INTRODUCER LOCK APPARATUS
20220387759 · 2022-12-08
Assignee
Inventors
- Michael Turovskiy (Fremont, CA, US)
- JAYSON DELOS SANTOS (FREMONT, CA, US)
- Michael P. Wallace (Fremont, CA, US)
Cpc classification
A61M2025/0006
HUMAN NECESSITIES
A61B17/221
HUMAN NECESSITIES
A61B2017/00469
HUMAN NECESSITIES
A61B2017/347
HUMAN NECESSITIES
International classification
Abstract
Apparatuses and methods for retaining a catheter are disclosed. In particular, described herein are apparatuses (e.g., introducer lock apparatuses, devices and systems including them) and methods for securing a catheter relative to an introducer sheath. In particular these apparatuses and method may secure an outer catheter of a mechanical thrombectomy apparatus to prevent the outer catheter from moving proximally when an inner member within the outer catheter is pulled proximally, applying a compression force that would otherwise drive the outer catheter proximally.
Claims
1. An introducer lock apparatus, the apparatus comprising: a first body comprising a catheter channel extending proximally to distally in a first axis, wherein the catheter channel is configured to seat a catheter therein; a sheath connector at a distal end of the first body, the sheath connector at least partially surrounding the catheter channel and is configured to releasably engage with an introducer sheath; a second body hingeably coupled to the first body; and a clamping channel extending through a lateral side of the second body, the clamping channel forming an angle relative to the second body, so that the clamping channel has an apparent diameter through the clamping channel in the first axis that is at a maximum when the second body is bent at a first angle relative to the first body, further wherein the apparent diameter through the clamping channel in the first axis decreases as the angle relative to the second body increases.
2. The apparatus of claim 1, further comprising one or more teeth extending into the clamping channel from a wall of the clamping channel.
3. The apparatus of claim 1, further comprising a locking tooth extending out of the clamping channel and projecting from an outer surface of the second body at a locking angle.
4. The apparatus of claim 1, wherein a central axis extending along the clamping channel is parallel with the first axis when the apparent diameter is at the maximum.
5. The apparatus of claim 1, wherein the catheter channel is open along an outward-facing side of the first body.
6. The apparatus of claim 5, wherein the clamping channel forms a C-shaped channel having a side opening that does not align with the opening of the catheter channel.
7. The apparatus of claim 5, wherein the sheath connector only partially surrounding the catheter channel.
8. The apparatus of claim 1, wherein the sheath connector comprises a Leur fitting.
9. The apparatus of claim 1, wherein the sheath connector comprises a partial Leur fitting.
10. The apparatus of claim 1, further comprising a stop on the first body, limiting the angle between the first body and the second body.
11. The apparatus of claim 1, wherein the first angle relative to the first body is between 120-130 degrees.
12. The apparatus of claim 1, wherein the second body comprises a rigid arm.
13. The apparatus of claim 1, further comprising a bias configured to hold the second body at the first angle relative to the first body.
14. A method of operating a mechanical atherectomy system, the method comprising: advancing a distal end of an outer catheter of the mechanical atherectomy system through a sheath and into a body lumen; securing the outer catheter within an introducer lock apparatus coupled to the proximal end of the sheath so that a first region of the outer catheter is seated in a catheter channel of a first body extending in a first axis, and a second region of the outer catheter proximal to the first region is held within a clamping channel of the introducer lock apparatus, wherein the clamping channel is formed through a lateral side of a second body that is hingeably coupled to the first body; pulling an inner shaft of the mechanical atherectomy system proximally to invert a tubular member over a distal end of the outer catheter so that it rolls over the distal end of the outer catheter and into the outer catheter; and locking the outer shaft to the sheath by changing the angle of the second body when the inner shaft is driven proximally by pulling the inner shaft, so that an apparent diameter through the clamping channel in the first axis decreases.
15. The method of claim 14, wherein pulling the inner shaft proximally applies a proximal force on the outer catheter that changes the angle of the second body to lock the outer shaft to the sheath.
16. The method of claim 14, wherein locking the outer shaft to the sheath comprise gripping an outer surface of the outer catheter with one or more teeth extending from a wall of the clamping channel and into the clamping channel.
