Abstract
The invention relates to a system comprising a catheter device with a radially compressible part, a sleeve, and a device for compressing said radially compressible part and introducing the radially compressible part into the sleeve, as well as a method for using such a system.
Claims
1. A system for introducing a radially compressible part of a catheter device into a sleeve, comprising: a sleeve, a catheter device comprising a radially compressible part, the radially compressible part being configured to be transferred at least in part into the sleeve; a compression pipe which comprises movable fins for receiving the radially compressible part, the movable fins having an open state and a closed state.
2. The system according to claim 1, wherein the radially compressible part comprises a radially compressible rotor and a radially compressible housing.
3. The system according to claim 1, wherein the sleeve is a peel-away sheath or the sleeve is a cannula.
4. The system according to claim 3, wherein the cannula pertains to the catheter device itself.
5. The system according to claim 1, wherein the catheter device comprises a pigtail and/or a distal bearing, the distal bearing or the pigtail comprising an elongated portion.
6. The system according to claim 1, wherein the compression pipe comprises a tube for receiving the elongated portion or a portion of the catheter device lying proximally or distally of the radially compressible part.
7. The system according to claim 6, wherein the tube of the compression pipe comprises a recess for receiving the pigtail.
8. The system according to claim 1, wherein the compression pipe comprises between two and ten movable fins.
9. The system according to claim 1, wherein the compression pipe comprises three or four movable fins.
10. The system according to claim 1, wherein gaps extending between neighboring movable fins extend axially or spirally.
11. The system according to claim 10, wherein slits are provided in the compression pipe, the slits extending axially or spirally, as continuations of the gaps or in between the gaps.
12. The system according to claim 11, wherein ends of radially displaced slits overlap axially with ends of gaps and/or axially designed slits
13. The system according to claim 10, wherein a gap remains between neighboring movable fins in the closed state.
14. The system according to claim 1, wherein neighboring fins are connected by a membrane or skin.
15. The system according to claim 1, further comprising a reducer for radially compressing the movable fins of the compression pipe and the radially compressible part received between the movable fins.
16. The system according to claim 15, wherein the reducer is designed as a pipe with a distal and a proximal opening and configured to receive the sleeve and the compression pipe, and wherein the sleeve comprises a stop configured to abut against an end of the reducer when the sleeve is introduced into the proximal opening of the reducer and/or wherein the compression pipe comprises a stop configured to abut against an end of the reducer when the compression pipe is introduced into the distal opening of the reducer, such that a gap remains between the sleeve and the compression pipe when the compression pipe and the sleeve are introduced into the reducer.
17. The system according to claim 15, wherein the reducer is designed as a pipe with a distal and a proximal opening, comprising a proximal cylindrical portion of constant inner diameter and a distal conical portion, where the inner diameter increases in distal direction, the distal conical portion configured for receiving the movable fins and the radially compressible part received by the movable fins.
18. The system according to claim 15, wherein the reducer comprises a first stop for limiting the movement of the sleeve with respect to the reducer in the distal direction.
19. The system according to claim 18, wherein the reducer comprises a second stop opposite to the first stop for limiting the movement of the compression pipe with respect to the reducer in the proximal direction.
20. The system according to claim 1, wherein an inner diameter of the movable fins in the closed state and an inner diameter of the sleeve differ by at most 1 mm.
21. The system according to claim 17, wherein the compression pipe is provided around the catheter device, such that the movable fins face the compressible part and the reducer is provided on an opposite side of the compressible part, such that the conical portion of the reducer faces the compressible part, further comprising a disk device with a hole, characterized in that the disc device is provided around the catheter device in a section between the cylindrical portion of the reducer and the compressible part.
22. A method for inserting a radially compressible part of a catheter device into a sleeve, the method comprising the steps of: providing a reducer around the catheter device proximally of the compressible part; providing the sleeve around the catheter device proximally of the reducer; providing a compression pipe around the catheter device, such that the radially compressible part is located between movable fins of the compression pipe; and executing the following steps: moving the reducer towards the compression pipe, such that the compression pipe slides into a distal opening of the reducer; continuing the relative movement of the compression pipe and the reducer such that the movable fins slide through a distal conical portion of the reducer, effecting compression of the movable fins from an open state to a closed state, thus compressing the radially compressible part; continuing the relative movement such that the movable fins in the compressed state and the compressed radially compressible part slide along a proximal cylindrical portion of the reducer; and providing the sleeve proximally against the compression pipe or against a stop pertaining to the reducer, the stop being provided proximally of the compression pipe, and pulling a catheter tube of the catheter in a proximal direction while holding on to the sleeve, such that at least the portion of the catheter device comprising the radially compressible part slides out of the compression pipe and into the sleeve.
