Double thermoform cannula
Patent Information
- Application Number
- JP2024187570
- Authority / Receiving Office
- JP · JP
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2019-06-28
- Filing Date
- 2024-10-24
- Publication Date
- 2025-04-28
- Estimated Expiration
- 2040-06-25
Smart Images
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Abstract
Description
[Technical field]
[0001] CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to U.S. Patent Application No. 62 / 868,476, filed June 28, 2019, which is incorporated by reference in its entirety. Additionally, this application is related to U.S. Patent Application Publication No. 2017 / 0215918, entitled "Thermoform Cannula with Variable Cannula Body Stiffness," and U.S. Patent No. 8,795,576, entitled "Radiopaque Cannula Marker," both of which are incorporated by reference in their entirety. [Background technology]
[0002] background An intravascular blood pump assembly, such as an assembly with an intracardiac blood pump, may be introduced into the heart to deliver blood from the heart to the arteries. The intravascular blood pump may be introduced percutaneously through the vascular system during a cardiac procedure, such as by catheterization. Some blood pumps are designed to assist the left side of the heart, drawing blood from the left ventricle of the heart and discharging the blood through a cannula into the aorta. Some blood pumps that assist the left side of the heart are introduced by catheterization through the femoral artery into the ascending aorta, across the aortic valve, and into the left ventricle. Some systems are designed to assist the right side of the heart, and the blood pump is introduced through a vein and through the venous system (e.g., the vena cava) into the right side of the heart. Blood pump systems may also be surgically implanted or inserted through the subclavian and / or carotid arteries. During insertion of the blood pump assembly into the patient through the blood vessels, it may be difficult to advance the blood pump through the patient's tortuous pathways or calcified anatomy.
[0003] Complications with pump introduction due to these tortuous paths can potentially cause damage to the blood pump assembly or to the patient. For example, in right heart procedures, damage can occur as the blood pump navigates a tortuous path within the right heart to the right heart (e.g., spanning between the inferior vena cava and the pulmonary artery). In some instances, the cannula of the blood pump bears most of the load on the pump as it navigates its path to and through the heart. For example, the cannula of a right heart blood pump may be stretched or bent as a result of its placement. Similarly, various interfaces between the cannula and the inflow and outflow components of the pump may also be stretched or bent, causing damage to the blood pump. Known blood pump assemblies include the Impella® pump by Abiomed, Inc. The Impella® pump system generally includes a catheter, a pump, a power source to drive the rotor of the pump, a cannula for crossing a heart valve, and an atraumatic extension. The Impella® pump can be introduced into a patient to assist the left or right heart. Summary of the Invention
[0004] overview The systems, methods, and devices described herein provide a reinforced cannula for use in a blood pump assembly configured to withstand forces encountered during insertion and operation of the blood pump. In some aspects of the present technology, the reinforced cannula is a dual thermoformed cannula having at least one thermoformed reinforced end portion that is stiffer than an intermediate portion of the cannula. The thermoformed outer end reinforcement layer allows the cannula body to stretch more easily rather than the cannula ends when the cannula is subjected to applied stress, thereby reducing stress on the interface between the cannula ends and their respective adjacent components. Thus, the thermoformed reinforced end portion, also referred to as the thermoformed outer end reinforcement layer, can function as a strain relief section for the cannula.
[0005] The thermoformed outer end reinforcement layer may be disposed at the interface between the cannula and one of the other components of the blood pump assembly. For example, the thermoformed outer end reinforcement layer may be disposed at the interface between the distal end of the cannula and the distal component (e.g., blood inflow cage), or at the interface between the proximal end of the cannula and the pump housing, or both. The thermoformed outer end reinforcement layer may help prevent separation of the cannula from the other components of the blood pump assembly. The thermoformed outer end reinforcement layer may also improve strength at the interface between the cannula and the other component (e.g., blood inflow cage disposed distal to the cannula).
[0006] The thermoformed outer end reinforcement layer may have a higher durometer hardness than the middle portion of the outer layer of the cannula. In some implementations, the thermoformed outer end reinforcement layer is at least twice as stiff as the middle portion of the cannula. In other implementations, the thermoformed outer end reinforcement layer is about 1.5 to about 5.5 times as stiff as the middle portion of the cannula. In some implementations, the thermoformed outer end reinforcement layer is about 2 to about 5 times as stiff as the middle portion of the cannula. In further implementations, the thermoformed outer end reinforcement layer is about 3 to about 4 times as stiff as the middle portion of the cannula. In certain implementations, the thermoformed outer end reinforcement layer is about 3.5 times as stiff as the middle portion of the cannula.
[0007] In addition, one or more layers of the cannula body may also be formed using a thermoforming process. Incorporating a thermoformed layer into the middle portion of the cannula may provide additional structural reinforcement to the cannula along its length. Furthermore, thermoforming one or more layers of the cannula body may help increase the manufacturing yield of cannulas for pumps with short bond regions.
