US20220378459A1 - Intravascular device having a selectively defectable tip - Google Patents
Intravascular device having a selectively defectable tip Download PDFInfo
- Publication number
- US20220378459A1 US20220378459A1 US17/885,302 US202217885302A US2022378459A1 US 20220378459 A1 US20220378459 A1 US 20220378459A1 US 202217885302 A US202217885302 A US 202217885302A US 2022378459 A1 US2022378459 A1 US 2022378459A1
- Authority
- US
- United States
- Prior art keywords
- section
- distal
- proximal
- inner member
- degrees
- 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.)
- Pending
Links
- 238000005520 cutting process Methods 0.000 claims abstract description 18
- 230000004044 response Effects 0.000 claims abstract description 12
- 238000005452 bending Methods 0.000 claims description 21
- 239000000463 material Substances 0.000 claims description 13
- 229910001220 stainless steel Inorganic materials 0.000 claims description 9
- 239000010935 stainless steel Substances 0.000 claims description 8
- 230000006835 compression Effects 0.000 claims description 7
- 238000007906 compression Methods 0.000 claims description 7
- 239000000853 adhesive Substances 0.000 claims description 5
- 230000001070 adhesive effect Effects 0.000 claims description 5
- 229910001000 nickel titanium Inorganic materials 0.000 claims description 4
- 206010002329 Aneurysm Diseases 0.000 description 15
- 210000003484 anatomy Anatomy 0.000 description 13
- 238000000034 method Methods 0.000 description 10
- 210000005166 vasculature Anatomy 0.000 description 9
- 238000009826 distribution Methods 0.000 description 4
- 208000037834 fusiform aneurysm Diseases 0.000 description 4
- 230000009286 beneficial effect Effects 0.000 description 3
- 238000004519 manufacturing process Methods 0.000 description 3
- 230000002792 vascular Effects 0.000 description 3
- 230000008901 benefit Effects 0.000 description 2
- 230000015572 biosynthetic process Effects 0.000 description 2
- 238000003466 welding Methods 0.000 description 2
- 210000004556 brain Anatomy 0.000 description 1
- 150000001875 compounds Chemical class 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 230000003111 delayed effect Effects 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 239000000975 dye Substances 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 230000003073 embolic effect Effects 0.000 description 1
- 230000037361 pathway Effects 0.000 description 1
- 229920000642 polymer Polymers 0.000 description 1
- 230000000750 progressive effect Effects 0.000 description 1
- 238000007493 shaping process Methods 0.000 description 1
- 238000005476 soldering Methods 0.000 description 1
- 239000000126 substance Substances 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0138—Tip steering devices having flexible regions as a result of weakened outer material, e.g. slots, slits, cuts, joints or coils
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
- A61B17/12113—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel within an aneurysm
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61L—METHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
- A61L29/00—Materials for catheters, medical tubing, cannulae, or endoscopes or for coating catheters
- A61L29/02—Inorganic materials
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
- A61M25/09041—Mechanisms for insertion of guide wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
- A61B2017/003—Steerable
- A61B2017/00305—Constructional details of the flexible means
- A61B2017/00309—Cut-outs or slits
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00831—Material properties
- A61B2017/00951—Material properties adhesive
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B2017/1205—Introduction devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B2017/320733—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with a flexible cutting or scraping element, e.g. with a whip-like distal filament member
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M2025/0042—Microcatheters, cannula or the like having outside diameters around 1 mm or less
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0133—Tip steering devices
- A61M25/0147—Tip steering devices with movable mechanical means, e.g. pull wires
Definitions
- Interventional devices such as guidewires and catheters are frequently utilized in the medical field to perform delicate procedures deep within the human body.
- a catheter is inserted into a patient's femoral, radial, carotid, or jugular vessel and navigated through the patient's vasculature to the heart, brain, or other targeted anatomy as required.
- a guidewire is first routed to the targeted anatomy, and one or more catheters are subsequently passed over the guidewire and routed to the targeted anatomy. Once in place, the catheter can be used to deliver drugs, stents, embolic devices, radiopaque dyes, or other devices or substances for treating the patient in a desired manner.
- a micro catheter and guidewire are routed simultaneously toward the targeted anatomy while the guidewire resides within the micro catheter, and then the guidewire is passed further into the anatomy by translating within the micro catheter.
- Such intravascular devices must be angled through the tortuous bends and curves of a vasculature passageway to arrive at the targeted anatomy.
- Such an interventional device requires sufficient flexibility, particularly closer to its distal end, to navigate such tortuous pathways.
- the interventional device must also be able to provide sufficient torquability (i.e., the ability to transmit torque applied at the proximal end all the way to the distal end), pushability (i.e., the ability to transmit axial push to the distal end rather than bending and binding intermediate portions), and structural integrity for performing intended medical functions.
- the distal tip of the device may be necessary to pass the distal tip of the device through a fusiform aneurysm, which can present even further difficulties.
- the vascular walls will generally confine the path forward and limit the possible movement of the distal tip of the device.
- the distal tip of the device when passing through a fusiform aneurysm, the distal tip of the device must navigate through the open three-dimensional space between the proximal and distal openings of the aneurysm. Because of the relatively less confined space within the aneurysm, it can be extremely difficult to properly align the distal tip to the distal opening.
- the operator can push/pull the intravascular device to move the distal tip forward or backward, and can apply torque to rotate the distal tip.
- the procedure may be seriously delayed or rendered impossible. Accordingly, there is a long felt and ongoing need for intravascular devices providing enhanced navigation capabilities.
- An intravascular device such as a guidewire device, includes a hollow proximal section and a hollow distal section joined to the proximal section and extending distally from the proximal section to form a continuous lumen extending from a proximal end of the device to a distal end of the device.
- An inner member extends from the proximal end to the distal end and is joined to the distal end. The inner member is translatable within the lumen in response to applied tension.
- At least the distal section includes a micro-fabricated cutting pattern that enables deflection of the distal end in response to the application of tension to the inner member.
- the cutting pattern of the distal section includes a one-beam or two-beam configuration, though other embodiments may include a three-beam configuration or a configuration of more than three beams.
- the distal section includes a one-beam section having a plurality of beams substantially aligned on a single side to form a preferred bending direction.
- the substantially aligned beams may be disposed at the most distal section of the device adjacent the distal end. This arrangement can beneficially provide reliable and predictable deflection of the distal end of the device when tension is applied to the inner member.
- the intravascular device may be constructed of any suitable medical grade materials. Some embodiments include at least one of a proximal section formed as a stainless steel tube, a distal section formed of a nickel-titanium alloy, and an inner member formed of stainless steel.
- the inner member may be a ground stainless steel core that has a wider cross-sectional diameter at a more proximal section and a narrower cross-sectional diameter at a more distal section.
- the intravascular devices described herein may be utilized in any medical procedure requiring passage into the vasculature. Certain embodiments are particularly beneficial in procedures with difficult navigation challenges, such as those requiring passage deep into the neurovasculature and/or when trying to navigate through a fusiform aneurysm. For example, when attempting to navigate through a fusiform aneurysm from the proximal opening to the distal opening, it can be difficult to maneuver through the open three-dimensional space of the aneurysm to reach the distal side. Having additional control over navigation of the device can enable the operator to get past the aneurysm and continue navigating the vasculature. The additional movement, particularly when combined with predictable response as a result of defined distal section cutting patterns, can be the difference between a successful and unsuccessful procedure.
- an operator is typically limited to pushing/pulling the device and rotating the device to navigate the patient's vasculature.
- the limited control over navigation can make it extremely difficult to align the distal tip in the desired manner.
- the additional navigational control offered by the features described herein provides another option for moving the device into proper orientation with respect to patient anatomy.
- the additional option of selectively deflecting the tip may be enough to overcome the navigation impediment to allow the device to reach the target.
- FIGS. 1 A and 1 B illustrate an exemplary embodiment of a guidewire device having features providing selective deflection
- FIGS. 2 A and 2 B illustrate another embodiment of a guidewire device including a one-beam configuration where beams are substantially aligned on a single side to form a preferred bending direction;
- FIG. 3 illustrates the device of FIGS. 2 A and 2 B nested within a micro catheter
- FIGS. 4 A through 4 D illustrate various beam configurations that may be utilized in various combinations to provide desired bending characteristics in the intravascular device
- FIG. 5 illustrates a cutting pattern with a helical arrangements of beams
- FIG. 6 graphically illustrates a distributed cut pattern and shows a typical helical pattern for comparison
- FIG. 7 graphically illustrates an imperfect ramp cut pattern
- FIG. 8 graphically illustrates a sawtooth cut pattern and shows a typical helical pattern for comparison
- FIGS. 9 and 10 illustrate differences in rotational offsets, showing differences in spacing artifacts resulting from different sizes of rotational offset jumps.
- FIGS. 11 A through 11 C illustrate various spiral cut patterns that may be utilized to provide desired bending characteristics in the distal section of the intravascular device.
- the present disclosure relates to intravascular devices having features that provide enhanced navigation capabilities.
- embodiments are described herein which include a selectively deflectable tip for enabling additional navigation control of the device through vascular anatomy.
- many examples are provided in the context of a guidewire device. It will be understood, however, that the same concepts may be readily applied to a micro catheter application. Accordingly, the concepts and features described herein are not intended to be limited to any particular form of intravascular device.
- FIGS. 1 A and 1 B illustrate a distal region of an exemplary guidewire device 100 .
- the device 100 includes a proximal section 102 and a distal section 104 which together form an elongated hollow member.
- the device 100 also includes an inner member 106 extending from a proximal end (not shown) through the proximal section 102 and through the distal section 104 to attach to a distal tip 108 .
- the distal tip is preferably formed as a polymer adhesive, though other embodiments may additionally or alternatively utilize soldering, welding, fixture hardware, or other suitable attachment means.
- the inner member 106 is translatable within the lumen formed by the proximal and distal sections 102 , 104 , such that the application of tension or compression to the inner member 106 causes the distal section to deflect.
- Tension or compression may be applied as a result of a user respectively pulling or pushing the inner member 106 at the proximal end of the device and/or operating a control (e.g., dial, button, slider) operatively connected to the inner member 106 .
- the proximal section 102 is formed as a stainless steel hypotube
- the distal section 104 is formed as a nickel titanium alloy
- the inner member 106 is formed as a stainless steel wire.
- the inner member 106 is formed as a wire of substantially uniform diameter along its length.
- the wire preferably has a diameter that provides sufficient structural integrity and strength but that is small enough to allow sufficient flexibility of the device at the distal end.
- the wire may have, for example, a diameter of about 0.0002 inches to about 0.005 inches, or about 0.003 inches.
- the inner member 106 is formed as a ground core having a diameter that is wider at more proximal sections and that tapers to a narrower diameter at the distal end (e.g., tapers to about 0.002 inches at the distal end).
- a narrower diameter at the distal end e.g., tapers to about 0.002 inches at the distal end.
- the inner member 106 may have a diameter of about 0.006 to about 0.010 inches for most of its length within the more proximal sections of the device, with a series of one or more tapering sections that reduce the diameter as the inner member 106 gets progressively closer to the distal end.
- the inner member 106 of the devices described herein extends through the inner lumen of the device. This enables selective deflection/steering of the distal end of much smaller devices, such as those suitable for passage deep into the neurovasculature. At these relatively small diameters, it would be impractical or impossible to provide pull wires within the thickness of the circumferential wall of such a device.
- FIGS. 1 A and 1 B beneficially enable the tip of the guidewire device 100 to be selectively deflected to assist in navigating the patient's tortuous vasculature.
- the distal section 104 may be micro-fabricated to provide for preferential directional bending. In this manner, when translation (tension or compression) is applied to the inner member, there is a consistent, expected resulting deflection that occurs at the distal section 104 of the device.
- a variety of different distal section configurations can be utilized to provide a desired response to the adjustment to inner member tension.
- the cutting patterns described below in relation to FIGS. 4 A through 11 C may be utilized in any combination to provide the distal section with a bending response that matches particular user preferences and/or application needs. For example, leaving the majority of beams on one side of the distal section following a micro-fabricated cutting process will provide a preferred bending direction to the distal section.
- Different arrangements of sections having preferred bending cutting patterns and uniform bending sections can result in the formation of various compound curves, corkscrew shapes, hook-like shapes, and the like.
- the proximal section may also be micro-fabricated with one or more cut patterns. Typically, the proximal section will be configured to have greater relative rigidity than the distal section.
- FIGS. 2 A and 2 B illustrate in cross-section an embodiment of a guidewire device 200 with a distal section 204 having a one-beam configuration with the beams 210 arranged on a single side to form a “spine” of the distal section 204 .
- This arrangement leaves the open fenestrations 212 on the opposite side of the beams 210 .
- the guidewire device 200 is constructed in a similar fashion to the embodiment of FIGS. 1 A and 1 B , and includes a proximal section 202 , an inner member 206 , and a distal end 208 .
- the distal section 204 when tension is applied to the inner member 206 , the distal section 204 will deflect away from the side where the open fenestrations 212 are aligned and toward the spine formed by the aligned beams 210 .
- the space and increased flexibility provided by the fenestrations 212 allows the distal section 204 to preferentially bend in the illustrated direction.
- FIGS. 2 A and 2 B represents one presently preferred embodiment
- other embodiments may include variably spaced (non-aligned) beam arrangements.
- some cut patterns may result in beam arrangements that are sufficiently flexible to provide effective deflection of the distal section 204 even though the beams are not substantially aligned.
- An alternative embodiment includes pre-shaping the distal tip of the guidewire device such that the application of tension to the inner member leads to a straightening and/or stiffening effect, rather than causing the distal tip to bend.
- a guidewire device may be formed to be biased toward a pre-curved shape such as in FIG. 2 B .
- the inner member 206 can then be manipulated to move the distal section 204 toward a relatively straighter position such as in FIG. 2 A .
- FIG. 3 illustrates an implementation where the guidewire device 200 is utilized in conjunction with a micro catheter 201 .
- the guidewire device 200 is positioned within the micro catheter 201 .
- the selectively deflectable portion of the guidewire device 200 so that it coincides with a portion of the micro catheter 201 that is desired to be bent, and by manipulating the inner member of the guidewire device 200 , the resulting deflection of the distal section of the guidewire device 200 can be translated to the micro catheter 201 .
- This type of maneuver can beneficially provide an operator with additional navigation options and abilities. For example, when trying to navigate through an aneurysm from the proximal opening to the distal opening, it can be difficult to maneuver through the open three-dimensional space of the aneurysm to reach the distal side. Having additional control over navigation of the device can enable the operator to get past the aneurysm and continue navigating the vasculature.
- the additional movement particularly when combined with predictable response as a result of defined distal section cutting patterns, can be the difference between a successful and unsuccessful procedure.
- an operator is typically limited to pushing/pulling the device and rotating the device to navigate the patient's vasculature.
- the limited control over navigation can make it extremely difficult to align the distal tip in the desired manner.
- the additional navigational control offered by the features described herein provides another option for moving the device into proper orientation with respect to patient anatomy.
- the additional option of selectively deflecting the tip may be enough to overcome the navigation impediment to allow the device to reach the target.
- the intravascular devices described herein may be any length necessary for navigating a patient's anatomy to reach a targeted anatomical area.
- An intravascular device typically has a length ranging from about 150 to 350 cm, but the principles described herein can readily be applied to devices having shorter or longer lengths as well.
- Embodiments described herein may include cut patterns which form fenestrations arranged to increase flexibility of the device while maintaining good torquability.
- Cut patterns described herein may have different configurations defined by the number of resulting longitudinal beams resulting from each set of cuts at a given longitudinal position along the device. For example, in a “two-beam” configuration, each cut location along the length of the device includes a pair of opposed cuts resulting in a pair of opposed, axially extending beams. Typically, the two beams within the resulting beam pair are symmetrically spaced about the circumference of the catheter (i.e., spaced about 180 degrees apart), though in other embodiments they may be differentially circumferentially spaced.
- the triad of beams in a three-beam configuration are typically symmetrically spaced about the circumference by about 120 degrees
- the set of beams in a four-beam configuration are typically spaced about the circumference by about 90 degrees
- other embodiments may include differential circumferential spacing.
- Embodiments may include multiple sections each having a different beam configuration to provide different respective flexibility characteristics and a desired flexibility gradient across the length of the device.
- a particular section having a particular beam configuration can include cuts arranged to provide a flexibility gradient within the particular section itself. For example, longitudinal spacing between cuts may be progressively less at areas closer to the distal end of the device. In this manner, a device may be configured to provide a desired flexibility profile across the length of the device by including both inter- and intra-sectional flexibility gradients.
- FIGS. 4 A through 4 D illustrate various embodiments of cut patterns which may be utilized in the devices described herein.
- FIG. 4 A shows a “two-beam” configuration
- FIG. 4 B shows a “three-beam” configuration
- FIGS. 4 C and 4 D show different versions of a “one-beam” configuration.
- Other embodiments may include configurations of more than three resulting beams per cut location (e.g., a “four-beam” cut pattern, “five-beam” cut pattern, etc.). All other manufacturing parameters being equal, the higher the number of resulting beams at each cut position, the lower the flexibility and the higher the torquability of the section.
