WO2017059186A1 - Catheter structure with improved support and related systems, methods and devices - Google Patents

Catheter structure with improved support and related systems, methods and devices Download PDF

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Publication number
WO2017059186A1
WO2017059186A1 PCT/US2016/054638 US2016054638W WO2017059186A1 WO 2017059186 A1 WO2017059186 A1 WO 2017059186A1 US 2016054638 W US2016054638 W US 2016054638W WO 2017059186 A1 WO2017059186 A1 WO 2017059186A1
Authority
WO
WIPO (PCT)
Prior art keywords
catheter
tube
distal
elongate members
shaft
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.)
Ceased
Application number
PCT/US2016/054638
Other languages
English (en)
French (fr)
Inventor
William Norman
Fernando Di Caprio
Gianfranco Panarello
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
QXMedical LLC
Original Assignee
QXMedical LLC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by QXMedical LLC filed Critical QXMedical LLC
Priority to EP25176215.9A priority Critical patent/EP4578480A3/en
Priority to EP16852671.3A priority patent/EP3355980B1/en
Priority to JP2018517167A priority patent/JP2018533392A/ja
Publication of WO2017059186A1 publication Critical patent/WO2017059186A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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
    • A61M25/06Body-piercing guide needles or the like
    • A61M25/0662Guide tubes
    • 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
    • A61M25/0133Tip steering devices
    • A61M25/0147Tip steering devices with movable mechanical means, e.g. pull wires
    • 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
    • A61M25/0043Catheters; Hollow probes characterised by structural features
    • A61M25/0045Catheters; Hollow probes characterised by structural features multi-layered, e.g. coated
    • 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
    • A61M25/0043Catheters; Hollow probes characterised by structural features
    • A61M25/005Catheters; Hollow probes characterised by structural features with embedded materials for reinforcement, e.g. wires, coils, braids
    • A61M25/0052Localized reinforcement, e.g. where only a specific part of the catheter is reinforced, for rapid exchange guidewire port
    • 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
    • A61M25/0043Catheters; Hollow probes characterised by structural features
    • A61M25/0054Catheters; Hollow probes characterised by structural features with regions for increasing flexibility
    • 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
    • A61M2025/0004Catheters; Hollow probes having two or more concentrically arranged tubes for forming a concentric catheter system
    • 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
    • A61M25/0043Catheters; Hollow probes characterised by structural features
    • A61M25/0045Catheters; Hollow probes characterised by structural features multi-layered, e.g. coated
    • A61M2025/0046Coatings for improving slidability
    • A61M2025/0047Coatings for improving slidability the inner layer having a higher lubricity
    • 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
    • A61M25/0043Catheters; Hollow probes characterised by structural features
    • A61M2025/0062Catheters; Hollow probes characterised by structural features having features to improve the sliding of one part within another by using lubricants or surfaces with low friction
    • 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
    • A61M2025/0175Introducing, guiding, advancing, emplacing or holding catheters having telescopic features, interengaging nestable members movable in relations to one another
    • 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
    • A61M25/0108Steering means as part of the catheter or advancing means; Markers for positioning using radio-opaque or ultrasound markers

