U.S. patent number 3,847,140 [Application Number 05/208,583] was granted by the patent office on 1974-11-12 for operating handle for spring guides.
This patent grant is currently assigned to United States Catheter & Instrument Corporation. Invention is credited to Robert J. Ayella.
United States Patent |
3,847,140 |
Ayella |
November 12, 1974 |
OPERATING HANDLE FOR SPRING GUIDES
Abstract
A rotating and tip deflecting handle for spring guides, having a
generally cylindrical handle portion, including a hand grip, an
intermediate assembly and a carriage slidable with respect to the
handle portion, means in each of said relatively slidable portions
for engaging, respectively, the guide wire or the core wire, and
the parts of said portions in which said engaging means are located
being rotatable with respect to said hand grip. Modifications of
the handle design adapt it for use with the slightly differing
spring guides of various manufacturers.
Inventors: |
Ayella; Robert J. (Lutherville,
MD) |
Assignee: |
United States Catheter &
Instrument Corporation (Glens Falls, NY)
|
Family
ID: |
22775133 |
Appl.
No.: |
05/208,583 |
Filed: |
December 16, 1971 |
Current U.S.
Class: |
600/585 |
Current CPC
Class: |
A61M
25/09041 (20130101) |
Current International
Class: |
A61B
5/02 (20060101); A61M 25/00 (20060101); A61m
025/00 (); A61b 005/02 () |
Field of
Search: |
;128/2M,2.5R,348-351,356,33R,DIG.9 |
References Cited
[Referenced By]
U.S. Patent Documents
Primary Examiner: Truluck; Dalton L.
Attorney, Agent or Firm: Finch; Walter G.
Claims
What I claim is:
1. A handle for a flexible, elongated controllable tip spring guide
having a tubular guide body and a core wire projecting from the
proximal end of said guide body, said handle comrising:
a hand grip located at a first, proximal end of the handle, said
hand grip having circumferential and axial dimensions such that
said hand grip can be held substantially within the palm of the
hand of an operator;
an intermediate assembly rotationally and non-slidably mounted in a
generally coaxial relationship with the hand grip, the intermediate
assembly including a core having at a first, proximal end thereof a
cylindrical end portion rotatably engaged in the distal end of the
hand grip, the core further having a middle block portion and a
distal rod portion coaxial with the cylindrical end portion, the
distal rod portion extending axially of the hand grip, the rod
portion being longitudinally grooved, said block portion having a
radially disposed hole in the plane of said groove, and said hole
being connected to said groove by a slit narrower than the diameter
of said hole whereby a lug on the end of one of said guide body and
a core wire can be retained within said hole with the core wire
passing through said slit and said groove;
means on the intermediate assembly for retaining the spring guide
along the axis of said handle such that the distal end of said
spring guide extends beyond the distal end of the rod portion of
the core;
means mounted on said intermediate assembly for rotationally
positioning said intermediate assembly; and,
a slidable carriage slidably and non-rotationally mounted on the
intermediate assembly so as to permit axial positioning of said
carriage on said assembly, said slidable carriage having means for
engaging the other one of said guide body and core wire.
2. A handle according to claim 1 wherein at least one of said guide
body and wire engaging means includes a radially open slot having
wider and narrower portions.
3. A handle according to claim 1 which includes, at its distal end,
an adjuster element movable axially of the handle and provided with
means for securement in different axially adjusted positions.
4. A handle according to claim 1 wherein the means for positioning
the intermediate assembly comprises a wheel-like member axially
spaced from the hand grip so as to permit rotation of the
wheel-like member by the thumb and forefinger of said operator.
5. A handle according to claim 1 wherein the slidable carriage is
non-rotatably mounted on the distal rod portion of the core.
6. A handle according to claim 5 wherein the slidable carriage is
provided with a longitudinal slot in register with the groove in
the rod portion, said slot terminating distally adjacent a slitted
abutment adapted to bear against a lug on the proximal end of the
tubular guide body.
7. A handle according to claim 6 which includes an adjuster element
slidable engaged with a distal end portion of the carriage and
provided with means for securement in different axially adjusted
positions.
8. A handle assembly according to claim 1 and including means on
the intermediate assembly for engaging one of said guide body and
core wire.
