BALLOON CATHETER
20220088354 · 2022-03-24
Assignee
Inventors
Cpc classification
A61M2025/1079
HUMAN NECESSITIES
International classification
Abstract
A balloon catheter includes a tubular inner shaft, a balloon partly covering the inner shaft and having a distal end joined to the inner shaft, and a tubular outer shaft accommodating a part of the inner shaft. The outer shaft includes a balloon joint joined to a base end of the balloon and a reduced diameter area being accommodated in the balloon and having a smaller outer diameter than the balloon joint part, and is joined to the inner shaft in the balloon. A communication hole provides a flow path between the expansion lumen and the inside of the balloon. In the balloon, an outer diameter on the outermost periphery of a structure formed by the inner shaft, the X-ray opaque marker, and the outer shaft decreases continuously or stepwise from the base end toward the distal end of the balloon.
Claims
1. A balloon catheter, comprising: an inner shaft having a tubular shape; a balloon covering a portion of the inner shaft and including a distal end joined to the inner shaft; an X-ray opaque marker on an inner peripheral surface side or an outer peripheral surface side of the inner shaft; and an outer shaft having a tubular shape and accommodating a part of the inner shaft, wherein the outer shaft includes a balloon joint joined to a base end of the balloon and a reduced diameter area in the balloon and having an outer diameter smaller than an outer diameter of the balloon joint, the outer shaft being joined to the inner shaft in the balloon, the balloon catheter includes a communication hole that provides a flow path between an inside of the balloon with an expansion lumen formed between an inner peripheral surface of the outer shaft and an outer peripheral surface of the inner shaft, and in the balloon, an outer diameter on an outermost periphery of a structure formed by the inner shaft, the X-ray opaque marker, and the outer shaft decreases continuously or stepwise from the base end toward the distal end of the balloon.
2. The balloon catheter according to claim 1, wherein a distal end of the reduced diameter area in the outer shaft is joined to the inner shaft.
3. The balloon catheter according to claim 2, wherein a thickness of the distal end of the reduced diameter area of the outer shaft is thinner than a thickness of the balloon joint of the outer shaft.
4. The balloon catheter according to claim 3, wherein a thickness of the outer shaft decreases continuously or stepwise from the balloon joint of the outer shaft toward the distal end of the reduced diameter area of the outer shaft.
5. The balloon catheter according to claim 1, wherein the X-ray opaque marker is on a distal end side of the outer shaft in an axial direction of the inner shaft, and a distance between a base end of the X-ray opaque marker and the distal end of the outer shaft in the axial direction is less than twice a thickness of the balloon.
6. The balloon catheter according to claim 1, wherein the X-ray opaque marker is on a distal end side of the outer shaft in an axial direction of the inner shaft, and an outer diameter of the X-ray opaque marker is equal to or smaller than an outer diameter of the distal end of the reduced diameter area.
7. The balloon catheter according to claim 1, wherein the X-ray opaque marker is nearer a base end than is a joint portion between the inner shaft and the outer shaft.
8. The balloon catheter according to claim 7, wherein the X-ray opaque marker is at a position corresponding to the balloon joint of the outer shaft or nearer a distal end than the position corresponding to the balloon joint of the outer shaft is, in an axial direction of the inner shaft.
9. The balloon catheter according to claim 1, wherein the outer diameter of the balloon joint of the outer shaft is smaller than an outer diameter of a portion of the outer shaft nearer a base end than is the balloon joint.
10. The balloon catheter according to claim 1, wherein an outer peripheral surface of the reduced diameter area of the outer shaft decreases continuously in diameter from the balloon joint toward the distal end of the outer shaft.
11. The balloon catheter according to claim 1, wherein the outer peripheral surface of the reduced diameter area of the outer shaft decreases in diameter in a plurality of steps from the balloon joint toward the distal end of the outer shaft.
12. The balloon catheter according to claim 1, wherein the reduced diameter area includes a separated portion separated from the outer peripheral surface of the inner shaft in a radially outward direction of the inner shaft, and the communication hole is in the separated portion.
13. The balloon catheter according to claim 1, wherein the distal end of the reduced diameter area of the outer shaft is at a position separated from a joint between the inner shaft and the balloon in an axial direction of the inner shaft.
14. The balloon catheter according to claim 1, wherein the reduced diameter area of the outer shaft is integrally formed with a portion of the outer shaft adjacent to the reduced diameter area.