[0008] According to some aspects of the present technology, an intravascular blood pump system for insertion into the heart includes a pump having a rotor and one or more blades disposed within the pump housing for transporting fluid through the pump housing. A drive system is also included along with a motor and drive train. The motor can be an internal motor powered by an electrical line or can be an external motor with a drive cable connecting the pump and the motor. The blood pump system further includes an elongated catheter that connects the pump to an external control system outside the patient's body and through which the drive cable or electrical wire passes. A cannula is disposed distal to the pump housing and connects with a distal end of the pump housing. As used herein, "distal" refers to a direction away from the operator of the blood pump and toward the patient. Similarly, "proximal" refers to a direction toward the operator of the blood pump and away from the patient. The cannula has a length, a proximal end, a middle portion, and a distal end. The distal end of the cannula is attached to a proximal end of an inflow cage that extends distally from the cannula, and the distal end of the inflow cage is attached to a distal atraumatic protrusion. The inflow cage spaces the cannula from the distal atraumatic projection, and blood passes through the inflow cage into the cannula.
[0009] The cannula may be comprised of at least three concentric cylindrical layers: an inner layer, a reinforcing layer, and an outer layer. Each layer extends longitudinally along the length of the cannula, defining the body of the cannula from the distal end of the cannula to the proximal end of the cannula. The outer layer surrounds the reinforcing layer which surrounds the inner layer. The three concentric layers, particularly the inner layer, further define a lumen extending along the length of the cannula. The inner and outer layers of the cannula body may be thermoformed. In certain implementations, a thermoformed outer end reinforcing layer is disposed over the outer layer of the cannula at least one of the distal and proximal ends of the cannula. The combination of the thermoformed outer end reinforcement layer with the thermoformed inner and outer layers provides structural stability to the cannula body and allows the thermoformed end reinforcement layers - rather than the cannula body layers - to function as strain relief sections of the cannula when the cannula is subjected to shear forces during insertion and operation of the cannula in the patient's vasculature.
[0010] In some implementations, the cannula is constructed with a thermoformed inner layer that extends along the length of the cannula. The inner layer includes an inner material and has an inner diameter and an outer diameter. In some implementations, the outer diameter of the inner layer is about 1 Fr to about 5 Fr. In other implementations, the outer diameter of the inner layer is about 2 Fr to about 4 Fr. In certain implementations, the outer diameter of the inner layer is about 3 Fr. In certain implementations, the radial thickness of the inner layer is about 0 mm to about 0.2 mm. In further implementations, the radial thickness of the inner layer is about 0.05 mm to about 0.15 mm. In some implementations, the radial thickness of the inner layer is about 0.1 mm. In further implementations, the outer layer has a radial thickness of about 0 mm to about 0.15 mm. In certain implementations, the outer layer has a radial thickness of about 0.075 mm to about 0.125 mm. In certain implementations, the outer layer has a radial thickness of about 0.1 mm. The thickness of each layer can be adjusted to obtain a given total thickness of the cannula. In certain implementations, the total radial thickness of the cannula is about 0 mm to about 0.5 mm. In some implementations, the total radial thickness of the cannula is about 0.15 mm to about 0.35 mm. In further implementations, the total radial thickness of the cannula is about 0.3 mm. In some implementations, the outer diameter of the intermediate portion of the cannula is about 17 Fr to about 22 Fr. In certain implementations, the outer diameter of the intermediate portion of the cannula is about 18 Fr to about 21 Fr. In further implementations, the outer diameter of the intermediate portion of the cannula is about 19.5 Fr.
[0011] For cannulas having an outer layer with a fixed outer diameter, the amount of material at a given longitudinal point along the length of the cannula can be adjusted by adjusting the radial thickness (e.g., outer diameter and / or inner diameter) of the inner layer during the manufacturing process. Adjusting the amount of material present at a longitudinal point along the length of the cannula changes the stiffness at that point, with points with more material being stiffer and points with less material being less stiff. Thus, to create a desired stiffness profile along the length of the cannula, the radial thickness of the inner layer can be adjusted such that a given point along the length of the cannula has an amount of material of the desired stiffness.
[0012] In addition, the cannula may be configured with a coil made of a shape memory material, and the coil may be disposed across the outer diameter of the inner layer. The cannula may further have a thermoformed outer layer extending along the length of the cannula and disposed over the inner layer and the coil. In certain implementations, the coil is embedded in the outer layer. In further implementations, the coil comprises a shape memory material that is at least one of Nitinol or a copper aluminum alloy. The outer layer of the cannula comprises an outer material. In certain implementations, the outer material comprises polyurethane. In some implementations, the outer material comprises Texin®. Texin is a thermoplastic polyurethane (TPU). In some implementations, the inner material comprises polyurethane. In other implementations, the inner material comprises Texin®. When polyurethane is used for the inner and / or outer layers, it may comprise polyether or polyester. In certain implementations, the inner and outer materials are the same.
[0013] In some implementations, the inner layer extends longitudinally beyond the outer layer at at least one of the distal and proximal ends of the cannula body. These longer portions of the inner layer are referred to as the distal medial projection and the proximal medial projection, respectively. In implementations having a distal medial projection, a continuous reinforcing profile can be formed along the length of the cannula by adding a thermoformed outer end reinforcing layer to the end of the outer layer. In certain implementations, at least one of the distal medial projection and the proximal medial projection has a length of about 1 centimeter to about 5 centimeters. In other implementations, at least one of the distal medial projection and the proximal medial projection has a length of about 2 centimeters to about 4 centimeters. In certain implementations, at least one of the distal medial projection and the proximal medial projection has a length of about 3 centimeters.