23. The method for inserting a radially compressible part of a catheter device into a sleeve, the method comprising the steps of: providing a reducer around the catheter device proximally of a compressible part; providing the sleeve around the catheter device proximally of the reducer; providing a compression pipe around the catheter device, such that movable fins of the compression pipe face in the proximal direction; and executing the following steps: moving the reducer and a disk device towards the compression pipe, such that the disk device pushes the compressible part between the movable fins and sliding the movable fins into a distal opening of the reducer until the disk device gives in or breaks; continuing the relative movement of the compression pipe and the reducer such that the movable fins slide through a distal conical portion of the reducer, effecting compression of the movable fins from an open state to a closed state, thus compressing the radially compressible part; continuing the relative movement such that the movable fins in the compressed state and the compressed radially compressible part slide along a proximal cylindrical portion of the reducer; and providing the sleeve proximally against the compression pipe or against a stop pertaining to the reducer, the stop being provided proximally of the compression pipe, and pulling a catheter tube of the catheter in a proximal direction while holding on to the sleeve, such that at least the portion of the catheter device comprising the radially compressible part slides out of the compression pipe and into the sleeve.
24. The system according to claim 1, wherein an inner diameter of the movable fins in the closed state and an inner diameter of the sleeve differ by at most 0.5 mm.
Description
[0035] Aspects and embodiments of the system according to the application are exemplified in FIGS. 1 to 13.
[0036] FIG. 1 shows a catheter device which is positioned within the left ventricle of a heart;
[0037] FIG. 2 shows a distal end region of a catheter device;
[0038] FIGS. 3 a and b show the distal end region of the catheter device with a compression tube and a reducer;
[0039] FIG. 4 shows a compressible part of a catheter device being pulled into a sleeve without compression pipe and reducer;
[0040] FIGS. 5 a and b show the compression pipe from two different perspectives;
[0041] FIGS. 6 a and b show the reducer from two different perspectives;
[0042] FIG. 7 shows a cut through the reducer;
[0043] FIG. 8 shows the compression pipe and the reducer without the catheter device;
[0044] FIGS. 9 a and b show the distal end region of the catheter device with a compression tube and a reducer and a disk device;
[0045] FIG. 9 c shows the disk device from FIGS. 9 a and b;
[0046] FIG. 10 shows a setup as in FIG. 2, where the compression tube is provided in an alternative configuration;
[0047] FIGS. 11 a and b show the rotor and the housing in the expanded state and in the compressed state;
[0048] FIG. 12 shows the compression tube and the reducer and the catheter device with the compressible part in the compressed state;
[0049] FIG. 13 shows a rotor housing with fewer struts near the proximal end;
[0050] FIGS. 14a and 14b shows the sleeve and the compression pipe which are introduced into the reducer, the sleeve and the compression pipe having additional stops;
[0051] FIG. 15 shows an embodiment of the compression pipe with additional slits; and
[0052] FIGS. 16a-e show embodiments of the compression pipe exhibiting different configurations for the gaps between the fins.