15. The balloon catheter according to claim 14, wherein the reduced diameter area of the outer shaft is formed by extending the distal end of the outer shaft.
16. The balloon catheter according to claim 1, wherein a thickness of the reduced diameter area of the outer shaft is thinner than a thickness of the balloon joint of the outer shaft.
17. The balloon catheter according to claim 1, wherein the X-ray opaque marker is at least partially embedded in the inner shaft.
Description
BRIEF DESCRIPTION OF DRAWINGS
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DETAILED DESCRIPTION
A. First Embodiment
A-1. Basic Configuration of Balloon Catheter 100
[0041]
[0042] The balloon catheter 100 is a medical device to be inserted into a blood vessel or the like to widen and expand a lesion (a constricted part or an occluded part) in the blood vessel or the like. The balloon catheter 100 includes an inner shaft 10, an outer shaft 20, and the balloon 30.
[0043] The inner shaft 10 is a tubular (for example, a hollow cylindrical) member having a distal end and a base end that are open. It is noted that the meaning of “tubular (hollow cylindrical)” herein is not limited to a perfectly tubular shape (hollow cylindrical shape), and the shape may be substantially tubular in general (for example, a substantially hollow cylindrical shape such as a slightly conical shape and a shape partially having an unevenness). A guide wire lumen S1 through which a guide wire 60 (see
[0044] The outer shaft 20 is a tubular (for example, a hollow cylindrical) member having a distal end and a base end that are open. An inner diameter of the outer shaft 20 is larger than an outer diameter of the inner shaft 10. The outer shaft 20 accommodates a part of the inner shaft 10 and is arranged to be located coaxially with the inner shaft 10 with a portion of the inner shaft 10 that extends along the Z-axis direction. An expansion lumen S2 through which a fluid G for expansion used for expanding the balloon 30 flows, is formed between an outer peripheral surface of the inner shaft 10 and an inner peripheral surface of the outer shaft 20. The fluid G may be a gas, e.g., helium gas, CO.sub.2 gas, O.sub.2 gas, and the like, or a liquid, e.g., physiological saline, a contrast medium, and the like.
[0045] Specifically, the outer shaft 20 includes a shaft main body part 22 having a tubular shape with an annular cross section, a balloon joint part 24, and a reduced diameter part 26, described in detail below. The joint part 24 is located on a distal end side of the outer shaft 20 with respect to the shaft main body part 22 and has an inner diameter and an outer diameter that are smaller than those of the shaft main body part 22. Inner peripheral surfaces of the shaft main body part 22 and the balloon joint part 24 are separated from the outer peripheral surface of the inner shaft 10 over the entire circumference around the axis (Z-axis direction) of the inner shaft 10 (see
[0046] The distal end part of the inner shaft 10 protrudes toward the distal end side from the distal end part of the outer shaft 20. The base end of the inner shaft 10 is curved to the side with respect to an axial direction of the inner shaft 10 (a length direction of the inner shaft 10, that is, the Z-axis direction in each figure) to be connected to a side wall of the shaft main body part 22 of the outer shaft 20, and is open on the outer peripheral surface of the shaft main body part 22. The opening on the outer peripheral surface of the shaft main body part 22 forms a base end side guide wire port 16 of the inner shaft 10, and the guide wire 60 is inserted from the base end side guide wire port 16. That is, the balloon catheter 100 in the present embodiment is a so-called rapid exchange type catheter.
[0047] The inner shaft 10 and the outer shaft 20 are formed of a material having a heat-sealability and a certain degree of flexibility. Examples of the material for forming the inner shaft 10 and the outer shaft 20 include thermoplastic resins, more specifically, polyolefins, e.g., polyethylene, polypropylene, polybutene, ethylene-propylene copolymers, ethylene-vinyl acetate copolymers, ionomers, or mixtures of two or more types of these compounds, polyvinyl chloride resin, polyamides, polyamide elastomers, polyesters, polyester elastomers, and thermoplastic polyurethane.
