WO1992003963A1 - Deformable and removable sheath for optical catheter - Google Patents

Deformable and removable sheath for optical catheter Download PDF

Info

Publication number
WO1992003963A1
WO1992003963A1 PCT/US1991/006107 US9106107W WO9203963A1 WO 1992003963 A1 WO1992003963 A1 WO 1992003963A1 US 9106107 W US9106107 W US 9106107W WO 9203963 A1 WO9203963 A1 WO 9203963A1
Authority
WO
WIPO (PCT)
Prior art keywords
sheath
body
catheter
passageway
patient
Prior art date
Application number
PCT/US1991/006107
Other languages
French (fr)
Inventor
Edwin L. Adair
Original Assignee
Adair Edwin Lloyd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority to US58159190A priority Critical
Priority to US581,591 priority
Application filed by Adair Edwin Lloyd filed Critical Adair Edwin Lloyd
Publication of WO1992003963A1 publication Critical patent/WO1992003963A1/en

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105Steering means as part of the catheter or advancing means; Markers for positioning
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00064Constructional details of the endoscope body
    • A61B1/00071Insertion part of the endoscope body
    • A61B1/00078Insertion part of the endoscope body with stiffening means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/00131Accessories for endoscopes
    • A61B1/00135Oversleeves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/005Flexible endoscopes
    • A61B1/01Guiding arrangements therefore
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/30Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure
    • A61B2090/306Devices for illuminating a surgical field, the devices having an interrelation with other surgical devices or with a surgical procedure using optical fibres
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/02General characteristics of the apparatus characterised by a particular materials
    • A61M2205/0266Shape memory materials
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M3/00Medical syringes, e.g. enemata; Irrigators
    • A61M3/02Enemata; Irrigators
    • A61M3/0279Cannula; Nozzles; Tips; their connection means

Abstract

A deformable sheath (S) for an optical catheter includes an elongated, deformable hollow body (12) having a normal predetermined shape which is compatible with its intended use in situ in a passageway in the patient. The body (12) has a distal end (14) and a proximate end (16) with a plurality of channels extending therebetween. An optical catheter (C) extends through one (28) of the channels in the body, having a distal end aligned with the distal end of the body and a proximate end extending outwardly beyond the proximate end of the body, the catheter assuming the normal shape of the body. A substantially rigid guide wire (W) is extendable through a second (20) of the channels to straighten the body during insertion of the sheath into a passageway within the patient. This guide wire (W) is removable from the body after insertion so that the body resumes its normal predetermined shape. The sheath can include a third channel for insertion of a laser fiber (30) for laser lithotripsy or an electrohydraulic probe to fracture stones. A lock coupler (22) is attached to the proximate end (16) of the body (12) for attachment to a fitting to properly align and connect the sheath and its catheter and other instruments with external instrumentation.

Description

DEFORMABLE AND REMOVABLE SHEATH FOR OPTICAL CATHETER

Tec n: :al Field

The present invention relates to a deformable and removable sheath and more particularly to a deformable and removable sheath for use with an optical catheter which can be straightened by a guide wire for insertion in the passageway leading to a body cavity of a patient and can be returned to its original shape after insertion by removal of the guide wire.

Background Art

Most optical catheters on the market today are made in a conventional manner wherein they include an elongated body or shaft containing both image fibers and light carrying fibers. The catheter may also have additional passageways for irrigation and/or for conducting operative or investigative procedures. Sometimes it also will be provided with a steering mechanism for pointing the distal end thereof. Most optical catheters are configured in a shape to do one specific examination. For example, one may be a flexible cysto-urethroscope for examination of the lower genitourinary tract. Another may be a bronchoscope for looking into the respiratory tract. Still another may be a flexible hysteroscope for looking into the uterus. Once any of these devices is manufactured, it is locked into that configuration and generally can only be used for the purpose for which it was constructed. In other words, it is not adaptable for other types of examinations. An exception to this is that in rare instances one may use a flexible hysteroscope for looking into the bladder. If this is done only because the regular scope is broken or unavailable, or done by mistake.

There also is a device now available for looking the nasal sinuses. This is a small flexible scope which has an eyepiece, a steering mechanism for changing direction of the device to allow its manipulation into a sinus opening and a light connector. However, it cannot be used for any other purpose.

