Source: https://patents.google.com/patent/US5423806A/en
Timestamp: 2019-08-23 04:57:41
Document Index: 537772936

Matched Legal Cases: ['art 10', 'art 10', 'art 10', 'art 10', 'art 10', 'art 10']

US5423806A - Laser extractor for an implanted object - Google Patents
Laser extractor for an implanted object Download PDF
US5423806A
US5423806A US08/131,055 US13105593A US5423806A US 5423806 A US5423806 A US 5423806A US 13105593 A US13105593 A US 13105593A US 5423806 A US5423806 A US 5423806A
US08/131,055
A. Wahlstrom Dale
1993-10-01 Application filed by Medtronic Inc filed Critical Medtronic Inc
1993-10-01 Priority to US08/131,055 priority Critical patent/US5423806A/en
1993-10-01 Assigned to MEDTRONIC, INC. reassignment MEDTRONIC, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: WAHLSTROM, DALE A., WILLIAMS, TERRELL M.
1995-06-13 Publication of US5423806A publication Critical patent/US5423806A/en
A lead extraction device which utilizes laser light to separate an implanted object, such as a pacemaker lead, from fibrous scar tissue and thereby permit the implanted object to be extracted from a body. The extraction device features a catheter having a central lumen. The lumen is preferably dimensioned so a pacemaker lead will fit within. The catheter is thereby guided by the lead. The catheter has at least one optical fiber to emit laser light from the distal end and thereby separate the lead from fibrous scar tissue. Disclosed embodiments include catheters which emit light parallel as well as inwardly perpendicular to the catheter and the lead. Through such catheters the lead may be separated along its length, as well as separated at its distal end from fibrous scar tissue, thereby permitting the lead to be readily extracted from the body.
This invention relates to a method and apparatus for removal of an implanted object from a patient's body and specifically for removal of transvenous endocardial leads from a patient's heart and the venous paths thereto.
As discussed above, many of the prior methods and devices for lead removal involved the application of traction or rotation or both to the lead. U.S. Pat. No. 4,574,800 to Peers-Trevarton, incorporated herein by reference, discloses a lead extraction device constructed to fit within the central lumen of a lead conductor coil and wedge a distal portion of such device in the distal portion of the lead. Such an arrangement permits traction force to be transmitted from the proximal end of the device to the distal portion of the lead. This avoids the need to impart any substantial pulling forces along the length of the lead. As mentioned above, pulling along the lead body may result in rupture of the lead, possibly resulting in the conductor coil to unwind within a patient.
Thus it is an object of the present invention to remove an implanted object affixed by fibrous scar tissue in a body.
FIG. 1 is depicts a lead placed in the venous system and having its distal tip located in the heart.
Turning to the FIGS., the present invention comprises generally a catheter 1 configured to remove an implanted object from a patient's body, and especially designed to remove an implanted pacemaker lead from a patient's venous system and heart. As seen in FIG. 1 a typical transvenous endocardial lead 2 connects a pacemaker 3 to heart 10 through the right subclavian vein 4, the superior vena cava 5 and down into the heart 10. Transvenous endocardial lead 2 is shown specifically in the right ventricle 12, although leads to the right atrium 11 are often used also. Distal end 13 of lead 2 includes an electrode 14 for electrically stimulating the heart 10 and a plurality of tines 15 to provide fixation of lead 2 within heart 10. As discussed above, during chronic implantation lead 2 becomes affixed along its side surfaces 20 to inner surfaces 21 of the venous system and at its distal end 13 to heart 10 through the formation of fibrous scar tissue 22. Catheter 1 is designed to separate such fibrous scar tissue 22 from lead 2 and has a series of optical fibers 23 running throughout. Optical fibers 23 are connected at their proximal end 42 to a laser light energy source (not shown) by coupler 44 and are arranged to emit laser light energy 64 from distal end 25 of catheter 1. Catheter body 30 has a guide lumen 31 configured to permit catheter 1 to be introduced over lead 2 and be guided thereby. Specifically guide lumen 31 extends from distal end 25 of catheter 1 to proximal end 17 of catheter body 30. Catheter 1 further features stylet tube 50 to permit catheter 1 to be further guided or pushed by a stylet (not shown.) Distal end 25 of catheter 1 preferably features an annular series of optical fibers 23 which thereby provide an annular source of laser light energy about the circumference of lead 2. Through such an arrangement catheter 1 may be guided along lead 2 permitting laser light energy 64 emitted from optical fibers 23 to ablate any fibrous scar tissue 22 affixing lead 2 within the venous system and heart 10.
