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Claims  |
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What is claimed is:
1. A system for anchoring a tubular lead-type member within a cranial burr
hole in a patient, comprising:
a baseplate, the baseplate having an upper cylindrical portion with an
upper axial lumen therethrough and a lower extending central flange with a
lower axial lumen therethrough, the upper and lower lumens being
configured to receive the member, and the baseplate flange being
positioned within the burr hole;
fixation means positioned within the upper baseplate portion for fixing the
member to the baseplate, the fixation means having a lumen therethrough
for receiving the member; and
connector means positioned above the fixation means and within the upper
portion for making a connection to the member,
whereby the member can be inserted axially through the fixation means lumen
and through the upper and lower baseplate lumens, fixed to the baseplate,
and then connected to the connector.
2. The system as described in claim 1, wherein the tubular member is a
brain lead for conducting electrical signals, and further comprising an
external lead connected to the brain lead at the connector means.
3. The system as described in claim 1, wherein the baseplate comprises an
adaptor adapting the baseplate to the burr hole.
4. The system as described in claim 1, wherein the tubular member is a
brain catheter for carrying fluids to or from the patient's brain, and
further comprising an external catheter connected to the brain catheter at
the connector means.
5. The system as described in claim 4, wherein the baseplate comprises at
least one radial path, and the connector means comprises a 90 degree fluid
connector having an axial portion positioned within the upper axial lumen
and a radial portion positioned within the path.
6. The system as described in claim 5, wherein the fixation means comprises
a compression seal positioned below the connector means and within the
upper lumen.
7. The system as described in claim 5, wherein the fixation means comprises
a screw cap with a first axial lumen therethrough positioned distal to the
connector means, and a compression seal with a second axial lumen
therethrough positioned proximal to the connector means.
8. A system for anchoring a brain stimulation lead so that the distal end
of the lead is securely fixed in position beneath a hole in a patient's
cranium, comprising:
baseplate means for fitting into and securing to the hole, the baseplate
means having an axial lumen extending therethrough configured to receive
the lead, and an upper portion having a receiving cavity, and
fixation means positioned within the receiving cavity for fixing the lead
to the baseplate means, the fixation means comprising a compressible seal
having a central lumen aligned with the axial lumen and configured for
snugly receiving the lead therethrough, and compressing means for holding
the seal under compression, whereby the seal central lumen is compressed
to fixedly engage the lead.
9. The system as described in claim 8, wherein the baseplate means
comprises at least one slot extending radially from the axial lumen, and
further comprising connection means for providing a 90 degree path from
the axial lumen into the slot, whereby after the lead has been fixed by
the fixation means it can be positioned through the slot so as to exit the
baseplate at about 90 degrees relative to the baseplate lumen.
10. The system as described in claim 8, wherein the compression seal is
made of silicone rubber.
11. The system as described in claim 8, further comprising right angle
guide means for guiding the lead at a right angle to the axial lumen, and
securing means for securing the guide means to the baseplate means.
12. The system as described in claim 8, wherein the lead is terminated just
above the fixation means, and comprising connector means for electrically
and mechanically connecting an extender lead to the lead just above the
fixation means.
13. The system as described in claim 12, wherein the baseplate means upper
portion has a pathway for receiving the connector means.
14. The system as described in claim 8, wherein the compression means has
outward restraining means for restraining radially outward extension of
the compressible seal, whereby when the seal is compressed it extends
radially inward and engages the member.
15. A method for in-line placement of a brain member selected either from a
stimulus lead or a fluid delivery catheter, the method comprising:
in-line positioning the member so that a distal end thereof is in a desired
position within the patient's brain, and a proximal portion thereof
extends outside of the patient's skull;
securing the member just above the patient's skull with radially inward
compressive force on the member, and
after the securing, making an operative connection from the secured member
to an external element.
16. The method of claim 15, comprising selecting a stimulus lead, and
making a 90 degree connection to the lead just above the point where the
lead is radially secured.
17. The method of claim 15, comprising selecting the member to be a
stimulus lead, and further comprising cutting the lead to leave a proximal
portion just above the point where it is radially secured and making an
electrical connection from the proximal portion to an extender lead.