Definitions

  • Patent 5,439,445 to Kontos and U.S. Patent 5,290,247 to Crittendon all show the use of a catheter having a tubular portion that extends or telescopes beyond the guiding catheter, and an elongated manipulation/insertion wire or shaft attached to the tubular portion to manipulate the tubular portion axially - in push / pull fashion - within the guiding catheter after it has been inserted through the hemostasis valve and into the guiding catheter.
  • the Adams '562 patent suggests that the proximal manipulation/insertion wire may actually be a low-diameter tubular shaft for conducting fluid to inflate and deflate a restriction balloon that restricts movement of the tubular portion.
  • Example 4 relates to the catheter according to Example 1, wherein the proximal shaft comprises at least one additional sheath segment, wherein each of the at least one additional sheath segments is disposed around a different length of the first and second elongate members.
  • Example 8 relates to the catheter according to Example 1, wherein the first elongate member is configured to extend distally into a first portion of the tubular wall, and further wherein the second elongate member is configured to extend distally into a second portion of the tubular wall.
  • Example 15 relates to the catheter according to Example 9, wherein the proximal shaft further comprises a distal opening in fluid communication with the shaft lumen, whereby the shaft lumen is in fluid communication with an area external to the catheter and proximal to the distal tube.
  • Example 17 relates to the catheter according to Example 1, further comprising at least one support member disposed in the proximal portion of the distal tube.
  • Example 19 relates to the catheter according to Example 1, wherein the proximal shaft comprises a third elongate member.
  • Example 24 relates to the catheter according to Example 1, wherein the first length of the first and second elongate members is a portion of an entire length of the first and second elongate members such that the first sheath segment is disposed around the portion of the entire length of the first and second elongate members.
  • Example 25 relates to the catheter according to Example 1, further comprising a second sheath segment disposed around a second length of the first and second elongate members such that the second length of the first and second elongate members is disposed within the second sheath segment, wherein the proximal shaft further comprises a first shaft lumen defined by the first sheath segment and a second shaft lumen defined by the second sheath segment.
  • FIG. 1 is an environmental view showing the use of one embodiment of the subject device in a conventional guiding catheter, which is used to perform various medical procedures.
  • FIG. 8A is a side view of an extension catheter showing the junction of the proximal and distal portions, according to one implementation.
  • FIG. 18 is a perspective view of a portion of a catheter with a support membrane, according to one embodiment.
  • the positioning and configuration of the distal portions 44, 46 of the rods 30, 32 in the connection zone 42 in the wall 40 of the distal tube 14, according to any of the embodiments depicted in FIGS. 3A-4B, can enhance the kink resistance of that portion of the tube 14 as well as assisting in transmitting a distal or proximal force to the distal tube 14 in a more even fashion during use of the catheter 10.
  • FIGS. 5B-5N show that the shaft 16 can, in certain embodiments, have various configurations relating to the number, shape, and size of the elongate members.
  • the shaft 16 has a sheath segment 60 with two large rods 62, 64 and one small rod 66.
  • the sheath 60 also has lumens 70A, 70B, 70C, 70D defined within the sheath 60 as a result of the configuration of the rods 62, 64, 66.
  • Each elongate member 62, 64, 66 disposed within the sheath 60 provides additional support or reinforcement to the shaft 16 while also resulting in multiple lumens within the segment 60.
  • the opening must be large enough and/or have sufficient clearance to allow for easy insertion of various medical devices into the opening such that the devices can be urged distally through the tube and out of the opening at the distal end of the tube.
  • clearance at the opening at the proximal end of the distal tube can be optimized by minimizing the profile (by reducing the diameter, etc.) of the manipulation shaft according to various configurations as disclosed herein.
  • the tube 160 has a lumen (not shown) in fluid communication with the lumen 182 of the sheath segment 162 and further in fluid communication with the lumen 180 of the distal tube 152.
  • the tube 160 can have a lumen (not shown) that is not in fluid communication with the lumen 182 or the lumen 180.
  • the tube 160 has no lumen.
  • two marker bands 184 are positioned around the rods 156, 158.
  • the proximal end of the lumen 206 in the shaft 200 does not have an opening. That is, the proximal end of the lumen 206 is not in fluid communication with any opening at the proximal end of the shaft 200.
  • a radiopaque marker (not shown) can be located anywhere in or near the connection zone 270 (e.g. on the manipulation shaft 262 in or near the connection zone 270 or in the distal tube 260 in the connection zone 270).
  • any of the markers 274, 276, 278 can be non-cylindrical.
  • one or more of the markers 274, 276, 278 can be strips or other known configurations.
  • markers 274, 276, 278 can be helpful to indicate to the doctor or surgeon the location of the proximal end 282 of the tube 260 in relation to the guiding catheter (not shown) so that they do not insert or push the proximal end 282 past the distal end of the guiding catheter.
  • certain embodiments include a third marker 278 located at some optimal point along the tube 260 in between the other two markers 274 and 276, as shown in Figs. 2B, 12B, and 12C. As best shown in FIG. 2B, the doctor or surgeon can use this third marker 278 to track how far the tube 260 is extending beyond the guiding catheter 12. That is, the third marker 278 can be used in certain circumstances as a limit indicator.
  • the inner layer 344 also has a protective wrap (also referred to as an "extended portion,” “extension,” “distal wrap,” or “protective tip”) 348 that extends beyond the length of the outer layer 346 and, in this implementation, is wrapped around the distal end of the outer layer 346 such that the external portion (also referred to as “outer portion” or “distal portion”) of the extended portion 348 extends toward the proximal end of the tube 340 and is positioned against or adjacent to the exterior surface of the outer layer 346.
  • This configuration creates a fold 350 (also referred to herein as a "distal fold") of the extended portion 348 at the catheter tip 342 that facilitates protection of the tube layers at the tip 342.
  • the positioning of the extended portion 348 as shown ensures that the ends of the layers 344, 346 are not exposed at the distal end of the tube 340, thereby reducing the risk of delamination and the problems related thereto.
  • any of the various catheter embodiments disclosed herein can also have an outer support membrane (also referred to as a "support membrane” or “support layer”) disposed around a proximal portion of the distal tube. It is also understood that any embodiment of the support membrane as disclosed or contemplated herein can also be incorporated into any other known catheter.
  • FIG. 18 depicts one embodiment of a catheter 400 in which the distal tube 404 has a support membrane 406 disposed around and coupled to the external wall 408 of the distal tube 404.
  • the membrane 406 is disposed around a portion of the wall 408 and extends longitudinally along the length of the tube 404 such that the proximal end of the membrane 406 does not extend to the proximal end 410 of the tube 404. That is, the membrane 406 is positioned such that it is spaced from the proximal end 410 of the tube 404. Alternatively, the membrane 406 can extend to the proximal end 410 of the tube 404. According to certain implementations, the membrane 406 is disposed in the connection zone (or region) of the distal tube 404 in which the manipulation shaft 402 is coupled to the tube 402 (similar to the connection zone 42 discussed above with respect to FIG. 3A).
  • circumference membrane can utilize a high strength material while not rendering the catheter tube hindered or inoperable.
  • any of the various improved proximal end embodiments disclosed or contemplated herein can be integrated into or combined with any boosting catheter, including the boosting catheter disclosed and claimed in U.S. Application 14/210,572, entitled “Boosting Catheter and Related Systems and Methods,” which is hereby incorporated herein by reference in its entirety.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Pulmonology (AREA)
  • Anesthesiology (AREA)
  • Biophysics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Mechanical Engineering (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
PCT/US2016/054638 2015-10-01 2016-09-30 Catheter structure with improved support and related systems, methods and devices Ceased WO2017059186A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
EP25176215.9A EP4578480A3 (en) 2015-10-01 2016-09-30 Catheter structure with improved support
EP16852671.3A EP3355980B1 (en) 2015-10-01 2016-09-30 Catheter structure with improved support
JP2018517167A JP2018533392A (ja) 2015-10-01 2016-09-30 改善された支持体を備えるカテーテル構造および関連するシステム、方法、およびデバイス