17. The method of claim 14, wherein locking the outer shaft to the sheath comprises gripping an outer surface of the outer catheter with one or more locking teeth extending from an outer surface of the second body at a locking angle.
18. The method of claim 14, wherein the method is performed by a user holding the sheath with a first hand and a proximal end of the inner member with a second hand.
19. The method of claim 17, wherein the user does not hold the outer catheter.
20. The method of claim 14, wherein locking the outer shaft to the sheath comprises gripping one or more stops on an outer surface of the outer catheter.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0048] Novel features of embodiments described herein are set forth with particularity in the appended claims. A better understanding of the features and advantages of the embodiments may be obtained by reference to the following detailed description that sets forth illustrative embodiments and the accompanying drawings.
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DETAILED DESCRIPTION
[0067] Minimally invasive medical procedures often use catheter-based systems to provide therapy that would otherwise require more traumatic methods. The smaller incisions associated with catheter therapies that are used to enter the body may promote faster healing and lessen the recovery time for the patient. During minimally invasive procedures, a distal end of the catheter may be used to manipulate various tools or internal organs while the clinician operates at a distance. In some cases, the clinician may use robotics to manipulate or control the catheter.
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[0069] The outer catheter 1905 may include multiple elements (control wires, shafts, etc.) to manipulate and/or articulate objects at the distal end. In particular, the methods and apparatuses for controlling a catheter described herein may be useful for preventing undesirable movement in an outer catheter of the mechanical thrombectomy apparatus. For example, a medical procedure may require the clinician to move portions of the catheter separately. A mechanical thrombectomy apparatus may have an inner catheter 1905 having a lumen holding an inner shaft 1913 (e.g., puller). Manipulation of a tool may require that the inner shaft move with respect to the outer catheter. In some cases, providing the relative motion may require holding the outer catheter while at the same time moving the inner shaft. However, the clinician may also need to guide the catheter at the same time, making control of the catheter-based system difficult.
[0070] In general, an inverting tube apparatus (also referred to herein as “mechanical thrombectomy apparatus” or “inverting thrombectomy apparatus”) may be configured to remove material, such as clot, using a length of inverting tube, as shown in
[0071] For example,
[0072] In
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[0074] In
[0075] In general, the mechanical thrombectomy apparatuses described in
[0076] Examples of the subject matter described in this disclosure may be used to temporarily grip or restrain a portion of the outer catheter enabling the clinician greater control of the mechanical thrombectomy apparatus. Some examples may include an introducer lock apparatus that may be removably attached to an introducer sheath. The introducer lock apparatus may include a first body hingeably coupled to a second body. A catheter may pass through the introducer sheath and a clamping channel of the second body. As the catheter moves proximally with respect to the introducer sheath, the clamping channel and the second body may increase engagement with an outer portion of the catheter thereby clamping the catheter.
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[0078] The introducer lock apparatus 102 may be initially inserted into the introducer sheath 104, as shown in the first view of a catheter controlling system 150. That is, the introducer lock apparatus 102 may not yet have been rotated a quarter-turn with respect to the introducer sheath 104. Thus, the introducer lock apparatus 102 may not yet be locked into the introducer sheath 104.
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[0081] In some cases, one or more mechanical devices may be attached to and be operated by a distal end of the mechanical thrombectomy apparatus 200. For example, differential movement between the outer catheter 210 and the inner shaft 220 may operate a distally coupled mechanical device. Operation of the mechanical device may require that differential forces be applied between the outer catheter 210 and the inner shaft 220.
[0082] Thus, moving the inner shaft 220 with respect to the outer catheter 210 may require holding or gripping the outer catheter 210 while applying force to the inner shaft 220. In some cases, gripping the outer catheter 210 may be necessary to overcome friction or operate a mechanical device with the inner shaft 220. If the mechanical thrombectomy apparatus 200 is inserted into the introducer sheath 104 and the sheath 106 of
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[0085] The introducer lock apparatus 102 may include a first body 301 and a second body 310. The first body 301 may include male lugs (not shown) to engage with, attach, and/or couple to the introducer sheath 104. As shown, the first body 301 may be colinear and/or coplanar with respect to the mechanical thrombectomy apparatus 200. The second body 310 may include a clamping channel 311 to receive the mechanical thrombectomy apparatus 200.