Because of the necessity for providing a variety of types and styles of catheters, the cost invested in optical catheters can be quite high, inasmuch as they are not interchangeable.

Disclosure of the Invention

A deformable sheath for an optical catheter is provided which includes an elongated, deformable hollow body having a normal predetermined shape which is compatible with its intended use in situ in a passageway in the patient. The body has a distal end and a proximate end with a plurality of channels extending therebetween. An optical catheter extends through one of the channels in the body, having a distal end aligned with the distal end of the body and a proximate end extending outwardly beyond the proximate end of the body, the catheter assuming the normal shape of the body. A substantially rigid guide wire is provided which is extendable through a second of the channels to straightened the body during insertion of the sheath into a passageway within the patient. This guide wire is removable from the body after insertion so that the body resumes its normal predetermined shape. The sheath can include a third channel for insertion of a laser fiber or laser lithotripsy or an electrohydraulic probe to fracture stones. A lock coupler is attached to the proximate end of the body for attachment to a fitting to properly align and connect the sheath and its catheter to external instrumentation.

The guide wire can comprise a long slender body having a distal end and a proximate end receivable in the sheath body. A hand""e is attached to the proximate end of the gu a wire body to aid in inserting and withdrawing the guide wire from the sheath.

With this invention, it can be seen that deformable sheaths of the type just described can be provided each having a different natural shape depending on its intended use. The catheter, which is quite expensive, can be removed from one sheath after use for one purpose and inserted in another sheath for use for another purpose. The sheath, which is inexpensive, can be disposable to minimize the transfer of disease or infection from one patient to the next.

Additional advantages of this invention will become apparent from the description which follows, taken in conjunction with the accompanying drawings.

Brief Description of the Drawing's

Figure 1 is a perspective view showing a deformable and removable sheath and guide wire constructed in accordance with this invention for use with an optical catheter attached to a console;

Figure 2 is a perspective view of the deformable and removable sheath of Figure 1 with the guide wire in place;

Figure 3 is a perspect 2 view of the deformable and removable sheath with t e guide wire removed; Figure 4 is an enlarged vertical section, taken along line 4-4 of Figure 2, showing the interior of the guide wire with the sheath and catheter in place; and Figure 5 is an enlarged perspective view of the proximate end of the deformable and removable sheath.

Best Mode For Carrying Out the Invention

In accordance with this invention, a sheath S is provided which may have a preformed shape as shown in Figure 1 which is compatible with the shape of the passageway of a patient in which it is to be used. This sheath S can be slid over catheter C which is removably connected to a console 10, such as the type shown in U.S. Patent No. 4,589,404. Since the catheter is flexible, it will assume the shape of sheath S when inserted therein. However, for insertion of the catheter and sheath into the passageway of the patient, a guide wire W is provided. Conveniently, the sheath S has a body 12 which has an open distal end 14 and a connector 16 at the proximate end. As best seen in Figure 5, connector 16 has a central opening 18 for receiving the catheter C and a side opening 20 for receiving guide wire W. The central opening 18 is formed in a lock coupler in the form of a female luer lock 22 to allow attachment to a fitting which has a male luer adaptor so that the catheter will be positioned in a fixed position within the sleeve. The side opening 20 can receive the body 24 of guide wire W which is inserted and withdrawn by means of handle 26 on the proximate end thereof. Once inserted the guide wire W will straighten out the sheath to the position shown in Figure 2 for easy insertion into a passageway in a patient's body. As best seen in Figure 4, catheter C is received in a channel 28 within sheath body 12. Conveniently, channel 28 can also receive devices, such as a laser fiber 30 for lithotripsy. Similarly, an irrigation passageway 32 can be provided. A fiber optic bundle 34 is also provided which may include one or more optic fibers for transmitting light from console 10 to the distal end of the catheter C to illuminate the site under investigation. In addition, bundle 34 will contain coherent fibers to project an image to a video screen (not shown) associated with console 10. When inserted, these elements will extend through channel 28 to the distal end 14 of sheath S. Once the sheath with the catheter and guide wire have been inserted into the passageway of the patient so that the distal end 14 of the sheath is properly positioned within a body cavity for observation and/or treatment, guide wire W is withdrawn and the sheath returns to its normal position, as shown in Figures 1 and 3 which conforms to the particular passageway for which it was designed. Of course, if observation and/or treatment is desired in a different bodily passageway, then a different sheath will be used with the same catheter and guide wire in the manner just described.

