CONTROL WIRE DISTAL SECUREMENT IN STEERABLE CATHETER
A secure attachment method and structure for a wire (including non-metallic fiber, yarn, cable, etc.) is provided within a steerable catheter that includes a proximal end, a distal end, and an intermediate catheter body length therebetween, with at least a first catheter lumen extending longitudinally through the catheter body, at least a first elongate wire disposed longitudinally through the first catheter lumen, and an adhesive substantially within, and securing the wire to, a dilated distalmost length of the first longitudinal lumen, where at least a lengthwise portion of the wire is frayed or otherwise at least partially disaggregated. The structure and method provides for robustly secure affixation that will allow steering/deflection control by manipulation of another portion of the wire.
This application is a non-provisional application which claims priority to U.S. provisional applications Ser. Nos. 62/367,910; 62/367,918; 62/367,938; 62/367,951; and 62/367,959; all filed Jul. 28, 2016, each of which is incorporated by reference herein in its entirety.
TECHNICAL FIELDEmbodiments disclosed herein generally relate to steerable catheters, including endoscopes. More particularly embodiments disclosed herein relate to a structures and methods for securely attaching the control wires/fibers within a steerable catheter.
BACKGROUNDDeflecting catheters, also referred to as steerable catheters are used in a variety of medical and non-medical procedures. In diagnostic and therapeutic medical procedures, a steerable catheter provides an operator (e.g., physician) with the ability to articulate the distal tip of the catheter in order to travel through constrained and/or tortuous anatomy, and/or to direct the distal catheter tip in a particular direction. Similar mechanisms are used in medical and nonmedical endoscopes to steer them to a target site and to orient a device portion (e.g., including a camera or other visualization means) in a desired direction.
In a typical design, control wires are manipulably attached at a proximal end of the device, and also attached at or near a distal end of the device. Such a configuration operates by manipulating one or more of the control wires to increase and/or decrease a generally longitudinal force on the distal device end that will deflect it in a desired direction. In order to prevent a premature or undesired deflection of the device, it is necessary to provide a balanced starting tension between the proximal and distal ends of the control wires. Various mechanisms in the art have been developed for doing this including threaded tensioning bolts or pins that include an aperture transversely through a head and/or shaft for receiving a proximal end portion of one or more control wires, which can then be tightened or loosened in order to provide a desired tensioning level of the control wire(s). These mechanisms often are mounted to a shaft or housing of the steerable device.
It is be desirable to provide tensioning means that provide finely tunable tensioning for very small diameter fibers, where the tuned/tensioned fibers will be secure in order to provide predictable and desirable steering behavior for a steerable catheter, and particularly for a steerable cholangioscope or other small-diameter endoscope, including providing highly-secure proximal-end anchoring of the fibers to/within the control handle.
BRIEF SUMMARYIn one aspect, embodiments disclosed herein may include a steerable catheter device with steering control wires fixedly attached in a distal end of a catheter shaft, as well as methods for effecting that fixed attachment.
In one aspect, embodiments disclosed herein may include a secure attachment of a wire within a steerable catheter that includes a proximal end, a distal end, and an intermediate catheter body length therebetween, with at least a first catheter lumen extending longitudinally through the catheter body, at least a first elongate wire disposed longitudinally through the first catheter lumen, and a first adhesive having a first viscosity, the first adhesive disposed substantially within, and securing the wire to, the first longitudinal lumen, where at least a lengthwise portion of the wire is frayed or otherwise at least partially disaggregated.
Various embodiments are described below with reference to the drawings in which like elements generally are referred to by like numerals. The relationship and functioning of the various elements of the embodiments may better be understood by reference to the following detailed description. However, embodiments are not limited to those illustrated in the drawings. It should be understood that the drawings are not necessarily to scale, and in certain instances details may have been omitted that are not necessary for an understanding of embodiments disclosed herein, such as—for example—conventional fabrication and assembly.