[0014] In addition, the cannula may further include a first thermoformed outer end reinforcement layer. In some implementations, the first thermoformed outer end reinforcement layer extends over the outer layer of the cannula at the proximal end of the cannula. In other implementations, the first thermoformed outer end reinforcement layer extends over a proximal portion of the proximal inner layer that is longer than the outer layer to form a continuous reinforcement profile along the length of the cannula. The first thermoformed outer end reinforcement layer may include a reinforcement material and form a reinforced section between the cannula and the pump housing. The first thermoformed outer end reinforcement layer may be configured to reduce the possibility of separation between the pump housing and the cannula due to forces applied to the cannula during percutaneous insertion of the intravascular blood pump system into the patient's body. When the blood pump assembly is in place within the patient's heart, the cannula may extend beyond the patient's aortic valve such that a distal end of the cannula is disposed within the left ventricle and a proximal end of the cannula is disposed within the aorta.
[0015] In certain implementations, the cannula further includes a second thermoformed outer end reinforcement layer. In some implementations, the second thermoformed outer end reinforcement layer is disposed over the outer layer at the distal end of the cannula. In other implementations, the second thermoformed outer end reinforcement layer extends over the distal inner projection to form a continuous reinforcement profile along the length of the cannula. In such implementations, the distal thermoformed outer end reinforcement layer includes a reinforcement material. In some implementations, the distal end of the cannula interfaces with the inflow cage, and the distal thermoformed outer end reinforcement layer forms a second reinforced section of the cannula at the interface between the cannula and the inflow cage. In implementations with a distal thermoformed outer end reinforcement layer, the distal thermoformed outer end reinforcement layer can function as a strain relief section to reduce the possibility of separation between the inflow cage and the cannula due to forces applied to the cannula during percutaneous insertion.
[0016] In some implementations, the radial thickness of the reinforcement layers tapers. For example, the radial thickness of the proximal thermoformed outer end reinforcement layer may taper to a decreasing thickness in the distal direction. In other implementations, the radial thickness of the distal thermoformed outer end reinforcement layer may taper to a decreasing thickness in the distal direction. In certain implementations, the radial thickness of both thermoformed outer end reinforcement layers may taper to a decreasing thickness in the distal direction. In certain implementations, the radial thickness of at least one of the thermoformed outer end reinforcement layers tapers from about 1 millimeter thick to a minimum thickness approaching zero. In other implementations, the radial thickness of at least one of the thermoformed outer end reinforcement layers tapers from about 0.7 millimeter thick to near zero. In further implementations, the radial thickness of at least one of the thermoformed outer end reinforcement layers tapers from about 0.4 millimeter thick to near zero.
[0017] In some implementations, the inner layer includes an inner material, the outer layer includes an outer material, and the thermoformed outer end reinforcement layer includes a reinforcement material. In certain implementations, the inner and outer materials include the same material. In some implementations, at least one of the inner and outer materials is polyurethane. In further implementations, the inner material is polyester polyurethane. In other implementations, the inner material is polyether urethane. In certain implementations, at least one of the outer and reinforcement materials is polyether polyurethane. In some implementations, at least one of the inner and outer materials is Texin®. A polymer may be selected based on its behavior during heat shrinkage. Additionally, a particular polymer selected for use in the cannula may be selected for its particular mechanical properties. For example, the selected polymer may have a stiffness such that the cannula body bends more easily than the thermoformed outer end reinforcement layer when the cannula is subjected to stress.
[0018] In some implementations, the reinforced portion of the cannula has a stiffness between about 0.5 and 3 times that of the intermediate portion of the cannula. In other implementations, the reinforced portion of the cannula has a stiffness between about 1 and about 2.75 times that of the intermediate portion of the cannula. In further implementations, the reinforced portion of the cannula has a stiffness between about 1.5 and about 2.5 times that of the intermediate portion of the cannula. In certain implementations, the reinforced portion of the cannula has a stiffness less than 2.5 times that of the intermediate portion of the cannula. The stiffness ratio of the reinforced portion of the cannula and the intermediate portion of the cannula can be adjusted by incorporating one or more thermoformed outer end reinforcement layers of different stiffness. In addition, the stiffness ratio can also be adjusted by incorporating materials with different stiffnesses that fall within the following ranges: The stiffness ratio of the reinforced portion of the cannula and the intermediate portion of the cannula can be advantageously selected to reduce the likelihood of kinking that would otherwise occur due to a large difference in stiffness between the reinforced portion of the cannula and the intermediate portion of the cannula.