18. The method of claim 15, comprising selecting the member to be a fluid
catheter, and further comprising cutting the catheter just above the point
where it is radially secured, and connecting an external catheter to the
cut catheter.
19. A system for anchoring a brain stimulation or fluid catheter member
within a cranial burr hole in a patient, comprising:
baseplate means securable to the patient's skull for providing a central
lumen through the burr hole, the baseplate means having a receiving area;
compression means positioned in the receiving area and having a central
lumen therethrough for providing a radial compression force against the
member when it is positioned through the baseplate lumen and the
compression means lumen.
20. The system as described in claim 19, wherein the compression means
comprises a compressible seal and a compression screw, the screw being
configured to cause inward radial expansion of the seal when it is screwed
toward the seal.
21. A brain stimulation system comprising:
an electrical pulse generator;
a lead having a proximal end and a distal end, the proximal end having a
connector to connect the lead to the electrical pulse generator, the
distal end having at least one electrode to connect the lead to the brain;
means for anchoring the lead to a skull of a patient, the means for
anchoring having baseplate means for fitting into and securing to the
skull, the baseplate means having an axial lumen extending therethrough
configured to receive the lead, and an upper portion having a receiving
cavity, and
fixation means positioned within the receiving cavity for fixing the lead
to the baseplate means, the fixation means comprising a compressible seal
having a central lumen aligned with the axial lumen and configured for
snugly receiving the lead therethrough, and compressing means for holding
the seal under compression, whereby the seal central lumen is compressed
to fixedly engage the lead.
22. The system as described in claim 21, wherein the baseplate means
comprises at least one slot extending radially from the axial lumen, and
further comprising connection means for providing a 90 degree path from
the axial lumen into the slot, whereby after the lead has been fixed by
the fixation means it can be positioned through the slot so as to exit the
baseplate at about 90 degrees relative to the baseplate lumen.
23. The system as described in claim 21, wherein the compression seal is
made of silicone rubber.
24. The system as described in claim 21, further comprising right angle
guide means for guiding the lead at a right angle to the axial lumen, and
securing means for securing the guide means to the baseplate means.
25. The system as described in claim 21, wherein the lead is terminated
just above the fixation means, and comprising connector means for
electrically and mechanically connecting an extender lead to the lead just
above the fixation means.
26. The system as described in claim 25, wherein the baseplate means upper
portion has a pathway for receiving the connector means.
27. The system as described in claim 21, wherein the compression means has
outward restraining means for restraining radially outward extension of
the compressible seal, whereby when the seal is compressed it extends
radially inward and engages the member.
28. A system for delivering therapy to a patient's brain comprising:
a device to emit a medical therapy;
a member having a first end and a second end, the first end coupled to the
device, the second end coupled to a patient's brain, the member
transmitting the emmitted medical therapy from the device to the patient's
brain
means for anchoring the member to a skull of a patient, the means for
anchoring having baseplate means for securing to the skull, the baseplate
means having an axial lumen extending therethrough configured to receive
the member;
means for fixing the member to the baseplate means, the means for fixing
positioned within baseplate means, the means for fixing comprising a
compressible seal having a central lumen aligned with the axial lumen and
configured for snugly receiving the member therethrough, and compressing
means for holding the seal under compression, whereby the seal central
lumen is compressed to fixedly engage the member.
29. The system as described in claim 28, wherein the member is a medical
electrical lead and the device is an implantable pulse generator.
30. The system as described in claim 28, wherein the member is a catheter
and the device is an implantable drug administration system. |
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Claims  |
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Description  |
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FIELD OF THE INVENTION
This invention relates to a cranial connector or anchoring system and, more
particularly, to a system and method for anchoring a brain stimulation
lead or cranial catheter which has been implanted through a cranial burr
hole and in a selected target area of a patient's brain.
