Endoscopic snare net

Abstract

To provide an endoscopic snare net.SOLUTION: An endoscopic snare net comprises a net engaging a loop, e.g., by weaving the loop through a mesh of the net, and a tube having a lumen through which the net and loop may be extended and withdrawn by a control wire. The loop has one or more corners and / or a looped free-floating slip tether, which prevent the net from sliding free of the loop as the loop is retracted into the lumen of the tube even if the loop is over-extended beyond the end of the tube.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] Related Applications This application claims priority to U.S. Provisional Patent Application No. 62 / 531,470, filed July 12, 2017, which is incorporated by reference herein in its entirety.

[0002] The technical field relates to an endoscopic device, and more particularly to a snare net for an endoscope. [Background technology]

[0003] Snare nets are known that tie a portion of the net to a cold loop or loop. Examples of known snare nets can be found in U.S. Patent Nos. 8,016,838, 7,618,437, 6,814,739, 5,906,621, 5,759,187, 5,486,182, 5,336,277, 5,201,740, and 5,190,542. However, all of these known snare nets require difficult time creating a pocket to capture the polyp or foreign body, have complex mechanisms, contain excess netting material that can get caught, or require passage through a larger diameter lumen. While some complex systems solve one or more of the problems, the added complexity can potentially make them prone to failure and add substantial costs to the medical procedure. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] U.S. Patent No. 8,016,838 [Patent Document 2] U.S. Patent No. 7,618,437 [Patent Document 3] U.S. Patent No. 6,814,739 [Patent Document 4] U.S. Patent No. 5,906,621 [Patent Document 5] U.S. Patent No. 5,759,187 [Patent Document 6] U.S. Patent No. 5,486,182 [Patent Document 7] U.S. Patent No. 5,336,277 [Patent Document 8] U.S. Patent No. 5,201,740 [Patent Document 9] U.S. Patent No. 5,190,542 Summary of the Invention [Means for solving the problem]

[0005] The endoscopic snare net device includes a shaped loop, a net, and a tube having a lumen configured and arranged to receive an introducer through which the loop and snare net are threaded. The lumen is defined by the wall of the tube, such as a polymeric tube. Here, "lumen" refers to the open space inside the tube, and is not limited to biological lumens. The tube wall may have a collar disposed within the lumen, which may be fixed to the wall at a position some distance from the end of the tube or may float freely within the tube around a control wire. The shaped loop may be made of a resilient, flexible material, such as a metal. For example, the metal may be steel, nitinol, titanium, or an alloy thereof. The distal end of the loop may be folded and shaped to expand upon initial exit of the lumen. One or more folded corners may be disposed adjacent to the distal end of the loop.

[0006] In one example, the loop has one or more resilient bends at its proximal end that cause the loop to open and remain open when the loop is fully extended from the tube. For example, folded corners are provided in addition to one or more resilient bends that bias the loop open when extended from the tube. In one example, the folded corners are themselves provided by bends in the loop, but the folded corners serve a different purpose than the one or more resilient bends that bias the loop open. Instead of biasing the loop open when the loop is extended from the tube, the folded corners serve to lock the snare net during closure when the loop is extended from the tube, and the snare net can be attached to the loop by a single knot at the distal end of the loop, by weaving the loop through an opening in the net, and / or by a tether looped through the net at the proximal end of the loop. In one example, a loop without at least one folded corner causes the net to advance forward in the loop when the loop is retracted into the tube. In contrast, a loop with at least one folded corner pulls the netting into the tube with the loop. Also, pairs of folded corners on opposite sides of the loop help form discrete pockets in the netting as the loop and netting are pulled into the tube when the loop is closed. When the loop is fully deployed, the netting is flat, but as the loop is retracted, a pocket is formed in the netting that can be used to capture foreign objects while the loop closes around them.

[0007] In one example, the bend in the folded corner does not form a loop (i.e., the folded corner is open, does not loop around itself, and does not intersect with itself). Instead, in this example, the bends forming the folded corner include a first bend in a first direction, a second bend in a second direction, and a third bend in a third direction. The first bend is closer to the proximal end of the loop than the other bends. The bend in the loop creates an angle between the portion of the loop before the bend and the portion of the loop after the bend. The first bend can bend the loop such that the first portion of the folded corner is directed more inwardly, for example, in a direction toward an imaginary line extending from the central longitudinal axis of the tube, as the loop is extended from the tube.