[0048] As illustrated in
[0049] The balloon 30 is an expansion part expandable and contractible in accordance with the supply and discharge of the fluid G. The balloon 30 covers a distal end part of the inner shaft 10 protruding from the distal end of the outer shaft 20. Further, a distal end part 32 of the balloon 30 is joined, e.g., welded, to the inner shaft 10 (the outer peripheral surface on the base end side of the distal tip 12) and a base end part 34 of the balloon 30 is joined, e.g., welded, to the outer peripheral surface of the balloon joint part 24 in the outer shaft 20. The distal end part of the distal tip 12 is open on a more distal end side than the distal end part 32 of the balloon 30. In the contracted state, the balloon 30 is folded to be in close contact with the outer peripheral surfaces of the inner shaft 10 and the outer shaft 20 (see
[0050] The balloon 30 may be formed of a material having a certain degree of flexibility, and may be formed of a material being thinner than the inner shaft 10 and the outer shaft 20 and having flexibility. Examples of the material for forming the balloon 30 include polyolefins such as polyethylene, polypropylene, polybutene, ethylene-propylene copolymers, ethylene-vinyl acetate copolymers, ionomers, or mixtures of two or more types of these, thermoplastic resins such as soft polyvinyl chloride resin, polyamides, polyamide elastomers, polyesters, polyester elastomers, polyurethane, and fluororesin, silicone rubber, and latex rubber.
A-2. Detailed Configuration of Balloon Catheter 100
[0051] Next, a detailed configuration of the balloon catheter 100 of the present embodiment will be described. As illustrated in
[0052] As illustrated in
[0053] The taper part 26B is located between the small-diameter part 26A and the balloon joint part 24 in the axial direction (Z-axis direction) of the inner shaft 10. A diameter of an outer peripheral surface of the taper part 26B decreases continuously from a boundary position between the taper part 26B and the balloon joint part 24 toward a boundary position between the taper part 26B and the small-diameter part 26A. The diameter of the outer peripheral surface of the taper part 26B may decrease linearly toward the distal end side or may decrease in a curved shape toward the distal end side. The balloon joint part 24 refers to a portion of the outer shaft 20 that is joined to, i.e., in direct contact with, the balloon 30. Thus, as illustrated in
[0054] As illustrated in
[0055] Further, as illustrated in
[0056] Further, as illustrated in
[0057] The balloon catheter 100 of the present embodiment may include an X-ray opaque marker 50. The X-ray opaque marker 50 is a tubular (for example, a hollow cylindrical) member, is located at the distal end side of the outer shaft 20 with respect to the reduced diameter part 26, and is arranged to surround the outer peripheral surface of the inner shaft 10. The X-ray opaque marker 50 may be formed of any material opaque to X-rays, e.g., a metal such as gold, platinum, tungsten, and the like. Thus, when the balloon catheter 100 is inserted into a living body, the position of the X-ray opaque marker 50 can be imaged by X-rays from the outside of the living body. It is noted that a base end of the X-ray opaque marker 50 is adjacent to the distal end of the reduced diameter part 26 of the outer shaft 20, e.g., may be in direct contact with the small-diameter part 26A along the Z-axis direction. Further, as illustrated in
[0058] Relational Expression 1 below is satisfied for the outer diameters of the inner shaft 10, the outer shaft 20, and the X-ray opaque marker 50, and thus, as described above, the outer diameter gradually decreases from the balloon joint part 24 toward the outer peripheral surface of the inner shaft 10.
Outer diameter D1 of balloon joint part 24>outer diameter of taper part 26B>outer diameter D2 of small-diameter part 26A>outer diameter D3 of X-ray opaque marker 50>outer diameter D4 of inner shaft 10 Relational Expression 1
[0059] Therefore, in a state where the fluid G is not provided in the internal space S3 and the balloon 30 is contracted (hereinafter, simply referred to as a “contracted state”), the diameter of the balloon 30 gradually decreases to follow the outer shapes of the reduced diameter part 26 of the outer shaft 20, the inner shaft 10, and the X-ray opaque marker 50, from the base end part 34 joined to the balloon joint part 24 of the outer shaft 20 toward the distal end part 32. That is, the outer diameter of the balloon 30 also gradually decreases from the base end part 34 toward the distal end part 32 (see (A) of
[0060] It is noted that, for example, an outer diameter D0 of the outer shaft 20 is 0.77 mm, the outer diameter D1 of the balloon joint part 24 in the outer shaft 20 is 0.75 mm, the outer diameter D2 of the small-diameter part 26A in the reduced diameter part 26 is 0.57 mm, the outer diameter D3 of the X-ray opaque marker 50 is 0.54 mm, and the outer diameter D4 of the inner shaft 10 is 0.48 mm. Further, the difference between the outer diameter D1 of the balloon joint part 24 and the outer diameter D2 of the small-diameter part 26A is 0.18 mm, the difference between the outer diameter D2 of the small-diameter part 26A and the outer diameter D3 of the X-ray opaque marker 50 is 0.03 mm, and the difference between the outer diameter D3 of the X-ray opaque marker 50 and the outer diameter D4 of the inner shaft 10 is 0.06 mm.
