WO1994011048A1 - Rapid exchange catheter - Google Patents
Rapid exchange catheter Download PDFInfo
- Publication number
- WO1994011048A1 WO1994011048A1 PCT/US1993/010989 US9310989W WO9411048A1 WO 1994011048 A1 WO1994011048 A1 WO 1994011048A1 US 9310989 W US9310989 W US 9310989W WO 9411048 A1 WO9411048 A1 WO 9411048A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- catheter
- distal end
- shaft
- guidewire
- balloon
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0169—Exchanging a catheter while keeping the guidewire in place
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M2025/0183—Rapid exchange or monorail catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
- A61M2025/09008—Guide wires having a balloon
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1079—Balloon catheters with special features or adapted for special applications having radio-opaque markers in the region of the balloon
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
- A61M25/0069—Tip not integral with tube
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/104—Balloon catheters used for angioplasty
Definitions
- the present invention relates to over-the-wire PTCA balloon catheters, and more particularly, to a rapid exchange catheter with the guidewire lumen at the distal tip.
- This fixed wire system featured a core or guidewire fixed within the catheter to stiffen it so that it could be pushed into position in the vascular system. Blockage in a coronary artery could be reduced by positioning the balloon dilatation catheter across from the blockage and inflating the balloon causing the blockage to decrease.
- Dr. John Simpson began to modify the fixed wire system developing an over-the-wire catheter with a free central lumen for movable guide wires and with a dilatation balloon formed from the outer surface covering in a unitary, that is, one-piece construction.
- This catheter system is the subject of U.S. Pat. No. 4,323,071 assigned to Advance Cardiovascular Systems, Inc. (ACS) .
- ACS Advance Cardiovascular Systems, Inc.
- the over-the-wire system is advantageous because th guidewire can be left in place.
- the catheter is withdraw over the guidewire and another catheter slid into place ove it.
- a disadvantage of this exchange procedure is that it i difficult to keep the guidewire in place, since removing th catheter requires removal of the guidewire and subsequen recrossing of the stenosis, or alternatively, the use of very long "exchange" guidewire of approximately 300 cm whic is difficult to handle.
- Such a procedure requires tw operators who must be in communication during the procedure. This requires more time and risks contamination by droppin the guidewire from the sterile field.
- An alternative to thes long exchange guidewires is a two-part guidewire. This i also undesirable because it requires additional time t assemble and may be too thick to allow smooth exchanges.
- Rapid exchange catheters were developed to respond to th disadvantage of the long "exchange" wire in over-the-wir systems. These catheters have shorter guidewire lumens s that the guidewire exits from the catheter closer to th balloon than to the proximal end of the catheter. Thi enables the physician to anchor or hold the guidewire as he o she removes the catheter from the body, the exchange occurrin over the shorter guidewire lumen.
- the guidewire lumen passes throug the balloon and is generally coaxial with respect to th inflation lumen, but exits (or enters) in the side port a least 10 centimeters from the distal tip of the catheter.
- Th Yock disclosure suggests a lumen of 10 or more centimeters; i catheters on the market, the lumen varies from about 9 to 35 centimeters in length.
- the lengthened guidewire lumen induces friction between the catheter and guidewir during catheter manipulation and withdrawal. Such frictio can contribute to extraneous guidewire movement.
- German patent application P 39 34 695.1 to Rupprecht discloses a longitudinal slot 2 which extends up the central axis of the catheter reaching from any location on the catheter to the end of the catheter.
- the longitudinal slot allows the rapid exchange of the guidewire by guiding it up the central guide channel 3 throughout the entire length of the catheter.
- Other art of interest includes balloon catheters such a that described by Bj ⁇ rn Nordenstr ⁇ m in Acta radiol, 57: 411 416, November 1962.
- a flexible steel wire is introduce through the tip of the catheter and taken out through the sid hole distal to the balloon (page 112 Fig. I type I and pag 413 Fig. 2 type 2) .
- the Nordenstr ⁇ m catheter material consist of teflon or opaque polythene material plus late rubber balloons. (See page 412) . Thus air bubbles are no visible during the purging process to alert the operator t malfunction. Furthermore, latex balloons do not have a know diameter at specific pressures and may expand beyond the siz of the vessel.
- An angiocardiographic balloon catheter is also describe by Bj ⁇ rn Nordenstr ⁇ m in RADIOLOGY, 85: 256 - 259, July- December 1965.
- Page 257, Fig. A depicts a relatively long ti through which the guidewire is passed to facilitate th injection of contrast medium.
- U. S. patent No. 4,824,435 to Giesy and U. S. patent No. 5,046,497 to Millar represent another variety of catheters, those for instrument delivery.
- Giesy discloses a method an apparatus for guiding diagnostic and therapeutic devices into tortuous body passages but not a second catheter or dilatatio device.
- a secondary guidewire 12 or an obturator 42 has a guide loop 10 or lumen comprising a member which may be threaded over a primary guidewire 14. This allows passage of an instrument over the guidewire 14 without the use of a through-lumen.
- the guide loop 10 is positioned at the tip or distal end of the instrument. The instrument is advanced alongside the guide wire 14 and is kept on course via the secondary guide wire 12 pushing behind the instrument.
- U. S. patent No. 5,046,497 to Millar discloses a couplin structure 20 slidably engaging the guidewire allowing a plurality of diagnostic or therapeutic catheters such as sensor-carrying catheters to be coupled to a common guidewire.
- the present invention discloses a rapid exchange medical catheter having a wire guiding means external to the shaft for slidably mounting over the guidewire, the wire guiding means being a short tubular member having a proximal end and a distal end extending proximally from the distal end of the shaft and terminating before the distal end of the therapy means.
- the advantages of applicant's invention are first, only one operator is required for the procedure, second, an inner lumen is not required to accommodate the guidewire, third, a short exchange lumen results in less friction and a faster exchange, and fourth, pinching the guidewire is minimized as the catheter is being removed through the tortuous path thereby tending to minimize pulling out the guidewire upon withdrawal of the catheter.
- FIG. 1 represents the longitudinal cross-sectional view of a dual lumen embodiment of an angioplasty catheter incorporating the present invention
- FIG. 2 represents the cross-sectional view shown in Fig. 1 along the line 2-2 of the dual lumen embodiment's region preceding the proximal end of the balloon;
- FIG. 3 represents the cross-sectional view along the line
- FIG. 4 represents the side elevational view of a dual lumen embodiment
- FIG. 5 represents the longitudinal cross-sectional view of a single lumen embodiment
- FIG. 6 represents the cross-sectional view along the line 6-6 of the single lumen embodiment's region following the distal end of the balloon;
- FIG. 7 represents the cross-sectional view along the line 7-7 of the single lumen embodiment's region preceding the proximal end of the balloon;
- FIG. 8 represents the side elevational view of a single lumen embodiment
- FIG. 9a represents a one piece molded tip
- FIG. 9b represents a staked pin tip attachment
- FIG. 9c represents a bored and bonded tip attachment
- FIG. 9d represents a tip with recessed lumen
- FIG. 9e represents a tip with a tubular member parallel to the shaft.