[0008] For example, a portion of the loop disposed before the first bend (i.e., the portion closer to the proximal end of the snare loop) may flare outward from the imaginary line as the loop is extended from the tube, and a first portion of the folded corner after the first bend may extend with a smaller outward flare, substantially parallel, or inward flare. Here, "greater outward flare" refers to a larger angle away from the direction of an imaginary line extending from the central longitudinal axis of the tube, and "greater inward flare" refers to a smaller angle toward the direction of the imaginary line extending from the same axis. In one example, the first bend changes the direction of the loop to a larger inward flare, the second bend changes the direction of the loop to a larger outward flare, and the third bend changes the direction of the loop to a larger inward flare.

[0009] In one example, when the loop is extended from the tube, a first portion of the greater inward flaring of the folded corner is substantially parallel to the imaginary line. The term "substantially parallel" does not mean exactly parallel. Instead, the term "substantially parallel" refers to a flaring of plus or minus 5 degrees or less from parallel to the imaginary line extending from the central longitudinal axis of the tube. In an alternative example, the first portion converges inward, i.e., an imaginary line extending from the first portion eventually meets with the imaginary line extending from the central longitudinal axis of the tube, both extending toward the distal end of the loop. In yet another example, the first portion of the folded corner flares outward, but not as far outward as the portion of the loop immediately preceding the first bend of the folded corner.

[0010] In one example, the floating tether tether is sized with an inner diameter that is larger than the outer diameter of the control wire that passes through the inner diameter of the floating tether, so that the floating tether is not fixed to the control wire and easily slides along the control wire inside the tube. In one example, the outer diameter of the tether tether is larger than the inner diameter of the tube that surrounds the tether tether, so that the tether tether is locked in a fixed position relative to the tube. In an alternative example, the floating tether tether has an outer diameter that is smaller than the inner diameter of the tube that surrounds the tether tether, so that the floating tether tether slides freely or "floats" inside the tube.

[0011] A method of using a snare net includes extending the net from a lumen engaged with a snare loop so that the loop opens; endoscopically positioning the net and loop to retrieve an object such as a foreign body or polyp; and at least partially retracting the net and loop back into the lumen, causing the loop to at least partially close and creating a pocket in the net, wherein a portion of the folded corner engages a portion of the net near the proximal end of the loop, so that the net is pulled into the lumen by the folded corner as the loop is retracted into the lumen.

[0012] In one example, an endoscopic snare net device comprises a shaped loop having a distal end and a proximal end, the distal end of the loop shaped to expand when it first exits the lumen and the proximal end of the loop having one or more corners that exit the lumen after the distal end of the loop, a net, and a tube having a lumen constructed and arranged to receive an introducer through which the loop and snare net are threaded.

[0013] The lumen is defined by the wall of the tube, the net is engaged with the shaped loop such that the loop is held in the shaped loop by weaving the loop through holes in the net, the net is anchored at the distal end of the shaped loop, and the net engages with one or more corners of the shaped loop at the proximal end of the shaped loop, the one or more corners being shaped to keep the net from slipping forward in the shaped loop while extending from the lumen of the shaped loop and net and while pulling back into the lumen of the shaped loop and net.

[0014] For example, the shaped loop may be made from a resilient, flexible material such as a metal, e.g., steel, nitinol, titanium, or an alloy thereof. In one example, a steel loop is used. The tube may have a collar disposed within the lumen, and the collar may be fixed to the wall of the tube at a location a distance from the end of the tube or may be free-floating. Optionally, a tether may be coupled to the collar at a first end of the tether and to a net at a second end of the tether opposite the first end. The tube may have a free-floating collar disposed around a control wire inside the tube and coupled to the shaped loop. The tether may be coupled to the collar at a first end of the tether and to a net at a second end of the tether opposite the first end.

[0015] In one example, the length of the tether is selected so that when the proximal end of the shaped loop enters the vessel during retraction of the shaped loop and net, the tether engages the net and pulls the net into the vessel.

[0016] For example, one or more corners may be folded, providing one or more resilient bends that bias the loop open when extended from the lumen, in addition to any bends that bias the loop open. The one or more corners lock the snare net to the loop during closure, with the net being locked to the distal end of the loop by only one point of attachment, for example, at the distal end of the loop. The one or more corners may include at least a first corner on a first side of the proximal end of the loop and a second corner on a second side of the proximal end of the loop opposite the first side, such that a separate pocket is formed in the net at the proximal end of the loop and the net is pulled into the tube as the loop closes. The one or more corners may be open to prevent the loop from extending over any other portion of the loop, i.e., preventing the loop from looping over itself to form a smaller loop.

