US20020058888A1 - Dock exchange system for composite guidewires - Google Patents
Dock exchange system for composite guidewires Download PDFInfo
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- US20020058888A1 US20020058888A1 US09/736,854 US73685400A US2002058888A1 US 20020058888 A1 US20020058888 A1 US 20020058888A1 US 73685400 A US73685400 A US 73685400A US 2002058888 A1 US2002058888 A1 US 2002058888A1
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- Prior art keywords
- guidewire
- intracorporeal
- composite
- extension
- composite guidewire
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- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
- A61M2025/09058—Basic structures of guide wires
- A61M2025/09083—Basic structures of guide wires having a coil around a core
-
- 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
- A61M2025/09133—Guide wires having specific material compositions or coatings; Materials with specific mechanical behaviours, e.g. stiffness, strength to transmit torque
-
- 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
- A61M2025/09166—Guide wires having radio-opaque features
-
- 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
- A61M2025/09175—Guide wires having specific characteristics at the distal tip
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M25/0108—Steering means as part of the catheter or advancing means; Markers for positioning using radio-opaque or ultrasound markers
-
- 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
- A61M25/09016—Guide wires with mandrils
- A61M25/09033—Guide wires with mandrils with fixed mandrils, e.g. mandrils fixed to tip; Tensionable wires
Definitions
- This invention relates to the field of guidewires for advancing intraluminal devices such as stent delivery catheters, balloon dilatation catheters, atherectomy catheters and the like within a patient's body, specifically, within a patient's vasculature.
- a guiding catheter having a preformed distal tip is percutaneously introduced into a patient's peripheral artery, e.g., femoral, radial or brachial artery, by means of a conventional Seldinger technique and advanced therein until the distal tip of the guiding catheter is seated in the ostium of a desired coronary artery.
- a preload technique which is used primarily for over-the-wire (OTW) devices
- bare wire technique which is used primarily for rail type systems.
- a guidewire is positioned within an inner lumen of an OTW device such as a dilatation catheter or stent delivery catheter with the distal tip of the guidewire just proximal to the distal tip of the catheter and then both are advanced through the guiding catheter to the distal end thereof.
- the guidewire is first advanced out of the distal end of the guiding catheter into the patient's coronary vasculature until the distal end of the guidewire crosses the arterial location where the interventional procedure is to be performed, e.g., a lesion to be dilated or a dilated region where a stent is to be deployed.
- the catheter which is slidably mounted onto the guidewire, is advanced out of the guiding catheter into the patient's coronary anatomy over the previously introduced guidewire until the operative portion of the intravascular device, e.g. the balloon of a dilatation or a stent delivery catheter, is properly positioned across the arterial location.
- the interventional procedure is performed.
- the catheter can then be removed from the patient over the guidewire.
- the guidewire is left in place for a period of time after the procedure is completed to ensure reaccess to the arterial location if it is necessary.
- a rapid exchange type perfusion balloon catheter such as described and claimed in U.S. Pat. No. 5,516,336 (McInnes et al), can be advanced over the in-place guidewire so that the balloon can be inflated to open up the arterial passageway and allow blood to perfuse through the distal section of the catheter to a distal location until the dissection is reattached to the arterial wall by natural healing.
- the guidewire is first advanced by itself through the guiding catheter until the distal tip of the guidewire extends beyond the arterial location where the procedure is to be performed. Then a rail type catheter, such as described in U.S. Pat. No. 5,061,273 (Yock) and the previously discussed McInnes et al. which are incorporated herein by reference, is mounted onto the proximal portion of the guidewire which extends out of the proximal end of the guiding catheter which is outside of the patient. The catheter is advanced over the guidewire, while the position of the guidewire is fixed, until the operative means on the rail type catheter is disposed within the arterial location where the procedure is to be performed. After the procedure the intravascular device may be withdrawn from the patient over the guidewire or the guidewire advanced further within the coronary anatomy for an additional procedure.
- Conventional guidewires for angioplasty, stent delivery, atherectomy and other vascular procedures usually comprise metallic elongated core member with one or more tapered sections near the distal end thereof and a flexible body such as a metallic helical coil or a tubular body of polymeric material disposed about the distal portion of the core member.
- a shapable member which may be the distal extremity of the core member or a separate shaping ribbon which is secured to the distal extremity of the core member, extends through the flexible body and is secured to the distal end of the flexible body by soldering, brazing or welding which forms a rounded distal tip.
- Torquing means are provided on the proximal end of the core member to rotate, and thereby steer, the guidewire while it is being advanced through a patient's vascular system.
- the invention is directed to an intracorporeal guiding device which can be in the form of a guidewire.
- the device includes an elongate member having a proximal section and a distal section.
- the distal section is made at least partially of a fiber composite matrix and has at least one segment with increasing flexibility in a distal direction.
- the fiber composite matrix can be configured to have little or no metal content so as to avoid creating imaging artifacts with sensitive imaging systems such as MRI and the like.
- a flexible body is disposed about the distal section of the elongate member.
- Tihe flexible body can have a variety of configurations, including a helical coil and a polymer layer.
- the flexible body which consists of a polymer layer can be doped with a radiopaque material in order to improve visualization of the device under fluoroscopic imaging and the like.
- the elongate intracorporeal guiding device can have an elongate core disposed within a core lumen of the elongate member.
- the elongate core can be fixed or secured within the core lumen, or it may be moveable in an axial direction. Movement of the elongate core within the core lumen of the device may be used to adjust the flexibility of the distal section.
- a shapeable segment can be secured to the distal end of the elongate member with the flexible body disposed at least partially about the shapeable segment.
- the shapeable segment is comprised of metal which can be flattened to provide improved shapeability in a specified orientation.
- the invention is also directed to a method of making an elongate intracorporeal guiding device.
- the method includes disposing at least one layer of thin fiber about a mandrel. This can be done by winding, stranding, braiding or any other suitable method.
- a binding agent is then applied to the fiber material. If necessary, the binding agent can then be cured. Alternatively, a binding agent may be present on a thin fiber prior to disposing the thin fiber on the mandrel.
- the invention is directed to a method of advancing an elongate intracorporeal guiding device within a patient's body.
- the method includes providing an elongate intracorporeal guiding device having a distal section configured so as not to create imaging artifacts when used with MRI imaging.
- the elongate intracorporeal guiding device is then inserted into the patient's body and advanced within the patient's body under MRI imaging to a desired site.
- a distal section configured to not create imaging artifacts with MRI imaging, or other sensitive imaging methods, can be a distal section constructed essentially of non-metallic fiber composite matrix optionally including polymer materials having little or not metallic content.
- the invention is also directed to a dock exchange system for composite guidewires.
- the incorporation of a dock exchange system into a composite guidewire must consider the filament nature of the composite guidewire and how it is manufactured.
- the docking mechanism of the present invention is a hypotube or a crimped or crimpable tube attached to the proximal end of the guidewire which receives the tip of an extension guidewire.
- the hypotube or crimped or crimpable tube and the extension tip are so designed that once the latter is inserted, it is held in place unless a certain amount of tensile force is applied.
- the mechanism involves, for example, crimping the extension tip or placing magnets inside the hollow section.
- FIG. 1 is an elevational view in partial section of an intracorporeal guiding device having features of the invention.
- FIG. 2 is a transverse cross sectional view of the intracorporeal guiding device of FIG. 1 taken along lines 2 - 2 in FIG. 1.
- FIG. 3 is a transverse cross sectional view of the intracorporeal guiding device of FIG. 1 taken along lines 3 - 3 in FIG. 1.
- FIG. 4 is a transverse cross sectional view of the intracorporeal guiding device of FIG. 1 taken along lines 4 - 4 in FIG. 1.
- FIG. 5 is an elevational view in partial section of a part of a distal section of an intracorporeal guiding device having features of the invention.
- FIG. 6 is a transverse cross sectional view of the intracorporeal guiding device of FIG. 5 taken along lines 6 - 6 in FIG. 5.
- FIG. 7 is an elevational view in partial section of an intracorporeal guiding device having features of the invention.
- FIG. 8 is a transverse cross sectional view of the intracorporeal guiding device of FIG. 7 taken along lines 8 - 8 in FIG. 7.
- FIG. 9 is a schematic view of thin fibers being braided onto a mandrel
- FIG. 10 is a schematic view of a thin fiber being wound onto a mandrel.
- FIG. 11 is a schematic view of thin fibers being stranded onto a mandrel.
- FIG. 12 shows a dock exchange system in which the composite guidewire has a hollow proximal end for receiving the distal end of the extension wire.
- FIGS. 13 and 14 show alternative designs having a hypotube with an outer diameter identical to or smaller than the outer diameter of the proximal section of the composite guidewire.
- FIG. 15 shows a dock exchange system with a smaller inner diameter at the proximal end of the composite guidewire that constricts around the tip of the extension wire.
- FIGS. 16 - 18 show a dock exchange system in which the filler material is a solid cylinder cut in half along its length to create a larger surface area to hold onto the tip of the extension wire.
- FIG. 19 shows a dock exchange system in which the filler material has a texture that enhances the adhesion strength between the composite and extension guidewires.
- FIGS. 20 & 21 show a dock exchange system in which the composite and extension guidewires are held together by magnetic force.
- FIG. 22 shows a dock exchange system in which the hollow proximal section of the composite guidewire has a constriction for preventing the tip of the extension wire from sliding out.
- FIG. 1 shows an intracorporeal guiding device 10 having features of the invention.
- An elongate member 11 made entirely of fiber composite matrix 12 has a proximal section 13 , a proximal end 14 , a distal section 15 and a distal end 16 .
- the elongate member 11 can be made partially out of fiber composite matrix 12 .
- An optional core member 17 is disposed within a core lumen 18 of the elongate member 11 and is axially moveable within the core lumen 18 as indicated by arrow 21 .
- the core member 17 has a proximal end 22 and a distal end 23 and may also be secured within the core lumen 18 either by frictional force, an epoxy or other adhesive, or by any other suitable means.
- An optional shapeable segment 24 having a proximal end 25 and a distal end 26 has an end cap 27 disposed at the proximal end 25 of the shapeable segment 24 .
- the end cap 27 is disposed over and secured to the distal end 16 of the elongate member 11 .
- the end cap 27 may be secured to the distal end 16 of the elongate member 11 by a friction fit, adhesive such as an epoxy, or any other suitable method.
- a flexible body in the form of a helical coil 30 having a proximal end 31 and a distal end 32 is disposed about the shapeable segment 24 .
- the distal end 32 of the helical coil 30 is secured to the distal end 26 of the shapeable segment 24 with a body of solder 33 or the like.
- the proximal end 31 of the helical ccil 30 can be similarly secured to the proximal end 25 of the shapeable segment 24 .
- the fiber composite matrix 12 of the elongate member 11 may be formed in a variety of configurations and from a variety of materials.
- the fiber composite matrix 12 can be formed from a plurality of non-metallic thin fibers 34 made of carbon fiber braided over a mandrel (not shown) in one or more layers.
- a cured or hardened binding agent 35 such as an epoxy resin, polyester resin or other suitable material is disposed about the thin fibers 34 to form the fiber composite matrix 12 .
- the binding agent 35 can optionally be doped with a radiopaque material in order to provide radiopacity to the elongate member 11 .
- one or more radiopaque thin fibers 34 can be made of the same or similar radiopaque materials discussed above with regard to radiopaque dopants for the binding agent and may be used when forming the fiber composite matrix 12 in order to provide radiopacity to the device 10 .
- a conductor, insulated or uninsulated, or other type of conduit capable of carrying an electric, light, or other type of signal can be substituted or molded into the thin fibers 34 .
- a signal conveying information such as temperature of pressure from the distal end 16 to the proximal end 14 of the elongate member 11 .
- a fiber optic is used, light or a light signal can be transmitted from the distal end 16 to the proximal end 14 of the elongate member 11 , or from the proximal end 14 to the distal end 16 .
- the aforementioned mandrel is removed after the binding agent is cured.
- the core member 17 could serve as a forming mandrel such as that discussed above, or a separate mandrel could be used for forming the fiber composite matrix 12 arid then be removed. A core member 17 could then be inserted into the core lumen 18 once the forming mandrel is removed.
- the thin fiber 34 could also be wound or stranded about the forming mandrel prior to curing of the binding agent. Any appropriate number of layers of thin fiber 34 may be braided, stranded or wound about a forming mandrel in order to achieve a desired thickness of the fiber composite matrix 12 .
- approximately 1 to about 10 layers of thin fiber 34 may be used, specifically, about 2 to about 6 layers of thin fiber.
- the thin fibers 34 can have a transverse dimension of about 0.0005 to about 0.002 inch (about 0.0013 to 0.0051 cm), specifically about 0.001 to about 0.0015 inch (about 0.0025 to 0.0038 cm) and can be made of carbon fiber.
- Other materials that can be used for the thin fibers 34 are polymeric substances such as Nylon (polyamides), Kevlar (polyarylamides), fiberglass and the like.
- the flexibility of the elongate member 11 can be controlled to some degree by varying the manner in which the one or more thin fibers are configured within the fiber composite matrix with respect to axial position along the elongate member 11 .
- the angle the thin fiber 34 makes with a line parallel to a longitudinal axis 36 of the elongate member 12 adjacent the thin fiber 34 can affect the longitudinal flexibility of the elongate member and hence the intracorporeal guiding device 10 .
- the distal section 15 of the elongate member 11 can be tapered to a reduced outer transverse dimension distally in one or more segments in order to increase the flexibility of such a segment.
- the tapering of a segment can be achieved by grinding a segment of substantially constant outer diameter after formation of the elongate member 11 .
- the tapering of a segment could be achieved by varying the number of layers or configuration of the thin fiber or fibers 34 in the formation process of the elongate member 11 .
- the diameter of the core lumen 18 within the elongate member 11 could be increased distally in a segment of the distal section 15 of the elongate member 11 in order to increase the flexibility of the segment.
- the core member 17 can be made from a metal such as stainless steel, MP35N, L605 or other high strength materials.
- the core member 17 may also be configured to be radiopaque and can have materials such as gold, platinum, platinum-iridium, tungsten and the like contained therein.
- the core member 17 may also be made of a fiber composite material similar to that of the elongate member 11 with a binding agent for such a fiber composite material being doped with a non-metallic radiopaque material in order to provide radiopacity to the core member 17 and avoid introduction of metallic content which might interfere with sensitive imaging methods as discussed above.
- the core member 17 can have an outer transverse dimension of about 0.001 to about 0.015 inches (about 0.0025 to 0.038 cm), specifically about 0.002 to about 0.005 inches (about 0.0051 to 0.0127 cm).
- the core member 17 can also be ground to have one or more tapered segments, specifically, tapered segment tapering distally to a reduced transverse dimension in order to provide greater flexibility in the distal section 15 of the elongate member 11 .
- the shapeable segment 24 can have a configuration similar to shapeable segments of guiding devices known in the art.
- the shapeable segment 24 is formed of stainless steel which has optionally been flattened. Specifically, the shapeable segment 24 has been flattened to a progressively greater degree in a distal direction. Thus, a thickness of the flattened portion at the proximal end 25 of the shapeable segment 24 is thicker than the thickness of the flattened portion of the shapeable segment 24 at the distal end 26 of the shapeable segment 24 .
- the length of the flexible segment 24 can be from about 2 to about 30 cm, specifically, about 3 to about 10 cm.
- the thickness of the shapeable segment 24 at the flattened distal end can be from about 0.0005 to about 0.006 inch (about 0.0013 to 0.0152 cm), specifically, about 0.001 to about 0.002 inch (about 0.0025 to 0.0051 cm).
- Other materials suitable for the shapeable segment 24 include MP35N, L605 or other high strength materials.
- the helical coil 30 can be made from a variety of suitable materials including stainless steel, platinum, platinum iridium, gold or the like.
- the helical coil 30 could also be made from a fiber composite matrix or other non-metal material in order to enable the intracorporeal guiding device 10 to have a distal section or an overall composition with a zero or minimum amount of metallic composition.
- minimizing the metallic content of the intracorporeal guiding device 10 improves compatibility with sensitive imaging devices such as MRI.
- the material of the helical coil 30 can have a transverse dimension of about 0.001 to about 0.005 inch (about 0.0025 to 0.0127 cm), specifically, about 0.002 to about 0.003 inch (about 0.0051 to 0.0076 cm).
- the nominal outer transverse dimension of the proximal section 13 of the elongate member 11 can be from about 0.005 to about 0.035 inch (about 0.0127 to 0.0889 cm), specifically, about 0.01 to about 0.02 inch (about 0.0254 to 0.13508 cm), and more specifically about 0.012 to about 0.016 inch (about 0.0305 to 0.0407 cm).
- the overall length of the intracorporeal guiding device 10 can be from about 100 to about 300 cm, specifically about 150 to about 200 cm.
- FIG. 2 is a transverse cross sectional view of the intracorporeal guiding device 10 of FIG. 1 taken along lines 2 - 2 in FIG. 1.
- the fiber composite matrix 12 is substantially concentrically disposed about the core member 17 as discussed above.
- the end cap 27 is disposed about the fiber composite matrix 12 which is substantially concentrically disposed about the core lumen 18 .
- the helical coil 30 is disposed about the shapeable segment 24 .
- FIGS. 5 and 6 depict an alternative embodiment of a shapeable segment 40 wherein the end cap 27 of the shapeable segment 24 of FIG. 1 has been replaced with a handle portion 41 which is disposed within and secured to the distal end 42 of the elongate member 43 .
- a configuration such as that shown in FIG. 5 allows for a smooth continuous transition from an outer surface 44 of the elongate member 43 to an outer surface 45 of the helical coil 46 .
- a fiber composite matrix 47 is substantially concentrically disposed about the handle portion 41 of the shapeable segment 40 .
- Components of the embodiment of the intracorporeal guiding device 48 shown in FIGS. 5 and 6 could have similar relationships, dimensions and materials to similar components of the embodiment of the intracorporeal guiding device 10 shown in FIGS. 1 - 4 .
- FIGS. 7 and 8 show another embodiment of an intracorporeal guiding device 50 having features of the invention.
- An elongate member 51 has a proximal section 52 , a proximal end 53 , a distal section 54 and a distal end 55 .
- the distal section 54 has a tapered segment 56 which tapers distally to a reduced transverse dimension in order to increase the flexibility of the distal section 54 .
- the elongate member 51 is formed of a fiber composite matrix 57 such as that described above with regard to other embodiments of the invention.
- a core member 58 is optionally secured within a core lumen 61 of the elongate member 51 .
- the core member 58 can be made of a non-metallic fiber composite matrix or other essentially non-metallic material in order to avoid interference with sensitive imaging systems such as MRI and the like.
- the tapered segment 56 of the distal section 54 of the elongate member 51 tapers in a curved configuration which can provide a smooth transition in flexibility.
- a flexible body in the form of a polymer layer 62 is substantially concentrically disposed about the distal section 54 of the elongate member 51 .
- a rounded polymer cap 63 is secured to the distal end 55 of the elongate member 51 to facilitate securement of the polymer layer 62 to the elongate member 51 and to provide a rounded non-traumatic tip for the intracorporeal guiding device 50 .
- the rounded polymer cap 63 can be a separate element as shown in FIG. 7, or it may be a continuation and integral portion of polymer layer 62 .
- the polymer layer 62 has a proxial end 63 and distal end 64
- the polymer layer 62 can be made from a diverse range of materials, including polyurethane, polyethylene, Nylon, silicone, or any other suitable polymer.
- the polymer layer 62 can optionally be doped with a radiopaque material in order to facilitate imaging of the guiding device 50 under fluoroscopy.
- the polymer layer 62 can be applied by coextrusion, heat shrink, bonding with a suitable adhesive or any other appropriate method.
- the polymer layer 62 can be formed on the distal section 54 of the elongate member 51 or may be extruded independently and later secured to the distal section 54 .
- the length and outer dimensions of the polymer layer 62 can be similar to those of the helical coil 30 discussed above. FIG.
- FIG. 8 is a transverse cross sectional view of the intracorporeal guiding device 50 of FIG. 7 taken along lines 8 - 8 in FIG. 7.
- the polymer layer 62 is shown substantially concentrically disposed about the fiber composite matrix 57 which is substantially concentrically disposed about the core member 58 .
- Components of the embodiment of the intracorporeal guiding device 50 shown in FIGS. 7 and 8 could have similar relationships, dimensions and materials to similar components of the embodiment of the intracorporeal guiding device 10 shown in FIGS. 1 - 6 .
- FIG. 9 illustrates four thin fibers 70 being braided onto a mandrel.
- FIG. 10 illustrates a single thin fiber 72 being wound onto a mandrel 73 .
- a double layer section 74 is shown where the thin fiber 72 been wound back onto itself in order to form two layers.
- FIG. 11 shows four thin fibers 75 being stranded onto a mandrel 76 .
- the pitch angle 77 that a line 78 extending from one of the thin fibers 75 makes with a line 79 orthogonal to a longitudinal axis 80 of the mandrel 76 .
- the pitch angle 77 of stranded, braided or wound thin fiber 75 can vary significantly.
- the pitch angle 77 can be just over zero degrees for a single thin fiber 75 being wound close spaced so that adjacent windings are touching each other.
- the pitch angle 77 can be up to 90 degrees for multiple stranded thin fibers 75 which extend essentially parallel to the longitudinal axis 80 of the mandrel 76 .
- the pitch angle 77 can be from about 20 to about 70 degrees, specifically, about 30 to about 60 degrees, and more specifically about 40 to about 50 degrees.
- Such variations in pitch angle 77 can be used to control the flexibility of the resulting elongate member for a fixed cross section of fiber composite material.
- FIGS. 12 - 22 illustrate dock exchange systems of the present invention for composite guidewires.
- FIG. 12 shows a dock exchange system in which the composite guidewire 80 has a hollow proximal end 81 for receiving the distal end 82 of the extension wire 83 .
- FIGS. 13 and 14 show alternative designs having a hypotube or a crimped or crimpable tube 84 .
- the outer diameter of the hypotube or the crimped or crimpable tube is either identical to (FIG. 13) or smaller than that of the proximal section of the composite guidewire (FIG. 14).
- the hypotube or crimped or crimpable tube may be made of a metal (such as steel), an alloy (such as Nitinol) or a polymer (such as a polyetheretherketone).
- the tube is from about 1 cm to about 3 cm in length.
- the wall of the tube is from about 0.0002 inches to about 0.003 inches in thickness.
- the composite filaments are wound around a continuous spool of mandrel that is removed after winding and cutting to length, then the hollow section is naturally made at the proximal end. If a hypotube or crimped or crimpable tube is desired, these can be added after the mandrel is removed. They can be inserted into the hollow left by the mandrel, or can be attached to the end of the composite guidewire using glue, thermal bonding, mechanical bonding or the combination thereof.
- the hollow section is also naturally made at the proximal end.
- a hypotube or crimped or crimpable tube can be temporarily attached to the end of the mandrel before the winding process and left in place when the mandrel is removed.
- they can also be inserted into the hollow left by the mandrel, or can be attached to the end of the composite guidewire using glue, thermal bonding, mechanical bonding or the combination thereof.
- the composite filaments are wound around a continuous spool of mandrel that becomes a permanent part of the guidewire, then the hollow section is created by drilling into the proximal end of the mandrel after the composite wire has been cut to length. If a hypotube or crimped or crimpable tube is desiredi, these can be attached after winding and cutting to length to the end of the composite guidewire using glue, thermal bonding, mechanical bonding or the combination thereof.
- the composite filaments are wound around a precut length of the mandrel that becomes a permanent part of the guidewire, then the hollow section is created by just winding past the end of the mandrel. If a hypotube or crimped or crimpable tube is desired, these can be attached either permanently to the proximal end of the mandrel before the winding process or afterwards in a similar fashion as stated above.
- the hollow proximal section of the composite guidewire or the hypotube may be partially or totally filled with a filler material to enhance the attachment strength between the composite guidewire and the extension guidewire.
- the filler material may be incorporated during the braiding or winding process to make the composite guidewire.
- the composite wires are wound around the filler material.
- the filler material may be added before or after the braiding or winding process to make the composite guidewire.
- the filler material may be certain grades of silicone, textured polymer, adhesive materials, magnets or a combination of two or more thereof.
- extension guidewire When the distal end of the extension guidewire is inserted into or in contact with the filler material it remains attached due to the interfacial adhesion or magnetic attraction force between the filler material and the tip of the extension guidewire.
- the filler material 85 may be tubular in form 86 with a small inner diameter 87 that constricts around the tip of the extension wire as shown in FIG. 15.
- the filler polymer may have a constricted end, which prevents the tip of the extension guidewire from easily sliding out once it is inserted.
- the filler material may also be a solid cylinder cut in half along its length 88 which creates a larger surface area to hold onto the tip 82 of the extension guidewire 83 as shown in FIGS. 16 - 18 .
- the filler material may also be a piece of solid, which the tip of the extension guidewire may puncture into.
- FIG. 19 shows that when the filler material 85 is a textured polymer, such as can be imparted by a molding or extrusion process or the proper selection of polymer blends, the surface of the filler material that comes in contact with the tip 82 of the extension guidewire 83 may have a texture that enhances the adhesion strength between the composite and extension guidewires.
- the filler material is an adhesive material, such as some classes of silicones or acrylates
- the filler material may be an adhesive glue that is designed to strongly hold on the tip of the extension guidewire yet still allow repeated attachment and detachment of the tip.
- the proximal section of the composite guidewire may instead have one or several magnets that are incorporated before, during or after the winding process.
- the magnet(s) 89 are cylindrical and embedded at the bottom closed end of the hollow section.
- the tip of the extension guidewire may also be fitted with magnets 90 that are aligned to enhance the attractive force to the magnets.
- FIG. 21 shows that the magnet or magnets inside the composite guidewire may instead form a half cylinder 91 that sets inside the hollow section, hypotube, or crimped or crimpable tube.
- the tip of the extension guidewire may be shaped as a half-cylinder or have a correctly aligned half-cylinder magnet 92 as well. This tip can then slide into the proximal end of the composite guidewire and due to the attraction of the two magnets or the magnet to the metal, it stays in place.
- the hollow proximal section, hypotube, or the crimped or crimpable tube may have a constriction or constrictions 93 along its length that prevent the tip of the extension guidewire from readily sliding out once inserted, as shown in FIG. 22.
- the tip of the extension guidewire may have one or more of the following characteristics.
- the tip of extension guidewire may be made of a metal, an alloy or a polymer, as those described above for the hypotube and crimped or crimplable tube.
- the tip of the extension guidewire may be uncoated or coated with a tacky material such as certain grades of silicon, textured polymers or adhesives to enhance the adhesion strength.
- the extension guidewire may be round, flat or oblong along its length and it may be nontapered or tapered with one or more dimensions increasing or decreasing as one moves distally along its length.
- the tip of the extension guidewire may be formed with a ball, flared or expanded end.
- the tip of the extension guidewire may have a magnet or magnets as described above.
- the end of the composite guidewire may be fitted with the tip as described above.
- the extension guidewire now has the docking station.
- the tip or tips are attached either before, during or after the winding process to make the composite guidewire.
- the tip may instead be a modification to the proximal end of the mandrel if the mandrel is to become a permanent part of the composite guidewire. The modification may be done before or after the winding process to make the composite guidewire.
Abstract
An elongate intracorporeal guiding device for providing access to desired sites within a patients body. The device, which may be configured as a guidewire, is constructed so as to be compatible with sensitive imaging methods such as MRI and the like and not create imaging artifacts or interference with such imaging methods. The guiding device may be constructed so as to have a distal working section that has minimal metallic content or minimal content of materials that can cause imaging artifacts or interference with MRI imaging, other sensitive imaging methods or the like. The device may also have a dock exchange system to allow attachment and detachment of an extension guidewire.
Description
- This application is a continuation-in-part of U.S. Ser. No. 09/468,976 filed on Dec. 21, 1999, which is incorporated herein in its entirety by reference.
- This invention relates to the field of guidewires for advancing intraluminal devices such as stent delivery catheters, balloon dilatation catheters, atherectomy catheters and the like within a patient's body, specifically, within a patient's vasculature.
- In a typical percutaneous procedure in a patient's coronary system, a guiding catheter having a preformed distal tip is percutaneously introduced into a patient's peripheral artery, e.g., femoral, radial or brachial artery, by means of a conventional Seldinger technique and advanced therein until the distal tip of the guiding catheter is seated in the ostium of a desired coronary artery. There are two basic techniques for advancing a guidewire into the desired location within the patient's coronary anatomy, the first is a preload technique which is used primarily for over-the-wire (OTW) devices and the bare wire technique which is used primarily for rail type systems. With the preload technique, a guidewire is positioned within an inner lumen of an OTW device such as a dilatation catheter or stent delivery catheter with the distal tip of the guidewire just proximal to the distal tip of the catheter and then both are advanced through the guiding catheter to the distal end thereof. The guidewire is first advanced out of the distal end of the guiding catheter into the patient's coronary vasculature until the distal end of the guidewire crosses the arterial location where the interventional procedure is to be performed, e.g., a lesion to be dilated or a dilated region where a stent is to be deployed.
- The catheter, which is slidably mounted onto the guidewire, is advanced out of the guiding catheter into the patient's coronary anatomy over the previously introduced guidewire until the operative portion of the intravascular device, e.g. the balloon of a dilatation or a stent delivery catheter, is properly positioned across the arterial location. Once the catheter is in position with the operative means located within the desired arterial location, the interventional procedure is performed. The catheter can then be removed from the patient over the guidewire. Usually, the guidewire is left in place for a period of time after the procedure is completed to ensure reaccess to the arterial location if it is necessary. For example, in the event of arterial blockage due to dissected lining collapse, a rapid exchange type perfusion balloon catheter such as described and claimed in U.S. Pat. No. 5,516,336 (McInnes et al), can be advanced over the in-place guidewire so that the balloon can be inflated to open up the arterial passageway and allow blood to perfuse through the distal section of the catheter to a distal location until the dissection is reattached to the arterial wall by natural healing.
- With the bare wire technique, the guidewire is first advanced by itself through the guiding catheter until the distal tip of the guidewire extends beyond the arterial location where the procedure is to be performed. Then a rail type catheter, such as described in U.S. Pat. No. 5,061,273 (Yock) and the previously discussed McInnes et al. which are incorporated herein by reference, is mounted onto the proximal portion of the guidewire which extends out of the proximal end of the guiding catheter which is outside of the patient. The catheter is advanced over the guidewire, while the position of the guidewire is fixed, until the operative means on the rail type catheter is disposed within the arterial location where the procedure is to be performed. After the procedure the intravascular device may be withdrawn from the patient over the guidewire or the guidewire advanced further within the coronary anatomy for an additional procedure.
- Conventional guidewires for angioplasty, stent delivery, atherectomy and other vascular procedures usually comprise metallic elongated core member with one or more tapered sections near the distal end thereof and a flexible body such as a metallic helical coil or a tubular body of polymeric material disposed about the distal portion of the core member. A shapable member, which may be the distal extremity of the core member or a separate shaping ribbon which is secured to the distal extremity of the core member, extends through the flexible body and is secured to the distal end of the flexible body by soldering, brazing or welding which forms a rounded distal tip. Torquing means are provided on the proximal end of the core member to rotate, and thereby steer, the guidewire while it is being advanced through a patient's vascular system.
- Further details of guidewires, and devices associated therewith for various interventional procedures can be found in U.S. Pat. No. 4,748,986 (Morrison et al.); U.S. Pat. No. 4,538,622 (Samson et al.): U.S. Pat. No. 5,135,503 (Abrams); U.S. Pat. No. 5,341,818 (Abrams et al.); U.S. Pat. No. 5,345,945 (Hodgson, et al.) and U.S. Pat. No. 5,636,641 (Fariabi) which are hereby incorporated herein in their entirety by reference thereto.
- Conventional metallic guidewires using tapered distal core sections as, discussed above can be difficult to use with sensitive imaging systems such as Magnetic Resonance Imaging (MRI) and the like because the metal content of the guidewire can create imaging artifacts that obscure the image produced, and can be heated or moved around by the strong MRI magnetic field. MRI compatible alloys or metals have lower magnetic susceptibilities. Such alloys include certain grades of stainless steel, Elgiloy and Nitinol. What has been needed is a guidewire that is compatible for use with sensitive imaging systems and methods such as MRI and the like.
- The invention is directed to an intracorporeal guiding device which can be in the form of a guidewire. The device includes an elongate member having a proximal section and a distal section. The distal section is made at least partially of a fiber composite matrix and has at least one segment with increasing flexibility in a distal direction. The fiber composite matrix can be configured to have little or no metal content so as to avoid creating imaging artifacts with sensitive imaging systems such as MRI and the like. In one embodiment, a flexible body is disposed about the distal section of the elongate member. Tihe flexible body can have a variety of configurations, including a helical coil and a polymer layer. In a particular embodiment, the flexible body which consists of a polymer layer can be doped with a radiopaque material in order to improve visualization of the device under fluoroscopic imaging and the like.
- In another embodiment, the elongate intracorporeal guiding device can have an elongate core disposed within a core lumen of the elongate member. The elongate core can be fixed or secured within the core lumen, or it may be moveable in an axial direction. Movement of the elongate core within the core lumen of the device may be used to adjust the flexibility of the distal section.
- In another embodiment, a shapeable segment can be secured to the distal end of the elongate member with the flexible body disposed at least partially about the shapeable segment. In some embodiments, the shapeable segment is comprised of metal which can be flattened to provide improved shapeability in a specified orientation.
- The invention is also directed to a method of making an elongate intracorporeal guiding device. The method includes disposing at least one layer of thin fiber about a mandrel. This can be done by winding, stranding, braiding or any other suitable method. A binding agent is then applied to the fiber material. If necessary, the binding agent can then be cured. Alternatively, a binding agent may be present on a thin fiber prior to disposing the thin fiber on the mandrel.
- Furthermore, the invention is directed to a method of advancing an elongate intracorporeal guiding device within a patient's body. The method includes providing an elongate intracorporeal guiding device having a distal section configured so as not to create imaging artifacts when used with MRI imaging. The elongate intracorporeal guiding device is then inserted into the patient's body and advanced within the patient's body under MRI imaging to a desired site. A distal section configured to not create imaging artifacts with MRI imaging, or other sensitive imaging methods, can be a distal section constructed essentially of non-metallic fiber composite matrix optionally including polymer materials having little or not metallic content.
- Finally, the invention is also directed to a dock exchange system for composite guidewires. The incorporation of a dock exchange system into a composite guidewire must consider the filament nature of the composite guidewire and how it is manufactured. The docking mechanism of the present invention is a hypotube or a crimped or crimpable tube attached to the proximal end of the guidewire which receives the tip of an extension guidewire. The hypotube or crimped or crimpable tube and the extension tip are so designed that once the latter is inserted, it is held in place unless a certain amount of tensile force is applied. The mechanism involves, for example, crimping the extension tip or placing magnets inside the hollow section.
- FIG. 1 is an elevational view in partial section of an intracorporeal guiding device having features of the invention.
- FIG. 2 is a transverse cross sectional view of the intracorporeal guiding device of FIG. 1 taken along lines2-2 in FIG. 1.
- FIG. 3 is a transverse cross sectional view of the intracorporeal guiding device of FIG. 1 taken along lines3-3 in FIG. 1.
- FIG. 4 is a transverse cross sectional view of the intracorporeal guiding device of FIG. 1 taken along lines4-4 in FIG. 1.
- FIG. 5 is an elevational view in partial section of a part of a distal section of an intracorporeal guiding device having features of the invention.
- FIG. 6 is a transverse cross sectional view of the intracorporeal guiding device of FIG. 5 taken along lines6-6 in FIG. 5.
- FIG. 7 is an elevational view in partial section of an intracorporeal guiding device having features of the invention.
- FIG. 8 is a transverse cross sectional view of the intracorporeal guiding device of FIG. 7 taken along lines8-8 in FIG. 7.
- FIG. 9 is a schematic view of thin fibers being braided onto a mandrel
- FIG. 10 is a schematic view of a thin fiber being wound onto a mandrel.
- FIG. 11 is a schematic view of thin fibers being stranded onto a mandrel.
- FIG. 12 shows a dock exchange system in which the composite guidewire has a hollow proximal end for receiving the distal end of the extension wire.
- FIGS. 13 and 14 show alternative designs having a hypotube with an outer diameter identical to or smaller than the outer diameter of the proximal section of the composite guidewire.
- FIG. 15 shows a dock exchange system with a smaller inner diameter at the proximal end of the composite guidewire that constricts around the tip of the extension wire.
- FIGS.16-18 show a dock exchange system in which the filler material is a solid cylinder cut in half along its length to create a larger surface area to hold onto the tip of the extension wire.
- FIG. 19 shows a dock exchange system in which the filler material has a texture that enhances the adhesion strength between the composite and extension guidewires.
- FIGS. 20 & 21 show a dock exchange system in which the composite and extension guidewires are held together by magnetic force.
- FIG. 22 shows a dock exchange system in which the hollow proximal section of the composite guidewire has a constriction for preventing the tip of the extension wire from sliding out.
