Medical device for manipulation of a medical implant
Claim Score by NHIP
Abstract
This invention relates to medical devices for manipulating medical implants such as, for example, stents, distal protection filters, and septal occluders in a patient's body, and the methods of use thereof. Generally, a medical device of the invention includes a sleeve and an expandable component joined to the sleeve which transitions between a collapsed configuration and a deployed configuration for capturing a medical implant in a patient's body.

Term
Term ended
Projected expiry passed 17 July 2024, 2.2 years ago.
- Priority and filed
- Published
- Projected expiry
- Today
24 claims: 3 independent, 21 dependent
- 1A medical device for manipulating a medical implant in a patient's body comprising:a sleeve comprising a lumen, a distal end and a proximal end;an expandable component, wherein at least a portion of the expandable component is joined to the sleeve, the expandable component transitioning between a collapsed configuration when the expandable component is enclosed by the sleeve, and a deployed configuration, wherein a portion of the expandable component is extended beyond the distal end of the sleeve.
- 18A method for manipulating a medical implant in a patient's body comprising:providing a medical device comprising a sleeve comprising a lumen, a distal end and a proximal end and an expandable component, wherein at least a portion of the expandable component is joined to the sleeve, the expandable component transitioning between a collapsed configuration when the expandable component is enclosed by the sleeve, and a deployed configuration wherein a portion of the expandable component is extended beyond the distal end of the sleeve.
- 24Broadest claimClaim Score 84, broad(NHIP)A medical device for capturing a medical implant in a patient's body comprising:a sleeve means;an expandable means, wherein at least a portion of the expandable means is joined to the sleeve means, the expandable means transitioning between a collapsed configuration when the expandable means is enclosed by the sleeve means, and a deployed configuration, wherein a portion of the expandable means is extended beyond the sleeve means;and means for deploying the expandable means beyond the sleeve means.
Independent claims3
79 paragraphs in 5 sections, as filed
FIELD OF THE INVENTION
[0001] This invention generally relates to a cardiovascular medical device. More particularly, this invention relates to a medical device for manipulating a medical implant in the cardiovascular system of a patient and methods of use of such a medical device.
BACKGROUND OF THE INVENTION
[0002] Medical implants have wide-spread use in percutaneous vascular and cardiac surgery. These implants include, in particular, distal protection filter devices for the capture of thrombi in major veins such as the lower caval vein, occlusion devices for permanent or temporary obturation of a vessel lumen or permanent occlusion of defects in cardiac walls such as an atrial septal defect (ASD), a patent ductus arteriosus (PDA), or other cardiovascular defects such as, patent foramen ovale (PFO) and left atrial appendage (LAA).
[0003] Cardiac wall septal defects are usually congenital in nature leading to abnormal openings, holes or shunts between the chambers of the heart or the great blood vessels, causing abnormal shunting of blood through the opening. Such defects may result, for example, from the incomplete formation of the septum, or wall, between cardiac chambers during fetal life when the heart develops from a folded tube into a four chambered, two unit system. These deformities can result in significant health risks such as, high pulmonary arterial pressures and fatal heart failure, if not corrected.
[0004] Initially, atrial septal defects were corrected by open heart surgery. However, in order to avoid the morbidity and mortality associated with open heart surgery, a variety of transcatheter closure techniques have been attempted in patients. In such techniques, a medical implant such as an occluding device, is delivered percutaneously through an intravascular catheter into a patient. Once the occluding device is positioned adjacent the defect, it is attached to the wall adjacent the septum in a manner which permits it to effectively block the passage of blood through the defect. One such medical implant is a septal occluder which is inserted percutaneously via a catheter into a chamber of the heart to occlude a septal defect in a patient. A septal occluder is typically adapted very closely to the shape and size of the defect which is to be closed and is positioned very precisely upon implantation into the patient's heart. However, in the event that the septal occluder is dislodged from its intended location, or misaligned with the defect, it is often difficult to retrieve the septal occluder due to its shape or size. Furthermore, the process of retrieving the septal occluder often causes damage to the surrounding vasculature.
[0005] In addition to the use of medical implants for the treatment of septal defects, medical implants are also used to capture embolic debris caused by medical procedures that blood vessels stenosed or occluded in a patient caused by the deposit of plaque or other material on the walls of the blood vessels. Angioplasty, for example, is a widely known medical procedure wherein a dilating device, such as an inflatable balloon, is introduced into the occluded region of the vessel. The balloon is inflated, dilating the occlusion and thereby increasing intraluminal diameter. Plaque material may be inadvertently dislodged during angioplasty. This material is free to travel downstream, possibly lodging within another portion of the blood vessel that may supply a vital organ thereby causing damage to the organ by obstructing blood flow to the organ.
[0006] Medical implants such as distal protection filters are typically introduced into the desired blood vessel for capturing embolic debris dislodged during angioplasty. One of the problems associated with the removal of a medical implant such as a distal protection filter from a patient's body is that the retrieval process results in the collapse of the distal protection filter causing egress of particulate embolic matter back into the bloodstream. In the case of cerebral angioplasty, for example, emboli dislodged during the retrieval of a distal protection filter from a patient's body may travel to the brain, possibly causing a stroke, which can lead to permanent neurological injuries or even the death of the patient. Therefore, while distal protection filters are useful for trapping embolic debris that is dislodged or generated during a medical procedure, such as angioplasty, the egress of embolic debris trapped in a distal protection filter back into the bloodstream of a patient while the distal protection filter is being removed from the patient's body remains a problem.