BACKGROUND OF THE INVENTION
Systems for providing either electrical stimulation of the brain or
coupling fluid to or from the brain are coming into increased use for
various purposes. Electrical stimulation of the brain is utilized for
relief of chronic pain and treatment of movement disorders. A typical
electrical brain stimulation system comprises a pulse generator
operatively connected to the brain by a lead. The lead has one or more
electrodes at its distal end, designed to be implanted within the
patient's brain at a precise location, so that the electrode or electrodes
are optimally and safely positioned for the desired stimulation. The lead
is connected to the pulse generator at its proximal end, and also needs to
be anchored with respect to a burr hole drilled in the patient's skull or
cranium, in order to hold the distal end which carries the electrodes
reliably secure. Likewise, in the case of a catheter for providing fluid
to the brain or for providing drainage, it is necessary to be able to
secure the distal portion of the catheter that passes through the skull
and transfers the fluid at a predetermined exact location within the
brain. Still further, for a combined catheter and lead member, such secure
and reliable anchoring of the member so that the distal end is precisely
located within the skull, is very important.
Reference is made to U.S. Pat. No. 5,464,446, "Brain Lead Anchoring
System," assigned to Medtronic, Inc., which is incorporated herein by
reference. The referenced patent illustrates an effective lead anchoring
system, and it discusses the method of providing access through the skull
by drilling a burr hole with a cranial drill, inserting a stimulation lead
through the burr hole and positioning it so that the electrode or
electrodes are at the desired stimulation site. The lead is positioned
using a stereotactic instrument, which permits a very precise movement
within the brain. Once the lead is positioned and tested to determine that
the results of stimulation are satisfactory, it is critical that the lead
is not to be moved, since even the slightest displacement can result in
less than optimal results, and even injury to the brain.
The referenced anchoring system shows a basic anchor for fixing the lead in
place with the distal portion extended through the cranial burr hole, and
then securing it by bending it into a slit such that it is held by a
friction fit. However, neither this system, nor any other known system,
provides a reliable way for accurately securing the lead, or catheter,
before it is bent into the fixation position. Thus, such systems do not
provide against small movement of the distal end of the lead at the time
of fixating, or securing the lead in place. What is required, and what has
remained a substantial need in the art, is a system and method for
accurately placing a cranial lead directly through the skull "in line,"
and without kinking, and which enables securing of the lead or catheter
precisely in position relative to the brain before it is removed from the
stereotactic instrument and connected either to a stimulator or fluid
source. The cranial connector of this invention accomplishes this, and
provides a sealed feedthrough for electrical or fluid connection from
outside the skull to an area within the skull.
SUMMARY OF THE INVENTION
It is an object of this invention to provide a system and method for
anchoring a brain stimulation lead or catheter, either one of which is
hereinafter referred to as a "member", so that the distal end of the
member can be securely fixed in position beneath a hole in the patient's
cranium at precisely the desired location. More specifically, the object
is to enable such secure fixation before release of the member from the
stereotactic instrument used to position the member, and before final
securing of the member so as to interconnect with a therapeutic device.
In accordance with the above object, there is provided a system for
anchoring a cranial member in the form of a brain stimulation lead or
fluid catheter so that the distal end of the member can be accurately
positioned and held in place while the member is disconnected from a
stereotactic instrument and securely positioned for connection to a pulse
generator, fluid source or any other type of therapeutic device. The
system has a baseplate with an upper portion which rests on and is screwed
into the skill, and a lower portion which is positioned through a cranial
hole that has been drilled to receive it. An adaptor ring can be secured
to the baseplate lower portion in the situation where a larger hole needs
to be drilled, either due to problems with the initial hole or simply due
to the preference of the physician. The baseplate has an axial lumen
extending therethrough configured to receive the member, and a receiving
cavity in the upper portion. A fixation subassembly, preferably in the
form of a compressible seal with a central lumen therethrough which is
configured for snugly receiving the member, and a compression screw for
holding the seal under compression, is positioned within the receiving
cavity and tightened to anchor or lock the member with a radial
compressive force on a portion of the member that is within the baseplate
lumen. With this system and method, the member can be accurately
positioned and, while it is still maintained in line by the stereotactic
instrument with which it is positioned, it is secured with respect to the
patient's skull.