[0019] The thermoformed outer end reinforcement layer may include a material having a higher stiffness than the material of the intermediate portion of the cannula. Additionally, the shape of the thermoformed outer end reinforcement layer may be tailored to achieve a desired stiffness ratio between the thermoformed outer end reinforcement layer and the intermediate portion. For example, the thermoformed outer end reinforcement layer may have a radial thickness of about 0 to about 0.3 mm. In further implementations, the thermoformed outer end reinforcement layer has a radial thickness of about 0.05 mm to about 0.15 mm. In certain implementations, the thermoformed outer end reinforcement layer has a radial thickness of about 0.075 mm to about 0.125 mm. In further implementations, the thermoformed outer end reinforcement layer has a radial thickness of less than about 0.1 mm. Additionally, the thermoformed outer end reinforcement layer may have a variety of lengths. In certain implementations, the thermoformed outer end reinforcement layer has a length of about 1 centimeter to about 3 centimeters. In other implementations, the thermoformed outer end reinforcement layer has a length of about 2 centimeters. In some implementations, the length of the thermoformed outer end reinforcement layer is about 3 mm to about 9 mm. In certain implementations, the length of the thermoformed outer end reinforcement layer is about 5 mm to about 7 mm. In other implementations, the length of the thermoformed outer end reinforcement layer is about 6 mm. At least one advantage of the variability of the cannula stiffness due to the cannula shape and material is that the stiffness profile along the cannula length can be tailored. For example, a given procedure may require a cannula of a particular stiffness based on the insertion angle of the procedure. The insertion angle of the procedure may vary based on the patient's anatomy and insertion site. Thus, the cannula shape and material can be tailored to provide a particular stiffness profile along the cannula length that is desired for a given procedure.
[0020] In certain implementations, the inner material has an inner material hardness of about 45D to about 65D. In other implementations, the inner material has an inner material hardness of about 50D to about 60D. In further implementations, the inner material has an inner material hardness of about 55D. In some implementations, the outer material has an outer material hardness of about 75A to about 95A. In other implementations, the outer material has an outer material hardness of about 80A to about 90A. In further implementations, the outer material has an outer material hardness of about 85A. In some implementations, the hardness of the reinforcing material is about 1 grade to about 3 grades higher than the hardness of the inner material. In certain implementations, the hardness of the reinforcing material is about 2 grades higher than the hardness of the inner material. In certain implementations, the reinforcing material has a reinforcing hardness of about 45D to about 65D. In other implementations, the reinforcing material has a reinforcing hardness of about 50D to about 60D. In further implementations, the reinforcement material has a reinforcement hardness of about 55D. In certain implementations, the inner hardness and the reinforcement hardness are equal or nearly equal. The relative hardnesses of the inner material, outer material, and reinforcement material can be selected such that the thermoformed outer end reinforcement layer acts as a strain relief section when the cannula is subjected to stress.
[0021] In some implementations, the intermediate portion of the cannula has an outer diameter that is smaller than the outer diameter of one or both reinforced portions of the cannula. The outer diameter of the intermediate portion of the cannula can be configured to span a range of diameters to obtain acceptable stiffness of the cannula body. In some implementations, the outer diameter of the reinforced outer end layer is larger than the average outer diameter of the intermediate portion of the cannula. In certain implementations, the outer diameter of the intermediate portion of the cannula is about 2 Fr to about 7 Fr, and the outer diameter of the reinforced portion of the cannula is about 3 Fr to about 8 Fr. In other implementations, the outer diameter of the intermediate portion of the cannula is about 3 Fr to about 6 Fr, and the outer diameter of the reinforced portion of the cannula is about 4 Fr to about 7 Fr. In certain implementations, the outer diameter of the intermediate portion of the cannula is about 4 Fr to about 5 Fr, and the outer diameter of the reinforced portion of the cannula is about 5 Fr to about 6 Fr.
[0022] In certain implementations, the intermediate portion of the cannula is configured to have an inner layer, a coil, and an outer layer, and the reinforced portion of the cannula is an extension of the cannula from the intermediate portion, further including an outer end reinforcement layer thermoformed to one or both of the end regions of the cannula.
[0023] Methods for manufacturing a cannula having an inner layer and a reinforced end region are also contemplated. In one implementation, the cannula is manufactured by thermoforming the inner layer onto a mandrel, disposing a shape memory coil across the outer diameter of the inner layer, and thermoforming the outer layer of the cannula over the inner layer and the coil of the cannula to extend along the length of the cannula. An outer end reinforcement layer is then thermoformed to extend over the outer layer of the cannula at a proximal end of the cannula. The thermoformed outer end reinforcement layer forms a reinforced section of the cannula between the cannula and the pump housing. The thermoformed outer end reinforcement layer can be configured to help prevent separation between the pump housing and the cannula during percutaneous insertion of the intravascular blood pump system into the patient's body. In addition, the reinforced section of the cannula is configured to increase the stiffness of the cannula at the interface between the cannula and the pump housing. In some implementations, the reinforced portion of the cannula has a stiffness of about 1.5 to 5.5 times that of an intermediate portion of the cannula. In other implementations, the reinforced portion of the cannula is about 2 to about 5 times as stiff as the middle portion of the cannula. In further implementations, the reinforced portion of the cannula is about 3 to about 4 times as stiff as the middle portion of the cannula. In certain implementations, the reinforced portion of the cannula is about 3.5 times as stiff as the middle portion of the cannula. In another implementation, a method for manufacturing a cannula for use in a blood pump assembly includes the cannula joined to a pump housing of the pump assembly configured to at least partially surround a rotor and an inflow cage of the pump assembly. In such implementations, the method further includes joining the inflow cage to a distal end of the cannula and joining the pump housing to a proximal end of the cannula. In a further implementation, at least one of joining the inflow cage to the distal end of the cannula and joining the pump housing to the proximal end of the cannula includes applying an epoxy to the components to be joined and thermally curing the epoxy.
