U.S. patent number 3,612,058 [Application Number 04/722,015] was granted by the patent office on 1971-10-12 for catheter stylets.
This patent grant is currently assigned to Electro-Catheter Corporation. Invention is credited to Bernard Ackerman.
United States Patent |
3,612,058 |
Ackerman |
October 12, 1971 |
CATHETER STYLETS
Abstract
Catheter stylet having an elongated bodily flexible outer casing
means comprising helically wound wire, and elongated reinforcing
means extending generally axially therethrough comprising at least
one strengthening portion.
Inventors: |
Ackerman; Bernard (Edison
Township, NJ) |
Assignee: |
Electro-Catheter Corporation
(N/A)
|
Family
ID: |
24900183 |
Appl.
No.: |
04/722,015 |
Filed: |
April 17, 1968 |
Current U.S.
Class: |
600/585;
604/95.01 |
Current CPC
Class: |
A61M
25/09033 (20130101) |
Current International
Class: |
A61M
25/00 (20060101); A61m 025/00 () |
Field of
Search: |
;128/348-351,341,356,2,2.05 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Truluck; Dalton L.
Claims
What is claimed is:
1. A catheter stylet comprising, in combination, an elongated
bodily flexible outer casing means a flexible tip portion and a
main body portion, said means elongated bodily flexible outer
casing means comprising helically wound wire, an elongated hollow
tubular reinforcing and stiffening element entirely within said
casing and extending axially throughout said main body portion, and
a reinforcing bodily flexible strand portion disposed axially
through both said tubular element and said flexible tip portion
whereby the overall structural integrity if the stylet is
increased, and separate bonding means securing both of the inner
and outer walls of said tubular element to said strand and said
outer casing respectively.
2. Catheter stylet as defined in claim 1 further including means
securing said stiffening element against movement relative to said
casing means.
3. Catheter stylet defined in claim 2, wherein said bodily flexible
strand portion comprises multiple wire strands.
4. Catheter stylet defined in claim 3, wherein said multiple
strands are twisted to define a wire rope.
5. Catheter stylet defined in claim 4, further comprising means
securing said bodily flexible portion to said stiffening
element.
6. Catheter stylet defined in claim 5, wherein said securing means
securing said stiffening element against movement relative said
casing means and said securing means securing said bodily flexible
portion to said stiffening element comprising a material selected
from the group consisting of epoxy, solder and silver solder.
7. Catheter stylet defined in claim 6, further comprising means
securing the distal end portions of said casing means and said
flexible portion to preclude breakage and separation of said
stylet.
8. Catheter stylet defined in claim 6, wherein said tubular portion
extends proximally of a location spaced apart from the distal end
portion of said casing, wherein said bodily flexible strand portion
extends to said distal end portion of said casing and wherein the
style further comprises means securing the distal end portion of
said bodily flexible portion and the distal end portion of said
casing means.
9. Catheter stylet defined in claim 8 wherein said securing means
comprises a bight formed in said bodily flexible portion.
10. Catheter stylet defined in claim 8 wherein said securing means
comprises a material having the characteristics of epoxy.
Description
This invention relates generally to catheter stylets and, more
particularly, to catheter stylets comprising portions of differing
flexibility and to methods of manufacture thereof.
Catheter stylets of the class to which the present invention
pertains may be utilized in a variety of surgical and medical
operations and procedures. For example, and without limitation,
such stylets may be inserted into or through bodily chambers and
passages to function as mechanical probes, as supports for
catheters, as guides for catheters, as electrodes, and the
like.
It is of the utmost importance that a catheter stylet be so
fabricated as to minimize breakage thereof while in a bodily cavity
or passage and, preferably to substantially eliminate any such
possibility. While such a possibility can be to a great extent
minimized and, in fact, substantially eliminated, this may not, in
all cases be sufficient. For example, presently catheter stylets
are being utilized for percutaneous catheterizations into arterial
and cardiac systems and, even, in direct cardiac catheterization.