A-3. Usage Example of Balloon Catheter 100
[0061] Next, a usage example of the balloon catheter 100 in the first embodiment will be described.
[0062] Next, in a state where the balloon distal end portion in the balloon catheter 100 is inserted into the lesion L, the fluid G is sent from the expansion lumen S2 into the internal space S3 of the balloon 30 to expand the balloon 30. Therefore, as illustrated in (B) of
[0063] Subsequently, as illustrated in (C) of
A-4. Effects of Present Embodiment
[0064] As described above, in the balloon catheter 100 of the present embodiment, the fluid G for expanding the balloon 30 can be sent from the expansion lumen S2 into the internal space S3 of the balloon 30, via the communication hole 28 formed in the outer shaft 20. Further, the outer shaft 20 includes the reduced diameter part 26, and the reduced diameter part 26 is accommodated in the balloon 30 and has an outer diameter smaller than the outer diameter D1 of the balloon joint part 24 joined to the base end part 34 of the balloon 30. As a result, the diameter of the balloon 30 in the contracted state gradually decreases to follow the outer shape of the reduced diameter part 26 of the outer shaft 20 from the base end part 34 joined to the balloon joint part 24 of the outer shaft 20 toward the distal end part 32.
[0065] Here, (A) and (B) of
[0066] On the other hand, as illustrated in (A) of
[0067] Further, in the present embodiment, the distal end of the reduced diameter part 26 in the outer shaft 20 is joined to the inner shaft 10. Therefore, for example, compared with a configuration in which a portion of the outer shaft 20, which is nearer the base end than the reduced diameter part 26 is, is joined to the inner shaft 10, the pushing force from the outer shaft 20 to the inner shaft 10 is transmitted even more efficiently. Further, deformation in the shape of the reduced diameter part 26 due to a load from the pushing force may be suppressed. Thereby, according to the present embodiment, the passability of the balloon catheter 100 may be improved.
[0068] Further, in the present embodiment, the diameter of the outer peripheral surface of the reduced diameter part 26 decreases in a plurality of steps from the balloon joint part 24 toward the distal end part of the outer shaft 20. Therefore, according to the present embodiment, compared with, for example, a configuration in which the entire outer peripheral surface of the reduced diameter part 26 is parallel to the axial direction (the Z-axis direction) of the outer shaft 20, decrease in the transmissibility of the pushing force from the outer shaft 20 to the inner shaft 10 due to the difference in outer diameters between the balloon joint part 24 of the outer shaft 20 and the inner shaft 10 may be suppressed and the passability of the balloon catheter 100 may be further improved.
[0069] Assuming a configuration in which the communication hole 28 communicating the expansion lumen S2 and the internal space S3 of the balloon 30 is formed between the inner peripheral surface of the outer shaft 20 and the outer peripheral surface of the inner shaft 10, the outer diameter of the outer shaft 20 is increased for securing the diameter of the communication hole 28, and as a result, the pushability of the balloon catheter 100 may decrease. On the other hand, in the present embodiment, the communication hole 28 is formed in the taper part 26B of the reduced diameter part 26 of the outer shaft 20 which is separated from the inner shaft 10. Therefore, an increase in the diameter of the outer shaft 20 due to the formation of the communication hole 28 may be suppressed.
[0070] Further, in the present embodiment, the distal end of the reduced diameter part 26 of the outer shaft 20 is arranged at a position separated from the joint portion 36 of the inner shaft 10 and the balloon 30. Thus, according to the present embodiment, compared with, for example, a configuration in which the distal end of the reduced diameter part 26 of the outer shaft 20 extends to the joint portion 36 of the inner shaft 10 and the balloon 30, the diameter of a distal end side portion of the balloon 30 in the contracted state is small. Thus, the pushability of the distal end side portion of the balloon catheter 100 into the lesion in the contracted state of the balloon 30 may be improved.