[0024] In a particular implementation, thermoforming the inner layer involves placing an inner extruded sleeve over a mandrel and placing a first heat shrink tube around the inner extruded sleeve. The heat shrink tube and inner extruded sleeve are then heated to soften the sleeve and cause the heat shrink tube to apply a compressive force against the sleeve in the direction of the mandrel. The first heat shrink tube is then removed.
[0025] In another implementation, thermoforming the outer layer includes placing an outer extruded sleeve including the outer material over the inner layer and the coil, followed by placing a second heat shrink tube around the outer extruded sleeve. The heat shrink tube and the outer extruded sleeve are then heated to soften the sleeve and cause the second heat shrink tube to apply a compressive force against the sleeve in the direction of the inner layer and the coil, embedding the coil into the outer material. The second heat shrink tube is then removed. [Brief description of the drawings]
[0026] These and other objects and advantages will become apparent from the following detailed description considered in conjunction with the accompanying drawings, in which like reference characters refer to like parts throughout.
[0027] [Figure 1] 1A-1C show an exemplary blood pump assembly having a thermoformed outer end reinforcement layer at its proximal end in accordance with aspects of the present disclosure. [Diagram 2] 1 is an exemplary cross-sectional view illustrating a cannula for use in a blood pump assembly having a thermoformed outer end reinforcement layer according to aspects of the present disclosure. [Diagram 3] 1A-1C show an exemplary blood pump assembly having two thermoformed outer end reinforcement layers according to aspects of the present disclosure. [Figure 4] 1A-1C illustrate an exemplary method for manufacturing a stiffening cannula according to aspects of the present disclosure. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0028] Detailed Description To provide an overall understanding of the systems, methods, and devices disclosed herein, certain exemplary implementations are described. Although the implementations and features described herein are specifically described for use in connection with blood pump assemblies, it will be understood that the teachings may be adapted and applied to other pumps and other types of medical devices.
[0029] 1 illustrates an exemplary blood pump assembly 100 having a pump 102 with a motor 106 and a rotor 104, a pump housing 108, a catheter 110 with a distal end 112, a cannula 114 with a proximal end 116, a distal end 118, an intermediate section 120, a length 124, a thermoformed inner layer 126, a coil 128, an inner layer outer diameter 130, a thermoformed outer layer 132, a thermoformed outer end reinforcement layer 134, and an atraumatic extension 136. The rotor 104 of the pump 102 includes at least one blade (not shown) for transporting fluid through the pump 102. The pump housing 108 surrounds the at least one blade of the rotor 104. A proximal end 116 of the cannula 114 is coupled to the pump housing 108, and a distal end 118 of the cannula 114 is coupled to a blood inflow cage 122, which is itself coupled to a flexible, atraumatic extension 136. The extension 136 may help stabilize the pump 102 by acting as a rectifying region when the pump 102 is placed within a patient. In some implementations, the extension 136 is a pigtail.
[0030] Cannula 114 may have the same structure as shown below with respect to FIG. 2. In that regard, cannula 114 of FIG. 1 includes a thermoformed inner layer 126 extending along the length 124 of cannula 114, inner layer 126 including an inner material. In addition, cannula 114 includes a coil 128 including a shape memory material disposed on thermoformed inner layer 126. Cannula 114 further includes a thermoformed outer layer 132 extending along the length 124. The outer layer includes an outer material. A thermoformed outer end reinforcement layer 134 extends over the outer layer of cannula 114 at the proximal end 116 of cannula 114. Thermoformed outer end reinforcement layer 134 includes a reinforcement material. Additionally, thermoformed outer end reinforcement layer 134 provides additional stability to the joint between cannula 114 and pump housing 108.
[0031] In some implementations, the thermoformed outer end reinforcement layer 134 is at least twice as stiff as the intermediate portion 120 of the cannula 114. In other implementations, the thermoformed outer end reinforcement layer 134 is about 1.5 to 5.5 times as stiff as the intermediate portion 120 of the cannula 114. In other implementations, the thermoformed outer end reinforcement layer 134 is about 2 to about 5 times as stiff as the intermediate portion 120 of the cannula 114. In further implementations, the thermoformed outer end reinforcement layer 134 is about 3 to about 4 times as stiff as the intermediate portion 120 of the cannula 114. In certain implementations, the thermoformed outer end reinforcement layer 134 is about 3.5 times as stiff as the intermediate portion 120 of the cannula 114.
[0032] As discussed above, in certain implementations, the inner material has a hardness of about 45D to about 65D. In other implementations, the inner material has a hardness of about 50D to about 60D. In further implementations, the inner material has a hardness of about 55D. In some implementations, the outer material has a hardness of about 75A to about 95A. In other implementations, the outer material has a hardness of about 80A to about 90A. In further implementations, the outer material has a hardness of about 85A. In certain implementations, the reinforcing material has a hardness of about 45D to about 65D. In other implementations, the reinforcing material has a hardness of about 50D to about 60D. In further implementations, the reinforcing material has a hardness of about 55D. In certain implementations, the hardness of the inner material and the reinforcing material are equal or nearly equal.