SUMMARY OF THE INVENTION
[0007] The invention disclosed herein relates to medical devices and the methods of use of the medical devices for manipulating medical implants in patients. The medical devices of the invention result in a significant reduction in or prevention of problems and risks associated with the recovery or delivery of medical implants in patients such as, for example, escape of embolic debris from a distal protection filter as it is being removed from a patient or damaging of blood vessels during the delivery or retrieval of a septal occluder from a patient.
[0008] A medical device according to the invention can be used to capture a medical implant for retrieval or delivery into a patient's body.
[0009] In one aspect, the invention is directed to a medical device including a sleeve and an expandable component. The sleeve includes a lumen, a distal end and a proximal end and at least a portion of the expandable component is joined to the sleeve. The expandable component transitions between a collapsed state when the expandable component is enclosed by the sleeve, and a deployed state when a portion of the expandable component is extended beyond the distal end of the sleeve. The expandable component is sized and shaped for manipulating a medical implant in a patient's body. For example, in one embodiment, manipulating includes capturing a medical implant for recovery from or delivering of the medical implant inside a patient's body.
[0010] In one embodiment,the medical device of the invention further includes an elongate member. The elongate member includes a distal end and a proximal end and at least a portion of the elongate member is slideably moveable within the lumen of the sleeve. In one embodiment, at least a portion of the expandable component is joined to the elongate member. In a particular embodiment, at least a portion of the expandable component is joined to the distal end of the elongate member.
[0011] In various embodiments of the foregoing aspect of the invention, the expandable component of the medical device is joined to the distal end of the sleeve.
[0012] The expandable component is deployed by relative sliding motion of the sleeve and the expandable component. In one embodiment, the expandable component is reciprocatably moveable relative to the sleeve, wherein the sleeve is stationary. In another embodiment, the sleeve is reciprocatably moveable relative to the expandable component, wherein the expandable component is stationary. The expandable component may also be deployed by relative sliding motion of the elongate member within the lumen of the sleeve relative to the sleeve.
[0013] In one embodiment, the expandable component has a conical shape in the deployed state. The expandable component may be sized and shaped to manipulate a septal occluder. The expandable component may also be sized and shaped to manipulate a distal protection filter.
[0014] In another aspect, the invention relates to methods for manipulating a medical implant in a patient's body using the aforementioned medical devices of the invention. One method of the invention includes providing a medical device of the invention including a sleeve with a lumen, a distal end and a proximal end and an expandable component, where at least a portion of the distal portion of the expandable component is joined to the sleeve and the expandable component transitions between a collapsed state when the expandable component is enclosed by the sleeve and a deployed state when a portion of the expandable component is extended beyond the distal end of the sleeve, the expandable component being sized and shaped for manipulating a medical implant in a patient's body.
[0015] Another method of the invention includes providing the medical device that further includes an elongate member that is slideably moveable within the lumen of the sleeve.
[0016] In one embodiment, manipulating a medical implant using a method according to the invention includes capturing a medical implant for delivery inside a patient's body using the medical device of the invention. In another embodiment, manipulating a medical implant using the method according to the invention includes capturing a medical implant for retrieval from a patient's body.
[0017] In other aspects, the invention relates to a medical device for capturing a medical implant in a patient's body including a sleeve means, an expandable means, and means for deploying the expandable means beyond the sleeve means. At least a portion of the expandable means is joined to the sleeve means and the expandable means transitions between a collapsed state when the expandable means is enclosed by the sleeve means and a deployed state when a portion of the expandable means is extended beyond the sleeve means, the expandable means being sized and shaped for capturing the medical implant in the patient's body.
[0018] In all embodiments of the foregoing aspects of the invention, the medical implant to be captured can be a septal occluder, a stent or a distal protection filter.
[0019] In all the foregoing aspects of the invention, the expandable component can be fabricated from several materials and can assume many configurations. Suitable materials include any material that is flexible, collapsible and atraumatic. In one embodiment, the expandable component includes a mesh that is cylindrical. In another embodiment, the expandable component includes braided material. The expandable component can assume many configurations such as a braid or an elastomeric tube. The braid configuration can include multiple braids or a partial braid.
[0020] The directional terms distal and proximal require a point of reference. The term “distal” refers to a direction that points away from an operator of a medical device in accordance with the invention and into the patient's body. The term “proximal” refers to a direction that points toward an operator of the medical device in accordance with the invention and away from the patient's body.
[0021] These and other objects, along with advantages and features of the present invention herein disclosed, will become apparent through reference to the following description, the accompanying drawings, and the claims. Furthermore, it is to be understood that the features of the various embodiments described herein are not mutually exclusive and can exist in various combinations and permutations.
BRIEF DESCRIPTION OF THE DRAWINGS
[0022] In the drawings, like reference characters generally refer to corresponding parts throughout the different views. The drawings are not necessarily to scale, emphasis instead being placed on illuminating the principles and concepts of the invention.