[0053] FIG. 1 shows a catheter device 1 used as a blood pump. The catheter device 1 is introduced into a patient, such that a portion of the distal end region of the catheter device 1 is positioned within the left ventricle 5.3 of the heart 5.1 of the patient. In a driving region, which can lie outside of the patient's body, a motor 6 is provided for driving a drive shaft 1.5. A portion of the drive shaft 1.5 is covered by the catheter tube 1.3. The drive shaft 1.5 and the catheter tube 1.3 extend from the driving region to the distal end region, where a radially compressible rotor 1.1.1 is driven by the drive shaft 1.5. The compressible rotor 1.1.1 is located within a compressible housing 1.1.2. The compressibility of the rotor 1.1.1 and the housing 1.1.2 is useful for introducing the rotor into the patient's body. During operation, the rotor 1.1.1 and the housing 1.1.2 are in an expanded state. The housing 1.1.2 prevents damage to heart tissue such as for instance the tendinous chords, as it prevents tissue from being sucked into the rotor 1.1.1 or becoming entangled with the rotor 1.1.1 or the drive shaft 1.5. The distal end of the drive shaft 1.5 lies within a distal bearing 1.2. The catheter device 1 can further comprise an atraumatic tip, for instance designed as a pigtail tip 1.2.2. The atraumatic tip 1.2.2 can for instance be made of Pebax, PU, or another flexible medical grade polymer and it can comprise an elongated portion 1.2.1. In the embodiment shown in FIG. 3a, the distal end of the drive shaft is borne in the elongated portion 1.2.1. The distal bearing 1.2 and the atraumatic tip can however also be provided separately. The rotor 1.1.1 and the drive shaft 1.5 can rotate such that a flow of blood away from the distal end, towards the proximal end is effected, i.e. a blood flow out of the left ventricle 5.3 into the aorta 5.2 and to other regions of the patient's body. A downstream tubing 1.4 is provided proximally of the rotor 1.1.1 and the rotor housing 1.1.2. The downstream tubing 1.4 has a downstream opening 1.4.1 that lies proximally of the aortic valve 5.4, such that the blood passes the aortic valve within the downstream tubing 1.4 and can then stream into the aorta 5.2. The downstream tubing 1.4 is made of a flexible material, such that it can be compressed by the aortic valve 5.4 as the patient's heart 5.1 continues to pump.
[0054] FIG. 2 shows the distal end region of a catheter device with a radially compressible part 1.1. The radially compressible part 1.1 comprises a radially compressible rotor 1.1.1 and a radially compressible housing 1.1.2. The rotor 1.1.1 can for instance be inserted into the left ventricle of a human heart and is designed to be driven by means of a drive shaft 1.5 to effect a flow of fluid in a proximal direction, away from the distal bearing, into a downstream tubing 1.4 provided proximally of the rotor, and out of the downstream opening 1.4.1 of the downstream tubing 1.4, for instance into the aorta of a human. Distally of the compressible part 1.1, a distal bearing 1.2 is provided. The bearing comprises an elongated portion 1.2.1 for rotatably mounting the drive shaft 1.5 and a flexible pig tail 1.2.2.
[0055] FIG. 3 a shows the distal end region of the catheter device as shown in FIG. 1, with an additional compression pipe 2 and a reducer 3 to aid the insertion of the catheter device, in particular the compressible part 1.1, into a sleeve 4. The sleeve 4 is provided around the catheter device 1, proximally of the compressible part 1.1. The compression pipe 2 is provided around a portion of the compressible part 1.1, wherein the movable fins 2.2 lie around a distal portion of the compressible part 1.1 and the tube 2.1 of the compression pipe 2 extends distally thereof. The pipe 2 surrounds the elongated portion 1.2.1 of the distal bearing 1.2, wherein a recess 2.1.1 of the compression pipe 2 allows the pigtail 1.2.2 of the distal bearing 1.2 to remain in the curled position. The Reducer 3 is provided proximally of the compression pipe. The proximal portion of the reducer 3 is a cylindrical portion 3.1 and the distal portion of the reducer 3 is a conical portion 3.2, the radius of which increases in distal direction. The aperture angle of the conical portion 3.2 can for instance be between 6 and 10. The reducer can now be moved in the distal direction, with respect to the catheter device 1 and the compression pipe 2. The distal opening 3.2.1 of the reducer 3 is large enough for the movable fins 2.2 to slide into the distal opening 3.2.1 in the open state. Frictional forces and/or the pigtail 1.2.2 residing in the recess 2.1.1 ensure that the compression pipe 2 does not slide of the catheter device 1 on the distal end. As the relative movement continues, and the movable fins 2.2 slide through the conical portion 3.2 of the reducer 3, the movable fins enter in contact with the conical inner wall 3.2.2 of the conical portion 3.2 of the reducer 3 and are therefore continuously compressed. As the movable fins 2.2 are compressed, the radially compressible part 1.1 which is provided between the movable fins 2.2 is also compressed and the compression force acts preferably in an axial section, where the rotor is located. As the proximal end of the compression pipe 2 enters the cylindrical portion 3.1, compression is completed. The compression pipe 2 slides further, until a front part 2.2.1 of the movable fins strikes a second stop 3.1.4 near the proximal opening 3.1.1 of the reducer 3, opposing the first stop 3.1.3. The compression pipe 2 can now not be moved further in the proximal direction on the catheter device 1. The sleeve 4 can now be provided against the first stop 3.1.3 or against the front part 2.2.1 of the movable fins 2.2. By holding on to the sleeve 4 and pulling on a proximal end of the catheter tube, the compressible part 1.1 is pulled out of the compression pipe 2, through the proximal opening 3.1.1 of the reducer 3, and into the sleeve 4.
