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WO2019046352A1 - Fil de guidage d'ancrage et ses procédés d'utilisation - Google Patents

Fil de guidage d'ancrage et ses procédés d'utilisation Download PDF

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Publication number
WO2019046352A1
WO2019046352A1 PCT/US2018/048422 US2018048422W WO2019046352A1 WO 2019046352 A1 WO2019046352 A1 WO 2019046352A1 US 2018048422 W US2018048422 W US 2018048422W WO 2019046352 A1 WO2019046352 A1 WO 2019046352A1
Authority
WO
WIPO (PCT)
Prior art keywords
segment
expandable segment
expandable
deployed state
lumen
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2018/048422
Other languages
English (en)
Inventor
Patrick W. KELLY
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Sanford Health
Original Assignee
Sanford Health
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Sanford Health filed Critical Sanford Health
Publication of WO2019046352A1 publication Critical patent/WO2019046352A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09—Guide wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09—Guide wires
    • A61M2025/09133—Guide wires having specific material compositions or coatings; Materials with specific mechanical behaviours, e.g. stiffness, strength to transmit torque
    • A61M2025/09141—Guide wires having specific material compositions or coatings; Materials with specific mechanical behaviours, e.g. stiffness, strength to transmit torque made of shape memory alloys which take a particular shape at a certain temperature