1. A device for removing an object from the venous system comprising:
an elongated catheter having a distal end and a proximal end, said catheter having a tubular portion;
a lumen in said catheter so that said object may be introduced into said lumen;
at least one optical fiber supported by said tubular portion, said optical fiber extending to a region proximate said distal end of said catheter, said distal end having a guard assembly, said guard assembly comprising a guard band positioned about an exterior surface of said elongated catheter and a guard ring positioned about an interior surface of said elongated catheter, said optical fiber extending between said guard band and said guard ring, said optical fiber having a distal end, said guard assembly having a distal end, said optical fiber distal end is spaced proximally from said guard assembly distal end; and
a source of laser energy communicating with said optical fiber so that said light energy will be transmitted to said region proximate said distal end of said catheter.
2. The device of claim 1 further comprising a stylet port in said catheter to permit a stylet to be mated with said catheter.
10. A method for removing an implanted object affixed to a body by fibrous scar tissue comprising the steps of:
introducing a catheter having a lumen and at least one optical fiber into said venous system, said catheter further having a distal end having a guard assembly, said guard assembly comprising a guard band positioned about an exterior surface of said catheter and a guard ring positioned about an interior surface of said catheter, said optical fiber having a distal end, said guard assembly having a distal end, said optical fiber distal end is spaced proximally from said guard assembly distal end;
positioning said implanted object within said lumen of said catheter;
positioning said distal end of said catheter proximate said fibrous scar tissue;
transmitting laser energy through said optical fiber to said fibrous scar tissue immediately adjacent said distal end; and
removing said object from said venous system.
11. A method for removing an implanted object affixed by fibrous scar tissue in a body comprising the steps of:
providing a catheter body having a tubular portion supporting at least one optical fiber, said optical fiber having a distal end, said catheter body having a lumen therethrough, said catheter further having a distal end having a guard assembly, said guard assembly comprising a guard band positioned about an exterior surface of said catheter and a guard ring positioned about an interior surface of said catheter, said guard band having a distal end, said optical fiber distal end is spaced proximally from said guard band distal end;
placing the catheter body around said implanted object;
moving said catheter body along said implanted object until a distal end of said catheter body is positioned adjacent fibrous scar tissue which affixes said implanted object;
energizing a laser connected to said optical fiber to cause laser energy to be emitted into said fibrous scar tissue immediately adjacent said distal end;
moving the catheter body along said implanted object as the fibrous scar tissue releases said implanted object; and
removing said implanted object from said venous system.
