. The tool of claim 16, wherein the engagement mechanism includes a pair of opposed engagement members that compress the implantable lead between the engagement members when the engagement mechanism is forced into the engaged state.
18. The tool of claim 17, wherein at least one of the engagement members includes a hard stop that inhibits excessive compression of the implantable lead by the pair of engagement members.
19. A method of using a lead insertion tool to insert a lead connector end of an implantable lead into a lead receptacle of a header of an implantable pulse generator, the implantable lead including a lead body extending distally from the lead connector end, the implantable lead extending through the tool such that the lead connector end projects out of a leading end of the tool and the lead body extends out of a trailing end of the tool, the method comprising: causing the lead connector end to enter the lead receptacle by causing an engagement mechanism of the tool to engage the implantable lead while displacing the tool towards the lead receptacle with a free end of the lead connector end aligned with the lead receptacle.
20. The method of claim 19, further comprising: displacing the tool away from the lead receptacle and along the implantable lead with the engagement mechanism disengaged from the implantable lead and then again causing the engagement mechanism of the tool to engage the implantable lead while again displacing the tool towards the lead receptacle to further drive the lead connector end into the lead receptacle; and
wherein the engagement mechanism self-biases out of engagement with the implantable lead.
US15/241,866 2016-08-19 2016-08-19 Lead insertion tool Abandoned US20180050209A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US15/241,866 US20180050209A1 (en) 2016-08-19 2016-08-19 Lead insertion tool
US16/147,146 US10933231B2 (en) 2016-08-19 2018-09-28 Lead insertion tool

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US15/241,866 US20180050209A1 (en) 2016-08-19 2016-08-19 Lead insertion tool

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US16/147,146 Continuation US10933231B2 (en) 2016-08-19 2018-09-28 Lead insertion tool

Publications (1)

Publication Number Publication Date
US20180050209A1 true US20180050209A1 (en) 2018-02-22

Family

ID=61191104

Family Applications (2)

Application Number Title Priority Date Filing Date
US15/241,866 Abandoned US20180050209A1 (en) 2016-08-19 2016-08-19 Lead insertion tool
US16/147,146 Active 2037-02-15 US10933231B2 (en) 2016-08-19 2018-09-28 Lead insertion tool

Family Applications After (1)

Application Number Title Priority Date Filing Date
US16/147,146 Active 2037-02-15 US10933231B2 (en) 2016-08-19 2018-09-28 Lead insertion tool

Country Status (1)

Country Link
US (2) US20180050209A1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10926093B2 (en) 2016-05-05 2021-02-23 Pacesetter, Inc. System and method for loading a leadless pacemaker onto a catheter-based delivery system

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5456699A (en) * 1993-12-08 1995-10-10 Intermedics, Inc. Cardiac stimulator lead insertion tool

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10926093B2 (en) 2016-05-05 2021-02-23 Pacesetter, Inc. System and method for loading a leadless pacemaker onto a catheter-based delivery system

Also Published As

Publication number Publication date
US10933231B2 (en) 2021-03-02
US20190030319A1 (en) 2019-01-31

Similar Documents

Publication Publication Date Title
US5261395A (en) Tooless pulse generator to lead connection
US10218133B2 (en) Distal connector assemblies for medical lead extensions
US8897876B2 (en) Systems and methods for making and using connectors for electrical stimulation systems
US9656093B2 (en) Systems and methods for making and using connector contact arrays for electrical stimulation systems
US7422487B2 (en) Electrical connector and devices using the same
US4860750A (en) Sidelock pacer lead connector
US8433424B2 (en) Implantable retention system and method
US9192409B2 (en) Steerable stylet handle assembly
US20080208301A1 (en) Implantable neurostimulator adapters
US20060167522A1 (en) Connector for use in an implantable stimulator device
US9610434B2 (en) System and method for making and using a lead introducer for an implantable electrical stimulation system
US20080208302A1 (en) Implantable neurostimulator adapters
JP2007501052A (en) Implantable medical lead connector sleeve
US5573551A (en) Implantable medical device with detachable battery or electronic circuit
WO1997024779A2 (en) Tool-less locking and sealing assembly for implantable medical device
US20030176906A1 (en) Method and apparatus for connecting various implantable medical treatment system component devices
US7133722B2 (en) Device-to-lead terminal connector for implantable tissue stimulators
CN103515760B (en) By electrode machinery and it is electrically connected to the adapter of at least one calibrating terminal contact
US10933231B2 (en) Lead insertion tool
EP3045202B1 (en) Lead lock for securing a lead to a pulse generator
US20190290323A1 (en) Loading tool for a biostimulator
US20160346554A1 (en) Vented set screw for implantable medical device
CN110665122A (en) Leadless pacemaker, head end component, tail end component and delivery device thereof
JP6590466B2 (en) Extracorporeal cardiac pacemaker with electrodes that can be temporarily connected to the heart, connected via plug-in connectors
AU2020226356B2 (en) Lead introducers and systems and methods including the lead introducers

Legal Events

Date Code Title Description
AS Assignment

Owner name: ADVANCED NEUROMODULATION SYSTEMS, INC. DBA ST. JUD

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:RAINES, AARON;REEL/FRAME:039486/0861

Effective date: 20160819

STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION