METHOD AND APPARATUS FOR REMOVABLE CATHETER VISUAL LIGHT THERAPEUTIC SYSTEM
20170224952 · 2017-08-10
Inventors
- Mitchell D. Barneck (Clearfield, UT, US)
- Nathaniel L. Rhodes (Salt Lake City, UT, US)
- James P. Allen (Salt Lake City, UT, US)
- Martin de la Presa (Salt Lake City, UT, US)
- Curtis D. Long (Cottonwood Heights, UT, US)
Cpc classification
A61N5/062
HUMAN NECESSITIES
A61N2005/063
HUMAN NECESSITIES
A61M2025/0019
HUMAN NECESSITIES
International classification
Abstract
A medical device assembly is provided for removable insertion into a catheter with a lumen. The medical device assembly comprises an electromagnetic radiation (EMR) source for providing non-ultraviolet, therapeutic EMR having an intensity sufficient to inactivate one or more infectious agents and/or to stimulate healthy cell growth causing a healing effect, and a removable EMR conduction system at least partially insertable into and removable from the lumen of the catheter. The EMR conduction system has at least one optical element providing axial propagation of the therapeutic EMR through an insertable elongate body. The elongate body may have an exterior surface between a coupling end and a distal end tip that has at least one modified portion permitting the radial emission of therapeutic EMR from the elongate body proximate the modified portion. Such modified portion may be gradient along the exterior surface.
Claims
1. A medical device assembly for removable insertion into a catheter with a lumen, comprising: an electromagnetic radiation (EMR) source for providing non-ultraviolet, therapeutic EMR having an intensity comprising a radiant exposure of at least 0.1 J/cm.sup.2 and power of at least 0.005 mW, such intensity being sufficient to cause a therapeutic effect of at least one of inactivating one or more infectious agents and promoting healing; a removable EMR conduction system at least partially insertable into and removable from the lumen of the catheter, the EMR conduction system comprising at least one optical element having an elongate body conducive to the axial propagation of the therapeutic EMR through the elongate body, the elongate body having an exterior surface between a proximal coupling end and an distal end tip, the exterior surface having at least one modified portion allowing the emission of therapeutic EMR radially from the elongate body; and a coupling to connect the EMR source to the EMR conduction system.
2. The medical device assembly as in claim 1 wherein the EMR conduction system comprises a plurality of optical elements, wherein the elongate body of each optical element has a length and at least two of the elongate bodies have differing lengths such that elongate bodies of differing lengths terminate at varying distances from the coupling end of the elongate body.
3. The medical device assembly as in claim 1 wherein the optical element further comprises at least one optical feature selected from a group of optical features consisting of a reflective surface, an optically transmissible material, a lens, a fiber optic filament, and any combination thereof.
4. The medical device assembly as in claim 1 wherein the optical element is capable of transmitting more than one wavelength or intensity EMR.
5. The medical device assembly as in claim 1 further comprising at least one optical diversion element to redirect EMR from at least one of the electromagnetic source and the optical element into at least one of the fluid lines, the convergence chamber, and the catheter connection hub.
6. The medical device assembly as in claim 1 wherein the therapeutic EMR has a wavelength that ranges from above 380 nm to 900 nm.
7. The medical device assembly as in claim 1 wherein the EMR source has an adjustable duty cycle length.
8. The medical device assembly as in claim 1 wherein the EMR source is selected from a group consisting of a solid state laser, a semiconductor laser, a diode laser, a light emitting diode, a fluorescent, or an incandescent light source.
9. The medical device assembly as in claim 1, wherein at least one modified portion is progressively modified such that the intensity of the therapeutic EMR emitted through the modified portion is substantially equivalent along the length of the modified portion.
10. The medical device assembly as in claim 9 wherein the modified portion having intensity substantial equivalency is achieved through gradient modification, such gradient modification comprising at least one of physical and chemical modification of the exterior surface of the elongate body of the at least one optical element.
11. The medical device assembly as in claim 1 wherein at least a portion of the emission of EMR is non-axial and the non-axial emission is achieved through at least one of deflecting structures dispersed interior to the exterior surface of the elongate body and a core-cladding boundary.
12. A medical device assembly for insertion into a catheter with at least one lumen, comprising: an electromagnetic radiation (EMR) source selected from a group consisting of a solid state laser, a semiconductor laser, a diode laser, and a light emitting diode, the EMR source for providing non-ultraviolet, therapeutic EMR having a wavelength in a range of above 380 nm to 904 nm and having an intensity comprising a radiant exposure of at least 0.1 J/cm.sup.2 and power of at least 0.005 mW, such intensity being sufficient to cause a therapeutic effect of at least one of inactivating infectious agents and promoting healing; an removable EMR conduction system at least partially insertable into and removable from the at least one lumen of the catheter, the EMR conductive system comprising at least one optical element having an elongate body conducive to the substantially axial propagation of the therapeutic EMR along the elongate body; and at least one coupling to connect the radiation source to the EMR conduction system.
13. The medical device assembly as in claim 12 wherein the wavelength of the therapeutic EMR is selected from a group of wavelengths including wavelengths centered about 400 nm, 405 nm, 415 nm, 430 nm, 440 nm, 445 nm, 455 nm, 470 nm, 475 nm, 632 nm, 632.8 nm, 640 nm, 650 nm, 660 nm, 670 nm, 680 nm, 780 nm, 808 nm, 830 nm, and 904 nm.
14. The medical device assembly as in claim 12 wherein the therapeutic EMR comprises one or more of the selected wavelengths being emitted in at least one of alternating and parallel treatment patterns.
15. The medical device assembly as in claim 12 wherein power density of the therapeutic EMR is within a range from 0.1 mW/cm.sup.2 to 1 W/cm.sup.2.
16. The medical device assembly as in claim 12 wherein the radiant exposure of the therapeutic EMR is within a range from 1.0 mJ/cm.sup.2 to 1.0 kJ/cm.sup.2.
17. The medical device assembly as in claim 12 wherein the EMR conduction system does not preclude injecting a liquid simultaneously into or around the EMR conduction system residing within a catheter.
18. The method for effectively sterilizing a catheter having a lumen with an interior surface dimension while the catheter is disposed within a patient's body, comprising the steps of: inserting an EMR conduction system into the lumen, the EMR conduction system having an exterior surface dimension which is less than the interior surface dimension of the lumen; transmitting a non-ultraviolet, sterilizing EMR into the EMR conduction system for an amount of time and at an intensity comprising a radiant exposure of at least 0.1 J/cm.sup.2 and power of at least 0.005 mW, such intensity being sufficient to effectively sterilize at least a portion of the catheter; and emitting non-ultraviolet, sterilizing EMR through at least a portion of the catheter;
19. The medical device assembly as in claim 18 wherein the catheter is translucent, permitting EMR to transmit into tissue surrounding the catheter within the patient's body.
20. The medical device assembly as in claim 18 wherein at least a portion of the EMR conduction system comprises radiopacifiers to facilitate visualization within the patient's body.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0033] In order that the manner in which the above-recited and other features and advantages of the present disclosure are obtained will be readily understood, reference is made to exemplary embodiments thereof which are illustrated in the appended figures. Understanding that these figures depict only typical exemplary embodiments and are not therefore to be considered limiting of the scope of the present disclosure, the exemplary embodiments will be described and explained through the use of the accompanying figures in which:
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TABLE-US-00001 REFERENCE NUMERALS catheter 10 patient′s body 12 insertable optical element 14 line tubing 16 EMR conduction system 18 electromagnetic radiation component 20 insertable catheter component 22 elongate body 24 electromagnetic radiation coupling element 28 power source 26 internal lumen 30 proximal catheter hub assembly 32 distal end tip 34 elongate catheter body 36 catheter of varying lengths 38 convergence chamber 40 termination of the optical element 42 flexible protection tubing 44 line clamp 46 transdermal area 48 optical assembly 50 intermediate coupling 52 patch cable 54 EMR conduction extending segment 56 forward connector 58 rearward connector 60 exterior surface 62 tip 64 connecting element 88 EMR hub connector 90 collimating lens 92 optical element connector 94 alignment shaft 98 an aligning bore 99 non-modified optical span 100 segment-modified optical span 102 single modified portion 103 fully-modified optical span 104 single elongated modified portion 105 multi-modified optical span 106 modified tip portion 107 first section 108 microscopic structures free area 109 second section 110 minimal concentration 111 third section 112 moderate concentration 113 fourth section 114 maximal concentration 115 core 116 microscopic structures 117 optical element cladding 118 cladding boundary 120 first dispersal 121 control device 122 second dispersal 123 wand 124 third dispersal 125 acid spray 126 outer region 127 inner region 129 boundary region 131 insertion site A
DETAILED DESCRIPTION OF THE INVENTION
[0046] The exemplary embodiments of the present disclosure will be best understood by reference to the drawings, wherein like parts are designated by like numerals throughout. It should be understood that the components of the exemplary embodiments, as generally described and illustrated in the figures herein, could be arranged and designed in a wide variety of different configurations. Thus, the following more detailed description of the exemplary embodiments of the apparatus, system, and method of the present disclosure, as represented in
[0047] In this application, the phrases “connected to”, “coupled to”, and “in communication with” refer to any form of interaction between two or more entities, including mechanical, capillary, electrical, magnetic, electromagnetic, pneumatic, hydraulic, fluidic, and thermal interactions.
[0048] The phrases “attached to”, “secured to”, and “mounted to” refer to a form of mechanical coupling that restricts relative translation or rotation between the attached, secured, or mounted objects, respectively. The phrase “slidably attached to” refer to a form of mechanical coupling that permits relative translation, respectively, while restricting other relative motions. The phrase “attached directly to” refers to a form of securement in which the secured items are in direct contact and retained in that state of securement.
[0049] The term “abutting” refers to items that are in direct physical contact with each other, although the items may not be attached together. The term “grip” refers to items that are in direct physical contact with one of the items firmly holding the other. The term “integrally formed” refers to a body that is manufactured as a single piece, without requiring the assembly of constituent elements. Multiple elements may be formed integral with each other, when attached directly to each other to form a single work piece. Thus, elements that are “coupled to” each other may be formed together as a single piece.
[0050]
[0051] The catheters 10 depicted in
[0052] Catheters 10 suitable for use with the insertable optical element 14 may be of several different makes, sizes, and functions. For example, catheters that are translucent may be particularly suited to permit the passage of radially emitted EMR therethrough to the tissue surrounding the catheter 10. Catheters 10 that have an interior surface dimension (inside diameter) sufficiently larger than the exterior surface dimension (outer diameter) of the insertable optical element 14 may permit the injection or withdrawal of fluid (liquid or gas) simultaneously through the catheter while that insertable optical element 14 resides within the catheter 10.
[0053] Also, some catheters 10 have radiopacifiers embedded within the walls of the catheter 10 so that an image of where the catheter 10 is located within the patient's body 12 may be determined. However, some catheters have no such radiopacifiers. In either case, it is contemplated by this disclosure that radiopacifiers may be contained in or on the insertable optical element 14 to provide detection of the location of the catheter 10 within the patient's body 12 when the catheter 10 does not have radiopacifiers, and to provide detection of the location of the insertable optical element 14 disposed within the catheter 10 whether or not the catheter 10 has radiopacifiers (this may require differing radiopacifiers in some instances so that the catheter 10 and the insertable optical element 14 may be distinguished).
[0054] With some exemplary embodiments, at least one of the proximal catheter hub assemblies 32 may have an optical fiber element alignment shaft 98 that aligns an optical element connector 94 and the insertable optical element 14.
[0055]
[0056] The EMR component 20 comprises the EMR power source 26 (
[0057] Of particular interest to each of the embodiments is the use of light having wavelengths ranging from above 380 nm and about 900 nm. Additionally, the intensity and power of the light emitted server to inactivate of infectious agents and/or to promote healing. A range of radiant exposures covering 0.1 J/cm.sup.2 to 1 kJ/cm.sup.2 and a range of powers from 0.005 mW to 1 W, and power density range covering 1 mW/cm.sup.2 and 1 W/cm.sup.2 are of interest for these exemplary device assemblies and methods. These ranges of wavelengths, power densities, and radiant exposures have been shown to have either antimicrobial effects or positive biological effects on healing tissue. These positive biological effects include reduction of inflammatory cells, increased proliferation of fibroblasts, stimulation of collagen synthesis, angiogenesis inducement and granulation tissue formation.
[0058] For each exemplary embodiment described herein, the EMR conduction system 18 and method for disinfecting/healing could be utilized in an adjustable or predetermined duty cycle. If treatments began immediately after sterile procedure was initiated, device related infections may be inhibited. This includes device related biofilm growth.
[0059] A treatment may include at least one wavelength of therapeutic EMR that acts as a predominant wavelength selected to sterilize one or more target organisms and selected from the group of wavelengths centered about 400 nm, 405 nm, 415 nm, 430 nm, 440 nm, 455 nm, 470 nm, 475 nm, 660 nm, and 808 nm. Another treatment may include alternating the predominant wavelength between a first predominant wavelength and a second predominant wavelength (differing from the first predominant wavelength) in a selected treatment pattern. Further, sterilizing EMR and EMR that stimulates healthy cell growth may be transmitted simultaneously in tandem or alternatively.
[0060] Another embodiment of the present disclosure is depicted in
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[0064] The first view (uppermost) of the series of views shows a non-modified optical span 100 of the insertable optical element 14 that is without any radial dispersion (i.e., the insertable optical element 14 has not been modified to provide radial emission of light from the body of the insertable optical element 14). With this embodiment, therapeutic, non-ultra-violet EMR may be provided to a tip 64 with no radial emission from the non-modified optical span 100 other than at the tip 64.
