CN101072601B - 用于向皮下插入导联电极组件的工具及其成套件 - Google Patents
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Abstract
本发明涉及用于电极植入的装置和方法。第一个实施例包括可在组织中形成通道的电极插入工具,其远端与导联相连,因此当取出电极插入工具时,导联可被拉入所形成的通道间隙中。其它实施例包括用以插入电极/导联组件的方法,其中,插入工具首先被用来在组织中形成通道,然后用来将电极/导联拉入所形成的通道间隙中。在还有一个实施例中,插入工具接着又被装上可分裂式鞘套,并被用来在组织中形成另外一个路径,然后将插入工具取出,而使鞘套留在原位;将导联插入鞘套中,最后从导联上面取下可分裂式鞘套。
Description
技术领域
本发明涉及包括电极植入的医学治疗领域。更具体地说,本发明涉及用于心脏治疗的电极植入或插入的领域。
背景技术
使用可植入式起搏器和去纤颤器来治疗或预防各种心脏问题已经变得较为普遍。这类治疗的一些困难与电极的放置和使用寿命有关。一般来说,在插入时动作必须熟练、小心和轻柔以避免损坏导联(lead)和/或电极。在放入之后,导联可能因承受心脏搏动和病人运动所产生的重复应力而断裂。导联和电极还可能偏离其所要求的位置。
对于经静脉的植入来说,通常是在荧光透视的帮助下推进导联穿过静脉到达心脏或其附近的位置。接着将导联固定到心脏组织或者用被动锚定机构比如尖齿来防止导联移动。心脏组织将会在导联周围形成,从而衰减感测到的信号,并改变起搏和/或去纤颤的阈值。由于植入需要穿越脉管系统以及在心脏内放置和固定,因此可能产生许多问题。
许多导联插入技术将导联推动到组织中的位置或者推动导联穿过脉管系统。推动导联会使导联受力因而可能引起导联破坏。对于脉管植入,设有通道但受制于狭窄和急弯。非脉管植入要求穿透现有的组织。尽管另加的硬度可有助于导联插入和精确放置,但是,较硬的导联产生其自身的问题如移位、穿孔和断裂。当硬度增大时,导联无意中刺穿组织的可能性增大。而且,如果具有额外的硬度,导联在肌肉运动时就不能保持在原位,会增大任何有关纤维瘤的尺寸,并且有可能产生移位。
发明内容
本发明的第一个实施例包括一种用于植入导联电极组件的工具。这种工具可以包括手柄和较为刚性的轴杆,轴杆具有近端和远端,其中手柄固定在轴杆的近端。轴杆的远端包括可以用来连接到导联电极组件上的连接机构。当使用时,连接机构使得工具在被推进穿过组织之后能够固定到导联电极组件上。在这样固定之后,工具能够拉动或推动导联电极组件穿过已经用工具形成通道的那部分组织。
轴杆还可以设有从手柄中的端口或套筒(比如Luer套筒)向远端延伸的管腔。于是轴杆可以包括输液端口,用于在植入过程中将被迫通过管腔的流体注入到组织中。在一示例性实施例中,输液端口和管腔用来在植入过程中注入局部麻醉剂如利多卡因。
连接机构可以是缝合线孔的形式,使得缝合线能够从中穿过。在一优选实施例中,输液端口通往缝合线孔。轴杆可以是直的,也可以包括弯曲部分,或者可以构成弯曲弧段。在一实施例中,轴杆的曲率近似于病人下胸腔的曲率。轴杆还可以是能够成形的,因此用户能够使轴杆的形状适合于人体选定部分如病人胸腔的形状。
在另一实施例中,提供了一种电极插入工具成套件,这种工具成套件包括用于插入电极的工具以及可与工具一起使用的可分裂式鞘套。工具可以具有上述一个或多个部件。可分裂式鞘套的尺寸优选做成能够适贴地套在工具上。这种工具成套件还可以包括一个以上直的和弯的插入工具、用于连接到这一个或多个插入工具上的输液管组、以及用于改造或调整插入工具形状的成形工具。
还有一些实施例包括用于向皮下将电极和导联插入病人体内的方法。在一个这样的实施例中,第一和第二切口在间隔开的位置形成。具有近端和远端的插入工具通过第一切口插入,并在皮下朝第二切口推进。插入工具的远端可以通过第二切口穿出。接着将电极/导联组件连接到插入工具的远端,并经由与插入时相同的路径取出插入工具。当取出插入工具时,电极/导联组件被拉到病人的皮下。在另一个可供选择的实施例中,插入工具的远端并没有从第二切口穿出,而只是使该远端靠近切口,使得能够将电极/导联组件连接到那里。