[0086] The first body 301 may be hingeably attached to the second body 310. Thus, a hinge joint 312 that includes hinge pin may couple (e.g., hingeably couple) the first body 301 to the second body 310. In some examples, the introducer lock apparatus 102 may include a spring (not shown), such a spiral spring near or around the hinge pin to bias the second body 310 with respect to the first body 301. For example, the spring may bias a position of the second body 310 in the position shown and also allow the second body 310 to pivot to receive the mechanical thrombectomy apparatus 200 in the clamping channel 311. In some cases, the hinge joint 312 may allow the second body 310 to pivot in a plane perpendicular to an axis or centerline of the mechanical thrombectomy apparatus 200.
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[0088] In some examples, the second body 310 may pivot approximately 135 degrees relative the first body, where the second body is fully extended when the second body is in the fully extended position (180 degrees from the first body). Alternatively, if the angle is measure as the change in angle from the fully extended position, the first body is forty-five degrees with respect to the first body 301. This first angle (135 degrees) may be the angle at which the clamping channel has an apparent diameter through the clamping channel in the first axis that is at a maximum when the second body is bent at a first angle relative to the first body to receive the mechanical thrombectomy apparatus 200. Thus, the clamping channel 311 may be configured to accept a diameter of the outer catheter 210 when pivoted at about forty-five degrees with respect to the first body 301.
[0089] As the inner shaft 220 is moved proximally with respect to the introducer sheath 104, the outer catheter 210 may also be pulled proximally. Motion of the outer catheter 210 may be due to friction, forces required to operate a mechanical device coupled to a distal end of the mechanical thrombectomy apparatus 200, or the like. (For reference, the proximal direction is to the right and the distal direction is to the left in
[0090] In some examples, one or more stops (not shown) may be molded or attached to the outer catheter 210. The stops may be larger than the outer catheter 210 and may increase engagement with the clamping channel 311 and/or the teeth 360A-360C compared to just the outer catheter 210.
[0091] During use, if the mechanical thrombectomy apparatus 200 is moved in a distal direction with respect to the introducer sheath 104, the second body 310 may also move distally relaxing the grip on the mechanical thrombectomy apparatus 200. Thus, the mechanical thrombectomy apparatus 200 may be preferentially allowed to move distally, while preferentially restricted from moving proximally.
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[0094] The first body 420 may include a hinge joint 421, locking lugs 422, and a catheter channel 423. The hinge joint 421 may enable the first body 420 to hingeably couple and pivot with respect to the second body 430. For example, the hinge joint 421 may enable the first body 420 to pivot about a hinge pin (not shown) on an axis perpendicular to an axis of a catheter, such as the mechanical thrombectomy apparatus 200 (also not shown). The catheter channel 423 may enable the catheter to pass proximate to the first body 420 without binding or any other impediment.
[0095] The locking lugs 422 may be male lugs that are configured to fit and mate with a female channel within the introducer sheath 104. Notably, the locking lugs 422 may include a gap or opening that advantageously allows attachment of the introducer lock apparatus 400 to the introducer sheath 104 after a catheter has been inserted in the introducer sheath 104 and/or sheath 106.
[0096] The second body 430 may also include a hinge joint (hidden in this view), a clamping channel 431, and teeth 432A-432C. The second body 430 may be coupled to the hinge joint 421 with a hinge pin thereby enabling the second body 430 to pivot about the hinge pin with respect to the first body 420. For example, the hinge joint may enable the second body 430 to pivot about a hinge pin on an axis perpendicular to an axis of the mechanical thrombectomy apparatus 200.
[0097] The clamping channel 431 may generally be shaped as a three-sided slot within the second body 430. Two of the sides of the clamping channel 431 may be approximately parallel with each other and disposed at approximately a forty-five degree angle with respect to a surface of the second body 430. A plurality of teeth 432A-432C may be disposed within the clamping channel 431. Although three teeth 432A-432C are shown, in other examples the clamping channel 431 may include any feasible number of teeth. In some examples, at least one of the teeth 432A-432C may be perpendicular to the parallel surfaces of the clamping channel 431. For example, tooth 432C may be relatively perpendicular with respect to the parallel surfaces of the clamping channel 431. The teeth 432A-432C may enable the second body 430 to grip the outer catheter 210 of the mechanical thrombectomy apparatus 200. In some examples, the teeth 432A-432C may grip one or more stops molded or attached to the outer catheter 210. The tooth that projects out of the clamping channel may be referred to as a locking tooth 432C.