If a catheter stylet should break during such a procedure, the
result could be fatal. In such situations, substantial elimination
of the possibility of breakage may not be deemed sufficient but,
rather, it is desirable that even in the unlikely event that a
catheter stylet should break while in or extending through a bodily
passage, chamber or organ that the entire catheter stylet be
capable of removal without leaving any broken pieces disposed
within the body.
Yet another criterion, however, of catheter stylets is that they
be, in general, flexible. The degree of flexibility, however,
manipulated many procedures should not be constant throughout the
length of the stylet. For example, for percutaneous, arterial and
direct cardiac catheterization, it is desirable that the distal end
portion of the stylet be quite flexible to preclude any possibility
of damage to cardiac and/or vascular tissue by contact therewith,
and to follow easily around curves in the vascular system. However,
it is preferable that the remainder of the stylet be somewhat
stiffer or less flexible than the distal end portion to enable the
catheter stylet to be readily and easily directed to the desired
location and to be capable of sustaining the required flexural
forces without buckling.
Still further, it is exceptionally desirable that catheter stylets
be capable of being readily sterilized, and be smooth and easily
manipulated. However, it must be borne in mind that catheter
stylets may be of exceedingly small diameter, on the order of 1 to
2 millimeters in diameter and quite long, and may, for example, be
approximately 150 centimeters long.
Having in mind the foregoing, it is a primary object of the present
invention to provide novel catheter stylets and methods of
manufacture thereof.
Another primary object of the present invention, in addition to the
foregoing object, is the provision of catheter styles comprising
portions of differing flexibility and methods of manufacture
thereof.
Yet another primary object of the present invention, in addition to
each of the foregoing objects, is the provision of such catheter
stylets which are constructed and arranged to preclude the
possibility of a tip portion breaking away therefrom and being left
within bodily passages or cavities and methods of manufacture
thereof.
Yet still another primary object of the present invention, in
addition to each of the foregoing objects, is the provision of such
catheter styles comprising a helical spring wire casing, a
stiffening member extending partially therethrough and retaining
means connected with the stiffening means and extending through the
remaining portions of the casing to retain the entire stylet as a
single unit even if the casing should break and methods of
manufacture thereof.
Another and yet still further primary object of the present
invention, in addition to each of the foregoing objects, is the
provision of such catheter stylets which are electrically
conductive enabling utilization thereof as an electrode for
bioelectronics such as cardiac defibrillation, cardiac pacing,
electrocardiography, the transmission or reception of electrical
signals or impulses from substantially any bodily location, and the
like and methods of manufacture thereof.
Yet still another primary object of the present invention in
addition to each of the foregoing objects, is the provision of such
cardiac stylets capable of utilization as a guide wire for the
insertion of open-ended catheters into bodily passages such as, and
by way of example only, in accordance with the Seldinger technique
for inserting a catheter into a blood vessel, as for
angiocardiography, or the like, and methods of manufacture
thereof.
Yet still further, it is also a primary object of the present
invention, in addition to each of the foregoing objects, to provide
such catheter styles which are simple, easy, and inexpensive to
manufacture and use which may be readily and easily sterilized.
IN THE DRAWING:
FIG. 1 is an enlarged partial cross-sectional illustration of the
distal end portion of a catheter stylet constructed in accordance
with the principles of the present invention and
FIG. 2 is a cross-sectional view taken along line 2--2 of FIG.
1.
With reference now to the drawing, there is shown and illustrated a
catheter stylet or guide wire constructed in accordance with the
principles of the present invention and designated generally by the
reference character 10. The stylet or guide wire 10 may comprise an
outer casing 12, a distal tip 14, stiffening means 16 and
reinforcing means 18. The outer casing 12 is preferably of highly
flexible material and may, for example, comprise a continuous
helical coil of hardened and tempered stainless steel spring wire.
For example, the casing 12 may be fabricated of a stainless steel
wire of approximately five to seven-thousandths diameter so that
the casing 12 would be approximately 0.024 inch inside
diameter.