[0033] The stiffness ratio of the reinforced portion of the cannula and the intermediate portion of the cannula can be adjusted to provide a desired stiffness profile along the length of the cannula. The stiffness ratio can be adjusted by incorporating one or more thermoformed outer end reinforcement layers of varying stiffness. The thermoformed outer end reinforcement layer can include a material having a higher stiffness than the intermediate portion of the cannula. The stiffness ratio can be further adjusted by incorporating materials having various stiffnesses that fall within the ranges described above. In addition, the shape of the thermoformed outer end reinforcement layer can also be adjusted to achieve a desired stiffness ratio. For example, the thermoformed outer end reinforcement layer 134 can have a radial thickness of about 0.05 mm to about 0.15 mm. In certain implementations, the radial thickness of the thermoformed outer end reinforcement layer 134 is less than about 0.1 mm. In addition, the thermoformed outer end reinforcement layer 134 can have a varying length. In certain implementations, the length of the thermoformed outer end reinforcement layer 134 is about 1 centimeter to about 3 centimeters. In other implementations, the length of the thermoformed outer end reinforcement layer 134 is about 2 centimeters. In some implementations, the length of the thermoformed outer end reinforcement layer 134 is about 3 mm to about 9 mm. In certain implementations, the length of the thermoformed outer end reinforcement layer 134 is about 5 mm to 7 mm. In other implementations, the length of the thermoformed outer end reinforcement layer 134 is about 6 mm. In general, different procedures requiring different insertion methods and angles may require a cannula with a specific stiffness profile along the length of the cannula. For example, femoral insertion of a blood pump assembly into an obese patient may suffer from kinking due to the vessels being deeper relative to the insertion point than in an underweight patient. In such cases, it may be desirable to increase the reinforcement of the distal and proximal ends of the cannula inserted in the procedure of the obese patient.
[0034] FIG. 2 illustrates an exemplary partial longitudinal cross-sectional view of a cannula 200 for use in a blood pump assembly having a thermoformed outer end reinforcement layer, such as the cannula 114 of FIG. 1. The cannula 200 of FIG. 2 has an inner layer 202, a coil 204, an outer layer 206, a thermoformed outer end reinforcement layer 208, a proximal end 210, an intermediate portion 212, and a distal end 214. The inner layer 202 has an outer diameter 216. The inner layer 202 includes an inner material. Similarly, the outer layer 206 includes an outer material. In some implementations, the inner material is polyurethane. In some implementations, the outer material is polyurethane. In such cases, the polyurethane of the inner material and / or the outer material may include polyether or polyester. The coil 204 includes a shape memory material, and the coil 204 is disposed on the inner layer 202. The shape memory material may be Nitinol or a copper aluminum alloy. A thermoformed outer end reinforcement layer 208 extends over the outer layer 206 at the proximal end 210 of the cannula 200. The thermoformed outer end reinforcement layer 208 includes a reinforcement material and forms a reinforced section at or near where the cannula 200 is coupled, for example, to a pump housing (e.g., pump housing 108 of FIG. 1).
[0035] In some implementations, the thermoformed outer end reinforcement layer 208 has a stiffness between about 1.5 and 5.5 times that of the intermediate portion 212 of the cannula 200. In other implementations, the thermoformed outer end reinforcement layer 208 has a stiffness between about 2 and 5 times that of the intermediate portion 212 of the cannula 200. In further implementations, the thermoformed outer end reinforcement layer 208 has a stiffness between about 3 and 4 times that of the intermediate portion 212 of the cannula 200. In certain implementations, the thermoformed outer end reinforcement layer 208 has a stiffness between about 3.5 times that of the intermediate portion 212 of the cannula 200. At least one advantage of the various stiffness ratios of the thermoformed outer end reinforcement layer 208 and intermediate portion 212 is that a cannula having a particular stiffness profile can be selected for a procedure depending on the tortuosity of the vasculature to be traversed by the cannula during the procedure.
[0036] The stiffness ratio of the thermoformed outer end reinforcement layer 208 and the intermediate section 212 of the cannula 200 can be adjusted by varying the shape of one or both of these elements to obtain a desired stiffness profile along the length of the cannula 200. For example, the thermoformed outer end reinforcement layer 208 can be made stiffer by increasing the radial thickness of the thermoformed outer end reinforcement layer 208. In addition, the intermediate section 212 can be made less stiff than the thermoformed outer end reinforcement layer 208 by decreasing the radius of the intermediate section 212. Furthermore, the stiffness ratio of the intermediate section 212 and the thermoformed outer end reinforcement layer 208 can be adjusted by changing the outer diameter 216 of the inner layer 202. For example, increasing the outer diameter 216 of the inner layer 202 while maintaining the same thickness of the inner layer 202 and the same outer diameter of the outer layer 206 will result in a less stiff intermediate section 212 because there will be less material in the intermediate section 212 to bend. Conversely, decreasing the outer diameter 216 of the inner layer 202 while maintaining the same thickness of the inner layer 202 and the same outer diameter of the outer layer 206 will result in a greater amount of material in the bending intermediate section 212, making the intermediate section 212 stiffer. Additionally, the stiffness ratio of the intermediate section 212 and the thermoformed outer end reinforcement layer 208 can also be tailored by incorporating materials having different stiffnesses. At least one advantage of being able to tailor the stiffness ratio of the intermediate section 212 and the thermoformed outer end reinforcement layer 208 of the cannula 200 is that a desired stiffness profile can be implemented along the length of the cannula 200 that is particularly suited for a given procedure.
