[go: up one dir, main page]

WO1993012713A1 - Mecanisme prolongateur de fil de guidage - Google Patents

Mecanisme prolongateur de fil de guidage Download PDF

Info

Publication number
WO1993012713A1
WO1993012713A1 PCT/US1992/010937 US9210937W WO9312713A1 WO 1993012713 A1 WO1993012713 A1 WO 1993012713A1 US 9210937 W US9210937 W US 9210937W WO 9312713 A1 WO9312713 A1 WO 9312713A1
Authority
WO
WIPO (PCT)
Prior art keywords
guidewire
segment
guidewire segment
proximal end
distal end
Prior art date
Application number
PCT/US1992/010937
Other languages
English (en)
Inventor
Jeffrey L. Kraus
Original Assignee
Danforth Biomedical Incorporated
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 Danforth Biomedical Incorporated filed Critical Danforth Biomedical Incorporated
Publication of WO1993012713A1 publication Critical patent/WO1993012713A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09—Guide wires
    • A61M25/0905—Guide wires extendable, e.g. mechanisms for extension

Definitions

  • the invention generally relates to guidewires for use in medical procedures, more specifically to extendable guidewires for medical procedures including percutaneous transluminal angioplasty that enable the exchange of catheters, such as dilation balloon catheters, within a body vessel with preserved intra-luminal access.
  • over-the-wire catheters have been developed that permit the performance of a variety of therapeutic procedures within body vessels with less morbidity relative to the corresponding surgical alternatives.
  • these catheters are advanced over guidewires to provide directional control.
  • exchange wires were developed for this purpose. Exchange wires are particularly long wires which can be substituted for conventional guidewires in anticipation of the performance of a catheter exchange. Although effective in preserving intravascular access during the course of a catheter exchange, experience has found these wires to be cumbersome to use. More recently, extendable guidewires were developed which are substantially easier to use and equally effective in preserving intravascular access during the course of an exchange procedure. Extendable guidewires use attachable segments to incrementally increase the length of the guidewire and thereby function as both a standard guidewire and an exchange wire. The use of extendable guidewires eliminate the need to substitute guidewires having fixed lengths.
  • U.S. Patent No. 4,827,941 teaches an extendable guidewire for cardiovascular procedures which provides a connection between an extension section and a guidewire, the connection relying upon a friction fit.
  • the coupling mechanism of this device has the disadvantage of requiring a degree of opposing longitudinal forces to join the two components together. Given the delicate nature of many narrow gauge guidewires, such an application of force frequently can result in kinks or bends which, if significant, can render the resulting extended guidewire useless.
  • U.S. Patent No. 4,966,163 also teaches an extendable guidewire for vascular procedures.
  • This device uses male and female threaded sections to join an extension section onto a guidewire.
  • a threaded engagement reduces the necessity of applying longitudinal force
  • such a male-female threaded configuration in a typical intravascular guidewire application requires threads to be fabricated in the range of 0.010 to 0.011 inches in diameter. Quality threads of this dimension are difficult or near impossible to fabricate using conventional technology. Sophisticated microfabrication technologies must be employed. As a result, these micro- threads are extremely costly to construct.
  • the invention provides a new and improved coupling mechanism for extendable guidewires which can be used in a variety of procedures, including coronary and peripheral vascular procedures.
  • a first guidewire segment includes a hollow mating tube secured to the proximal end of the first guidewire segment.
  • the mating tube includes an aperture tangential to the longitudinal axis of the tube and is open at the proximal end.
  • a second guidewire segment has an elbow at its distal end. Coupling the second guidewire segment to the first guidewire segment is accomplished by first inserting the proximal end of the second guidewire segment into the aperture of the first guidewire segment until the proximal end of the second guidewire segment extends out beyond the proximal end of the first guidewire segment, and then pulling the second guidewire segment through the aperture from its proximal end until the elbow engages the aperture.
  • a first guidewire segment and a second guidewire segment employ a coupling mechanism with a hook and eyelet configuration.
  • an eyelet is formed at the proximal end of the first guidewire segment.
  • the second guidewire segment includes a hook located at its distal end. To couple the first guidewire segment and the second guidewire segment together, the hook of the second guidewire segment is engaged with the eyelet located on the first guidewire segment.
  • a tubular sheath located on the first guidewire segment is then moved over the hook and eyelet connection junction to protect and secure the connection and provide a smooth outer surface for passing catheter systems over the junction.
  • the aforementioned constructions of the coupling mechanism enable the extension of guidewires used in the performance of catheter-based medical procedures.
  • the extension of such wires makes possible the use of previously installed conventional-length guidewires in the performance of catheter exchange procedures with preserved intraluminal access.
  • Each of the coupling means permit reversible extension with less propensity to provoke kinks during this process relative to the prior art.
  • all of the aforementioned constructions are easy to manufacture.
  • Fig. la is a perspective view of an alternative embodiment of the invention shown partially in section with a first guidewire segment and a second guidewire segment in the disengaged condition;
  • Fig. lb is a plan view of the alternative embodiment illustrated in Fig. la also shown partially in section with the second guidewire segment and the first guidewire segment in the fully engaged condition;
  • Fig. lc is a plan view of an alternative embodiment of the coupling means disclosed in Figs, la-lb shown partially in section with a first guidewire segment and a second guidewire segment in the disengaged condition;
  • Fig. Id is a plan view of the embodiment of the coupling means disclosed in Fig. lc shown partially in section with a first guidewire segment and a second guidewire segment in the fully engaged condition;
  • Fig. 2 is a plan view of an outer sheath used in another alternative embodiment of the invention where a first guidewire segment and a second guidewire segment engage with a hook and catch coupling mechanism;
