Laceration system and device, and methods for laceration
A laceration device for use in medical procedures includes a shaft having a proximal portion defining a proximal end, and an opposed distal portion defining a distal end. A perforation electrode is at the distal end, and a first electrical connector extends proximally from the perforation electrode for connection to a power source. An outwardly extending barb is positioned proximal of the distal end. The barb has an inner end proximate the shaft and an outer end opposite the inner end. A laceration electrode is proximal of and adjacent the inner end of the barb, and a second electrical connector extends proximally from the laceration electrode for connection to the power source.
1 . A laceration device for use in medical procedures, comprising:
a shaft, the shaft having a proximal portion defining a proximal end, and an opposed distal portion defining a distal end;
a perforating tip at the distal end;
an outwardly extending barb positioned proximal of the distal end, the barb having an inner end proximate the shaft and an outer end opposite the inner end, wherein the barb is movable between a deployed position in which the outer end is moved radially outwardly from the shaft, and a collapsed position in which the outer end is moved radially towards the shaft, the barb being biased towards the deployed position whereby the barb collapses from the deployed position to the collapsed position as the barb passes through an anatomical structure and moves back to the deployed position upon clearing the anatomical structure; and
a laceration electrode proximal of and adjacent the inner end of the barb, and an electrical connector extending proximally from the laceration electrode for connection to a power source;
wherein the barb is configured to flex to an engaged position when force is applied in a direction opposite to the collapsed position, the barb being configured to resist movement beyond the engaged position to prevent proximal movement of the laceration device when the outer end contacts a distal surface of an anatomical structure.
2 . The laceration device of claim 1 , further comprising a handle connected to the proximal end of the shaft, wherein the handle comprises a control for manipulating the barb.
3 . The laceration device of claim 1 , wherein the barb is integral with the shaft.
4 . The laceration device of claim 1 , wherein the perforating tip comprises a perforation electrode, and the device further comprises another electrical connector extending proximally from the perforation electrode for connection to the power source.
5 . The laceration device of claim 4 , wherein
the shaft and the barb are formed from an electrically insulative material;
the electrical connectors are in the form of wires that are embedded in the electrically insulative material of the shaft.
6 . The laceration device of claim 1 , wherein the barb is radiopaque, includes a radiopaque marker, echogenic, or includes an echogenic marker.
7 . The laceration device of claim 6 , wherein the laceration electrode and the perforation electrode are formed by exposed ends of the electrical connectors.
8 . The laceration device of claim 7 , further comprising a retainer for retaining the barb in the collapsed position.
9 . The laceration device of claim 8 , wherein:
the laceration device comprises a first insulated wire forming the shaft, and a second insulated wire,
the second insulated wire is crimped to define a first section extending along the first insulated wire, and a second section extending radially outwardly from the first portion and forms the barb.
10 . The laceration device of claim 9 , wherein the laceration electrode is positioned at the crimp.
11 . The laceration device of claim 9 , wherein the retainer comprises a sheath housing at least a portion of the first insulated wire and at least a portion of the first section of the second insulated wire, wherein when in the collapsed position, the second section of the second insulated wire is housed within the sheath, and when in the deployed position, the second section of the second insulated wire is outside of the sheath.
12 . The laceration device of claim 11 , wherein the barb is movable from the collapsed position to the deployed position by sliding the second insulated wire proximally relative to the sheath.
13 . A method for creating a laceration, comprising:
a. advancing a perforating tip of a laceration device towards a proximal surface of a target anatomical structure, the laceration device comprising a first insulated wire forming a shaft and a second insulated wire crimped to define a first section extending along the first insulated wire and second section extending radially outwardly from the first section and forming a barb;
b. advancing the perforating tip to perforate the target anatomical structure;
c. advancing the laceration device to position the perforating tip beyond a distal surface of the target anatomical structure and to pass the barb of the laceration device through the perforation;
d. retracting the laceration device to abut the barb with the distal surface of the target anatomical structure and position a laceration electrode of the laceration device in contact with the target anatomical structure; and
e. with the barb abutting the distal surface of the target anatomical structure, activating the laceration electrode of the laceration device applying force to the laceration device to lacerate the target anatomical structure.
14 . The method of claim 13 , wherein step b. comprises supplying RF energy to a perforation electrode of the perforating tip and step e. comprises supplying RF energy to the laceration electrode.
15 . The method of claim 13 , wherein between step c. and step d., the method further comprises moving the barb from a collapsed position to a deployed position.
16 . The method of claim 15 , wherein moving the barb from the collapsed position to the deployed position comprises moving the barb radially outwardly from the laceration electrode.
17 . The method of claim 15 , wherein moving the barb from the collapsed position to the deployed position comprises sliding the barb proximally with respect to the perforation electrode.
18 . The method of claim 15 , wherein
the barb is biased towards the deployed position;
during steps a. to c., the barb is held in the collapsed position; and
moving the barb from the collapsed position to the deployed position comprises releasing the hold on the barb.
19 . The method of claim 13 , wherein the target anatomical structure is a valve leaflet.
20 . A laceration system for use in medical procedures, comprising:
an RF generator configured to selectively deliver RF energy to a perforation electrode for tissue perforation and to a laceration electrode for tissue laceration; and
a laceration device, the laceration device comprising i) a shaft, the shaft having a proximal portion defining a proximal end, and an opposed distal portion defining a distal end, ii) a perforating tip at the distal end, iii) an outwardly extending barb positioned proximal of the distal end, the barb having an inner end proximate the shaft and an outer end opposite the inner end, wherein the barb is movable between a deployed position in which the outer end is moved radially outwardly from the shaft, and a collapsed position in which the outer end is moved radially towards the shaft, the barb being biased towards the deployed position whereby the barb collapses from the deployed position to the collapsed position as the barb passes through an anatomical structure and moves back to the deployed position upon clearing the anatomical structure and iv) a laceration electrode proximal of and adjacent the inner end of the barb, the laceration electrode electrically connectable to the RF generator.