[0037] 3 illustrates an exemplary blood pump assembly 300 having a pump 302 with a motor 306 and rotor 304, a pump housing 308, a catheter 310 having a distal end 312, a cannula 314 having a proximal end 316, a distal end 318, an intermediate section 320, a distal opening 340, a length 324, a thermoformed inner layer 326, a coil 328, an inner layer outer diameter 330, a thermoformed outer layer 332, a proximal thermoformed outer end reinforcement layer 334, a distal thermoformed outer end reinforcement layer 336, an atraumatic extension 338, and an inflow cage 322. Similar to the thermoformed outer end reinforcement layer 134 of FIG. 1, the proximal thermoformed outer end reinforcement layer 334 extends over the outer layer of the cannula 314 at the proximal end 316 of the cannula 314 and includes a reinforcement material. Proximal thermoformed outer end reinforcement layer 334 may provide additional stability to cannula 314 at or near the interface between cannula 314 and pump housing 308. Similarly, distal thermoformed outer end reinforcement layer 336 extends over the outer layer of cannula 314 at the distal end 318 of cannula 314 and includes a reinforcement material that may be the same or different from the reinforcement material used in proximal thermoformed outer end reinforcement layer 334. Distal thermoformed outer end reinforcement layer 336 may provide additional stability to cannula 314 at or near the interface between cannula 314 and inflow cage 322.
[0038] The proximal thermoformed outer end reinforcement layer 334 has an outer diameter 342, and the intermediate portion 320 has an outer diameter 344. In some implementations, the outer diameter 344 of the intermediate portion 320 is smaller than the outer diameter 342 of the proximal thermoformed outer end reinforcement layer 334. Similarly, the distal thermoformed outer end reinforcement layer 336 has an outer diameter 346. In some implementations, the outer diameter 344 of the intermediate portion 320 is smaller than the outer diameter 346 of the distal thermoformed outer end reinforcement layer 334.
[0039] In some implementations, at least one of the proximal and distal thermoformed outer end reinforcement layers 334 and 336 is approximately 1.5 to 5.5 times stiffer than the intermediate portion 320 of the cannula 314. In other implementations, at least one of the proximal and distal thermoformed outer end reinforcement layers 334 and 336 is approximately 2 to 5 times stiffer than the intermediate portion 320 of the cannula 314. In further implementations, at least one of the proximal and distal thermoformed outer end reinforcement layers 334 and 336 is approximately 3 to 4 times stiffer than the intermediate portion 320 of the cannula 314. In certain implementations, at least one of the proximal and distal thermoformed outer end reinforcement layers 334 and 336 is approximately 3.5 times stiffer than the intermediate portion 320 of the cannula 314. As previously discussed, the stiffness ratio of the reinforced portion of the cannula and the intermediate portion of the cannula can be adjusted to obtain a desired stiffness profile along the length of the cannula by varying the shape and material of the reinforced portion and the intermediate portion of the cannula. As previously mentioned, different procedures requiring different insertion methods and angles may require cannulas with different stiffness profiles.
[0040] FIG. 4 illustrates an exemplary method 400 of manufacturing a cannula. The cannula may be, for example, any of the cannulas described above in connection with FIGS. 1-3. The method 400 first includes step 402, in which an inner layer including an inner material, an inner diameter, and an outer diameter is thermoformed onto a mandrel. Subsequently, step 404 includes disposing a shape memory coil over the outer diameter of the inner material. Then, step 406 includes thermoforming an outer layer over the coil and the inner layer, the outer layer configured to extend along the length of the cannula. The outer layer includes an outer material.
[0041] Step 408 includes thermoforming an outer end reinforcement layer to extend over the outer layer at the end of the cannula. The outer end reinforcement layer includes a reinforcement material and forms a reinforced section of the cannula. For example, the reinforcement material may be applied to the proximal end of the cannula as shown in Figures 1 and 2 and configured to increase the stiffness of the cannula at or near the interface between the cannula and the portion of the pump to which the proximal end of the cannula is joined (e.g., between the cannula and the pump housing). In such a case, the method may further include bonding the thermoformed outer end reinforcement layer to a pump housing of the blood pump assembly. Similarly, the reinforcement material may be applied to the distal end of the cannula as shown in Figure 3 and configured to increase the stiffness of the cannula at or near the interface between the cannula and the portion of the pump to which the distal end of the cannula is joined (e.g., between the cannula and the inflow cage). In such a case, the method may further include bonding the thermoformed outer end reinforcement layer to the inflow cage of the blood pump assembly.
