WO2023202904A1 - Fil central à structures allongées pour conducteurs dans un dispositif intraluminal et dispositifs, systèmes et procédés associés - Google Patents

Fil central à structures allongées pour conducteurs dans un dispositif intraluminal et dispositifs, systèmes et procédés associés Download PDF

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Publication number
WO2023202904A1
WO2023202904A1 PCT/EP2023/059356 EP2023059356W WO2023202904A1 WO 2023202904 A1 WO2023202904 A1 WO 2023202904A1 EP 2023059356 W EP2023059356 W EP 2023059356W WO 2023202904 A1 WO2023202904 A1 WO 2023202904A1
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WO
WIPO (PCT)
Prior art keywords
core wire
core
conductive member
conductive
flexible elongate
Prior art date
Application number
PCT/EP2023/059356
Other languages
English (en)
Inventor
William Joseph BOYLE
Mathijs De Wit
Original Assignee
Koninklijke Philips N.V.
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 Koninklijke Philips N.V. filed Critical Koninklijke Philips N.V.
Publication of WO2023202904A1 publication Critical patent/WO2023202904A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6851—Guide wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body

Definitions

  • the subject matter described herein relates to intraluminal physiology sensing devices (e.g., an intravascular pressure sensing and/or flow sensing guidewire).
  • the intraluminal device may include core wire with areas within the perimeter of the core wire in which power and/or data communication lines are placed between a distal sensor and a proximal electrical connector.
  • Existing intravascular guidewires with a sensor have fine-gauge electrical wires that provide transmission of electrical signals for the sensor. These guidewires are small and have a small diameter in order to fit inside small blood vessels. Further, the core wire and the electrical wires within the guidewires take up separate spaces inside the guidewires. So the size of the core wire is limited because there needs to be enough space to fit the electrical wires. Additionally, the fine-gauge electrical wires typically have circular cross-section, which occupies space with the very small outer diameter of the guidewire.
  • intraluminal physiology sensing devices e.g., an intravascular pressure-sensing and/or flow-sensing guidewire
  • the elongate structures can include the shape of the core wire and/or the area next to the core wire that is defined by the shape.
  • One or multiple electrical wires are positioned along the elongate structure.
  • the elongate structures can be a cut or a groove in the core wire and/or the area next to the cut or groove.
  • the core wire with the elongate structure can have a cross-section that is non-circular or not completely circular.
  • Placing an electrical wire in the one or more elongate structures of the core wire means that the electrical wire and core wire now occupy overlapping areas.
  • the electrical wire can overlap with the hypothetical cross-section of the core wire, if the core did have a completely circular cross-section.
  • the cross- sectional area of the core wire may be increased (into the area that was previously used for the electrical wire).
  • the increased diameter core wire assembly disclosed herein has particular, but not exclusive, utility for intraluminal medical catheters, guidewires, or guide catheters.
  • an apparatus in an exemplary aspect, includes an intravascular guidewire comprising: a flexible elongate member configured to be positioned within a blood vessel of a patient, wherein the flexible elongate member comprises a proximal portion, a distal portion, and a core wire with an elongate structure; a sensor disposed at the distal portion of the flexible elongate member, wherein the sensor is configured to obtain medical data related to the blood vessel while the flexible elongate member is positioned within the blood vessel; a connector disposed at the proximal portion of the flexible elongate member; a first conductive member in electrical communication with the sensor; and a second conductive member in electrical communication with the connector, wherein the first conductive member and the second conductive member are disposed along the elongate structure of the core wire.
  • the intravascular guidewire further comprises a polymer coating over the core wire, wherein the polymer coating is disposed within the elongate structure.
  • polymer coating surrounds the first conductive member and the second conductive member.
  • the first conductive member and the second conductive member are electrically and mechanically coupled at a location within the elongate structure.
  • the intravascular guidewire further comprises a polymer coating over the core wire, wherein the polymer coating surrounds the location.
  • the intravascular guidewire further comprises solder electrically and mechanically coupling the first conductive member and the second conductive member, wherein the solder is disposed within the elongate structure.
  • the intravascular guidewire further comprises a polymer coating over the core wire, wherein the polymer coating surrounds the first conductive member, the second conductive member, and the solder.
  • the first conductive member comprises a first cross-sectional shape
  • the second conductive member comprises a different second cross-sectional shape.
  • the intravascular guidewire comprises an overlap between a first length of the first conductive member and a second length of the second conductive member, wherein the overlap is disposed within the elongate structure.
  • the elongate structure spans a length of the core wire from the proximal portion to the distal portion.
  • the core wire comprises a further elongate structure.
  • the intravascular guidewire further comprises a polymer coating over the core wire, wherein core wire comprises a plurality of channels different than the elongate structure and configured to provide a surface area for the polymer coating to couple to the core wire.
  • core wire is made of a metallic material. In some aspects, the core wire is made of a composite material.
  • an apparatus in an exemplary aspect, includes an intravascular guidewire comprising: a flexible elongate member configured to be positioned within a blood vessel of a patient, wherein the flexible elongate member comprises a proximal portion, a distal portion, and a core wire with an elongate structure; at least one of a pressure sensor or a flow sensor disposed at the distal portion of the flexible elongate member, wherein at least one of the pressure sensor or a flow sensor is configured to obtain at least one of pressure data or flow data, respectively, related to the blood vessel while the flexible elongate member is positioned within the blood vessel; a connector disposed at the proximal portion of the flexible elongate member; a first conductive member in electrical communication with the sensor; and a second conductive member in electrical communication with the connector, wherein the first conductive member and the second conductive member are disposed along the elongate structure of the core wire.
  • Fig. 1 is a diagrammatic top view of an intravascular device, according to aspects of the present disclosure.
  • FIG. 2 is a diagrammatic side view of an intravascular sensing system that includes an intravascular device, according to aspects of the present disclosure.
  • Fig. 3 A is a diagrammatic cross-sectional view of a core wire of a flexible elongate member, according to aspects of the present disclosure.
  • Fig. 3B is a diagrammatic cross-sectional view of a core wire of a flexible elongate member, according to aspects of the present disclosure.
  • Fig. 4 is a diagrammatic cross-sectional view of a core wire of a flexible elongate member, according to aspects of the present disclosure.