- FIG. 10 represents the longitudinal cross-sectional view with the polyimide tip.
- FIG. 11 represents the cross-sectional view along the line 11-11 in Fig. 10.
- Applicants have developed a rapid exchange balloon dilatation catheter with a short tubular guidewire lumen at the distal tip.
- the purpose of a guidewire is to aid in positioning the catheter across a specific intervascular obstruction.
- This invention is intended for use as a dilatation catheter having a balloon means at the distal end to be placed across a stenosis. Under fluoroscopic guidance, the guidewire can be placed first in proximity to a stenosis and then across the stenosis. The rapid exchange balloon dilatation catheter can then be inserted into the stenosis following the path established by the guidewire. Further manipulations of the catheter are made to position the device across the obstruction.
- the balloon is inflated in such a manner that the diameter of the obstructed area is increased.
- multiple catheters are frequently required during a procedure.
- the dilatation catheter can be withdrawn, leaving the guidewire in position across the stenosis.
- a different device can then be inserted over the guidewire, as for example, an intervascular ultrasound device, an angioscopy device, a fiber optic viewing catheter, an arterial stent delivery catheter, or another dilatation catheter to further enlarge the cross sectional diameter of the obstruction by means of repeated dilatation with a balloon of greater diameter.
- the physician may be desirable for the physician to be able to place the guidewire across another obstruction and to dilate this with a balloon dilatation catheter having a balloon of a different diameter.
- the average number of catheters used per patient procedure is 1.6.
- the advantages of applicant's invention are first, only one operator is required for the PTCA procedure, second, an inner lumen is not required to accommodate the guidewire, third, a short exchange lumen results in less friction and a faster exchange, and fourth, pinching the guidewire is minimized as the catheter is being removed through the tortuous path thereby tending to minimize pulling out the guidewire upon withdrawal of the catheter.
- the catheter is inserted over an angioplasty guidewire by inserting the guidewire into the lumen within the catheter shaft.
- the catheter is inserted over an angioplasty guidewire without using the lumen through the catheter shaft.
- the guidewire is instead back-loaded through a distal tip tubular member.
- a typical rapid exchange guidewire is of approximately 180 cm in length.
- Conventional over-the-wire methods of loading the distal end of the catheter over the proximal end of the guidewire require a lumen running throughout the catheter shaft.
- the conventional over-the-wire guidewire and catheter requires a guidewire length of approximately 300 cm thereby requiring two operators for the procedure.
- the inner lumen in applicant's catheter shaft is not used by the guidewire and is therefore free for other uses such as blood perfusion.
- the inner guidewire lumen can also be eliminated entirely thereby reducing shaft profile.
- a short exchange lumen causes less friction during the procedure resulting in a faster exchange. Additionally, friction between the catheter and the guidewire must be kept to a minimum to reduce extraneous movement of the guidewire and keep it stationary.
- the present invention addresses this matter by shortening the length of the contact surface between the catheter and the guidewire as well as by forming the exchange portion of the catheter out of a material with a very low coefficient of friction.
- the present invention addresses the problem of pinching the guidewire as the catheter is being removed through the tortuous path thereby pulling out the guidewire and resulting in the loss of guidewire positioning over the stenosis.
- a factor which contributes to guidewire pinching includes the position of the guidewire exit port.
- the position of the guidewire exit port at the proximal balloon bond can cause the balloon to become snagged during withdrawal of the catheter into the ancillary guide catheter.
- the resultant buckling of the catheter may result in inadvertent withdrawal of the guidewire from the lesion due to seizure of the guidewire by the buckled lumen. This may have deleterious effects upon the patient undergoing angioplasty.
- the present invention tends to minimize the likelihood of guidewire seizure during catheter withdrawal by positioning the exchange component distal to the inflatable balloon and by using a short exchange lumen which keeps the guidewire relatively straight.
- a guidewire lumen of .75 cm can be used.
- Another factor which tends to minimize the likelihood of guidewire seizure in the present invention includes the low coefficient of friction in materials such as polyimide.
- the distal tip guidewire lumen is a short tubular member consisting of any biocompatible material such as polyethylene, polycarbonate, polyimide, combinations thereof or biocompatible metals such as #304 stainless steel.
- the guidewire lumen is open on both ends and extends rearwardly (proximally) from the distal extremity of the catheter and terminates before the distal end of the balloon attachment.
- This tubular member allows rapid exchange of angioplasty catheters by sliding the original catheter over the guidewire and out the vessel while maintaining the position of the guidewire across the stenosis so that a new catheter can be advanced to the stenosis if required.
- the simple design results in lower manufacturing costs than conventional over- the-wire catheters as fewer components, fewer manufacturing steps and less tubing is required.
- This invention can be implemented as either a single lumen catheter or a dual lumen catheter.
- the advantage of the single lumen configuration over a dual lumen configuration is that of its lower profile. A low profile enhances the ability of a catheter to cross a stenosis.
- the advantage of the dual lumen embodiment is that the inner lumen can be used for fluid delivery such as blood perfusion or the infusion of an oxygenated liquid, anticoagulants or other drugs.
- the single lumen invention can be better understood by referring to the drawings in FIGs. 5 through FIG. 8.
- the balloon catheter 5 single lumen system consists of the following.
- a central core wire 10 is made of any biocompatible material, preferably of #304 stainless steel.
- the core wire 10 provides stiffness which improves pushability and torquability.
- the core wire 10 may optionally be surrounded by a helically wound spring coil 15 which provides pushability from within instead of the need to rely on an outer shaft for pushability.
- the core wire 10 also provides push to the distal tip 45.
- the spring coil 15 can be made of any biocompatible material, preferably of #304 stainless steel.
- the spring coil 15 extends from the manifold 110 to the distal end of the balloon 125.
- the balloon 25 is made of biocompatible material such as low density polyethylene.
- the catheter shaft is comprised of a helical spring coil 15, which is covered by a jacket 20 consisting of a biocompatible material such as a polymer or polyethylene.
- the jacket 20 is heat shrunk about the spring coil 15.
- the distal end of the balloon 125 is heat shrunk about the distal end of the spring coil 115.
- the proximal end of the balloon 120 is heat shrunk about the spring coil 15.
- the area of the spring coil 15 within the jacket 20 defines the balloon inflation lumen 30.