在还有一个实施例中,通过第一切口将插入工具完全取出,直至电极/导联组件上与插入工具相连的部分被拉动穿过第一切口。接着经过第一切口将插入工具插入,并在皮下沿不同于第二切口的方向推进插入工具。优选的是,插入工具的推进方向相对于第一和第二切口的连线形成相当大的角度。然后取出插入工具,并通过由插入工具形成的路径推进电极/导联组件。
在还有一个实施例中,至少在通过第一切口第二次插入时,插入工具上面带有鞘套。在插入工具和鞘套被插入到所要求的程度之后,将插入工具取出,使鞘套留在原位。接着将电极/导联组件插入鞘套至所要求的程度。最后,取出鞘套。优选的是,这种鞘套包括薄弱轴线,或者是一个可分裂式鞘套,使得能够从电极/导联组件上取下鞘套,而不会损坏或移动组件。
附图说明
图1示出了包括若干部件的电极插入工具成套件的透视图;
图2A-2B示出了直的电极插入工具的透视图和剖视图;
图3A-3B示出了弯的电极插入工具的透视图和剖视图;
图4A-4C示出了电极插入工具手柄的详细剖视图;
图5A-5B详细示出了电极插入工具顶端的透视图和剖视图;
图6A-6C示出了导联电极组件的透视图和细节图;
图7示出了插入工具弯曲装置的透视图;
图8示出了输液管组的局部透视图;
图9A-9B分别示出了结合在一起的插入工具和可分裂式鞘套,以及单独的可分裂式鞘套;
图10示出了病人身体上示例性切口的相对位置;
图11A-11J示出了电极插入的示例性方法;和
图12A-12B示出了不同传感器布置方式的若干方面。
具体实施方式
下面参考附图加以详细说明。这些附图不一定是按比例的,只是示出了说明性的实施例,因而不能用来限定本发明的范围。
应当注意到用语“导联”和“导联电极组件”当在这里使用时代表不同的意义,其中导联电极组件是连接在一起的导联和电极。Bardy等人的美国专利申请No.09/940,377通过引用而结合于本文中。Bardy等人提出了用以插入包括皮下容器和电极的去纤颤器的方法,并说明了皮下去纤颤器和方法的其它细节。
图1示出了包括若干部件的导联电极组件插入工具成套件的透视图。工具成套件10包括直的插入工具20、弯的插入工具40、弯曲工具100和输液管组110。工具成套件10还可以包括如图9A-9B中示出的可分裂式鞘套(但在这里未示出)。在一些用作说明的实施例中,插入工具20、40包括用不锈钢管制成的细长轴杆,并带有塑料手柄,不过,如果有需要的话,其中任何一个部分也可以使用其它材料制成。输液管组110通常包括可弯曲的聚合物管形件,不过这并不是必需的。弯曲工具100可用来调节插入工具20、40的形状,尽管这同样不是必需的。这些部件的细节特征在下面进一步介绍。
图2A-2B示出了直的电极插入工具的透视图和剖视图。参考图2A,工具20在其手柄26的远侧大体上是直的,并包括轴杆部分22,轴杆部分22优选足够刚性,以便能够推动至远端24而形成穿过组织的路径。在一些实施例中,较为坚硬的金属件如不锈钢轴杆被用作轴杆部分22。轴杆22固定到手柄26的近端附近,在那里设有一个Luer连接器28。
轴杆22的远端24示出了若干个连接机构,包括凹槽30和缝合线孔32。举例来说,凹槽30可以是径向沟槽,使得能够用活结固定细丝如缝合线。缝合线孔32使得细丝或缝合线能够从中穿过然后系在那里。工具的末端还可以具有特殊的几何形状,以连接特定的电极。
参考图2B,所示工具20被切开或剖视,可以看到轴杆22从手柄26中穿过。轴杆22构成一个管腔34,它从Luer连接器28延伸到通往缝合线孔32的输液端口。手柄26可以以任何适当的方式连在轴杆22上,比如用粘结剂、机械固定装置(即配对螺纹、槽口等)、热熔接、或者通过将手柄26外覆模制到轴杆22上。为任何这样一种连接方式提供额外机械强度的一个方法是,在手柄26下面的轴杆22中设置偏置弯管36。
图3A-3B示出了弯的电极插入工具的透视图和剖视图。其构造特征与图2A-2B中的那些类似。参考图3A,工具40具有渐变或平滑的弯曲部分,其可以选择成或者成形成符合病人的人体构造。具体地说,在优选实施例中,弯曲部分被选择成对应于病人肋骨的弯曲度,使得沿病人胸部穿过病人皮下的间隙时,能够形成较少的创伤。