- FIG. 1 shows an
intracorporeal guiding device 10 having features of the invention. Anelongate member 11 made entirely offiber composite matrix 12 has aproximal section 13, aproximal end 14, adistal section 15 and adistal end 16. Optionally, theelongate member 11 can be made partially out offiber composite matrix 12. Anoptional core member 17 is disposed within acore lumen 18 of theelongate member 11 and is axially moveable within thecore lumen 18 as indicated byarrow 21. Thecore member 17 has aproximal end 22 and adistal end 23 and may also be secured within thecore lumen 18 either by frictional force, an epoxy or other adhesive, or by any other suitable means. Anoptional shapeable segment 24 having aproximal end 25 and adistal end 26 has anend cap 27 disposed at theproximal end 25 of theshapeable segment 24. Theend cap 27 is disposed over and secured to thedistal end 16 of theelongate member 11. Theend cap 27 may be secured to thedistal end 16 of theelongate member 11 by a friction fit, adhesive such as an epoxy, or any other suitable method. A flexible body in the form of ahelical coil 30 having aproximal end 31 and adistal end 32 is disposed about theshapeable segment 24. Thedistal end 32 of thehelical coil 30 is secured to thedistal end 26 of theshapeable segment 24 with a body ofsolder 33 or the like. Theproximal end 31 of thehelical ccil 30 can be similarly secured to theproximal end 25 of theshapeable segment 24. - The
fiber composite matrix 12 of theelongate member 11 may be formed in a variety of configurations and from a variety of materials. In the embodiment theintracorporeal guiding device 10 of FIG. 1, thefiber composite matrix 12 can be formed from a plurality of non-metallicthin fibers 34 made of carbon fiber braided over a mandrel (not shown) in one or more layers. A cured or hardened bindingagent 35 such as an epoxy resin, polyester resin or other suitable material is disposed about thethin fibers 34 to form thefiber composite matrix 12. The bindingagent 35 can optionally be doped with a radiopaque material in order to provide radiopacity to theelongate member 11. Materials such as gold, platinum, platinum-iridium, tungsten, barium compounds or bismuth compounds may be used for doping the bindingagent 35. In addition, one or more radiopaquethin fibers 34 can be made of the same or similar radiopaque materials discussed above with regard to radiopaque dopants for the binding agent and may be used when forming thefiber composite matrix 12 in order to provide radiopacity to thedevice 10. In addition, a conductor, insulated or uninsulated, or other type of conduit capable of carrying an electric, light, or other type of signal can be substituted or molded into thethin fibers 34. This can be done in order to carry a signal conveying information such as temperature of pressure from thedistal end 16 to theproximal end 14 of theelongate member 11. If a fiber optic is used, light or a light signal can be transmitted from thedistal end 16 to theproximal end 14 of theelongate member 11, or from theproximal end 14 to thedistal end 16. During formation of theelongate member 11, the aforementioned mandrel is removed after the binding agent is cured. - During the formation process for the
elongate member 11, thecore member 17 could serve as a forming mandrel such as that discussed above, or a separate mandrel could be used for forming thefiber composite matrix 12 arid then be removed. Acore member 17 could then be inserted into thecore lumen 18 once the forming mandrel is removed. Thethin fiber 34 could also be wound or stranded about the forming mandrel prior to curing of the binding agent. Any appropriate number of layers ofthin fiber 34 may be braided, stranded or wound about a forming mandrel in order to achieve a desired thickness of thefiber composite matrix 12. For anintracorporeal guiding member 10 having aelongate member 11 with aproximal section 13 having an outer diameter of about 0.008 to about 0.040 inches (about 0.020 to 0.102 cm), approximately 1 to about 10 layers ofthin fiber 34 may be used, specifically, about 2 to about 6 layers of thin fiber. Thethin fibers 34 can have a transverse dimension of about 0.0005 to about 0.002 inch (about 0.0013 to 0.0051 cm), specifically about 0.001 to about 0.0015 inch (about 0.0025 to 0.0038 cm) and can be made of carbon fiber. Other materials that can be used for thethin fibers 34 are polymeric substances such as Nylon (polyamides), Kevlar (polyarylamides), fiberglass and the like. - The flexibility of the
elongate member 11 can be controlled to some degree by varying the manner in which the one or more thin fibers are configured within the fiber composite matrix with respect to axial position along theelongate member 11. Specifically, the angle thethin fiber 34 makes with a line parallel to alongitudinal axis 36 of theelongate member 12 adjacent thethin fiber 34 can affect the longitudinal flexibility of the elongate member and hence theintracorporeal guiding device 10. In addition, thedistal section 15 of theelongate member 11 can be tapered to a reduced outer transverse dimension distally in one or more segments in order to increase the flexibility of such a segment. The tapering of a segment can be achieved by grinding a segment of substantially constant outer diameter after formation of theelongate member 11. Alternatively, the tapering of a segment could be achieved by varying the number of layers or configuration of the thin fiber orfibers 34 in the formation process of theelongate member 11. Also, the diameter of thecore lumen 18 within theelongate member 11 could be increased distally in a segment of thedistal section 15 of theelongate member 11 in order to increase the flexibility of the segment. - The
core member 17 can be made from a metal such as stainless steel, MP35N, L605 or other high strength materials. Thecore member 17 may also be configured to be radiopaque and can have materials such as gold, platinum, platinum-iridium, tungsten and the like contained therein. Thecore member 17 may also be made of a fiber composite material similar to that of theelongate member 11 with a binding agent for such a fiber composite material being doped with a non-metallic radiopaque material in order to provide radiopacity to thecore member 17 and avoid introduction of metallic content which might interfere with sensitive imaging methods as discussed above. Thecore member 17 can have an outer transverse dimension of about 0.001 to about 0.015 inches (about 0.0025 to 0.038 cm), specifically about 0.002 to about 0.005 inches (about 0.0051 to 0.0127 cm). Thecore member 17 can also be ground to have one or more tapered segments, specifically, tapered segment tapering distally to a reduced transverse dimension in order to provide greater flexibility in thedistal section 15 of theelongate member 11. - Generally, the
shapeable segment 24 can have a configuration similar to shapeable segments of guiding devices known in the art. Regarding the embodiment of the guidingdevice 10 shown in FIG. 1, theshapeable segment 24 is formed of stainless steel which has optionally been flattened. Specifically, theshapeable segment 24 has been flattened to a progressively greater degree in a distal direction. Thus, a thickness of the flattened portion at theproximal end 25 of theshapeable segment 24 is thicker than the thickness of the flattened portion of theshapeable segment 24 at thedistal end 26 of theshapeable segment 24. The length of theflexible segment 24 can be from about 2 to about 30 cm, specifically, about 3 to about 10 cm. The thickness of theshapeable segment 24 at the flattened distal end can be from about 0.0005 to about 0.006 inch (about 0.0013 to 0.0152 cm), specifically, about 0.001 to about 0.002 inch (about 0.0025 to 0.0051 cm). Other materials suitable for theshapeable segment 24 include MP35N, L605 or other high strength materials. - The
helical coil 30 can be made from a variety of suitable materials including stainless steel, platinum, platinum iridium, gold or the like. Thehelical coil 30 could also be made from a fiber composite matrix or other non-metal material in order to enable theintracorporeal guiding device 10 to have a distal section or an overall composition with a zero or minimum amount of metallic composition. As mentioned above, for certain applications and uses, minimizing the metallic content of theintracorporeal guiding device 10 improves compatibility with sensitive imaging devices such as MRI. The material of thehelical coil 30 can have a transverse dimension of about 0.001 to about 0.005 inch (about 0.0025 to 0.0127 cm), specifically, about 0.002 to about 0.003 inch (about 0.0051 to 0.0076 cm). - The nominal outer transverse dimension of the
proximal section 13 of theelongate member 11 can be from about 0.005 to about 0.035 inch (about 0.0127 to 0.0889 cm), specifically, about 0.01 to about 0.02 inch (about 0.0254 to 0.13508 cm), and more specifically about 0.012 to about 0.016 inch (about 0.0305 to 0.0407 cm). The overall length of theintracorporeal guiding device 10 can be from about 100 to about 300 cm, specifically about 150 to about 200 cm. - FIG. 2 is a transverse cross sectional view of the
