Lead extraction device

Abstract

An extraction device for removing an implanted structure, such as a cardiac lead, from a body vessel. An elongated sheath having a proximal end, a distal end, and a passageway extending therethrough is sized such that at least a distal portion of the sheath is receivable in the body vessel. A tip configured for disassociating at least a portion of the implanted structure from the body vessel is engaged at the distal end of the sheath. A handle is configured for engagement with the proximal end of the sheath. The handle includes an actuator and a drive mechanism responsive to the actuator for selectively translating input of the actuator into rotary movement and/or axial advancement of the sheath.

1 . A device for removing an implanted structure from a body vessel, the device comprising: 
 an elongated sheath having a proximal end, a distal end, and a passageway extending therethrough, said sheath having a length such that at least a distal portion of said sheath is receivable in said body vessel, said passageway sized such that said implanted structure is receivable therein; and    a handle configured for engagement with said sheath proximal end, said handle including an actuator and a drive mechanism responsive to said actuator, said drive mechanism operable for selectively translating input of said actuator into at least one of rotation and axial advancement of said sheath.    
     
     
         2 . The device of  claim 1 , further comprising a tip engaged with said sheath distal end for disassociating at least a portion of said implanted structure from said body vessel.  
     
     
         3 . The device of  claim 1 , wherein said actuator comprises a trigger, and said drive mechanism comprises a rack and gear assembly responsive to said trigger for causing rotation of said sheath.  
     
     
         4 . The device of  claim 3 , wherein said handle further comprises a hub for receiving said sheath proximal end.  
     
     
         5 . The device of  claim 4 , further comprising a first bevel gear operationally engaged with said rack and gear assembly for rotation responsive to movement of said rack and gear assembly, and a second bevel gear operationally engaged with said first bevel gear for rotation responsive to rotation of said first bevel gear, said second bevel gear operationally engaged with said hub such that rotation of second bevel gear drives a rotation of said hub.  
     
     
         6 . The device of  claim 1 , wherein said handle includes a wall, said wall having a portion pivotable to an open position for receiving the proximal end of said sheath, and pivotable to a closed position for retaining said sheath in engagement with said handle.  
     
     
         7 . The device of  claim 1 , wherein said drive mechanism comprises a power source, said power source operationally engaged with said proximal end of said sheath for translating said input of said actuator into rotation of said sheath.  
     
     
         8 . The device of  claim 7 , wherein said power source is capable of supplying at least one of electrical, battery and pneumatic power.  
     
     
         9 . The device of  claim 2 , wherein said tip comprises a proximal end and a distal end, said tip proximal end configured for engagement with an inner surface of said sheath distal end.  
     
     
         10 . The device of  claim 9 , wherein said tip proximal end has an outer surface, said outer surface including at least one ring extending therealong for engaging said inner surface.  
     
     
         11 . The device of  claim 2 , wherein said tip comprises at least one disruptor mechanism disposed along an outer surface of said tip.  
     
     
         12 . The device of  claim 2 , wherein said tip comprises at least one disruptor element disposed along an outer surface and an inner surface of said tip.  
     
     
         13 . The device of  claim 2 , wherein said tip comprises a proximal end and a distal end, said distal end including a plurality of perforations therethrough, said tip further comprising at least one disruptor element at least partially winding through said perforations.  
     
     
         14 . The device of  claim 1 , wherein said actuator comprises a first actuator for providing input to enable rotation of said sheath, said device further comprising a second actuator for providing input to enable axial advancement of said sheath.  
     
     
         15 . A device for removing an implanted structure from an obstruction in a body vessel, the device comprising: 
 a handle;    an elongated sheath assembly engaged with said handle, said handle and said elongated sheath assembly defining a passageway therethrough for receiving said implanted structure, said sheath assembly comprising a radially inner first sheath having a proximal end and a distal end, a second sheath overlying said first sheath and having a proximal end and a distal end, said second sheath having a cutting tip affixed at said distal end, and a flexible member engaged with said first sheath for providing spring action to said first sheath, said first sheath being axially movable relative to said second sheath, said respective first and second sheaths being sized such that the distal end of said first sheath extends distally beyond the distal end of said second sheath when no obstruction is encountered, and said distal ends of said first and second sheaths extend substantially the same length in the distal direction when an obstruction is encountered.    
     
     
         16 . The device of  claim 15 , wherein said spring member comprises an elongated boot having a proximal portion and a distal portion, said boot proximal portion engaged with said proximal end of said first sheath and axially movable therewith, and said boot distal portion engaged with said proximal end of said second sheath.  
     
     
         17 . The device of  claim 16 , further comprising a third sheath overlying said second sheath, said third sheath engaged at a distal end of said handle.  
     
     
         18 . The device of  claim 15 , wherein said cutting tip is bonded to an inner surface of said second sheath.  
     
     
         19 . The device of  claim 18 , wherein said cutting tip comprises a plurality of cutting members, said cutting members sized and positioned such that a distal end of at least one of said cutting members extends distally beyond the distal end of said second sheath, and extends distally beyond the distal end of said first sheath when said first and second sheath distal ends extend substantially the same length in the distal direction.  
     
     
         20 . The device of  claim 19 , wherein said cutting tip comprises a plurality of slots, and wherein said cutting tip is thermally bonded to said second sheath such that a melted portion of said second sheath extends through said slots.  
     
     
         21 . A device for removing an implanted structure from a body vessel, comprising: 
 a striker mechanism, said striker mechanism comprising an axially movable elongated body having a leading edge at a distal end thereof, a bias member carried by said elongated body, said bias member capable of compression upon axial movement of said elongated body in a proximal direction, and of generating an axial spring force in a distal direction upon release of said compression, and a stop member for limiting axial movement of said elongated body in said distal direction;    a flange positioned for engagement with said elongated body leading edge upon generation of said axial spring force, and for transmitting said axial spring force in said distal direction; and    an elongated member positioned for receiving said transmitted axial spring force from said flange member such that incremental axial movement of said elongated member in said distal direction is generated thereby, said elongated member having a tip at a distal end thereof configured for separating said implanted structure from said vessel; wherein said device comprises a longitudinal passageway therethrough for receiving said implanted structure.    
     
     
         22 . The device of  claim 21 , further comprising a power source operationally engaged with said elongated member for enabling selective rotation of said elongated member.  
     
     
         23 . The device of  claim 21 , further comprising a power source in communication with said flange member, said device being structured such that said flange member is capable of rotational movement upon activation of said power source, and for transmission of said rotational movement to said elongated member and said tip.  
     
     
         24 . The device of  claim 23 , further comprising a drive gear engaged with said power source and adapted for rotation upon activation of said power source, said flange member being engaged with said drive gear such that said flange member is rotatable upon rotation of said drive gear.  
     
     
         25 . The device of  claim 21 , further comprising a housing for said striker mechanism.  
     
     
         26 . The device of  claim 25 , wherein said striker mechanism comprises a knob member positioned proximal of said housing and engaged with a proximal end of said elongated body, said knob member being selectively movable in said proximal direction for compressing said bias member.  
     
     
         27 . The device of  claim 26 , wherein said stop member comprises a collar positioned along a length of said elongated body, said collar positioned for limiting distal movement of said leading edge upon release of said compression.  
     
     
         28 . The device of  claim 21 , wherein said elongated member comprises an elongated coil, a proximal end of said coil being received in an opening of said flange member, and a distal end of said coil being operationally engaged with said tip.  
     
     
         29 . The device of  claim 28 , wherein said tip comprises a plurality of axially outwardly extending fingers capable of gripping said implanted structure.