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201562235751P 2015-10-01 2015-10-01
US62/235,751 2015-10-01

Publications (1)

Publication Number Publication Date
WO2017059186A1 true WO2017059186A1 (en) 2017-04-06

Family

ID=58424791

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2016/054638 Ceased WO2017059186A1 (en) 2015-10-01 2016-09-30 Catheter structure with improved support and related systems, methods and devices

Country Status (4)

Country Link
US (1) US10780247B2 (enExample)
EP (2) EP4578480A3 (enExample)
JP (1) JP2018533392A (enExample)
WO (1) WO2017059186A1 (enExample)

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2019236741A1 (en) * 2018-06-05 2019-12-12 Medtronic Vascular, Inc. Medical catheter
WO2021067175A1 (en) * 2019-09-30 2021-04-08 Abiomed, Inc. Malleable sheath body
US11559663B2 (en) 2018-06-05 2023-01-24 Medtronic Vascular, Inc. Catheter including slidable push grip
EP4122519A1 (en) * 2021-07-09 2023-01-25 Neuravi Limited Intermediate catheter access assist to cerebral arteries
US11723962B2 (en) 2016-05-04 2023-08-15 Fred Hutchinson Cancer Center Cell-based neoantigen vaccines and uses thereof
US11911573B2 (en) 2018-06-05 2024-02-27 Medtronic Vascular, Inc. Medical catheter

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US11660420B2 (en) 2018-09-17 2023-05-30 Seigla Medical, Inc. Catheters and related devices and methods of manufacture
US9844383B2 (en) 2013-05-08 2017-12-19 Embolx, Inc. Devices and methods for low pressure tumor embolization
US12268824B2 (en) 2018-07-27 2025-04-08 Embolx, Inc. Shaped catheter tip for tracking over a guidewire through turns in the vasculature
US11464948B2 (en) 2016-02-16 2022-10-11 Embolx, Inc. Balloon catheters and methods of manufacture and use
US10350382B1 (en) 2018-06-08 2019-07-16 Embolx, Inc. High torque catheter and methods of manufacture
US9550046B1 (en) 2016-02-16 2017-01-24 Embolx, Inc. Balloon catheter and methods of fabrication and use
US11712539B2 (en) 2016-04-27 2023-08-01 Qxmedical, Llc Devices for assisting with advancement of catheters and related systems and methods
US11660079B2 (en) * 2017-08-31 2023-05-30 Cornell University Catheter system and method of use
EP3681471B1 (en) * 2017-09-15 2025-03-05 Oxular Limited Ophthalmic delivery device
WO2020096945A1 (en) * 2018-11-06 2020-05-14 Qxmedical, Llc Devices for assisting with advancement catheters and related systems and methods
JP7539606B2 (ja) * 2019-01-07 2024-08-26 テレフレックス ライフ サイエンシズ リミテッド ライアビリティ カンパニー ガイド延長カテーテル
EP4017568A4 (en) 2019-08-20 2023-10-18 Embolx, Inc. CATHETERS AND METHODS OF MANUFACTURE AND USE
CA3128527A1 (en) * 2020-09-10 2022-03-10 Baylis Medical Company Inc. Elongated medical catheter including marker band
WO2023278594A1 (en) 2021-07-02 2023-01-05 Embolx, Inc. Catheters adapted for agent delivery
CN118718207A (zh) * 2024-04-10 2024-10-01 业聚医疗器械(深圳)有限公司 导引延长导管