- an elongated section 300 includes a plurality of axially extending beams 302 and circumferentially extending rings 304 .
- the elongated section 300 has a two-beam cut pattern because two circumferentially opposing beams 302 are disposed between each pair of adjacent rings 304 .
- the opposing cuts in each cut pair will typically have equal depth, leaving each beam of the resulting beam pair symmetrically circumferentially spaced.
- Other embodiments may include cut pairs with opposing cuts of differential depth. The greater the difference between the depths of opposing cuts in each cut pair, the closer together circumferentially the beams of the resulting beam pair will be, and therefore the more similar functionally the two-beam cut will be to a one-beam cut.
- the illustrated embodiment shows a distribution of beam pairs angularly offset by 90 degrees from one pair to the next along the axis of the member.
- the angular offset may be more or less than 90 degrees.
- the angular offset may be about 5, 15, 30, 45, 60, 75, 80, or 85 degrees (in either direction), or may include a plurality of different offset values.
- an angular offset is applied at each successive beam pair. In other embodiments, an angular offset is applied at each successive “segment,” with each segment including more than one beam pair.
- a “segment” is a repeating structural unit of the catheter section.
- a single segment can be defined as a first pair of opposing beams 302 disposed between two adjacent rings 304 (one proximal ring and one distal ring) and a second pair of opposing beams extending from the distal ring and being rotationally offset by about 90 degrees from the first pair of opposing beams 302 .
- an embodiment having such segments and having a rotational offset of 5 degrees from segment to segment would have a first beam pair at a 0 degree position, a second at 90 degrees, a third at 5 degrees, a fourth at 95 degrees, etcetera.
- FIG. 4 B illustrates an elongated section 400 having a plurality of beams 402 and rings 404 arranged in a three-beam configuration.
- each triad of beams at each cut location is symmetrically circumferentially spaced by 120 degrees.
- An angular offset of 60 degrees is applied at each successive cut location.
- the beams of a triad need not be symmetrically spaced.
- an angular offset of more or less than 60 degrees may be used, and it may be applied at each successive cut location or at each successive segment.
- a segment may be defined as a first triad of beams 402 disposed between two adjacent rings 404 (one proximal ring and one distal ring) and a second triad of beams extending from the distal ring and being rotationally offset by about 60 degrees from the first triad 402 .
- FIG. 4 C illustrates an elongated section 500 having a series of beams 502 and rings 504 arranged in a one-beam configuration.
- An angular offset of 180 degrees is applied at each successive cut location.
- an angular offset of more or less than 180 degrees may be used, and it may be applied at each successive cut location or at each successive segment.
- a segment may be defined as a first beam 502 disposed between two adjacent rings 504 (one proximal ring and one distal ring) and a second beam extending from the distal ring and being rotationally offset by about 180 degrees from the first beam 502 .
- FIG. 4 D illustrates another embodiment of an elongated section 600 having a series of beams 602 and rings 604 arranged in a one-beam configuration.
- the cuts are provided so that the beams 602 are aligned along one side of the section length, rather than having an angular offset.
- Such an embodiment can beneficially provide preferential bending in one direction (i.e., toward the aligned beams 602 ).
- FIG. 5 illustrates an embodiment of a typical helical cut pattern intended to minimize preferred bending directions.
- a rotational offset is applied at each successive segment of the elongate member 900 to form the helical pattern.
- FIG. 5 illustrates a helical one-beam cut pattern where each cut leaves a single beam 902 between each set of adjacent rings 904 .
- successive beams are shown as being offset by about 180 degrees, each successive pair is part of a “segment,” and each successive segment is shown as having a rotational offset of about 5 degrees
- the rotational offset may be applied from segment to segment, as shown in FIG. 5 , or may alternatively be applied at each successive cut.
- This type of helical arrangement may also be used in embodiments having different cut configurations.
- a two-beam configuration may have a helical arrangement with rotational offset applied at each successive segment or at each successive cut pair.
- Some embodiments may include a section having a distributed beam arrangement resulting from a non-helical and non-linear cut pattern. This type of pattern effectively eliminates or minimizes preferred bending directions.
- FIG. 6 graphically compares one example of a distributed pattern with a conventional helical pattern. As shown, the helical cut pattern applies a constant rotational offset from segment to segment along the length of the elongated member. The distributed cut pattern applies a rotational offset that effectively distributes bending axes without relying on a helical pattern.
- the helical and distributed patterns graphically shown in FIG. 6 are for devices having a two-beam configuration. Since a typical two-beam configuration will space each beam pair apart by about 180 degrees, a beam pair at a given position will be indistinguishable from a beam pair rotationally offset by 180 degrees. Accordingly, the possible rotational positions for beam pairs are shown as ranging from 0 to 180 degrees, with the zero and 180 degree positions being equal to one another. Other distributed pattern embodiments may exhibit different rotational spacing. For example, a one-beam configuration will typically be distributed across the full available 360 degree rotational space, and a three-beam pattern will typically exhibit 120 degree symmetry, and therefore be distributed across a 120 degree rotational space.
- the distributed pattern shown in FIG. 6 is “non-helical.”
- a helix is commonly defined as following a curve on a conical or cylindrical surface that would become a straight line if the surface were unrolled into a plane.
- any curved lines tracing the arrangement of the segments along the length of the elongated member 900 would form straight lines if the elongated member 900 were cut open and “unrolled” into a plane.
- a rotational offset limit is also applied to prevent the formation of rigid spacing artifacts (discussed further below with respect to FIGS. 9 and 10 ).
- the rotational offset limit defines a limit on the acceptable rotational “jump” from one beam pair to the next or from one segment to the next.
- a rotational offset limit with a value of about 10 to 30 degrees from one segment to the next, or a rotational offset limit that rotates successive beam pairs by 90 degrees ⁇ that value, has been shown to provide effective distribution of bending axes without causing overly rigid spacing artifacts.
- the rotational offset limit may restrict rotation from one beam pair to the next to a value within a range of about 60 to 120 degrees, or about 70 to 110 degrees, or about 80 to 100 degrees.
- Other embodiments may utilize other rotational offset limits, or may even omit the rotational offset limit, depending on particular product and/or application needs.
- the rotational offset limit may be raised to a value higher than 30 degrees if the resulting spacing artifacts are acceptable for a particular application.
- the exemplary distributed cut pattern illustrated in FIG. 6 utilizes a rotational offset limit of 30 degrees.
- a first beam pair is positioned at an arbitrary 0 degree position, and the second beam pair is positioned at 90 degrees.
- the greatest remaining gaps in the available 180 degree space are between 0 and 90 degrees and between 90 and 180 degrees (where 0 and 180 degrees represent the same position).
- Placing the next beam pair near a midpoint of one of these gaps, such as at 45 degrees would best distribute the bending axes of the device. However, placing the next beam pair at 45 degrees would violate the rotational offset limit of 30 degrees.
- the next beam pair is therefore placed to be close to the midpoint of a remaining gap without violating the rotational offset limit.
- the third beam pair is placed at 30 degrees.
- the fourth beam pair is placed at 120 degrees, which is 90 degrees from the third beam pair.
- every other beam pair is offset 90 degrees from the previous beam pair.
- Alternative embodiments need not necessarily follow this particular pattern.
- the illustrated embodiment is an example of varying the applied offset from segment to segment, other embodiments may apply the variable offset from beam pair to beam pair.
- the largest remaining positional gaps are now between 30 and 90 degrees and between 120 and 180 degrees.
- the fifth and sixth beam pairs are placed at 60 and 120 degrees, respectively.
- the remaining positional gaps are now located every 30 degrees (i.e., between 0 and 30 degrees, between 30 and 60 degrees, between 60 and 90 degrees, etc.).
- remaining angular positions are filled in a manner that radially spaces beam pairs as fast as possible without violating the rotational offset limit.
- the available angular positions are provided at a granularity of 10 degrees.
- all angular positions may be considered as filled when each 10 degree increment has been filled.
- the illustrated pattern may therefore includes beam pairs positioned at approximately every 10 degree position before resetting.
- Such an arrangement is referred to herein as having a “positional granularity” of 10 degrees.
- Alternative embodiments may utilize a different positional granularity, such as a granularity of 0.1, 0.5, 1, 3, 5, 10, 15, 18, 20, 25, or 30 degrees, for example.
- the positional gaps may be filled using a different particular sequence as long as rotational jumps are within the predetermined rotational offset limit.
- the next beam pair is positioned to be close to the approximate center of the largest remaining positional gap without violating the rotational offset limit.
- the segment may be positioned at the 10 to 20 degree position.
- alternative embodiments may utilize a positional granularity that fills in positions of more or less than 10 degrees. Where fewer segments are used before resetting the pattern, the size range of each suitable position will be larger, and where more segments are used before resetting the pattern, the size ranges will become smaller. Some embodiments may include about 6 to 36 beam pairs, or about 10 to 18 beam pairs, before the availability of filled angular positions within the 180 degree radial space is reset. Other embodiments may include many more beam pairs before available positions are reset. As the predetermined positional granularity is lowered, the number of beam pairs needed to fill all available angular positions will rise. Thus, a device having a positional granularity of 1 degree will use 180 beam pairs to fill 180 available angular positions.
- the distributed cut pattern need not identically repeat itself after resetting. Therefore, as used herein, the terms “reset,” “resetting,” and the like refer to resetting the availability of angular positions within the 180 degree radial space after it has been filled by beam pairs, and the terms do not necessarily imply that the subsequent refilling of angular positions along the next section of the elongated member will exactly repeat the previous pattern. Indeed, in at least some embodiments, the entire length of the distributed pattern may be non-repeating.
- FIG. 7 graphically illustrates another embodiment of a non-helical cut pattern formed by intentionally disrupting an otherwise helical pattern with a series of purposefully designed imperfections.
- This type of cut pattern is referred to herein as an “imperfect ramp” pattern.
- the intentional divergences of an imperfect ramp pattern beneficially function to reduce or prevent preferred torsional and curvature relics inherent in a true helical arrangement.
- segments are arranged such that no three successive beam pairs or segments are spaced according to the same rotational offset. In other words, no three beam pairs or segments are arranged so as to form a straight line if the cylindrical elongated member were unrolled into a plane.
- a true helical pattern is typically formed by rotationally offsetting each successive segment or each successive beam pair by a constant value.
- a true helical pattern in a two-beam structure may be formed by rotationally offsetting each successive cut pair by a constant value of 5 degrees, 85 degrees, 95 degrees, or some other constant value that is not a multiple of 90 degrees.
- an imperfect ramp pattern may be formed by rotationally offsetting each successive beam pair by a constant value ⁇ a variable modifying value.
- a rotational offset that includes a constant value ⁇ a variable modifying value is referred to herein as an “imperfect rotational offset.”
- the variable modifying value may range from 5 to 15 degrees. In other embodiments, the variable modifying value may range from 2.5 to 30 degrees, or some other range suitable for the intended purpose of the resulting device.
- the variable modifying value is preferably randomly selected at each segment or beam pair to which it is applied, with upper and lower bounds of the random selection being defined by the modifying value range (e.g., 5 to 15 degrees).
- the constant value portion of the offset is typically 180 degrees in a one beam pattern, 90 degrees in a two-beam pattern, 60 degrees in a three-beam pattern, etcetera.
- Alternative embodiments may apply the imperfect ramp pattern between segments of different sizes and/or between segments with different internal offsets.
- some embodiments may include segments having more than two pairs of beams (and more than two corresponding rings) and/or with internal offsets different than 90 degrees.
- the illustrated example shows a two-beam cut pattern where each pair of the opposing cuts results in two circumferentially opposing beams, it will be understood that the distributed offset patterns may also be applied to one-beam cut patterns, three-beam cut patterns, and patterns having more than three beams between adjacent rings.
- FIG. 8 illustrates another embodiment of a non-helical cut pattern referred to herein as a “sawtooth” pattern.
- the sawtooth cut pattern can beneficially avoid preferred bending axes while also limiting preferred curvature directions inherent in helical patterns.
- a sawtooth cut pattern periodically reverses the direction of the rotational offset.
- Both the sawtooth pattern and the helical pattern of FIG. 8 have an angular offset of about 10 degrees between adjacent segments, with each cut pair within each segment offset by 90 degrees. Whereas the helical pattern simply continues with these offset values in the same direction through multiple rotations around the circumference of the elongated member, the sawtooth pattern reaches a first apex position before reversing direction and continuing toward a second apex position. Upon reaching the second apex position, the sawtooth pattern then reverses again and continues back toward the first apex. The pattern then repeats along the desired length of the elongated member.
- the first apex position is set at about 90 degrees (i.e., 90 degrees for the first cut pair of the segment and 180 degrees for the second cut pair of the segment).
- the pattern reverses toward the second apex position.
- the second apex position is set at about 0 degrees (i.e., 0 degrees for the first cut pair of the segment and 90 degrees for the second cut pair of the segment).
- Alternative embodiments may include other apex positions.
- the first apex position is less than 360 degrees in a one-beam configuration, less than 180 degrees in a two-beam configuration, less than 120 degrees in a three-beam configuration, and so on.
- the first apex position is about 180 degrees for a one-beam configuration, 90 degrees for a two-beam configuration, 60 degrees for a three-beam configuration, and so on.
- the angular offset from segment to segment in the sawtooth pattern of FIG. 8 is about 10 degrees. In other embodiments of sawtooth cut patterns, the angular offset may be more or less than 10 degrees, such as from about 5 degrees to about 30 degrees. Additionally, or alternatively, portions of the cut pattern between the apexes may include a variable offset. For example, one or more portions between the apexes may include an imperfect rotational offset such as described above in relation to FIG. 7 .
- Alternative embodiments may apply the sawtooth pattern between segments of different sizes and/or between segments with different internal offsets.
- some embodiments may include segments having more than two pairs of beams (and more than two corresponding rings) and/or with internal offsets different than 90 degrees.
- the illustrated example shows a two-beam cut pattern where each pair of the opposing cuts results in two circumferentially opposing beams, it will be understood that the distributed offset patterns may also be applied to one-beam cut patterns, three-beam cut patterns, and patterns having more than three beams between adjacent rings.
- FIG. 9 illustrates an example of an undesirable spacing artifact that may result where a rotational offset limit is not applied.
- FIG. 9 illustrates a section of an elongated member 700 having a first segment 750 a and a second segment 750 b .
- the first segment 750 a includes a first pair of beams 730 a (only one of which is visible in this view) and second pair of beams 730 b and 730 c which are offset from the first pair by 90 degrees.
- the second segment 750 b includes a first pair of beams 730 d and 730 e , and a second pair of beams 730 f and 730 g which are offset from the first pair by 90 degrees.
- Each beam within a pair is circumferentially spaced from its corresponding beam by 180 degrees.
- the second segment 750 b is offset from the first segment 750 a by 45 degrees, which positions the first pair of beams 730 d and 730 e off by 45 degrees from the first pair of beams 730 a and positions the second pair of beams 730 f and 730 g off by 45 degrees from the second pair of beams 730 b and 730 c.
- the beam 730 e is only spaced from the beam 730 c by 45 degrees, whereas the beam 730 d is spaced from the beam 730 c by 135 degrees. This disproportionate spacing may be undesirable because the region of the elongated member 700 having the smaller spacing may be overly rigid and/or the region having the larger spacing may be overly flexible.
- FIG. 10 illustrates a section of an elongated member 800 with a more limited rotational offset of about 20 degrees applied between a first segment 850 a and a second segment 850 b .
- the first segment 850 a includes a first pair of beams 830 a and a second pair of beams 830 b and 830 c
- the second segment 850 b includes a first pair of beams 830 d and 830 e and a second pair of beams 830 f and 830 g .
- the spacing discrepancy between beams 830 b , 830 c , 830 d , and 830 e is less pronounced.
- Beam 830 d is spaced 70 degrees from beam 830 b
- beam 830 e is spaced 110 degrees from beam 830 b
- beam 830 e is spaced 70 degrees from beam 830 c
- beam 830 d is spaced 110 degrees from beam 830 c .
- FIGS. 11 A through 11 C illustrate embodiments of a “spiral” cut pattern that may be included in one or more sections of the device.
- a section 170 of device is cut to provide an outer body of resulting helically oriented coil members 174 , with the pitch of the resulting coil defining the size of the fenestrations.
- a spiral cut pattern provides less torquability and more flexibility than a one-beam pattern.
- spiral sections are less beneficial at more proximal sections of the device where torquability concerns are particularly important, but are beneficial at more distal sections, and particularly at or near the distal end of the device, where flexibility concerns become more important.
- the spiral cut section 170 forms an integral piece of material with one or more adjacent sections of the elongated device.
- the spiral pattern results from a cutting operation performed on the section.
- a single piece of material can be micro-fabricated to include one or more sections of different cut arrangements, in addition to the one or more spiral cut patterns.
- FIG. 11 A also includes a series of bridges 172 that remain between and connect adjacent coil members 174 of the spiral pattern.
- Such bridges 172 can function to somewhat limit the flexibility of the section 170 relative to a similar spiral pattern omitting such bridges.
- FIG. 11 B illustrates another spiral cut section 180 that may be included in the hollow elongated member 104 .