- An aperture 100 is cut through the spring coil 15 and jacket 20 to permit transmission of fluids from the balloon inflation lumen 30 to the balloon 25.
- the core wire 10 is affixed by bonding or welding the proximal end of the core wire 10 to the spring coil 15 at the proximal end of the manifold 110.
- the distal end of the core wire 10 could be welded to the spring coil distal end 115. If so, however, the device would not react symmetrically since such welding will stiffen only one side.
- the core wire 10 is free to float within the spring coil 15 and moves independently of the spring coil 15. Balloon inflation liquids are perfused through the balloon inflation lumen 30.
- a radiopaque marker band 40 is bonded to the core wire 10 preferably at the point which is the center of the balloon 25 although it could be located other places such as the proximal and/or distal ends of the balloon 25.
- the marker band 40 is used to provide a fluoroscopic indication of the location of the balloon 25 thereby allowing the operator to adjust the position of the balloon 25.
- Preferred materials for the marker band 40 include 100% gold, 100 % iridium, or alloys of these materials such as a Pt-Ir alloy consisting of 90% platinum and 10% iridium.
- the preferred density is of at ⁇ least 19.3 to 21.0 gm/cm 3 .
- the entire spring coil 15, or just the distal portion of the spring coil 15 can be fabricated of a radiopaque materials as described above to make the spring coil 15 visible by fluoroscopy.
- a typical balloon 25 for any of applicant's embodiments has the following length, diameter and material characteristics.
- Balloon length ranges from 2 cm to 4 cm with the diameter size ranging from 1.5 mm to 5.0 mm.
- the balloon 25 is made of a biocompatible material such as low density polyethylene or similar materials which have a known diameter under a specific pressure.
- the distal end of the Balloon 25 is heat shrunk to the distal end of the core wire 10. Balloon 25 may also be heat shrunk over the distal tip 45 or portions thereof with the core wire 10 inserted therein and glued, bonded, brazed or fastened to the distal tip 45 with any other suitable method.
- Applicant's catheter material for all embodiments comprises any biocompatible polymer or metal.
- Polymers include polyimide and more preferably polyethylene which is clear.
- a clear radiolucent material is preferable because air bubbles visible during the purging process alert the operator to malfunction.
- only the spring coil 15 and radiopaque marker band 40 are not clear.
- the dual lumen invention can be better understood by referring to the drawing in FIGs. 1 through 4.
- the balloon catheter 5 dual lumen system consists of the following.
- a central core wire 10 provides stiffness which improves pushability and torquability.
- the core wire 10 may optionally be surrounded by a helically wound spring coil 15 to increase pushability instead of the need to rely on an outer shaft for pushability.
- the core wire 10 also provides push to the distal tip 45.
- the spring coil 15 would, however, increase the profile and the cost and it may be more desirable to use a polymer shaft 35 instead.
- a spring coil 15 When a spring coil 15 is used, it extends from the manifold 65 to the distal end of the balloon 125 and is covered by a plastic jacket 20 consisting of a biocompatible material such as polyethylene which is heat shrunk about the spring coil 15.
- the distal end of the balloon 125 is heat shrunk to the distal end of the spring coil 115.
- the proximal end of the balloon 120 is heat shrunk to the shaft 35.
- the area of the spring coil 15 within the jacket 20 defines the inner lumen 70.
- the core wire 10 is free to float within the spring coil 15 and moves independently of the spring coil 15. Liquids can flow through the inner lumen 70.
- one or more exit ports 60 are created in the jacket 20 and balloon distal end 125 to permit the liquid to move from the inner lumen 70 into the blood stream.
- a manifold 65 suitable for the introduction of additional fluids as required.
- a balloon inflation lumen 30 surrounds the jacket 20. The inflation lumen's 30 distal end is connected with the manifold 65 and receives liquids therethrough for purposes of inflating the balloon 25 thereby reducing the stenosis.
- the radiopaque marker band 40 is affixed to the spring coil 15 and can be used to fluoroscopically view the position of the balloon 25 to allow the user to adjust the position of the balloon 25.
- Surrounding the inflation lumen 30 is the shaft 35 which is constructed of any biocompatible material such as a polymer.
- the balloon 25 is affixed to the shaft 35 by heat shrinking.
- the molded distal tip 45 has a rearwardly extending guidewire lumen 50 through which the guidewire 55 is threaded.
- the guidewire 55 can be any useful size, preferably a standard size such as .010 mm, .014 mm, or .018 mm.
- the guidewire lumen 50 can be nearly parallel with the core wire 10 as a biaxial tip, or it can angle upward to the center of the distal tip 45 as in Fig. 9a. Angling the guidewire lumen 50 upward from 0 to 60 degrees, more preferably 0 to 15 degrees and most preferably 0 degrees allows a more tapered distal tip 45 with a smaller profile.
- the proximal end of the guidewire lumen 50 where it exits the distal tip 45 should be tapered to reduce the possibility of snagging the tapered area 75 in the guide catheter upon exit.
- the distal tip 45 guidewire lumen 50 can be implemented with a variety of attachment variations and tip shapes. Attachment variations include bonding the distal tip 45 to the shaft 35 or a one piece molded tip as in Fig.
- the distal tip 45 could also be molded with a staked pin 80 and welded to the core wire 10 as in Fig. 9b.
- the staked pin 80 could also be threaded, knurled or ribbed for improved grip.
- the distal tip 45 could be bored 85 as with a laser and the distal tip 45 then fit and bonded over the distal end of the catheter shaft.
- Tip shape embodiments include a recess 90 for ease of loading as in Fig. 9d.
- the distal tip 45 could be fluted, streamlined or bullet shaped. In Fig.
- the distal tip 45 could also exit the therapy means at a downward slope to accommodate maintaining the guidewire at a 0 degree angle to the shaft so that pinching the guidewire tends to be minimized as the catheter is removed through a tortuous path.
- the distal tip 45 can be implemented with a variety of shapes and attachments as long as that embodiment is capable of supporting the guidewire 55.
- Fig. 10 represents an embodiment of the invention with the polyimide annulus 95 in the distal tip 45.
- the polyimide annulus 95 acts as a reinforcement member and as a guidewire lumen 50.
- Polyimide is advantageous because it is stiff, absorbs force, is smooth, reduces friction, and it is strong. In addition to a polyimide, other biocompatible materials having these properties could be used.
- FIG. 10 may include a spring coil with a polyethylene sheath.
- the spring coil 15 does not stop at the proximal balloon bond as it does in the Fig. 10 embodiment but continues through the balloon 25.
- the polyimide annulus 95 should not be longer than about .75 cm due to the stiffness o polyimide.