[0017] For example, when the loop is extended from the tube, each of the one or more corners may include a first bend at a first bend angle direction, a second bend at a second bend angle direction opposite the first bend angle direction, and a third bend at a third bend angle direction opposite the second bend angle direction, each of the one or more corners being positioned to extend outward from an imaginary line extending from the central longitudinal axis of the tube. The first bend angular direction may flare inward more than the angular direction of an adjacent portion of the loop closer to the proximal end of the loop, the second bend angular direction may flare outward more than the first bend angular direction, and the third bend angular direction may flare inward more than the second bend angular direction, so that, for example, an outwardly extending corner is formed at an outward apex where the loop extending along the second bend angular direction flares toward the third bend angular direction, and an inwardly extending bend is formed at an inward apex where the loop extending from the first bend angular direction flares toward the second bend angular direction. In one example, the one or more corners form at least one zigzag shape in a portion of the loop.

[0018] In one example, a loop tether couples the loop to the control wire, the collar is sized with a collar inner diameter larger than the wire outer diameter of the control wire, and the loop tether has a loop tether outer diameter larger than the collar inner diameter of the collar, so that the collar cannot slip over the loop tether outer diameter.

[0019] In one example, a method of using an endoscopic snare net includes extending the net and loops from a lumen so that the loops are open; endoscopically positioning the net and loops to retrieve an object; and at least partially retracting the net and loops back into the lumen to at least partially close the loops and create a pocket in the net, wherein one or more of the corners engage a portion of the net near the proximal end of the loop, such that as the loop is retracted into the lumen, a portion of the net is pulled into the lumen by the one or more corners. [Claims] [Additional note 1] A snare net device for an endoscope, a shaped loop having a distal end and a proximal end, the distal end of the loop being shaped to expand when it first exits a lumen, and the proximal end of the loop having one or more corners that exit the lumen after the distal end of the loop; The net and a tube having a lumen constructed and arranged to receive an introducer through which the loop and snare net are passed, a tube, the lumen being defined by a wall of the tube, the net being engaged with the shaped loop such that the loop is held in the shaped loop by weaving through holes in the net, the net being anchored at the distal end of the shaped loop, and the net being engaged at the proximal end of the shaped loop with the one or more corners of the shaped loop, the one or more corners being shaped to keep the net from sliding forward in the shaped loop while extending from the lumen of the shaped loop and the net and while pulling the net back into the lumen of the shaped loop and the net; A snare net device for an endoscope comprising: [Additional note 2] The snare net device for an endoscope described in Appendix 1, wherein the molded loop can be made from an elastic and flexible material. [Additional note 3] The snare net device for an endoscope according to claim 2, wherein the elastic and flexible material is made of metal. [Additional note 4] The snare net device for an endoscope according to claim 3, wherein the metal is steel, nitinol, titanium, or an alloy thereof. [Additional note 5] The snare net device for an endoscope according to claim 1, wherein the metal is steel. [Additional note 6] An endoscopic snare net device as described in Appendix 1, wherein the tube has a collar disposed within the lumen, and the collar is fixed to the wall of the tube at a position a certain distance from the end of the tube. [Additional note 7] An endoscopic snare net device as described in Appendix 6, further comprising a tether, the tether being coupled to the collar at a first end of the tether and coupled to the net at a second end of the tether opposite the first end. [Additional note 8] An endoscopic snare net device as described in Appendix 1, wherein the tube has a collar disposed within the lumen, the collar floating freely within the tube and disposed around a control wire coupled to the loop. [Additional note 9] An endoscopic snare net device as described in Appendix 8, further comprising a tether, the tether being coupled to the collar at a first end of the tether and coupled to the net at a second end of the tether opposite the first end. [Additional Note 10] 10. The snare net device for an endoscope according to claim 9, wherein the length of the tether is selected so that when a proximal end of the formed loop enters the tube during retraction of the formed loop and the net, the tether engages with the net and pulls the net into the tube. . [Additional Note 11] An endoscopic snare net device as described in Appendix 10, wherein the one or more corners are bent to provide one or more elastic bends in addition to any bends that bias the loop open. [Additional Note 12] The one or more corners