- the spiral cut pattern of section 180 omits bridges between coil members 184 , and therefore has relatively greater flexibility than the spiral section 170 shown in FIG. 11 A (assuming materials, pitch, diameter, wall thickness, and other relevant factors are otherwise substantially equal).
- Bridges 172 can also be arranged to provide flexibility bias in one or more directions.
- the bridges 172 may be spaced about every 45, 60, 75, 90, 105, 120, 135, 150, 165, or 180 degrees around the spiral shape of the device. Greater spacing may also be provided between successive bridges. For example, multiples of 360 degrees may be added to any of the foregoing angle spacing values to provide an even greater spacing arrangement. Less spacing generally limits flexibility to a greater degree, while greater spacing generally provides greater relative flexibility. In some embodiments, spacing of the bridges 172 can vary across the length of the section 170 . For example, spacing between the bridges 172 can become progressively greater toward the distal end of the section in order to progressively increase distal flexibility.
- FIG. 11 C illustrates, in cross-sectional view, an embodiment of a section 190 where spacing between spiral cuts is tailored to be progressively narrower as the cuts near the distal end of the section.
- the dimension 191 between two of the coil members 194 is smaller at a more distal region than the dimension 193 between more proximally located coil members 192 .
- the cut width indicated by dimension 195 , is substantially constant.
- the cut width 195 may be adjusted as an alternative to or in addition to the progressive changes in coil member size shown by dimensions 191 and 193 .
- Other embodiments may omit progressively changing features, or may include one or more sections including progressively changing features and one or more other sections with substantially constant coil dimensionality.
- a spiral cut pattern omitting bridges will provide greater flexibility than a spiral cut pattern with bridges, which will provide greater flexibility than a one-beam cut pattern, which will provide greater flexibility than a two-beam cut pattern, which will provide greater flexibility than a three-beam pattern, and so on.
- the terms “approximately,” “about,” and “substantially” as used herein represent an amount or condition close to the stated amount or condition that still performs a desired function or achieves a desired result.
- the terms “approximately,” “about,” and “substantially” may refer to an amount or condition that deviates by less than 10%, or by less than 5%, or by less than 1%, or by less than 0.1%, or by less than 0.01% from a stated amount or condition.
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Engineering & Computer Science (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Surgery (AREA)
- Anesthesiology (AREA)
- Pulmonology (AREA)
- Biophysics (AREA)
- Hematology (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Vascular Medicine (AREA)
- Chemical & Material Sciences (AREA)
- Inorganic Chemistry (AREA)
- Epidemiology (AREA)
- Neurosurgery (AREA)
- Reproductive Health (AREA)
- Mechanical Engineering (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
Abstract
An intravascular device, such as s guidewire device, includes a hollow proximal section and a hollow distal section joined to the proximal section and extending distally from the proximal section to form a continuous lumen extending from a proximal end of the device to a distal end of the device. An inner member extends from the proximal end to the distal end and is joined to the distal end. The inner member is translatable within the lumen in response to applied tension. At least the distal section includes a micro-fabricated cutting pattern that enables deflection of the distal end in response to the application of tension to the inner member.
Description
- This application is a continuation of U.S. application Ser. No. 15/848,878, filed Dec. 20, 2017 and titled “Intravascular Device Having a Selectively Deflectable Tip,” which claims priority to and the benefit of U.S. Provisional Patent Application No. 62/438,407, filed on Dec. 22, 2016 and titled “Steerable Intravascular Devices.” Each of the foregoing applications is incorporated herein by reference in its entirety.
- Interventional devices such as guidewires and catheters are frequently utilized in the medical field to perform delicate procedures deep within the human body. Typically, a catheter is inserted into a patient's femoral, radial, carotid, or jugular vessel and navigated through the patient's vasculature to the heart, brain, or other targeted anatomy as required. Often, a guidewire is first routed to the targeted anatomy, and one or more catheters are subsequently passed over the guidewire and routed to the targeted anatomy. Once in place, the catheter can be used to deliver drugs, stents, embolic devices, radiopaque dyes, or other devices or substances for treating the patient in a desired manner. In other circumstances, a micro catheter and guidewire are routed simultaneously toward the targeted anatomy while the guidewire resides within the micro catheter, and then the guidewire is passed further into the anatomy by translating within the micro catheter.
- In many applications, such intravascular devices must be angled through the tortuous bends and curves of a vasculature passageway to arrive at the targeted anatomy. Such an interventional device requires sufficient flexibility, particularly closer to its distal end, to navigate such tortuous pathways. However, other design aspects must also be considered. For example, the interventional device must also be able to provide sufficient torquability (i.e., the ability to transmit torque applied at the proximal end all the way to the distal end), pushability (i.e., the ability to transmit axial push to the distal end rather than bending and binding intermediate portions), and structural integrity for performing intended medical functions.
- Many intravascular procedures involve directing an intravascular device to portions of the neurovasculature. These procedures require that the device be guided through the carotid siphon and other tortuous paths. Such maneuvering can be difficult. In some instances, procedures are unable to complete or become much costlier and lengthy because of these difficulties. Precise control of the device is required. However, due to the inherent structure of the vascular anatomy involved, it can be difficult to get the catheter properly positioned at the targeted treatment site.
- In some circumstances, it may be necessary to pass the distal tip of the device through a fusiform aneurysm, which can present even further difficulties. When passing the device through normal vasculature, the vascular walls will generally confine the path forward and limit the possible movement of the distal tip of the device. In contrast, when passing through a fusiform aneurysm, the distal tip of the device must navigate through the open three-dimensional space between the proximal and distal openings of the aneurysm. Because of the relatively less confined space within the aneurysm, it can be extremely difficult to properly align the distal tip to the distal opening.
- Typically, the operator can push/pull the intravascular device to move the distal tip forward or backward, and can apply torque to rotate the distal tip. However, if no combination of these maneuvers can properly align the distal tip to the targeted anatomy, such as the distal opening of an aneurysm, the procedure may be seriously delayed or rendered impossible. Accordingly, there is a long felt and ongoing need for intravascular devices providing enhanced navigation capabilities.
- An intravascular device, such as a guidewire device, includes a hollow proximal section and a hollow distal section joined to the proximal section and extending distally from the proximal section to form a continuous lumen extending from a proximal end of the device to a distal end of the device. An inner member extends from the proximal end to the distal end and is joined to the distal end. The inner member is translatable within the lumen in response to applied tension. At least the distal section includes a micro-fabricated cutting pattern that enables deflection of the distal end in response to the application of tension to the inner member.
- In preferred embodiments, the cutting pattern of the distal section includes a one-beam or two-beam configuration, though other embodiments may include a three-beam configuration or a configuration of more than three beams. In one embodiment, the distal section includes a one-beam section having a plurality of beams substantially aligned on a single side to form a preferred bending direction. For example, the substantially aligned beams may be disposed at the most distal section of the device adjacent the distal end. This arrangement can beneficially provide reliable and predictable deflection of the distal end of the device when tension is applied to the inner member.
- The intravascular device may be constructed of any suitable medical grade materials. Some embodiments include at least one of a proximal section formed as a stainless steel tube, a distal section formed of a nickel-titanium alloy, and an inner member formed of stainless steel. The inner member may be a ground stainless steel core that has a wider cross-sectional diameter at a more proximal section and a narrower cross-sectional diameter at a more distal section.
- The intravascular devices described herein may be utilized in any medical procedure requiring passage into the vasculature. Certain embodiments are particularly beneficial in procedures with difficult navigation challenges, such as those requiring passage deep into the neurovasculature and/or when trying to navigate through a fusiform aneurysm. For example, when attempting to navigate through a fusiform aneurysm from the proximal opening to the distal opening, it can be difficult to maneuver through the open three-dimensional space of the aneurysm to reach the distal side. Having additional control over navigation of the device can enable the operator to get past the aneurysm and continue navigating the vasculature. The additional movement, particularly when combined with predictable response as a result of defined distal section cutting patterns, can be the difference between a successful and unsuccessful procedure.
- Using a conventional guidewire device, an operator is typically limited to pushing/pulling the device and rotating the device to navigate the patient's vasculature. In some circumstances, such as when passing through an aneurysm, the limited control over navigation can make it extremely difficult to align the distal tip in the desired manner. The additional navigational control offered by the features described herein provides another option for moving the device into proper orientation with respect to patient anatomy. In certain applications where simple push/pull and rotate movements are insufficient to properly guide the device, the additional option of selectively deflecting the tip may be enough to overcome the navigation impediment to allow the device to reach the target.
- In order to describe the manner in which the above-recited and other advantages and features of the invention can be obtained, a more particular description of the invention briefly described above will be rendered by reference to specific embodiments thereof which are illustrated in the appended drawings. Understanding that these drawings depict only typical embodiments of the invention and are not therefore to be considered to be limiting of its scope, the invention will be described and explained with additional specificity and detail through the use of the accompanying drawings in which:
-
FIGS. 1A and 1B illustrate an exemplary embodiment of a guidewire device having features providing selective deflection; -
FIGS. 2A and 2B illustrate another embodiment of a guidewire device including a one-beam configuration where beams are substantially aligned on a single side to form a preferred bending direction; -
FIG. 3 illustrates the device ofFIGS. 2A and 2B nested within a micro catheter; -
FIGS. 4A through 4D illustrate various beam configurations that may be utilized in various combinations to provide desired bending characteristics in the intravascular device; -
FIG. 5 illustrates a cutting pattern with a helical arrangements of beams; -
FIG. 6 graphically illustrates a distributed cut pattern and shows a typical helical pattern for comparison; -
FIG. 7 graphically illustrates an imperfect ramp cut pattern; -
FIG. 8 graphically illustrates a sawtooth cut pattern and shows a typical helical pattern for comparison; -
FIGS. 9 and 10 illustrate differences in rotational offsets, showing differences in spacing artifacts resulting from different sizes of rotational offset jumps; and -
FIGS. 11A through 11C illustrate various spiral cut patterns that may be utilized to provide desired bending characteristics in the distal section of the intravascular device. - The present disclosure relates to intravascular devices having features that provide enhanced navigation capabilities. In particular, embodiments are described herein which include a selectively deflectable tip for enabling additional navigation control of the device through vascular anatomy. In the following description, many examples are provided in the context of a guidewire device. It will be understood, however, that the same concepts may be readily applied to a micro catheter application. Accordingly, the concepts and features described herein are not intended to be limited to any particular form of intravascular device.
- Further, although many of the following examples are described in the specific context of passing through an aneurysm in a neurovascular procedure, it will be understood that the described embodiments are not limited solely to such applications. The intravascular device embodiments described herein may therefore be utilized in other applications where the enhanced navigation capabilities of the device may be advantageous.
-
FIGS. 1A and 1B illustrate a distal region of anexemplary guidewire device 100. Thedevice 100 includes aproximal section 102 and adistal section 104 which together form an elongated hollow member. Thedevice 100 also includes aninner member 106 extending from a proximal end (not shown) through theproximal section 102 and through thedistal section 104 to attach to adistal tip 108. The distal tip is preferably formed as a polymer adhesive, though other embodiments may additionally or alternatively utilize soldering, welding, fixture hardware, or other suitable attachment means. - As shown in
FIG. 1B , theinner member 106 is translatable within the lumen formed by the proximal anddistal sections inner member 106 causes the distal section to deflect. Tension or compression may be applied as a result of a user respectively pulling or pushing theinner member 106 at the proximal end of the device and/or operating a control (e.g., dial, button, slider) operatively connected to theinner member 106. - Various materials may be utilized for the construction of the guidewire device. In one preferred embodiment, the
proximal section 102 is formed as a stainless steel hypotube, thedistal section 104 is formed as a nickel titanium alloy, and theinner member 106 is formed as a stainless steel wire. - In the illustrated embodiment, the
inner member 106 is formed as a wire of substantially uniform diameter along its length. In such embodiments, the wire preferably has a diameter that provides sufficient structural integrity and strength but that is small enough to allow sufficient flexibility of the device at the distal end. The wire may have, for example, a diameter of about 0.0002 inches to about 0.005 inches, or about 0.003 inches. - In alternative embodiments, the
inner member 106 is formed as a ground core having a diameter that is wider at more proximal sections and that tapers to a narrower diameter at the distal end (e.g., tapers to about 0.002 inches at the distal end). Such embodiments beneficially allow for good flexibility at the distal end of the device while providing more structure for maintaining integrity at more proximal sections of the device. For example, theinner member 106 may have a diameter of about 0.006 to about 0.010 inches for most of its length within the more proximal sections of the device, with a series of one or more tapering sections that reduce the diameter as theinner member 106 gets progressively closer to the distal end. - In contrast to conventional steerable guide sheaths/catheters that include pull wires extending through the circumferential wall of the device, the
inner member 106 of the devices described herein extends through the inner lumen of the device. This enables selective deflection/steering of the distal end of much smaller devices, such as those suitable for passage deep into the neurovasculature. At these relatively small diameters, it would be impractical or impossible to provide pull wires within the thickness of the circumferential wall of such a device. - The embodiments shown in
FIGS. 1A and 1B beneficially enable the tip of theguidewire device 100 to be selectively deflected to assist in navigating the patient's tortuous vasculature. Thedistal section 104 may be micro-fabricated to provide for preferential directional bending. In this manner, when translation (tension or compression) is applied to the inner member, there is a consistent, expected resulting deflection that occurs at thedistal section 104 of the device. - A variety of different distal section configurations can be utilized to provide a desired response to the adjustment to inner member tension. The cutting patterns described below in relation to
FIGS. 4A through 11C may be utilized in any combination to provide the distal section with a bending response that matches particular user preferences and/or application needs. For example, leaving the majority of beams on one side of the distal section following a micro-fabricated cutting process will provide a preferred bending direction to the distal section. Different arrangements of sections having preferred bending cutting patterns and uniform bending sections can result in the formation of various compound curves, corkscrew shapes, hook-like shapes, and the like. In some embodiments the proximal section may also be micro-fabricated with one or more cut patterns. Typically, the proximal section will be configured to have greater relative rigidity than the distal section. -
FIGS. 2A and 2B illustrate in cross-section an embodiment of aguidewire device 200 with adistal section 204 having a one-beam configuration with thebeams 210 arranged on a single side to form a “spine” of thedistal section 204. This arrangement leaves theopen fenestrations 212 on the opposite side of thebeams 210. As shown, theguidewire device 200 is constructed in a similar fashion to the embodiment ofFIGS. 1A and 1B , and includes aproximal section 202, aninner member 206, and adistal end 208. - As shown in
FIG. 2B , when tension is applied to theinner member 206, thedistal section 204 will deflect away from the side where theopen fenestrations 212 are aligned and toward the spine formed by the aligned beams 210. The space and increased flexibility provided by thefenestrations 212 allows thedistal section 204 to preferentially bend in the illustrated direction. These features beneficially enable reliable deflection of the distal tip when theinner member 206 is actuated. In contrast, a device not having aligned fenestrations may deflect less predictably and/or be too rigid to easily and selectively deflect. - Although the embodiment shown in
FIGS. 2A and 2B represents one presently preferred embodiment, other embodiments may include variably spaced (non-aligned) beam arrangements. For example, some cut patterns may result in beam arrangements that are sufficiently flexible to provide effective deflection of thedistal section 204 even though the beams are not substantially aligned. - An alternative embodiment includes pre-shaping the distal tip of the guidewire device such that the application of tension to the inner member leads to a straightening and/or stiffening effect, rather than causing the distal tip to bend. For example, a guidewire device may be formed to be biased toward a pre-curved shape such as in
FIG. 2B . Theinner member 206 can then be manipulated to move thedistal section 204 toward a relatively straighter position such as inFIG. 2A . -
FIG. 3 illustrates an implementation where theguidewire device 200 is utilized in conjunction with amicro catheter 201. As shown, theguidewire device 200 is positioned within themicro catheter 201. By translating the selectively deflectable portion of theguidewire device 200 so that it coincides with a portion of themicro catheter 201 that is desired to be bent, and by manipulating the inner member of theguidewire device 200, the resulting deflection of the distal section of theguidewire device 200 can be translated to themicro catheter 201. - This type of maneuver can beneficially provide an operator with additional navigation options and abilities. For example, when trying to navigate through an aneurysm from the proximal opening to the distal opening, it can be difficult to maneuver through the open three-dimensional space of the aneurysm to reach the distal side. Having additional control over navigation of the device can enable the operator to get past the aneurysm and continue navigating the vasculature. The additional movement, particularly when combined with predictable response as a result of defined distal section cutting patterns, can be the difference between a successful and unsuccessful procedure.
- Using a conventional guidewire device, an operator is typically limited to pushing/pulling the device and rotating the device to navigate the patient's vasculature. In some circumstances, such as when passing through an aneurysm, the limited control over navigation can make it extremely difficult to align the distal tip in the desired manner. The additional navigational control offered by the features described herein provides another option for moving the device into proper orientation with respect to patient anatomy. In certain applications where simple push/pull and rotate movements are insufficient to properly guide the device, the additional option of selectively deflecting the tip may be enough to overcome the navigation impediment to allow the device to reach the target.
- The intravascular devices described herein may be any length necessary for navigating a patient's anatomy to reach a targeted anatomical area. An intravascular device typically has a length ranging from about 150 to 350 cm, but the principles described herein can readily be applied to devices having shorter or longer lengths as well.