[0023]FIG. 1A illustrates a partially-sectioned schematic view of an embodiment of a medical device in accordance with the invention including the expandable component in a collapsed configuration;
[0024]FIG. 1B illustrates a partially-sectioned schematic view of an embodiment of the medical device illustrated in FIG. 1A including the expandable component in a partially-deployed configuration;
[0025]FIG. 1C illustrates a partially-sectioned schematic view of an embodiment of the medical device illustrated in FIG. 1A including the expandable component in a substantially-deployed configuration;
[0026]FIG. 1D illustrates a partially-sectioned schematic view of an embodiment of the medical device illustrated in FIG. 1A including the expandable component in a fully-deployed configuration;
[0027]FIG. 2A illustrates a partially-sectioned schematic view of an embodiment of a medical device in accordance with the invention including an expandable component with an open proximal section;
[0028]FIG. 2B illustrates a partially-sectioned schematic view of an embodiment of a medical device in accordance with the invention including a cylindrical expandable component with open distal and proximal portions;
[0029]FIG. 2C illustrates a partially-sectioned schematic view of an embodiment of a medical device in accordance with the invention including a funnel-shaped expandable component;
[0030]FIG. 3A illustrates a partially-sectioned schematic view of an embodiment of a medical device in accordance with the invention including an elongate member;
[0031]FIG. 3B illustrates s a partially-sectioned schematic view of an embodiment of the medical device illustrated in FIG. 3A including the expandable component in a substantially-deployed configuration for capturing a medical implant;
[0032]FIG. 4A illustrates a partially-sectioned schematic view of an embodiment of a medical device in accordance with the invention including a lumen extending substantially through the entire length of the elongate member of the medical device;
[0033]FIG. 4B illustrates a partially-sectioned schematic view of an embodiment of the medical device illustrated in FIG. 4A including the expandable component in a substantially-deployed configuration for capturing a medical implant;
[0034]FIG. 5A illustrates a schematic side-view of an embodiment of the expandable component of a medical device in accordance with the invention in a deployed configuration;
[0035]FIG. 5B illustrates a schematic end-view of the deployed configuration of an embodiment of the expandable component of the medical device illustrated in FIG. 5A;
[0036]FIG. 5C illustrates a schematic side-view of an embodiment of the expandable component illustrated in FIG. 5A in a collapsed configuration;
[0037]FIG. 6 is a cross-sectional view of the medical device of FIG. 4A through <b>6</b>-<b>6</b>.
[0038]FIG. 7A illustrates a partially-sectioned schematic view of an embodiment of the medical device illustrated in FIG. 5A including a guide wire and a medical implant with a lumen;
[0039]FIG. 7B illustrates a partially-sectioned schematic view of the medical device illustrated in FIG. 7A, where the guide wire is extended substantially through the entire length of the medical device and the medical implant and beyond the distal end of the medical implant;
[0040]FIG. 7C illustrates a partially-sectioned schematic view of the medical device illustrated in FIG. 7A including the expandable component capturing the medical implant;
[0041]FIG. 8A illustrates a schematic view of a medical implant including a guide wire attached to a medical implant;
[0042]FIG. 8B illustrates a partially-sectioned schematic view of an embodiment of the medical device illustrated in FIG. 8A, where the distal end of the sleeve of the medical device is adjacent the free end of the guide wire;
[0043]FIG. 8C illustrates a partially-sectioned schematic view of an embodiment of the medical device illustrated in FIG. 8A including the expandable component of the medical device capturing the medical implant;
[0044]FIG. 9 illustrates a partially-sectioned schematic view of an embodiment of the medical device according to the invention including the expandable component in a substantially-deployed configuration covering the proximal pores of the distal protection filter;
[0045]FIG. 10A illustrates a partially-sectioned schematic view of an embodiment of the medical device illustrated in FIG. 5A in accordance with the invention, including the expandable component in a collapsed configuration and the distal end of the sleeve aligned with a collapsible medical implant;
[0046]FIG. 10B illustrates a partially-sectioned schematic view of the medical device of FIG. 10A including the expandable component in a partially-deployed configuration adjacent the proximal portion of the collapsible medical implant; and
[0047]FIG. 10C illustrates a partially-sectioned schematic view of the medical device of FIG. 10A including the expandable component in a substantially-deployed configuration capturing the medical implant in a substantially-collapsed state.
DESCRIPTION
[0048] Embodiments of the present invention are described below. The invention is not limited to these embodiments, and various modifications to the disclosed embodiments are also encompassed by the invention. A medical device according to the invention can be used to manipulate a medical implant in a patient's body. In one embodiment, the medical device is used for capturing a medical implant in a patient such as, for example, a vascular distal protection filter or a cardiac septal occluder.
[0049] Referring to FIG. 1A, a medical device <b>100</b> according to the invention includes a sleeve <b>102</b>, an expandable component <b>104</b>, and an actuator <b>142</b>. The sleeve <b>102</b> includes a proximal end <b>106</b>, and a lumen <b>108</b> that extends longitudinally within at least a portion of the sleeve <b>102</b> and terminates at a distal end <b>110</b> of the sleeve <b>102</b>. The distal end <b>110</b> of the sleeve <b>102</b> has a circumference <b>112</b>. The expandable component <b>104</b> includes a first portion <b>114</b>, a second portion <b>116</b> and a third portion <b>118</b>. The first portion <b>114</b> of the expandable component <b>104</b> is permanently joined around the circumference of the distal end <b>110</b> of the sleeve <b>102</b> and includes a lumen <b>122</b>. The third portion <b>118</b> of the expandable component <b>104</b> is the portion that is closest to the proximal end <b>106</b> of the sleeve <b>102</b> when the expandable component <b>104</b> is in a collapsed state <b>120</b>, as illustrated in FIG. 1A. The intermediate or second portion <b>116</b> of the expandable component <b>104</b> extends between the first portion <b>114</b> and the third portion <b>118</b> and includes the lumen <b>122</b> that extends between the first portion <b>114</b> of the expandable component <b>104</b> and the third portion <b>118</b> of the expandable component <b>104</b>. The lumen <b>122</b> of the expandable component <b>104</b> includes a depth <b>124</b>.