  • Fig. 5 is a diagrammatic side view of a portion of a flexible elongate member, according to aspects of the present disclosure.
  • Fig. 6 is a diagrammatic cross-sectional view of a core wire of a flexible elongate member, according to aspects of the present disclosure.
  • Fig. 7 is a diagrammatic cross-sectional view of a core wire of a flexible elongate member, according to aspects of the present disclosure.
  • Fig. 8 is a diagrammatic cross-sectional view of a core wire of a flexible elongate member, according to aspects of the present disclosure.
  • Fig. 9 is a diagrammatic cross-sectional side view of a portion of the flexible elongate member, according to aspects of the present disclosure.
  • Fig. 10A and 10B illustrate a cross-sectional view of a flexible elongate member of Fig. 9, as seen along lines of various sections, according to aspects of the present disclosure.
  • Fig. 11 is a diagrammatic cross-sectional side view of a portion of a flexible elongate member, according to aspects of the present disclosure.
  • Fig. 12A-12C illustrates a cross-sectional view of the flexible elongate member 106 of Fig. 11, as seen along lines of various sections, according to aspects of the present disclosure.
  • the increased diameter core wire has a cross-sectional geometry with one or more elongate structures that allows conductive members to be partially or fully recessed into the one or more elongate structures.
  • the overall diameter and/or cross-sectional area of the core wire may be increased.
  • the conductive members are not recessed.
  • the column stiffness and torque response of the intraluminal device may be improved as well, which may lead to improved guidewire pushability (e.g., the user pushing or moving the proximal portion of the intravascular device longitudinally causes the desired response of the distal portion of the intravascular device to move longitudinally) and deliverability (e.g., ability of the device to be navigated by the user through, e.g., tortuous vasculature, to the desired location within a blood vessel) when the device is manipulated within intravascular anatomy.
  • Guidewire pushability e.g., the user pushing or moving the proximal portion of the intravascular device longitudinally causes the desired response of the distal portion of the intravascular device to move longitudinally
  • deliverability e.g., ability of the device to be navigated by the user through, e.g., tortuous vasculature, to the desired location within a blood vessel
  • Column stiffness and torque response are needed to ensure that the distal tip of a guidewire may be navigated to the desired location in
  • a proximal end of a distal core and a distal end of a proximal core are reduced in diameter so that the multi-filar bundle may fit inside of the hypotube and allow sufficient space for the multi-filar bundle.
  • This reduction in diameter makes it more likely for this area of the wire to kink during bending/handling.
  • Example devices incorporating a multi-filar conductor bundle and/or conductive ribbons include intraluminal medical guidewire devices as described for example in U.S. Patent No. 10,595,820 B2, U.S. Patent Publication Nos. 2014/0187874, 2016/0058977, and 2015/0273187, and in U.S. Provisional Patent Application No. 62/552,993 (filed August 31, 2017), each of which is hereby incorporated by reference in its entirety as though fully set forth herein.
  • the features, components, and/or steps described with respect to one aspect may be combined with the features, components, and/or steps described with respect to other aspects of the present disclosure.
  • the aspects of the present disclosure may be described with respect to a blood vessel, it will be understood that the devices, systems, and methods described herein may be configured for use in any suitable anatomical structure or body lumen including a blood vessel, blood vessel lumen, an esophagus, eustachian tube, urethra, fallopian tube, intestine, colon, and/or any other suitable anatomical structure or body lumen.
  • the devices, systems, and methods described herein may be used to examine any number of anatomical locations and tissue types, including without limitation, organs including the liver, heart, kidneys, gall bladder, pancreas, lungs; ducts; intestines; nervous system structures including the brain, dural sac, spinal cord and peripheral nerves; the urinary tract; as well as valves within the blood vessels, chambers or other parts of the heart, and/or other systems of the body.
  • the device may be used to examine man-made structures such as, but without limitation, heart valves, stents, shunts, filters, and other devices. For the sake of brevity, however, the numerous iterations of these combinations will not be described separately.
  • Fig. 1 is a diagrammatic top view of an intravascular device 102, according to aspects of the present disclosure.
  • the intravascular device 102 may be an intravascular, intraluminal, or endoluminal device, such as a guidewire, a catheter, or a guide catheter sized and shaped for positioning within a blood vessel of a patient.
  • the intravascular device 102 may include a sensor 112.
  • the sensor 112 may be a pressure sensor configured to measure a pressure of blood flow within the vessel of the patient.
  • the intravascular device 102 includes the flexible elongate member 106.
  • the sensor 112 is disposed at the distal portion 107, also referred to as a distal subassembly, of the flexible elongate member 106.
  • the sensor 112 may be mounted at the distal portion 107 within a housing 280 in some aspects.
  • a flexible tip coil 290 extends between the housing 280 and the distal end 108.
  • the connection portion 114 is disposed at the proximal portion 109, also referred to as a proximal subassembly, of the flexible elongate member 106.
  • the connection portion includes the conductive portions 132, 134, 136.
  • the conductive portions 132, 134, 136 may be conductive ink that is printed and/or deposited around the flexible elongate member 106.
  • the conductive portions 132, 134, 136 may be conductive, metallic rings that are positioned around the flexible elongate member.
  • the locking section 118 and knob or retention section 120 are disposed at the proximal portion 109 of the flexible elongate member 106.
  • the intravascular device 102 in Fig. 1 includes a distal core 210 and a proximal core 220.
  • the distal core 210 and the proximal core 220 are metallic components forming part of the body of the intravascular device 102.
  • the distal core 210 and the proximal core 220 are flexible metallic rods that provide structure for the flexible elongate member 106.
  • the diameter of the distal core 210 and the proximal core 220 that electrically and mechanically couples the distal core 210 to the proximal core 220 may vary along its length.
  • a joint between the distal core 210 and proximal core 220, which electrically and mechanically couples the distal core 210 to the proximal core 220, is surrounded and contained by a hypotube 215, which is a tubular member.
  • the intravascular device 102 includes a distal assembly and a proximal assembly that are electrically and mechanically joined together, which results in electrical communication between the sensor 112 and the conductive portions 132, 134, 136.