- A. Beam Configurations
- Embodiments described herein may include cut patterns which form fenestrations arranged to increase flexibility of the device while maintaining good torquability. Cut patterns described herein may have different configurations defined by the number of resulting longitudinal beams resulting from each set of cuts at a given longitudinal position along the device. For example, in a “two-beam” configuration, each cut location along the length of the device includes a pair of opposed cuts resulting in a pair of opposed, axially extending beams. Typically, the two beams within the resulting beam pair are symmetrically spaced about the circumference of the catheter (i.e., spaced about 180 degrees apart), though in other embodiments they may be differentially circumferentially spaced. Likewise, the triad of beams in a three-beam configuration are typically symmetrically spaced about the circumference by about 120 degrees, the set of beams in a four-beam configuration are typically spaced about the circumference by about 90 degrees, etcetera, though other embodiments may include differential circumferential spacing.
- All other manufacturing parameters being equal (e.g., similar materials, cut depth, cut spacing, etc.), a configuration having a greater number of beams will be less flexible but have greater capacity for transmitting torque. Embodiments may include multiple sections each having a different beam configuration to provide different respective flexibility characteristics and a desired flexibility gradient across the length of the device. At the same time, a particular section having a particular beam configuration can include cuts arranged to provide a flexibility gradient within the particular section itself. For example, longitudinal spacing between cuts may be progressively less at areas closer to the distal end of the device. In this manner, a device may be configured to provide a desired flexibility profile across the length of the device by including both inter- and intra-sectional flexibility gradients.
-
FIGS. 4A through 4D illustrate various embodiments of cut patterns which may be utilized in the devices described herein.FIG. 4A shows a “two-beam” configuration,FIG. 4B shows a “three-beam” configuration, andFIGS. 4C and 4D show different versions of a “one-beam” configuration. Other embodiments may include configurations of more than three resulting beams per cut location (e.g., a “four-beam” cut pattern, “five-beam” cut pattern, etc.). All other manufacturing parameters being equal, the higher the number of resulting beams at each cut position, the lower the flexibility and the higher the torquability of the section. - As shown in
FIG. 4A , anelongated section 300 includes a plurality of axially extendingbeams 302 and circumferentially extendingrings 304. Theelongated section 300 has a two-beam cut pattern because two circumferentially opposingbeams 302 are disposed between each pair ofadjacent rings 304. The opposing cuts in each cut pair will typically have equal depth, leaving each beam of the resulting beam pair symmetrically circumferentially spaced. Other embodiments may include cut pairs with opposing cuts of differential depth. The greater the difference between the depths of opposing cuts in each cut pair, the closer together circumferentially the beams of the resulting beam pair will be, and therefore the more similar functionally the two-beam cut will be to a one-beam cut. - The illustrated embodiment shows a distribution of beam pairs angularly offset by 90 degrees from one pair to the next along the axis of the member. In alternative embodiments, the angular offset may be more or less than 90 degrees. For example, the angular offset may be about 5, 15, 30, 45, 60, 75, 80, or 85 degrees (in either direction), or may include a plurality of different offset values.
- In some embodiments, an angular offset is applied at each successive beam pair. In other embodiments, an angular offset is applied at each successive “segment,” with each segment including more than one beam pair. As used herein, a “segment” is a repeating structural unit of the catheter section. In some embodiments, a single segment can be defined as a first pair of opposing
beams 302 disposed between two adjacent rings 304 (one proximal ring and one distal ring) and a second pair of opposing beams extending from the distal ring and being rotationally offset by about 90 degrees from the first pair of opposingbeams 302. Thus, an embodiment having such segments and having a rotational offset of 5 degrees from segment to segment would have a first beam pair at a 0 degree position, a second at 90 degrees, a third at 5 degrees, a fourth at 95 degrees, etcetera. -
FIG. 4B illustrates anelongated section 400 having a plurality ofbeams 402 and rings 404 arranged in a three-beam configuration. In this embodiment, each triad of beams at each cut location is symmetrically circumferentially spaced by 120 degrees. An angular offset of 60 degrees is applied at each successive cut location. As with the two-beam configuration described above, the beams of a triad need not be symmetrically spaced. Likewise, an angular offset of more or less than 60 degrees may be used, and it may be applied at each successive cut location or at each successive segment. In a three-beam configuration, for example, a segment may be defined as a first triad ofbeams 402 disposed between two adjacent rings 404 (one proximal ring and one distal ring) and a second triad of beams extending from the distal ring and being rotationally offset by about 60 degrees from thefirst triad 402. -
FIG. 4C illustrates anelongated section 500 having a series ofbeams 502 and rings 504 arranged in a one-beam configuration. An angular offset of 180 degrees is applied at each successive cut location. As with the other configurations described above, an angular offset of more or less than 180 degrees may be used, and it may be applied at each successive cut location or at each successive segment. In a one-beam configuration, for example, a segment may be defined as afirst beam 502 disposed between two adjacent rings 504 (one proximal ring and one distal ring) and a second beam extending from the distal ring and being rotationally offset by about 180 degrees from thefirst beam 502. -
FIG. 4D illustrates another embodiment of anelongated section 600 having a series ofbeams 602 and rings 604 arranged in a one-beam configuration. In this embodiment, the cuts are provided so that thebeams 602 are aligned along one side of the section length, rather than having an angular offset. Such an embodiment can beneficially provide preferential bending in one direction (i.e., toward the aligned beams 602). -
FIG. 5 illustrates an embodiment of a typical helical cut pattern intended to minimize preferred bending directions. As shown, a rotational offset is applied at each successive segment of theelongate member 900 to form the helical pattern.FIG. 5 illustrates a helical one-beam cut pattern where each cut leaves asingle beam 902 between each set ofadjacent rings 904. Although successive beams are shown as being offset by about 180 degrees, each successive pair is part of a “segment,” and each successive segment is shown as having a rotational offset of about 5 degrees The rotational offset may be applied from segment to segment, as shown inFIG. 5 , or may alternatively be applied at each successive cut. This type of helical arrangement may also be used in embodiments having different cut configurations. For example, a two-beam configuration may have a helical arrangement with rotational offset applied at each successive segment or at each successive cut pair. - B. Distributed Patterns
- Some embodiments may include a section having a distributed beam arrangement resulting from a non-helical and non-linear cut pattern. This type of pattern effectively eliminates or minimizes preferred bending directions.
FIG. 6 graphically compares one example of a distributed pattern with a conventional helical pattern. As shown, the helical cut pattern applies a constant rotational offset from segment to segment along the length of the elongated member. The distributed cut pattern applies a rotational offset that effectively distributes bending axes without relying on a helical pattern. - The helical and distributed patterns graphically shown in
FIG. 6 are for devices having a two-beam configuration. Since a typical two-beam configuration will space each beam pair apart by about 180 degrees, a beam pair at a given position will be indistinguishable from a beam pair rotationally offset by 180 degrees. Accordingly, the possible rotational positions for beam pairs are shown as ranging from 0 to 180 degrees, with the zero and 180 degree positions being equal to one another. Other distributed pattern embodiments may exhibit different rotational spacing. For example, a one-beam configuration will typically be distributed across the full available 360 degree rotational space, and a three-beam pattern will typically exhibit 120 degree symmetry, and therefore be distributed across a 120 degree rotational space. - The distributed pattern shown in
FIG. 6 is “non-helical.” A helix is commonly defined as following a curve on a conical or cylindrical surface that would become a straight line if the surface were unrolled into a plane. Using the helical cut pattern shown inFIG. 5 as an example, any curved lines tracing the arrangement of the segments along the length of theelongated member 900 would form straight lines if theelongated member 900 were cut open and “unrolled” into a plane. In contrast, in the distributed pattern shown inFIG. 6 , there are no lines tracing the arrangement of the beams/segments that form straight lines. - Given a starting beam pair arbitrarily assigned to a zero degree position, successive beam pairs are rotationally offset to maximize the radial distribution of beam positions across the available 180 degree rotational space as quickly as possible (i.e., in as few cuts as possible). However, in the illustrated embodiment, a rotational offset limit is also applied to prevent the formation of rigid spacing artifacts (discussed further below with respect to
FIGS. 9 and 10 ). - The rotational offset limit defines a limit on the acceptable rotational “jump” from one beam pair to the next or from one segment to the next. A rotational offset limit with a value of about 10 to 30 degrees from one segment to the next, or a rotational offset limit that rotates successive beam pairs by 90 degrees ±that value, has been shown to provide effective distribution of bending axes without causing overly rigid spacing artifacts. For example, the rotational offset limit may restrict rotation from one beam pair to the next to a value within a range of about 60 to 120 degrees, or about 70 to 110 degrees, or about 80 to 100 degrees. Other embodiments may utilize other rotational offset limits, or may even omit the rotational offset limit, depending on particular product and/or application needs. For example, the rotational offset limit may be raised to a value higher than 30 degrees if the resulting spacing artifacts are acceptable for a particular application.
- The exemplary distributed cut pattern illustrated in
FIG. 6 utilizes a rotational offset limit of 30 degrees. As shown, a first beam pair is positioned at an arbitrary 0 degree position, and the second beam pair is positioned at 90 degrees. The greatest remaining gaps in the available 180 degree space are between 0 and 90 degrees and between 90 and 180 degrees (where 0 and 180 degrees represent the same position). Placing the next beam pair near a midpoint of one of these gaps, such as at 45 degrees, would best distribute the bending axes of the device. However, placing the next beam pair at 45 degrees would violate the rotational offset limit of 30 degrees. The next beam pair is therefore placed to be close to the midpoint of a remaining gap without violating the rotational offset limit. In this example, the third beam pair is placed at 30 degrees. The fourth beam pair is placed at 120 degrees, which is 90 degrees from the third beam pair. - In this particular example, every other beam pair is offset 90 degrees from the previous beam pair. Alternative embodiments need not necessarily follow this particular pattern. For example, where the illustrated embodiment is an example of varying the applied offset from segment to segment, other embodiments may apply the variable offset from beam pair to beam pair.
- Continuing with the example distribution of
FIG. 6 , the largest remaining positional gaps are now between 30 and 90 degrees and between 120 and 180 degrees. The fifth and sixth beam pairs are placed at 60 and 120 degrees, respectively. The remaining positional gaps are now located every 30 degrees (i.e., between 0 and 30 degrees, between 30 and 60 degrees, between 60 and 90 degrees, etc.). As the pattern continues, remaining angular positions are filled in a manner that radially spaces beam pairs as fast as possible without violating the rotational offset limit. - In the illustrated example, the available angular positions are provided at a granularity of 10 degrees. In other words, all angular positions may be considered as filled when each 10 degree increment has been filled. The illustrated pattern may therefore includes beam pairs positioned at approximately every 10 degree position before resetting. Such an arrangement is referred to herein as having a “positional granularity” of 10 degrees. Alternative embodiments may utilize a different positional granularity, such as a granularity of 0.1, 0.5, 1, 3, 5, 10, 15, 18, 20, 25, or 30 degrees, for example.
- The exact positioning illustrated may be adjusted, and it will be understood that the pattern shown in
FIG. 6 is illustrative only. For example, the positional gaps may be filled using a different particular sequence as long as rotational jumps are within the predetermined rotational offset limit. Preferably, when filling in gaps between rotational positions, the next beam pair is positioned to be close to the approximate center of the largest remaining positional gap without violating the rotational offset limit. For example, where a gap exists between the 0 degree position and the 30 degree position, the segment may be positioned at the 10 to 20 degree position. - Further, alternative embodiments may utilize a positional granularity that fills in positions of more or less than 10 degrees. Where fewer segments are used before resetting the pattern, the size range of each suitable position will be larger, and where more segments are used before resetting the pattern, the size ranges will become smaller. Some embodiments may include about 6 to 36 beam pairs, or about 10 to 18 beam pairs, before the availability of filled angular positions within the 180 degree radial space is reset. Other embodiments may include many more beam pairs before available positions are reset. As the predetermined positional granularity is lowered, the number of beam pairs needed to fill all available angular positions will rise. Thus, a device having a positional granularity of 1 degree will use 180 beam pairs to fill 180 available angular positions.
- Moreover, because there are multiple ways of filling available angular positions according to the predetermined parameters (e.g., positional granularity and rotational offset limit) of the selected distributed pattern, the distributed cut pattern need not identically repeat itself after resetting. Therefore, as used herein, the terms “reset,” “resetting,” and the like refer to resetting the availability of angular positions within the 180 degree radial space after it has been filled by beam pairs, and the terms do not necessarily imply that the subsequent refilling of angular positions along the next section of the elongated member will exactly repeat the previous pattern. Indeed, in at least some embodiments, the entire length of the distributed pattern may be non-repeating.
- It will be understood that the foregoing principles may also be applied to an embodiment having a one-beam arrangement, an embodiment having a three-beam arrangement, or an embodiment having more than a three-beam arrangement. The same principles described above may be applied to a one-beam embodiment, except that the range of angular positions to fill will extend to 360 degrees. Likewise, the same principles may be generally applied to a three-beam embodiment, except that the range of angular positions to fill will typically extend to 120 degrees.
- C. Imperfect Ramp Patterns
-
FIG. 7 graphically illustrates another embodiment of a non-helical cut pattern formed by intentionally disrupting an otherwise helical pattern with a series of purposefully designed imperfections. This type of cut pattern is referred to herein as an “imperfect ramp” pattern. The intentional divergences of an imperfect ramp pattern beneficially function to reduce or prevent preferred torsional and curvature relics inherent in a true helical arrangement. As shown, segments are arranged such that no three successive beam pairs or segments are spaced according to the same rotational offset. In other words, no three beam pairs or segments are arranged so as to form a straight line if the cylindrical elongated member were unrolled into a plane. - In contrast to the imperfect ramp patterns of
FIG. 7 , a true helical pattern is typically formed by rotationally offsetting each successive segment or each successive beam pair by a constant value. For example, a true helical pattern in a two-beam structure may be formed by rotationally offsetting each successive cut pair by a constant value of 5 degrees, 85 degrees, 95 degrees, or some other constant value that is not a multiple of 90 degrees. - In an imperfect ramp cut pattern, the modifying value is intentionally made variable rather than constant. For example, as in
FIG. 7 , an imperfect ramp pattern may be formed by rotationally offsetting each successive beam pair by a constant value ±a variable modifying value. A rotational offset that includes a constant value ±a variable modifying value is referred to herein as an “imperfect rotational offset.” - The variable modifying value may range from 5 to 15 degrees. In other embodiments, the variable modifying value may range from 2.5 to 30 degrees, or some other range suitable for the intended purpose of the resulting device. The variable modifying value is preferably randomly selected at each segment or beam pair to which it is applied, with upper and lower bounds of the random selection being defined by the modifying value range (e.g., 5 to 15 degrees). The constant value portion of the offset is typically 180 degrees in a one beam pattern, 90 degrees in a two-beam pattern, 60 degrees in a three-beam pattern, etcetera.
- Alternative embodiments may apply the imperfect ramp pattern between segments of different sizes and/or between segments with different internal offsets. For example, some embodiments may include segments having more than two pairs of beams (and more than two corresponding rings) and/or with internal offsets different than 90 degrees. Further, even though the illustrated example shows a two-beam cut pattern where each pair of the opposing cuts results in two circumferentially opposing beams, it will be understood that the distributed offset patterns may also be applied to one-beam cut patterns, three-beam cut patterns, and patterns having more than three beams between adjacent rings.
- D. Saw tooth Patterns
-
FIG. 8 illustrates another embodiment of a non-helical cut pattern referred to herein as a “sawtooth” pattern. As with other non-helical cut patterns described herein, the sawtooth cut pattern can beneficially avoid preferred bending axes while also limiting preferred curvature directions inherent in helical patterns. In contrast to a helical pattern, a sawtooth cut pattern periodically reverses the direction of the rotational offset. - Both the sawtooth pattern and the helical pattern of
FIG. 8 have an angular offset of about 10 degrees between adjacent segments, with each cut pair within each segment offset by 90 degrees. Whereas the helical pattern simply continues with these offset values in the same direction through multiple rotations around the circumference of the elongated member, the sawtooth pattern reaches a first apex position before reversing direction and continuing toward a second apex position. Upon reaching the second apex position, the sawtooth pattern then reverses again and continues back toward the first apex. The pattern then repeats along the desired length of the elongated member. - For example, the first apex position is set at about 90 degrees (i.e., 90 degrees for the first cut pair of the segment and 180 degrees for the second cut pair of the segment). Upon reaching the first apex position, the pattern reverses toward the second apex position. In this embodiment, the second apex position is set at about 0 degrees (i.e., 0 degrees for the first cut pair of the segment and 90 degrees for the second cut pair of the segment). Alternative embodiments may include other apex positions. Given an arbitrary zero degree starting position, the first apex position is less than 360 degrees in a one-beam configuration, less than 180 degrees in a two-beam configuration, less than 120 degrees in a three-beam configuration, and so on. Preferably, the first apex position is about 180 degrees for a one-beam configuration, 90 degrees for a two-beam configuration, 60 degrees for a three-beam configuration, and so on.