[0050] In one embodiment according to the invention, the expandable component <b>104</b> is slideably moveable in the lumen <b>108</b> of the sleeve <b>102</b> transitioning between the collapsed configuration <b>120</b> through substantially deployed states illustrated in FIGS. 1B and 1C, to a fully-deployed configuration <b>126</b>, illustrated in FIG. 1D. In one embodiment, the actuator <b>142</b> reciprocatably slides the expandable component <b>104</b> between the collapsed configuration <b>120</b> and the fully-deployed configuration <b>126</b>, and any configuration between the collapsed configuration <b>120</b> and the fully-deployed configuration <b>126</b>, depending on the intended application of the medical device <b>100</b>. Alternatively, the actuator <b>142</b> may actuate the sleeve <b>102</b> reciprocatably while the expandable component <b>104</b> is stationary.
[0051] Referring to FIG. 1A, in the collapsed configuration <b>120</b>, the expandable component <b>104</b> is enclosed within the lumen <b>108</b> of the sleeve <b>102</b>. The expandable component <b>104</b> in the collapsed configuration <b>120</b> includes a lumen <b>122</b> with a depth indicated by arrow <b>124</b>. The depth <b>124</b> of the lumen <b>122</b> of the expandable component <b>104</b> decreases as the expandable component transitions from the collapsed configuration <b>120</b>, illustrated in FIG. 1A, to the fully-deployed configuration <b>126</b>, illustrated in FIG. 1D. In the fully-deployed state <b>126</b>, the depth <b>124</b> is almost nil or close to zero.
[0052] The configuration of the expandable component <b>104</b> when it transitions between the collapsed configuration <b>120</b> and the expanded configuration <b>126</b> is determined by the intended application of the medical device <b>100</b> in a patient's body. For example, for application of the medical device for capturing a medical implant, referring to FIGS. 1B and 1C, the expandable component <b>104</b> is configured between the collapsed configuration <b>120</b> and the fully-deployed configuration <b>126</b>. As the expandable component <b>104</b> is deployed, the third portion <b>118</b> of the expandable component <b>104</b> moves toward the distal end <b>110</b> of the sleeve <b>102</b>, pushing the second portion <b>116</b> of the expandable component <b>104</b>, which lies proximal to the first portion <b>114</b> when the expandable component <b>104</b> is in the collapsed configuration <b>120</b>, beyond the distal end <b>110</b> of the sleeve <b>102</b>. For example, referring to FIG. 1B, in an intermediate or partially-deployed configuration <b>128</b> of the expandable component <b>104</b>, the third portion <b>118</b> of the expandable component <b>104</b> moves in a proximal direction toward the distal end <b>110</b> of the sleeve <b>102</b>, resulting in at least a portion of the second portion <b>116</b> of the expandable component <b>104</b> extruded beyond the distal end <b>110</b> of the sleeve <b>102</b>. Referring now to FIG. 1C, a substantially-deployed configuration <b>130</b> of the expandable component <b>104</b> is illustrated. In this embodiment, the length of the extruded portion <b>132</b> of the expandable component <b>104</b> is greater than the length of the expandable component <b>104</b> that remains enclosed within the lumen <b>108</b> of the sleeve <b>102</b>. Referring to FIG. 1D, which depicts a fully-deployed configuration <b>126</b> of the expandable component <b>104</b>, the entire length of the expandable component <b>104</b> is extruded beyond the distal end of the sleeve <b>102</b>. The length of the extruded portion <b>132</b> of the expandable element <b>104</b> in the fully-deployed state <b>126</b> is the full length of the expandable element <b>104</b> within the lumen <b>108</b> of the sleeve <b>102</b> in the collapsed configuration <b>120</b>. The length of the extruded portion <b>132</b> of the expandable component <b>104</b> beyond the distal end <b>110</b> of the sleeve <b>102</b> is selected according to the intended application of the medical device <b>100</b> in the patient's body. <b>100531</b> Referring again to FIGS. 1A-1D, the length of the extruded portion <b>132</b> varies from none in the collapsed configuration <b>120</b>, illustrated in FIG. 1A, to increasing magnitude in the various deployed states illustrated in FIGS. 1B-1D, with the length of the extruded portion <b>132</b> being maximal in the fully-deployed configuration <b>126</b>, illustrated in FIG. 1D. For example, in one embodiment, the extruded portion <b>132</b> formed by the expandable component <b>104</b> is shaped and sized for capturing a medical implant such as a prosthetic occluder in a patient's body. Accordingly, the configuration of the expandable component <b>104</b> lies between the collapsed configuration <b>120</b> and the fully-deployed configuration <b>126</b>.