[0056] FIG. 3 b shows the same setup as FIG. 3 a, but with an additional set of stops 3.3 for holding the compression pipe 2 in an uncompressed state in place with respect to the reducer 3. The catheter device 1 can be packaged and delivered to the practitioner in this configuration, with the compressible rotor 1.1.1 and housing 1.1.2 in the uncompressed state, but the compression pipe 2 and the reducer 3 in a configuration as shown in FIG. 3 b, such that the compressible part is protected.
[0057] FIG. 4 shows the distal end region of the catheter device 1 being pulled into a sleeve 4 according to the prior art. The housing 1.2 and the rotor 1.1 are thereby compressed as they are squeezed into the sleeve 4. The compression force is mediated directly by the edges of the sleeve, resulting in strong deformation of the compressible part, at least in the regions 1.1.a and 1.1.b illustrated in FIG. 3. Furthermore, the force acting on the compressible part 1.1 acts in the distal direction, the rotor 1.1.1 is therefore pushed towards the distal end and cannot expand axially in the proximal direction as it is compressed. This can lead to inaccurate folding of the rotor or kinks in the compressed rotor.
[0058] FIGS. 5a and 5b show the compression pipe 2 from two different perspectives. The compression pipe 2 comprises three movable fins 2.2 which are shown in an open position. In the open position, a gap 2.2.2 is found between neighboring fins. The movable fins 2.2 are preferably designed such that upon compression, in particular compression by means of a reducer 3 as shown in FIG. 3, said gap 2.2.2 does not fully close. By having a residual gap 2.2.2 when the fins are in the closed state, a compressible part 1.1 or other parts of the catheter device such as the downstream tubing 1.4 cannot be pinched or caught between the fins. In FIG. 5a, the recess 2.1.1 is visible, which allows for a pigtail 1.2.2 to remain in the curled position when the compression pipe 2 is provided around a distal bearing 1.2 or a pigtail 1.2.2. Thus, different sizes of catheter devices, with different lengths of distal bearings, can be accommodated. Also, providing the pigtail 1.2.2 in a recess, rather than the pigtail protruding past the distal end of the compression pipe, protects the pigtail 1.2.2 at least in part from being bent laterally. In FIG. 5b, the front part 2.2.1 of the movable fins 2.2 is visible, which is designed to strike a second stop 3.1.4 of the reducer 3.
[0059] FIGS. 6a and 6b show the reducer 3 from two different perspectives. The reducer 3 comprises a cylindrical portion 3.1, and a conical portion 3.2. The reducer is typically provided around a catheter device 1, such that the cylindrical portion lies proximally of the conical portion. The inner radius of the conical portion 3.2 increases away from the cylindrical portion 3.1, towards a distal opening 3.2.1.