- As described above, the angular offset from segment to segment in the sawtooth pattern of
FIG. 8 is about 10 degrees. In other embodiments of sawtooth cut patterns, the angular offset may be more or less than 10 degrees, such as from about 5 degrees to about 30 degrees. Additionally, or alternatively, portions of the cut pattern between the apexes may include a variable offset. For example, one or more portions between the apexes may include an imperfect rotational offset such as described above in relation toFIG. 7 . - Alternative embodiments may apply the sawtooth pattern between segments of different sizes and/or between segments with different internal offsets. For example, some embodiments may include segments having more than two pairs of beams (and more than two corresponding rings) and/or with internal offsets different than 90 degrees. Further, even though the illustrated example shows a two-beam cut pattern where each pair of the opposing cuts results in two circumferentially opposing beams, it will be understood that the distributed offset patterns may also be applied to one-beam cut patterns, three-beam cut patterns, and patterns having more than three beams between adjacent rings.
- E. Spacing Artifacts
-
FIG. 9 illustrates an example of an undesirable spacing artifact that may result where a rotational offset limit is not applied.FIG. 9 illustrates a section of anelongated member 700 having afirst segment 750 a and asecond segment 750 b. Thefirst segment 750 a includes a first pair ofbeams 730 a (only one of which is visible in this view) and second pair ofbeams second segment 750 b includes a first pair ofbeams beams second segment 750 b is offset from thefirst segment 750 a by 45 degrees, which positions the first pair ofbeams beams 730 a and positions the second pair ofbeams beams - Applying such a 45 degree offset from the
first segment 750 a to thesecond segment 750 b may at first be considered desirable because it places the bending axes of thesecond segment 750 b in between the bending axes of thefirst segment 750 a. However, the 45 degree jump also results in beam spacing between segments which can leave an overly rigid artifact in a portion of theelongated member 700. In the illustratedmember 700, thebeam 730 d is only spaced from thebeam 730 b by 45 degrees, whereas thebeam 730 e is spaced from thebeam 730 b by 135 degrees. Likewise, thebeam 730 e is only spaced from thebeam 730 c by 45 degrees, whereas thebeam 730 d is spaced from thebeam 730 c by 135 degrees. This disproportionate spacing may be undesirable because the region of theelongated member 700 having the smaller spacing may be overly rigid and/or the region having the larger spacing may be overly flexible. - In contrast, a more limited jump in the rotational offset applied from one segment to the next will minimize the discrepancy in beam spacing between segments. For example,
FIG. 10 illustrates a section of anelongated member 800 with a more limited rotational offset of about 20 degrees applied between a first segment 850 a and asecond segment 850 b. As in theelongated member 700 ofFIG. 9 , the first segment 850 a includes a first pair of beams 830 a and a second pair ofbeams second segment 850 b includes a first pair ofbeams beams second segment 850 b is offset from the first segment 850 a by a more limited 20 degrees, the spacing discrepancy betweenbeams Beam 830 d is spaced 70 degrees frombeam 830 b, andbeam 830 e is spaced 110 degrees frombeam 830 b. Likewise,beam 830 e is spaced 70 degrees frombeam 830 c andbeam 830 d is spaced 110 degrees frombeam 830 c. Thus, although a spacing discrepancy still exists between segments, it may be controlled to a suitable degree by providing an appropriate rotational offset limit. - F. Spiral Patterns
-
FIGS. 11A through 11C illustrate embodiments of a “spiral” cut pattern that may be included in one or more sections of the device. As shown inFIG. 11A , asection 170 of device is cut to provide an outer body of resulting helically orientedcoil members 174, with the pitch of the resulting coil defining the size of the fenestrations. Typically, a spiral cut pattern provides less torquability and more flexibility than a one-beam pattern. As such, in most applications, spiral sections are less beneficial at more proximal sections of the device where torquability concerns are particularly important, but are beneficial at more distal sections, and particularly at or near the distal end of the device, where flexibility concerns become more important. - In preferred embodiments, the
spiral cut section 170 forms an integral piece of material with one or more adjacent sections of the elongated device. For example, rather than welding, adhering, or otherwise attaching a separate coil member to another section of the device (which unfavorably introduces potential failure points and increases manufacturing difficulty), the spiral pattern results from a cutting operation performed on the section. In this manner, a single piece of material can be micro-fabricated to include one or more sections of different cut arrangements, in addition to the one or more spiral cut patterns. - The embodiment shown in
FIG. 11A also includes a series ofbridges 172 that remain between and connectadjacent coil members 174 of the spiral pattern.Such bridges 172 can function to somewhat limit the flexibility of thesection 170 relative to a similar spiral pattern omitting such bridges.FIG. 11B , for example, illustrates another spiral cutsection 180 that may be included in the hollowelongated member 104. The spiral cut pattern ofsection 180 omits bridges betweencoil members 184, and therefore has relatively greater flexibility than thespiral section 170 shown inFIG. 11A (assuming materials, pitch, diameter, wall thickness, and other relevant factors are otherwise substantially equal).Bridges 172 can also be arranged to provide flexibility bias in one or more directions. - In
embodiments having bridges 172, such as the embodiment shown inFIG. 11A , thebridges 172 may be spaced about every 45, 60, 75, 90, 105, 120, 135, 150, 165, or 180 degrees around the spiral shape of the device. Greater spacing may also be provided between successive bridges. For example, multiples of 360 degrees may be added to any of the foregoing angle spacing values to provide an even greater spacing arrangement. Less spacing generally limits flexibility to a greater degree, while greater spacing generally provides greater relative flexibility. In some embodiments, spacing of thebridges 172 can vary across the length of thesection 170. For example, spacing between thebridges 172 can become progressively greater toward the distal end of the section in order to progressively increase distal flexibility. - Additionally, or alternatively, a spiral cut pattern may be varied along its length to provide desired flexibility characteristics.
FIG. 11C illustrates, in cross-sectional view, an embodiment of asection 190 where spacing between spiral cuts is tailored to be progressively narrower as the cuts near the distal end of the section. As shown, the dimension 191 between two of thecoil members 194 is smaller at a more distal region than thedimension 193 between more proximally located coil members 192. In the illustrated embodiment, the cut width, indicated bydimension 195, is substantially constant. In alternative embodiments, thecut width 195 may be adjusted as an alternative to or in addition to the progressive changes in coil member size shown bydimensions 191 and 193. Other embodiments may omit progressively changing features, or may include one or more sections including progressively changing features and one or more other sections with substantially constant coil dimensionality. - Typically, assuming that device materials, device size, cut widths (and resulting beam size in the axial direction), cut spacing (and resulting ring size in the axial direction), and cut depth (and resulting beam width in the circumferential direction) are the same, a spiral cut pattern omitting bridges will provide greater flexibility than a spiral cut pattern with bridges, which will provide greater flexibility than a one-beam cut pattern, which will provide greater flexibility than a two-beam cut pattern, which will provide greater flexibility than a three-beam pattern, and so on.
- The terms “approximately,” “about,” and “substantially” as used herein represent an amount or condition close to the stated amount or condition that still performs a desired function or achieves a desired result. For example, the terms “approximately,” “about,” and “substantially” may refer to an amount or condition that deviates by less than 10%, or by less than 5%, or by less than 1%, or by less than 0.1%, or by less than 0.01% from a stated amount or condition.
- Elements described in relation to any embodiment depicted and/or described herein may be combinable with elements described in relation to any other embodiment depicted and/or described herein. For example, any element described in relation to any of the different cut patterns in
FIGS. 4A through 11C may be combinable with any element described in relation to any of the deflectable tip devices ofFIGS. 1 through 3 .
Claims (20)
1. An intravascular device, comprising:
an elongated hollow proximal section;
an elongated hollow distal section joined to the proximal section and extending distally from the proximal section to form a continuous lumen extending from a proximal end of the device to a distal end of the device; and
an inner member extending from the proximal end to the distal end, the inner member being joined to the distal end and being translatable within the lumen in response to applied tension or compression,
wherein at least the distal section includes a micro-fabricated cutting pattern that enables deflection of the distal end in response to the application of tension or compression to the inner member, and
wherein the cutting pattern includes a one-beam section having a plurality of beams substantially aligned on a single side to create a preferred bending direction.
2. The device of claim 1 , wherein the distal section is biased toward a pre-curved shape such that the application of tension to the inner member causes straightening of the distal section.
3. The device of claim 1 , wherein the distal section is biased toward a straight shape such that the application of tension to the inner member causes curving of the distal section.
4. The device of claim 1 , wherein the cutting pattern further comprises a two-beam section.
5. The device of claim 4 , wherein the two-beam section is proximal of the one-beam section.
6. The device of claim 1 , wherein the cutting pattern further comprises a one-beam section in which beams are not aligned on a single side.
7. The device of claim 6 , wherein the one one-beam section in which beams are not aligned on a single side is proximal of the one-beam section having beams substantially aligned on a single side.
8. The device of claim 1 , further comprising a polymeric tip joined to the distal end.
9. The device of claim 8 , wherein the polymeric tip is formed from an adhesive material and wherein the inner member is joined to the distal end via the adhesive material.
10. The device of claim 1 , wherein the proximal section is a stainless steel tube.
11. The device of claim 1 , wherein the distal section is formed from a nickel-titanium alloy.
12. The device of claim 1 , wherein the proximal section and the distal section are made from different materials.
13. The device of claim 1 , wherein the inner member is formed from stainless steel.
14. The device of claim 1 , wherein the inner member is a ground stainless steel core that has a wider cross-sectional diameter at a more proximal section and a narrower cross-sectional diameter at a more distal section.
15. An intravascular system, comprising:
a catheter; and
a guidewire device with a deflectable distal tip, the guidewire device being configured to enable passage of the catheter thereover such that deflection of the guidewire enables corresponding deflection of the catheter, the guidewire device comprising
an elongated hollow proximal section;
an elongated hollow distal section joined to the proximal section and extending distally from the proximal section to form a continuous lumen extending from a proximal end of the device to a distal end of the device; and
an inner member extending from the proximal end to the distal end, the inner member being joined to the distal end and being translatable within the lumen in response to applied tension or compression,
wherein at least the distal section includes a micro-fabricated cutting pattern that enables deflection of the distal end in response to the application of tension or compression to the inner member, and
wherein the cutting pattern includes a one-beam section having a plurality of beams substantially aligned on a single side to create a preferred bending direction.
16. The system of claim 15 , wherein the guidewire device further comprises a polymeric tip formed from an adhesive material, and wherein the inner member is joined to the distal end via the adhesive material.
17. The system of claim 15 , wherein the proximal section of the guidewire device is a stainless steel tube and the distal section of the guidewire device is formed from a nickel-titanium alloy.
18. The system of claim 15 , wherein the proximal section of the guidewire device and the distal section of the guidewire device are made from different materials.
19. The system of claim 15 , wherein the cutting pattern further comprises a two-beam section proximal of the one-beam section.
20. The system of claim 19 , wherein the cutting pattern further comprises a one-beam section in which beams are not aligned on a single side, the one-beam section in which beams are not aligned on a single side being proximal of the one-beam section having beams substantially aligned on a single side.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US17/885,302 US20220378459A1 (en) | 2016-12-22 | 2022-08-10 | Intravascular device having a selectively defectable tip |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201662438407P | 2016-12-22 | 2016-12-22 | |
US15/848,878 US11452541B2 (en) | 2016-12-22 | 2017-12-20 | Intravascular device having a selectively deflectable tip |
US17/885,302 US20220378459A1 (en) | 2016-12-22 | 2022-08-10 | Intravascular device having a selectively defectable tip |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/848,878 Continuation US11452541B2 (en) | 2016-12-22 | 2017-12-20 | Intravascular device having a selectively deflectable tip |
Publications (1)
Publication Number | Publication Date |
---|---|
US20220378459A1 true US20220378459A1 (en) | 2022-12-01 |
Family
ID=62625698
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/848,878 Active US11452541B2 (en) | 2016-12-22 | 2017-12-20 | Intravascular device having a selectively deflectable tip |
US17/885,302 Pending US20220378459A1 (en) | 2016-12-22 | 2022-08-10 | Intravascular device having a selectively defectable tip |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/848,878 Active US11452541B2 (en) | 2016-12-22 | 2017-12-20 | Intravascular device having a selectively deflectable tip |