  • pressure data obtained by the sensor 112 (in this example, sensor 112 is a pressure sensor) may be transmitted to the conductive portions 132, 134, 136.
  • Control signals from a computer in communication with the intravascular device 102 may be transmitted to the sensor 112 via the conductive portions 132, 134, 136.
  • the distal subassembly may include the distal core 210.
  • the distal subassembly may also include the sensor 112, conductive members 230, and/or one or more layers of insulative polymer/plastic 240 surrounding the conductive members 230 and the distal core 210.
  • the polymer/plastic layer(s) may protect the conductive members 230.
  • the proximal subassembly may include the proximal core 220.
  • the proximal subassembly may also include one or more layers of polymer layer(s) 250 (hereinafter polymer layer 250) surrounding the proximal core 220 and/or conductive ribbons 260 embedded within the one or more layers of polymer layer(s) 250.
  • proximal subassembly and the distal subassembly may be separately manufactured. During the assembly process for the intravascular device 102, the proximal subassembly and the distal subassembly may be electrically and mechanically joined together.
  • flexible elongate member may refer to one or more components along the entire length of the intravascular device 102, one or more components of the proximal subassembly (e.g., including the proximal core 220, etc.), and/or one or more components the distal subassembly (e.g., including the distal core 210, etc.).
  • the intravascular device 102 may include one, two, three, or more core wires, also referred to as core members, extending along its length.
  • a single core wire may extend substantially along the entire length of the flexible elongate member 106.
  • the locking section 118 and the knob or retention section 120 may be integrally formed at the proximal portion of the single core wire.
  • the sensor 112 may be secured at the distal portion of the single core wire.
  • the locking section 118 and the knob or retention section 120 may be integrally formed at the proximal portion of the proximal core 220.
  • the sensor 112 may be secured at the distal portion of the distal core 210.
  • the intravascular device 102 includes one or more conductive members 230 in communication with the sensor 112.
  • the conductive members 230 may be one or more electrical wires that are directly in communication with the sensor 112.
  • the conductive members 230 are electrically and mechanically coupled to and in electrical communication with the sensor 112 by, e.g., soldering.
  • the conductive members 230 include two or three electrical wires (e.g., a bifilar cable or a trifilar cable).
  • An individual electrical wire may include a bare metallic conductor surrounded by one or more insulating layers.
  • the conductive members 230 may extend along the length of the distal core 210. For example, at least a portion of the conductive members 230 may be spirally wrapped around the distal core 210.
  • the intravascular device 102 includes one or more conductive ribbons 260 at the proximal portion of the flexible elongate member 106.
  • the conductive ribbons 260 are embedded within polymer layer(s) 250.
  • the conductive ribbons 260 are directly in communication with the conductive portions 132, 134, and/or 136.
  • the conductive members 230 are electrically and mechanically coupled to and in electrical communication with the sensor 112 by, e.g., soldering.
  • the conductive portions 132, 134, and/or 136 include conductive ink (e.g., metallic nano-ink, such as silver or gold nano-ink) that is deposited or printed directed over the conductive ribbons 260.
  • electrical communication between the conductive members 230 and the conductive ribbons 260 may be established at the connection region 270 of the flexible elongate member 106.
  • the conductive portions 132, 134, 136 may be in electrically communication with the sensor 112.
  • intravascular device 102 includes the locking section 118 and the knob or retention section 120.
  • a machining process is necessary to remove the polymer layer 250 and the conductive ribbons 260 in the locking section 118 and to shape proximal core 220 in the locking section 118 to the desired shape.
  • the locking section 118 includes a reduced diameter while the knob or retention section 120 has a diameter substantially similar to that of proximal core 220 in the connection portion 114.
  • an insulation layer 158 is formed over the proximal end portion of the connection portion 114 to insulate the exposed conductive ribbons.
  • FIG. 2 is a diagrammatic side view of an intraluminal (e.g., intravascular) sensing system 100 that includes an intravascular device 102 includes conductive members 230 (e.g., a multi-filar electrical conductor bundle) and conductive ribbons 260, according to aspects of the present disclosure.
  • the intravascular device 102 may be an intravascular guidewire sized and shaped for positioning within a blood vessel of a patient.
  • the intravascular device 102 includes a distal end 108 and a sensor 113.
  • the sensor 113 may be a pressure sensor and/or flow sensor configured to measure a pressure of blood flow within the vessel of the patient, or another type of sensor including but not limited to a temperature or imaging sensor, or combination sensor measuring more than one property.
  • the intravascular device 102 includes a flexible elongate member 106.
  • the sensor 113 is disposed at a distal portion 107 of the flexible elongate member 106.
  • the sensor 113 may be mounted at the distal portion 107 within a housing 282 in some aspects.
  • a flexible tip coil 290 extends distally from the housing 282 at the distal portion 107 of the flexible elongate member 106.
  • a connection portion 114 located at a proximal end of the flexible elongate member 106 includes conductive portions 132, 134.
  • the conductive portions 132, 134 may be conductive ink that is printed and/or deposited around the connection portion 114 of the flexible elongate member 106. In some aspects, the conductive portions 132, 134 are conductive, may be metallic bands or rings that are positioned around the flexible elongate member. A locking area is formed by a collar or locking section 118 and knob or retention section 120 are disposed at the proximal portion 109 of the flexible elongate member 106.
  • the intravascular device 102 in Fig. 2 includes core wire including a distal core 210 and a proximal core 220.
  • the distal core 210 and the proximal core 220 are metallic components forming part of the body of the intravascular device 102.
  • the distal core 210 and the proximal core 220 may be flexible metallic rods that provide structure for the flexible elongate member 106.
  • the distal core 210 and/or the proximal core 220 may be made of a metal or metal alloy.
  • the distal core 210 and/or the proximal core 220 may be made of stainless steel, Nitinol, Titanium, nickel -cob al t- chromium-molybdenum alloy (e.g., MP35N), and/or other suitable materials.
  • the distal core 210 and/or the proximal core 220 may be made from a stiff graphite or similar composite material, such as carbon fiber, Kevlar, etc.
  • the distal core 210 and the proximal core 220 are made of the same material. In other aspects, the distal core 210 and the proximal core 220 are made of different materials.