It will be understood from the foregoing, that preformed sleeves can be provided which are made of any shape, any diameter and almost any length. The shape given to the sleeve is dependant upon its use. For example, one curve is imparted to the body of the sheath for viewing the inside upper pole calys of the kidney. Still another shape is given to a sleeve for use with a catheter for viewing the inside of the middle calys. Still a third shape is used for viewing the inside lower calys of the kidney.

This invention has been described in detail with reference to a particular embodiment thereof, but it will be understood that various other modifications can be effected within the spirit and scope of this invention.

Claims

CLAIMSin the claims:
1. Apparatus having a deformable and removable sheath, for use with an optical catheter wherein said sheath with a catheter therein is to be positioned in a passageway leading to a body cavity of a patient for observation and/or treatment, said apparatus comprising: an elongated, deformable, hollow body having a normal predetermined shape which is compatible with its intended use in situ, said body having a distal end, a proximate end and a plurality of channels extending from said proximate end to said distal end; an optical catheter extendable through one of said channels in said body, having a distal end aligned with said distal end of said body and a proximate end extending outwardly beyond said proximate end of said body, said catheter assuming the normal shape of said body; and a substantially rigid guide wire extendable through a second of said channels to straighten said body during insertion of said sheath in the passageway of the patient and removable from said body after insertion so that said body resumes its normal predetermined shape in the passageway.
2. Apparatus, as claimed in Claim 1, further including: a third channel for insertion of additional devices, such as a laser fiber for laser lithotripsy or an electrohydraulic probe to fracture stones; and a lock coupler attached to said proximate end of said body for attachment to a fitting to properly align and connect said sheath and its catheter and other instruments with external instrumentation.
3. Apparatus, as claimed in Claim 2, wherein said lock coupler includes: a central opening for receiving the catheter; and a side opening for receiving the guide wire.
4. Apparatus, as claimed in Claim 1, wherein: said guide wire comprises: a long, slender, substantially rigid body, having a distal end and a proximate end, receivable in said sheath body; and a handle attached to said proximate end of said guide wire body to aid in inserting and withdrawing said guide wire from said sheath.
5. Apparatus, as claimed in Claim 1, wherein: said sheath is disposable after each use.
6. A method of using an optical catheter in successive investigative and/or operative procedures, said method comprising the steps of: inserting a flexible optical catheter into an elongated sheath; inserting the sheath with the catheter in place therein into a passageway in the body of the patient; causing the sheath to assume a desired shape or orientation to properly position the catheter; conducting an investigative and/or operative procedure; removing the used sheath with the catheter in place therein from the passageway in the body of the patient; removing the catheter from the used sheath; and disposing of the used sheath.
7. A method, as claimed in Claim 6, including the further steps of: inserting the catheter in a new sheath; and repeating the steps of Claim 6.
8. A method of using an optical catheter in successive investigative and/or operative procedures, said method comprising the steps of: inserting a stiff wire into a flexible, elongated sheath, which has a predetermined curved shape which conforms to a specific passageway in the body of a patient, to straighten the sheath; inserting a flexible optical catheter into the sheath along side of the wire; inserting the sheath with the wire and catheter in place therein into a passageway in the body of a patient having the same shape as the predetermined curve of the sheath; removing the wire from the sheath so that the sheath and the catheter therein return to the predetermined shape of the sheath which now conforms with the shape of the passageway; conducting an investigative and/or operative procedure; removing the used sheath with the catheter in place therein from the passageway in the body of the patient; removing the catheter from the used sheath; and disposing of the used sheath.
9. A method, as claimed in Claim 8, including the further steps of: inserting the catheter in a new sheath; and repeating the steps of Claim 8.
PCT/US1991/006107 1990-09-12 1991-08-27 Deformable and removable sheath for optical catheter WO1992003963A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
US58159190A true 1990-09-12 1990-09-12
US581,591 1990-09-12

Publications (1)

Publication Number Publication Date
WO1992003963A1 true WO1992003963A1 (en) 1992-03-19

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1991/006107 WO1992003963A1 (en) 1990-09-12 1991-08-27 Deformable and removable sheath for optical catheter

