Steerable stylet and manipulative handle assembly

Details Steerable stylet and manipulative handle assembly Steerable stylet and manipulative handle assembly

1997-06-26

1999-02-23

Peffley, Michael

Surgery

Diagnostic testing

Flexible catheter guide

604 95, A61B 500

Patent

active

058738428

ABSTRACT:
A steerable stylet and manipulative handle assembly especially adapted for guiding the introduction of an endocardial pacing or cardioversion/defibrillation lead or a catheter to a desired location in a patient's cardiovascular system. The steerable stylet or catheter designed to be introduced into the lumen of a lead comprises an outer, elongated tubular member of a length sufficient to extend through the length of the lead or catheter from its proximal opening to the distal end thereof, a traction element or pull wire extending generally through the length of the tubular member and within its lumen except for a predetermined distance in the distal portion thereof, and a manipulative handle coupled to the proximal ends of the tubular member and wire which may be employed with one hand to both rotate the tubular member and impart a continuously variable curve in the distal portion thereof. The distal portion of the tubular member is especially configured to be either attached to or cooperate with the distal end of the pull wire so that proximally-directed traction applied by the handle to the wire causes the distal portion of the tubular member to bend. The distal portion of the tubular member is provided with openings to allow the wire to exit and re-enter the lumen of the tubular member in the distal portion so that traction applied to the wire bows the tubular member into a curve of desired radius. In use, the distal portion of the wire residing outside the lumen of the tubular member is constrained within the lumen of the lead or catheter. Traction applied by the manipulative handle to the wire is sufficient to cause the distal portion of the pacing lead to assume various angles of curvature from straight to approximately one hundred eighty degrees. The distal portion of the tubular member which bows in response to the applied traction is preferably cut out or flattened to avoid kinking. The manipulative handle may be employed with one hand to impart the desired degree of curvature while rotating the lead or catheter to direct its distal end through the venus system and into the desired site within a chamber of the heart or the coronary sinus. The ability to dynamically change the degree of curvature during advancement avoids the necessity of removing and recurving the stylet during the introduction of the lead or catheter.

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