工具40包括轴杆部分42,它优选足够刚性,以便能够推动至远端44而形成穿过组织的路径。在一些实施例中,较为坚硬的金属件如不锈钢轴杆被用作轴杆部分42。轴杆42固定到手柄46的近端附近,在那里设有一个Luer连接器48。除了金属件之外,还可以使用能够推得动的聚合物件,或者可以使用包括聚合物层和编织支承结构的编织轴杆件。
轴杆42的远端44示出了两个连接机构,包括凹槽50和缝合线孔52。举例来说,凹槽50可以是径向沟槽,使得能够用活结固定细丝如缝合线。缝合线孔52使得细丝或缝合线能够从中穿过然后系在那里。在另一实施例中,缝合钉可以穿过孔52,因此可以使用手术钉合器而不是用手对缝合线进行捆绑或打结。
参考图3B,图中示出了工具40的剖面或剖视图,轴杆42从手柄46中穿过。轴杆42构成一个管腔54,它从Luer连接器48延伸到通往缝合线孔52的输液端口。手柄46可以以任何适当的方式固定到轴杆42上,比如用粘结剂、机械固定装置(即配对螺纹、槽口等)、热熔接、或者通过将手柄46外覆模制到轴杆42上。用以提高结合机械强度的一种方法是,在手柄46下面的轴杆42中设置偏置弯管56。
图4A-4C示出了电极插入工具手柄的详细剖视图。电极插入工具手柄60可以对应于图2A-2B和3A-3B中所示的手柄26、46。手柄60包括Luer端口62,以便能够到由轴杆66构成的管腔。如图4B中所示,Luer端口/阀62包括可固定到如输液装置上的近端固定部分70和可固定到轴杆66上的远端固定部分72。
在所示实例中,可以注入局部麻醉剂如利多卡因。也可以注入其它麻醉剂、抗感染药物、或设计/被选择用来防止或限制肿胀或其它组织损伤反应的药物。提供用以限制组织损伤反应药物的优点是可以限制在植入导联周围任何组织生长的尺寸。另一种方法是,比如为了确保导联的良好固定,可以提供设计成能使局部组织损伤反应达到最大的物质。而且,某些组织粘合剂也可以通过管腔输送。
如图4A和4C中所示,手柄主要部分64可以被设计成具有扁平的一侧和较宽的一侧。这种设计有助于医生/执业医师在用轴杆66形成通道和拉动时握紧装置,除此之外,还能为图4A中所示的偏置弯管68提供空间。轴杆66的偏置弯管68有助于将轴杆66固定在手柄主要部分64中。根据本发明,可以使用其它手柄设计方案。
图5A-5B详细示出了电极插入工具顶端的透视图和剖视图。顶端80可以对应于图2A-2B和3A-3B中所示的远端24、44。顶端80包括“子弹”形状的圆端82,用以在组织层之间穿行而避免穿透组织层。在一优选实施例中,圆端82是锥形的,使得能够穿入皮下脂肪组织,而不会刺穿皮肤。此外还包括两个示例性的连接机构,包括缝合线孔84和径向沟槽86,使得能够用比如活结来固定缝合线。
在图5B中还示出了带有末端82、缝合线孔84以及凹槽86的顶端80。图5B中还示出了终止于输液端口的管腔88,输液端口朝横向开口穿过缝合线孔84。利用这种结构,缝合线孔84起到两个作用,既可作为连接机构又可作为输液端口的延伸。管腔88延伸穿过轴杆的其余部分(未示出)至手柄及Luer阀,如图2A-2B和3A-3B中所示的那样。
图6A-6C示出了导联电极组件的透视图和细节图。所示导联电极组件90具有若干个电极,包括一个线圈电极(coil electrode)92和两个感测电极(sense electrode)94。组件90具有远端96。如图6A以及图6B中进一步所示,远端96可以包括缝合线孔98,不过也可以使用其它任何一种连接机构,比如图5A-5B中所示的径向凹槽或图6C中所示与末端96′结合的挂钩/槽口98′。对于径向凹槽86或挂钩/槽口98′来说,通过将一圈缝合材料(比如细绳)缚紧到凹槽86或挂钩/槽口98′中,可以使缝合材料或缝合钉固定到远端96、96′上。包括一个线圈电极92和两个感测电极94的导联电极组件只是作为可借助于本发明的方法/装置插入的导联电极组件的一个例证。