Country Status (2)

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CA (1) CA2050204A1 (en)
WO (1) WO1992003963A1 (en)

Cited By (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4223897A1 (en) * 1992-07-21 1994-01-27 Wolfgang Daum Flexible tubes for instruments such as used in endoscopy - consists of super flexible tubes which can be inserted one inside another to penetrate otherwise inaccessible regions
US5351678A (en) * 1992-09-01 1994-10-04 Citation Medical Corporation Endoscope scope assembly for full hemisphere view
US5456245A (en) * 1993-09-20 1995-10-10 Sofamor Danek Properties, Inc. Flexible endoscope probe and method of manufacture
WO1997037601A1 (en) * 1996-04-04 1997-10-16 Somatex Medizintechnische Instrumente Gmbh Laser applicator set
WO2000069500A1 (en) * 1999-05-14 2000-11-23 Boston Scientific Limited Guide wire insertion and re-insertion tools and methods of use
US6312404B1 (en) 1996-09-13 2001-11-06 Boston Scientific Corporation Single operator exchange billiary catheter
US6346093B1 (en) 1996-09-13 2002-02-12 Scimed Life Systems, Inc. Single operator exchange biliary catheter with common distal lumen
US6520951B1 (en) 1996-09-13 2003-02-18 Scimed Life Systems, Inc. Rapid exchange catheter with detachable hood
US6582401B1 (en) 1996-09-13 2003-06-24 Scimed Life Sytems, Inc. Multi-size convertible catheter
US6585641B1 (en) * 2000-11-02 2003-07-01 Ge Medical Systems Global Technology Company, Llc Transesophageal probe with variable stiffness
US6663597B1 (en) 1996-09-13 2003-12-16 Boston Scientific Corporation Guidewire and catheter locking device and method
US6764484B2 (en) 2001-03-30 2004-07-20 Scimed Life Systems, Inc. C-channel to o-channel converter for a single operator exchange biliary catheter
GB2404592A (en) * 2003-08-05 2005-02-09 Abdel Taguri A cannula
US7811250B1 (en) 2000-02-04 2010-10-12 Boston Scientific Scimed, Inc. Fluid injectable single operator exchange catheters and methods of use
US8343041B2 (en) 2008-05-19 2013-01-01 Boston Scientific Scimed, Inc. Integrated locking device with passive sealing
US8388521B2 (en) 2008-05-19 2013-03-05 Boston Scientific Scimed, Inc. Integrated locking device with active sealing
US8480629B2 (en) 2005-01-28 2013-07-09 Boston Scientific Scimed, Inc. Universal utility board for use with medical devices and methods of use
US8888681B2 (en) 2007-01-03 2014-11-18 Boston Scientific Scimed, Inc. Method and apparatus for biliary access and stone retrieval
US9352124B2 (en) 2001-08-14 2016-05-31 Boston Scientific Scimed, Inc. Method of and apparatus for positioning and maintaining the position of endoscopic instruments
EP2898815A4 (en) * 2012-07-13 2016-08-03 Masashi Kimura Guide tube, guide device, and method for using guide device

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0132344A2 (en) * 1983-07-20 1985-01-30 Purdue Research Foundation Improved catheter based cardiac output sensor
US4589404A (en) * 1984-01-03 1986-05-20 Medical Dynamics, Inc. Laser endoscope
US4882777A (en) * 1987-04-17 1989-11-21 Narula Onkar S Catheter
EP0347170A1 (en) * 1988-06-13 1989-12-20 Indianapolis Center for Advanced Research Inc. Catheter system
FR2653657A1 (en) * 1989-10-26 1991-05-03 Croisy Renaud Endoscope for carrying out an examination and operation in a cavity of the human body by means of laser shots

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0132344A2 (en) * 1983-07-20 1985-01-30 Purdue Research Foundation Improved catheter based cardiac output sensor
US4589404A (en) * 1984-01-03 1986-05-20 Medical Dynamics, Inc. Laser endoscope
US4882777A (en) * 1987-04-17 1989-11-21 Narula Onkar S Catheter
EP0347170A1 (en) * 1988-06-13 1989-12-20 Indianapolis Center for Advanced Research Inc. Catheter system
FR2653657A1 (en) * 1989-10-26 1991-05-03 Croisy Renaud Endoscope for carrying out an examination and operation in a cavity of the human body by means of laser shots