[0060] In FIG. 7, a cut through the reducer 3 is shown. The distal opening 3.2.1, of the conical portion 3.2 of the reducer 3 is shown on the left. The inner radius of the conical portion 3.2 decreases away from the distal opening 3.2.1, such that the inner wall 3.2.2 describes a section of a circular conical surface. To the right of the conical portion 3.2, the cylindrical portion is shown. The inner wall 3.1.2 of the cylindrical portion describes a cylindrical surface. The opening angle 3.2.3 of the wall 3.2.2 of the conical portion 3.2 with respect to the wall 3.1.2 of the cylindrical portion 3.1 can for instance be, between 6 and 10. The cylindrical section 3.1 has a proximal opening 3.1.1. Near the proximal opening, a first stop 3.1.3 on the proximal side and an opposing second stop 3.1.4, on the distal side, are provided. The reducer 3 is designed such that the movable fins 2.2 can be introduced into the distal opening 3.2.1 in an uncompressed or almost uncompressed state. If the compression pipe 2 slides along the reducer 3 in proximal direction, the movable fins 2.2 are radially isotropically compressed as the fins 2.2 slide through the conical portion 3.2 of the reducer 3. Once the movable fins 2.2 reach the cylindrical portion 3.1, compression is completed. The fins 2.2 can now slide further until they strike the second stop 3.1.4. The diameter of a cylindrical space contained within the movable fins 2.2 in the compressed state differs preferably by less than 1 mm from the inner diameter of the proximal opening 3.1.1, particularly preferably by less than 0.5 mm, such that a compressible part 1.1 can slide out of said cylindrical space and through the proximal opening 3.1.1 and into the sleeve 4. The sleeve 4 can thereby be provided proximally of the reducer 3, against the first stop 3.1.3.
[0061] FIG. 8 shows the compression pipe 2 and the reducer 3 without the catheter device 1. The movable fins 2.2 have been inserted through the distal opening 3.2.1 of the reducer, into the conical portion 3.2 of the reducer 3, i.e., the fins 2.2 are slightly compressed due to the conical inner wall 3.2.2. The compression pipe is oriented such that the tube 2.1 is located distally of the movable fins 2.2. The recess 2.1.1 can be seen near the distal end of the tube 2.1. On the proximal side of the setup, the cylindrical portion 3.1 of the reducer can be seen, with the proximal opening 3.1.1 and the first stop 3.1.3 and the second stop 3.1.4.
[0062] FIGS. 9 a and 9 b show the catheter device 1, the compression pipe 2 and the reducer 3 and an additional disk device 3.4 or membrane with a hole.
[0063] In FIG. 9 a, the disk device 3.4 is provided around the drive shaft 1.5 and the catheter tube 1.3 between the reducer 3 and the compressible part 1.1. As the reducer 3 is moved towards the compression pipe 2 and the compressible part, the front part of reducer 3 near the distal opening 3.2.1 of the reducer, enters in contact with the disk device 3.4, and thereby pushes the disk device 3.4 towards the compression pipe 2 and the compressible part 1.1. As the disk device 3.4 thus approaches the compressible part 1.1, the disk device 3.4 pushes the compressible part 1.1 between the movable fins 2.2 of the compression pipe, thus positioning the compressible part such that the compression force during the subsequent compression can act at the desired position. The movable fins 2.2 and the distal opening 3.2.1 of the reducer 3 are designed such that the movable fins 2.2 enter smoothly into the distal opening 3.2.1 of the reducer when the uncompressed radially compressible part 1.1 is at said desired position. As the relative movement of the reducer 3 and the disk device 3.4 with respect to the compression pipe 2 continues, the disk device 3.4 gives in or breaks, such that the compression pipe 2 with the radially compressible part 1.1 received therein inter the conical portion of the reducer.
[0064] FIG. 9 b shows a similar setup as FIG. 9 a, but with the disk device 3.4 attached to the reducer 3. The disk device 3.4 is provided in the distal opening 3.2.1 of the reducer. The handling is similar to the handling described in the context of FIG. 9 a. As the reducer 3 and the disk device 3.4 approach the compression pipe 2 and the radially compressible part 1.1, the radially compressible part is first pushed between the movable fins 2.2 and positioned at a desired location, wherein the movable fins 2.2 are starting to slide into the conical portion of the reducer 3, but are not yet being compressed or only slightly compressed. As the relative movement of the reducer 3 with respect to the compression pipe 2 continues, the disk gives in or breaks and the movable fins 2.2 and thus the radially compressible part 1.1 are compressed as they slide through the conical portion of the reducer 3.