[0053] With continued reference to FIGS. 1A-1D, in one embodiment, the expandable component <b>104</b> has a pocket with a depth <b>124</b>. The first portion <b>114</b> of the expandable component <b>104</b> is open and has a rim <b>134</b> with a circumference <b>136</b>. The third portion <b>118</b> of the expandable component <b>104</b> is closed and has a base <b>138</b> forming the bottom of the pocket. The rim <b>134</b> of the expandable component <b>104</b> is joined to the distal end <b>110</b> of the sleeve <b>102</b> at a plurality of points about the circumference <b>136</b> of the rim <b>134</b>. For example, the rim <b>134</b> of the expandable component <b>104</b> may be joined to the distal end <b>110</b> of the sleeve <b>102</b> by an adhesive, sutures, crimping, or heat welding, for example. In one embodiment according to the invention, the circumference <b>136</b> of the rim <b>134</b> of the expandable component <b>104</b> is joined to the circumference <b>112</b> of the distal end <b>110</b> of the sleeve <b>102</b>.
[0054] In another embodiment according to the invention, referring now to FIG. 2A, the expandable component <b>104</b> may be a tube. The base <b>138</b> of the tubular expandable component <b>104</b> may be imperforate or perforate. For example, illustrated in FIG. 2A, the base <b>138</b> may surround a hole <b>140</b>. The hole <b>140</b> may be useful for axially slideable movement of, for example, a guide wire in the lumen <b>108</b> of the sleeve <b>102</b> and through the lumen <b>122</b> of the expandable component <b>104</b>. In a particular embodiment, illustrated in FIG. 2B, the expandable component <b>104</b> is tubular having a cylindrical shape with an open first portion <b>114</b> and an open third portion <b>118</b>. In yet another embodiment, illustrated in FIG. 2C, the expandable component <b>104</b> is funnel shaped having an open first portion <b>114</b> and an open or third portion <b>118</b>.
[0055] In all the foregoing aspects of the invention, the overall length of the medical device <b>100</b> is selected according to the intended application of the medical device <b>100</b> in the patient's body. The overall length of the medical device <b>100</b> depends on the specific blood vessel in the patient's body in which the medical implant is located. Generally, the overall length will be in the range of about 25 cm to about 175 cm. In one embodiment, the overall length of the medical device <b>100</b> is about 100 cm to about 150 cm, and preferably about 120 cm. Devices for different applications, or those intended for use with children, will be of different lengths.
[0056] The expandable component <b>104</b> of the medical device <b>100</b> may be made from a variety of materials that are flexible and largely atraumatic. Examples of such materials include, for example, polyester, nylon, and steel. In one embodiment, the expandable component <b>104</b> is a tube that is made from a braided material. The braided material can be manufactured in part or entirely from a plastic, a fabric, or a metal or any combinations of the above. In one embodiment, the braided material is made of a combination of polyester and steel. In a preferred embodiment, the steel is incorporated into the polyester. Generally, the ratio of steel to polyester in the braided material ranges from about 0.2 to about 0.5 and preferably about 0.25. The braided material can either be single-stranded or multi-stranded. The braided material can be formed as a mesh of individual filaments of materials such as, for example, polyester, polyethylene terephthalate or PET, polypropylene, nitinol, steel or any combinations of these materials. In a particular embodiment, the braided material is inverted over itself and secured to the distal end <b>110</b> of the sleeve <b>102</b>. In another embodiment, the expandable component <b>104</b> is a woven or elastomeric tube or sock. Suitable materials for the manufacture of the expandable component <b>104</b> in the form of an elastomeric tube include at least in part, for example, PEBAX (ATOFINA Chemicals, Inc., Philadelphia, Pa.), KRATON (Kraton Polymers, Houston, Tex.), C-Flex (silicone modified thermoplastic elastomers) (Consolidated Polymer Technologies, Largo, Fla.), polyurethane, expandable polytetrafluoroethylene or PTFE or any combinations of these materials. In yet another embodiment, the expandable component <b>104</b> is a cylindrical mesh. In a preferred embodiment, the expandable component <b>104</b>, in any configuration, includes a lubricious coating. Suitable materials for the manufacture of the lubricious coating include at least in part, for example, TEFLON (Dupont, Wilmington, Del.), a hydrophilic coating, polyethylene oxide, hydrogel or any combinations of these materials.
[0057] The maximum outer diameter of the expandable component <b>104</b> in the deployed configuration is dependent on its intended application inside a patient's body. The maximum outer diameter of the expandable component <b>104</b> in the deployed configuration must be no greater than the inside diameter of the blood vessel into which the medical device <b>100</b> is inserted. For example, to capture an intravascular distal protection filter, the outer diameter of the expandable component <b>104</b> in a substantially-deployed configuration <b>130</b> typically is in the range of about 4 mm to about 8 mm, preferably about 6 mm, whereas to capture an interatrial septal occluder, the outer diameter of the expandable component <b>104</b> in a substantially-deployed configuration <b>130</b> typically is in the range of about 17 mm to about 43 mm, preferably about 25 mm.
[0058] Similarly, the entire length of the expandable component <b>104</b> and accordingly, the length <b>132</b> of the expandable component <b>104</b> extruded beyond the distal end <b>110</b> of the sleeve <b>102</b> depends on the application of the medical device <b>100</b>. For example, the length of the extruded portion <b>132</b> in the fully-deployed configuration, which is equal to the full length of the expandable element <b>104</b>, typically is in the range of about 10 mm to about 30 mm, preferably about 25 mm when the medical implant intended to be captured is an intravascular distal protection filter, whereas the length of the extruded portion <b>132</b> in the fully-deployed configuration typically is in the range of about 25 mm to about 100 mm, preferably about 90 mm when the medical implant intended to be captured is an interatrial septal occluder.