Cited By (28)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4223897C2 (en) * 1992-07-21 1999-05-12 Daum Gmbh A tubular transport arm
DE4223897A1 (en) * 1992-07-21 1994-01-27 Wolfgang Daum Flexible tubes for instruments such as used in endoscopy - consists of super flexible tubes which can be inserted one inside another to penetrate otherwise inaccessible regions
US5351678A (en) * 1992-09-01 1994-10-04 Citation Medical Corporation Endoscope scope assembly for full hemisphere view
US5456245A (en) * 1993-09-20 1995-10-10 Sofamor Danek Properties, Inc. Flexible endoscope probe and method of manufacture
US6283958B1 (en) 1996-04-04 2001-09-04 Somatex Medizintechnische Instrumente Gmbh Laser applicator set
WO1997037601A1 (en) * 1996-04-04 1997-10-16 Somatex Medizintechnische Instrumente Gmbh Laser applicator set
US6312404B1 (en) 1996-09-13 2001-11-06 Boston Scientific Corporation Single operator exchange billiary catheter
US6606515B1 (en) 1996-09-13 2003-08-12 Scimed Life Systems, Inc. Guide wire insertion and re-insertion tools and methods of use
US6346093B1 (en) 1996-09-13 2002-02-12 Scimed Life Systems, Inc. Single operator exchange biliary catheter with common distal lumen
US6520951B1 (en) 1996-09-13 2003-02-18 Scimed Life Systems, Inc. Rapid exchange catheter with detachable hood
US6582401B1 (en) 1996-09-13 2003-06-24 Scimed Life Sytems, Inc. Multi-size convertible catheter
US6997908B2 (en) 1996-09-13 2006-02-14 Scimed Life Systems, Inc. Rapid exchange catheter with detachable hood
US6663597B1 (en) 1996-09-13 2003-12-16 Boston Scientific Corporation Guidewire and catheter locking device and method
WO2000069500A1 (en) * 1999-05-14 2000-11-23 Boston Scientific Limited Guide wire insertion and re-insertion tools and methods of use
US7811250B1 (en) 2000-02-04 2010-10-12 Boston Scientific Scimed, Inc. Fluid injectable single operator exchange catheters and methods of use
US6585641B1 (en) * 2000-11-02 2003-07-01 Ge Medical Systems Global Technology Company, Llc Transesophageal probe with variable stiffness
US8721623B2 (en) 2001-03-30 2014-05-13 Boston Scientific Scimed, Inc. C-channel to O-channel converter for a single operator exchange biliary catheter
US7160283B2 (en) 2001-03-30 2007-01-09 Boston Scientific Scimed, Inc. C-channel to O-channel converter for a single operator exchange biliary catheter
US7905876B2 (en) 2001-03-30 2011-03-15 Boston Scientific Scimed, Inc. C-channel to O-channel converter for a single operator exchange biliary catheter
US6764484B2 (en) 2001-03-30 2004-07-20 Scimed Life Systems, Inc. C-channel to o-channel converter for a single operator exchange biliary catheter
US9352124B2 (en) 2001-08-14 2016-05-31 Boston Scientific Scimed, Inc. Method of and apparatus for positioning and maintaining the position of endoscopic instruments
GB2404592A (en) * 2003-08-05 2005-02-09 Abdel Taguri A cannula
US8480629B2 (en) 2005-01-28 2013-07-09 Boston Scientific Scimed, Inc. Universal utility board for use with medical devices and methods of use
US8888681B2 (en) 2007-01-03 2014-11-18 Boston Scientific Scimed, Inc. Method and apparatus for biliary access and stone retrieval
US9131831B2 (en) 2008-02-11 2015-09-15 Boston Scientific Scimed, Inc. Integrated locking device with passive sealing
US8388521B2 (en) 2008-05-19 2013-03-05 Boston Scientific Scimed, Inc. Integrated locking device with active sealing
US8343041B2 (en) 2008-05-19 2013-01-01 Boston Scientific Scimed, Inc. Integrated locking device with passive sealing
EP2898815A4 (en) * 2012-07-13 2016-08-03 Masashi Kimura Guide tube, guide device, and method for using guide device

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