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[0100] The second body 430 may include hinge joints 433A and 433B. In some examples, the second body 430 may include any feasible number of hinge joints. Another view of the clamping channel 431 is also shown.
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[0102] The arrow 520, which may be an example of the arrow 424 of
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[0105] The clamping channel 610 may include approximately parallel surfaces 613A and 613B. The teeth 620A-620C may be disposed on the parallel surfaces 611A and 611B. In particular, one or more of the teeth (620C) may be normal (e.g., perpendicular or ninety degrees) with respect to the parallel surfaces 611A and 611B. Furthermore, the parallel surfaces 611A and 611B may be disposed at approximately at an angle (e.g., between 30-50 degrees, between 35-55 degrees, about forty-five degrees, etc.) with respect to surface 650.
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[0108] In this example, the locking tooth 620C is the tooth that extends out of the clamping channel and projects from an outer surface of the second body at a locking angle. As shown in
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[0110] In
[0111] Next, in block 704 an outer catheter is received in a clamping channel of an introducer lock apparatus. For example, an introducer lock apparatus may include a first body removably attached to an introducer sheath and a second body hingeably coupled to the first body. The second body may include a clamping channel that can receive the catheter, and in particular receive an outer catheter. In some examples, the clamping channel may be a slot disposed at approximately a forty-five degree angle with respect to an outer surface of the second body.
[0112] Next in block 706, the clinician may move an inner shaft of the mechanical atherectomy apparatus within the mechanical atherectomy apparatus in order to pull the inverting tube of the mechanical atherectomy apparatus into the outer catheter, rolling over the distal end opening of the outer catheter, but compressing the outer catheter, and potentially driving it proximally. For example, the clinician may move the inner shaft proximally with respect to the introducer sheath. As a result, the catheter in general, and the outer catheter in particular, may also move in a proximal direction.
[0113] Next in block 708, the clamping channel engages with the outer catheter in response to motion of the inner shaft. Since the second body (which includes the clamping channel) is coupled to the first body, and since the first body is coupled to the introducer sheath, motion of the catheter with respect to the introducer sheath may be reduced or limited as the clamping channel engages. For example, the clamping channel may increase a grip of the catheter as the inner shaft of the catheter moves in a proximal direction. In some examples, the clamping channel may include one or more teeth to engage and or grip the outer catheter. In other examples, the catheter may include one or more stops on the outer catheter to engage with the clamping channel.
[0114] When a feature or element is herein referred to as being “on” another feature or element, it can be directly on the other feature or element or intervening features and/or elements may also be present. In contrast, when a feature or element is referred to as being “directly on” another feature or element, there are no intervening features or elements present. It will also be understood that, when a feature or element is referred to as being “connected”, “attached” or “coupled” to another feature or element, it can be directly connected, attached, or coupled to the other feature or element or intervening features or elements may be present. In contrast, when a feature or element is referred to as being “directly connected”, “directly attached” or “directly coupled” to another feature or element, there are no intervening features or elements present. Although described or shown with respect to one embodiment, the features and elements so described or shown can apply to other embodiments. It will also be appreciated by those of skill in the art that references to a structure or feature that is disposed “adjacent” another feature may have portions that overlap or underlie the adjacent feature.
[0115] Terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. For example, as used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” when used in this specification, specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups thereof. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items and may be abbreviated as “/”.
[0116] Spatially relative terms, such as “under”, “below”, “lower”, “over”, “upper” and the like, may be used herein for ease of description to describe one element or feature's relationship to another element(s) or feature(s) as illustrated in the figures. It will be understood that the spatially relative terms are intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if a device in the figures is inverted, elements described as “under” or “beneath” other elements or features would then be oriented “over” the other elements or features. Thus, the exemplary term “under” can encompass both an orientation of over and under. The device may be otherwise oriented (rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. Similarly, the terms “upwardly”, “downwardly”, “vertical”, “horizontal” and the like are used herein for the purpose of explanation only unless specifically indicated otherwise.
