Guide wire system
A guide wire system configured to guide a medical device (e.g., a medical lead) to a target area within a patient. The guide wire system may be configured to penetrate and pass through a tissue wall in the patient to guide the medical device to the target area. The guide wire system includes a support section configured to expand to substantially maintain a position relative to the tissue wall. The guide wire system includes a pull wire configured to cause the support portion to expand. The expanded support section may provide counter-traction to a distal force on the tissue wall exerted by a medical device during, for example, fixation of the medical device to the target area, or other stages of an implantation. The support section is configured to re-establish an initial configuration for proximal withdrawal from the tissue wall.
1. A guide wire system comprising:
an elongated body defining a proximal portion, a support portion, a distal portion, and a distal tip at a distal end of the elongated body;
wherein the elongated body includes a body wall defining an inner lumen within at least the support portion,
wherein the elongated body defines at least two slits extending through the wall in the support portion and the elongated body defines an expansion member between the two slits, and
wherein the distal tip is configured to penetrate a tissue wall; and
a pull wire configured to exert a proximal force on the distal portion of the elongated body when the proximal force is exerted on the pull wire, wherein the expansion member is configured to expand radially outward from an initial dimension to an expanded dimension when the proximal force is exerted on the distal portion,
wherein the distal portion defines a cross-sectional dimension substantially equal to the initial dimension, and
wherein the expansion member is resiliently biased to displace toward the inner lumen and return to defining the initial dimension when the proximal force exerted by the pull wire decreases.
2. The guide wire system of claim 1 ,
wherein the elongated body is configured to cause the distal tip to pass through the tissue wall such that the support portion is between the distal tip and the tissue wall; and
wherein the expansion member is configured to expand radially outward such that the expansion member exerts a proximal force against the tissue wall when a proximal force is exerted on the elongated body.
3. The guide wire system of claim 1 , wherein the elongated body defines a longitudinal axis extending within the inner lumen at least through the support portion, and wherein the two slits are substantially parallel to the longitudinal axis.
4. The guide wire system of claim 1 , wherein the elongated body defines a plurality of expansion members in the support portion, wherein each expansion member is between a first longitudinal slit and a second longitudinal slit.
5. The guide wire system of claim 4 , wherein each expansion member in the plurality is configured to expand radially outward from the inner lumen when the proximal force is exerted on the distal portion.
6. The guide wire system of claim 1 , wherein the expansion member is configured to displace inward toward the inner lumen when the proximal force exerted by the pull wire decreases and a tissue wall exerts a force toward the inner lumen on the expansion member.
7. The guide wire system of claim 1 , wherein the body wall further defines the inner lumen within the proximal portion, and wherein the pull wire extends through the inner lumen within the proximal portion.
8. The guide wire system of claim 1 , wherein the elongated body defines a distal opening which opens to the inner lumen, wherein the pull wire extends through the distal opening, and wherein the pull wire includes a bearing structure at a distal end of the pull wire, wherein the bearing structure is configured to exert the proximal force on the distal portion when a proximal force is exerted on the pull wire.
9. The guide wire system of claim 1 , wherein a distal portion of the pull wire is secured to at least one of the distal portion of the elongated body or the inner lumen.
10. The guide wire system of claim 1 , wherein the expansion member has a first end attached to the proximal section and a second end attached to the distal portion, and wherein the expansion member is configured such that the second end displaces proximally toward the first end when the expansion member expands radially outward from the inner lumen.
11. The guide wire system of claim 1 , wherein a portion of the expansion member is configured to experience a mechanical stress when the expansion member expands radially outward from the inner lumen, and wherein the elongated body includes a feature configured to reduce the mechanical stress experienced by the expansion member.
12. The guide wire system of claim 1 , further comprising a lead defining a lead lumen,
wherein the proximal portion of the elongated body is configured to pass through a lead lumen defined by a lead, and
wherein the expansion member is configured to expand radially outward to prevent the support portion, the distal portion, and the distal tip from passing through the lead lumen.
13. The guide wire system of claim 1 , further comprising an inner sheath including a sheath body defining a lumen, wherein the inner sheath includes a fixation element configured to engage tissue, and wherein the elongated body is configured to translate within the lumen.
14. A guide wire system comprising:
an elongated body defining a proximal portion, a support portion, a distal portion, and a distal tip at a distal end,
wherein the elongated body includes a body wall defining an inner lumen at least within the support portion,
wherein the elongated body defines at least two slits extending through the wall in the support portion and the elongated body defines an expansion member between the two slits, and
wherein the distal tip is configured to penetrate a tissue wall;
a pull wire configured to exert a proximal force on the distal portion of the elongated body when the proximal force is exerted on the pull wire, wherein the expansion member is configured to expand radially outward from the inner lumen when the proximal force is exerted on the distal portion; and
an inner sheath including a sheath body defining a lumen, wherein the inner sheath includes a fixation element configured to engage tissue, and wherein the elongated body is configured to translate within the lumen.
15. The guide wire system of claim 14 ,
wherein the tissue wall is a septum separating a first chamber and a second chamber of a heart,
wherein the elongated body is configured to cause the distal tip to pass through the septum such that the support portion is between the distal tip and the septum, and
wherein the expansion member is configured to expand radially outward such that the expansion member exerts a proximal force against the tissue wall when a proximal force is exerted on the elongated body.
16. The guide wire system of claim 14 , wherein the body wall further defines the inner lumen within the proximal portion, and wherein the pull wire extends through the inner lumen in the proximal portion.
17. A method, comprising:
translating an elongated body within a lumen defined by a sheath body of an inner sheath, the inner sheath including a fixation element configured to engage tissue;
exerting, using a pull wire, a force in a proximal direction on a distal portion of an elongated body defining a proximal portion, a support portion, the distal portion, and a distal tip at a distal end of the elongated body, the distal tip configured to penetrate a tissue wall at a distal end; and
radially expanding, using the force on the distal portion, an expansion member of the elongated body, the expansion member defined between at least two slits extending through a body wall of the elongated body in the support portion, wherein the body wall defines an inner lumen within the support portion.
18. The method of claim 17 , further comprising:
translating the elongated body to cause the distal tip to pass through the tissue wall such that the support portion is between the distal tip and the tissue wall; and
causing the expansion member to exert a proximal force against the tissue wall by exerting a proximal force on the elongated body when the expansion member is radially expanded outward.
19. The guide wire system of claim 1 , wherein a difference between the cross-sectional dimension defined by the distal portion and the initial dimension is less than or equal to 20% of the initial dimension.
20. The guide wire system of claim 19 , wherein the elongated body defines a longitudinal axis extending within the inner lumen at least through the support portion, and wherein the initial dimension and cross-sectional dimension are perpendicular to the longitudinal axis.