Guidewire Adjuster for Stent Positioning in Aortic Arch
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Solution Overview
Problem
Conventional delivery systems face challenges in adjusting the position of a stent during interventional procedures, particularly in the aortic arch area, where the sheath cannot effectively transmit movement to the stent, leading to unsatisfactory clinical results due to the stent being positioned lower than expected.
Innovation Solution
A guidewire adjuster with a support mechanism and driving mechanism that allows for axial movement of the guidewire relative to the sheath, connected to a control handle, enabling the stent to be adjusted upwardly by advancing the guidewire and thus the sheath at the aortic arch, ensuring precise positioning.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Manufacturing precision
If the sheath is withdrawn to adjust stent position, then the stent can be moved upward, but the sheath gets locked at the inner side of the aortic arch bending portion and cannot transmit movement
Solution Approach 1:
The delivery system is divided into separate functional components: the sheath, the core shaft, and the guidewire adjuster. The guidewire adjuster can be independently operated to move the guidewire relative to the sheath, allowing stent position adjustment without requiring sheath movement. This segmentation resolves the contradiction by providing an alternative adjustment mechanism that avoids the sheath locking issue in the aortic arch.
Solution Approach 2:
The guidewire acts as an intermediary element between the operator and the stent. By adjusting the guidewire position through the guidewire adjuster, the stent can be moved upward without directly moving the sheath. This intermediary approach allows position adjustment while avoiding the sheath's interaction with the aortic arch bending portion.
2Manufacturing precision
If the sheath is advanced forward to adjust stent position, then the stent can be moved upward, but the sheath abuts the outer side of the aortic arch and cannot transmit movement
Solution Approach 1:
The delivery system is divided into separate functional components: the sheath, the core shaft, and the guidewire adjuster. The guidewire adjuster can be independently operated to move the guidewire relative to the sheath, allowing stent position adjustment without requiring sheath movement. This segmentation resolves the contradiction by providing an alternative adjustment mechanism that avoids the sheath locking issue in the aortic arch.
Solution Approach 2:
The guidewire acts as an intermediary element between the operator and the stent. By adjusting the guidewire position through the guidewire adjuster, the stent can be moved upward without directly moving the sheath. This intermediary approach allows position adjustment while avoiding the sheath's interaction with the aortic arch bending portion.
3Productivity
If the stent is deployed in a lower position due to aortic arch geometry, then the delivery procedure is completed, but the clinical results are unsatisfactory and repositioning is impossible
Solution Approach 1:
The guidewire adjuster is designed to be operable both before and after stent deployment. This allows the operator to make preliminary position adjustments before releasing the stent, and also to perform corrective adjustments after deployment if the stent ends up in a lower than desired position. This preliminary and post-deployment adjustment capability ensures accurate positioning while maintaining procedure completion.
Solution Approach 2:
The system allows dynamic adjustment of the guidewire's axial position relative to the sheath through the guidewire adjuster. By changing this parameter (the relative position of guidewire and sheath), the stent position can be adjusted upward even after deployment, transforming a fixed-position problem into a dynamically adjustable system.
Data Source
AI summary
The present invention provides a guidewire adjuster and a delivery-system control handle provided with the guidewire adjuster. The guidewire adjuster includes a support mechanism which has a lumen for a guidewire to extend therethrough; and a driving mechanism for driving the guidewire to move back and forth in the lumen. The guidewire adjuster is able to drive the guidewire to move with respect to a sheath of the delivery system. The support mechanism is connected to the control handle of the delivery system and forms a lumen for accommodating the guidewire. A proximal end of the sheath together with the stent can be driven to move upwardly, due to the relative movement between the guidewire and the sheath of the delivery system. Therefore, the position of the stent can be adjusted by advancing the guidewire forward when the stent has been deployed at a lower position than expected.