[0065] FIG. 9 c shows the disk device 3.4 from FIGS. 9 a and 9 b. The disk device 3.4 is preferably configured as a thin plate. It can for example be made of PTFE, PE; or Silicone. The disk device 3.4 comprises a hole 3.4.1 at the center or near the center. The disk device 3.4 can comprise a slit which runs from the hole 3.4.1 to the outer edge of the disk device 3.4, such that the disk device can be clipped or mounted around the catheter tube 1.3. The disk device 3.4 comprises no sharp edges at the rim of the hole 3.4.1 or along the slit 3.4.2, such that the catheter device 1 or the catheter tube 1.3 is not damaged when the disk device 3.4 is clipped on. The disk device, in particular the edge of the hole 3.4.1 are designed such that the disk exhibits good sliding properties on the catheter. The disk device 3.4 can for example be circular. The radius or radial extension of the disk device is larger than the radius of the cylindrical portion of the reducer. Preferably, the radius or radial extension of the disk device is larger than the radius of a circular plane circumscribed by the front parts of the movable fins in the uncompressed state. The disk device 3.4 is flexible such that it can give in and/or fall off as the disk device is pushed into the conical portion of the reducer 3.
[0066] FIG. 10 shows the distal end region of the catheter device with the compression pipe 2 and the reducer 3, similarly to FIG. 3. However, in FIG. 10, the compression pipe is provided in an alternative configuration. The compression pipe 2 is reversed with respect to the configuration from FIG. 3. The movable fins 2.2 of the compression pipe are now provided around the compressible part 1.1 from the proximal side, such that the tube 2.1 surrounds a portion of the catheter device 1 that lies proximally of the compressible part 1.1 and the distal bearing 1.2 is exposed. The reducer 3 is provided around the compression pipe 2 with the conical portion 3.2 distally of the cylindrical portion 3.1. The catheter device 1 and the compression pipe 2 are now moved in a proximal direction, relative to the reducer 3, such that the tube 2.1 enters the reducer first. When the movable fins 2.2 with the compressible part enter the conical portion 3.2 of the reducer, the compression of the compressible part 1.1 starts. In this configuration, the compressible part 1.1 is pulled into the compression pipe 2 when a pulling force is exerted on the proximal end of the catheter tube 1.3. Thus, different from the configuration from FIG. 3, no frictional forces are needed to preserve the relative position of the catheter device 1 and the compression pipe 2. The reducer 3 can be designed without stops at the proximal opening. The sleeve 4 can then be provided directly on the proximal end of the compression pipe 2. A configuration with stops, as shown in FIGS. 2, 6 and 7, is also possible. Then, the cylindrical portion 3.1 of the reducer should be long enough to entirely accommodate the compression pipe 2, i.e., both the tube 2.1 and the movable fins 2.2, such that the movable fins 2.2 can fully enter the cylindrical portion 3.1 of the reducer 3 and be fully compressed.
[0067] FIGS. 11 a and 11 b shows the rotor 1.1.1 and the housing 1.1.2 and the sleeve 4 in two states, uncompressed (a) and compressed (b). When the rotor 1.1.1 and the housing 1.1.2 are transferred into the sleeve 4, the rotor 1.1.1 and the housing 1.1.2 are compressed in a radial direction, from their expanded states 1.1.1, 1.1.2 into their compressed states 1.1.1, 1.1.2. The rotor 1.1.1 in the expanded state has an axial length 1.1.3. As the rotor 1.1.1 is compressed to the compressed state 1.1.1, the axial length increases to a length 1.1.3. Similarly, the housing 1.1.2 in the expanded state has an axial length 1.1.4. As the housing 1.1.2 is compressed to the compressed state 1.1.2, the axial length increases to a length 1.1.4. The elongation of the rotor allows for a better compression than if the length is kept constant. If the compression force has a larger radial component, as in the case when the compression pipe 2 and the reducer 3 are used, the rotor 1.1.1 can expand axially. On the other hand, if the rotor is simply pulled into a sleeve 4 as shown in FIG. 3, axial elongation of the rotor 1.1.1 is hindered which can result in faulty folding of the rotor and/or kinks in the rotor.
[0068] FIG. 12 shows the reducer 3, a part of the compression pipe 2, a part of the sleeve 4 and the radially compressible part 1.1 with the rotor 1.1.1 and the housing 1.1.2 in the compressed state. The rotor 1.1.1 and the housing 1.1.2 are provided between the movable fins 2.2 of the compression pipe, the movable fins 2.2 being fully introduced into the cylindrical portion 3.1 of the reducer and, thus, in the fully compressed position. A front part 2.2.1 of the movable fins 2.2 abuts a first stop 3.1.4 of the reducer, such that the compression pipe 2 cannot slide all the way through the reducer 3. In the embodiment depicted in FIG. 12, the front part 2.2.1 of the movable fins 2.2 acts as a stop for the sleeve 4 provided around the drive shaft 1.5 and the catheter tube 1.3. By holding on to the sleeve 4 and pulling on the catheter tube 1.3 in the proximal direction, the compressible part slides out of the compression tube 2 and the reducer 3, into the sleeve 4.