In a preferred embodiment, the baseplate has an upper cylindrical portion
with an axial lumen therethrough, and a lower extending central flange
with a axial lumen therethrough. The baseplate, with or without an
adaptor, is fitted into the burr hole in the patient's skull. The
baseplate has at least one path, and preferably four roughly orthogonal
paths extending radially from the upper lumen to the outside of the upper
cylindrical portion. A connector element, for connecting either a
stimulating lead or a fluid-carrying catheter, is positioned within the
upper portion for making a connection from the member through a selected
one of the radial grooves. The fixation sub-assembly includes a
compression seal which is positioned on top of the baseplate, and a
compression screw which is positioned on top of the compression seal,
before the connector is installed. The compression screw is threadedly
screwed into the baseplate to compress the seal, thereby securing the seal
to the in-line member and thus securing the member to the baseplate and
the skull. After the in-line member has been precisely secured without
movement, the connector is then severed above the compression screw cap,
and the member is connected through the connector either to a pulse
generator or to a fluid source or drain device.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a perspective view showing an anchoring or fixation system in
accordance with the invention which provides anchoring or fixation of a
medical electrical lead or catheter to a patient's skull, the lead or
catheter coupled at it distal end to a patient's brain and coupled at its
proximal end to an implantable medical device.
FIG. 2A is an exploded perspective view showing the component parts of a
fluid catheter anchoring system embodiment of this invention; FIG. 2B is a
cross-sectional view of the system embodiment of FIG. 2A with the parts
joined together.
FIG. 3 is an exploded perspective view, with some of the elements shown in
cross-section, of the system illustrated in FIGS. 2A and 2B, and including
a tool used in assembling the system.
FIG. 4A is an exploded perspective view of the component parts of a lead
anchoring system embodiment; FIG. 4B is a cross-sectional view of the
assembled system illustrated in FIG. 4A.
FIG. 5 is a block diagram of a fluid delivery system utilizing the
anchoring system of this invention.
FIG. 6 is a cross-sectional view of another embodiment of a stimulation
lead anchoring system with an extender connected within the anchoring
system.
FIG. 7 is a flow diagram of steps taken in carrying out the method of this
invention whereby a stimulation lead or fluid catheter is anchored in
place with respect to a patient's skull.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to FIGS. 1A, 1B and 2, there is shown an anchoring or
fixation system 1 in accordance with this invention which provides
anchoring or fixation of a medical electrical lead or catheter 2 to a
patient's skull 3. Typically such a lead or catheter is coupled at it
distal end to a patient's brain and coupled at its proximal end to an
medical device 4 or the like. In this embodiment the medical device 4 is
implantable, although any suitable medical device may be used, including
implantable as well as external pulse generators, drug administration
system, draining systems or any other such device which emits a desired
medical therapy.
Turning now to FIGS. 2 through 7, FIG. 2 shows several views of the
anchoring or fixation system 1 in accordance with this invention.
Installation of the anchoring system is preceded by drilling of a suitable
hole in the patient's skull. Preferably the hole size is selected as the
baseplate screw size, which is a standard. However, if a larger hole size
is preferred by the physician, an adaptor ring is used. The adaptor ring
is mounted to the baseplate prior to mounting the baseplate on the
patient's head, to avoid the difficulty of handling such a small item
later during the surgery. Various ring sizes are available for adapting to
the hole size to be used.
Baseplate 34, either alone or, as shown connected to screw adapter 32, is
positioned within a burr hole within the patient's cranium, the cranium
being illustrated as C. The baseplate is screwed into the patient's skull.
Adapter 32 is typically one of two different sizes, corresponding to the
diameter of the burr hole that has been drilled. The adapter has an axial,
or central lumen therethrough, the wall of the lumen being threaded to
receive the lower flange portion 36 of baseplate 34. Baseplate 34 has an
upper portion with a diameter greater than the diameter of the screw
adapter, and a lower axially extending flange portion 36 which is threaded
so as to fixedly engage the screw adapter 32 that has been placed within
the burr hole. As is seen also in FIG. 2, baseplate 34 has an upper axial
lumen with a diameter greater than the lumen portion of flange 36.