Generally, embodiments disclosed herein relate to a structure and system for securely attaching the proximal ends of control wires (including any kind of control fiber, regardless of construction material) to the control spool(s) of a steerable catheter. In the most preferred embodiments, the structure and system include means for tuning—that is finely adjusting—relative tension of each of those control wires between the proximal end and a permanently/securely attached distal control wire end attached more distally within the steerable device. Too much or too little tension in each of the control wires (on its own, and more particularly in relation to the other control wire(s)) can cause premature or otherwise undesired deflection of the steerable device and/or may cause the steerable device to operate in a manner that is not desired or predictable. During assembly of a steerable catheter device, the system can be used to take up slackness one or all control wires.
The invention is defined by the claims, may be embodied in many different forms, and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey enabling disclosure to those skilled in the art. As used in this specification and the claims, the singular forms “a,” “an,” and “the” include plural referents unless the context clearly dictates otherwise.
The terms “proximal” and “distal” are used herein in the common usage sense where they refer respectively to a handle/doctor-end of a device or related object and a tool/patient-end of a device or related object. The term “about,” “substantially,” and other relative terms and terms of degree, when used with reference to any volume, dimension, proportion, or other quantitative value is intended to communicate a definite and identifiable value within the standard parameters that would be understood by one of skill in the art, and should be interpreted to include at least any legal equivalents, minor but functionally-insignificant variants, and encompassing a range that includes up to a range mathematically significant figures, although not requiring the full breadth of such range.
The term “control wire” (including just “wire”) is used herein to denote the elongate members that connect a control surface of a steerable catheter with a deflectable distal portion of the catheter, and it may include metallic, polymeric, and/or other materials including—by way of non-limiting example—ultrahigh molecular weight polyethylene yarn (e.g., Dyneema™), aramid fibers, monofilament line, multifilament/multifilar cable, and/or other materials that preferably have high tensile strength with low longitudinal stretch so as to provide predictable operation behavior. With regard to distal attachment of the control wire(s), a multifilar, braided, or other structure is preferred, which may be at least partially frayed or otherwise partially disaggregated (e.g., in order to provide greater surface area than a unitary aggregated wire structure, as described further below). One example of a control wire may include a 4×-50 Denier ultra-high tenacity polyethylene braid having a very small outer diameter of about 0.18 mm (measured in accordance with ASTM D-1907); high strength (about 5.6 kg, and at least equal to or greater than 4.75 kg, measured in accordance with ASTM D-6775); low longitudinal stretch/ elongation (about 5%, ±2%, measured in accordance with ASTM D-6775) (e.g., as available from Textile Development Associates Inc. of Brookfield, Conn.). Certain preferred control wire embodiments include or may even consist of high modulus fiber material that is nonconductive and/or substantially nonstretching. In one embodiment, a high modulus fiber control wire material may be braided. One such high modulus fiber material can be a High Molecular Density Polyethylene, a melt spun liquid crystal polymer fiber rope, or a spun para-aramid fiber polymer, or a high strength ceramic fiber. In some embodiments, a high modulus fiber control wire material may have a tensile strength in a range of about 300 ksi (2,000 MPa) to 1,500 ksi (10,400 MPa), and/or a tensile modulus in the range of about 5,000 ksi (35,000 MPa) to about 20,000 ksi (140,000 MPa).
One embodiment of a steerable catheter device 100 is described with reference to
A partially disassembled view of the control handle portion of the steerable catheter device 100 is shown in
As shown in
As shown in
The faces of adjacent gear teeth 158a preferably are oriented about 90° relative to each other and at about 45° relative to a radially central diameter, as shown in the drawings. This construction provides for a firm and secure engagement of the squared off end of a detent between adjacent teeth. As shown, for example, in
With reference to
The preferred travel path of each control wire is described with reference to
On the inner spool, the control wire 136 is disposed through the longitudinal central lumen of the tube 137 and exits a tube opening (not shown) that is aligned with the control wire passage 146a, through which passage 146a the wire 136 is disposed to engage around a gear rotatably mounted in the gear receptacle 145a. The control wire 138 (a distal end of which preferably is securely fixedly attached in a distal catheter portion—not shown, about or exactly 180° opposite of control wire 136) is disposed through the longitudinal central lumen of the tube 137 and exits a tube opening (not shown) that is aligned with the control wire passage 146b, through which passage 146b the wire 138 is disposed to engage around a gear rotatably mounted in the gear receptacle 145b.