Country Status (8)
Country | Link |
---|---|
US (2) | US11452541B2 (en) |
EP (1) | EP3558435A4 (en) |
JP (1) | JP7069172B2 (en) |
KR (1) | KR20190097243A (en) |
CN (1) | CN110099713B (en) |
AU (1) | AU2017382303A1 (en) |
CA (1) | CA3046654A1 (en) |
WO (1) | WO2018119334A1 (en) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11951267B2 (en) | 2016-07-18 | 2024-04-09 | Scientia Vascular, Inc. | Guidewire devices having shapeable tips and bypass cuts |
Families Citing this family (12)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10363389B2 (en) | 2009-04-03 | 2019-07-30 | Scientia Vascular, Llc | Micro-fabricated guidewire devices having varying diameters |
US11406791B2 (en) | 2009-04-03 | 2022-08-09 | Scientia Vascular, Inc. | Micro-fabricated guidewire devices having varying diameters |
JP5751709B2 (en) | 2008-12-08 | 2015-07-22 | サイエンティア バスキュラー エルエルシー | Micro-cutting device for forming cuts in products |
US11207502B2 (en) | 2016-07-18 | 2021-12-28 | Scientia Vascular, Llc | Guidewire devices having shapeable tips and bypass cuts |
US10821268B2 (en) | 2016-09-14 | 2020-11-03 | Scientia Vascular, Llc | Integrated coil vascular devices |
EP3842091B1 (en) | 2017-05-26 | 2023-09-13 | Scientia Vascular, Inc. | Micro-fabricated medical device having a non-helical cut arrangement |
US11305095B2 (en) | 2018-02-22 | 2022-04-19 | Scientia Vascular, Llc | Microfabricated catheter having an intermediate preferred bending section |
WO2021152816A1 (en) * | 2020-01-31 | 2021-08-05 | 朝日インテック株式会社 | Rotation transmission structure, catheter, and guide wire |
KR102247637B1 (en) | 2020-07-10 | 2021-05-03 | 주식회사 레노메디컬 | Electrolytic-polished core wire and core wire electrolytic polishing device |
CN111956934B (en) * | 2020-08-31 | 2021-09-10 | 尚华 | Medical guide wire |
CN116407733A (en) * | 2021-12-30 | 2023-07-11 | 神途医疗科技(上海)有限公司 | Interventional device |
CN115554576A (en) * | 2022-11-29 | 2023-01-03 | 北京普益盛济科技有限公司 | Micro-guide wire protection tube and micro-guide wire assembly |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20170234411A1 (en) * | 2014-08-27 | 2017-08-17 | Steerable Instruments nv | Torque-transmitting steering mechanism for a steerable tool |
Family Cites Families (348)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2022065A (en) | 1932-07-07 | 1935-11-26 | Frederick C Wappler | Therapeutic applicator device |
US2187299A (en) | 1935-08-13 | 1940-01-16 | Burkhardt Otto Wilhelm | Dressing of individual blocks of stone |
US3183702A (en) | 1960-11-21 | 1965-05-18 | Rca Corp | Method of and apparatus for cutting and deburring tubes |
US3612058A (en) | 1968-04-17 | 1971-10-12 | Electro Catheter Corp | Catheter stylets |
US3572334A (en) | 1968-11-27 | 1971-03-23 | Johnson & Johnson | Intravenous catheter placement unit |
US3920058A (en) | 1971-02-22 | 1975-11-18 | Willard H Walker | Method of sawing logs |
US3709271A (en) | 1971-07-01 | 1973-01-09 | Mc Farland L Co | Method and apparatus for deep incising poles |
US4163406A (en) | 1977-12-15 | 1979-08-07 | Genevieve I. Hanscom | Centering device for feeding articles to a food slicer |
US4239069A (en) | 1979-08-10 | 1980-12-16 | Zimmerman Edwin H | Automatic cant production machine |
SE419059B (en) | 1980-07-03 | 1981-07-13 | Kockums Ind Ab | CONTROL DEVICE ON THE SAW SHEET'S SUPPLIED SUBDIVISION MACHINERY FOR WORK |
US5506682A (en) | 1982-02-16 | 1996-04-09 | Sensor Adaptive Machines Inc. | Robot vision using targets |
JPS59102509A (en) | 1983-11-21 | 1984-06-13 | Fujikawa Seikou Kk | Double-acting multihead type drilling and slotting device |
US4801297A (en) | 1984-06-01 | 1989-01-31 | Edward Weck Incorporated | Catheter having slit tip |
US4688540A (en) | 1984-12-27 | 1987-08-25 | Disco Abrasive Systems, Ltd. | Semiconductor wafer dicing machine |
US5102390A (en) | 1985-05-02 | 1992-04-07 | C. R. Bard, Inc. | Microdilatation probe and system for performing angioplasty in highly stenosed blood vessels |
US4719924A (en) | 1986-09-09 | 1988-01-19 | C. R. Bard, Inc. | Small diameter steerable guidewire with adjustable tip |
US4989608A (en) | 1987-07-02 | 1991-02-05 | Ratner Adam V | Device construction and method facilitating magnetic resonance imaging of foreign objects in a body |
US4846186A (en) | 1988-01-12 | 1989-07-11 | Cordis Corporation | Flexible guidewire |
US4895168A (en) | 1988-01-21 | 1990-01-23 | Schneider (Usa) Inc., A Pfizer Company | Guidewire with movable core and external tubular safety cover |
US5507751A (en) | 1988-11-09 | 1996-04-16 | Cook Pacemaker Corporation | Locally flexible dilator sheath |
US5372587A (en) | 1989-01-09 | 1994-12-13 | Pilot Cariovascular Systems, Inc. | Steerable medical device |
US5047045A (en) | 1989-04-13 | 1991-09-10 | Scimed Life Systems, Inc. | Multi-section coaxial angioplasty catheter |
US5084022A (en) | 1989-10-04 | 1992-01-28 | Lake Region Manufacturing Company, Inc. | Graduated guidewire |
US5095915A (en) | 1990-03-19 | 1992-03-17 | Target Therapeutics | Guidewire with flexible distal tip |
US5147317A (en) | 1990-06-04 | 1992-09-15 | C.R. Bard, Inc. | Low friction varied radiopacity guidewire |
US5069217A (en) | 1990-07-09 | 1991-12-03 | Lake Region Manufacturing Co., Inc. | Steerable guide wire |
US5345945A (en) | 1990-08-29 | 1994-09-13 | Baxter International Inc. | Dual coil guidewire with radiopaque distal tip |
CA2095814C (en) | 1990-11-09 | 2002-09-17 | John E. Abele | Guidewire for crossing occlusions in blood vessels |
US5174302A (en) | 1990-12-04 | 1992-12-29 | Cordis Corporation | Variable radiopacity guidewire with spaced highly radiopaque regions |
AU660444B2 (en) | 1991-02-15 | 1995-06-29 | Ingemar H. Lundquist | Torquable catheter and method |
US5315996A (en) | 1991-02-15 | 1994-05-31 | Lundquist Ingemar H | Torquable catheter and method |
US5454787A (en) | 1991-02-15 | 1995-10-03 | Lundquist; Ingemar H. | Torquable tubular assembly and torquable catheter utilizing the same |
US5154725A (en) | 1991-06-07 | 1992-10-13 | Advanced Cardiovascular Systems, Inc. | Easily exchangeable catheter system |
US5741429A (en) | 1991-09-05 | 1998-04-21 | Cardia Catheter Company | Flexible tubular device for use in medical applications |
CA2117088A1 (en) | 1991-09-05 | 1993-03-18 | David R. Holmes | Flexible tubular device for use in medical applications |
US6027863A (en) | 1991-09-05 | 2000-02-22 | Intratherapeutics, Inc. | Method for manufacturing a tubular medical device |
US5437288A (en) | 1992-09-04 | 1995-08-01 | Mayo Foundation For Medical Education And Research | Flexible catheter guidewire |
IL106946A0 (en) | 1992-09-22 | 1993-12-28 | Target Therapeutics Inc | Detachable embolic coil assembly |
US5382259A (en) | 1992-10-26 | 1995-01-17 | Target Therapeutics, Inc. | Vasoocclusion coil with attached tubular woven or braided fibrous covering |
US5441483A (en) | 1992-11-16 | 1995-08-15 | Avitall; Boaz | Catheter deflection control |
JP3114908B2 (en) | 1992-11-16 | 2000-12-04 | 三菱電線工業株式会社 | Rigid inclined torque tube, method for manufacturing the same, and catheter using the torque tube |
US5326374A (en) | 1992-12-01 | 1994-07-05 | Michael N. Ilbawi | Body-implantable device for controlling the size of a fluid passageway |
US5358493A (en) | 1993-02-18 | 1994-10-25 | Scimed Life Systems, Inc. | Vascular access catheter and methods for manufacture thereof |
US7883474B1 (en) | 1993-05-11 | 2011-02-08 | Target Therapeutics, Inc. | Composite braided guidewire |
JP3383009B2 (en) | 1993-06-29 | 2003-03-04 | テルモ株式会社 | Vascular catheter |
ES2194896T3 (en) | 1993-11-12 | 2003-12-01 | Micro Interventional Syst | SMALL DIAMETER CATHETER WITH ELEVATED PAIR. |
DE69412638T2 (en) | 1993-12-10 | 1998-12-24 | Schneider Usa Inc | GUIDE CATHETER |
US5911715A (en) | 1994-02-14 | 1999-06-15 | Scimed Life Systems, Inc. | Guide catheter having selected flexural modulus segments |
US5569218A (en) | 1994-02-14 | 1996-10-29 | Scimed Life Systems, Inc. | Elastic guide catheter transition element |
US5673707A (en) | 1994-09-23 | 1997-10-07 | Boston Scientific Corporation | Enhanced performance guidewire |
US5554114A (en) | 1994-10-20 | 1996-09-10 | Micro Therapeutics, Inc. | Infusion device with preformed shape |
DK0728494T3 (en) | 1994-12-15 | 2000-03-13 | Schneider Europ Gmbh | catheter |
EP0729765B1 (en) | 1995-03-02 | 2000-06-14 | Schneider (Europe) GmbH | A method for manufacturing a guide wire |
JPH08308934A (en) | 1995-05-22 | 1996-11-26 | Piolax Inc | Medical tube |
US5551444A (en) | 1995-05-31 | 1996-09-03 | Radius Medical Technologies, Inc. | Flexible guidewire with radiopaque outer coil and non-radiopaque inner coil |
US5746701A (en) | 1995-09-14 | 1998-05-05 | Medtronic, Inc. | Guidewire with non-tapered tip |
US5997487A (en) | 1995-10-11 | 1999-12-07 | Micro Therapeutics, Inc. | Infusion wire having fixed core wire |
US5833632A (en) | 1995-12-07 | 1998-11-10 | Sarcos, Inc. | Hollow guide wire apparatus catheters |
US20030069522A1 (en) * | 1995-12-07 | 2003-04-10 | Jacobsen Stephen J. | Slotted medical device |
US5931830A (en) | 1995-12-07 | 1999-08-03 | Sarcos L.C. | Hollow coil guide wire apparatus for catheters |
US6428489B1 (en) | 1995-12-07 | 2002-08-06 | Precision Vascular Systems, Inc. | Guidewire system |
US5659205A (en) | 1996-01-11 | 1997-08-19 | Ebara International Corporation | Hydraulic turbine power generator incorporating axial thrust equalization means |
US6004279A (en) | 1996-01-16 | 1999-12-21 | Boston Scientific Corporation | Medical guidewire |
US5573867A (en) | 1996-01-31 | 1996-11-12 | Westinghouse Electric Corporation | Purge gas protected transportable pressurized fuel cell modules and their operation in a power plant |
US6436056B1 (en) | 1996-02-28 | 2002-08-20 | Boston Scientific Corporation | Polymeric implements for torque transmission |
US5792154A (en) | 1996-04-10 | 1998-08-11 | Target Therapeutics, Inc. | Soft-ended fibered micro vaso-occlusive devices |
US6440088B1 (en) | 1996-05-24 | 2002-08-27 | Precision Vascular Systems, Inc. | Hybrid catheter guide wire apparatus and method |
US5916194A (en) | 1996-05-24 | 1999-06-29 | Sarcos, Inc. | Catheter/guide wire steering apparatus and method |
US6017319A (en) | 1996-05-24 | 2000-01-25 | Precision Vascular Systems, Inc. | Hybrid tubular guide wire for catheters |
US5690120A (en) | 1996-05-24 | 1997-11-25 | Sarcos, Inc. | Hybrid catheter guide wire apparatus |
US5833631A (en) | 1996-06-28 | 1998-11-10 | Target Therapeutics, Inc. | Fiber tip guidewire |
JP3223421B2 (en) | 1996-08-13 | 2001-10-29 | 株式会社東京精密 | Dicing equipment |
US6014919A (en) | 1996-09-16 | 2000-01-18 | Precision Vascular Systems, Inc. | Method and apparatus for forming cuts in catheters, guidewires, and the like |
US6553880B2 (en) | 1996-09-16 | 2003-04-29 | Sarcos, Lc | Micromachining system |
AUPO251096A0 (en) | 1996-09-23 | 1996-10-17 | Cardiac Crc Nominees Pty Limited | Polysiloxane-containing polyurethane elastomeric compositions |
US6251086B1 (en) | 1999-07-27 | 2001-06-26 | Scimed Life Systems, Inc. | Guide wire with hydrophilically coated tip |
US5911717A (en) | 1997-03-17 | 1999-06-15 | Precision Vascular Systems, Inc. | Catheter deliverable thrombogenic apparatus and method |
US5800454A (en) | 1997-03-17 | 1998-09-01 | Sarcos, Inc. | Catheter deliverable coiled wire thromboginic apparatus and method |
US5876356A (en) | 1997-04-02 | 1999-03-02 | Cordis Corporation | Superelastic guidewire with a shapeable tip |
EP0879616A1 (en) | 1997-05-21 | 1998-11-25 | Schneider (Europe) GmbH | Guide wire |
US7494474B2 (en) | 1997-06-04 | 2009-02-24 | Advanced Cardiovascular Systems, Inc. | Polymer coated guidewire |
US6183420B1 (en) | 1997-06-20 | 2001-02-06 | Medtronic Ave, Inc. | Variable stiffness angioplasty guide wire |
US7037316B2 (en) | 1997-07-24 | 2006-05-02 | Mcguckin Jr James F | Rotational thrombectomy device |
WO1999016347A1 (en) | 1997-09-29 | 1999-04-08 | Scimed Life Systems, Inc. | Intravascular imaging guidewire |
US6056702A (en) | 1998-10-02 | 2000-05-02 | Cordis Corporation | Guidewire with outer sheath |
JP3203364B2 (en) | 1997-12-01 | 2001-08-27 | 株式会社東京精密 | Alignment method and apparatus |
US6110164A (en) | 1997-12-05 | 2000-08-29 | Intratherapeutics, Inc. | Guideless catheter segment |
US6168570B1 (en) | 1997-12-05 | 2001-01-02 | Micrus Corporation | Micro-strand cable with enhanced radiopacity |
US6033394A (en) | 1997-12-05 | 2000-03-07 | Intratherapeutics, Inc. | Catheter support structure |
US6022369A (en) | 1998-02-13 | 2000-02-08 | Precision Vascular Systems, Inc. | Wire device with detachable end |
US6346091B1 (en) | 1998-02-13 | 2002-02-12 | Stephen C. Jacobsen | Detachable coil for aneurysm therapy |
US6824550B1 (en) | 2000-04-06 | 2004-11-30 | Norbon Medical, Inc. | Guidewire for crossing occlusions or stenosis |
US20060074442A1 (en) * | 2000-04-06 | 2006-04-06 | Revascular Therapeutics, Inc. | Guidewire for crossing occlusions or stenoses |
US6245030B1 (en) | 1998-03-04 | 2001-06-12 | C. R. Bard, Inc. | Flexible kink resistant, low friction guidewire with formable tip, and method for making same |
US20060047223A1 (en) | 2004-08-31 | 2006-03-02 | Ryan Grandfield | Apparatus and method for joining stainless steel guide wire portion to nitinol portion, without a hypotube |
JP3988156B2 (en) | 1998-04-10 | 2007-10-10 | Nskワーナー株式会社 | Elastic tube type brake band |
US6132389A (en) | 1998-04-23 | 2000-10-17 | Advanced Cardiovascular Systems, Inc. | Proximally tapered guidewire tip coil |
US6306105B1 (en) | 1998-05-14 | 2001-10-23 | Scimed Life Systems, Inc. | High performance coil wire |
EP1378262A3 (en) | 1998-06-12 | 2004-03-17 | Cardiac Pacemakers, Inc. | Modified guidewire for left ventricular access lead |
US6139511A (en) | 1998-06-29 | 2000-10-31 | Advanced Cardiovascular Systems, Inc. | Guidewire with variable coil configuration |
AU2004201816B2 (en) | 1998-07-08 | 2006-12-07 | Ams Research Corporation | Occluding Device and Method of Use |
US6022343A (en) | 1998-09-03 | 2000-02-08 | Intratherapeutics, Inc. | Bridged coil catheter support structure |
JP2000116787A (en) | 1998-10-16 | 2000-04-25 | Piolax Inc | Tube for medical treatment |
US6033288A (en) | 1998-10-29 | 2000-03-07 | Kulicke & Soffa Investments, Inc. | Monitoring system for dicing saws |
US6214042B1 (en) | 1998-11-10 | 2001-04-10 | Precision Vascular Systems, Inc. | Micro-machined stent for vessels, body ducts and the like |
US6235598B1 (en) | 1998-11-13 | 2001-05-22 | Intel Corporation | Method of using thick first spacers to improve salicide resistance on polysilicon gates |
US6063101A (en) | 1998-11-20 | 2000-05-16 | Precision Vascular Systems, Inc. | Stent apparatus and method |
US6228073B1 (en) | 1998-12-15 | 2001-05-08 | Medtronic, Inc. | Angiography luer hub having wings proximal to the plurality of grips and strain relief |
US6402706B2 (en) | 1998-12-30 | 2002-06-11 | Advanced Cardiovascular Systems, Inc. | Guide wire with multiple polymer jackets over distal and intermediate core sections |
US6179828B1 (en) | 1999-03-19 | 2001-01-30 | Merit Medical Systems, Inc. | Infusion system with fixed occluding wire |
US6302870B1 (en) | 1999-04-29 | 2001-10-16 | Precision Vascular Systems, Inc. | Apparatus for injecting fluids into the walls of blood vessels, body cavities, and the like |
US6610046B1 (en) | 1999-04-30 | 2003-08-26 | Usaminanotechnology Inc. | Catheter and guide wire |
