US 4,582,056 AGranted

Endocardial lead extraction apparatus and method

OwnerCharles E. McCorkle, Jr.inventor

Life of this patent

Estimating the term…

Loading patent…

Abstract

A composite assembly includes a first catheter having a lead grasping mechanism extending through a channel thereof, a second catheter concentrically disposed over the first catheter and having a smooth, tapered end and a third catheter concentrically disposed over the second catheter and is used to remove an inoperative endocardial lead from a patient's heart through a venous path. A free end of the lead is grasped and held securely to the first catheter by a grasping mechanism. The second and third catheters then are slid as a unit through the venous path over the grasped end of the lead as opposing tensile force is maintained on the first catheter to prevent movement of the lead. The second catheter is rotated to cause its smooth, tapered, leading edge with outward sharp serrations to separate scar tissue from the lead and dilate a path through the scar tissue. The third catheter, which also has a smooth leading edge and outward sharp serrations is further advanced a predetermined amount forward over the second catheter and is rotated to separate and/or dislodge a tip of the lead which is embedded in scar tissue of the heart. The composite assembly along with the lead therein then is removed as a unit from the heart via the venous path without causing excessive forces to be applied to the vein or the wall of the heart.

Claims7

Dependent claims

An apparatus for removing an endocardial lead from the heart of a patient via a venous path, said endocardial lead having a free end and a distal end with a tip that is lodged in tissue in said heart, said apparatus comprising in combination:

(a) first catheter means, having a distal end and a proximal end, for insertion into a venous path to said heart;
(b) lead grasping means for grasping a portion of said endocardial lead distant from said tip;
(c) stylet means extending entirely through the length of said first catheter means and connected to said lead grasping means for manipulating of said lead grasping means from said proximal end of said first catheter means and drawing of said lead grasping means and a grasped portion of said endocardial lead into said distal end of said first catheter means and lodging said grasped portion of said endocardial lead in said distal end of said first catheter means;
(d) stylet tension maintaining means disposed at the proximal end portion of said first catheter means for maintaining sufficient tension on said stylet means to cause said lead grasping means and said grasped portion of said endocardial lead to remain lodged inside of said distal end of said first catheter means and insecurely attached relationship to said distal end of said first catheter means;
(e) second catheter means disposed concentrically about said first catheter means for controlled advancement over said first catheter means and said endocardial lead toward said tip and for engaging the tissue surrounding said tip and pushing said tissue surrounding said tip away from said tip to separate that tissue from said tip, said second catheter means having a distal end and a proximal end;
(f) first means for effecting controlled advancing of said second catheter means over said first catheter means and said endocardial lead toward said tip;
and
(g) second means for effecting controlled advancing of said distal end of said second catheter means over said distal end of said first catheter means into sid tissue surrounding said tip and for effecting controlled rotation of said second catheter means relative to said first catheter means, to further effectuate said separating of said tissue from said tip.

5 more elements

An apparatus for removing an elongated foreign article from a patient's body via a venous path, said apparatus comprising in combination:

(a) a first catheter, having a distal end and a proximal end, for insertion into a venous path in the patient's body;
(b) grasping means for grasping a portion of said elongated foreign article;
(c) stylet means having a proximal end and a distal end and extending entirely through the length of said first catheter and connected to said grasping means for manipulating of said grasping means from said proximal end of said first catheter and drawing of said grasping means and a grasped portion of said elongated foreign article into an enlarged opening in said distal end of said first catheter means, said grasped portion of said elongated foreign article being small enough and/or flexible enough to allow said grasped portion to be drawn into said enlarged opening in said distal end of said first catheter means;
and
(d) stylet tension maintaining means disposed at the proximal end portion of said first catheter for maintain sufficient tension on said stylet means to retain said grasping means and said grasped portion of said elongated foreign article in said enlarged opening in said distal end of said first catheter and in securely attached relationship to said distal end of said first catheter, such that said first catheter effectively becomes an extension of said elongated foreign article.

2 more elements

A method for removing an elongated foreign article from a patient's body via a venous path, said method comprising the step of:

(a) providing a first catheter for insertion into a venous path in the patient's body, said first catheter having a proximal end and a distal end;
(b) providing a grasping means for grasping a portion of said elongated foreign body;
(c) providing a stylet means extending entirely through the length of said first catheter, a distal end of said stylet being connected to said grasping means to effectuate manipulating of said grasping means from said proximal end of said first catheter and drawing of said grasping means and a grasped portion of said elongated foreign article into an enlarged opening in said distal end of said first catheter, said grasped portion of elongated foreign article being small enough and/or flexible enough to allow said grasped portion to be drawn into said enlarged opening in said distal end of said first cather;
(e) passing said first catheter, said grasping means and said stylet means into the venous path to advance a portion of said grasping means to a portion of said elongated foreign article;
(f) manipulating a proximal end of said stylet to open a grasping portion of said grasping means and close it upon a portion of said elongated foreign article;
(g) pulling said grasping means and the grasped portion of the elongated foreign article into said enlarged opening and maintaining tension on said stylet means to draw said lead grasping means and said grasped portion of said elongated foreign object into said enlarged opening and maintain said elongated foreign object in securely attached relationship with the distal end of said first catheter so that first catheter effectively becomes an extension of said elongated foreign object;
and
(h) withdrawing said first catheter, said grasping means said stylet, and said elongated foreign object as a unit out of said venous path.

5 more elements

Dependencies are inferred from the claim text.

Facts

Application: 06/651,439Filed 17 Sep 1984 · continuation
Priority: 30 Mar 1983
Granted: 15 Apr 1986
Term ends: Not estimatedThe source records don’t support an estimate.

Classification17 codes

A61B 17/320016
Surgical cutting instruments: endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
A61B 17/221
Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones;…
A61B 17/29
Surgical forceps: forceps for use in minimally invasive surgery
A61B 17/32053
Excision instruments: punch like cutting instruments, e.g. using a cylindrical or oval knife