Baseplate 34 also has a plurality of radially extending slots, or paths
35, adapted to fit a radial extension, or arm 43 of connector 42, as
discussed hereinbelow. A compression seal 38 likewise has an axial lumen
to accommodate the lead or catheter member 28. Seal 38 is suitably made of
silicone rubber and has an inner diameter adapted to just receive the
outer diameter of the lead or catheter member. Seal 38 is compressible, so
that when compressive force is applied from top and bottom, i.e., axially,
it is expands radially, providing a tight compressive fixation with the
member 28. Compression screw cap 40, which also has an inner lumen to
accommodate member 28, is placed down over top of seal 38, and is threaded
to engage threads on the upper lumen of baseplate 34. As seen particularly
in FIG. 2, compression screw cap 40 has a notch 41 to restrain seal 38
from being squeezed radially outwardly, such that the axial compression
causes seal 38 to extend plastically inwardly and provide a tight fixation
with the member 28. Compression screw 40 is screwed into place by tool 46,
which has engaging spokes 47 which seat into complementary holes shown in
screw 40.
A 90 degree fluid connector element 42, having a radially extending arm 43,
is placed on top of compression screw 40, with arm 43 being positioned in
a selected one of the radial slots, or paths 35. Connector 42 has a
central axial opening in the bottom for communicating with the lumen of
baseplate 34, which opening connects through arm 43 to provide a right
angle path for fluid. In practice, another catheter-like tube is connected
to the outer end of arm 43, to provide fluid transport to or from the
anchoring assembly and member 28. An end cap 44, threaded on its outer
circumference, is then screwed into the upper lumen of baseplate 34 with
tool 46, to tightly secure the entire assembly.
Still referring to FIGS. 2A, 2B and 3, it can be now seen how the fixation
assembly is utilized for direct in-line and accurate positioning of the
member 28, without movement of the member at the time that it is secured
in place. The member is threaded through elements 32, 34, 38 and 40, which
are loosely pre-mounted, and secured to a stereotactic instrument (not
shown), the use of which instrument is well known in the art. Upon
accurate positioning of the distal end of the catheter or lead, and
verification of such positioning, the member is held in a fixed in-line,
or axial position by the stereotactic instrument. Note that at this point,
there has been solely direct vertical, or in-line positioning of the
member, such that at no time need it be bent at any point, which is very
important in order to maintain it in a kink-free condition. The outer
bottom portion of baseplate 34 rests on the top of the cranium C, as
illustrated in FIG. 2B. Compression seal 38 is placed into position, and
then compression screw 40 is placed down on top of seal 38, and screwed
into position with the wrench, or tool 46. Note that wrench 46 is
longitudinally slit, so that it can be placed around the member 28. At
this time, with a proximal portion of a catheter still being secured to
the stereotactic instrument, the member is now securely fixed into
position within baseplate 34, due to the radially inward compressive force
of seal 38. The stereotactic instrument is then released from the
catheter, and the catheter is severed or cut just a short distance above
where it is extends upward from the upper surface of compression screw 40.
The distance that the cut catheter protrudes above the surface of screw 40
corresponds to the height of the axial portion of connector 42, to ensure
that when connector 42 is next placed down on top of the surface of screw
40, the catheter makes good fluid connection into the axial body portion
of connector 42. The arm 43 of connector 42 is positioned within a
selected one of the slots 35 of baseplate 34. End cap 44 is then screwed
into place on top of connector 42 with tool 46, resulting in the fully
assembled anchoring system as shown in FIG. 2B. An external catheter, not
shown, can then be connected to the tip or distal end of arm 43, to
provide fluid communication between the brain and an external fluid source
or sink.