图7示出了插入工具弯曲装置的透视图。弯曲装置100包括由间隙104隔开的柱子102。为了使装置比如图2A-2B或3A-3B中所示插入工具20、40的轴杆弯曲,可以将选定装置的轴杆穿过间隙104并相对于弯曲工具100转动,于是柱子102能够以不同的弯曲程度对装置重塑形状。这么做可以使选定的插入工具更加精确地符合病人的人体构造。柱子102可以被修改而包括盖帽、槽口、凹槽、挂钩、悬臂或类似的构造,用以保持穿过间隙104的装置以防止其脱落。
图8示出了输液管组的局部透视图。管组110可以与图2A-2B或3A-3B中所示的其中一个插入工具20、40一起使用。管组110被用来作为一个可弯曲的延伸部分,使得能够容易地将输液装置连接到所选定插入工具的Luer阀上。管组110包括第一和第二连接器112、114以及在它们之间的可弯曲的管状轴杆116。
图9A-9B分别示出了结合在一起的插入工具和可分裂式鞘套,以及单独的可分裂式鞘套。图9A示出了具有手柄152和延伸至远端156的轴杆154的插入工具150,并带有布置在它上面的可分裂式鞘套158。可分裂式鞘套158在尺寸上设置成能够适贴地套在轴杆154上,并且优选比轴杆154更短,使得远端156能够伸出到可分裂式鞘套158以外。
如图9B中进一步所示,可分裂式鞘套158具有近端手柄部分160和远端162。远端162可以是渐缩形的或变细的,因此在插入到组织中时不会有前“凸肩”。优选的是,可分裂式鞘套158足够细,使其远端162在插入时不会产生非常大的阻力,因而不需要进行修磨或作类似的处理。
或者,尽管未在图9A中示出,但是,插入工具150在其远端附近可以包括朝向近端的凸缘,用以承接可分裂式鞘套158的远端。这种朝近端的凸缘可以这样形成,即把可分裂式鞘套158预先装到轴杆上,然后提供一个能够固定(比如通过加热、焊接或粘结)到轴杆远端上的重叠的或单独的末端。在另一实施例中(同样参考图9B),可分裂式鞘套158的远端162可以修磨光滑,以消除远端凸肩。可分裂式鞘套158还包括纵向薄弱部位164,用以裂开手柄部分160,纵向薄弱部位164还朝远端162延伸,使得能够裂开鞘套本身。
图10示出了在一示例性的操作过程中病人身体上切口的相对位置。所示病人200具有正中平面202和粗略示出的心脏204。同样较为粗略近似地示出了切口位置包括第一切口206和第二切口208。切口206、208优选都在病人200的同一根肋骨之上或者在同一对肋骨之间。每个切口应足够深使得能够接触到皮下组织,但优选不要进一步延伸到病人200体中。这样的切口可以形成在病人的任何肋骨之上,但优选形成在病人的第三和第十二根肋骨之间。在另一优选实施例中,从第一切口到第二切口的线至少部分沿着乳房下的皱襞。而且第二切口优选形成在左腋前线区域。虽然这些是目前优选的位置,但是,每个切口的具体位置在本发明的范围之内可以有很大变化。
图11A-11J示出了电极插入的示例性方法。图11A示出了在病人200中形成第一切口206和第二切口208之后的第一步。还注意到在病人200的皮下区域中已经形成袋囊(pocket)207。袋囊207可以这样形成,即通过第二切口插入套管针然后用套管针分开组织层,来构成皮下袋囊207,或者利用手动钝器解剖法来接受可植入式装置。插入工具210(图中示出在它上面包括可分裂式鞘套218)即将通过第一切口206插入。如图11B中所示,从第一切口206朝第二切口推进插入工具210并使其穿过第二切口,沿此路径形成穿过皮下组织的通道。尽管图中示出了远端212被推进到穿过第二切口208,但这一插入程度并不是必须的。插入工具210被推进到能够从切口208外面接触到插入工具210的远端212上的连接机构时就足够远了。为了便于说明,图11B中示出的连接机构包括缝合线孔216。在这一插入和形成通道的过程中,局部麻醉剂比如利多卡因或类似的液体可以通过Luer套筒214输入,然后穿过插入工具210中的管腔。
如图11C中所示,下一步包括利用缝合线环224将导联电极组件220的远端连接到插入工具210的远端212,其中缝合线环224穿过插入工具210中的缝合线孔216以及导联电极组件220上的对应缝合线孔222。所示的示例性导联电极组件220的上面带有两个感测电极和一个电击电极;这种构造方式只是作为导联电极组件的一个示例,应用本发明时不必限于这样的导联电极组件。