Definitions

  • Steerable guide wires known in the art may not achieve active fixation in a lumen in which the guide wires are deployed.
  • a target vessel having an environment such as an aneurysm.
  • the guide wire may be pulled out of the target vessel prematurely. This may result in a longer surgery, thereby increasing the time that a patient is subjected to anesthesia, exposing the operating room staff to more radiation, and introducing the patient to more nephrotoxic intravenous contrast, for example.
  • losing guide wire access to a target vessel may result in the operator not being able to regain access resulting in the patient not having perfusion to a particular end organ as an outcome of the procedure.
  • the present disclosure is directed to an apparatus that improves anchoring of a steerable guide wire within a branched vessel, for example, by using an anchoring apparatus to anchor a guide wire to the vasculature prior to advancement and deployment of an over- the-wire medical device.
  • an anchoring apparatus to anchor a guide wire to the vasculature prior to advancement and deployment of an over- the-wire medical device.
  • vessels or other lumens, including, but not limited to ducts, orifices, the digestive tract, and/or any other structure having a lumen
  • anchoring the guide wire to a subject's vasculature may have a stabilizing effect for the tip of the catheter and afford greater stability and confidence for the operator of an implantable device to be deployed in vivo.
  • the anchor may hold the guide wire in place against the vasculature.
  • the guide wire may be used in a similar way to a through-wire, which is a guide wire advanced into one access point such as the groin then through and out of a second access point such as the arm.
  • This through-wire can be secured on both ends thereby preventing movement of the through- wire and providing support to the through-wire as the operator is working.
  • This anchoring guide wire may be used for improving the delivery of therapeutic devices such as bare metal stents, covered stents, as well as any other over-the-wire device.
  • the present disclosure provides an apparatus that includes a guide wire having a non-coiled segment, a leading segment, and a first expandable segment positioned between the non-coiled segment and the leading segment, wherein the leading segment includes a first end and a second end, wherein the first expandable segment has a first end and a second end and is configured to transition between a constrained state and a deployed state, wherein the first expandable segment is straight and extends between the first end of the first expandable segment and the second end of the first expandable segment in the constrained state, wherein the first expandable segment has a coiled arrangement configured to exert pressure on a lumen in the deployed state, wherein the first end of the first expandable segment is closer to the first end of the leading segment than the second end of the first expandable segment in the constrained state, and wherein the second end of the first expandable segment is closer to the first end of the leading segment than the first end of the first expandable segment in the deployed state.
  • the present disclosure provides a method that includes: (a) introducing an apparatus according to the first aspect into a lumen via arterial access, wherein the guide wire is disposed in a catheter such that a first expandable segment is in the constrained state, and (b) transitioning the first expandable segment from the constrained state to the deployed state, thereby anchoring the guide wire in the lumen.
  • Figure 1 is a perspective view of a guide wire in a deployed state, according to an example embodiment.
  • Figure 2 is a perspective view of the guide wire of Figure 1 in a constrained state, according to an example embodiment.
  • Figure 3 is a perspective view of another guide wire in a deployed state, according to an example embodiment.
  • Figure 4 is a perspective view of the guide wire of Figure 3 in a constrained state, according to an example embodiment.
  • Figure 5 is a side view of a guide wire disposed within a catheter, in accordance with one embodiment of the invention.
  • Figure 6 is a flow chart depicting functions that can be carried out in accordance with example embodiments of the disclosed methods.
  • Coupled means associated directly, as well as indirectly.
  • a member A may be directly associated with a member B, or may be indirectly associated therewith, e.g., via another member C. It will be understood that not all relationships among the various disclosed elements are necessarily represented.
  • first Unless otherwise indicated, the terms "first,” “second,” etc. are used herein merely as labels, and are not intended to impose ordinal, positional, or hierarchical requirements on the items to which these terms refer. Moreover, reference to, e.g., a “second” item does not require or preclude the existence of, e.g., a "first” or lower-numbered item, and/or, e.g., a "third" or higher-numbered item.
  • apparatus, element and method “configured to” perform a specified function is indeed capable of performing the specified function without any alteration, rather than merely having potential to perform the specified function after further modification.
  • the apparatus, element, and method “configured to” perform a specified function is specifically selected, created, implemented, utilized, programmed, and or designed for the purpose of performing the specified function.
  • “configured to” denotes existing characteristics of an apparatus, element, and method which enable the apparatus, element, and method to perform the specified function without further modification.
  • an apparatus, element, and method described as being “configured to” perform a particular function may additionally or alternatively be described as being “adapted to” and/or as being “operative to” perform that function.
  • a "catheter” is an apparatus that is connected to a deployment mechanism and is configured to house a prosthetic device that can be delivered over a guide wire.
