Electrosurgical device for creating a channel through a region of tissue and methods of use thereof
A method and apparatus are disclosed for an RF guidewire for applying RF energy to create a channel through a region of tissue within a patient's body. The RF guidewire is configured to have a hydrophilic coating disposed thereon to reduce friction to facilitate traversal through vasculature while maintaining its mechanical, electrical and thermal properties.
1. A wire for navigating tortuous vasculature and creating a channel through a region of tissue using energy provided by an electrical energy source, the wire comprising:
a core wire for receiving the energy from the electrical energy source;
an electrode tip provided at a distal end of the core wire for delivery of the energy to the region of tissue, the electrode tip being electrically coupled to the core wire;
an electrical insulation surrounding the core wire, the electrical insulation comprising at least one inner insulation layer and at least one outer insulation layer;
a hydrophilic coating applied to an outer most insulation layer of the at least one outer insulation layer;
a thermal shield which is electrically insulative disposed between a proximal end of the electrode tip and the electrical insulation for thermally protecting the electrical insulation from heat produced by the delivery of the energy through the electrode tip; and
the thermal shield having a first outer diameter which is constant along a distal portion of the thermal shield and a second outer diameter which is constant along a proximal portion of the thermal shield wherein the first outer diameter is greater than the second outer diameter, wherein the electrical insulation is formed around the proximal portion of the thermal shield providing a smooth transition of an outer surface between the distal portion of the thermal shield and the electrical insulation whereby an outer diameter of the wire is constant along the distal portion of the thermal shield and the proximal portion of the thermal shield.
2. The wire of claim 1 , further comprising a support structure for supporting the electrode tip, the support structure having a proximal end, wherein the proximal end of the support structure is positioned distally with respect to a distal end of the thermal shield.
3. The wire of claim 1 , wherein the at least one inner insulation layer comprises one or more inner polymer layers and wherein the at least one outer insulation layer comprises one or more outer polymer layers.
4. The wire of claim 3 , wherein the at least one inner insulation layer comprises an electrically resistive inner insulation layer in contact with the core wire along a length of the core wire.
5. The wire of claim 4 , wherein the electrically resistive inner insulation layer comprises a polymer defining an electrically resistive inner polymer layer.
6. The wire of claim 5 , wherein the electrically resistive inner polymer layer has a di-electric constant that is greater than the di-electric constant of the one or more outer polymer layers.
7. The wire of claim 5 , wherein the electrically resistive inner polymer layer has a width that is less than the width of the at least one outer insulation layer.
8. The wire of claim 5 , wherein the electrical insulation comprises:
a proximal insulation segment, the proximal insulation segment comprising the electrically resistive inner polymer layer and a substantially rigid outer polymer layer that surrounds the electrically resistive inner polymer layer, the proximal insulation segment being substantially rigid for allowing for pushability and torquability;
an intermediate insulation segment, wherein the intermediate insulation segment comprises the electrically resistive inner polymer layer, a substantially rigid outer polymer layer surrounding the electrically resistive inner polymer layer partially along a radial width of the electrosurgical device, a substantially flexible outer polymer layer surrounding the electrically resistive inner polymer layer partially along a radial width of the electrosurgical device, the intermediate insulation segment being more flexible than the proximal insulation segment to allow the electrosurgical device to be advanced through tortuous vasculature; and
a distal insulation segment comprising a thermal barrier for protecting the intermediate and proximal insulation segments from the delivery of energy from the electrode tip and the heat produced thereby;
wherein the hydrophilic coating is disposed along the substantially rigid outer polymer layer along the proximal insulation segment and the substantially flexible outer polymer layer along the intermediate insulation segment wherein the substantially rigid outer polymer layer along the proximal insulation segment and the substantially flexible outer polymer layer along the intermediate insulation segment, enable the hydrophilic coating to be disposed thereon.
9. The wire of claim 8 , wherein the hydrophilic coating is selected from the group consisting of: hyaluronic acid (HA), and a hydrogel.
10. The wire of claim 9 , wherein the hydrogel selected from the group consisting of: polyvinylpyrrolidone (PVP), poly (ethylene oxide) (PEO) or poly (ethylene glycol) (PEG).
11. The wire of claim 8 , wherein the thermal shield comprises a ceramic thermal shield.
12. The wire of claim 11 , wherein the ceramic thermal shield is tubular.
13. The wire of claim 8 , wherein an area where the distal and intermediate insulation segments meet forms a joint where the substantially flexible outer polymer layer of the intermediate insulation segment overlaps and is positioned over the thermal barrier of the distal insulation segment.
14. The wire of claim 8 , wherein an area where the distal and intermediate insulation segments meet forms a joint where the thermal barrier of the distal insulation segment overlaps and is positioned over the substantially flexible outer polymer layer of the intermediate insulation segment.
15. The wire of claim 1 , wherein the outer most insulation layer comprises a non-fluorinated polymer.
16. The wire of claim 15 , wherein the outer most insulation layer is selected from the group consisting of: polyimide, polyamide-imide, and polyether ether ketone (PEEK), polyurethane, nylon, polypropylene, silicone, polyether block amide, and high density polyethylene (HDPE).
17. The wire of claim 1 , wherein the at least one inner insulation layer and the at least one outer insulation layer, other than the outer most insulation layer, are selected from the group consisting of: polyimide, polyamide-imide, and polyether ether ketone (PEEK), polytetrafluoroethylene (PTFE), Polyethylene terephthalate (PET) polyurethane, nylon, polypropylene, silicone, polyether block amide, and High Density Polyethylene (HDPE).
18. The wire of claim 1 wherein the thermal shield comprises a discrete change in outer diameter between the first outer diameter and second outer diameter.