除了缝合线孔216、222之外,还可以使用如上面所示出的其它连接机构如挂钩或径向凹槽。也可以使用磁性、螺纹型、锁珠、卡扣配合或其它类型的连接方式,但是为了便于说明,在这里并没有示出磁性、螺纹型、锁珠、卡扣配合的连接方式。连接机构只要能够将插入工具的远端连接到另一个器件比如导联电极组件上就足够了。有利的是,缝合线孔、挂钩或径向凹槽使得能够利用容易得到(和结实)的缝合材料或缝合钉来实现较为简单和可靠的连接。尤其是,固定缝合线或缝合钉较为简单。对于缝合线来说,可以使用任何类型的结扣,从简单的活结到许多更加坚固和更加复杂的结扣。取下也是简单、容易和十分安全的,只需切断缝合线/缝合钉224。
现在参考图11D,图中示出了下一步,其中插入工具210通过第一切口206被取出,利用缝合线224和缝合线孔216、222将导联电极组件220拉入由插入工具210在切口206、208之间形成的通道中。如图所示,这一步骤一直进行到至少能够从病人体外够到缝合线224。
在本发明的一个实施例中,所述方法可以到此为止。对于被拉到切口206、208之间路径中的导联电极组件220,其尺寸被设计成可以使连接到导联电极组件220近端的容器230被拉入袋囊207中。接着切断缝合线224并缝合切口206、208,于是就装置放入而言,植入基本上完成。由于在形成通道之后导联电极组件220是被拉入到位而不是被送入或推入到位的,所以导联电极组件220上的应力减小。而且,通过从一明确位置的第一切口206向另一明确位置的第二切口208推进,能够严格控制这样确定的路径的两端。因此,能够避免放置不准确的问题。
另一个可供选择的实施例在图11E-11J中继续。在图11D的步骤之后,如图11E中所示,导联电极组件220被拉动更大的距离,使得能够接触到它的远端222。导联电极组件220可以拉到足够远,使其离开第一切口206一定的量。接着,如图11F中所示,将带有可分裂式鞘套218的插入工具210重新插入第一切口206中,这一次的方向与前面的不同。在另一个备选的实施例中,在图11A-11E所示步骤中使用的第一种插入工具优选是弯的,而在图11F-11J中使用的第二种插入工具优选是直的,可分裂式鞘套只用于直的插入工具。
如图11G中所示,通过第一切口206朝位于第一切口的靠头部一侧(指向病人头部)的选定点或位置×232将插入工具210插入。优选的是,从第一切口206画到第二切口208的线相对于从第一切口画到位置×232的线形成一定的角度θ,角度θ在大约20至160度之间。更为优选的是,角度θ在75至105度的范围之内,并且为大约90度。
在插入工具210已经插入所要求的距离后,而且还能从病人外面接触到可分裂式鞘套218时,将插入工具210取出而将可分裂式鞘套218留在原位,如图11H中所示。接着,将导联电极组件220的远端引导到可分裂式鞘套218中,还是在图11H中示出。在导联电极组件220被引导到可分裂式鞘套218中所要求的距离之后,可以通过抓住手柄234并撕开鞘套将可分裂式鞘套218取出,如图11I中所示。在这一点上,如图11I中所示,导联电极组件220优选沿纵向深入病人足够远,使得容器230能够通过切口208进入袋囊207而位于病人200内。如图11J所示,接着封闭切口206、208,使导联电极组件220和容器230被完全植入。在此之后,植入完成,可以使用各种方法来“激活”和/或编排容器230的动作,而且无论是哪一种用于起搏和/或去纤颤的电子装置,都可以容纳在里面。
图11J中所示电极组件植入方式的一个优点是,导联电极组件220上的电极以一种新的方式相对于容器230对准。在现有技术的装置中,容器230往往与导联电极组件上的电极大致在同一直线上。容器230上的电极可以偏离导联电极组件的轴向方向,使得能够有某些小的角度变化,以换取电极之间距离的减少。即使有两个以上的感测电极,但是,由不同感测电极对收到的信号也将很少变化,因为在同一直线上的电极除了紧靠在一起的电极对之外,一般来说不会接收远场中十分不同的信号,因而不管怎样都会产生不良的信号。象图11J中所示那样插入的组件能够使导联电极组件220远端上的多个传感器连同至少一个容器电极在角度方向上产生更宽的变化,而不需要接近容器和电极之间的距离。