[0071] In the present embodiment, the X-ray opaque marker 50 is arranged at the distal end side of the outer shaft 20 in the axial direction of the inner shaft 10. The distance between the base end of the X-ray opaque marker 50 and the distal end of the outer shaft 20 in the axial direction may be less than twice the thickness of the balloon 30. Thus, compared with a configuration in which the X-ray opaque marker 50 is not arranged at the distal end side of the inner shaft 10, a position of the distal end part of the balloon catheter 100 in the living body can be imaged accurately. If the distance between the base end of the X-ray opaque marker 50 and the distal end of the outer shaft 20 in the axial direction is equal to or more than twice the thickness of the balloon 30, a decrease in an expansion function of the balloon 30 and damage to the balloon 30 due to, for example, the balloon 30 entering a space between the base end of the X.sup.-ray opaque marker 50 and the distal end of the outer shaft 20 may not be suppressed.
[0072] Further, in the present embodiment, the X-ray opaque marker 50 having an outer diameter smaller than the outer diameter of the reduced diameter part 26 of the outer shaft 20 is provided. Therefore, according to the present embodiment, compared with, for example, a configuration in which the outer diameter of the X-ray opaque marker 50 located at the distal end side of the reduced diameter part 26 is larger than the outer diameter of the reduced diameter part 26, a decrease in the transmissibility of the pushing force from the outer shaft 20 to the inner shaft 10 due to the difference in outer diameters between the X-ray opaque marker 50 and the inner shaft 10 may be suppressed, and the passability of the balloon catheter 100 may not be further improved.
[0073] Further, in the present embodiment, the outer diameter D1 of the balloon joint part 24 of the outer shaft 20 is smaller than the outer diameter D0 of a portion (the shaft main body part 22) of the outer shaft 20 nearer the base end than the balloon joint part 24 is. According to the present embodiment, compared with, for example, a configuration in which the outer diameter of the balloon joint part 24 of the outer shaft 20 is equal to or greater than the outer diameter of the shaft main body part 22, the passability of the balloon catheter 100 when moving the balloon catheter 100 to the distal end side after the balloon catheter 100 reaches the lesion may be improved, and damage to the balloon 30 due to the balloon 30 getting stuck when the balloon catheter 100 is moved to the base end side may be suppressed.
[0074] Further, in the present embodiment, the reduced diameter part 26 of the outer shaft 20 is formed integrally with the shaft main body part 22 of the outer shaft 20. According to the present embodiment, compared with a configuration in which the reduced diameter part 26 and the shaft main body part 22 are formed separately, a decrease in the passability of the balloon catheter 100 due to a difference in rigidity between the reduced diameter part 26 and the shaft main body part 22 may be suppressed.
B. Second Embodiment
[0075]
[0076] As illustrated in
[0077] Further, in the balloon catheter 100a of the second embodiment, a communication hole 28a is formed between inner peripheral surfaces of the reduced diameter part 26a in the outer shaft 20a and the X-ray opaque marker 50a, and the outer peripheral surface of the inner shaft 10. Specifically, as illustrated in
[0078] As described above, in the balloon catheter 100a of the second embodiment, the diameter of the outer peripheral surface of the reduced diameter part 26a decreases continuously from the balloon joint part 24 toward the distal end part of the outer shaft 20a. That is, in the present embodiment, there is no level difference from the balloon joint part 24 to the distal end part of the outer shaft 20a. Therefore, according to the present embodiment, compared with, for example, a configuration in which the entire outer peripheral surface of the reduced diameter part 26a is parallel to the axial direction (the Z-axis direction) of the inner shaft 10 and a configuration in which the diameter of the reduced diameter part 26a decreases in a plurality of steps, a decrease in the transmissibility of the pushing force from the outer shaft 20a to the inner shaft 10 due to the difference in outer diameters between the balloon joint part 24 of the outer shaft 20a and the inner shaft 10 may be more effectively suppressed and the passability of the balloon catheter 100a may be further improved.
C. Modifications
[0079] The technique disclosed herein is not limited to the above-described embodiment, and may be modified into various modes without departing from the spirit of the above-described embodiment. For example, the following modifications can be applied.