Such a casing would be quite flexible and capable of being
literally bent during passage, for example, through blood vessels,
or the like. Moreover, such a construction would not be easily
broken but, upon continued flexing of the casing 12 minute
fractures could occur. Furthermore, since metals are not generally
homogeneous, tiny flaws, carbon spots, or the like could produce a
location more susceptible to breakage. No matter what inspection
procedures are utilized, such a fine wire, when would into helical
coil spring configuration, could not be safely relied upon, without
reinforcement, as a catheter stylet or guide wire such as that of
the character described since some slight possibility would always
exist of such a wire fracturing during use.
To provide a generally rounded nose or distal end to the casing 12,
the tip 14 may be provided to aid in guiding the stylet 10 and to
preclude the distal end portion thereof from tearing, piercing, or
otherwise injuring bodily tissues. The tip 14 may, for example, be
formed of metal, plastic, or the like. For example, the distal end
or tip 14 may be fabricated of solder, silver solder, or other
molten metal by dipping the distal end portion of the casing 12
into a molten bath or by heating the distal end portion and
applying solder or silver solder thereto in the form of a wire, or
the like. However, the distal end tip 14 may also be fabricated of
a plastic material, such as an epoxy cement, or the like.
The medical utilizations of the catheter stylets or guide wires 10
constructed in accordance with the principles of the present
invention generally require that only the distal end portion be
exceptionally flexible, while the remainder of the stylet or guide
wire be somewhat stiffer. For example, it is often desirable that
approximately the distal 3 centimeters of the stylet be exceedingly
flexible to aid in guiding or steering the stylet through the
bodily passages and to preclude damage to bodily tissues due to
contact, tremor or the like.
As an aid in inserting and steering the stylets, it may be
preferable that the remainder of the casing proximal of the distal
3 centimeters referred to above be stiffened or reinforced and the
reinforcing means 16 may be inserted within the casing 12 extending
from the proximal end (not shown) to a location approximately 3
centimeters from the distal end. The reinforcing means 16 may, for
example, comprise stainless steel hypodermic tubing having, for
example, an outside diameter of approximately 0.020 inch and an
inside diameter of approximately 0.010 inch. Since, as heretofore
pointed out, the casing 12 may have an internal diameter of
approximately 0.024 inch, it may be readily seen that there is a
clearance of approximately 0.002 inch between the hypodermic tubing
or reinforcing means 16 and the interior of the casing 12 enabling
the reinforcing means or hypodermic tubing to be inserted
therewithin.
The distal end portion of the reinforcing means or hypodermic
tubing 16 may be secured with the casing 12, as b means of an epoxy
cement, solder, or the like. Epoxy cement, however, is
exceptionally suitable in that its high wetting ability enables the
formation of a firm bond even at such generally inaccessible
location as between the periphery of the hypodermic tubing 16 at
the distal end portion thereof and the interior of the casing 12
adjacent thereto. If desired, the proximal end portion of the
reinforcing or stiffening means 16 may be similarly secured with
the casing 12.
As heretofore pointed out, it is a primary desideratum that any
possibility of breakage of the casing 12 and subsequent separation
thereof so as to leave a portion thereof disposed within the body
of a patient be absolutely precluded. As heretofore pointed out,
the likelihood of breakage may be substantially reduced by proper
design, heat treatment ans inspection. However, as also heretofore
pointed out, design to positively eliminate breakage is
substantially impossible within the limits of size dictated by the
use.
It is believed readily obvious, however, that the only danger of
breakage such as would leave a portion of the stylet within a
patient's body would be if the stylet fractured at the 3
-centimeter flexible distal end portion since the stiffening means
16 serves, additionally, to reinforce the remainder of the stylet.
If, however, the casing should fracture within the distal 3
centimeters, then the hypodermic tubing 16 would not be effective
to enable removal thereof and, accordingly, the tip 14 and distal
end portion of the casing 12 could be released into the body.