  • the catheter may include a guide wire lumen for over-the-wire guidance and may be used for delivering the medical device to a target lumen.
  • a "guide wire” is an elongated cable comprised of one or more biocompatible materials including metals and polymers. Guide wires may be used for selecting target lumens and guiding catheters to target deployment locations. Guide wires are typically defined as wires used independently of other devices that do not come as part of an assembly.
  • lumen refers to a passage within an arterial or tubular structure, such as the pulmonary arteries or a passage within the tubular housings or catheters through which a guide wire may be disposed.
  • first end refers to the end of the apparatus that will be a “distal end” upon deployment in vivo.
  • second end refers to the end of the apparatus that will be a “proximal end” upon deployment in vivo.
  • constrained state refers to when the apparatus is disposed in a catheter and is substantially straight.
  • deployment state refers to when the apparatus has been positioned in the target lumen and is unsheathed from the catheter and is actively being expanded. The apparatus has a greater diameter in the deployed state than in the constrained state.
  • the guide wire 102 may be a continuous wire including the non-coiled segment 104, leading segment 106, and first expandable segment 108.
  • the first expandable segment 108 is straight and extends between the first end 114 of the first expandable segment 108 and the second end 1 16 of the first expandable segment 108 in the constrained state.
  • the first expandable segment 108 has a coiled arrangement configured to exert pressure on a lumen 1 8 in the deployed state.
  • the first end 1 14 of the first expandable segment 108 is closer to the first end 1 10 of the leading segment 106 than the second end 1 6 of the first expandable segment 108 in the constrained state (as shown in Figure 2), and the second end 116 of the first expandable segment 108 is closer to the first end 110 of the leading segment 106 than the first end 1 14 of the first expandable segment 108 in the deployed state (as shown in Figure 1 ).
  • the first end 1 10 of the leading segment 106 comprises a distal end of the guide wire 102
  • the first end 1 14 of the first expandable segment 108 is located distal to the second end 116 of the first expandable segment 108 in the constrained state
  • the first end 1 14 of the first expandable segment 108 is located proximal to the second end 116 of the first expandable segment 108 in the deployed state.
  • the distal first end 114 of the first expandable segment 108 is not the most distal portion of the first expandable segment 108 when the apparatus 100 is in the deployed state, as shown in Figure 1.
  • the non-coiled segment 104, the first expandable segment 108, and the leading segment 106 may generally be co-axial and constructed of a single wire with a thickness in the range of about 0.254 mm to about 1.016 mm.
  • the length of the leading segment 106 has a length in a range from about 2 mm to about 200 mm.
  • the total length of the guide wire 102 may range from about 100 cm to about 500 cm, and preferably from about 100 cm to about 300 cm.
  • the guide wire 102 may comprise a shape memory wire, for example, nitinol (nickel-titanium), titanium, titanium alloys, copper-aluminum- nickel alloys, various plastics, or any other suitable material capable of retaining shape memory.
  • the first expandable segment 108 may be configured to exist in one of two different states: a constrained state (as shown in Figure 2) and a deployed state (as shown in Figure 1 ). As shown in Figures 1 and 2, the first expandable segment 108 is substantially straight in the constrained state and has a coiled arrangement in the deployed state. As such, the effective diameter of the guide wire 102 increases in the deployed state. In one embodiment, in the constrained state, the first expandable segment 108 is substantially non-coiled and is disposed within a catheter 120, as discussed in additional detail below.
  • the first expandable segment 108 has a coiled aiTangement configured to exert pressure against the walls 118 of the vessel or lumen 119 into which the apparatus 100 is introduced.
  • the coiled arrangement of the first expandable segment 108 may exert a pressure against the walls 118 of the target vessel or lumen 119 that may range from about 0.25 ATM to about 3.0 ATM, and preferably from about 0.5 ATM to about 1.5 ATM.
  • coiled arrangement of the first expandable segment 108 may have a length 122 in the range of about 10 mm to about 100 mm, and an expanded diameter 124 in the range of about 1 mm to about 80 mm, where the expanded diameter corresponds to the largest effective diameter of the coiled arrangement.
  • the expanded diameter 124 of the coiled arrangement of the first expandable segment 108 in the deployed state may be approximately 20 percent larger than a diameter of the target vessel or lumen 119 in which the apparatus 100 is deployed.
  • different portions of the first expandable segment 108 may exert different pressures on the lumen 1 1 8.
  • one portion 109 of the first expandable segment 108 may be a more tightly-wound coil and thereby exert more pressure against the wall 1 18 of the target vessel or lumen than other portions 11 1 of the first expandable segment 108.
  • coils of one portion 109 of the first expandable segment 108 may have a larger effective diameter and may therefore exert more pressure on the wall 1 18 of the target vessel or lumen than coils of another portion 1 1 1 of the first expandable segment 108.
  • one portion 109 of the guidewire forming part of the first expandable segment 108 may have a greater diameter that may exert more pressure against the wall 1 18 of the target vessel or lumen than other portions 1 11 of the first expandable segment 108.
  • coils of one portion 109 of the first expandable segment 108 may be at a different pitch than coils of another portion 1 1 1 of the first expandable segment 108.