intracorporeal guiding device 10 of FIG. 1 taken along lines 2-2 in FIG. 1. Thefiber composite matrix 12 is substantially concentrically disposed about thecore member 17 as discussed above. In FIG. 3, theend cap 27 is disposed about thefiber composite matrix 12 which is substantially concentrically disposed about thecore lumen 18. In FIG. 4, thehelical coil 30 is disposed about theshapeable segment 24. - FIGS. 5 and 6 depict an alternative embodiment of a
shapeable segment 40 wherein theend cap 27 of theshapeable segment 24 of FIG. 1 has been replaced with ahandle portion 41 which is disposed within and secured to thedistal end 42 of theelongate member 43. A configuration such as that shown in FIG. 5 allows for a smooth continuous transition from anouter surface 44 of theelongate member 43 to anouter surface 45 of thehelical coil 46. Afiber composite matrix 47 is substantially concentrically disposed about thehandle portion 41 of theshapeable segment 40. Components of the embodiment of theintracorporeal guiding device 48 shown in FIGS. 5 and 6 could have similar relationships, dimensions and materials to similar components of the embodiment of theintracorporeal guiding device 10 shown in FIGS. 1-4. - FIGS. 7 and 8 show another embodiment of an
intracorporeal guiding device 50 having features of the invention. Anelongate member 51 has aproximal section 52, aproximal end 53, adistal section 54 and adistal end 55. Thedistal section 54 has a taperedsegment 56 which tapers distally to a reduced transverse dimension in order to increase the flexibility of thedistal section 54. Theelongate member 51 is formed of afiber composite matrix 57 such as that described above with regard to other embodiments of the invention. Acore member 58 is optionally secured within acore lumen 61 of theelongate member 51. Thecore member 58 can be made of a non-metallic fiber composite matrix or other essentially non-metallic material in order to avoid interference with sensitive imaging systems such as MRI and the like. The taperedsegment 56 of thedistal section 54 of theelongate member 51 tapers in a curved configuration which can provide a smooth transition in flexibility. A flexible body in the form of apolymer layer 62 is substantially concentrically disposed about thedistal section 54 of theelongate member 51. Arounded polymer cap 63 is secured to thedistal end 55 of theelongate member 51 to facilitate securement of thepolymer layer 62 to theelongate member 51 and to provide a rounded non-traumatic tip for theintracorporeal guiding device 50. Therounded polymer cap 63 can be a separate element as shown in FIG. 7, or it may be a continuation and integral portion ofpolymer layer 62. Thepolymer layer 62 has aproxial end 63 anddistal end 64. - The
polymer layer 62 can be made from a diverse range of materials, including polyurethane, polyethylene, Nylon, silicone, or any other suitable polymer. Thepolymer layer 62 can optionally be doped with a radiopaque material in order to facilitate imaging of the guidingdevice 50 under fluoroscopy. Thepolymer layer 62 can be applied by coextrusion, heat shrink, bonding with a suitable adhesive or any other appropriate method. Thepolymer layer 62 can be formed on thedistal section 54 of theelongate member 51 or may be extruded independently and later secured to thedistal section 54. The length and outer dimensions of thepolymer layer 62 can be similar to those of thehelical coil 30 discussed above. FIG. 8 is a transverse cross sectional view of theintracorporeal guiding device 50 of FIG. 7 taken along lines 8-8 in FIG. 7. Thepolymer layer 62 is shown substantially concentrically disposed about thefiber composite matrix 57 which is substantially concentrically disposed about thecore member 58. Components of the embodiment of theintracorporeal guiding device 50 shown in FIGS. 7 and 8 could have similar relationships, dimensions and materials to similar components of the embodiment of theintracorporeal guiding device 10 shown in FIGS. 1-6. - FIG. 9 illustrates four
thin fibers 70 being braided onto a mandrel. FIG. 10 illustrates a singlethin fiber 72 being wound onto amandrel 73. Adouble layer section 74 is shown where thethin fiber 72 been wound back onto itself in order to form two layers. FIG. 11 shows fourthin fibers 75 being stranded onto amandrel 76. Also shown is thepitch angle 77 that aline 78 extending from one of thethin fibers 75 makes with aline 79 orthogonal to alongitudinal axis 80 of themandrel 76. Thepitch angle 77 of stranded, braided or woundthin fiber 75 can vary significantly. Thepitch angle 77 can be just over zero degrees for a singlethin fiber 75 being wound close spaced so that adjacent windings are touching each other. Thepitch angle 77 can be up to 90 degrees for multiple strandedthin fibers 75 which extend essentially parallel to thelongitudinal axis 80 of themandrel 76. In one embodiment, thepitch angle 77 can be from about 20 to about 70 degrees, specifically, about 30 to about 60 degrees, and more specifically about 40 to about 50 degrees. Such variations inpitch angle 77 can be used to control the flexibility of the resulting elongate member for a fixed cross section of fiber composite material. - FIGS.12-22 illustrate dock exchange systems of the present invention for composite guidewires. FIG. 12 shows a dock exchange system in which the
composite guidewire 80 has a hollowproximal end 81 for receiving thedistal end 82 of theextension wire 83. FIGS. 13 and 14 show alternative designs having a hypotube or a crimped orcrimpable tube 84. The outer diameter of the hypotube or the crimped or crimpable tube is either identical to (FIG. 13) or smaller than that of the proximal section of the composite guidewire (FIG. 14). - The hypotube or crimped or crimpable tube may be made of a metal (such as steel), an alloy (such as Nitinol) or a polymer (such as a polyetheretherketone). The tube is from about 1 cm to about 3 cm in length. The wall of the tube is from about 0.0002 inches to about 0.003 inches in thickness.
- If the composite filaments are wound around a continuous spool of mandrel that is removed after winding and cutting to length, then the hollow section is naturally made at the proximal end. If a hypotube or crimped or crimpable tube is desired, these can be added after the mandrel is removed. They can be inserted into the hollow left by the mandrel, or can be attached to the end of the composite guidewire using glue, thermal bonding, mechanical bonding or the combination thereof.
- If the composite filaments are wound around a precut length of the mandrel that is removed after the winding process, then the hollow section is also naturally made at the proximal end. In this construction, if a hypotube or crimped or crimpable tube is desired, these can be temporarily attached to the end of the mandrel before the winding process and left in place when the mandrel is removed. Alternatively, they can also be inserted into the hollow left by the mandrel, or can be attached to the end of the composite guidewire using glue, thermal bonding, mechanical bonding or the combination thereof.
- If the composite filaments are wound around a continuous spool of mandrel that becomes a permanent part of the guidewire, then the hollow section is created by drilling into the proximal end of the mandrel after the composite wire has been cut to length. If a hypotube or crimped or crimpable tube is desiredi, these can be attached after winding and cutting to length to the end of the composite guidewire using glue, thermal bonding, mechanical bonding or the combination thereof.
- If the composite filaments are wound around a precut length of the mandrel that becomes a permanent part of the guidewire, then the hollow section is created by just winding past the end of the mandrel. If a hypotube or crimped or crimpable tube is desired, these can be attached either permanently to the proximal end of the mandrel before the winding process or afterwards in a similar fashion as stated above.
- The hollow proximal section of the composite guidewire or the hypotube may be partially or totally filled with a filler material to enhance the attachment strength between the composite guidewire and the extension guidewire. With a hollow proximal section, the filler material may be incorporated during the braiding or winding process to make the composite guidewire. In other words, the composite wires are wound around the filler material. With a hypotube or crimped or crimpable tube, the filler material may be added before or after the braiding or winding process to make the composite guidewire.
- The filler material may be certain grades of silicone, textured polymer, adhesive materials, magnets or a combination of two or more thereof.
- When the distal end of the extension guidewire is inserted into or in contact with the filler material it remains attached due to the interfacial adhesion or magnetic attraction force between the filler material and the tip of the extension guidewire.