9. A handle for a flexible, elongated controllable tip spring guide
having a tubular guide body and a core wire projecting from the
proximal end of said guide body, said handle comprising:
a hand grip located at a first, proximal end of the handle, said
hand grip having circumferential and axial dimensions such that
said hand grip can be held substantially within the palm of the
hand of an operator;
an intermediate assembly including a mounting plug rotationally and
non-slidably mounted at a first, proximal end in a generally
coaxial relationship at the distal end of said hand grip, the
intermediate assembly further including a rod having a first,
proximal end fixed in the second, distal end of said plug
eccentrically thereof, the second, distal end of said rod extending
axially beyond said plug and having mounted on said distal end a
guide body mounting block, said guide body mounting block having
means for providing a rigid attachment to said rod;
means on the intermediate assembly for engaging one of said guide
body and core wire;
means on the intermediate assembly for retaining the spring guide
along the axis of said handle such that the distal end of said
spring guide extends beyond the distal end of said intermediate
member;
means mounted on the intermediate assembly for rotationally
positioning said intermediate assembly; and,
a slidable carriage slidably and non-rotatably mounted on the rod
of the intermediate assembly between said plug and said guide body
mounting block so as to permit axial positioning of said carriage
on said assembly, the slidable carriage having means for engaging
the other one of said guide body and core wire.
10. A handle according to claim 9 wherein the guide body mounting
block is traversed from end to end by a slot.
11. A handle according to claim 10 wherein said slot is formed with
an enlarged chamber to receive the proximal end fitting of a guide
body, said chamber being bounded proximally and distally by
narrowed parts of said slot adapted to restrain said fitting from
axial movement out of said chamber.
12. A handle according to claim 9 which includes a trigger fixed in
said carriage and projecting therefrom, said trigger being shaped
and positioned for convenient operation by the operator's finger to
slide the carriage axially toward or away from the hand grip.
13. A handle according to claim 9 in which the guide body mounting
block is formed with a distally extending portion, said adjuster
element being provided with means for securement in different
axially adjusted positions.
14. A handle according to claim 9 wherein the means for positioning
the intermediate assembly comprises a wheel-like member axially
spaced from the hand grip so as to permit rotation of the
wheel-like member by the thumb and forefinger of an operator.
Description
With the advent of spring guides, comprising a tubular guide body
and provided with a core or control wire to effect controllable
curvature and straightening of the guide tip, there arose the need
for handles adapted for manipulation of the guide bodies and their
core wires. Muller U.S. Pat. No. 3,452,740 shows a "Spring Guide
Manipulator" intended for operation of the spring guide disclosed
in Muller U.S. Pat. No. 3,452,742. Cook U.S. Pat. No. 3,521,620
shows both a spring guide and a handle therefor, as does Pierie et
al. U.S. Pat. No. 3,552,384. These patents and the references cited
therein set forth the background of the present invention and also
illustrate the variations in spring guide details which
neccessitate the provision of modifications in the handle to adapt
it for use with the Muller guide (Muller '740, FIGS. 7 and 8), the
Cook guide (Cook FIG. 5) or the A.H.S.C. guide (Pierie FIGS. 13 and
14), for instance.
The handle disclosed herein has the basic elements identified in
the "Abstract" and present in the Muller handle but simplified in
construction and operation, and arranged for very convenient
manipulation.
Practical embodiments of the invention are shown in the
accompanying drawings, wherein:
FIG. 1 represents a side view, in slight perspective, of a first
form of spring guide operating handle with the proximal end portion
of a spring guide mounted therein;
FIG. 2 represents an axial section on the line II--II of FIG. 1, on
a reduced scale;
FIG. 3 represents an enlarged transverse section on the line
III--III of FIG. 2;
FIG. 4 represents an enlarged transverse section on the line IV--IV
of FIG. 2;
FIG. 5 represents a side view, in slight perspective, of a second
form of spring guide operating handle with the proximal end portion
of a spring guide mounted therein;
FIG. 6 represents an axial vertical section showing the handle of
FIG. 5 on a reduced scale;
FIG. 7 represents a transverse section on the line VII--VII of FIG.
6;
FIG. 8 represents a transverse section on the line VIII--VIII of
FIG. 6;
FIG. 9 represents a transverse section on the line IX--IX of FIG.
6.