Each control wire preferably is securely and permanently attached to a gear 150 in a manner that provides for predictable and desirable performance of the device with regard not only to removal of slack and tensioning during assembly of a steerable catheter device, but also during operation of the device including steering/deflection of the distal catheter portion. In view of the foregoing description, it should be appreciated that, during assembly, a proximal end of the control wire is directed into a gear receptacle via a control wire passage. For the sake of exemplary illustration, reference is made here to
In one preferred embodiment, the control wire will be directed from the groove 156 through a wire-securing fenestration 155 that is open through the gear head 154. From that fenestration 155, the distal end of the wire 118 passes along and within a slot 155a disposed radially in the outward face of the gear head 154, then traverses the thickness of the gear head 154 via a notch 155b (which notch is within the outer circumference of the gear head 154). There, back within the groove 156, the distal end of the wire 118 can be knotted around a less-distal portion of the wire 118, and the knot preferably secured with adhesive (knot not shown, but various knots and adhesives are well-known in the art). It will be appreciated that a couple of turns of the wire around the core within the groove will additionally frictionally secure the wire around the groove, whereupon the split mounting end 152 of the gear can be mounted/“clicked” into the gear-mounting aperture 121b for adjustment to take up slack and tension the wire as described above. Those of skill in the art will appreciate this process with respect to providing secure windability of the control wires relative to each of the four gears in the drawings and this description, which four wires and gears provide for controlled deflection/movement along and between all four transverse axes of the distal catheter end. It is preferable that the control wire be secured around/through the gear head and not through the core/shaft—both for ease of assembly, and also to minimize the stress risers present in the wire along its load-bearing regions during tensioning and operation of the steerable catheter.
One of the challenges in constructing a steerable catheter device (including particularly very small-diameter devices, such as a device configured for use as a cholangioscope) is securely and fixedly/permanently attaching control wires within the distal end, which is imperative for predictable and consistent steering performance. With reference to
The catheter body distal portion 160 shown includes eight lumens that extend longitudinally through the catheter body 104, where all of those lumens are at least generally, preferably substantially, or even exactly parallel with each other. The first and second control wire lumens 166, 168 may receive the paired opposite control wires 116, 118, where the first and second lumens are disposed radially 180° opposite each other across a radially off-center longitudinal axis of the catheter body. The third and fourth control wire lumens 176, 178 may receive the paired opposite control wires 136, 138, where the third and fourth lumens also are disposed radially 180° opposite each other across a radially off-center longitudinal axis of the catheter body. As shown, relative to the radially off-center longitudinal axis of the catheter body, the first and fourth lumens, and the second and third lumens each are disposed radially less than 90° from each other, respectively. Other, larger lumens shown may be configured for purposes other than allowing passage of a control wire (e.g., for passage of a wire guide or other accessory, illumination structure, visualization elements/structures, introduction/extraction of fluids, and/or other purposes). In one embodiment, the outer diameter of the distal end portion 160 may be about 4 mm, with the inner diameter of the control wire lumens 166, 168, 176, 178 each being about 0.3 mm, and the inner diameters of the other lumens ranging from about 0.75 mm to about 1.5 mm.