secure the net to the loop during closure, and the net is secured to the distal end of the loop by only one attachment point at the distal end of the loop. [Additional Note 13] The one or more corners comprise at least a first corner on a first side of the proximal end of the loop and a second corner on a second side of the proximal end of the loop opposite the first side, so that individual pockets are formed within the net at the proximal ends of the loops and the net is pulled into the tube when the loops close. [Additional Note 14] An endoscopic snare net device as described in Appendix 1, wherein the one or more corners are opened so that the loop does not extend over any other portion of the loop. [Additional Note 15] An endoscopic snare net device as described in Appendix 14, wherein each of the one or more corners comprises a first bend in a first bending angle direction, a second bend in a second bending angle direction opposite to the first bending angle direction, and a third bend in a third bending angle direction opposite to the second bending angle direction, arranged so that when the loop is extended from the tube, each of the one or more corners extends outward from an imaginary line extending from the central longitudinal axis of the tube. [Additional Note 16] The snare net device for an endoscope described in Appendix 15, wherein the first bending angle direction extends inward more than the angle direction of an adjacent portion of the loop closer to the proximal end of the loop, the second bending angle direction extends outward more than the first bending angle direction, and the third bending angle direction extends inward more than the second bending angle direction, whereby an outwardly extending corner is formed at an outward vertex where the loop extending along the second bending angle direction extends toward the third bending angle direction, and an inwardly extending bend is formed at an inward vertex where the loop extending from the first bending angle direction extends toward the second bending angle direction. [Additional Note 17] An endoscopic snare net device as described in appended item 16, wherein the one or more corners form at least one zigzag-shaped portion in a portion of the loop. [Additional Note 18] An endoscopic snare net device as described in Appendix 8, further comprising a loop anchoring portion that connects the loop to the control wire, wherein the collar is sized with a collar inner diameter that is larger than the wire outer diameter of the control wire, and the loop anchoring portion has a loop anchoring portion outer diameter that is larger than the collar inner diameter of the collar, so that the collar cannot slide beyond the loop anchoring portion outer diameter. [Additional Note 19] A snare net for an endoscope, a loop having a distal end and a proximal end; The net and a tube having a lumen constructed and arranged to receive an introducer through which the loop and snare net are passed, The lumen is defined by the wall of the tube, and the netting is such that the loops are a tube engaged with the shaped loop such that the net is retained in the loop by being knitted through holes in the tube, the net being anchored at the distal end of the loop, the distal end of the loop being shaped to expand when first exiting the lumen, and the proximal end of the loop having a bend to continue to extend outward as it is extended beyond the lumen; a loop mooring portion; a free-floating collar disposed about a control wire within the tube, the collar sized with a collar inner diameter larger than an outer wire diameter of the control wire, the loop tether coupling the control wire to the loop, the loop tether having a loop tether outer diameter larger than the collar inner diameter of the collar so that the collar cannot slide past the loop tether; a tether that is not secured to the control wires, is not secured to the tube, and is coupled to the collar at a first end and to the net at a second end opposite the first end so as to tether the net to the free-floating collar; A snare net for an endoscope. [Additional Note 20] A method for using the snare net device for an endoscope according to claim 1, extending the net and the loops from the lumen so that the loops are open; endoscopically positioning the net and the loop to retrieve an object; retracting the net and the loop at least partially back into the lumen, causing the loop to at least partially close and creating a pocket in the net, wherein one or more of the corners engage a portion of the net near the proximal end of the loop so that the portion of the net is pulled into the lumen by the one or more corners as the loop is retracted into the lumen; A method comprising:

[0020] The following drawings are illustrative examples and do not limit any claims that may ultimately be issued. [Brief explanation of the drawings]

[0021] [Figure 1] FIG. 1 is a diagram showing an example of an endoscopic snare net. [Figure 2] FIG. 2 is a detailed view (A) of the example in FIG. 1. [Figure 3] FIG. 10 is a diagram showing another example of an endoscopic snare net. [Figure 4] FIG. 10 is a detailed view of a tether when used with any of the previous examples. DETAILED DESCRIPTION OF THE INVENTION

[0022] When the same reference numbers are used, these labels refer to similar parts in the examples shown in the drawings.