  • one portion of the first expandable segment 108 may exert a different pressure against the wall 1 18 of the target vessel or lumen than other portions.
  • each portion of the first expandable segment 108 may exert substantially the same pressure against the wall 1 18 of the target vessel or lumen as the other portions.
  • the leading segment 106 may extend beyond the first expandable segment 108 in order to help guide the anchoring apparatus 100 (while in the constrained state) through the target lumen 119 to a suitable deployment position. Additionally, the leading segment 106 may be shaped or constructed in such a way as to mitigate inadvertent injury to portions of the walls 118 of the target vessel or lumen 1 19 with which the leading segment 106 comes into contact. For instance, the distal first end 110 of the leading segment 106 may be rounded or smoothed.
  • leading segment 106 may be constructed of a different material than the rest of the guide wire 102, such as a conformable material that is less stiff than the other portions of the apparatus 100 (e.g., less stiff than both the non-coiled segment 104 and the first expandable segment 108), or less stiff than other, traditional in vivo materials. As such, the leading segment 106 may be considered "atraumatic.”
  • the leading segment 106 may also beneficially be substantially straight, making loading the guide wire 102 into a catheter 120 easier.
  • the substantially straight leading segment 106 allows the operator loading the guide wire 102 into a catheter 120 to get the guide wire 102 started in the catheter 120 before trying to advance the first expandable segment 108.
  • the leading segment 106 also makes advancing the guide wire 102 through the catheter 120 easier. If the terminal extent of the leading segment 106 were coiled, the coiled natui ' e would push the tip of the guide wire 102 into the inner surface of the catheter 120 making advancement of the guide wire 102 challenging. Instead, the substantially straight leading segment 106 enables the operator to more easily advance the guide wire 102 to the desired location.
  • leading segment 106 remains substantially straight even when the guide wire 102 is in the deployed state, unless the wall 1 18 of a target vessel or lumen 119 is acting upon the leading segment 106.
  • the leading segment 106 need not be constructed from a shape memory material.
  • the leading segment 106 may extend beyond the first expandable segment 108 at a length of about 2 mm to about 200 mm, and preferably extend a length of about 3 mm to about 50 mm.
  • the guide wire 102 may further include a second expandable segment 126 positioned between the non-coiled segment 104 and the first expandable segment 108.
  • the second expandable segment 126 may be configured to transition between a constrained state (shown in Figure 4) and a deployed state (shown in Figure 3) similar to the first expandable segment 108.
  • the second expandable segment 126 may have a first end 128 and a second end 130 and is configured to transition between a constrained state and a deployed state.
  • the guide wire 102 may be a continuous wire including the non-coiled segment 104, leading segment 106, first expandable segment 108, and second expandable segment 126.
  • the second expandable segment 126 is straight and extends between the first end 128 of the second expandable segment 126 and the second end 130 of the second expandable segment 126 in the constrained state.
  • the second expandable segment 126 is arranged as a coiled wire configured to exert pressure on a wall 1 18 of the target vessel or lumen 119 in the deployed state.
  • the first end 128 of the second expandable segment 126 is closer to the first end 1 10 of the leading segment 106 than the second end 130 of the second expandable segment 126 in the constrained state, and the second end 130 of the second expandable segment 126 is closer to the first end 110 of the leading segment 106 than the first end 128 of the second expandable segment 126 in the deployed state.
  • the second expandable segment 126 may be disposed within a catheter 120.
  • the second expandable segment 126 is arranged as a second coiled wire configured to exert pressure on the walls 1 18 of the target vessel or lumen 119 in which the apparatus 100 is disposed.
  • the first expandable segment 108 and the second expandable segment 126 are arranged to exert the same pressure on a wall 118 of the target vessel or lumen 119; however, in other embodiments, the first expandable segment 108 is arranged to exert a different pressure on the wall 118 of the target vessel or lumen 119 than the second expandable segment 126.
  • first expandable segment 108 is arranged to exert a greater pressure on the wall 1 18 of the target vessel or lumen 1 19 than the second expandable segment 126.
  • second expandable segment 126 is arranged to exert a greater pressure on the wall 1 1 8 of the target vessel or lumen 1 19 than the first expandable segment 108.
  • Other examples are possible as well.
  • Figure 5 illustrates the apparatus 100 disposed within a catheter 120.
  • a catheter 120 may be slid backward toward the non-coiled segment 104, thereby exposing the first expandable segment 108 to the vasculature and allowing the first expandable segment 108 to expand and coil thereby exerting an outward force on the walls 1 18 of the target vessel or lumen 1 19.
  • the guide wire 102 may be pushed through the catheter 120 to advance and expose the first expandable segment 108 in the same way.
  • the catheter 120 may be pushed back over the first expandable segment 108; or, alternatively, the first expandable segment 108 pulled back through the catheter 120.
  • the first expandable segment 108 is configured to transition between the constrained state and the deployed state by simultaneously sliding the first expandable segment 108 out of the catheter 120 and sliding the catheter 120 over the first expandable segment 108.
  • the catheter 120 comprises a delivery catheter portion 132 and an interface catheter portion 134.
  • the delivery catheter portion 132 may be shaped or constructed in such a way as to mitigate inadvertent injury to portions of the lumen 118 with which the delivery catheter portion 132 comes into contact.