[0059] Referring now to FIGS. 3A and 3B, in one embodiment according to the invention, the medical device <b>100</b> includes an elongate member <b>144</b> axially positioned and slideably moveable within the lumen <b>108</b> of the sleeve <b>102</b>. The elongate member <b>144</b> includes a distal end <b>146</b> and a proximal end <b>148</b>. In one embodiment, referring to FIG. 4A, the third portion <b>118</b> of the expandable component <b>104</b> is secured to the distal end <b>148</b> of the elongate member <b>144</b> and the rim <b>134</b> of the expandable component <b>104</b> is secured to the distal end <b>110</b> of the sleeve <b>102</b>, for example, in an end to end or overlapping fashion. A variety of conventional techniques can be used for securing the distal end <b>146</b> of the elongate member <b>144</b> to the third portion <b>118</b> of the expandable component <b>104</b> including, for example, heat fusing, adhesive bonding, chemical bonding or mechanical attachment.
[0060] With continued reference to FIGS. 3A and 3B, in one embodiment, the elongate member <b>144</b> may be reciprocatably and axially moveable within the lumen <b>108</b> of the sleeve <b>102</b>. For example, the elongate member <b>144</b> is axially moved distally until the expandable component <b>104</b> transitions from the collapsed configuration <b>120</b>, illustrated in FIG. 3A, to a substantially-deployed configuration <b>130</b>, illustrated in FIG. 3B. The expandable component <b>104</b> may be deployed into a shape suitable for capturing a medical implant by slideably moving the sleeve <b>102</b> distally relative to the expandable component <b>104</b>.t. In a particular embodiment, the expandable component <b>104</b> is deployed into a conical shape. The expandable component <b>104</b> may be deployed beyond the distal end <b>110</b> of the sleeve <b>102</b> into a shape suitable for capturing a medical implant by axial movement of the elongate member <b>142</b> relative to the sleeve <b>102</b>, or, alternatively, by relative sliding motion of the sleeve <b>102</b> relative to the expandable component <b>104</b>.
[0061] Referring now to FIG. 4A, in another embodiment of the medical device <b>100</b> in accordance with the invention, the elongate member <b>144</b> has a lumen <b>150</b>. In a further embodiment of the invention, the lumen <b>150</b> axially extends through the entire length of the elongate member <b>144</b>. In a particular embodiment, illustrated in FIG. 4A, the lumen <b>122</b> of the expandable component <b>104</b> is continuous with the lumen <b>150</b> of the elongate member <b>144</b>. The expandable component <b>104</b> may transition from the collapsed configuration <b>120</b>, illustrated in FIG. 4A, to the fully-deployed configuration <b>126</b>, illustrated in FIG. 4B, by axial movement of the elongate member <b>144</b> relative to the sleeve <b>102</b> beyond the distal end <b>110</b> of the sleeve <b>102</b>, or alternatively, by relative sliding motion of the sleeve <b>102</b> relative to the expandable component <b>104</b>. Referring to FIG. 4B, between the collapsed configuration <b>120</b> and the fully-deployed configuration <b>126</b>, the expandable component <b>104</b> is deployed into substantially-deployed configuration <b>130</b> that includes a shape suitable for capturing a medical implant. In a particular embodiment, the expandable component <b>104</b> has a conical shape for capturing a medical implant. In a further embodiment, a guide wire may be inserted via the proximal end <b>148</b> of the elongate member <b>144</b> through the lumen <b>150</b> of the elongate member <b>144</b> and advanced through the lumen <b>122</b> of the expandable component <b>104</b> beyond the distal end <b>110</b> of the sleeve <b>102</b>.
[0062] Referring now to FIG. 5A, in the substantially-deployed configuration <b>130</b>, the expandable component <b>104</b> is shaped and sized to accommodate the shape and size of the medical implant intended to be captured. In a particular embodiment, illustrated in FIG. 5A, the expandable component <b>104</b> is deployed into a conical shape. In yet another embodiment, referring now to FIG. 5B, the expandable component <b>104</b> has a generally circular cross-section.
[0063] Referring again to FIG. 5A, in one embodiment, the expandable component <b>104</b> includes flexible support arms <b>152</b> that provide increased rigidity to form the framework for the shape assumed by the expandable component <b>104</b> when at least a portion of the expandable component <b>104</b> is extruded beyond the distal end <b>110</b> of the sleeve <b>102</b>. The arms <b>152</b> may be manufactured from a wire, such as spring wire. Referring now to FIG. 5C, the flexible support arms <b>152</b> occupy a reduced dimension in the radial direction when they are collapsed within the expandable component <b>104</b> in the collapsed configuration <b>120</b>. Referring again to FIG. 5A, when the expandable component <b>104</b> is deployed beyond the distal end <b>110</b> of the sleeve <b>102</b>, the flexible support arms <b>152</b>are released and spring outward to form the framework for the shape of the expandable component <b>104</b> in a deployed position.
[0064] The sleeve <b>102</b> is manufactured from biocompatible materials suitable for use inside a patient's body without causing damage to the vasculature. Suitable materials for the manufacture of the sleeve <b>102</b> include synthetic polymers such as polyethylene, polyurethane, polyglycolic acid, polyesters, polyamides, and mixtures, blends, copolymers thereof and any combinations of these materials. Preferred materials include polyesters such as polyfluorocarbons such as polytetrafluoroethylene (PTFE) with and without copolymerized hexafluoropropylene, and porous or nonporous polyurethanes. Especially preferred are the expanded fluorocarbon polymers.