[0080] The configuration of the balloon catheter 100 in the embodiment described above is merely an example and various modifications can be applied. For example, in the above-described embodiment, the outer diameter of the balloon joint part 24 in the outer shaft 20 may be equal to or larger than the outer diameter of the shaft main body part 22. Further, the above-described first embodiment may have a configuration in which the communication hole 28 is formed at a plurality of positions in the taper part 26B in the circumferential direction around the axis of the balloon catheter 100.
[0081] In the above-described embodiment, the distal end of the reduced diameter part 26 (the small-diameter part 26A) in the outer shaft 20 is configured to be joined to the inner shaft 10. However, the base end of the reduced diameter part 26 (for example, a portion in which the thickness of a part of the taper part 26B is increased) may be configured to be joined to the inner shaft 10, for example. That is, it is only required that the outer shaft 20 is configured to be joined to the inner shaft 10 in the balloon 30. Further, in the above-described embodiment, the distal end of the reduced diameter part 26 of the outer shaft 20 may be configured to extend to the joint portion 36 of the inner shaft 10 and the balloon 30.
[0082] In the first embodiment described above, instead of the taper part 26B, the reduced diameter part 26 may be configured to include a stepped part having a stepped surface perpendicular to the axial direction of the outer shaft 20. It is noted that, “M and N are perpendicular” herein does not mean that an angle formed by M and N is limited to an angle of 90 degrees, and it is only required that the angle formed by M and N is equal to or less than 90 degrees±5 degrees. In this case, the number of steps in the entire reduced diameter part 26 may be one step or a plurality of steps. Further, in the first embodiment described above, the communication hole 28 may be configured to be formed between the inner peripheral surface of the outer shaft 20 and the outer peripheral surface of the inner shaft 10. Moreover, in the second embodiment described above, the outer shaft 20a may have a configuration in which a communication hole is formed to penetrate the reduced diameter part 26a.
[0083] In the first embodiment described above, the outer diameter D3 of the X-ray opaque marker 50 may be equal to the outer diameter D2 of the small-diameter part 26A in the outer shaft 20. Further, in the second embodiment described above, the outer diameter of the base end of the X.sup.-ray opaque marker 50a may be smaller or larger than the outer diameter of the distal end of the reduced diameter part 26a. Moreover, in the second embodiment described above, a configuration may be employed in which a level difference is provided between the base end of the reduced diameter part 26a and the distal end of the balloon joint part 24. Further, in each of the above-described embodiments, the base ends of the X-ray opaque markers 50 and 50a may be separated from the distal ends of the reduced diameter parts 26 and 26a of the outer shaft 20. Moreover, in each of the above-described embodiments, a configuration may be employed in which a plurality of the X-ray opaque markers 50 and 50a are provided, or the X-ray opaque markers 50 and 50a are not provided.
[0084]
[0085]
Outer diameter D1 of balloon joint part 24>outer diameter D2 of small-diameter part 26A>outer diameter D3d of X-ray opaque marker 50d>outer diameter D4 of inner shaft 10 Relational Expression 2
[0086] Further, as illustrated in
Thickness te1 of small-diameter part 26A<thickness te2 of taper part 26B<thickness te3 of tubular part 26C (balloon joint part 24) Relational Expression 3
[0087] Therefore, in the fourth modification, the rigidity of the outer shaft 20 decreases stepwise from the balloon joint part 24 toward the distal end part of the outer shaft 20. Thus, occurrence of a deformation, e.g., a kink, in the outer shaft 20, may be suppressed. It is noted that, in the fourth modification, similarly to the third modification described above, the X-ray opaque marker 50d is arranged to surround the outer peripheral surface of the inner shaft 10.
[0088] Further, as illustrated in
[0089]
[0090] As illustrated in
[0091] Further, the material of each member in the above-described embodiment is merely an example and various modifications can be applied.
[0092] In the embodiment described above, a configuration in which the present invention is applied to the rapid exchange type balloon catheter 100 is described in an example, but the present invention may be applied to a so-called over-the-wire type balloon catheter.
[0093] Example embodiments have been disclosed herein, and although specific terms are employed, they are used and are to be interpreted in a generic and descriptive sense only and not for purpose of limitation. In some instances, as would be apparent to one of skill in the art as of the filing of the present application, features, characteristics, and/or elements described in connection with a particular embodiment may be used singly or in combination with features, characteristics, and/or elements described in connection with other embodiments unless otherwise indicated. Accordingly, various changes in form and details may be made without departing from the spirit and scope of the embodiments set forth in the claims.