  • the tip of the delivery catheter portion 132 may be rounded or smoothed, as shown in Figure 5.
  • the delivery catheter portion 132 may be constructed of a conformable material that is less stiff than other portions of the apparatus 100, or less stiff than other, traditional in vivo materials.
  • the first expandable segment 108 and the leading segment 106 may be disposed within the interface catheter portion 134.
  • a valve 142 on the leading edge of the interface catheter 134 can be opened allowing the operator to manipulate the non-coiled segment 104 of the guide wire 102 to thereby advance the guide wire 102 through the interface catheter 134 and into the delivery catheter 132,
  • a standard guide wire may be introduced into the lumen 1 19 via arterial access. Then, the delivery catheter 132 may be advanced into the lumen 1 19 over the standard guide wire until the delivery catheter 132 is in a desired location. At this point, the standard guide wire may be removed. Next, the interface catheter 134 may be coupled to an ex vivo end of the delivery catheter 132 (however, in some embodiments, the interface catheter 134 may already be coupled to the delivery catheter 132 at this point).
  • the first expandable segment 108 and the leading segment 106 of the guide wire 102 are then advanced through the interface catheter 134 and the delivery catheter 132, thereby deploying the first expandable segment 108 in a desired location in the lumen 119.
  • the delivery catheter 132 is removed from the lumen 1 19 leaving the guide wire 102 in position.
  • a therapeutic and/or implantable device such as a stent along with its delivery catheter, is then advanced over the non-coiled segment 104 of the guide wire to a desired treatment location. It will be appreciated that other arrangements are possible as well, including some arrangements that involve more or fewer steps than those described above, or steps in a different order than those described above.
  • FIG. 6 is a simplified flow chart illustrating a method 200 according to an exemplary embodiment. Although the blocks are illustrated in a sequential order, these blocks may also be performed in parallel, and/or in a different order than those described herein. Also, the various blocks may be combined into fewer blocks, divided into additional blocks, and/or removed based upon the desired implementation.
  • the method 200 includes introducing the apparatus 100 according to any of the embodiments described above into a lumen 1 19 via arterial access, where the guide wire 102 is disposed in a catheter 120 such that the first expandable segment 108 is in the constrained state.
  • the method 200 includes transitioning the first expandable segment 108 from the constrained state to the deployed state, thereby anchoring the guide wire 102 in the lumen 119.
  • transitioning the first expandable segment 108 from the constrained state to the deployed state may include sliding the first expandable segment 108 out of the catheter 120; or, alternatively or simultaneously, sliding the catheter 120 back over the first expandable segment 108.
  • the first expandable segment 108 may coil and expand due to shape memory, thereby exerting pressure on the lumen 1 19.
  • the pressure exerted on the lumen 119 in the expanded state where the first expandable segment 108 comes into contact with the lumen 1 19 may range from about 0.25 ATM to about 3.0 ATM.
  • the first expandable segment 108 may exert a graduated pressure on the lumen 119 such that a first portion 109 of the first expandable segment 108 exerts a different pressure than a second portion 111 of the first expandable segment 108.
  • each portion of the first expandable segment 108 may exert substantially the same pressure on the lumen 1 19.
  • transitioning the first expandable segment 108 from the constrained state to the deployed state comprises sliding the first expandable segment 108 out of the catheter 120 and expanding the first expandable segment 108 due to shape memory.
  • the method further comprises transitioning the first expandable segment 108 from the deployed state to the constrained state.
  • transitioning the first expandable segment 108 from the deployed state to the constrained state may comprise sliding the catheter 120 back over the first expandable segment 108 and returning the first expandable segment 108 to a substantially non-coiled arrangement.
  • the guide wire 102 further comprises a second expandable segment 126 positioned between the non-coiled segment 104 and the first expandable segment 106, the second expandable segment 126 being configured to transition between a constrained state and a deployed state, where in the deployed state the second expandable segment 126 is arranged as a second coiled wire.
  • the method 200 may further comprise exerting a graduated pressure on the walls 1 18 of the target vessel or lumen 1 19 via coils of the second expandable segment 126 in the deployed state such that a first portion 127 of the second expandable segment 126 exerts a different pressure than a second portion 129 of the second expandable segment 126.
  • introducing the apparatus 100 into the lumen 1 19 comprises introducing a delivery catheter 132 into a lumen 1 19 via arterial access, the delivery catheter 132 being coupled to an interface catheter 134 having disposed therein the guide wire 102 comprising a non-coiled segment 104, a first expandable segment 108, and a leading segment 106.
  • the interface catheter 134 may be coupled to the delivery catheter 132 via a luer-lock connector 140A, 140B, a threaded connector, or some other type of connector. Once the interface catheter 134 is connected to the delivery catheter 132, a valve 142 on the leading edge of the interface catheter 134 can be opened allowing the guide wire 102 to be advanced through the interface catheter 134 and into the delivery catheter 132.
  • the method 200 may further include removing the catheter 120 from the lumen
  • a therapeutic and/or implantable device such as a stent