[0117] Although the terms “first” and “second” may be used herein to describe various features/elements (including steps), these features/elements should not be limited by these terms, unless the context indicates otherwise. These terms may be used to distinguish one feature/element from another feature/element. Thus, a first feature/element discussed below could be termed a second feature/element, and similarly, a second feature/element discussed below could be termed a first feature/element without departing from the teachings of the present invention.
[0118] Throughout this specification and the claims which follow, unless the context requires otherwise, the word “comprise”, and variations such as “comprises” and “comprising” means various components can be co jointly employed in the methods and articles (e.g., compositions and apparatuses including device and methods). For example, the term “comprising” will be understood to imply the inclusion of any stated elements or steps but not the exclusion of any other elements or steps.
[0119] In general, any of the apparatuses and methods described herein should be understood to be inclusive, but all or a sub-set of the components and/or steps may alternatively be exclusive and may be expressed as “consisting of” or alternatively “consisting essentially of” the various components, steps, sub-components, or sub-steps.
[0120] As used herein in the specification and claims, including as used in the examples and unless otherwise expressly specified, all numbers may be read as if prefaced by the word “about” or “approximately,” even if the term does not expressly appear. The phrase “about” or “approximately” may be used when describing magnitude and/or position to indicate that the value and/or position described is within a reasonable expected range of values and/or positions. For example, a numeric value may have a value that is +/−0.1% of the stated value (or range of values), +/−1% of the stated value (or range of values), +/−2% of the stated value (or range of values), +/−5% of the stated value (or range of values), +/−10% of the stated value (or range of values), etc. Any numerical values given herein should also be understood to include about or approximately that value unless the context indicates otherwise. For example, if the value “10” is disclosed, then “about 10” is also disclosed. Any numerical range recited herein is intended to include all sub-ranges subsumed therein. It is also understood that when a value is disclosed that “less than or equal to” the value, “greater than or equal to the value” and possible ranges between values are also disclosed, as appropriately understood by the skilled artisan. For example, if the value “X” is disclosed the “less than or equal to X” as well as “greater than or equal to X” (e.g., where X is a numerical value) is also disclosed. It is also understood that the throughout the application, data is provided in a number of different formats, and that this data, represents endpoints and starting points, and ranges for any combination of the data points. For example, if a particular data point “10” and a particular data point “15” are disclosed, it is understood that greater than, greater than or equal to, less than, less than or equal to, and equal to 10 and 15 are considered disclosed as well as between 10 and 15. It is also understood that each unit between two particular units are also disclosed. For example, if 10 and 15 are disclosed, then 11, 12, 13, and 14 are also disclosed.
[0121] Although various illustrative embodiments are described above, any of a number of changes may be made to various embodiments without departing from the scope of the invention as described by the claims. For example, the order in which various described method steps are performed may often be changed in alternative embodiments, and in other alternative embodiments one or more method steps may be skipped altogether. Optional features of various device and system embodiments may be included in some embodiments and not in others. Therefore, the foregoing description is provided primarily for exemplary purposes and should not be interpreted to limit the scope of the invention as it is set forth in the claims.
[0122] The examples and illustrations included herein show, by way of illustration and not of limitation, specific embodiments in which the subject matter may be practiced. As mentioned, other embodiments may be utilized and derived there from, such that structural and logical substitutions and changes may be made without departing from the scope of this disclosure. Such embodiments of the inventive subject matter may be referred to herein individually or collectively by the term “invention” merely for convenience and without intending to voluntarily limit the scope of this application to any single invention or inventive concept, if more than one is, in fact, disclosed. Thus, although specific embodiments have been illustrated and described herein, any arrangement calculated to achieve the same purpose may be substituted for the specific embodiments shown. This disclosure is intended to cover any and all adaptations or variations of various embodiments. Combinations of the above embodiments, and other embodiments not specifically described herein, will be apparent to those of skill in the art upon reviewing the above description.