[0069] FIG. 13 shows a compressible housing 1.1.2 which features a lower density of struts 1.1.5 near the proximal end of the housing 1.1.2 and a higher density of struts 1.1.5 near the distal end of the housing 1.1.5. In a preferred mode of operation, a flow of blood in proximal direction is effected. Due to the low density of struts in the proximal end region, collision of blood cells with the struts is minimized and thus damage to the blood is minimized. However, in such a configuration, if the compressible housing 1.1.2, with a rotor 1.1.1 on the inside, is pulled into the sleeve 4 provided proximally of the housing 1.1.2, the risk of the rotor 1.1.1 being pinched or caught between the struts increases, if the compression is mediated only by the end of the sleeve 4. Therefore, a setup with a reducer 3 and a compression pipe 2 as described in the application is particularly useful, if a housing design as shown in FIG. 13 is desired.
[0070] FIG. 14a shows the sleeve 4 and the compression pipe 2 that are introduced into the reducer 3. The reducer exposes a step inside the cylindrical portion thereof, such that an inner diameter is reduced at the cylindrical end, into which end the sleeve is introduced. The inner diameter is thus slightly larger at the end of the cylindrical portion facing the conical portion, i.e., in the part of the cylindrical portion into which the compression pipe is introduced. In the embodiment shown in FIG. 14, the compression pipe 2 has an additional stop 2.3, abutting against the end of the reducer 3 on the side of the conical portion. The stop 2.3 is configured such that a gap 2.5 remains between the compression pipe and the step provided on the inside of the reducer 3, near the end of the movable fins 2.2 of the compression pipe. This way, parts of the catheter device 1 cannot be pinched between the front side 2.2.1 of the movable fins 2.2 and the step when the catheter device is pulled through the compression pipe 2. The sleeve 4 also has an additional stop 4.1 which abuts against the end of the cylindrical portion of the reducer 3, such that the end of the sleeve 4 that is introduced into the reducer 3 remains at a distance from the front side 2.2.1 of the movable 2.2 fins. This way, the gap 2.5 persists also when the sleeve 4 is introduced into the reducer 3.
[0071] The inner diameter of the part of the cylindrical portion of the reducer into which the sleeve 4 is introduced is between 0.2 and 1 mm, especially between 0.4 mm and 0.7 mm, larger than an outer diameter of the sleeve 4. This way, deforming of the sleeve 4 is tolerated when the catheter device is pulled into the sleeve 4. This is particularly advantageous as the rotor 1.1.1 is sometimes compressed to obtain an ellipsoid shape, rather than a circular shape.
[0072] The compression pipe 2 does not comprise a recess for receiving the pigtail 1.2.2 of the catheter device 1.
[0073] The step provided on the inside of the reducer 3 of FIG. 14a can also have a rounded shape or it can be designed as a slope. FIG. 14b shows such an arrangement with a transition zone 2.6 which does not have sharp edges. By pulling the pump head through this transition zone 2.6, a further reduction of the diameter of the pump head can be achieved.
[0074] FIG. 15 shows an embodiment of the compression pipe 2, wherein additional slits 2.4 are provided, perforating the compression pipe 2 in several places. The compression pipe 2 has four movable fins 2.2 separated by gaps 2.2.2. Slits 2.4 are provided both as a continuation of the gaps 2.2.i.e., radially aligned with the gapsand shifted with respect to the gaps 2.2.2 radially displaced to lie between two gaps 2.2.2. This way, the flexibility of the compression pipe is improved, enabling better compression behavior and helping to avoid pinching of parts of the catheter device 1.
[0075] The compression pipe 2 shown in FIG. 15 also exhibits the additional stop 2.3 as shown in and discussed in the context of FIG. 14.