[0042] In some implementations, the thermoformed outer end reinforcement layer has a stiffness between about 1.5 and about 5.5 times that of the mid-section of the cannula of the blood pump assembly. In other implementations, the thermoformed outer end reinforcement layer has a stiffness between about 2 and about 5 times that of the mid-section of the cannula of the blood pump assembly. In certain implementations, the thermoformed outer end reinforcement layer has a stiffness between about 3 and about 4 times that of the mid-section of the cannula of the blood pump assembly. In further implementations, the thermoformed outer end reinforcement layer has a stiffness between about 3.5 and about 5 times that of the mid-section of the cannula of the blood pump assembly. The thermoformed outer end reinforcement layer may be bonded to the pump housing or inflow cage by applying a curing epoxy.
[0043] As previously mentioned, the step of thermoforming the inner layer includes placing an inner extruded sleeve including the inner material on a mandrel, followed by placing a first heat shrink tube around the inner extruded sleeve. The heat shrink tube and the inner extruded sleeve are then heated to soften the sleeve and cause the heat shrink tube to apply a compressive force against the sleeve in the direction of the mandrel. The first heat shrink tube is then removed. Similarly, the step of thermoforming the outer layer includes placing an outer extruded sleeve including the outer material over the inner layer and the coil, followed by placing a second heat shrink tube around the outer extruded sleeve. The heat shrink tube and the outer extruded sleeve are then heated to soften the sleeve and cause the heat shrink tube to apply a compressive force against the sleeve in the direction of the inner layer and the coil, causing the coil to embed in the outer material. The second heat shrink tube is then removed.
[0044] The foregoing description is merely illustrative of the principles of the technology. Thus, the apparatus and methods described herein can be practiced in other than described implementations, which are presented for purposes of illustration and not limitation.
[0045] In addition, the disclosed features may be implemented in any combination or subcombination (including multiple subcombinations and subcombinations) with one or more other features described herein. The various features described or illustrated above, including any components thereof, may be combined or integrated into other systems. Furthermore, certain features may be omitted or not implemented without departing from the spirit of the present technology.
Claims
1. a pump having a pump housing and a rotor and configured to be operated by the motor; an elongate catheter having a distal end coupled to the motor or the pump housing; a cannula having a proximal end connecting with the distal end of the pump housing and a distal end with at least one distal opening, the cannula having a longitudinal length; a thermoformed inner layer extending along the longitudinal length of the cannula and including an inner material; a coil having a shape memory material disposed across an outer diameter of the inner layer; a thermoformed outer layer extending along the longitudinal length over the inner layer and the coil, the outer layer comprising an outer material; a thermoformed first outer end reinforcement layer extending over the outer layer at the proximal end of the cannula, the first reinforcement layer including a first reinforcement material and forming a first reinforced portion of the cannula; and a thermoformed second outer end reinforcement layer extending over the outer layer at the distal end of the cannula, the second reinforcement layer including a second reinforcement material and forming a second reinforced portion of the cannula; The cannula comprising: An intravascular blood pump system comprising:
2. The system of claim 1, wherein the first reinforced portion of the cannula has a stiffness greater than the stiffness of an intermediate portion of the cannula distal to the first reinforced portion of the cannula.
3. The system of claim 2, wherein the intermediate portion is proximal to the second reinforced portion of the cannula, and the second reinforced portion of the cannula has a stiffness greater than that of the intermediate portion.
4. A system as described in any one of claims 1 to 3, wherein the first reinforcing material is the same as the second reinforcing material.
5. The system of claim 1, wherein the distal end of the cannula is connected to an inflow cage.
6. A system described in any one of claims 1 to 5, wherein the thickness of the first outer end reinforcement layer tapers in the distal direction.
7. A system described in any one of claims 1 to 6, wherein the thickness of the second outer end reinforcement layer tapers in the distal direction.
8. The system of claim 1, wherein the inner material is polyester polyurethane.
9. The system of claim 1, wherein at least one of the outer material or the first reinforcing material is a polyether polyurethane.
10. The system of claim 1, wherein the inner material has a hardness in the range of approximately 45D to 65D.
11. The system of claim 1, wherein the outer material has a hardness in the range of approximately 75A to 95A.
12. The system of claim 1, wherein the first reinforcing material has a hardness in the range of approximately 55D to 75D.
13. A system as claimed in any one of claims 1 to 12, wherein the hardness of the inner material and the hardness of the first reinforcing material are equal or approximately equal.
14. The system of claim 1, wherein the coil is embedded in the outer layer.
15. The system of claim 1, wherein the shape memory material comprises at least one of Nitinol or a copper aluminum alloy.
16. The cannula of claim 1, wherein an outer diameter of the intermediate portion of the cannula is less than an outer diameter of the first reinforcement portion of the cannula; the intermediate portion of the cannula includes the inner layer, the coil, and the outer layer; the first reinforcement portion of the cannula includes the inner layer, the coil, the outer layer, and the first outer end reinforcement layer; A system according to any one of claims 2 to 15.
17. A system as described in any one of claims 1 to 16, wherein the cannula is configured to be positioned within the patient's heart so that the cannula extends beyond the aortic valve of the patient's heart, the distal end of the cannula is within the left ventricle of the patient's heart, and the proximal end of the cannula is within the aorta of the patient's heart.
18. A system as described in any one of claims 1 to 17, wherein the thermoformed first outer end reinforcement layer extends over the outer layer at the distal end of the pump housing and the proximal end of the cannula.