Referring now to FIGS. 4A and 5B, there are shown respectively an exploded
view and a cross sectional view of the same anchor assembly as shown in
FIGS. 2A and 2B, with the exception of the connector element. In this
embodiment, the connector is adapted to provide for a stimulus lead for
transmitting stimulus pulses to the brain, as opposed to a fluid carrying
catheter tube. Instead of fluid connector 42 as illustrated in FIGS. 2A
and 2B, there is provided a lead guide element 48, shown in perspective in
FIG. 4A and in cross-section in FIG. 4B. Element 48 is a basically
cylindrical element which has a bottom opening which communicates with the
lumen of compression screw 40, and which provides a 90 degree angle having
an output directed radially. Lead guide element 48 has its radial opening
positioned to lead directly to a selected one of the slots 35, so that the
lead can be guided through element 48 and passed through the path 35
roughly parallel to the patient's skull. In application, the lead 50 is
accurately positioned within the patient's brain, and tests are performed
to verify the position. At this point, the lead 50 remains fixed to the
stereotactic instrument which holds it firmly and reliably in the exact
chosen position, as illustrated in FIG. 4B. Elements 32, 34, 38 and 40,
the same as described with respect to FIGS. 2A and 2B, and having
coincident axial lumens through which the lead has already been
positioned, are then put into place and secured as described above. The
lead now being secured by compression seal 38 and the downward force of
compression screw 40, the lead is released from the stereotactic
instrument. Following this, the lead is passed through lead guide 48 and
the guide is positioned in place, with its opening communicating directly
with a selected groove 35. End cap 44 is then secured to hold the entire
assembly firmly fixed. The portion of the lead external to the anchoring
assembly can then can be manipulated as desired, e.g., connected to an
extender or extension lead in a known fashion.
Referring now to FIG. 5, there is shown a schematic diagram illustrative of
a fluid system having a connector 42T with a "T" pathway for providing
either fluid drain or fluid delivery. Connector 42T has, on the left, an
outlet 54 with connector elements for connecting a drainage tube thereto.
Coming out the right as seen in FIG. 5, there is a fluid delivery pathway
terminating in connector elements 53. A catheter 56 is shown connected to
fluid delivery arm 53, the other end of the catheter being connected to a
supply source 58. Supply 58 has a puncturable resealable membrane 60,
which communicates with a reservoir 62 for holding a drug or other desired
medicament in fluid form. A pump and battery are illustrated together at
64. The reservoir 62 can be filled by a syringe 66, in a known manner.
Referring now to FIG. 6, there is shown a diagram of an alternate
embodiment of the fixation or anchor system of this invention for fixing a
stimulation lead in place. In this embodiment, screw adapter 70
corresponds to prior screw adapter 32, and baseplate 72 corresponds to
baseplate 34. Baseplate 72 has an upper lumen which accommodates
compression seal 74 and compression screw cap 76, which are screwed into
position to hold lead 28 when it has been accurately positioned. After
this, and after disengagement of lead 28 from the stereotactic instrument,
the lead is severed, or cut just a short distance above where it extends
from the upper surface of compression screw cap 76. Reference is made to
the illustrated coil conductor shown extending above screw cap 76. A
contact screw 84 is screwed into a receiving opening 85, the lower length
of the screw having a diameter so as to make firm contact with the coil
loops at the cut end of lead 28. The screw, which is metallic, is in firm
contact with an upper metallic portion 79 of baseplate 32. An external
lead, or extender lead, illustrated at 80, is positioned at radial path
78, and securely fixed by set screws 86, 87, which make contact with the
conducting coil 78 of lead 80. In this manner, a secure mechanical and
electrical connection is made from the coil conductor of lead 28 to the
extender coil portion 78. This embodiment has the advantages of avoiding
extensive subcutaneous protrusions, and avoiding additional surgery as
normally needed to hide the lead to lead extender interface connection.
Tunneling for a subcutaneous lead extension can be done in the normal
manner, taking the lead extension out just at the point where it is
connected into the connector. Notice also that this arrangement allows
easy lead replacement, by simply disengaging extender 80 and undoing the
fixation system, so as to provide for replacement and positioning of a new
lead if desired.