- One example of a method of creating the polyimid annulus 95, as depicted in Fig. 10, includes the following. Cut the balloon 25 distal neck to 1 cm in length. Skive th proximal guidewire exit port 105. Insert a mandrel into a .25 cm to 1 cm length polyimide tube. Insert the polyimide tub into the catheter distal tip.
Abstract
The present invention relates to over-the-wire PTCA balloon catheters (5), and more particularly, to a rapid exchange catheter with the guidewire lumen (50) at the distal tip. The present invention discloses a rapid exchange medical catheter having a wire guiding means external to the shaft (35) for slidably mounting over the guidewire (55), the wire guiding means being a short tubular member having a proximal end and a distal end extending proximally at an angle greater than 0 degrees from the distal end of the shaft (35) and terminating before the distal end of the balloon therapy means.
Description
RAPID EXCHANGE CATHETER
BACKGROUND OF THE INVENTION Field of the Invention
The present invention relates to over-the-wire PTCA balloon catheters, and more particularly, to a rapid exchange catheter with the guidewire lumen at the distal tip.
Description of the Prior Art
This description of art is not intended to constitute an admission that any patent, publication or other information referred to is "prior art" with respect to this invention, unless specifically designated as such. In addition, this section should not be construed to mean that a search has been made or that no other pertinent information as defined in 37 C.F.R. § 1.56(a) exists. Catheters comprise tube-like members inserted into the body for diagnostic or therapeutic medical reasons. One of the therapeutic procedures applicable to the present invention is known as percutaneous transluminal coronary angioplasty (PTCA) . PTCA has evolved through three major stages, fixed wire systems, over-the-wire systems and rapid exchange systems. The first PTCA procedure was developed in approximately 1976-1977 by Dr. Andreas Gruntzig. This fixed wire system featured a core or guidewire fixed within the catheter to stiffen it so that it could be pushed into position in the vascular system. Blockage in a coronary artery could be reduced by positioning the balloon dilatation catheter across from the blockage and inflating the balloon causing the blockage to decrease.
In 1980-1981, Dr. John Simpson began to modify the fixed wire system developing an over-the-wire catheter with a free central lumen for movable guide wires and with a dilatation balloon formed from the outer surface covering in a unitary, that is, one-piece construction. This catheter system is the
subject of U.S. Pat. No. 4,323,071 assigned to Advance Cardiovascular Systems, Inc. (ACS) . Using such a movable wir system, one could more readily select the desired coronar artery and reach smaller branches as movable guide wires ar inherently smaller and more flexible than the fixed wir systems.
If a catheter must be exchanged for one of a differen size, the over-the-wire system is advantageous because th guidewire can be left in place. The catheter is withdraw over the guidewire and another catheter slid into place ove it. A disadvantage of this exchange procedure is that it i difficult to keep the guidewire in place, since removing th catheter requires removal of the guidewire and subsequen recrossing of the stenosis, or alternatively, the use of very long "exchange" guidewire of approximately 300 cm whic is difficult to handle. Such a procedure requires tw operators who must be in communication during the procedure. This requires more time and risks contamination by droppin the guidewire from the sterile field. An alternative to thes long exchange guidewires is a two-part guidewire. This i also undesirable because it requires additional time t assemble and may be too thick to allow smooth exchanges.
Rapid exchange catheters were developed to respond to th disadvantage of the long "exchange" wire in over-the-wir systems. These catheters have shorter guidewire lumens s that the guidewire exits from the catheter closer to th balloon than to the proximal end of the catheter. Thi enables the physician to anchor or hold the guidewire as he o she removes the catheter from the body, the exchange occurrin over the shorter guidewire lumen.
One of the first rapid exchange catheters in biaxial for is U.S. Patent No. 4,762,129 issued to Bonzel. A disadvantag of this catheter is the position of the guidewire exit port a the proximal balloon bond coupled with a short guidewir exchange lumen which can cause the balloon to become snagge
during withdrawal through the tortuous path. The resultan buckling of the catheter may result in inadvertent withdrawa of the guidewire from the lesion due to seizure of th guidewire by the buckled lumen. Rapid exchange catheter designs such as those in Yock,
U.S. Patent Nos. 5,040,548 and 5,061,273, responded to th Bonzel catheter disadvantages by lengthening the guidewir exchange lumen. In Yock, the guidewire lumen passes throug the balloon and is generally coaxial with respect to th inflation lumen, but exits (or enters) in the side port a least 10 centimeters from the distal tip of the catheter. Th Yock disclosure suggests a lumen of 10 or more centimeters; i catheters on the market, the lumen varies from about 9 to 35 centimeters in length. The lengthened guidewire lumen, however, induces friction between the catheter and guidewir during catheter manipulation and withdrawal. Such frictio can contribute to extraneous guidewire movement.
Other versions of rapid exchange catheters in biaxial form are shown in the following patents: U.S. Patent No. 4,748,982 issued to Horzewski, et al., and 4,988,356 issued to Crittenden. Here the guidewire lumen contains a slit extending its length (except where it passes through the balloon) so that the guidewire can be removed from the lumen through the slit at a point immediately proximal to the balloon. These variants, too, have a lengthened guidewire lumen which induces friction between the catheter and guidewire during catheter manipulation and withdrawal. Such friction can contribute to extraneous guidewire movement.
German patent application P 39 34 695.1 to Rupprecht discloses a longitudinal slot 2 which extends up the central axis of the catheter reaching from any location on the catheter to the end of the catheter. The longitudinal slot allows the rapid exchange of the guidewire by guiding it up the central guide channel 3 throughout the entire length of the catheter.
Other art of interest includes balloon catheters such a that described by Bjδrn Nordenstrδm in Acta radiol, 57: 411 416, November 1962. A flexible steel wire is introduce through the tip of the catheter and taken out through the sid hole distal to the balloon (page 112 Fig. I type I and pag 413 Fig. 2 type 2) . Because the guide wire must be angled t exit the side hole the Nordenstrδm guide wire will tend to ge caught and be removed along with the catheter precludin exchanging catheters. The Nordenstrδm catheter material consist of teflon or opaque polythene material plus late rubber balloons. (See page 412) . Thus air bubbles are no visible during the purging process to alert the operator t malfunction. Furthermore, latex balloons do not have a know diameter at specific pressures and may expand beyond the siz of the vessel.
An angiocardiographic balloon catheter is also describe by Bjδrn Nordenstrδm in RADIOLOGY, 85: 256 - 259, July- December 1965. Page 257, Fig. A depicts a relatively long ti through which the guidewire is passed to facilitate th injection of contrast medium.