  • the diameter of the distal core 210 and the proximal core 220 may vary along their respective lengths.
  • a joint between the distal core 210 and proximal core 220 is surrounded and contained by a hypotube 215.
  • the sensor 113 may in some cases be positioned at a distal end of the distal core 210.
  • the intravascular device 102 includes a distal subassembly and a proximal subassembly that are electrically and mechanically joined together, which creates an electrical communication between the sensor 113 and the conductive portions 132, 134.
  • flow data obtained by the sensor 113 may be transmitted to the conductive portions 132, 134.
  • the sensor 113 is a single ultrasound transducer element.
  • the transducer element emits ultrasound signals and receives echoes.
  • the transducer element generates electrical signals representative of the echoes.
  • the signal carrying filars carry this electrical signal from the sensor at the distal portion to the connector at the proximal portion.
  • the processing system 306 processes the electrical signals to extract the flow velocity of the fluid.
  • Control signals from the processing system 306 e.g., a processor circuit of the processing system 306) in communication with the intravascular device 102 may be transmitted to the sensor 113 via a connector 314 that is attached to the conductive portions 132, 134.
  • the distal subassembly may include the distal core 210.
  • the distal subassembly may also include the sensor 113, the conductive members 230, and/or one or more layers of insulative polymer/plastic 240 surrounding the conductive members 230 and the distal core 210.
  • the polymer/plastic layer(s) may insulate and protect the conductive members of the conductive members 230.
  • the proximal subassembly may include the proximal core 220.
  • the proximal subassembly may also include one or more polymer layers 250 (hereinafter polymer layer 250) surrounding the proximal core 220 and/or conductive ribbons 260 embedded within the one or more insulative and/or polymer layer 250.
  • polymer layer 250 polymer layers 250 surrounding the proximal core 220 and/or conductive ribbons 260 embedded within the one or more insulative and/or polymer layer 250.
  • the proximal subassembly and the distal subassembly are separately manufactured. During the assembly process for the intravascular device 102, the proximal subassembly and the distal subassembly may be electrically and mechanically joined together.
  • flexible elongate member may refer to one or more components along the entire length of the intravascular device 102, one or more components of the proximal subassembly (e.g., including the proximal core 220, etc.), and/or one or more components the distal subassembly (e.g., including the distal core 210, etc.). Accordingly, flexible elongate member may refer to the combined proximal and distal subassemblies described above. The joint between the proximal core 220 and distal core 210 is surrounded by the hypotube 215, which is a tubular member.
  • the intravascular device 102 may include one, two, three, or more core wires extending along its length.
  • a single core wire may extend substantially along the entire length of the flexible elongate member 106.
  • the locking section 118 and the knob or retention section 120 may be integrally formed at the proximal portion of the single core wire.
  • the sensor 113 may be secured at the distal portion of the single core wire.
  • the locking section 118 and the knob or retention section 120 may be integrally formed at the proximal portion of the proximal core 220.
  • the sensor 113 may be secured at the distal portion of the distal core 210.
  • the intravascular device 102 includes one or more conductive members 230 (e.g., a multi -filar conductor bundle or cable) in communication with the sensor 113.
  • the conductive members 230 may be one or more electrical wires that are directly in communication with the sensor 113.
  • the conductive members 230 are electrically and mechanically coupled to and in electrical communication with the sensor 113 by, e.g., soldering.
  • the conductive members 230 includes two or three electrical wires (e.g., a bifilar cable or a trifilar cable).
  • An individual electrical wire may include a bare metallic conductor surrounded by one or more insulating layers.
  • the conductive members 230 may extend along the length of the distal core 210. For example, at least a portion of the conductive members 230 may be spirally wrapped around the distal core 210, minimizing or eliminating whipping of the distal core within tortuous anatomy.
  • the intravascular device 102 includes one or more conductive ribbons 260 at the proximal portion of the flexible elongate member 106.
  • the conductive ribbons 260 are embedded within polymer layer 250.
  • the conductive ribbons 260 are directly in communication with the conductive portions 132 and/or 134.
  • conductive members 230 are electrically and mechanically coupled to and in electrical communication with the sensor 113 by, e.g., soldering.
  • the conductive portions 132 and/or 134 includes conductive ink (e.g., metallic nano-ink, such as copper, silver, gold, or aluminum nano-ink) that is deposited or printed directed over the conductive ribbons 260.
  • electrical communication between the conductive members 230 and the conductive ribbons 260 may be established at the connection portion 114 of the flexible elongate member 106.
  • the conductive portions 132, 134 may be in electrical communication with the sensor 113.
  • the intravascular device 102 includes a locking section 118 and knob or retention section 120.
  • a machining process is used to remove the polymer layer 250 and conductive ribbons 260 in locking section 118 and to shape proximal core 220 in locking section 118 to the desired shape.
  • locking section 118 includes a reduced diameter while knob or retention has a diameter substantially similar to that of proximal core 220 in the connection portion 114.
  • an insulation layer 158 is formed over the proximal end portion of the connection portion 114 to insulate the exposed conductive ribbons 260.
  • a connector 314 provides electrical connectivity between the conductive portions 132, 134 and a Patient Interface Monitor (PIM) 304.
  • PIM Patient Interface Monitor
  • the PIM 304 may in some cases connect to a console or processing system 306, which includes or is in communication with a display 308.
  • the intraluminal sensing system 100 may be deployed in a catheterization laboratory having a control room.
  • the processing system 306 may be located in the control room.
  • the processing system 306 may be located elsewhere, such as in the catheterization laboratory itself.
  • the catheterization laboratory may include a sterile field while its associated control room may or may not be sterile depending on the procedure to be performed and/or on the health care facility.
  • the intravascular device 102 may be controlled from a remote location such as the control room, such that an operator is not required to be in close proximity to the patient.
  • the intravascular device 102, PIM 304, and display 308 may be communicatively coupled directly or indirectly to the processing system 306. These elements may be communicatively coupled to the processing system 306 via a wired connection such as the conductive members 230, which is a standard copper multi-filar conductor bundle.
  • the processing system 306 may be communicatively coupled to one or more data networks, e.g., a TCP/IP -based local area network (LAN). In other aspects, different protocols may be utilized such as Synchronous Optical Networking (SONET). In some cases, the processing system 306 may be communicatively coupled to a wide area network (WAN).