[0065] Included in the class of preferred fluoropolymers are polytetrafluoroethylene (PTFE), fluorinated ethylene propylene (FEP), polyethylene terephthalate (PET), copolymers of tetrafluoroethylene (TFE) and perfluoro (propyl vinyl ether) (PFA), homopolymers of polychlorotrifluoroethylene (PCTFE), and its copolymers with TFE, ethylene-chlorotrifluoroethylene (ECTFE), copolymers of ethylene-tetrafluoroethylene (ETFE), polyvinylidene fluoride (PVDF), and polyvinyfluoride (PVF).
[0066] Referring to FIG. 6, the outer diameter <b>154</b> of the sleeve <b>102</b> and the inner diameter <b>156</b> of the lumen <b>150</b> of the elongate member <b>144</b> depend on the application inside a patient's body for which the medical device <b>100</b> is intended. For example, for capturing or delivering an intravascular distal protection filter, the outside diameter <b>154</b> of the sleeve <b>102</b> typically is in the range of about 0.4 mm to about 2.0 mm, preferably about 0.5 mm, and the inner diameter <b>156</b> of the elongate member <b>144</b> typically is in the range of about 0.2 mm to about 1.5 mm, preferably about 0.3 mm. Alternatively, for capturing or delivering a septal occluder, the outside diameter <b>154</b> of the sleeve <b>102</b> typically is in the range of 2 mm to about 6 mm, preferably about 5 mm, and the inner diameter <b>156</b> of the elongate member <b>144</b> typically is in the range of about 1.7 mm to about 5 mm, preferably about 4 mm.
[0067] The elongate member <b>144</b> can be made from a variety of materials and configurations. In one embodiment, the elongate member <b>144</b> is made from the same material as the sleeve <b>102</b>. In another embodiment, the elongate member <b>144</b> and the sleeve <b>102</b> are manufactured from different materials. Suitable materials for the manufacture of the elongate member <b>144</b> include, for example, synthetic polymers such as polyethylene, polyurethane, polyglycolic acid, PEBAX (ATOFINA Chemicals, Inc., Philadelphia, Pa.), polyesters, polyamides, and mixtures, blends, copolymers thereof, and any combinations of these materials.
[0068] In one embodiment, the sleeve <b>102</b> may be coated with a radio-opaque material that enables a health care practitioner to track the medical device <b>100</b> of the invention by an imaging device while the medical device is used in a patient. In another embodiment, the flexible support arms <b>152</b> may be coated with a radio-opaque material, which enables a health care practitioner to visualize the expandable component <b>104</b> by an imaging device as the operator tracks and maneuvers the expandable component <b>104</b> between the collapsed configuration <b>120</b> and the deployed configurations during a medical procedure to capture or position a medical implant in a patient's body.
[0069] In another aspect, the invention is a method for manipulating, for example, for delivering or capturing a medical implant in the body of a patient using the medical device <b>100</b> according to the invention. For example, referring now to FIGS. 7A-7C, in one embodiment according to the invention, the medical device <b>100</b> includes a guide wire <b>158</b> for delivering or capturing a medical implant <b>160</b> in a patient's body. In a particular embodiment, the medical implant <b>160</b> is an intravascular distal protection filter that includes a central lumen <b>162</b> through which the guide wire <b>158</b> may be advanced.
[0070] Referring now to FIG. 7A, according to the method of the invention, a health care practitioner inserts the guide wire <b>158</b> into the medical device <b>100</b> via the proximal end <b>148</b> of the elongate member <b>144</b>. The guide wire <b>158</b> is advanced proximally through the lumen <b>150</b> of the elongate member <b>144</b>, the lumen <b>150</b> of the elongate member <b>144</b> being continuous with the lumen <b>122</b> of the expandable component <b>104</b>.
[0071] Referring now to FIG. 7B, according to one embodiment of the invention, the guide wire <b>158</b> is advanced through the lumen <b>150</b> of the elongate member <b>144</b> into the lumen <b>122</b> of the expandable component <b>104</b>. The medical device <b>100</b> is positioned relative to the medical implant <b>160</b> in the patient's body such that the lumen <b>162</b> of the medical implant <b>160</b> is aligned with the lumen <b>122</b> of the expandable component <b>104</b>. With continued reference to <b>7</b>B, in one embodiment, the guide wire <b>158</b> is advanced through the lumen <b>162</b> and beyond the distal portion of the medical implant <b>160</b>.
[0072] The guide wire <b>158</b> may be used for positioning the medical implant <b>160</b> relative to the medical device <b>100</b> to capture the medical implant <b>160</b> with the medical device <b>100</b>, as well as for removal of the medical implant <b>160</b> from the patient's body. For example, the expandable component <b>104</b> of the medical device <b>100</b> is moved from the collapsed position <b>120</b>, illustrated in FIG. 7A, to the substantially-deployed position <b>130</b> illustrated in FIG. 7C, for subsequent capture of the medical implant <b>160</b>. In a particular embodiment, illustrated in FIG. 7C, the expandable component <b>104</b> is deployed beyond the distal end <b>110</b> of the sleeve <b>102</b> to form a conical shape for capturing a medical implant. Referring to FIG. 7C, the expandable component <b>104</b> in the deployed position surrounds and captures the medical implant <b>160</b>. The guide wire <b>158</b> is removed along with the medical device <b>100</b> from the patient's body, thereby retrieving the medical implant <b>160</b> from the patient's body.