U. S. patent No. 4,824,435 to Giesy and U. S. patent No. 5,046,497 to Millar represent another variety of catheters, those for instrument delivery. Giesy discloses a method an apparatus for guiding diagnostic and therapeutic devices into tortuous body passages but not a second catheter or dilatatio device. A secondary guidewire 12 or an obturator 42 has a guide loop 10 or lumen comprising a member which may be threaded over a primary guidewire 14. This allows passage of an instrument over the guidewire 14 without the use of a through-lumen. The guide loop 10 is positioned at the tip or distal end of the instrument. The instrument is advanced alongside the guide wire 14 and is kept on course via the secondary guide wire 12 pushing behind the instrument.
U. S. patent No. 5,046,497 to Millar discloses a couplin structure 20 slidably engaging the guidewire allowing a
plurality of diagnostic or therapeutic catheters such as sensor-carrying catheters to be coupled to a common guidewire.
SUMMARY OF THE INVENTION The present invention discloses a rapid exchange medical catheter having a wire guiding means external to the shaft for slidably mounting over the guidewire, the wire guiding means being a short tubular member having a proximal end and a distal end extending proximally from the distal end of the shaft and terminating before the distal end of the therapy means. The advantages of applicant's invention are first, only one operator is required for the procedure, second, an inner lumen is not required to accommodate the guidewire, third, a short exchange lumen results in less friction and a faster exchange, and fourth, pinching the guidewire is minimized as the catheter is being removed through the tortuous path thereby tending to minimize pulling out the guidewire upon withdrawal of the catheter.
BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 represents the longitudinal cross-sectional view of a dual lumen embodiment of an angioplasty catheter incorporating the present invention;
FIG. 2 represents the cross-sectional view shown in Fig. 1 along the line 2-2 of the dual lumen embodiment's region preceding the proximal end of the balloon; FIG. 3 represents the cross-sectional view along the line
3-3 of the dual lumen embodiment's region following the distal end of the balloon;
FIG. 4 represents the side elevational view of a dual lumen embodiment; FIG. 5 represents the longitudinal cross-sectional view of a single lumen embodiment;
FIG. 6 represents the cross-sectional view along the line 6-6 of the single lumen embodiment's region following the distal end of the balloon;
FIG. 7 represents the cross-sectional view along the line 7-7 of the single lumen embodiment's region preceding the proximal end of the balloon;
FIG. 8 represents the side elevational view of a single lumen embodiment;
FIG. 9a represents a one piece molded tip; FIG. 9b represents a staked pin tip attachment;
FIG. 9c represents a bored and bonded tip attachment;
FIG. 9d represents a tip with recessed lumen;
FIG. 9e represents a tip with a tubular member parallel to the shaft. FIG. 10 represents the longitudinal cross-sectional view with the polyimide tip.
FIG. 11 represents the cross-sectional view along the line 11-11 in Fig. 10.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Applicants have developed a rapid exchange balloon dilatation catheter with a short tubular guidewire lumen at the distal tip. The purpose of a guidewire is to aid in positioning the catheter across a specific intervascular obstruction. This invention is intended for use as a dilatation catheter having a balloon means at the distal end to be placed across a stenosis. Under fluoroscopic guidance, the guidewire can be placed first in proximity to a stenosis and then across the stenosis. The rapid exchange balloon dilatation catheter can then be inserted into the stenosis following the path established by the guidewire. Further manipulations of the catheter are made to position the device across the obstruction. If this is successful, the balloon is inflated in such a manner that the diameter of the obstructed area is increased. In PTCA, multiple catheters are frequently
required during a procedure. Once a stenosis has been crossed and dilated with the dilating balloon, the dilatation catheter can be withdrawn, leaving the guidewire in position across the stenosis. A different device can then be inserted over the guidewire, as for example, an intervascular ultrasound device, an angioscopy device, a fiber optic viewing catheter, an arterial stent delivery catheter, or another dilatation catheter to further enlarge the cross sectional diameter of the obstruction by means of repeated dilatation with a balloon of greater diameter. Additionally, it may be desirable for the physician to be able to place the guidewire across another obstruction and to dilate this with a balloon dilatation catheter having a balloon of a different diameter. The average number of catheters used per patient procedure is 1.6. The advantages of applicant's invention are first, only one operator is required for the PTCA procedure, second, an inner lumen is not required to accommodate the guidewire, third, a short exchange lumen results in less friction and a faster exchange, and fourth, pinching the guidewire is minimized as the catheter is being removed through the tortuous path thereby tending to minimize pulling out the guidewire upon withdrawal of the catheter.
With applicant's invention, only one operator is required for the procedure which does not require an inner lumen to accommodate the guidewire. In prior art the catheter is inserted over an angioplasty guidewire by inserting the guidewire into the lumen within the catheter shaft. In applicant's invention, the catheter is inserted over an angioplasty guidewire without using the lumen through the catheter shaft. The guidewire is instead back-loaded through a distal tip tubular member. A typical rapid exchange guidewire is of approximately 180 cm in length. Conventional over-the-wire methods of loading the distal end of the catheter over the proximal end of the guidewire require a lumen running throughout the catheter shaft. The conventional
over-the-wire guidewire and catheter requires a guidewire length of approximately 300 cm thereby requiring two operators for the procedure.
The inner lumen in applicant's catheter shaft is not used by the guidewire and is therefore free for other uses such as blood perfusion. The inner guidewire lumen can also be eliminated entirely thereby reducing shaft profile.
A short exchange lumen causes less friction during the procedure resulting in a faster exchange. Additionally, friction between the catheter and the guidewire must be kept to a minimum to reduce extraneous movement of the guidewire and keep it stationary. The present invention addresses this matter by shortening the length of the contact surface between the catheter and the guidewire as well as by forming the exchange portion of the catheter out of a material with a very low coefficient of friction.
The present invention addresses the problem of pinching the guidewire as the catheter is being removed through the tortuous path thereby pulling out the guidewire and resulting in the loss of guidewire positioning over the stenosis. A factor which contributes to guidewire pinching includes the position of the guidewire exit port. The position of the guidewire exit port at the proximal balloon bond can cause the balloon to become snagged during withdrawal of the catheter into the ancillary guide catheter. The resultant buckling of the catheter may result in inadvertent withdrawal of the guidewire from the lesion due to seizure of the guidewire by the buckled lumen. This may have deleterious effects upon the patient undergoing angioplasty. The present invention tends to minimize the likelihood of guidewire seizure during catheter withdrawal by positioning the exchange component distal to the inflatable balloon and by using a short exchange lumen which keeps the guidewire relatively straight. A guidewire lumen of .75 cm can be used. Another factor which tends to minimize the likelihood of guidewire seizure in the
present invention includes the low coefficient of friction in materials such as polyimide.