12. The method of claim 11 wherein said lumen is centrally located with respect to said catheter body.
US08/131,055 1993-10-01 1993-10-01 Laser extractor for an implanted object Expired - Lifetime US5423806A (en)
US08/131,055 US5423806A (en) 1993-10-01 1993-10-01 Laser extractor for an implanted object
US08/153,715 US5674217A (en) 1993-10-01 1993-11-16 Heart synchronized extractor for an implanted object
EP94930546A EP0721317B1 (en) 1993-10-01 1994-10-03 Laser extractor for an implanted object
DE69430311A DE69430311D1 (en) 1993-10-01 1994-10-03 An apparatus for removing an implanted object by means of laser beam
AU79629/94A AU683502B2 (en) 1993-10-01 1994-10-03 Laser extractor for an implanted object
DE69430311T DE69430311T2 (en) 1993-10-01 1994-10-03 An apparatus for removing an implanted object by means of laser beam
JP51093395A JP3450010B2 (en) 1993-10-01 1994-10-03 Laser apparatus for removing implanted object
PCT/US1994/011146 WO1995009575A1 (en) 1993-10-01 1994-10-03 Laser extractor for an implanted object
CA002172051A CA2172051C (en) 1993-10-01 1994-10-03 Laser extractor for an implanted object
US08/153,715 Continuation-In-Part US5674217A (en) 1993-10-01 1993-11-16 Heart synchronized extractor for an implanted object
US5423806A true US5423806A (en) 1995-06-13
ID=22447646
US08/131,055 Expired - Lifetime US5423806A (en) 1993-10-01 1993-10-01 Laser extractor for an implanted object
US08/153,715 Expired - Lifetime US5674217A (en) 1993-10-01 1993-11-16 Heart synchronized extractor for an implanted object
US (2) US5423806A (en)
EP (1) EP0721317B1 (en)
JP (1) JP3450010B2 (en)
AU (1) AU683502B2 (en)
CA (1) CA2172051C (en)
DE (2) DE69430311D1 (en)
WO (1) WO1995009575A1 (en)
WO2000057446A1 (en) * 1999-03-19 2000-09-28 Fed Corporation High efficiency electrodes for organic light emitting diode devices
US20040158235A1 (en) * 2003-02-11 2004-08-12 Robert Rudko TMR system and handpiece with ECG electrodes
US8128639B2 (en) * 2010-05-20 2012-03-06 Restoration Robotics, Inc. Tools and methods for harvesting follicular units
DD281500A7 (en) * 1987-09-24 1990-08-15 Humboldt-Universitaet Zu Berlin Direktorat F. Forschung,Dd Intrakardial, intravasal and intraluminal laser cutting device
WO1991019532A1 (en) * 1990-06-11 1991-12-26 Vascomed Institut Für Kathetertechnologie Gmbh Process and device for extracting helical electrodes which have become embedded in body organs
JPS6219858B2 (en) * 1980-07-14 1987-05-01 Olympus Optical Co
JPH0235288Y2 (en) * 1984-10-06 1990-09-25
SE465600B (en) * 1989-03-21 1991-10-07 Hans Wiksell Triggering Device Foer utloesande of chockvaag
US5163432A (en) * 1990-07-16 1992-11-17 Matsushita Electric Industrial Co., Ltd. Catheter type laser illuminating apparatus
1993-10-01 US US08/131,055 patent/US5423806A/en not_active Expired - Lifetime
1993-11-16 US US08/153,715 patent/US5674217A/en not_active Expired - Lifetime
1994-10-03 CA CA002172051A patent/CA2172051C/en not_active Expired - Fee Related
1994-10-03 EP EP94930546A patent/EP0721317B1/en not_active Expired - Lifetime
1994-10-03 DE DE69430311A patent/DE69430311D1/en not_active Expired - Lifetime
1994-10-03 WO PCT/US1994/011146 patent/WO1995009575A1/en active IP Right Grant
1994-10-03 AU AU79629/94A patent/AU683502B2/en not_active Ceased
1994-10-03 DE DE69430311T patent/DE69430311T2/en not_active Expired - Lifetime
1994-10-03 JP JP51093395A patent/JP3450010B2/en not_active Expired - Fee Related
"A severed Pacemaker Lead Entrapped in a Hepatic Vein", Storm et al, PACE, vol. 16, Jun. 1993, pp. 1349-1353.
"Alternate Approaches to Lead Extraction", by Byrd et al., PACE, vol. 16, Jul. 1993, p. 1538.
"Experimental Study About Removal of the Implanted Tined Polyurethane Ventricular Lead by Radiofrequency Waves Through the Lead", by Ebe et al., PACE, vol. 14, Aug. 1991, pp. 1222-1227.
"Extraction of Implanted Transvenous Pacing Leads: A Review of a Persistent Clinical Problem", by Myers et al., American Heart Journal, vol. 121, No. 3, Mar. 1991, pp. 881-888.
"Intravascular Lead Extractions: Technique Tips and U.S. Database Results", by Sellers et al., PACE, vol. 16, Jul. 1993, p. 1538.