[0076] FIGS. 16 a-e show different embodiments of the compression pipe 2, differing from each other in how the gaps 2.2.2 and slits 2.4 are arranged. In each case, the additional stop 2.3 is provided. The compression pipe 2 is shown in a compressed state.
[0077] In each case, the compression pipe 2 has four movable fins 2.2. The width of the fins 2.2 is chosen to be large enough to engage with the struts of the compressible housing of the catheter device 1. I.e., for a higher density of struts, thinner fins can be provided. When the density of struts is low in all parts of the housing, broader fins are provided, sometimes embodiments with three fins instead of four fins are chosen for a low density of struts.
[0078] FIG. 16a shows an embodiment in which the gaps 2.2.2 separating the fins 2.2 extend axially along the compression pipe.
[0079] FIG. 16b shows an embodiment in which the gaps 2.2.2 start in the longitudinal direction and then extend with a radial component, i.e. run in a spiral fashion. The gaps run about 45 around the circumference of compression pipe. The risk of pinching of the catheter device can be reduced by having a radial component for the gaps 2.2.2.
[0080] FIG. 16c also shows gaps 2.2.2 with a radial component. The gaps run around the circumference of the compression pipe, covering about 90.
[0081] FIG. 16d shows an embodiment with axially extending gaps 2.2.2 and having additional slits 2.4. The embodiment is similar to the one shown in FIG. 15. Slits 2.4 are provided both radially aligned with the gaps 2.2.2, distanced from the gaps, and in between neighboring gaps, distanced from the end of the compression pipe.
[0082] FIG. 16e shows an embodiment having both gaps 2.2.2 with a radial component and additional slits 2.4. The slits 2.2.2 show the same spiral course as the gaps 2.2.2, some slits being aligned with the spiral course of one of the gaps, other slits being arranged in between the spirals defined by the gaps 2.2.2.
[0083] Ends of radially displaced slits 2.7 overlap axially with ends of gaps 2.2.2 and/or axially aligned slits 2.4 (this is also shown in FIGS. 15 and 16).
LIST OF REFERENCE NUMERALS
[0084] 1 Catheter device [0085] 1.1 Radially compressible part [0086] 1.1.a Region of strong deformation [0087] 1.1.b Region of strong deformation [0088] 1.1.1 Radially compressible rotor [0089] 1.1.1 Radially compressible rotor (compressed state) [0090] 1.1.2 Radially compressible housing [0091] 1.1.2 Radially compressible housing (compressed state) [0092] 1.1.3 Length of radially compressible rotor [0093] 1.1.3 Length of radially compressible rotor (compressed state) [0094] 1.1.4 Length of radially compressible housing [0095] 1.1.4 Length of radially compressible housing (compressed state) [0096] 1.1.5 Struts of compressible housing (low density) [0097] 1.1.5 Struts of compressible housing (high density) [0098] 1.2 Distal bearing [0099] 1.2.1 Elongated portion of the distal bearing [0100] 1.2.2 Pigtail [0101] 1.3 Catheter tube [0102] 1.4 Downstream tubing [0103] 1.4.1 Downstream opening [0104] 1.5 Drive shaft [0105] 2 Compression pipe [0106] 2.1 Tube [0107] 2.1.1 Recess [0108] 2.2 Movable fins [0109] 2.2.1 Front part of the movable fins [0110] 2.2.2 Gap between neighboring movable fins [0111] 2.3 Stop [0112] 2.4 Slit [0113] 2.5 Gap [0114] 2.6 Transition zone [0115] 2.7 Slit [0116] 3 Reducer [0117] 3.1 Proximal cylindrical portion [0118] 3.1.1 Proximal opening [0119] 3.1.2 Cylindrical inner wall [0120] 3.1.3 First stop [0121] 3.1.4 Second stop [0122] 3.2 Distal conical portion [0123] 3.2.1 Distal opening [0124] 3.2.2 Conical inner wall [0125] 3.2.3 Opening angle of the conical inner wall [0126] 3.3 Third stop [0127] 3.4 Disk device [0128] 3.4.1 Hole [0129] 3.4.2 Slit [0130] 4 Sleeve [0131] 4.1 Stop [0132] 5.1 Heart [0133] 5.2 Aorta [0134] 5.3 Left ventricle [0135] 5.4 Aortic valve [0136] 6 Motor