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US5290247A (en) 1991-05-21 1994-03-01 C. R. Bard, Inc. Intracoronary exchange apparatus and method
US5385562A (en) 1990-10-29 1995-01-31 Scimed Life Systems, Inc. Guide catheter system for an angioplasty balloon catheter
US5439445A (en) 1992-08-07 1995-08-08 Boston Scientific Corporation Support catheter assembly
US5947940A (en) * 1997-06-23 1999-09-07 Beisel; Robert F. Catheter reinforced to prevent luminal collapse and tensile failure thereof
US20050165383A1 (en) 1998-02-04 2005-07-28 Uzi Eshel Urethral catheter and guide
WO2006010929A2 (en) * 2004-07-30 2006-02-02 Mediplus Limited Lock mechanism for a catheter
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US20130116701A1 (en) 2011-11-09 2013-05-09 Boston Scientific Scimed, Inc. Guide extension catheter
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US4581017B1 (en) 1983-03-07 1994-05-17 Bard Inc C R Catheter systems
US5385562A (en) 1990-10-29 1995-01-31 Scimed Life Systems, Inc. Guide catheter system for an angioplasty balloon catheter
US5290247A (en) 1991-05-21 1994-03-01 C. R. Bard, Inc. Intracoronary exchange apparatus and method
US5439445A (en) 1992-08-07 1995-08-08 Boston Scientific Corporation Support catheter assembly
US5947940A (en) * 1997-06-23 1999-09-07 Beisel; Robert F. Catheter reinforced to prevent luminal collapse and tensile failure thereof
US20050165383A1 (en) 1998-02-04 2005-07-28 Uzi Eshel Urethral catheter and guide
WO2006010929A2 (en) * 2004-07-30 2006-02-02 Mediplus Limited Lock mechanism for a catheter
US20080287786A1 (en) 2007-05-15 2008-11-20 Cook Incorporated Multifilar cable catheter
US20130116701A1 (en) 2011-11-09 2013-05-09 Boston Scientific Scimed, Inc. Guide extension catheter
EP2885017A2 (en) 2012-08-17 2015-06-24 Boston Scientific Scimed, Inc. Guide extension catheter
US20140081243A1 (en) 2012-09-17 2014-03-20 Boston Scientific Scimed, Inc. Collarless guide extension catheter
US20140276618A1 (en) 2013-03-15 2014-09-18 Qxmedical, Llc Boosting Catheter and Related Systems and Methods

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See also references of EP3355980A4

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11723962B2 (en) 2016-05-04 2023-08-15 Fred Hutchinson Cancer Center Cell-based neoantigen vaccines and uses thereof
US11654263B2 (en) 2018-06-05 2023-05-23 Medtronic Vascular, Inc. Medical catheter
JP2021526397A (ja) * 2018-06-05 2021-10-07 メドトロニック・ヴァスキュラー・インコーポレーテッド 医療用カテーテル
US11541208B2 (en) 2018-06-05 2023-01-03 Medtronic Vascular, Inc. Medical catheter
US11559663B2 (en) 2018-06-05 2023-01-24 Medtronic Vascular, Inc. Catheter including slidable push grip
WO2019236741A1 (en) * 2018-06-05 2019-12-12 Medtronic Vascular, Inc. Medical catheter
JP7353303B2 (ja) 2018-06-05 2023-09-29 メドトロニック・ヴァスキュラー・インコーポレーテッド 医療用カテーテル
US11911573B2 (en) 2018-06-05 2024-02-27 Medtronic Vascular, Inc. Medical catheter
US12257399B2 (en) 2018-06-05 2025-03-25 Medtronic Vascular, Inc. Medical catheter
US12311129B2 (en) 2018-06-05 2025-05-27 Medtronic Vascular, Inc. Medical catheter
WO2021067175A1 (en) * 2019-09-30 2021-04-08 Abiomed, Inc. Malleable sheath body
US12402910B2 (en) 2019-09-30 2025-09-02 Abiomed, Inc. Malleable sheath body
EP4122519A1 (en) * 2021-07-09 2023-01-25 Neuravi Limited Intermediate catheter access assist to cerebral arteries

Also Published As

Publication number Publication date
EP4578480A3 (en) 2025-08-27
JP2018533392A (ja) 2018-11-15
US20170095646A1 (en) 2017-04-06
EP3355980B1 (en) 2025-05-14
EP3355980A4 (en) 2019-06-26
EP4578480A2 (en) 2025-07-02
US10780247B2 (en) 2020-09-22
EP3355980A1 (en) 2018-08-08

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