The distal tip guidewire lumen is a short tubular member consisting of any biocompatible material such as polyethylene, polycarbonate, polyimide, combinations thereof or biocompatible metals such as #304 stainless steel. The guidewire lumen is open on both ends and extends rearwardly (proximally) from the distal extremity of the catheter and terminates before the distal end of the balloon attachment. This tubular member allows rapid exchange of angioplasty catheters by sliding the original catheter over the guidewire and out the vessel while maintaining the position of the guidewire across the stenosis so that a new catheter can be advanced to the stenosis if required. The simple design results in lower manufacturing costs than conventional over- the-wire catheters as fewer components, fewer manufacturing steps and less tubing is required.
This invention can be implemented as either a single lumen catheter or a dual lumen catheter. The advantage of the single lumen configuration over a dual lumen configuration is that of its lower profile. A low profile enhances the ability of a catheter to cross a stenosis. The advantage of the dual lumen embodiment is that the inner lumen can be used for fluid delivery such as blood perfusion or the infusion of an oxygenated liquid, anticoagulants or other drugs.
The single lumen invention can be better understood by referring to the drawings in FIGs. 5 through FIG. 8. The balloon catheter 5 single lumen system consists of the following. A central core wire 10 is made of any biocompatible material, preferably of #304 stainless steel. The core wire 10 provides stiffness which improves pushability and torquability. The core wire 10 may optionally be surrounded by a helically wound spring coil 15 which provides pushability from within instead of the need to rely on an outer shaft for pushability. The core wire 10 also provides
push to the distal tip 45. The spring coil 15 can be made of any biocompatible material, preferably of #304 stainless steel. The spring coil 15 extends from the manifold 110 to the distal end of the balloon 125. The balloon 25 is made of biocompatible material such as low density polyethylene. The catheter shaft is comprised of a helical spring coil 15, which is covered by a jacket 20 consisting of a biocompatible material such as a polymer or polyethylene. The jacket 20 is heat shrunk about the spring coil 15. The distal end of the balloon 125 is heat shrunk about the distal end of the spring coil 115. The proximal end of the balloon 120 is heat shrunk about the spring coil 15. The area of the spring coil 15 within the jacket 20 defines the balloon inflation lumen 30. An aperture 100 is cut through the spring coil 15 and jacket 20 to permit transmission of fluids from the balloon inflation lumen 30 to the balloon 25. The core wire 10 is affixed by bonding or welding the proximal end of the core wire 10 to the spring coil 15 at the proximal end of the manifold 110. The distal end of the core wire 10 could be welded to the spring coil distal end 115. If so, however, the device would not react symmetrically since such welding will stiffen only one side. The core wire 10 is free to float within the spring coil 15 and moves independently of the spring coil 15. Balloon inflation liquids are perfused through the balloon inflation lumen 30.
A radiopaque marker band 40 is bonded to the core wire 10 preferably at the point which is the center of the balloon 25 although it could be located other places such as the proximal and/or distal ends of the balloon 25. The marker band 40 is used to provide a fluoroscopic indication of the location of the balloon 25 thereby allowing the operator to adjust the position of the balloon 25. Preferred materials for the marker band 40 include 100% gold, 100 % iridium, or alloys of these materials such as a Pt-Ir alloy consisting of 90% platinum and 10% iridium. The preferred density is of at
π least 19.3 to 21.0 gm/cm3. In an alternative or additional embodiment to the marker band 40, the entire spring coil 15, or just the distal portion of the spring coil 15 can be fabricated of a radiopaque materials as described above to make the spring coil 15 visible by fluoroscopy.
A typical balloon 25 for any of applicant's embodiments has the following length, diameter and material characteristics. Balloon length ranges from 2 cm to 4 cm with the diameter size ranging from 1.5 mm to 5.0 mm. The balloon 25 is made of a biocompatible material such as low density polyethylene or similar materials which have a known diameter under a specific pressure. The distal end of the Balloon 25 is heat shrunk to the distal end of the core wire 10. Balloon 25 may also be heat shrunk over the distal tip 45 or portions thereof with the core wire 10 inserted therein and glued, bonded, brazed or fastened to the distal tip 45 with any other suitable method.
Applicant's catheter material for all embodiments comprises any biocompatible polymer or metal. Polymers include polyimide and more preferably polyethylene which is clear. A clear radiolucent material is preferable because air bubbles visible during the purging process alert the operator to malfunction. In the preferred embodiment, only the spring coil 15 and radiopaque marker band 40 are not clear. The dual lumen invention can be better understood by referring to the drawing in FIGs. 1 through 4. The balloon catheter 5 dual lumen system consists of the following. A central core wire 10 provides stiffness which improves pushability and torquability. The core wire 10 may optionally be surrounded by a helically wound spring coil 15 to increase pushability instead of the need to rely on an outer shaft for pushability. The core wire 10 also provides push to the distal tip 45. The spring coil 15 would, however, increase the profile and the cost and it may be more desirable to use a polymer shaft 35 instead. When a spring coil 15 is used, it
extends from the manifold 65 to the distal end of the balloon 125 and is covered by a plastic jacket 20 consisting of a biocompatible material such as polyethylene which is heat shrunk about the spring coil 15. The distal end of the balloon 125 is heat shrunk to the distal end of the spring coil 115. The proximal end of the balloon 120 is heat shrunk to the shaft 35. The area of the spring coil 15 within the jacket 20 defines the inner lumen 70. The core wire 10 is free to float within the spring coil 15 and moves independently of the spring coil 15. Liquids can flow through the inner lumen 70. When this is required, one or more exit ports 60 are created in the jacket 20 and balloon distal end 125 to permit the liquid to move from the inner lumen 70 into the blood stream. A manifold 65 suitable for the introduction of additional fluids as required. A balloon inflation lumen 30 surrounds the jacket 20. The inflation lumen's 30 distal end is connected with the manifold 65 and receives liquids therethrough for purposes of inflating the balloon 25 thereby reducing the stenosis. The radiopaque marker band 40 is affixed to the spring coil 15 and can be used to fluoroscopically view the position of the balloon 25 to allow the user to adjust the position of the balloon 25. Surrounding the inflation lumen 30 is the shaft 35 which is constructed of any biocompatible material such as a polymer. The balloon 25 is affixed to the shaft 35 by heat shrinking.
For either the Fig. 1 dual lumen or the Fig. 5 single lumen embodiment the following applies. The molded distal tip 45 has a rearwardly extending guidewire lumen 50 through which the guidewire 55 is threaded. The guidewire 55 can be any useful size, preferably a standard size such as .010 mm, .014 mm, or .018 mm.