  • WAN wide area network
  • the PIM 304 transfers the received signals to the processing system 306 where the information is processed and displayed (e.g., as physiology data in graphical, symbolic, or alphanumeric form) on the display 308.
  • the console or processing system 306 may include a processor and a memory.
  • the processing system 306 may be operable to facilitate the features of the intraluminal sensing system 100 described herein.
  • the processor may execute computer readable instructions stored on the non-transitory tangible computer readable medium.
  • the PIM 304 facilitates communication of signals between the processing system 306 and the intravascular device 102.
  • the PIM 304 may be communicatively positioned between the processing system 306 and the intravascular device 102.
  • the PIM 304 performs preliminary processing of data prior to relaying the data to the processing system 306.
  • the PIM 304 performs amplification, filtering, and/or aggregating of the data.
  • the PIM 304 also supplies high- and low-voltage DC power to support operation of the intravascular device 102 via the conductive members 230.
  • a multi-filar cable or transmission line bundle such as conductive members 230, may include a plurality of conductors, including one, two, three, four, five, six, seven, or more conductors.
  • the conductive members 230 includes two straight portions 232 and 236, where the conductive members 230 lies parallel to a longitudinal axis of the flexible elongate member 106, and a spiral portion 234, where the conductive members 230 is wrapped around the exterior of the flexible elongate member 106 and then overcoated with the insulative polymer/plastic 240.
  • Communication, if any, along the conductive members 230 may be through numerous methods or protocols, including serial, parallel, and otherwise, where one or more filars of the conductive members 230 carry signals.
  • One or more filars of the conductive members 230 may also carry direct current (DC) power, alternating current (AC) power, or serve as a ground connection.
  • the display or monitor 308 may be a display device such as a computer monitor or other type of screen.
  • the display or monitor 308 may be used to display selectable prompts, instructions, and visualizations of imaging data to a user.
  • the display 308 may be used to provide a procedure-specific workflow to a user to complete an intraluminal imaging procedure.
  • Fig. 3 A is a diagrammatic cross-sectional view of a core wire of a flexible elongate member 106, according to aspects of the present disclosure. Visible are a core wire 302 and conductive ribbons 260 (hereinafter referred to as conductive members 260) embedded in the polymer layer 250.
  • the core wire 302 includes a core surface 303.
  • core wire 302 may be the proximal core 220.
  • core wire 302 may be the distal core 210.
  • proximal core 220 and distal core 210 may be a single core wire, such that core wire 302 is the single core wire.
  • the proximal core 220 and the distal core 210 are in electrical communication with one another.
  • the proximal core 220 and the distal core 210 are electrical and/or mechanically coupled to one another.
  • the conductive members 260 and the core wire 302 may be electrically isolated from one another.
  • core wire 302 comprises one or more elongate structures 305.
  • the conductive members 260 are partially or fully recessed within the elongate structures 305.
  • the elongate structures 305 may be grooved portion of the core wire and/or the area defined by the grooves that is proximate to and/or adjacent to the core wire 302.
  • the one or more elongate structures 305 may be in the proximal core 220 only, in the distal core 210 only, or both in the proximal core 220 and the distal core 210.
  • the one or more elongate structures 305 are elongate in that the one or more elongate structures 305 extend for a length of the proximal core 220, a length of the distal core 210, or both.
  • conductive members 260 may extend along (e.g., wrapped in a spiral pattern, linearly, etc.) a length of an outside surface of the distal core 210.
  • conductive members 260 may extend along (e.g., wrapped in a spiral pattern, linearly, etc.) a length of an outside surface of the distal core 210.
  • conductive members 260 may extend along (e.g., wrapped in a spiral pattern, linearly, etc.) a length of an outside surface of the proximal core 220 and the distal core 210. In some instances, the length may be all of the length, a portion of the length, a majority of the length, less than half the length, etc.
  • One or more polymer layers 250 may be positioned around the proximal core and/or the distal core.
  • the one or more elongate structures 305 may be a space within a perimeter of the core wire 302 if the core wire 302 had completely circular cross section 311.
  • a portion of the core wire 302 is shaped to define an area (e.g., the elongate structures 305) within the perimeter of the core wire 302 if the core wire 302 had completely circular cross section 311.
  • the one or more elongate structures 305 may provide the core wire 302 with a cross-sectional shape that is not completely circular, such that the one or more elongate structures 305 include the space taken from the circular cross-section to make the non-circular cross section.
  • the one or more elongate structures 305 may be referenced as a groove, a recess, a channel, a trench, a cut, etc., and/or an area defined by the groove, the recess, the channel, the trench, the cut, etc.
  • conductive members 260 may be partially within the one or more elongate structures 305 (e.g., the circular cross-section shape 311 of core wire 302) and partially outside (i.e., the circular cross-section shape 311 of core wire 302).
  • the one or more elongate structures 305 includes an elongate structure bottom 307 that is positioned radially inward from the core surface 303 of the core wire 302.
  • the one or more elongate structures 305 further include elongate structure walls 309 that are perpendicular to the elongate structure bottom 307.
  • the one or more elongate structures 305 may be referred to as a straight elongate structure, a plain elongate structure, or a dado elongate structure.
  • the core surface 303 has one shape or cross-sectional profile while the one or more elongate structures 305 has a different second shape or cross-sectional profile.
  • Core surface 303 is circular, while the elongate structure is non-circular.
  • the entire perimeter of the core wire is a composite of the core surface 303 and the one or more elongate structures 305.
  • the perimeter of the core wire 302 thus has circular portions and non-circular portions (as a whole, the perimeter of the core wire is non-uniform around the circumference as a result of the one or more elongate structures 305).
  • core wire 302 having a cross-sectional geometry with one or more elongate structures 305 that spans a length of the core wire and that allows the conductive members 260 to be recessed into the one or more elongate structures 305, core wire 302 has an increased or greater cross- sectional area, resulting in a greater moment of inertia resulting in improved core wire column strength and torque transmission characteristics for an assembled flexible elongate member 106.