[0065] The second view (next view down) of the series of views shows an exemplary radial transmission equivalency over a single modified portion 103 (i.e., modified portion 103 has a gradient modification such that the emitted light has substantially the same intensity and power over the length of the modified portion 103) that provides radially dispersed light from a segment-modified optical span 102. The location of the single modified portion 103, in this instance, corresponds to where the catheter 10 enters the insertion site A when the insertable optical element 14 is inserted fully into the catheter 10. With this embodiment, radially emitted visual light may sterilize the insertion site A and the transdermal area 48 or any other predetermined site within the patient's body 12.
[0066] The third view of the series of views shows an example of a single elongated modified portion 105 that provides radially dispersed light from optical element 14 extending along most of a fully-modified optical span 104. The location of the single elongated modified portion 105 corresponds generally to the length of the insertable catheter component 22 of the catheter 10. With this embodiment, therapeutic light may be provided for substantially the entire length that the catheter 10 would be inserted within the patient's body 12.
[0067] The fourth view of the series of views shows an example of radial transmission equivalency at multiple locations. A single modified portion 103 and an additional radial transmission equivalency at a modified tip portion 107 are spaced along a multi-modified optical span 106. The locations of the modified portion 103 and the modified tip portion 107 correspond to areas of the body, including for example the insertion site A, where the delivery of non-ultraviolet, therapeutic EMR may be desired for sterilization and/or healing. It should be understood that there may be more than one modified portion 103 disposed along the length of the multi-modified optical span 106 and/or each modified portion 103 may have various lengths.
[0068] Also, it should be understood that in each of these views the modified portions depicted may be of modifications other than modification of the exterior surface 62 of the insertable optical element 14, such as for example, modifications including microscopic structures embedded within the insertable optical element 14 that allow radial transmission of light from the insertable optical element 14. Further, such modified portions 103, 105, 107 may have gradient patterns that allow for an overall substantially-uniform distribution of light over the length of the modified portion 103, 105, 107.
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[0070] The first section 108 represents an internally reflected region of the insertable optical element 14. As shown at the first section 108, there is no ablation (or other modification) and no microscopic structure within the core 116 of the insertable optical element 14. No therapeutic non-ultra-violet EMR will emit radially from the insertable optical element 14 at the first section 108.
[0071] The second section 110 represents a minimally emissive region of the insertable optical element 14. As shown at the second section 110, there is minimal ablation (or other modification) to the exterior surface 62 of the insertable optical element 14 and a minimal dispersal of microscopic structures 117 within the core 116 of the insertable optical element 14. From the second section 110, minimal therapeutic, non-ultra-violet EMR will emit radially from the insertable optical element 14. However, the amount of EMR emitted should have sufficient intensity and power to inactivate infectious agents and/or promote healing proximate the second section 110.
[0072] The third section 112 represents a moderately emissive region of the insertable optical element 14. As shown at the third section 112, there is moderate ablation (or other modification) to the exterior surface 62 of the insertable optical element 14 and moderate dispersal of microscopic structures 117 within the core 116 of the insertable optical element 14. From the third section 112, a moderate amount of therapeutic, non-ultra-violet EMR will emit radially from the insertable optical element 14 proximate the third section 112. However, prior to reaching the third section 112, the amount of light traveling down the insertable optical element 14 diminishes due to the radial emission of some of the light such as at second section 110. Consequently, the degree of the gradient of modification is selected so that the amount of EMR emitted radially at third section 112 should be substantially equivalent to the radial emission at the second section 110. Hence, the intensity and power of the EMR emitted may be substantially equivalent to the intensity and power emitted at second section 110 and is of sufficient intensity and power to inactivate infectious agents and/or promote healing.
[0073] The fourth section 114 represents a maximally emissive region of the insertable optical element 14. As shown at the fourth section 114, there is maximal ablation (or other modification) to the exterior surface 62 of the insertable optical element 14 and maximal dispersal of microscopic structures 117 within the core 116 of the insertable optical element 14. From the fourth section 114, a maximum amount of therapeutic, non-ultra-violet EMR will emit radially from the insertable optical element 14 proximate the fourth section 114. Again, prior to reaching the fourth section 114, the amount of light continuing to travel down the insertable optical element 14 diminishes due to the radial emission of some of the light such as at second section 110 and at third section 112. Consequently, the degree of the gradient of modification is selected so that the amount of EMR emitted radially at fourth section 114 should be substantially equivalent to the emissions at second section 110 and third section 112. The intensity and power of the EMR emitted may be substantially equivalent to the intensity and power emitted at second section 110 and third section 112 and is of sufficient intensity and power to inactivate infectious agents and/or promote healing.