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

La présente invention concerne un appareil (100) comprenant un fil de guidage (102) ayant un segment non enroulé (104), un segment avant (106), et un premier segment extensible (108) positionné entre le segment non enroulé (104) et le segment avant (106). Le premier segment extensible (108) a une première extrémité (114) et une seconde extrémité (116) et est configuré pour passer d'un état contraint à un état déployé. La première extrémité (114) du premier segment extensible (108) est plus proche d'une première extrémité (110) du segment avant (106) qu'une seconde extrémité (116) du premier segment extensible (108) dans l'état contraint, et une seconde extrémité (116) du premier segment extensible (108) est plus proche de la première extrémité (110) du segment avant (106) que la première extrémité (114) du premier segment extensible (108) dans l'état déployé.
PCT/US2018/048422 2017-08-30 2018-08-29 Fil de guidage d'ancrage et ses procédés d'utilisation Ceased WO2019046352A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201762552124P 2017-08-30 2017-08-30
US62/552,124 2017-08-30

Publications (1)

Publication Number Publication Date
WO2019046352A1 true WO2019046352A1 (fr) 2019-03-07

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2516718A (en) * 2013-07-30 2015-02-04 Queen Elizabeth Hospital King S Lynn Nhs Foundation Trust Medical guide wire
US20160101267A1 (en) * 2014-10-14 2016-04-14 Sanford Health Anchoring Device and Methods for Use
WO2018183191A1 (fr) * 2017-03-27 2018-10-04 Boston Scientific Scimed, Inc. Systèmes pour effectuer un mouvement de structures de tissu

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB2516718A (en) * 2013-07-30 2015-02-04 Queen Elizabeth Hospital King S Lynn Nhs Foundation Trust Medical guide wire
US20160101267A1 (en) * 2014-10-14 2016-04-14 Sanford Health Anchoring Device and Methods for Use
WO2018183191A1 (fr) * 2017-03-27 2018-10-04 Boston Scientific Scimed, Inc. Systèmes pour effectuer un mouvement de structures de tissu

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