Systems and methods for guiding a medical instrument
US-9521961-B2 · Dec 20, 2016 · US
US9901714B2 · US · B2
| Field | Value |
|---|---|
| Publication number | US-9901714-B2 |
| Application number | US-54576209-A |
| Country | US |
| Kind code | B2 |
| Filing date | Aug 21, 2009 |
| Priority date | Aug 22, 2008 |
| Publication date | Feb 27, 2018 |
| Grant date | Feb 27, 2018 |
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Official abstract text for this publication.
A stylet for use in guiding a distal tip of a catheter to a predetermined location within the body of a patient. In one embodiment the stylet is configured for use within a lumen of the catheter and comprises a core wire, an ECG sensor, and a magnetic assembly. The ECG sensor senses an ECG signal of a patient when the stylet is disposed within the lumen of the catheter and the catheter is disposed within the body of the patient. The magnetic assembly includes at least one element capable of producing a magnetic or electromagnetic field for detection by a sensor external to the patient. In another embodiment, the stylet includes a pre-shaped distal segment that is deflected with respect to a more proximal portion of the stylet, which in turn causes a distal segment of the catheter to be deflected when the stylet is received within the lumen.
Opening claim text (preview).
What is claimed is: 1. A stylet for use within a longitudinally extending lumen of a catheter, the stylet comprising: an elongate core wire including a proximal segment having a first diameter and a distal segment, wherein a portion of the distal segment includes a reduced diameter section having a second diameter less than the first diameter and a tapered transition region that transitions the elongate core wire between the first diameter and the reduced diameter section; a tubing portion covering a portion of both the tapered transition region and the reduced diameter section of the core wire; an ECG sensor for sensing an ECG signal of a patient when the stylet is disposed within the lumen of the catheter and the catheter is disposed within a body of a patient; and a magnetic assembly including at least one element capable of producing a magnetic or electromagnetic field for detection by a sensor external to the patient. 2. The stylet as defined in claim 1 , wherein the ECG sensor is in operable communication with a conductive pathway for passing the ECG signal externally with respect to the patient when the catheter is disposed within the patient. 3. The stylet as defined in claim 2 , wherein the ECG sensor includes a distal portion of the core wire, and wherein the conductive pathway includes portions of the core wire proximal to the distal portion. 4. The stylet as defined in claim 1 , wherein the ECG sensor includes at least one of the following: an annular ring disposed on the tubing portion of the stylet; and a conductive epoxy, at least a portion of the conductive epoxy being covered by the tubing portion. 5. The stylet as defined in claim 1 , wherein the tubing portion defines at least a portion of the ECG sensor. 6. The stylet as defined in claim 1 , wherein the tubing portion includes a conductive coil that covers at least a portion of the magnetic assembly. 7. The stylet as defined in claim 1 , wherein the ECG sensor includes a conductive wire that is separate from the core wire. 8. A method of guiding a catheter internally within a patient, the catheter defining at least one lumen in which a stylet including a magnetic assembly, an elongate core wire including a tubing sleeve covering a distal segment of the core wire, the distal segment of the core wire comprising a tapered transition region and a reduced diameter section, and an ECG sensor are removably disposed, the method comprising: introducing the catheter with the stylet disposed therein into the patient; detecting data relating to the magnetic assembly by an external sensor during advancement of the catheter within the patient body; and monitoring ECG signals sensed by the ECG sensor of the stylet during advancement of the catheter so as to position the catheter in a desired location within the patient. 9. The method of guiding as defined in claim 8 , wherein monitoring ECG signals further comprises: monitoring ECG signals sensed by the ECG sensor of the stylet during advancement of the catheter through a vasculature of the patient so as to position the catheter proximate an SA node of the heart of the patient. 10. The method of guiding as defined in claim 8 , further comprising: withdrawing the stylet from the at least one lumen of the catheter after the catheter has been positioned in a desired location. 11. A catheter assembly, comprising: a catheter defining a lumen; and a stylet for removable placement in the lumen, the stylet comprising: a core wire including a distal segment, a portion of the core wire distal segment defining a reduced diameter section and a transition region with respect to the core wire proximal to the distal segment, the core wire capable of sensing an ECG signal of a patient when the stylet is disposed within the lumen of the catheter and the catheter is disposed within a vasculature of the patient; a tubing portion covering the distal segment of the core wire, the tubing portion being secured to the core wire near the transition region and defining an air gap between an outer surface of the core wire and an inner surface of the tubing portion; and at least one magnetic element included in the air gap adjacent the core wire distal segment and covered by the tubing portion. 12. The catheter assembly as defined in claim 11 , wherein the core wire includes nitinol and a hydrophilic coating, and wherein the catheter assembly further comprises: an electrically conductive feature included at a distal end of the tubing portion, the electrically conductive feature in electrical communication with the core wire to enable the electrically conductive feature to detect an electrical impulse from a heart of a patient when a distal portion of the stylet is disposed within a vasculature of the patient. 13. The catheter assembly as defined in claim 12 , wherein the at least one magnetic element includes a plurality of permanent magnets interposed between the core wire and the tubing portion, and wherein the electrically conductive feature includes one of a conductive metal, an epoxy, and a tip weld material. 14. The catheter assembly as defined in claim 13 , wherein the core wire includes a distal end and the electrically conductive feature includes a conductive epoxy that is electrically connected to the core wire proximate the distal end of the core wire, and wherein the core wire defines a conductive pathway for passage of the ECG signal to a point exterior to the catheter. 15. The stylet as defined in claim 1 , wherein the tubing portion defines an air gap between an outer surface of the core wire and an inner surface of the tubing portion. 16. The stylet as defined in claim 15 , wherein at least one magnetic element is interposed in the air gap between the outer surface of the core wire and an inner surface of the tubing portion. 17. The stylet as defined in claim 1 , wherein the only magnetic or electronic equipment located at the distal segment of the elongate core wire are the ECG sensor and the magnetic assembly. 18. The stylet as defined in claim 17 , wherein the tubing portion is directly attached to the core wire at or near the tapered transition region and is sized to match the first diameter. 19. The stylet as defined in claim 1 , wherein the ECG sensor comprises the distal segment of the elongate core wire and a coil of conductive material disposed about a portion of the distal segment. 20. The stylet as defined in claim 19 , wherein the coil of conductive material is bonded to the distal segment of the elongate core wire by a tip weld, wherein the tip weld is shaped to provide the stylet with an atraumatic distal tip.
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