There have thus been illustrated several system embodiments for providing
easy, efficient and in-line placement of a brain stimulator lead or brain
catheter, and particularly providing for chronic fixation of the lead or
catheter member while it is still being held in place by the stereotactic
instrument. After accurate placement of the member within the brain, the
member is reliably secured to the fixation assembly, while still being
held in position by the stereotactic instrument. The feat of fixation
without movement is accomplished by the combination of a compression seal
and compression screw cap, which provides a radially inward compressive
force on the member which is being maintained "in-line," thereby
essentially eliminating any movement of the member due to bending or other
tensions during fixation. Note also that the apparatus and method of the
invention, in providing that the member is maintained vertical and axially
in line up until it is secured in place, ensures that the installation is
kink-free. In the fluid delivery or drain embodiment, a 90 degree pathway
is provided by a fluid connector element, meaning that the catheter itself
is never bent at 90 degrees.
Referring now to FIG. 7, there is illustrated a flow diagram of the steps
taken in securing a lead/catheter member with the system of this
invention. As illustrated at 90, the components of the system and any
other supporting apparatus are assembled. This means assembling all of the
constituent parts of the anchoring assembly for the chosen embodiment, the
bifunctional tool, the catheter or lead to be employed, the stereotactic
instrument, and any necessary test equipment. As shown at 91, the
patient's head is fixed, and the stereotactic instrument, or frame is
mounted on the head. Following this, the burr hole is drilled through the
patient's skull, as indicated at 92. If the physician selects a hole size
greater than the standard size, an appropriate adaptor is selected.
With everything in place, at 94 the physician premounts the baseplate
(including adaptor, if necessary), seal 38 and compression screw cap 40.
Following this, the catheter or lead member is positioned, using the
stereotactic instrument, to the desired location in the brain, as
indicated at 95. Following this, and while the lead is held secure by the
stereotactic instrument, at 96 the member is secured to the skull by
placing the compression seal in the baseplate and screwing on the
compression screw cap, thus causing radial compression against the outer
wall of the member and holding it in fixed position with respect to the
baseplate, and thus the patient's skull. Following this, the catheter or
lead member is released from the stereotactic instrument, and the
instrument is in turn removed from the patient, as shown at 97. A 90
degree connection of the member is then made, as illustrated at 98. For a
first fluid catheter embodiment, this means severing the catheter just
above the compression screw upper surface, and then placing a 90 degree
fluid connector element in place. For a first lead embodiment, this step
involves threading the lead through a 90 degree lead guide, and
positioning the lead guide in place on top of the compression screw
surface. Following this, as illustrated at 99, the assembly is secured by
screwing in an end cap to the top of the baseplate. The procedure is
completed by routing the member, either fluid catheter or electrical
stimulation lead, to a desired extender member and thence to an external
device, e.g., a fluid pump or a stimulus generator, as shown at 100.
Alternately, for the anchoring embodiment of FIG. 5, a 90 degree
connection for a stimulation lead is made by inserting an extender
conductor laterally through a path in the baseplate to make electrical
contact with the conductor of the stimulus lead, following which
electrical and mechanical connection of the lead conductor and extender
conductor is secured as described above.
There has thus been disclosed a connector system and method of accurately
and reliably connecting a cranial catheter or lead member, whereby the
distal end of the member is reliably positioned at a chosen location
within the patient's brain. The connection system of this invention
provides an effective feedthrough connector for either electrical
transmission, as through a brain stimulation lead, or fluid connection as
through a brain catheter. The connector system and method of anchoring
same enable straight in-line positioning of the member, and particularly
enable accurately securing the member without movement after the member
has been positioned to the optimal location. It should be understood that
the present invention is not limited to use only in anchoring electrical
leads, but may be used in many of various types of therapeutic or
diagnostic devices, including muscle, nerve or defibrillation leads. It is
to be further understood, moreover, the present invention may be employed
in many of various other types of therapeutic or diagnostic catheters. For
purposes of illustration only, however, the present invention has been
described in the context of electrical leads and catheters. As used
herein, however, the term lead is used in its broadest sense and includes
any other elongated member, including a catheter, which may be usefully
introduced into the body.
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Description  |
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