FIG. 10 represents a side view, in slight perspective, of a form of
spring guide operating handle with the proximal end portion of a
spring guide mounted therein;
FIG. 11 represents an axial section in the plane of the drawing
showing the handle of FIG. 10, on a reduced scale;
FIG. 12 represents a detail bottom plan view of a portion of the
handle shown in FIG. 11;
FIG. 13 represents a transverse section on the line XIII--XIII of
FIG. 11;
FIG. 14 represents a transverse section on the line XIV--XIV of
FIG. 11;
Referring to FIGS. 1 to 4, the handle assembly includes the hand
grip 1, the rotatable core 2, the slidable carriage 3, and the
adjuster 4. The hand grip is a solid cylinder having an axial bore
5 extending in from its distal end and a set screw 6 the end of
which can be normally projected slightly into said bore.
The core 2 comprises a cylindrical end portion 7 fitting freely
within the bore 5 and provided with an annular groove 8 into which
the end of the set screw 6 can be projected to hold the core
portion 7 in the bore while permitting relative rotation of the
core and hand grip. The middle portion of the core is in the form
of a block 9 with a hole 10 drilled radially to a distance beyond
the axis of the core portion 7. The distal end portion of the core
is a rod 11, coaxial with the end portion 7, provided with a first
longitudinal groove 12 on its upper surface and with a second
longitudinal groove 13 on one side. The groove 12 has a depth such
that its bottom is slightly below the common axis of the core end
portions, and the groove communicates with the hole 10 by means of
a slot 14 cut in the distal wall of the block 9. Said block is
bored, adjacent the slot 14 and perpendicularly to the medial plane
of the hole 10 and groove 12, to receive a set screw 15 having a
knurled head and an inner end which can be projected into the side
of slot 14.
The slidable carriage 3 includes the cylindrical body portion 16
and the integrally formed wheel 17, the wheel and about half of the
body being traversed axially by a bore 18 of a size to fit over the
end portion 11 of the core 2 and to be axially slidable thereon.
The adjusting screw 19 extends radially through a side wall of the
wheel (FIG. 3) and is provided with a small lug 20 on its inner
end, adapted to engage freely in the groove 13 to prevent rotation
of the carriage 3 relative to the core 2 while permitting,
normally, relative longitudinal movement. Part of the upper surface
of the body portion 16 is cut away, adjacent the wheel, to provide
a flat land 21, substantially coextensive with the bore 18. The
distal end portion of the body 16 is provided with bore 22, coaxial
with the bore 18, to receive the adjuster 4. An open slot 23
extends the entire length of the body portion 16 communicating with
an upward extension 24 of the bore 18 within the wheel 17, the slot
23 being enlarged laterally at a point 25 adjacent the wheel and at
a point 26 adjacent the distal end of the land 21. Immediately
proximal of the point 26 the bores 18 and 22 are separated by a
partition 27, grooved downward to a depth just below the axis of
the body 16.
The adjuster 4 comprises a rod section 29, of a size to fit freely
in the bore 22, and an enlarged head section 30, the rod section
being traversed by a small bore 31 and the head section having a
distally open larger bore 32. An adjusting screw 33 in the side of
the body 16 near its distal end is tightened against the rod
section 29 in any axially adjusted position of the latter (the
rotational adjustment of the adjuster 4 being generally
indifferent). The set screw 34 in the head 30 is adapted to engage
the stop-cock (not shown) of a catheter which may be fitted over
the spring guide to which the handle is attached.
In use, the controllable tip spring guide 35 has its proximal end
passed through the bore 31, after which the end lug 36 on the
control wire 37 is engaged in the hole 10 of the core 2 and the lug
38, on or near the proximal end of the spring guide is engaged in
the carriage 3 by insertion through the opening 26 to lie on the
axis of the carriage body in engagement with the distal face of the
partition 27. The lug 36 is held in position by tightening the set
screw 15 against the wire where it passes through the slot 14. The
lug 38 has no tendency to lift out of the slot 23 and so needs no
additional securement. When the fitting on the guide wire is
elongated, with lugs at each end, the proximal lug (not shown) is
received in the enlarged slot 25 and the distal lug 38 in the
opening 26, as described. If a catheter is carried by the spring
guide, its proximal end may be engaged in the adjuster 4 which can
be moved to and secured in different axial positions according to
the length of the catheter.