[0074] The modified portions may be modified by chemical, physical or other cladding modification (e.g., ablation) to alter the critical angle enough to allow light to emit radially. Additionally or alternatively, the modified portions may be modified by dispersing microscopic structures 117 of varying gradient concentration inside the core 116 of the insertable element 14. The gradient concentration of microscopic structures 117 within the core 116 shown in
[0075] The concentration of microscopic structures 117 within the core 116 affects the refractive index of the core 116 and the core-cladding boundary 118. The microscopic structures 117 (which may be voids, such as bubbles) create changes in the incident angle of the light as it passes through the insertable optical element 14. At certain incident angles, light leaves the optical element cladding 119 and emits radially from the cladding boundary 120.
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[0078] In
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[0080] There are several methods for achieving this gradient modification. Chemically, the insertable optical element 14 may be etched using a strong acid such as hydrofluoric acid or sulfuric acid and hydrogen-peroxide. Also, quartz powder, calcium fluoride, or an etching cream, usually carrying a fluorinated compound, may be used. Physically, heating the insertable optical element 14 or physical modification such as ablation by sanding, media blasting, grinding, or laser ablation modifications are also methods for creating gradient modification. Additionally, plasma ablation by laser modification causes the ionization of molecules and alteration of the exterior surface 62 of the insertable optical element 14. Other known methods for creating gradient ablation are contemplated by this disclosure. Regardless of the modification or manufacturing process, whether presently known or not, the insertable optical element 14 may be modified to have substantially equivalent radially emitted light along desired lengths. This uniformity in radially emitted light allows for a more accurate treatment dose for inactivating infectious agents and/or promoting healing.
[0081] In
[0082] The exemplary disclosure depicts an optical diversion element as a single collimating lens 92, but other types of optical diversion elements such as multiple lenses or different types of lenses may be used to collimate the light. Depending on the optical element 14 diameter, numerical aperture, and refractive index, specific lenses will be needed as an optical diversion element to reduce light loss.
[0083] Referring now to
[0084] This disclosure anticipates that the system and methods of this disclosure may be embodied in other specific forms without departing from its structures, methods, or other essential characteristics as broadly described herein and claimed hereinafter. The described embodiments are to be considered in all respects only as illustrative, and not restrictive. The scope of the disclosure is, therefore, indicated by the appended claims, rather than by the foregoing description. All changes that come within the meaning and range of equivalency of the claims are to be embraced within their scope.
[0085] For exemplary methods or processes of the invention, the sequence and/or arrangement of steps described herein are illustrative and not restrictive. Accordingly, it should be understood that, although steps of various processes or methods may be shown and described as being in a sequence or temporal arrangement, the steps of any such processes or methods are not limited to being carried out in any particular sequence or arrangement, absent an indication otherwise. Indeed, the steps in such processes or methods generally may be carried out in various different sequences and arrangements while still falling within the scope of the present invention.
[0086] Additionally, any references to advantages, benefits, unexpected results, or operability of the present invention are not intended as an affirmation that the invention has been previously reduced to practice or that any testing has been performed. Likewise, unless stated otherwise, use of verbs in the past tense (present perfect or preterit) is not intended to indicate or imply that the invention has been previously reduced to practice or that any testing has been performed.
[0087] Exemplary embodiments of the present invention are described above. No element, act, or instruction used in this description should be construed as important, necessary, critical, or essential to the invention unless explicitly described as such. Although several exemplary embodiments have been described in detail herein, those skilled in the art will readily appreciate that many modifications are possible in these exemplary embodiments without materially departing from the novel teachings and advantages of this invention. Accordingly, all such modifications are intended to be included within the scope of this invention as defined in the appended claims.
[0088] In the claims, any means-plus-function clauses are intended to cover the structures described herein as performing the recited function and not only structural equivalents, but also equivalent structures. Thus, although a nail and a screw may not be structural equivalents in that a nail employs a cylindrical surface to secure wooden parts together, whereas a screw employs a helical surface, in the environment of fastening wooden parts, a nail and a screw may be equivalent structures. Unless the exact language “means for” (performing a particular function or step) is recited in the claims, a construction under Section 112, 6th paragraph is not intended. Additionally, it is not intended that the scope of patent protection afforded the present invention be defined by reading into any claim a limitation found herein that does not explicitly appear in the claim itself.