  • the one or more elongate structures 305 are formed by shaping the core wire 302. In some instances, the one or more elongate structures 305 are formed by drawing the core wire 302 through a die. In some instances, the one or more elongate structures 305 are through an extrusion process. In some instances, the one or more elongate structures 305 are formed through form molding. In some aspects, the one or more elongate structures 305 are formed by removing material from the core wire 302. In some instances, the one or more elongate structures 3004 are formed through a grinding or laser ablation process.
  • the core wire 302 is stretched in tension and twisted to form a helical, barber pole pattern in the core wire.
  • the conductive members 260 are either partially or fully recessed within the one or more elongate structures 305.
  • a distal portion of the conductive members 260 is coupled to a sensor, such as sensor 112 or 113, such that the conductive members 260 are in electrical communication with the sensor.
  • a proximal potion of the conductive members 260 is coupled to a connector, such as the conductive portions 132, 134, or 136, such that the conductive members 260 are in electrical communication with the connector. In such instances, this manner of coupling is provided, so that connector and sensor are in communication via the first and second conductive members.
  • the conductive members 260 and the core wire 302 are coated with the polymer layer 250 such that the polymer layer 250 surrounds the conductive members 260 and the core wire 302, directly in contact with the conductive members 260 and the core wire 302.
  • the polymer layer 250 allows for the outer profile of the flexible elongate member 106 to be uniformly coated around its circumference, e.g., the polymer layer 250 fills in the non-circular portions of the core wire 302.
  • the outer profile of the flexible elongate member comprises a uniform shape (e.g., circular) as a result of the polymer layer 250, unlike the non-uniform shape of the core wire 302 (because of the one or more elongate structures 305).
  • the polymer layer 250 surrounds and insulates the conductive ribbons 260, in a given cross-section, from one another and insulates conductive ribbons 260 from the core wire 302.
  • the polymer layer 250 may include polytetrafluoroethylene (PTFE) lubricious flakes.
  • PTFE polytetrafluoroethylene
  • a lubricious surface is provided for the flexible elongate member 106.
  • the polymer layer 250 may be further coated by a hydrophilic coating.
  • Fig. 3B is a diagrammatic cross-sectional view of a core wire of a flexible elongate member 106, according to aspects of the present disclosure. Fig.
  • the elongate structure 305 may be a space within a perimeter 311 of the core wire 302 if the core wire 302 had completely circular cross section 311.
  • a portion of the core wire 302 is shaped to define an area (e.g., the elongate structure 305) within the perimeter of the core wire 302 if the core wire 302 had completely circular cross section 311.
  • the elongate structure 305 may provide the core wire 302 with a cross-sectional shape that is not completely circular, such that the elongate structure 305 includes the space taken from the circular cross-section to make the non-circular cross section.
  • the elongate structure 305 can extend radially from the perimeter 311 inwards towards the center of the core wire 302.
  • conductive members 260 may be completely within the one or more elongate structures 305 (e.g., the circular cross-section shape of core wire 302). In other instances, all or parts of one or more conductive members may be outside of the elongate structures 305.
  • Fig. 4 is a diagrammatic cross-sectional view of a core wire of a flexible elongate member 106, according to aspects of the present disclosure.
  • Fig. 4 includes features similar to those described in Fig. 3 A.
  • the one or more elongate structures 404 may be a space within a perimeter of the core wire 302 if the core wire 302 had completely circular cross section 411.
  • a portion of the core wire 302 is shape to define an area (e.g., the elongate structures 404) within the perimeter of the core wire 302 if the core wire 302 had completely circular cross section 411.
  • the Fig. 404 is an area within the perimeter of the core wire 302 if the core wire 302 had completely circular cross section 411.
  • the one or more elongate structures 404 includes an elongate structure bottom 407 that is positioned radially inward from the core surface 303 of the core wire 302.
  • the one or more elongate structures 404 further include elongate structure walls 409 that are perpendicular to the elongate structure bottom 407.
  • the one or more elongate structures 404 may be referred to as angular elongate structures.
  • the one or more elongate structures 404 are angular elongate structures that are deeper than the one or more elongate structures 305 in Fig. 3A in order to allow for multiple conductors to be partially or fully recessed within the one or more elongate structures 404.
  • one or more additional conductive members 406 i.e. first conductive members, may be partially or fully recessed within the one or more elongate structures 404.
  • respective ones of the one or more additional conductive members 406 may be electrically and mechanically coupled to respective ones of the conductive members 260 via a connection 408, e.g., soldering, ultrasonic welding, conductive adhesive, etc., such that respective ones of the conductive members 260 are in electrical communication with respective ones of the one or more additional conductive members 406.
  • the one or more additional conductive members 406 and the conductive members 260 may have a same cross- sectional shape or a different cross-sectional shape.
  • the polymer layer 250 surrounds the connection of conductive ribbons 260 to the conductive members 404 via the connection 408 insulating the connection from the core wire 302.
  • the connection of conductive ribbons 260 to the conductive members 404 via the connection 408 may be surrounded and covered by, e.g. an epoxy, adhesive, etc., and then surrounded by the polymer layer 250 insulating the connection from the core wire 302.
  • the connection of conductive ribbons 260 to the conductive members 404 via the connection 408 may only be surrounded and covered by, e.g. an epoxy, adhesive, etc.
  • Fig. 5 is a diagrammatic side view of a portion of the flexible elongate member 106, according to aspects of the present disclosure.
  • Fig. 5 is a cross-sectional side view of a portion of the flexible elongate member 106 that is identified in Fig. 4.
  • Visible are the conductive members 260 and the one or more additional conductive members 406 disposed within the one or more elongate structures 404.
  • the elongate structures 404 extend in length (e.g., left-right in the side view shown of Fig. 5) along the core wire 302.
  • the conductor 410 within the one or more additional conductive members 406 is exposed and electrically and mechanically coupled to a respective one of the conductive members 260 via a connection 408, e.g., soldering, ultrasonic welding, conductive adhesive, etc., such that respective ones of the conductive members 260 are in electrical communication with respective ones of the one or more additional conductive members 406.
  • a proximal portion, i.e. a first length, of a respective one of the one or more additional conductive members 406 overlaps a distal portion, i.e. a second length, of a respective one of the conductive members 260.