Within each of the control wire lumens, the respective control wire most preferably is free to move longitudinally except for a distalmost length that is securely and fixedly attached within a distalmost terminal length of the corresponding control wire lumen. In some embodiments, at least that a distalmost terminal length of the control wire lumen has a consistent/constant and uniform inner diameter that does not get larger at or near the distalmost terminus of the catheter body. In other embodiments, the distalmost terminal length of the control wire lumen may be slightly but smoothly flared to a larger inner diameter, but without any stepped or sharp transition of diameter. In still other embodiments, a distalmost length of the inner diameter of the control wire lumen may be dilated to a slightly larger diameter (e.g., up to about ⅓, or even ½ larger than the inner diameter along a major length of the catheter body, or of the entire remaining length of the catheter body and lumen). This is more clearly shown in
Two different non-limiting exemplary methods of securing a control wire, useful in each of the control wire lumens, is described here with reference to
For the first method, a pair of side holes 163, 165 is also shown in
Those of skill in the art will appreciate that a variety of different particular adhesives may be used in view of the presently disclosed novel structures and methods. The particular choice(s) of adhesive(s) may vary in keeping with the materials used for the catheter and the wire(s), as well as with regard to the dimensions and particular application/environment for which a given steerable catheter is configured. One exemplary embodiment of the present disclosure with reference to the first method and
In a second method and structure, also described with reference to
Next, an adhesive is injected or otherwise dispensed into an intact distal or distalmost length of the control lumen(s) (e.g., Loctite™ 4310, along and through about 5 mm to about 20 mm, with one range being about 10 mm to about 14 mm, where the term “intact” means that there are no side holes). The adhesive preferably occupies at least the lengthwise portion of the lumen occupied by the frayed or otherwise disaggregated length of the control fiber/wire occupying that lumen, and may extend proximally beyond that length. One method of introducing the adhesive is with a precision injecting/dispensing machine (e.g., an EFD fluid dispenser, available from Nordson EFD, East Providence, R.I., USA), where the tip of the dispenser is directed into the lumen and adhesive is injected for a desired lengthwise distance at sufficient pressure to surround and/or permeate the control fiber/wire. The adhesive may be a dual-cure adhesive, where a first curing step includes UV-curing, and a second step relies upon cyanoacrylate-type curing which can be controlled with temperature and/or humidity. One preferred adhesive includes high viscosity (e.g., about 100 cP or greater). The size and materials of the assembly may allow an assembler visually to inspect and monitor the amount and effectiveness of the injection/introduction of the adhesive. When the control wires are secured in place, the distal tip can be trimmed, shaped, chamfered, buffed, polished, and/or otherwise treated to present a desirable lower-profile and/or more atraumatic profile for the terminal distal tip.
Other effective adhesives for either method (or any combination of the methods, which is also contemplated herein) may include a variety of UV-curable and/or other light-curable adhesives. The viscosity of the adhesives may be selected with particular reference to the absolute and relative sizes of the wire lumen(s) and the wire(s). The materials and sizes, particularly of the wire(s) will be selected to transfer desired/needed force without breaking or stretching, without binding in the lumen(s), and also remaining small enough to keep the overall device of a desired size. Also, the catheter may include one or more metallic and/or polymeric reinforcing members (e.g., within the catheter wall, on the catheter wall exterior), but the control wires are not directly attached to any such members by the adhesive nor by other engagement. In preferred embodiments, the control wires exclude any sheath member, being constructed of materials that provide desired strength and limited elasticity in the very small diameters contemplated for the device embodiments described herein.
Those of skill in the art will appreciate that embodiments not expressly illustrated herein may be practiced within the scope of the claims, including that features described herein for different embodiments may be combined with each other and/or with currently-known or future-developed technologies while remaining within the scope of the claims. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation unless specifically defined by context, usage, or other explicit designation. It is therefore intended that the foregoing detailed description be regarded as illustrative rather than limiting. References herein to any industry standards (e.g., ASTM standards, and product identifiers such as particular polymers, as well as any trademarks) are defined as complying with the currently published standards and corresponding quantitatively and qualitatively defined specifications as of the original filing date of this disclosure unless expressly otherwise defined herein. And, it should be understood that the following claims, including all equivalents, are intended to define the spirit and scope of this invention. Furthermore, the advantages described above are not necessarily the only advantages of the invention, and it is not necessarily expected that all of the described advantages will be achieved with every embodiment. In the event of any inconsistent disclosure or definition from the present application conflicting with any document incorporated by reference, the disclosure or definition herein shall be deemed to prevail.
Claims
1. A steerable catheter comprising a secure attachment of a wire within the steerable catheter, said secure attachment comprising:
- an elongate catheter body including a proximal end, a distal end, and an intermediate catheter body length therebetween; at least a first control wire lumen extending longitudinally through the catheter body;
- at least a first elongate wire disposed longitudinally through the first control wire lumen;
- a first adhesive having a first viscosity, the first adhesive disposed substantially within, and securing the wire to, an intact distal length of the first longitudinal lumen, where at least a lengthwise portion of the wire is frayed or otherwise at least partially disaggregated.