The guidewire lumen 50 can be nearly parallel with the core wire 10 as a biaxial tip, or it can angle upward to the center of the distal tip 45 as in Fig. 9a. Angling the guidewire lumen 50 upward from 0 to 60 degrees, more
preferably 0 to 15 degrees and most preferably 0 degrees allows a more tapered distal tip 45 with a smaller profile. The proximal end of the guidewire lumen 50 where it exits the distal tip 45 should be tapered to reduce the possibility of snagging the tapered area 75 in the guide catheter upon exit. The distal tip 45 guidewire lumen 50 can be implemented with a variety of attachment variations and tip shapes. Attachment variations include bonding the distal tip 45 to the shaft 35 or a one piece molded tip as in Fig. 9a. The distal tip 45 could also be molded with a staked pin 80 and welded to the core wire 10 as in Fig. 9b. The staked pin 80 could also be threaded, knurled or ribbed for improved grip. Alternatively, as in Fig. 9c, the distal tip 45 could be bored 85 as with a laser and the distal tip 45 then fit and bonded over the distal end of the catheter shaft. Tip shape embodiments include a recess 90 for ease of loading as in Fig. 9d. The distal tip 45 could be fluted, streamlined or bullet shaped. In Fig. 9e the distal tip 45 could also exit the therapy means at a downward slope to accommodate maintaining the guidewire at a 0 degree angle to the shaft so that pinching the guidewire tends to be minimized as the catheter is removed through a tortuous path. The distal tip 45 can be implemented with a variety of shapes and attachments as long as that embodiment is capable of supporting the guidewire 55. Fig. 10 represents an embodiment of the invention with the polyimide annulus 95 in the distal tip 45. The polyimide annulus 95 acts as a reinforcement member and as a guidewire lumen 50. Polyimide is advantageous because it is stiff, absorbs force, is smooth, reduces friction, and it is strong. In addition to a polyimide, other biocompatible materials having these properties could be used. Other embodiments may include a spring coil with a polyethylene sheath. In such embodiments, the spring coil 15 does not stop at the proximal balloon bond as it does in the Fig. 10 embodiment but continues through the balloon 25. The polyimide annulus 95
should not be longer than about .75 cm due to the stiffness o polyimide. One example of a method of creating the polyimid annulus 95, as depicted in Fig. 10, includes the following. Cut the balloon 25 distal neck to 1 cm in length. Skive th proximal guidewire exit port 105. Insert a mandrel into a .25 cm to 1 cm length polyimide tube. Insert the polyimide tub into the catheter distal tip. Shrink the distal end o balloon 25 to capture the polyimide annulus 95. Remove th mandrel. The preceding specific embodiments are illustrative o the practice of the invention. It is to be understood, however, that other expedients known to those skilled in th art or disclosed herein, may be employed without departin from the spirit of the invention or the scope of the appende claims.
10
15
20
25
Claims
1. A catheter comprising: an elongated shaft (35) having a proximal end and distal end; a therapy means for providing medical treatment, th therapy means being mounted generally adjacent to th distal end of the shaft (35) ; and a wire guiding means for slidably mounting over guidewire (55) , the wire guiding means being a tubula member having a proximal end and a distal end an extending proximally at an angle greater than 0 degrees from the distal end of the shaft (35) and terminatin before the distal end of the therapy means.
2. The catheter of claim 1 wherein the tubular member extends proximally from the distal end of the shaft (35) at an angle of greater than 0 degrees to about 45 degrees to minimize pinching the guidewire (55) as the catheter is removed through a tortuous path.
3. The catheter of claim 2 wherein the tubular member extends proximally from the distal end of the shaft (35) at an angle of greater than 0 degrees to about 15 degrees to minimize pinching the guidewire (55) as the catheter is removed through a tortuous path.
4. The catheter of claim 1 wherein the tubular member is about 1 cm or shorter in length.
5. The catheter of claim 1 wherein the shaft (35) defines an inflation lumen and the therapy means comprises an expandable balloon (25) having a distal and a proximal end, the balloon (25) mounted on the shaft (35) for inflation and treatment of stenosis, the balloon (25) having an interior open to the inflation lumen (30) for fluid transmission.
6. The catheter of claim 5 wherein the shaft comprises a spring coil (15) covered by a jacket (20) and furthermore including a core wire (10) within the spring coil (15) .
7. The catheter of claim 1 comprising; the therapy means comprising an expandab balloon (25) having a distal end and proximal end f inflation and treatment of stenosis; a spring coil (15) covered by a jacket (20) , t spring coil (15) and jacket (20) extending longitudinal within the shaft (35) and balloon (25) to the distal e of the balloon (23) and defining an inner lumen (70) , t jacket (20) and balloon (25) each having at least o exit port (60) at the distal end so that liquids can transmitted from the inner lumen (70) to the exterior the catheter, the exit ports (60) of the inner lumen, t jacket and the balloon arranged relative to each oth such that fluid can flow outward; the shaft (35) surrounding the jacket (20) wi sufficient clearance to define an inflation lumen (30) the distal end of the shaft (35) ending general proximal to the balloon (25) with the proximal end of t balloon (25) affixed to the shaft (35) distal end and t distal end of the balloon (25) being affixed to t distal end of the jacket (20) ; and a core wire (10) within the spring coil (15) , t core wire (10) extending longitudinally the length of t catheter (5) .
8. The catheter of claim 1 wherein the tubular memb comprises a molded tip with a staked pin at the proximal e of the tip, the stalked pin welded to the distal end of a co wire running longitudinally throughout the shaft.
9. The catheter of claim 1 wherein the tubular membe further comprises an inner tubular member between about 0.2 cm to 1 cm long.
10. The catheter of claim 9 wherein the inner tubul member is made of polyimide.
11. The catheter of claim 1 wherein; the elongated shaf has an axis; the tubular member defines a guidewire lum offset and generally parallel to the axis of the shaft, t proximal end of the tubular member terminating before th distal end of the therapy means; and the distal end of th shaft exits the therapy means at an angle to accommodat maintaining the guidewire at a greater than 0 degree angle t the shaft to minimize pinching the guidewire as the cathete is removed through a tortuous path.
12. The catheter of claim 1 wherein the tubular membe is about 1 cm or shorter in length having a proximal end an a distal end and extending proximally from the distal end o the shaft at an angle to the longitudinal axis of the shaft o greater than 0 degrees to about 15 degrees so that th guidewire tends not to be pinched as the catheter is remove through a tortuous path, and the proximal end of the tubula member is distal to the distal end of the therapy means, th tubular member defining a lumen, the lumen having a straigh central axis throughout its length.
13. The catheter of claim 1 wherein the therapy means i an expandable balloon for inflation and treatment of stenosis the balloon made of materials which have a known diamete under a specific pressure, an interior open to an inflatio lumen for fluid transmission and having a distal end, and proximal end; and wherein the tubular member is not more tha about 1 cm in length.