"Intravascular Techniques for Extraction of Permanent Pacemaker Leads", by Byrd et al., Journal of Thoracic and Cardiovascular Surgery, vol. 101, No. 6, Jun. 1991, pp. 989-997.
"Lead Extraction", Byrd et al., Cardiology Clinics, vol. 10, No. 4, Nov. 1992, pp. 735-748.
"Migration of a Severed Transvenous Pacing Catheter and Its Successful Removal", by Ramo et al., The American Journal of Cardiology, vol. 22, Dec. 1968, pp. 880-884.
"Removal of Chronically Implanted Pacemaker Leads", by Ikeda, PACE, vol. 16, Jul. 1991, p. 1537.
"Successful Removal of a Severed Transvenous Pacemake Electrode", by Gould et al., PACE, vol.4, Nov.-Dec. 1981, pp. 713-715.
"Use of Laser to Extract Unwanted Pacemaker Leads", by Rao et al., Texas Heart Institute Journal, Physics, System Design, Experimental Applications, vol. 16, No. 3, 1989, pp. 163-168.
A severed Pacemaker Lead Entrapped in a Hepatic Vein , Storm et al, PACE, vol. 16, Jun. 1993, pp. 1349 1353. *
Alternate Approaches to Lead Extraction , by Byrd et al., PACE, vol. 16, Jul. 1993, p. 1538. *
Experimental Study About Removal of the Implanted Tined Polyurethane Ventricular Lead by Radiofrequency Waves Through the Lead , by Ebe et al., PACE, vol. 14, Aug. 1991, pp. 1222 1227. *
Extraction of Implanted Transvenous Pacing Leads: A Review of a Persistent Clinical Problem , by Myers et al., American Heart Journal, vol. 121, No. 3, Mar. 1991, pp. 881 888. *
Intravascular Lead Extractions: Technique Tips and U.S. Database Results , by Sellers et al., PACE, vol. 16, Jul. 1993, p. 1538. *
Intravascular Techniques for Extraction of Permanent Pacemaker Leads , by Byrd et al., Journal of Thoracic and Cardiovascular Surgery, vol. 101, No. 6, Jun. 1991, pp. 989 997. *
Lead Extraction , Byrd et al., Cardiology Clinics, vol. 10, No. 4, Nov. 1992, pp. 735 748. *
Migration of a Severed Transvenous Pacing Catheter and Its Successful Removal , by Ramo et al., The American Journal of Cardiology, vol. 22, Dec. 1968, pp. 880 884. *
Removal of Chronically Implanted Pacemaker Leads , by Ikeda, PACE, vol. 16, Jul. 1991, p. 1537. *
Successful Removal of a Severed Transvenous Pacemake Electrode , by Gould et al., PACE, vol.4, Nov. Dec. 1981, pp. 713 715. *
Use of Laser to Extract Unwanted Pacemaker Leads , by Rao et al., Texas Heart Institute Journal, Physics, System Design, Experimental Applications, vol. 16, No. 3, 1989, pp. 163 168. *
EP1009343A1 (en) * 1997-08-27 2000-06-21 Arthrocare Corporation Electrosurgical systems and methods for the removal of pacemaker leads
EP1009343A4 (en) * 1997-08-27 2001-01-10 Arthrocare Corp Electrosurgical systems and methods for the removal of pacemaker leads
EP0721317A1 (en) 1996-07-17
CA2172051A1 (en) 1995-04-13
AU7962994A (en) 1995-05-01
DE69430311T2 (en) 2002-11-28
JPH09503408A (en) 1997-04-08
JP3450010B2 (en) 2003-09-22
CA2172051C (en) 2000-08-08
WO1995009575A1 (en) 1995-04-13
EP0721317B1 (en) 2002-04-03
US5674217A (en) 1997-10-07
DE69430311D1 (en) 2002-05-08
AU683502B2 (en) 1997-11-13
DE69636565T2 (en) 2007-06-21 Electrophysiology catheter guidewire
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:WAHLSTROM, DALE A.;WILLIAMS, TERRELL M.;REEL/FRAME:006725/0622