图12A-12B进一步示出了几个相关的传感器特性。应当认识到,至少对于心脏中电活动的远场感测来说,平行的传感器对能够接收高度相关的信号。在短距离上,沿同一直线的两个以上的传感器所能获得的很少。给定如图12A中所示并定向的感测导联电极组件和容器装置,就可能产生无用的信号感测的问题。
给定容器300上的传感器X,以及导联电极组件302上的传感器Y和Z,当要求备用感测最大时,会产生主要的困难。具体地说,如果第一传感器对XY之间感测到最小的信号,那么传感器对YZ以及传感器对XZ将收到类似的最小信号,因为三个电极在同一直线上。如果收到的最小信号太接近于噪声层,那么传感器将不能产生足够的数据用以可靠的QRS探测,更不用说为起搏或去纤颤提供足够的有用信息了。即使X偏离导联电极组件302的直线,传感器对XY、XZ和YZ之间的角度差也很小。
如图12B中所示,连接到容器310上的导联组件312上的三个传感器X、Y和Z构成三个传感器对矢量314、316和318,它们之间的角度为α、β和γ。当电极X、Y和Z大致上不在同一直线上时可以避免上述问题,如图中所示。角度α、β和γ都较大,每个角度大于大约十五度。如果使用垂直的感测对,那么当其中一对收到最小的信号时,另一对收到最大的信号。虽然XY、XZ和YZ的矢量不完全垂直,但是,它们偏离同一直线的程度足以消除因图12A所示布置所产生的问题。当最需要传感器备用时(一对传感器接收到最小信号),图12B中的构造或布置方式能够提供非常好的备用。
在另一个实施例中(依靠另一种形式的分析),插入方法是这样进行的,即,使得三个传感器构成与心脏部分相交的平面。在还有一个实施例中,传感器是这样放置的,即,使得传感器对矢量之间的至少一个角度大于30度。更为优选的是,传感器对矢量之间的至少一个角度大于大约60度,而最为优选的是,传感器对矢量之间的至少一个角度大约在70-90度范围之内。注意,当提到传感器对矢量之间的角度时,指的是相交矢量对之间的较小的那个角度。另一种优选布置方式是,感测矢量之间的角度的正弦被有意增大,优选使得感测矢量之间至少一个角度的正弦大于或等于大约0.5。
为了简明起见,图12B中的布置只示出了三个传感器。优选可以包括四个电极,其中一个容器电极作为感测和电击电极,而两个导联电极只作为感测电极,它们设置在电击/感测电极线圈的远端和近端。实际上,除非在所附权利要求中用非包含性的语言专门限定,否则,导联电极组件中使用的传感器数目不应被理解为对本发明有限制性。
所属领域的技术人员应当认识到,除了在此介绍和设想的具体实施例之外,本发明可以以各种形式来实施。因此,在不脱离如所附权利要求所描述的本发明范围和精神的情况下,可以对其形式和细节作出修改。
Claims (10)
1.一种用于向皮下插入导联电极组件的工具,所述工具包括:
手柄;和
具有近端和远端的轴杆,所述轴杆在靠近其近端处固定于所述手柄上,并在靠近其远端处包括用以连接到导联电极组件上的连接机构,所述远端成形成用于穿过组织推进;
所述轴杆还设有在它里面延伸到远端输液端口的管腔;并且
所述连接机构是用于接受从中穿过的缝合线的缝合线孔,其中,所述远端输液端口通往所述缝合线孔。
2.根据权利要求1所述的工具,其特征在于,所述刚性轴杆在所述手柄远侧是直的。
3.根据权利要求1所述的工具,其特征在于,所述刚性轴杆在所述手柄的远侧包括弯曲部分,所述刚性轴杆的远端的轴向方向相对于所述手柄的轴向方向成一定角度,所述角度在30度和90度之间。
4.根据权利要求3所述的工具,其特征在于,所述角度为75度。
5.根据权利要求1所述的工具,其特征在于,所述刚性轴杆包括细长的金属管形件,靠近其近端具有偏置弯曲部分,所述手柄固定在所述偏置弯曲部分之上。
6.根据权利要求1所述的工具,其特征在于,所述连接机构包括缝合线孔。
7.根据权利要求1所述的工具,其特征在于,所述连接机构包括凹槽。
8.根据权利要求7所述的工具,其特征在于,所述凹槽是围绕所述轴杆延伸的径向凹槽。
9.根据权利要求1所述的工具,其特征在于,所述连接机构包括挂钩。
10.一种导联电极组件插入工具成套件,包括:
根据权利要求1所述的工具;和
具有纵向分裂线的可分裂式鞘套,所述鞘套限定了在尺寸上设置成可接受所述工具的管腔。
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- 2005-10-19 CN CN200580041756XA patent/CN101072601B/zh not_active Expired - Fee Related
- 2005-10-19 EP EP05810131A patent/EP1830918B1/en active Active
- 2005-10-19 CA CA2588024A patent/CA2588024C/en active Active
- 2005-10-19 DE DE602005021695T patent/DE602005021695D1/de active Active
- 2005-10-19 WO PCT/US2005/037759 patent/WO2006062590A1/en active Application Filing
- 2005-10-19 ES ES05810131T patent/ES2346551T3/es active Active
- 2005-10-19 AT AT05810131T patent/ATE469669T1/de active
- 2005-10-19 AU AU2005314611A patent/AU2005314611B2/en not_active Ceased
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2010
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2011
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2012
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2014
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US8801729B2 (en) | 2014-08-12 |
US20060122676A1 (en) | 2006-06-08 |
DE602005021695D1 (de) | 2010-07-15 |
ES2346551T3 (es) | 2010-10-18 |
AU2011202081A1 (en) | 2011-05-26 |
CA2588024A1 (en) | 2006-06-15 |
AU2011202081B2 (en) | 2013-04-04 |
CN101072601A (zh) | 2007-11-14 |
US7655014B2 (en) | 2010-02-02 |
AU2005314611B2 (en) | 2011-02-24 |
ATE469669T1 (de) | 2010-06-15 |
AU2005314611A1 (en) | 2006-06-15 |
US8157813B2 (en) | 2012-04-17 |
WO2006062590A1 (en) | 2006-06-15 |
JP4943343B2 (ja) | 2012-05-30 |
CA2588024C (en) | 2014-04-22 |
US20140324068A1 (en) | 2014-10-30 |
EP1830918B1 (en) | 2010-06-02 |
EP1830918A1 (en) | 2007-09-12 |
US20120191106A1 (en) | 2012-07-26 |
JP2008522655A (ja) | 2008-07-03 |
US20100137879A1 (en) | 2010-06-03 |
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