US6183410B1 (en) | 1999-05-06 | 2001-02-06 | Precision Vascular Systems, Inc. | Radiation exposure device for blood vessels, body cavities and the like |
JP3623896B2 (en) | 1999-05-29 | 2005-02-23 | 功 吉田 | Sheet material grooving machine |
US6458867B1 (en) | 1999-09-28 | 2002-10-01 | Scimed Life Systems, Inc. | Hydrophilic lubricant coatings for medical devices |
US7018406B2 (en) | 1999-11-17 | 2006-03-28 | Corevalve Sa | Prosthetic valve for transluminal delivery |
JP2001145699A (en) | 1999-11-22 | 2001-05-29 | Nissho Corp | Guide wire |
US20020062524A1 (en) | 1999-11-29 | 2002-05-30 | Vogland James H. | Mattress and sheet attachment assembly |
US6579246B2 (en) | 1999-12-22 | 2003-06-17 | Sarcos, Lc | Coronary guidewire system |
US6554820B1 (en) | 2000-03-08 | 2003-04-29 | Scimed Life Systems, Inc. | Composite flexible tube for medical applications |
GB0005642D0 (en) | 2000-03-10 | 2000-05-03 | Astrazeneca Uk Ltd | Chemical compounds |
US6494894B2 (en) | 2000-03-16 | 2002-12-17 | Scimed Life Systems, Inc. | Coated wire |
US6602207B1 (en) | 2000-07-19 | 2003-08-05 | Scimed Life Systems, Inc. | Guide wire stiffness transition element |
US6527746B1 (en) | 2000-08-03 | 2003-03-04 | Ev3, Inc. | Back-loading catheter |
EP1195174B1 (en) | 2000-10-03 | 2005-01-26 | William Cook Europe ApS | A guide wire |
US7097624B2 (en) | 2000-10-05 | 2006-08-29 | Scimed Life Systems, Inc. | Multi-layer and multi-section coils for guide wire |
US6492615B1 (en) | 2000-10-12 | 2002-12-10 | Scimed Life Systems, Inc. | Laser polishing of medical devices |
US6527732B1 (en) | 2000-10-17 | 2003-03-04 | Micro Therapeutics, Inc. | Torsionally compensated guidewire |
US6544197B2 (en) | 2000-10-20 | 2003-04-08 | Radius Medical Technologies, Inc. | Composite guidewire |
US6558355B1 (en) | 2000-12-29 | 2003-05-06 | Ethicon, Inc. | Flushable guidewire device |
JP2002237472A (en) | 2001-02-07 | 2002-08-23 | Disco Abrasive Syst Ltd | Method of cutting object to be processed |
EP1379177A2 (en) | 2001-04-17 | 2004-01-14 | Salviac Limited | A retrieval catheter tip and catheter |
AU2002345795B2 (en) | 2001-06-20 | 2008-01-10 | Microvention, Inc. | Medical devices having full or partial polymer coatings and their methods of manufacture |
WO2003004086A2 (en) | 2001-07-05 | 2003-01-16 | Precision Vascular Systems, Inc. | Troqueable soft tip medical device and method of usage |
JP2003011117A (en) | 2001-07-05 | 2003-01-15 | Canon Inc | Method and apparatus for cutting column-shaped base material, method and apparatus for cutting ingot by using light, and method for producing wafer |
US6918882B2 (en) | 2001-10-05 | 2005-07-19 | Scimed Life Systems, Inc. | Guidewire with stiffness blending connection |
US7421929B2 (en) | 2001-10-11 | 2008-09-09 | Andrew French | Drive apparatus |
US6652508B2 (en) | 2001-11-09 | 2003-11-25 | Scimed Life Systems, Inc. | Intravascular microcatheter having hypotube proximal shaft with transition |
JP3762290B2 (en) | 2001-12-03 | 2006-04-05 | 朝日インテック株式会社 | Medical guidewire |
US7670302B2 (en) | 2001-12-18 | 2010-03-02 | Boston Scientific Scimed, Inc. | Super elastic guidewire with shape retention tip |
US6702762B2 (en) | 2001-12-27 | 2004-03-09 | Advanced Cardiovascular Systems, Inc. | Apparatus and method for joining two guide wire core materials without a hypotube |
DE10213368A1 (en) | 2002-03-21 | 2003-10-02 | Biotronik Mess & Therapieg | Surface structure for a friction or sliding surface of a catheter or guide wire comprises recesses distributed on the surface for receiving a fluid for reducing friction, and sliding areas between the recesses |
US7128718B2 (en) | 2002-03-22 | 2006-10-31 | Cordis Corporation | Guidewire with deflectable tip |
US7769839B2 (en) | 2002-06-21 | 2010-08-03 | International Business Machines Corporation | Method and structure for autoconfiguration of overlay networks by automatic selection of a network designated router |
JP2004025340A (en) | 2002-06-25 | 2004-01-29 | Toshiba Corp | Surface working method and device |
US8425549B2 (en) | 2002-07-23 | 2013-04-23 | Reverse Medical Corporation | Systems and methods for removing obstructive matter from body lumens and treating vascular defects |
ATE480286T1 (en) | 2002-07-25 | 2010-09-15 | Boston Scient Ltd | MEDICAL DEVICE FOR NAVIGATION THROUGH ANATOMY |
US7914467B2 (en) | 2002-07-25 | 2011-03-29 | Boston Scientific Scimed, Inc. | Tubular member having tapered transition for use in a medical device |
US20040039371A1 (en) | 2002-08-23 | 2004-02-26 | Bruce Tockman | Coronary vein navigator |
US8465469B2 (en) | 2002-09-12 | 2013-06-18 | Medtronic Vascular, Inc. | Reinforced catheter and methods of making |
US20040087933A1 (en) | 2002-09-18 | 2004-05-06 | Lee Jeong S. | Stiff guiding catheter liner material |
US20040102719A1 (en) | 2002-11-22 | 2004-05-27 | Velocimed, L.L.C. | Guide wire control catheters for crossing occlusions and related methods of use |
US6866642B2 (en) | 2002-11-25 | 2005-03-15 | Advanced Cardiovascular Systems, Inc. | Enhanced method for joining two core wires |
AU2003297908A1 (en) | 2002-12-10 | 2004-06-30 | Battelle Memorial Institute | Articulated elements and methods for use |
US7077811B2 (en) | 2002-12-23 | 2006-07-18 | Scimed Life Systems, Inc. | Guidewire tip construction |
US8167821B2 (en) | 2003-02-26 | 2012-05-01 | Boston Scientific Scimed, Inc. | Multiple diameter guidewire |
US7182735B2 (en) | 2003-02-26 | 2007-02-27 | Scimed Life Systems, Inc. | Elongated intracorporal medical device |
US7276062B2 (en) | 2003-03-12 | 2007-10-02 | Biosence Webster, Inc. | Deflectable catheter with hinge |
US8052694B2 (en) | 2003-03-19 | 2011-11-08 | Boston Scientific Scimed, Inc. | Device for manipulating material in a tissue |
US7001369B2 (en) | 2003-03-27 | 2006-02-21 | Scimed Life Systems, Inc. | Medical device |
US7354442B2 (en) | 2003-05-05 | 2008-04-08 | Warsaw Orthopedic, Inc. | Bone anchor and methods of using the same |
JP2004329552A (en) | 2003-05-07 | 2004-11-25 | Vayu:Kk | Liquid medicine administering catheter |
US7758520B2 (en) | 2003-05-27 | 2010-07-20 | Boston Scientific Scimed, Inc. | Medical device having segmented construction |
JP4677205B2 (en) | 2003-07-17 | 2011-04-27 | テルモ株式会社 | Guide wire |
US20150011834A1 (en) | 2003-07-31 | 2015-01-08 | Cook Medical Technologies Llc | System and method for introducing multiple medical devices |
JP4681551B2 (en) | 2003-08-07 | 2011-05-11 | ブリヴァント リサーチ アンド ディベロップメント リミテッド | Guide wire for catheter |
EP1660168B1 (en) | 2003-09-05 | 2008-12-10 | Cook Urological Inc. | Double ended wire guide |
US7785273B2 (en) | 2003-09-22 | 2010-08-31 | Boston Scientific Scimed, Inc. | Guidewire with reinforcing member |
CR7129A (en) | 2003-10-29 | 2003-11-17 | Carlos Eduardo Rold N Villalobos | METHOD AND APPARATUS FOR STORAGE GASES AT LOW TEMPERATURE USING A REFRIGERATION RECOVERY SYSTEM |
US7867271B2 (en) | 2003-11-20 | 2011-01-11 | Advanced Cardiovascular Systems, Inc. | Rapid-exchange delivery systems for self-expanding stents |
US20050124976A1 (en) | 2003-12-04 | 2005-06-09 | Devens Douglas A.Jr. | Medical devices |
US7747314B2 (en) | 2003-12-30 | 2010-06-29 | Boston Scientific Scimed, Inc. | Distal assembly for a medical device |
AU2005228956B2 (en) | 2004-03-23 | 2011-08-18 | Boston Scientific Limited | In-vivo visualization system |
DE102004023642A1 (en) | 2004-05-10 | 2005-12-08 | Restate Patent Ag | Catheter guidewire, especially for percutaneous transluminal coronary angioplasty |
US7699056B2 (en) | 2004-06-10 | 2010-04-20 | Conceptus, Inc. | Medical devices and methods of making and using such devices |
DE102004028367A1 (en) | 2004-06-11 | 2005-12-29 | Biotronik Vi Patent Ag | Catheter Guidewire especially for cardio-vascular procedures |
WO2006012668A1 (en) | 2004-08-05 | 2006-02-09 | Cathrx Ltd | A steerable catheter |
US20060041186A1 (en) | 2004-08-17 | 2006-02-23 | Vancaillie Thierry G | Continuous flow single sheath for endoscope |
US7621904B2 (en) | 2004-10-21 | 2009-11-24 | Boston Scientific Scimed, Inc. | Catheter with a pre-shaped distal tip |
JP4907945B2 (en) | 2004-11-01 | 2012-04-04 | テルモ株式会社 | Medical guidewire |
US7989042B2 (en) | 2004-11-24 | 2011-08-02 | Boston Scientific Scimed, Inc. | Medical devices with highly flexible coated hypotube |
JP4571851B2 (en) | 2004-11-30 | 2010-10-27 | 株式会社ディスコ | Cutting equipment |
US8333714B2 (en) | 2006-09-10 | 2012-12-18 | Abbott Diabetes Care Inc. | Method and system for providing an integrated analyte sensor insertion device and data processing unit |
US7224917B2 (en) | 2005-03-25 | 2007-05-29 | Xerox Corporation | Method and system for reducing toner abuse in development systems of electrophotographic systems |
AU2006236272B2 (en) | 2005-04-20 | 2011-05-19 | Cook Medical Technologies Llc | Medical apparatus for rapid insertion |
DE102005022688B4 (en) | 2005-05-12 | 2011-06-30 | EPflex Feinwerktechnik GmbH, 72581 | Guidewire for a medical instrument |
US7370242B2 (en) | 2005-05-23 | 2008-05-06 | Network Appliance, Inc. | Thermal monitoring and response apparatus and method for computer unit |
US7110910B1 (en) | 2005-06-13 | 2006-09-19 | The Timken Company | Method and apparatus for determining the straightness of tubes and bars |
US20070185415A1 (en) | 2005-07-07 | 2007-08-09 | Ressemann Thomas V | Steerable guide wire with torsionally stable tip |
US7623899B2 (en) | 2005-09-16 | 2009-11-24 | Biosense Webster, Inc. | Catheter with flexible pre-shaped tip section |
US20080188928A1 (en) * | 2005-09-16 | 2008-08-07 | Amr Salahieh | Medical device delivery sheath |
US7850623B2 (en) | 2005-10-27 | 2010-12-14 | Boston Scientific Scimed, Inc. | Elongate medical device with continuous reinforcement member |
US8876772B2 (en) | 2005-11-16 | 2014-11-04 | Boston Scientific Scimed, Inc. | Variable stiffness shaft |
US8292827B2 (en) | 2005-12-12 | 2012-10-23 | Boston Scientific Scimed, Inc. | Micromachined medical devices |
US8152839B2 (en) | 2005-12-19 | 2012-04-10 | Boston Scientific Scimed, Inc. | Embolic coils |
US8377056B2 (en) | 2005-12-29 | 2013-02-19 | Boston Scientific Scimed, Inc. | Method of treating tissue with radio frequency vascular electrode array |
US20070167876A1 (en) | 2006-01-17 | 2007-07-19 | Euteneuer Charles L | Occluding guidewire and methods |
US8157837B2 (en) | 2006-03-13 | 2012-04-17 | Pneumrx, Inc. | Minimally invasive lung volume reduction device and method |
US7785317B2 (en) * | 2006-03-29 | 2010-08-31 | Codman & Shurtleff, Inc. | Joined metal tubing and method of manufacture |
US7766896B2 (en) | 2006-04-25 | 2010-08-03 | Boston Scientific Scimed, Inc. | Variable stiffness catheter assembly |
US20100114302A1 (en) | 2006-07-24 | 2010-05-06 | Abraham Tzafriri | Endovascular devices with axial perturbations |
US8021311B2 (en) | 2006-08-16 | 2011-09-20 | Boston Scientific Scimed, Inc. | Mechanical honing of metallic tubing for soldering in a medical device construction |
US8728010B2 (en) | 2006-08-24 | 2014-05-20 | Boston Scientific Scimed, Inc. | Elongate medical device including deformable distal end |
US8419658B2 (en) | 2006-09-06 | 2013-04-16 | Boston Scientific Scimed, Inc. | Medical device including structure for crossing an occlusion in a vessel |
US8551020B2 (en) | 2006-09-13 | 2013-10-08 | Boston Scientific Scimed, Inc. | Crossing guidewire |
US20080122226A1 (en) | 2006-11-29 | 2008-05-29 | Ebara International Corporation | Compact assemblies for high efficiency performance of cryogenic liquefied gas expanders and pumps |
US8556914B2 (en) | 2006-12-15 | 2013-10-15 | Boston Scientific Scimed, Inc. | Medical device including structure for crossing an occlusion in a vessel |
JP5020630B2 (en) | 2006-12-28 | 2012-09-05 | テルモ株式会社 | Guide wire |
JP2008161491A (en) | 2006-12-28 | 2008-07-17 | Asahi Intecc Co Ltd | Medical guide wire |
US7744545B2 (en) | 2006-12-28 | 2010-06-29 | Terumo Kabushiki Kaisha | Guide wire |
US20080188298A1 (en) | 2007-02-05 | 2008-08-07 | Atlantic City Cion & Slot Service Company, Inc. | Progressive gaming device and method of use |
US8622931B2 (en) | 2007-02-09 | 2014-01-07 | Boston Scientific Scimed, Inc. | Extruded guidewires and methods of making |
JP4981471B2 (en) | 2007-02-09 | 2012-07-18 | テルモ株式会社 | Guide wire |
WO2008100877A2 (en) | 2007-02-15 | 2008-08-21 | Vance Products Incorporated D/B/A, Cook Urological Incorporated | Dual stiffness wire guide |
JP2008245852A (en) | 2007-03-29 | 2008-10-16 | Terumo Corp | Guide wire |
US20080262474A1 (en) | 2007-04-20 | 2008-10-23 | Boston Scientific Scimed, Inc. | Medical device |
US20080269641A1 (en) | 2007-04-25 | 2008-10-30 | Medtronic Vascular, Inc. | Method of using a guidewire with stiffened distal section |
JP5441336B2 (en) | 2007-05-11 | 2014-03-12 | テルモ株式会社 | Guide wire |
US8270834B2 (en) | 2007-06-13 | 2012-09-18 | West Jr Lamar E | Frequency modulated burst mode optical system |
EP2162101B1 (en) | 2007-06-25 | 2019-02-20 | MicroVention, Inc. | Self-expanding prosthesis |
US8409114B2 (en) | 2007-08-02 | 2013-04-02 | Boston Scientific Scimed, Inc. | Composite elongate medical device including distal tubular member |
US20090036832A1 (en) | 2007-08-03 | 2009-02-05 | Boston Scientific Scimed, Inc. | Guidewires and methods for manufacturing guidewires |
US8105246B2 (en) | 2007-08-03 | 2012-01-31 | Boston Scientific Scimed, Inc. | Elongate medical device having enhanced torque and methods thereof |
US8821477B2 (en) | 2007-08-06 | 2014-09-02 | Boston Scientific Scimed, Inc. | Alternative micromachined structures |
US9808595B2 (en) | 2007-08-07 | 2017-11-07 | Boston Scientific Scimed, Inc | Microfabricated catheter with improved bonding structure |
US8128579B2 (en) | 2007-11-02 | 2012-03-06 | Boston Scientific Scimed, Inc. | Guidewires with improved fatigue life and methods of making the same |
US20090118675A1 (en) | 2007-11-02 | 2009-05-07 | Boston Scientific Scimed, Inc. | Elongate medical device with a shapeable tip |
US7806837B2 (en) | 2007-11-07 | 2010-10-05 | William Cook Europe Aps | Guide wire for catheter |
US20090177119A1 (en) | 2008-01-03 | 2009-07-09 | Boston Scientific Scimed, Inc. | Articulating intracorporeal medical device |
US8460213B2 (en) | 2008-01-03 | 2013-06-11 | Boston Scientific Scimed, Inc. | Cut tubular members for a medical device and methods for making and using the same |
US8540648B2 (en) | 2008-03-11 | 2013-09-24 | Epflex Feinwerktechnik Gmbh | Guide wire with marking pattern |
US8376961B2 (en) | 2008-04-07 | 2013-02-19 | Boston Scientific Scimed, Inc. | Micromachined composite guidewire structure with anisotropic bending properties |
US20090292225A1 (en) | 2008-05-21 | 2009-11-26 | Boston Scientific Scimed, Inc. | Medical device including a braid for crossing an occlusion in a vessel |
US20090318892A1 (en) | 2008-06-20 | 2009-12-24 | Maria Aboytes | Removable Core Implant Delivery Catheter |
CN201239164Y (en) | 2008-06-30 | 2009-05-20 | 扬州市瑞京科技发展有限公司 | Guide wire conveying device |
US8535243B2 (en) | 2008-09-10 | 2013-09-17 | Boston Scientific Scimed, Inc. | Medical devices and tapered tubular members for use in medical devices |
US20100063479A1 (en) | 2008-09-10 | 2010-03-11 | Boston Scientific Scimed, Inc. | Small profile, tubular component design and method of manufacture |
US11406791B2 (en) | 2009-04-03 | 2022-08-09 | Scientia Vascular, Inc. | Micro-fabricated guidewire devices having varying diameters |