  • Fig. 3 is a plan view of the proximal end of the first guidewire segment used in the alternative embodiment employing the outer sheath illustrated in Fig. 2, the first guidewire segment shown having an eyelet at the extreme proximal end;
  • Fig. 4 is a plan view of the embodiment employing the devices of Figs. 2 and 3, showing the second guidewire segment having a hook at the distal end which engages with the catch located at the proximal end of the first guidewire segment;
  • Fig. 5 is a plan view partially in section of the alterative embodiment illustrated in Fig. 4, the outer sheath shown slidable over the hook and eyelet connection junction; and
  • Fig. 6 is a plan view partially in section of the alternative embodiment illustrated in Fig. 5 with the outer sheath positioned completely over the hook and eyelet junction coupling the first guidewire segment and a second guidewire segment together and providing a smooth outer surface to facilitate smooth passage of a catheter system over the device.
  • first guidewire segment 102 includes mating tube 104 disposed at its proximal end.
  • Mating tube 104 includes aperture 106 formed near the proximal end 108 of mating tube 104.
  • the coupling mechanism embodies the engagement between the mating tube 104 and an extended end 112 of second guidewire segment 110.
  • Second guidewire segment 110 is formed having an elbow 112 at its extreme distal end and providing a head 122 which extends slightly out radially from the longitudinal axis of second guidewire segment 110.
  • Mating tube 104 can be fabricated using materials similar to that of outer sheath 44 described in the previous embodiments, i.e., HYPOTUBE® or suitable alternatives, including slightly flexible materials.
  • First guidewire segment 102 is formed having a tapered portion 114 which provides a
  • the outer diameter of post 116 is made substantially the same size as the inner diameter of mating tube 104.
  • Mating tube 104 is secured to first guidewire segment 102 by bonding along taper portion 114 and/or post 116 using appropriate bonding material.
  • mating tube 104 is formed from HYPOTUBE® material, appropriate adhesive or soldering techniques can be employed.
  • Fig. lb shows first guidewire segment 102 and second guidewire segment 110 of this embodiment in the fully engaged condition.
  • proximal end 118 of second guidewire segment 110 is inserted through aperture 106 into mating tube 104 and out open end 120.
  • the entire length of second guidewire segment 110 is pulled through aperture 106 until head 112 engages the rim of aperture 106.
  • Second guidewire segment 110 is constructed having an outer diameter slightly less than the inner diameter of mating tube 104.
  • head 122 extending outwardly from elbow 112 is secured within aperture 106.
  • the dimensional outward extension of head 122 is limited, however, to prevent the formation of a potential snag when running a catheter system over the extension mechanism 100.
  • the outward extension of head 122 is flush with the outer diameter of mating tube 104 as shown in Fig. la.
  • Disengagement of second guidewire segment 110 from first guidewire segment 102 is accomplished by pushing elbow 112 back out through aperture 106 in a reverse direction until second guidewire segment 110 is fully withdrawn from mating tube 104.
  • Aperture 106 is located close enough to open end 120 to allow second guidewire segment 110 to be disengaged without bending mating tube 104.
  • the relative location of the components in coupling mechanism 100 of this embodiment can be reversed if desired by constructing a second guidewire segment 100 having mating tube 104 and first guidewire segment having elbow 112 and head 122.
  • Figs, lc-ld illustrate an alternative embodiment to the coupling means disclosed in Figs, la-lb.
  • This embodiment is similar to the previous in that it relies upon the engagement of elbow 112 and aperture 106 to couple the first and second guidewire segments together.
  • This embodiment differs from the previous in that the distal end of second guidewire segment 110 can be installed directly into the proximal end of the first guidewire segment 102 as a result of slot 119 provided in the mating tube. Second guidewire segment 110 is secured in place by sliding cover tube 121 over slot 119.
  • FIG. 2-6 An additional alternative embodiment of the invention is shown in Figs. 2-6.
  • This embodiment uses a hook and eyelet coupling mechanism.
  • First guidewire segment 130 is shown in Fig. 8 having an eyelet 132 disposed at its proximal end 134. Eyelet 132 can be formed by tapering the outer diameter of first guidewire segment 130 down to a lesser diameter and bending it back upon itself to form an eye as indicated in Fig. 8. The eyelet is then secured by suitable soldering 136.
  • First guidewire segment 130 also includes an outer sleeve 138 as illustrated in Fig. 4.
  • Outer sleeve 138 can be formed of HYPOTUBE® consistent with the embodiments previously described.
  • Second guidewire segment 140 of this embodiment is formed having distal end 142 with a tapered portion 144 configured to form a hook 146.
  • Hook 146 includes open slot 148 which allows hook 146 to receive eyelet 132 as shown in Fig. 4.
  • first guidewire segment 130 is coupled with second guidewire segment 140 to thereby increase the effective length of the guidewire system just as in the previous embodiments.
  • outer sleeve 138 which is disposed around first guidewire segment 130, is slid up and over the mating junction of eyelet 132 and hook 146 as indicated in Fig. 5. In the fully engaged condition as shown in Fig.
  • outer sleeve 138 completely covers the mating junction between first guidewire segment 130 and second guidewire segment 140 to provide a smooth outer surface for passing a catheter system over the length of the mating junction.
  • Outer sleeve 138 is sized so that it snugly fits about second guidewire segment 140 to secure it into this position.
  • the two guidewire segments can be disengaged by withdrawing the outer sleeve 138 and uncoupling hook 146 and eyelet 132.
  • the respective coupling components on each guidewire segment can be reversed, if desired.
  • This embodiment like all embodiments previously described, provides a simple and efficient coupling mechanism for extending the length of the guidewire system.
  • guidewire extension mechanism can be fabricated in alternative dimensions and from a wide range of materials including, but not limited to titanium, platinum, palladium, plastics, as well as suitable alloys, ceramics, relatively flexible materials or any combination thereof. Also, modification to the constructions discussed can be employed.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