In order to manipulate the spring guide tip, the hand grip 1 is
held by the operator in one hand with the wheel 17 between the
thumb and fore-finger. Sliding the wheel away from the hand grip
pushes the spring guide forward in relation to the control wire and
thus changes the curvature of the spring guide tip, while its
orientation can be changed by rotating the wheel relatively to the
hand grip. If a particular degree of curvature is to be maintained
for a short or longer time the screw 19 may be tightened in order
to prevent, temporarily, relative axial movement of the carriage 3
on the core 2.
The second form of spring guide handle, shown in FIGS. 5 to 9,
comprises a hand grip 40, a rotatable support assembly 41 and a
slidable carriage 42. The hand grip 40 is similar to the hand grip
1, being a solid cylinder with an axial bore 43 and set screw 44
corresponding to the bore 5 and screw 6.
The support assembly 41 comprises a mounting plug 45 of T-shaped
axial section, the stem 46 being freely rotatable in the bore 43
and having an annular groove 47 adapted to receive the end of screw
44 which holds the plug in the bore while permitting relative
rotation. The enlarged head 48 has a diameter greater than that of
the hand grip and is knurled to facilitate manual rotation. A rod
49 has its proximal end 50 securely fixed in the head 48,
eccentrically thereof, and its distal end 51 carries the spring
guide mounting block 52.
The block 52 is generally rectangular, with a bore 53 extending
from end to end, and with a slot 54 extending inward from one of
its narrower sides, the slot 54 having a wider chamber 55 between
narrow distal and proximal portions 56, 57. The end 51 of rod 49 on
which block 52 is mounted is flattened at one side 58 (FIG. 7) and
the set screw 59 in a side wall of the block can be tightened
against said flat side to hold the block firmly in place. Between
the head 48 and the block 52 the top of the rod 49 is flattened, as
shown at 60, and a longitudinal groove 61 may also be formed in the
bottom of the rod (as viewed in the drawing).
The carriage 42 is also in the form of a rectangular block having a
bore 62 extending from end to end, the bore being of a size to
receive in free sliding relationship the rod 51. In the upper
distal end of the carriage there is a vertical slot 63 having a
narrowed slit 64 in the distal face of the block. A set screw 65 is
threaded in the top surface of the carriage and engageable with the
flat area 60 along the top of rod 49, and a trigger 66 is screwed
into the bottom of the block, with a lug 67 projecting freely into
the groove 61, whereby relative rotation of the carriage and rod is
prevented independently of the set screw 65.
In use, the handle of FIGS. 5 to 9 is mounted on a controllable tip
spring guide by placing the end lug 68 of the control wire in the
slot 63 with the adjacent wire passing through the slit 64. The
proximal end fitting 69 of the spring guide is placed in the
chamber 55 with adjacent portions of the guide and control wire
passing through the narrow slot portions 56, 57, and the fitting is
held firmly in place by means of the set screw 70 in the side of
the block 52, opposite from screw 59, the screw 70 having a tapered
inner end 71 for wedging the fitting 69 against the bottom of the
chamber 55. The slots 63 and 54 are of a depth such that the spring
guide lies on the axis of rotation of the plug 45 in the hand grip
40. When this handle is held in one hand of the operator, the plug
45 and all the elements mounted thereon can be rotated by the thumb
alone or thumb and forefinger acting on the knurled head 48, and
the curvature of the spring guide tip can be varied by pulling on
the trigger 66 to slide the carriage 42 away from the block 52, or
pushing the trigger to bring the carriage and block closer
together, thus varying correspondingly the relative positions of
the lug 68 and fitting 69.
In the third form, shown in FIGS. 10 to 14, all the parts are
substantially the same as just described in reference to FIGS. 5 to
9, except that the guide mounting block 72 is formed with an
integral distal extension 73 having a bore 74, coxial with the axis
of rotation of the rotatable elements, and adapted to receive an
adjuster 75, similar in form and purpose to the adjuster 4 of FIGS.
1 to 4. The adjuster 75 may be held in any desired position by
means of the set screw 76, corresponding to screw 33, and a set
screw 77 is provided in the enlarged head portion 78 of the
adjuster for the purposes described in reference to screw 34. FIG.
12 shows clearly, from a different point of view, the manner of
attaching the spring guide fitting 79 and control wire lug 80, as
shown and described in connection with fitting 69 and lug 68. FIGS.
10 to 14 also illustrate the fact that these handles can be held in
various rotational positions according to the personal judgment and
convenience of the operator in any given circumstances.
* * * * *