JP5751709B2 (en) | 2008-12-08 | 2015-07-22 | サイエンティア バスキュラー エルエルシー | Micro-cutting device for forming cuts in products |
US10363389B2 (en) | 2009-04-03 | 2019-07-30 | Scientia Vascular, Llc | Micro-fabricated guidewire devices having varying diameters |
US8795254B2 (en) | 2008-12-10 | 2014-08-05 | Boston Scientific Scimed, Inc. | Medical devices with a slotted tubular member having improved stress distribution |
WO2010067875A1 (en) | 2008-12-11 | 2010-06-17 | 株式会社カネカ | Medical tube |
US8444577B2 (en) | 2009-01-05 | 2013-05-21 | Cook Medical Technologies Llc | Medical guide wire |
US20100228150A1 (en) * | 2009-03-05 | 2010-09-09 | Lake Region Medical, Inc. | Neuro guidewire |
US20100234816A1 (en) | 2009-03-13 | 2010-09-16 | Cook Incorporated | Coated wire guide and method of making same |
KR101512539B1 (en) | 2009-03-19 | 2015-04-15 | 니혼라이프라인 가부시키가이샤 | Medical guide wire |
US9067332B2 (en) | 2009-04-03 | 2015-06-30 | Scientia Vascular, Llc | Micro-fabricated catheter devices formed with hybrid materials |
US9616195B2 (en) | 2009-04-03 | 2017-04-11 | Scientia Vascular, Llc | Micro-fabricated catheter devices having varying diameters |
US9950137B2 (en) | 2009-04-03 | 2018-04-24 | Scientia Vascular, Llc | Micro-fabricated guidewire devices formed with hybrid materials |
US9067333B2 (en) | 2009-04-03 | 2015-06-30 | Scientia Vascular, Llc | Micro-fabricated guidewire devices having elastomeric fill compositions |
CA2757655C (en) | 2009-04-03 | 2019-05-07 | Edward J. Snyder | Guidewires and catheters for use in surgical procedures |
US20100256604A1 (en) | 2009-04-03 | 2010-10-07 | Scientia Vascular, Llc | Micro-fabricated Catheter Devices Formed Having Elastomeric Compositions |
US20100256603A1 (en) | 2009-04-03 | 2010-10-07 | Scientia Vascular, Llc | Micro-fabricated Catheter Devices Formed Having Elastomeric Fill Compositions |
JP5639580B2 (en) | 2009-04-14 | 2014-12-10 | テルモ株式会社 | Medical guidewire |
JP4863321B2 (en) | 2009-06-16 | 2012-01-25 | 朝日インテック株式会社 | Medical guidewire |
JP4993632B2 (en) | 2009-06-16 | 2012-08-08 | 朝日インテック株式会社 | Medical guidewire |
US8409169B1 (en) | 2009-06-18 | 2013-04-02 | Gerald Moss | Catheter and method of making the same |
JP5534727B2 (en) | 2009-07-15 | 2014-07-02 | 三桜工業株式会社 | Metal tube exposure method for resin-coated metal tubes |
US8118817B2 (en) | 2009-07-21 | 2012-02-21 | Cook Medical Technologies Llc | Detachable embolization coil |
JP4913198B2 (en) | 2009-10-27 | 2012-04-11 | 株式会社パテントストラ | Medical guide wire, method for manufacturing medical guide wire, assembly of medical guide wire, microcatheter and guiding catheter, and assembly of medical guide wire, balloon catheter and guiding catheter |
US8137293B2 (en) | 2009-11-17 | 2012-03-20 | Boston Scientific Scimed, Inc. | Guidewires including a porous nickel-titanium alloy |
JP5004256B2 (en) | 2009-12-25 | 2012-08-22 | 朝日インテック株式会社 | Medical guidewire |
US20110160680A1 (en) | 2009-12-29 | 2011-06-30 | Cook Incorporated | Wire guide with cannula |
JP5146970B2 (en) | 2010-01-21 | 2013-02-20 | 朝日インテック株式会社 | Medical guidewire |
US8357140B2 (en) | 2010-01-29 | 2013-01-22 | Cordis Corporation | Highly flexible tubular device with high initial torque response for medical use |
US8454535B2 (en) | 2010-01-29 | 2013-06-04 | Cordis Corporation | Highly flexible tubular device for medical use |
JP2011206175A (en) | 2010-03-29 | 2011-10-20 | Terumo Corp | Guide wire |
EP2552530A1 (en) | 2010-03-31 | 2013-02-06 | Boston Scientific Scimed, Inc. | Guidewire with a flexural rigidity profile |
US9795765B2 (en) | 2010-04-09 | 2017-10-24 | St. Jude Medical International Holding S.À R.L. | Variable stiffness steering mechanism for catheters |
US8870863B2 (en) | 2010-04-26 | 2014-10-28 | Medtronic Ardian Luxembourg S.A.R.L. | Catheter apparatuses, systems, and methods for renal neuromodulation |
EP2613735B1 (en) | 2010-09-10 | 2018-05-09 | Covidien LP | Devices for the treatment of vascular defects |
US8480598B2 (en) | 2010-09-14 | 2013-07-09 | Abbott Cardiovascular Systems Inc. | Guide wire with soldered multilayer coil member |
US8500658B2 (en) | 2010-10-28 | 2013-08-06 | Abbott Cardiovascular Systems Inc. | Nickel-titanium core guide wire |
CN102560491A (en) | 2010-12-30 | 2012-07-11 | 鸿富锦精密工业(深圳)有限公司 | Aluminium and aluminium alloy surface antiseptic treatment method and product prepared by same |
JP5382953B2 (en) | 2011-01-28 | 2014-01-08 | 朝日インテック株式会社 | Guide wire |
WO2012106628A1 (en) | 2011-02-04 | 2012-08-09 | Boston Scientific Scimed, Inc. | Guidewires and methods for making and using the same |
US8622934B2 (en) | 2011-04-25 | 2014-01-07 | Medtronic Vascular, Inc. | Guidewire with two flexible end portions and method of accessing a branch vessel therewith |
US20130116705A1 (en) * | 2011-05-03 | 2013-05-09 | Amr Salahieh | Steerable Delivery Sheaths |
US9072874B2 (en) | 2011-05-13 | 2015-07-07 | Boston Scientific Scimed, Inc. | Medical devices with a heat transfer region and a heat sink region and methods for manufacturing medical devices |
JP5382881B2 (en) | 2011-06-15 | 2014-01-08 | 朝日インテック株式会社 | Guide wire |
JP2013013449A (en) | 2011-06-30 | 2013-01-24 | Asahi Intecc Co Ltd | Guidewire |
US8676301B2 (en) | 2011-07-14 | 2014-03-18 | Med Works Limited | Guide wire incorporating a handle |
WO2013058962A1 (en) | 2011-10-18 | 2013-04-25 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
US20130110000A1 (en) | 2011-10-31 | 2013-05-02 | Terumo Medical Corporation | Dual Diameter Introducer Guide Wire |
US20130123714A1 (en) | 2011-11-15 | 2013-05-16 | Boston Scientific Scimed, Inc. | Vessel protection membrane |
WO2013100045A1 (en) | 2011-12-28 | 2013-07-04 | テルモ株式会社 | Guide wire |
WO2013105099A2 (en) | 2012-01-15 | 2013-07-18 | Triticum Ltd. | Device and method for removing occlusions in a biological vessel |
WO2013118649A1 (en) | 2012-02-07 | 2013-08-15 | テルモ株式会社 | Guide wire |
US10029076B2 (en) | 2012-02-28 | 2018-07-24 | Covidien Lp | Intravascular guidewire |
US9364640B2 (en) | 2012-05-07 | 2016-06-14 | St. Jude Medical Atrial Fibrillation Division, Inc. | Medical device guidewire with helical cutout and coating |
US20130304108A1 (en) * | 2012-05-08 | 2013-11-14 | Daniel C. Weber | Systems and apparatus for treating blood vessels and related methods |
US9138566B2 (en) | 2012-05-13 | 2015-09-22 | Bendit Technologies Ltd. | Steering tool |
EP2740400A4 (en) | 2012-06-22 | 2016-01-27 | Olympus Corp | Bending tube and medical instrument |
US20140005558A1 (en) | 2012-06-29 | 2014-01-02 | Boston Scientific Scimed, Inc. | Pressure sensing guidewire |
US9968762B2 (en) | 2012-08-08 | 2018-05-15 | Cook Medical Technologies Llc | Wire guide with multiple tips |
DE102012214785A1 (en) | 2012-08-20 | 2014-02-20 | Epflex Feinwerktechnik Gmbh | Medical guide wire with MR marker |
US20140094787A1 (en) | 2012-09-28 | 2014-04-03 | Boston Scientific Scimed, Inc. | Flexible renal nerve modulation device |
WO2014066104A1 (en) | 2012-10-25 | 2014-05-01 | Boston Scientific Scimed, Inc. | Dual function medical devices |
CA2891113C (en) | 2012-11-14 | 2018-03-06 | Hollister Incorporated | Urinary catheters having varying flexibility |
US9433752B2 (en) | 2012-11-14 | 2016-09-06 | Biosense Webster (Israel) Ltd. | Catheter with flat beam deflection in tip |
US11400261B2 (en) | 2012-11-21 | 2022-08-02 | Concert Medical, Llc | Preformed guidewire |
US9474850B2 (en) | 2012-12-11 | 2016-10-25 | Biosense Webster (Israel) Ltd. | Lasso catheter with guide wire |
WO2014105578A1 (en) | 2012-12-27 | 2014-07-03 | Volcano Corporation | Intravascular guidewire with hyper flexible distal end portion |
US9848882B2 (en) | 2013-03-08 | 2017-12-26 | Scientia Vascular, Llc | Micro-fabricated embolic devices |
US9808311B2 (en) | 2013-03-13 | 2017-11-07 | Boston Scientific Scimed, Inc. | Deflectable medical devices |
CN105209102B (en) | 2013-03-15 | 2018-10-02 | 波士顿科学国际有限公司 | Pressure-sensing seal wire |
JP5814287B2 (en) * | 2013-03-25 | 2015-11-17 | 株式会社フジクラ | Guide wire |
WO2014162393A1 (en) | 2013-04-01 | 2014-10-09 | テルモ株式会社 | Guide wire |
EP3693052A1 (en) | 2013-07-03 | 2020-08-12 | Boston Scientific Scimed Inc. | Guidewire |
CN105682729B (en) | 2013-10-25 | 2019-06-18 | 直观外科手术操作公司 | The flexible instrument of controllable pipe with trough of belt |
EP3079597B1 (en) | 2013-12-13 | 2023-07-26 | Intuitive Surgical Operations, Inc. | Telescoping biopsy needle |
WO2015120155A1 (en) | 2014-02-06 | 2015-08-13 | Boston Scientific Scimed, Inc. | Occlusion device detachable by inflation of a balloon |
JP6294211B2 (en) | 2014-02-24 | 2018-03-14 | 朝日インテック株式会社 | Guide wire |
DE202014100863U1 (en) | 2014-02-26 | 2014-03-14 | Cormedics Medizintechnik GmbH | Guidewire for medical devices |
JPWO2015141290A1 (en) | 2014-03-19 | 2017-04-06 | テルモ株式会社 | Guide wire |
JP6251903B2 (en) | 2014-03-24 | 2017-12-27 | グンゼ株式会社 | Medical guidewire |
JP6109108B2 (en) | 2014-03-26 | 2017-04-05 | 大和ハウス工業株式会社 | Power supply system |
EP3072436A4 (en) | 2014-04-08 | 2017-09-13 | Olympus Corporation | Endoscope |
US20150306355A1 (en) | 2014-04-28 | 2015-10-29 | Mark Edman Idstrom | Guidewires with variable rigidity |
US11413017B2 (en) | 2014-04-28 | 2022-08-16 | Philips Image Guided Therapy Corporation | Pre-doped solid substrate for intravascular devices |
WO2016047499A1 (en) | 2014-09-26 | 2016-03-31 | テルモ株式会社 | Guide wire |
JP2016077765A (en) | 2014-10-22 | 2016-05-16 | 朝日インテック株式会社 | Guide wire |
EP3034126B1 (en) | 2014-11-13 | 2021-05-26 | Cook Medical Technologies LLC | Subintimal crossing wire guide |
US10518066B2 (en) | 2015-01-09 | 2019-12-31 | Mivi Neuroscience, Inc. | Medical guidewires for tortuous vessels |
JP6746503B2 (en) | 2015-01-23 | 2020-08-26 | テルモ株式会社 | Guide wire |
US11020017B2 (en) | 2015-02-16 | 2021-06-01 | Biosense Webster (Israel) Ltd. | Angioplasty guidewire |
WO2016136609A1 (en) | 2015-02-27 | 2016-09-01 | 二プロ株式会社 | Guide wire |
WO2016152194A1 (en) | 2015-03-20 | 2016-09-29 | テルモ株式会社 | Guide wire |
JP2016189998A (en) | 2015-03-31 | 2016-11-10 | 東レ・メディカル株式会社 | Guide wire for catheter |
US10305286B2 (en) | 2015-08-14 | 2019-05-28 | Solarcity Corporation | Multiple inverter power control systems in an energy generation system |
US10639456B2 (en) | 2015-09-28 | 2020-05-05 | Microvention, Inc. | Guidewire with torque transmission element |
CN105545375B (en) | 2015-12-14 | 2017-03-08 | 中国燃气涡轮研究院 | Twin beams finger sealing device |
WO2017123945A1 (en) | 2016-01-15 | 2017-07-20 | Boston Scientific Scimed, Inc. | Slotted tube with planar steering |
JP2017169253A (en) | 2016-03-14 | 2017-09-21 | 日立マクセル株式会社 | Power factor improvement device, and power storage device including the same |
US10252024B2 (en) | 2016-04-05 | 2019-04-09 | Stryker Corporation | Medical devices and methods of manufacturing same |
US11207502B2 (en) | 2016-07-18 | 2021-12-28 | Scientia Vascular, Llc | Guidewire devices having shapeable tips and bypass cuts |
US11052228B2 (en) | 2016-07-18 | 2021-07-06 | Scientia Vascular, Llc | Guidewire devices having shapeable tips and bypass cuts |
US11324495B2 (en) | 2016-07-29 | 2022-05-10 | Cephea Valve Technologies, Inc. | Systems and methods for delivering an intravascular device to the mitral annulus |
US10821268B2 (en) | 2016-09-14 | 2020-11-03 | Scientia Vascular, Llc | Integrated coil vascular devices |
JP6842933B2 (en) | 2017-01-20 | 2021-03-17 | テルモ株式会社 | Guide wire and manufacturing method of guide wire |
CN110944706B (en) | 2017-05-26 | 2022-08-12 | 血管科学有限公司 | Core wire joint for micro-machined medical instruments |
EP3842091B1 (en) | 2017-05-26 | 2023-09-13 | Scientia Vascular, Inc. | Micro-fabricated medical device having a non-helical cut arrangement |
US11305095B2 (en) | 2018-02-22 | 2022-04-19 | Scientia Vascular, Llc | Microfabricated catheter having an intermediate preferred bending section |
US11285294B2 (en) | 2018-08-17 | 2022-03-29 | Cook Medical Technologies Llc | Introducer with sheath having a withdrawal support wire |
CN113710304A (en) | 2019-04-24 | 2021-11-26 | 洛桑联邦理工学院 | Enhanced torque steerable guidewire |
US20200345975A1 (en) | 2019-05-02 | 2020-11-05 | Scientia Vascular, Llc | Intravascular device with enhanced one-beam cut pattern |
US20210346656A1 (en) | 2020-01-23 | 2021-11-11 | Scientia Vascular, Llc | High torque guidewire device |
US20210228845A1 (en) | 2020-01-23 | 2021-07-29 | Scientia Vascular, Llc | Guidewire having enlarged, micro-fabricated distal section |
-
2017
- 2017-12-20 US US15/848,878 patent/US11452541B2/en active Active
- 2017-12-21 JP JP2019532744A patent/JP7069172B2/en active Active
- 2017-12-21 KR KR1020197021482A patent/KR20190097243A/en not_active Application Discontinuation
- 2017-12-21 WO PCT/US2017/068056 patent/WO2018119334A1/en unknown
- 2017-12-21 AU AU2017382303A patent/AU2017382303A1/en not_active Abandoned
- 2017-12-21 CA CA3046654A patent/CA3046654A1/en not_active Abandoned
- 2017-12-21 CN CN201780080324.2A patent/CN110099713B/en active Active
- 2017-12-21 EP EP17882475.1A patent/EP3558435A4/en active Pending
-
2022
- 2022-08-10 US US17/885,302 patent/US20220378459A1/en active Pending
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20170234411A1 (en) * | 2014-08-27 | 2017-08-17 | Steerable Instruments nv | Torque-transmitting steering mechanism for a steerable tool |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11951267B2 (en) | 2016-07-18 | 2024-04-09 | Scientia Vascular, Inc. | Guidewire devices having shapeable tips and bypass cuts |
Also Published As
Publication number | Publication date |
---|---|
CN110099713A (en) | 2019-08-06 |
CA3046654A1 (en) | 2018-06-28 |
EP3558435A4 (en) | 2020-11-04 |
JP2020512048A (en) | 2020-04-23 |
CN110099713B (en) | 2022-07-01 |
KR20190097243A (en) | 2019-08-20 |
EP3558435A1 (en) | 2019-10-30 |
AU2017382303A1 (en) | 2019-07-11 |
JP7069172B2 (en) | 2022-05-17 |
US20180177517A1 (en) | 2018-06-28 |
WO2018119334A1 (en) | 2018-06-28 |
US11452541B2 (en) | 2022-09-27 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US20220378459A1 (en) | Intravascular device having a selectively defectable tip | |
JP7399206B2 (en) | Guidewire device with moldable tip and bypass notch | |
US20210008351A1 (en) | Integrated coil vascular devices | |
US20220280147A1 (en) | Micro-fabricated medical device having a non-helical cut arrangement | |
JP2020512048A5 (en) | ||
US20160074627A1 (en) | Vascular Re-entry Catheter | |
US20240123196A1 (en) | Guidewire devices having distally extending coils and shapeable tips | |
JP2024081798A (en) | GUIDEWIRE DEVICE HAVING DISTALLY EXTENDING COIL AND SHAPABLE TIP - Patent application |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
STPP | Information on status: patent application and granting procedure in general |
Free format text: DOCKETED NEW CASE - READY FOR EXAMINATION |
|
STPP | Information on status: patent application and granting procedure in general |
Free format text: NON FINAL ACTION MAILED |
|
AS | Assignment |
Owner name: SCIENTIA VASCULAR, INC., UTAH Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:LIPPERT, JOHN A.;SNYDER, EDWARD J.;REEL/FRAME:066484/0250 Effective date: 20221025 |
|
STPP | Information on status: patent application and granting procedure in general |
Free format text: RESPONSE TO NON-FINAL OFFICE ACTION ENTERED AND FORWARDED TO EXAMINER |
|
STPP | Information on status: patent application and granting procedure in general |
Free format text: FINAL REJECTION MAILED |