[0073] Referring now to FIG. 8A, in another embodiment of the method of the invention, the medical device <b>100</b> may be used to insert or capture a medical implant having a guidewire <b>158</b> attached at its proximal end <b>166</b>. Referring to FIG. 8B, the medical device <b>100</b> is positioned relative to the medical implant <b>160</b> such that the distal end <b>110</b> of the sleeve <b>102</b> is aligned with the free end <b>168</b> of the guide wire <b>158</b>. In this embodiment, the guide wire <b>158</b> enters the medical device <b>100</b> at the distal end <b>110</b> of the sleeve <b>102</b> via the lumen <b>122</b> of the expandable component <b>104</b> which is continuous with the lumen <b>150</b> of the elongate member <b>144</b>. Referring to FIG. 8C, the medical device <b>100</b> is advanced over the guide wire <b>158</b> or the guide wire <b>158</b> is advanced into the distal end <b>110</b> of the sleeve <b>102</b> of the medical device <b>100</b> until the medical device <b>100</b> is adjacent the medical implant <b>160</b>. The elongate member <b>144</b> is distally moved to deploy the expandable component <b>104</b> into a substantially-deployed configuration <b>130</b> beyond the distal end <b>110</b> of the sleeve <b>102</b>, for capturing the medical implant. The expandable component <b>104</b> may also be deployed by distally moving the sleeve relative to the expandable component.
[0074] Referring now to FIG. 9, in a particular embodiment according to the invention, the medical device <b>100</b> may be used to capture a distal protection filter <b>170</b> in a patient's body. A distal protection filter is a medical implant used for capturing embolic material that is dislodged during a medical procedure such as, angioplasty. While retrieving the distal protection filter <b>170</b>, the expandable component <b>104</b> of the medical device <b>100</b> covers the pores <b>172</b> on the proximal portion <b>174</b> of the distal protection filter <b>170</b> thereby preventing the egress of embolic debris from the distal protection filter <b>170</b> during angioplasty.
[0075] Referring to FIGS. 10A-10C, in one embodiment according to the invention, the medical device <b>100</b> is used for capturing a collapsible medical implant <b>178</b> inside a patient's body. The medical device <b>100</b> is positioned relative to the collapsible medical implant <b>178</b>, as illustrated in FIG. 10A, such that the distal end <b>11</b>O of the sleeve <b>102</b> is aligned with the proximal end <b>180</b> of the collapsible implant <b>178</b>. In one embodiment, the maximum diameter of the collapsible medical implant <b>178</b> in an uncollapsed state <b>182</b> is greater than the maximum diameter <b>154</b> of the lumen of the sleeve <b>102</b>.
[0076] Referring to FIGS. 10B-10C, the sleeve <b>102</b> is slideably moved relative to the expandable element <b>104</b>, deploying the expandable component <b>104</b> beyond the distal end <b>110</b> of the sleeve <b>102</b>. As the expandable component <b>104</b> transitions between the collapsed configuration, illustrated in FIG. 10A, and the substantially-deployed configuration, illustrated in <b>10</b>C, the extruded portion of the expandable component <b>104</b> radially compresses the medical implant <b>178</b>, leading to collapse of the medical implant <b>178</b>. The maximum diameter of the medical implant <b>178</b> decreases as the medical implant <b>178</b> transitions from the uncollapsed state <b>182</b> illustrated in FIG. 10A to the substantially-collapsed state <b>184</b>, illustrated in FIG. 10C
[0077] In all the foregoing aspects of the invention, a health practitioner can use a medical device <b>100</b> for the capture of medical implants used in the treatment of septal and atrial defects such as patent foramen ovale (PFO) and left atrial appendage (LAA).
[0078] In all the foregoing aspects of the invention, a health care practitioner can insert a medical device <b>100</b> of the invention inside a patient's body by a variety of means known in the art, including, for example, a catheter or a guide wire. In one method according to the invention, a health care practitioner inserts a medical device <b>100</b> of the invention via a catheter inside a patient's body. Following the insertion of the medical device <b>100</b> into the patient's body using a catheter, the expandable component <b>104</b> of the medical device <b>100</b> is deployed beyond the distal end of the catheter in the proximity of the medical implant to be captured inside the patient's body. The medical implant is captured by the expandable component <b>104</b> in the deployed configuration. Subsequent to the capture of the medical implant, both the medical device <b>100</b> and the captured medical implant are withdrawn into the larger bore diameter of the catheter for removal from the patient's body.
[0079] Other embodiments incorporating the concepts disclosed herein are within the spirit and scope of the invention. The described embodiments are illustrative of the invention and not restrictive.
Contents5
12 sheets
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Numbers
- Publication, DOCDB
- 2004181237
- Publication, EPODOC
- US2004181237
- Application
- 10386828
- Application, DOCDB
- 38682803
- Application, EPODOC
- US20030386828
Titles
- English
- Medical device for manipulation of a medical implant
Classification
- CPC, 11
- A61F2/95
- A61B17/12122
- A61B17/12172
- A61B2017/00575
- A61B2017/00601
- A61B2017/00623
- A61F2/011
- A61F2/013
- A61F2002/011
- A61F2002/9528
- A61F2230/0006
- IPC, 4
- A61B17 00
- A61F2 01
- A61F2 06
- A61F2 84
- USPC, 2
- 606108000
- 623001110