To preclude such a possibility, the stylet 10 may further comprise
the safety-reinforcing means 18 which, for example, may comprise a
strand of stainless steel wire or cable extending between the tip
14 and the hypodermic tubing 16. While substantially any material
may be utilized for the safety-reinforcing means 18, a strand of
stainless steel wire or cable has been found preferable in that it
is sufficiently flexible as to not adversely affect the flexibility
of the distal end portion while being sufficiently strong as to
substantially eliminate any danger of breakage. With the wire or
cable 18 extending between the hypodermic tubing 16 and the tip 14,
even if the casing 12 should fracture within the distal
3-centimeter portion, then upon withdrawal of the hypodermic tubing
16 and casing 12, the wire or cable 18 will pull the tip 14 at
adjacent portion of the casing of outwardly if the body. The wire
or cable 18 may, for example, comprise a 5- or 7-strand stainless
steel cable having an effective outside diameter of approximately
0.007 inch. The proximal end portion of the safely restraining wire
18 may be secured within the distal end portion of the hypodermic
tubing 16, as by means of an epoxy cement 20. The distal end
portion of the safety wire 18 may be embedded within the tip 14
during formation thereof and, for additional safety, may be formed
with a bight 22 to preclude any pulling out or separation
therebetween.
Similarly, any desired portion or portions of the stylet 10 may be
constructed and arranged to have maximum flexibility by omitting
the reinforcing or stiffening tubing therefrom while precluding
breakage and separation thereat by the incorporation of a
reinforcing wire or cable therethrough. Likewise, any desired
portion or portions of the stylet 10 may be made more or less stiff
by the incorporation of reinforcing or hypodermic tubing
therewithin, the particular outside diameter, inside diameter,
composition, and temper of the hypodermic tubing at such portion or
portions being effective to control the stiffness or flexibility
thereat.
It is to be expressly understood, however, that for maximum safety
each and every longitudinal portion of the stylet would comprise
both an outer casing and an inner generally axially extending
member, with that member being either a relatively stiff member
such as hypodermic tubing or a bodily flexible member, such as
twisted wire or cable. Furthermore, to preclude breakage or
separation, the inner member is preferably continuous that is,
comprises portions of tubing and wire or cable interconnected and
in line. The distal and proximal end portions of the inner member
may be secured with the outer casing as described above. Similarly,
the distal and proximal end portions of each of the hypodermic
tubing sections or portions may also be secured with the outer
casing as by an adhesive bond.
The inner member may be secured with the outer casing in
substantially any manner, but as hereinabove pointed out, na
adhesive bonding therebetween is especially suitable. Substantially
any adhesive-type material may be utilized, including metals such
as solders, silver solders, or the like or more conventional
adhesives, such as epoxy adhesives. Preferably, the adhesive,
whether it be a metal or an organic material, maximum of tensile
strength with a minimum bending momentor or maximum be one which in
the liquid state thereof exhibits the property of highly wetting
the outer sheathing, the wire or cable and the hypodermic tubing
enabling such wetting action to cause the adhesive to flow into the
narrow spaces between the outer sheathing, wire or cable and tubing
to provide firm bond therebetween. As pointed out above, epoxy
adhesives have been found to be especially suitable and capable of
sustaining or undergoing sterilization processes.
While the reinforcing means may comprise substantially any
elongated structure capable of being disposed within the casing
means, it has been found preferable that the bodily flexible
reinforcing means 18 comprise multiple-stranded twisted wire rope
to provide a maximum of tensile strength with a minimum bending
momentor or maximum resistance to bending with a minimum of
material and enabling secure axial or concentric joining with
bodily flexible reinforcing means 18.
Moreover, it is believed particularly pertinent to note that
stylets constructed according to the present invention are
constructed and arranged to preclude stretching, even of the distal
end portion, under tension, such as might occur if, for example,
the distal end may be caught upon withdrawal as the whole stylet
moves rearwardly. This is a very dangerous procedure, and it is
under such conditions that the greatest danger of breakage
exists.
Since the distal end portion of the stylets constructed in
accordance with the present invention are precluded from
stretching, the safety thereof is immeasurably greater than stylets
heretofore known.
* * * * *