[0023] FIG. 1 shows an example of an endoscopic snare net 10 including a net 11, a loop 12, and a tube 13. The tube 13 may include a lumen through which a cable 25 passes, which may be used to extend and retract the net 11 and loop 12. The loop 12 may be a wire, which may be flat or circular in cross section. The loop's wire may pass through the net above and below the plane of the net's weave through openings in the net. The net 11 is held in place by the loop 12. A knot 23 may attach the net 11 to a distal end 22 of the loop. For example, the distal end 22 of the loop may be bent to provide a biasing force that opens the loop 12 when the distal end 22 of the loop is extended from the tube 13.

[0024] Cable 25 can be coupled to loop 12 by connector 21, such as a crimp connector, so that moving the cable forward deploys the loop and net, and retracting cable 25 closes the loop and net and retrieves them into the lumen of tube 13. The cable and tube can be made to any length L.

[0025] For example, tether 16 can be attached at one end to coupling 24 disposed within the lumen of tube 13, and the other end of tether 16 can be looped around a portion of net 11 and / or loop 12. In one example, the length of the tether is approximately the same as the distance from the distal tip of the loop to the proximal end of the loop that extends from the lumen when the loop is fully extended. The tether can be looped around the net and loop, preventing both the net and loop from fully extending from the lumen, as shown in more detail in the example of FIG. 2.

[0026] The example in FIG. 1 shows multiple folded corners 30, 40. Additional folded corners may be added. Alternatively, for example, only a single folded corner may be provided. In testing, the pair of folded corners 30, 40 created a pocket in the snare net 11 when the loop 12 was retracted into the lumen. Detail A in FIG. 1 is shown in more detail in the example in FIG. 2. A first flared portion 37 of the loop extends from the lumen in this example, and a second flared portion 36 after the bend in the loop 12 flares outward more than the first portion of the loop. A first folded corner bend 35 directs the first folded corner portion 34 to a smaller outward flaring. A second folded corner bend 32 directs the second folded corner portion 33 to a larger outward flaring than either of the other portions. The third bend 31 directs the subsequent portion of the loop to a smaller outward expansion than the second portion 33 of the folded corner 30, which continues in an arcuate elliptical shape until it approaches the distal end 22 and knot 23.

[0027] Although not specifically shown in the drawings, the locations and angles of portions of folded corners 30, 40 are not the same. In folded corner 30, first corner portion 34 is substantially parallel, while in folded corner 40, the first corner portion flares outward more and is closer to the lumen opening of tube 13. For example, angle α between first folded corner portion 34 and second folded corner portion 33 may be greater than 90 degrees (or may be obtuse), less than 90 degrees (or may be acute), or substantially 90 degrees, where "substantially 90 degrees" means 90 degrees plus or minus 5 degrees when the loop is fully extended from the lumen. In one example, angle α is selected to prevent the net from slipping, for example, beyond folded corner 40.

[0028] In another example, a tether 115 can be coupled to the snare net 11. For example, FIG. 3 shows an example of a loop 112 without folded corners, and FIG. 4 shows a detailed view of the tether as it would be used in either of the previous examples. The tether 115 can be coupled to the net 11 by looping the tether through the net at its distal end 118, and coupling the proximal end 119 of the tether 115 to a floating tether tether 117 by looping the tether 115 through tether 117. Tether 117 is referred to as a floating tether tether because it is not secured to any other structure. The tether is not attached to either the tube or the wire 122. Instead, the tether slides freely or "floats" along the wire 122. One benefit of this floating tether is that tether 115 does not need to pull on net 117 as the net is deployed, even if the net is over-deployed. This prevents the net from being torn or unraveled by the tether. Instead, the tether floats on wire 122 until the user retracts the net and loop back into the vessel. Tether 117 could then become snagged by an obstruction, such as the end of connecting cannula 120. Alternatively, a separate folded cannula 121 could be folded on control wire 122 and act as an obstruction to engage floating tether tether 117. A space may be provided between tether 117 and any such obstruction to prevent snagging prior to retraction of the loop and net back into the vessel lumen. In one example, connecting cannula 120 may extend beyond the end of the snare loop. As shown in FIG. 4, the connecting cannula 120 can be a bent section of metal tubing, which can be the same material used in, for example, hypodermic needles.