2. The steerable catheter of claim 1, where a distalmost length of the first control wire lumen includes a larger inner diameter than does a less-distal length of the first control wire lumen.
3. The steerable catheter of claim 1, further comprising a plurality of control wire lumens, an elongate wire disposed through each lumen with a distalmost lengthwise portion of each wire being frayed or otherwise at least partially disaggregated.
4. The steerable catheter of claim 3, further comprising an adhesive disposed within each lumen along at least said distalmost lengthwise portion of each wire and securing said distalmost lengthwise portion of each wire to and within each control wire lumen.
5. The steerable catheter of claim 3, where a distalmost length of the each control wire lumen includes a larger inner diameter than a less-distal length of said control wire lumen.
6. The steerable catheter of claim 5, where the larger inner diameter along said distalmost length is up to one-third larger than the inner diameter of the control wire lumen along a major length of the catheter body.
7. The steerable catheter of claim 1, where the control wire comprises one or more of an UHMWPE fiber, a non-UHMWPE polyethylene fiber, braided polymer fiber, a twisted polymer fiber, a yarn, or any combination thereof.
8. A method of forming the secure attachment of the steerable catheter of claim 1, said method comprising steps of:
- dilating distalmost length of the first control wire lumen to a larger inner diameter;
- directing a distal lengthwise portion of the wire into a distal end of the first control wire lumen and fraying or otherwise at least partially disaggregating a distalmost terminal end of the wire, and where said distalmost terminal end is disposed within and/or immediately adjacent to a distalmost end terminal length of the first control wire lumen after the step of fraying or otherwise at least partially disaggregating; and
- directing the first adhesive into the first control wire lumen in a manner that attaches and secures the wire within the first control wire lumen.
9. The method of claim 8, wherein the distalmost length of the first control wire lumen is dilated up to one-third greater inner diameter than an inner diameter of a less-distal length of the first control wire lumen.
10. The method of claim 8, wherein the steerable catheter comprises a plurality of control wire lumens, and a distalmost length of each of the control wire lumens is dilated to a larger inner diameter than an inner diameter of a less-distal length of each of the control wire lumens.
11. The method of claim 10, further comprising directing a distal lengthwise portion of a control wire into a distal end of each of the plurality of control wire lumens and fraying or otherwise at least partially disaggregating a distalmost terminal end of the wire, and where said distalmost terminal end is disposed within and/or immediately adjacent to a distalmost end terminal length of the control wire lumens after the step of fraying or otherwise at least partially disaggregating.
12. The method of claim 11, further comprising directing adhesive into each control lumen in a manner securing the control wire to a distal length of a control wire lumen in which said control wire is disposed, where the adhesive occupies the lumen at least a lumen length in which the lengthwise portion of the wire is frayed or otherwise at least partially disaggregated.
13. The method of claim 11, where each control wire comprises one or more of an UHMWPE fiber, a non-UHMWPE polyethylene fiber, braided polymer fiber, a twisted polymer fiber, a yarn, or any combination thereof.
14. The method of claim 10, where the step of fraying or otherwise at least partially disaggregating a distalmost terminal end comprises gripping each wire with a tool and pulling the tool along and past the distalmost terminal end of said wire.
15. The method of claim 8, where each control wire comprises one or more of an UHMWPE fiber, a non-UHMWPE polyethylene fiber, braided polymer fiber, a twisted polymer fiber, a yarn, or any combination thereof.
16. The method of claim 8, where the step of fraying or otherwise at least partially disaggregating a distalmost terminal end of the first control wire comprises gripping the wire with a tool and pulling the tool along and past the distalmost terminal end of the wire.
Type: Application
Filed: Jul 20, 2017
Publication Date: Feb 1, 2018
Inventors: Luke T. Jungles (Winston-Salem, NC), Michael Lee Williams (Pinnacle, NC)
Application Number: 15/655,254