Système de fil de guidage télescopique réversible utilisé dans certains procédés médicaux tels que l'insertion et le remplacements de systèmes de cathéter. Le mécanisme d'assemblage se compose d'un raccord entre une protubérance de raccordement (152) et un logement (156) avec une gaine de protection (160), un segment cordé prolongateur (122) qui est accouplé avec un tube de raccordement pourvu d'une ouverture latérale (106) afin de raccorder les segments entre eux, ou un ensemble comprenant un crochet (146) et un ÷illet avec une gaine de protection afin de raccorder les segments entre eux.
PCT/US1992/010937 1991-12-23 1992-12-15 Mecanisme prolongateur de fil de guidage WO1993012713A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US81333791A 1991-12-23 1991-12-23
US813,337 1991-12-23

Publications (1)

Publication Number Publication Date
WO1993012713A1 true WO1993012713A1 (fr) 1993-07-08

Family

ID=25212091

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1992/010937 WO1993012713A1 (fr) 1991-12-23 1992-12-15 Mecanisme prolongateur de fil de guidage

Country Status (1)

Country Link
WO (1) WO1993012713A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4617932A (en) * 1984-04-25 1986-10-21 Elliot Kornberg Device and method for performing an intraluminal abdominal aortic aneurysm repair
US4966163A (en) * 1989-02-14 1990-10-30 Advanced Cardiovascular Systems, Inc. Extendable guidewire for vascular procedures
US5109867A (en) * 1991-04-19 1992-05-05 Target Therapeutics Extendable guidewire assembly

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4617932A (en) * 1984-04-25 1986-10-21 Elliot Kornberg Device and method for performing an intraluminal abdominal aortic aneurysm repair
US4966163A (en) * 1989-02-14 1990-10-30 Advanced Cardiovascular Systems, Inc. Extendable guidewire for vascular procedures
US5109867A (en) * 1991-04-19 1992-05-05 Target Therapeutics Extendable guidewire assembly

Similar Documents

Publication Publication Date Title
US5788653A (en) Guidewire extension with sliding release mechanism
EP0994742B1 (fr) Fil-guide a rigidite variable pour angioplastie
US5546958A (en) Guidewire extension system with tactile connection indication
US8202254B2 (en) Method for using a guidewire locking device
US4548206A (en) Catheter wire guide with movable mandril
US4827941A (en) Extendable guidewire for cardiovascular procedures
US6113557A (en) Variable stiffness angioplasty guide wire
US5271415A (en) Guidewire extension system
US4966163A (en) Extendable guidewire for vascular procedures
CA1278233C (fr) Fil-guide orientable de faible diametre a extremite reglable
US5701911A (en) Guide wire extension docking system
USRE34466E (en) Extendable guidewire for cardiovascular procedures
US5207650A (en) Infusion catheters
US5415178A (en) Extendable guidewire assembly
US5997508A (en) Expandable percutaneous introducer sheath
US5246009A (en) Guide wire assembly and method for catheter exchange
EP0664719B1 (fr) Pointe de catheter a revetement anti-frottement
JPH04236965A (ja) 可動のコアガイドワイヤー
WO2001070321A1 (fr) Gaine d'introduction de catheter
EP0699044A1 (fr) Systeme d'extension pour fil de guidage
US5195535A (en) Detachable guidewire extension
US5513650A (en) Guidewire extension connector - keyed joint
EP0837711A1 (fr) Catheters a capacite d'echange amelioree
AU6933391A (en) Telescoping guide catheter system
CA1262324A (fr) Collier-support souple

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): JP

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): AT BE CH DE DK ES FR GB GR IE IT LU MC NL PT SE

DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
122 Ep: pct application non-entry in european phase