- The
filler material 85 may be tubular inform 86 with a smallinner diameter 87 that constricts around the tip of the extension wire as shown in FIG. 15. In addition to being tubular, the filler polymer may have a constricted end, which prevents the tip of the extension guidewire from easily sliding out once it is inserted. The filler material may also be a solid cylinder cut in half along itslength 88 which creates a larger surface area to hold onto thetip 82 of the extension guidewire 83 as shown in FIGS. 16-18. The filler material may also be a piece of solid, which the tip of the extension guidewire may puncture into. - FIG. 19 shows that when the
filler material 85 is a textured polymer, such as can be imparted by a molding or extrusion process or the proper selection of polymer blends, the surface of the filler material that comes in contact with thetip 82 of the extension guidewire 83 may have a texture that enhances the adhesion strength between the composite and extension guidewires. When the filler material is an adhesive material, such as some classes of silicones or acrylates, the filler material may be an adhesive glue that is designed to strongly hold on the tip of the extension guidewire yet still allow repeated attachment and detachment of the tip. - The proximal section of the composite guidewire may instead have one or several magnets that are incorporated before, during or after the winding process. In the design as shown in FIG. 20, the magnet(s)89 are cylindrical and embedded at the bottom closed end of the hollow section. When the tip of the extension guidewire is inserted into the hollow section, hypotube, crimped or crimpable tube, it is held in place due to its attraction to the magnets. The tip of the extension guidewire may also be fitted with
magnets 90 that are aligned to enhance the attractive force to the magnets. FIG. 21 shows that the magnet or magnets inside the composite guidewire may instead form ahalf cylinder 91 that sets inside the hollow section, hypotube, or crimped or crimpable tube. The tip of the extension guidewire may be shaped as a half-cylinder or have a correctly aligned half-cylinder magnet 92 as well. This tip can then slide into the proximal end of the composite guidewire and due to the attraction of the two magnets or the magnet to the metal, it stays in place. - Alternatively, the hollow proximal section, hypotube, or the crimped or crimpable tube may have a constriction or
constrictions 93 along its length that prevent the tip of the extension guidewire from readily sliding out once inserted, as shown in FIG. 22. - In order to enhance dockability, the tip of the extension guidewire may have one or more of the following characteristics. The tip of extension guidewire may be made of a metal, an alloy or a polymer, as those described above for the hypotube and crimped or crimplable tube. The tip of the extension guidewire may be uncoated or coated with a tacky material such as certain grades of silicon, textured polymers or adhesives to enhance the adhesion strength. The extension guidewire may be round, flat or oblong along its length and it may be nontapered or tapered with one or more dimensions increasing or decreasing as one moves distally along its length. The tip of the extension guidewire may be formed with a ball, flared or expanded end. Furthermore, the tip of the extension guidewire may have a magnet or magnets as described above.
- In another embodiment, the end of the composite guidewire may be fitted with the tip as described above. In other words, the extension guidewire now has the docking station. In this case, the tip or tips are attached either before, during or after the winding process to make the composite guidewire. The tip may instead be a modification to the proximal end of the mandrel if the mandrel is to become a permanent part of the composite guidewire. The modification may be done before or after the winding process to make the composite guidewire.
- While particular forms of the invention have been illustrated and described, it will be apparent that various modifications can be made without departing from the spirit and scope of the invention. Accordingly, it is not intended that the invention be limited, except as by the appended claims.
Claims (15)
1. An intracorporeal composite guidewire comprising a proximal section which is hollow or is attached to a hypotube or crimped or crimpable tube to receive an extension guidewire.
2. The intracorporeal composite guidewire of claim 1 wherein the hypotube or the crimped or crimpable tube is made of a metal, an alloy or a polymer.
3. The intracorporeal composite guidewire of claim 1 wherein said hypotube or crimped or crimpable tube is attached to the proximal section of said composite guidewire using glue, thermal bonding, mechanical bonding or the combination thereof.
4. The intracorporeal composite guidewire of claim 1 wherein said hollow proximal section of the composite guidewire, the hypotube or the crimped or crimpable tube attached to the proximal section of the composite guidewire is partially or totally filled with a filler material.
5. The intracorporeal composite guidewire of claim 4 wherein said filler material is selected from a group consisting of certain grades of silicone, textured polymers, adhesive materials and magnets.
6. The intracorporeal composite guidewire of claim 5 wherein the hollow proximal section of the composite guidewire has one or more magnets.
7. The intracorporeal composite guidewire of claim 6 wherein the magnet(s) is cylindrical.
8. The intracorporeal composite guidewire of claim 6 wherein the magnet(s) is embedded at the bottom closed end of the hollow proximal section.
9. The intracorporeal composite guidewire of claim 1 wherein the hollow proximal section, the hypotube or the crimped or crimpable tube has a constriction or constrictions along its length to prevent the tip of the extension guidewire from sliding out once inserted.
10. The intracorporeal composite guidewire of claim 1 wherein the extension guidewire has a tip fitted with magnet(s) that are aligned to enhance attraction to the magnets placed in the hollow proximal section of the composite guidewire, the hypotube or the crimped or crimpable tube.
11. The intracorporeal composite guidewire of claim 10 wherein the magnet(s) inside the hollow proximal section of the composite guidewire, the hypotube or the crimped or crimpable tube forms a half cylinder and the tip of the extension guidewire is shaped as a half-cylinder or have a correctly aligned half-cylinder magnet.
12. The intracorporeal composite guidewire of claim 1 wherein the tip of the extension guidewire is made of a metal, an alloy or a polymer.
13. The intracorporeal composite guidewire of claim 1 wherein the tip of the extension guidewire is coated or uncoated.
14. The intracorporeal composite guidewire of claim 1 wherein the extension guidewire is round, flat or oblong along its length.
15. The intracorporeal composite guidewire of claim 1 wherein the extension guidewire is untapered or tapered with one or more dimensions increasing or decreasing as one moves distally along its length.
Priority Applications (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/736,854 US6451026B1 (en) | 1999-12-21 | 2000-12-13 | Dock exchange system for composite guidewires |
PCT/US2001/048644 WO2002047755A2 (en) | 2000-12-13 | 2001-12-13 | Dock exchange system for composite guide wires |
EP01990209A EP1341575A2 (en) | 2000-12-13 | 2001-12-13 | Dock exchange system for composite guide wires |
AU2002229072A AU2002229072A1 (en) | 2000-12-13 | 2001-12-13 | Dock exchange system for composite guide wires |
JP2002549322A JP2004515323A (en) | 2000-12-13 | 2001-12-13 | Docking exchange system for composite guidewire |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US46897699A | 1999-12-21 | 1999-12-21 | |
US09/736,854 US6451026B1 (en) | 1999-12-21 | 2000-12-13 | Dock exchange system for composite guidewires |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US46897699A Continuation-In-Part | 1999-12-21 | 1999-12-21 |
Publications (2)
Publication Number | Publication Date |
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US20020058888A1 true US20020058888A1 (en) | 2002-05-16 |
US6451026B1 US6451026B1 (en) | 2002-09-17 |
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ID=24961576
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Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US09/736,854 Expired - Lifetime US6451026B1 (en) | 1999-12-21 | 2000-12-13 | Dock exchange system for composite guidewires |
Country Status (5)
Country | Link |
---|---|
US (1) | US6451026B1 (en) |
EP (1) | EP1341575A2 (en) |
JP (1) | JP2004515323A (en) |
AU (1) | AU2002229072A1 (en) |
WO (1) | WO2002047755A2 (en) |
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US10543344B2 (en) * | 2014-08-15 | 2020-01-28 | Jaafer Golzar | Double-ended wire guide and method of use thereof |
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Also Published As
Publication number | Publication date |
---|---|
WO2002047755A2 (en) | 2002-06-20 |
EP1341575A2 (en) | 2003-09-10 |
WO2002047755A3 (en) | 2002-10-10 |
US6451026B1 (en) | 2002-09-17 |
AU2002229072A1 (en) | 2002-06-24 |
JP2004515323A (en) | 2004-05-27 |
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