  • the polymer layer 250 surrounds and insulates the location, which advantageously provides insulation where the two conductive members are otherwise bare (because the bare conductors are electrically and mechanically coupled).
  • Fig. 6 is a diagrammatic cross-sectional view of a core wire of a flexible elongate member 106, according to aspects of the present disclosure.
  • Fig. 6 includes features similar to those described in Fig. 3 A.
  • the one or more elongate structures are flatsided edges 604 around one or more sides of the core wire 302 and/or an area 613 defined by the flat-sided edges 604 that is proximate to and/or adjacent to the core wire 302.
  • the flatsided edges 604 define a space within a perimeter of the core wire 302 if the core wire 302 had completely circular cross section 611.
  • a portion of the core wire 302 is shaped (e.g., to have the flat-sided edges 604) to define the area 613 within the perimeter of the core wire 302 if the core wire 302 had completely circular cross section 611.
  • the additional conductive members 260 allow for five conductive members to be utilized. That is, not only are the four illustrated conductive members 260 used for electrical communication, but also the core wire 302 itself may be utilized as a conductor.
  • the core wire 302 may have more or less flat-sided edges 604 than shown.
  • the core wire 302 may have one, two, or three flat-sided edges.
  • the core wire 302 may have five, six or more flat-sided edges.
  • Fig. 7 is a diagrammatic cross-sectional view of a core wire of a flexible elongate member 106, according to aspects of the present disclosure.
  • Fig. 7 includes features similar to those described in Fig. 3A.
  • the core wire 302 has been sectionalized into three separate core sections 302a, 302b, and 302c.
  • each of the three separate core sections 302a, 302b, and 302c are utilized for electrical communication.
  • separate core sections 302a, 302b, and 302c may be coupled to one another by an adhesive 702, such as a polymer.
  • a material of the adhesive 702 may a same material as the polymer layer 250.
  • the material of the adhesive 702 may be different material from the material of the polymer layer 250.
  • Fig. 8 is a diagrammatic cross-sectional view of a core wire of a flexible elongate member 106, according to aspects of the present disclosure.
  • Fig. 8 includes features similar to those described in Fig. 3 A.
  • a plurality of anchor channels 802 are formed into the core wire 302.
  • the plurality of anchor channels 502 provide a greater surface area for adhering the polymer layer 250 to the core wire 302.
  • the anchor channels 502 are also portions of the core wire 302 that are shaped and can extend radially from the perimeter of the core wire 302 inwards towards the center of the core wire 302.
  • FIG. 9 is a diagrammatic cross-sectional side view of a portion of the flexible elongate member 106, according to aspects of the present disclosure.
  • the flexible elongate member 106 has a proximal end 902 and a distal end 904.
  • the proximal end 902 of the flexible elongate member 106 is larger in diameter than the distal end 904.
  • the diameter of the core wire 302 may vary along the length of the flexible elongate member 106.
  • Fig. 10A illustrates a cross-sectional view of the flexible elongate member 106 of Fig. 9, as seen along the lines of the section A-A taken therein, according to aspects of the present disclosure.
  • Fig. 10B illustrates a cross-sectional view of the flexible elongate member 106 of Fig. 9, as seen along the lines of the section B-B taken therein, according to aspects of the present disclosure.
  • the flexible elongate member 106 includes the core wire 302, the conductive members 260, and the polymer layer 250 that insulates the conductive members 260 from one another and also insulates conductive members 260 from the core wire 302.
  • the cross section illustrated in Fig. 10B is larger in diameter than the cross section illustrated in Fig. 10A.
  • the conductive members 260 may maintain their size throughout the length of the flexible elongate member 106.
  • the conductive members 260 may decrease in size proportional to the decrease in diameter of the core wire 302 along the length of the flexible elongate member 106.
  • the core wire 302 has a same shape (including elongate structures) along its length - the shapes are just proportionally bigger or smaller depending on where along the length.
  • the one or more elongate structures are flat-sided edges 1004 around one or more sides of the core wire 302 and/or an area 1013 defined by the flat-sided edges 1004 that is proximate to and/or adjacent to the core wire 302.
  • the flat-side edges 1004 define a space within a perimeter of the core wire 302 if the core wire 302 had completely circular cross section 1011.
  • a portion of the core wire 302 is shaped (e.g., to have the flat-sided edges 1004) to define the area 1013 within the perimeter of the core wire 302 if the core wire 302 had completely circular cross section 1011.
  • the conductive members 260 extend within those areas.
  • Fig. 11 is a diagrammatic cross-sectional side view of a portion of the flexible elongate member 106, according to aspects of the present disclosure.
  • the flexible elongate member 106 is stretched in tension and twisted to form a helical, barber pole pattern in the core wire.
  • Fig. 12A illustrates a cross-sectional view of the flexible elongate member 106 of Fig. 11, as seen along the lines of the section A-A taken therein, according to aspects of the present disclosure.
  • Fig. 12B illustrates a cross-sectional view of the flexible elongate member 106 of Fig. 11, as seen along the lines of the section B-B taken therein, according to aspects of the present disclosure.
  • Fig. 12C illustrates a cross-sectional view of the flexible elongate member 106 of Fig. 11, as seen along the lines of the section C- C taken therein, according to aspects of the present disclosure.
  • the flexible elongate member 106 illustrated in Figs. 12A-12C includes the core wire 302, the conductive members 260, and the polymer layer 250 that insulates the conductive members 260 from one another and also insulates conductive members 260 from the core wire 302.
  • the flexible elongate member has been twisted such that the conductive members 260 are at 135 degrees and 315 degrees form normal.
  • the flexible elongate member has been twisted such that the conductive members 260 are at 0 degrees and 180 degrees form normal.
  • Fig. 12A the flexible elongate member has been twisted such that the conductive members 260 are at 135 degrees and 315 degrees form normal.
  • the flexible elongate member has been twisted such that the conductive members 260 are at 0 degrees and 180 degrees form normal.
  • the flexible elongate member has been twisted such that the conductive members 260 are at 90 degrees and 270 degrees form normal.
  • the one or more elongate structures are flat-sided edges 1004 around one or more sides of the core wire 302 and/or an area 1213 defined by the flat-sided edges 1004 that is proximate to and/or adjacent to the core wire 302.