[0029] This detailed description provides examples that include the features and elements of the claims for purposes of enabling one skilled in the art to make and use the inventions set forth in the claims. However, these examples are not intended to directly limit the scope of the claims. Instead, the examples provide the features and elements of the claims that are disclosed in these specifications, claims, and drawings, and that may be modified and combined in manners known in the art. [Explanation of symbols]

[0030] 10 Endoscopic snare net 11 Net 12 Loops 13 tube 22 Distal end of loop 23 Knot 25 Cable 30, 40 folded corners 32 Second folded corner bend 33 Second part of folded corner 34 First part of folded corner 35 First folded corner bend 36 Second spreading part 37 First spreading part 112 Loops 115 Tether 117 Tether mooring section 118 Distal end 119 proximal end 120, 121 Cannula 122 control wire L Cable and tube length α is the angle between the first and second parts

Claims

1. A medical device comprising: a lumen defined by a wall of a tube, the tube having a proximal end and a distal end opposite the proximal end; a cable extending through the tube and into the lumen; a shaped loop having a distal end and a proximal coupling; It is equipped with the proximal coupling is coupled to the cable such that the formed loop can be extended from the lumen outward from the distal end of the tube by pushing the cable and retracted into the lumen toward the proximal end of the tube by pulling the cable; the distal end of the shaped loop is configured such that the shaped loop unfolds when the distal end of the shaped loop exits the lumen at the distal end of the tube; the shaped loop comprises a first side extending between the distal end of the shaped loop and the proximal coupling, and a second side extending between the distal end of the shaped loop and the proximal coupling opposite the first side; the first side is coupled to the second side by the distal end of the shaped loop and by the proximal coupling, and both the first side and the second side include a plurality of folded corners; the plurality of folded corners on the second side are asymmetrically disposed relative to the plurality of folded corners on the first side; each of the plurality of folded corners on the first side of the shaped loop includes a first bend, a second bend, and a third bend; the first bend is closest to the proximal coupling; the second bend is closer to the proximal coupling than the third bend; each of the plurality of folded corners on the second side of the shaped loop includes a first bend, a second bend, and a third bend; the first bend is closest to the proximal coupling; A medical device, wherein the second bend is closer to the proximal coupling than the third bend.

2. 10. The medical device of claim 1, wherein the wall of the tube is made of a polymer.

3. 10. The medical device of claim 1, wherein the shaped loop is formed from a resiliently flexible material.

4. 4. The medical device of claim 3, wherein the resilient, flexible material is a metal.

5. 5. The medical device of claim 4, wherein the metal is nitinol.

6. the shaped loop further comprises one or more resilient bends near the proximal coupling of the shaped loop; 10. The medical device of claim 1, wherein the one or more resilient bends are configured to cause the shaped loop to open and remain open when the shaped loop is fully extended from the distal end of the tube.

7. the first bent portion, the second bent portion, and the third bent portion on the left side of the formed loop do not form a loop; The medical device of claim 4 , wherein the left side does not cross itself.

8. On the left side of the shaped loop, for a first corner of the plurality of folded corners: The first bend is in a first direction. the second bend is in a second direction; the third bend is in a third direction; the first direction is oriented further inwardly than a portion of the shaped loop adjacent the proximal coupling and immediately adjacent the first bend; that is, the first direction is a direction further toward an imaginary line extending from the central longitudinal axis of the tube than the portion of the formed loop immediately preceding the first bend when the formed loop is extended from the tube; the second direction deviates further outward than the first direction; The medical device of claim 7 , wherein the third direction deviates further inward than the second direction.

9. The medical device of claim 8 , wherein the first direction is substantially parallel to the imaginary line.

10. 9. The medical device of claim 8, wherein a first portion of the folded corner remains deflected outward, but deflects outward less than a portion of the shaped loop immediately preceding the first bend of the folded corner.

11. at the second bend of the shaped loop, an angle α is defined by a portion of the shaped loop immediately preceding the second bend and a portion of the shaped loop immediately following the second bend; The medical device of claim 8 , wherein the angle α is substantially 90 degrees.

12. at the second bend of the shaped loop, an angle α is defined by a portion of the shaped loop immediately preceding the second bend and a portion of the shaped loop immediately following the second bend; The medical device of claim 8 , wherein the angle α is less than 90 degrees.

13. 10. The medical device of claim 1, wherein the cable is connected to the proximal coupling of the shaped loop by a connector.

14. 14. The medical device of claim 13, wherein the connector is crimped to the cable.

15. 2. The medical device of claim 1, wherein the folded corners on the second side are positioned closer to the proximal coupling than the folded corners on the first side, such that the folded corners on the second side are asymmetrically positioned relative to the folded corners on the first side.

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