  • the flat-side edges 1004 define a space within a perimeter of the core wire 302 if the core wire 302 had completely circular cross section 1211.
  • a portion of the core wire 302 is shaped (e.g., to have the flat-sided edges 1004) to define the area 1213 within the perimeter of the core wire 302 if the core wire 302 had completely circular cross section 1211.
  • the conductive members 260 extend within those areas.
  • the increased diameter core wire with elongate structures assembly advantageously enables a greater moment of inertia resulting in improved core wire column strength and torque transmission characteristics for an assembled interventional guidewire.
  • the increased diameter core wire has a cross-sectional geometry with one or more elongate structures that allows conductive members to be partially or fully recessed into the one or more elongate structures. By recessing the conductive members into the one or more elongate structures, as opposed to wrapping the conductive wires around the outside diameter of a core wire, the overall diameter and/or cross-sectional area of the core wire may be increased.
  • the column stiffness and torque response of the intraluminal device may be improved as well, which may lead to improved guidewire pushability and deliverability when the device is manipulated within intravascular anatomy.
  • the elongate structures and the conductive members within the elongate structures can be distributed symmetrically and/or uniformly around a perimeter of the cross-section of the core wire.
  • Such symmetric and/or uniform distribution can help advantageously avoid whipping of the guidewire (e.g., whipping occurs when the distal portion of the guidewire does not smoothly rotate with the proximal portion of the guidewire (e.g., which is controlled by a user), instead the distal portion of the guidewire rapidly rotates inside the blood vessel to catch up to the rotational position of the proximal portion of the guidewire.)
  • All directional references e.g., upper, lower, inner, outer, upward, downward, left, right, lateral, front, back, top, bottom, above, below, vertical, horizontal, clockwise, counterclockwise, proximal, and distal are only used for identification purposes to aid the reader’s understanding of the claimed subject matter, and do not create limitations, particularly as to the position, orientation, or use of the metal ink conductor assembly.
  • Connection references e.g., attached, coupled, connected, and joined are to be construed broadly and may include intermediate members between a collection of elements and relative movement between elements unless otherwise indicated. As such, connection references do not necessarily imply that two elements are directly connected and in fixed relation to each other.

Abstract

L'invention concerne un appareil comprenant un fil-guide intravasculaire avec un élément allongé flexible positionné à l'intérieur d'un vaisseau sanguin d'un patient. L'élément allongé flexible comprend une partie proximale, une partie distale et un fil central ayant une structure allongée. Le fil-guide intravasculaire comprend un capteur disposé au niveau de la partie distale de l'élément allongé flexible. Le capteur obtient des données médicales relatives au vaisseau sanguin tandis que l'élément allongé flexible est positionné à l'intérieur du vaisseau sanguin. Le fil-guide intravasculaire comprend un connecteur disposé à la partie proximale de l'élément allongé flexible. Le fil-guide intravasculaire comprend un premier élément conducteur en communication électrique avec le capteur. Le fil-guide intravasculaire comprend un second élément conducteur en communication électrique avec le connecteur. Le premier élément conducteur et le second élément conducteur sont disposés le long de la structure allongée du fil central.
PCT/EP2023/059356 2022-04-22 2023-04-11 Fil central à structures allongées pour conducteurs dans un dispositif intraluminal et dispositifs, systèmes et procédés associés WO2023202904A1 (fr)

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US202263333579P 2022-04-22 2022-04-22
US63/333,579 2022-04-22

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Citations (8)

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Publication number Priority date Publication date Assignee Title
WO2009054802A1 (fr) * 2007-10-26 2009-04-30 Radi Medical Systems Ab Fil guide de détection pourvu d'un enroulement de micro-câble
WO2013028737A1 (fr) * 2011-08-22 2013-02-28 Lake Region Manufacturing, Inc. D/B/A Fil-guide multiconducteur, de faible profil
US20140187874A1 (en) 2012-12-31 2014-07-03 Volcano Corporation Intravascular Devices, Systems, and Methods
US20150273187A1 (en) 2014-03-26 2015-10-01 Volcano Corporation Intravascular Devices, Systems, and Methods Having a Core Wire Formed of Multiple Materials
WO2016009317A1 (fr) * 2014-07-13 2016-01-21 Three Rivers Cardiovascular Systems Inc. Système et appareil comprenant un fil-guide à capteurs multiples à utiliser dans des interventions de cardiologie interventionnelle
US20160058977A1 (en) 2014-08-28 2016-03-03 Volcano Corporation Intravascular devices, systems, and methods having an adhesive filled distal tip element
US10595820B2 (en) 2012-12-20 2020-03-24 Philips Image Guided Therapy Corporation Smooth transition catheters
WO2022013266A1 (fr) * 2020-07-15 2022-01-20 Koninklijke Philips N.V. Dispositif de détection physiologique intraluminal avec conducteurs enrobant intégrés

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2009054802A1 (fr) * 2007-10-26 2009-04-30 Radi Medical Systems Ab Fil guide de détection pourvu d'un enroulement de micro-câble
WO2013028737A1 (fr) * 2011-08-22 2013-02-28 Lake Region Manufacturing, Inc. D/B/A Fil-guide multiconducteur, de faible profil
US10595820B2 (en) 2012-12-20 2020-03-24 Philips Image Guided Therapy Corporation Smooth transition catheters
US20140187874A1 (en) 2012-12-31 2014-07-03 Volcano Corporation Intravascular Devices, Systems, and Methods
US20150273187A1 (en) 2014-03-26 2015-10-01 Volcano Corporation Intravascular Devices, Systems, and Methods Having a Core Wire Formed of Multiple Materials
WO2016009317A1 (fr) * 2014-07-13 2016-01-21 Three Rivers Cardiovascular Systems Inc. Système et appareil comprenant un fil-guide à capteurs multiples à utiliser dans des interventions de cardiologie interventionnelle
US20160058977A1 (en) 2014-08-28 2016-03-03 Volcano Corporation Intravascular devices, systems, and methods having an adhesive filled distal tip element
WO2022013266A1 (fr) * 2020-07-15 2022-01-20 Koninklijke Philips N.V. Dispositif de détection physiologique intraluminal avec conducteurs enrobant intégrés

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