14. The catheter of claim 13 wherein the guidewire lume extends proximally from the distal end of the shaft at a angle of greater than 0 degrees to about 45 degress t minimize pinching the guidewire as the catheter is bein removed through a tortuous path.
15. The catheter of claim 14 wherein the lumen extend proximally from the distal end of the shaft at an angle o greater than 0 degrees to about 15 degrees to minimiz pinching the guidewire as the catheter is being remove through a tortuous path.
16. The catheter of claim 13 wherein the shaft i sufficiently clear and radiolucent to permit the viewing o air bubbles during the purging process.
17. The catheter of claim 16 wherein the guidewire lume extends proximally from the distal end of the shaft at a angle of greater than 0 degrees to about 45 degrees t minimize pinching the guidewire as the catheter is bein removed through a tortuous path.
18. The catheter of claim 16 wherein the lumen extend proximally from the distal end of the shaft at an angle o greater than 0 degrees to about 15 degrees to minimiz pinching the guidewire as the catheter is being remove through a tortuous path.
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Application Number | Priority Date | Filing Date | Title |
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US07/975,456 US5383853A (en) | 1992-11-12 | 1992-11-12 | Rapid exchange catheter |
US7/975,456921112 | 1992-11-12 |
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WO1994011048A1 true WO1994011048A1 (en) | 1994-05-26 |
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PCT/US1993/010989 WO1994011048A1 (en) | 1992-11-12 | 1993-11-12 | Rapid exchange catheter |
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Cited By (13)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5458639A (en) * | 1994-08-05 | 1995-10-17 | Medtronic, Inc. | Catheter balloon distal bond |
WO1996010434A1 (en) * | 1994-10-04 | 1996-04-11 | Medtronic, Inc. | Rapid exchange catheter |
US5536250A (en) * | 1994-04-01 | 1996-07-16 | Localmed, Inc. | Perfusion shunt device and method |
US5549553A (en) * | 1993-04-29 | 1996-08-27 | Scimed Life Systems, Inc. | Dilation ballon for a single operator exchange intravascular catheter or similar device |
US5562620A (en) * | 1994-04-01 | 1996-10-08 | Localmed, Inc. | Perfusion shunt device having non-distensible pouch for receiving angioplasty balloon |
US5571086A (en) * | 1992-11-02 | 1996-11-05 | Localmed, Inc. | Method and apparatus for sequentially performing multiple intraluminal procedures |
US5599306A (en) * | 1994-04-01 | 1997-02-04 | Localmed, Inc. | Method and apparatus for providing external perfusion lumens on balloon catheters |
US5752932A (en) * | 1993-04-29 | 1998-05-19 | Scimed Life Systems, Inc. | Intravascular catheter with a recoverable guide wire lumen and method of use |
GB2341102A (en) * | 1998-09-05 | 2000-03-08 | Smiths Industries Plc | A tracheostomy tube obturator |
US6056719A (en) * | 1998-03-04 | 2000-05-02 | Scimed Life Systems, Inc. | Convertible catheter incorporating a collapsible lumen |
EP2326381A2 (en) * | 2008-08-26 | 2011-06-01 | Silicon Valley Medical Instruments, Inc. | Distal section for monorail catheter |
US9119739B2 (en) | 2001-03-29 | 2015-09-01 | J.W. Medical Systems Ltd. | Balloon catheter for multiple adjustable stent deployment |
US9198784B2 (en) | 2005-06-08 | 2015-12-01 | J.W. Medical Systems Ltd. | Apparatus and methods for deployment of multiple custom-length prostheses |
Families Citing this family (178)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5599296A (en) * | 1991-02-14 | 1997-02-04 | Wayne State University | Apparatus and method of delivery of gas-supersaturated liquids |
US5730935A (en) * | 1984-07-12 | 1998-03-24 | Wayne State University | High pressure gas exchanger |
US5569180A (en) * | 1991-02-14 | 1996-10-29 | Wayne State University | Method for delivering a gas-supersaturated fluid to a gas-depleted site and use thereof |
US5693017A (en) * | 1991-02-14 | 1997-12-02 | Wayne State University | Apparatus and method of delivery of gas-supersaturated solutions to a delivery site |
US5961765A (en) * | 1994-09-20 | 1999-10-05 | Schneider (Europe) A. G. | Method of making a catheter |
ATE184799T1 (en) * | 1993-10-27 | 1999-10-15 | Schneider Europ Gmbh | INTERVENTIONAL CATHETER |
US6659977B2 (en) * | 1993-10-27 | 2003-12-09 | Schneider (Europe) A.G. | Multilayer interventional catheter |
US5477851A (en) * | 1995-01-26 | 1995-12-26 | Callaghan; Eric B. | Laryngeal mask assembly and method for removing same |
US5575771A (en) * | 1995-04-24 | 1996-11-19 | Walinsky; Paul | Balloon catheter with external guidewire |
US5827241A (en) * | 1995-06-07 | 1998-10-27 | C. R. Bard, Inc. | Rapid exchange guidewire mechanism |
JPH09117510A (en) * | 1995-10-26 | 1997-05-06 | Buaayu:Kk | Infusion catheter |
US5713854A (en) * | 1995-11-01 | 1998-02-03 | Cordis Corporation | Method and apparatus for dilatation catheterization |
US7266725B2 (en) * | 2001-09-03 | 2007-09-04 | Pact Xpp Technologies Ag | Method for debugging reconfigurable architectures |
US5690642A (en) | 1996-01-18 | 1997-11-25 | Cook Incorporated | Rapid exchange stent delivery balloon catheter |
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US6071285A (en) * | 1996-03-25 | 2000-06-06 | Lashinski; Robert D. | Rapid exchange folded balloon catheter and stent delivery system |
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US7641685B2 (en) * | 1996-05-03 | 2010-01-05 | Medinol Ltd. | System and method for delivering a bifurcated stent |
US6544276B1 (en) * | 1996-05-20 | 2003-04-08 | Medtronic Ave. Inc. | Exchange method for emboli containment |
US5797948A (en) * | 1996-10-03 | 1998-08-25 | Cordis Corporation | Centering balloon catheter |
JP2001503301A (en) * | 1996-11-08 | 2001-03-13 | フォガティー,トマス・ジェイ | Transvascular TMR device and method |
US6165166A (en) | 1997-04-25 | 2000-12-26 | Schneider (Usa) Inc. | Trilayer, extruded medical tubing and medical devices incorporating such tubing |
US6056722A (en) | 1997-09-18 | 2000-05-02 | Iowa-India Investments Company Limited Of Douglas | Delivery mechanism for balloons, drugs, stents and other physical/mechanical agents and methods of use |
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US20030233068A1 (en) * | 1997-09-18 | 2003-12-18 | Swaminathan Jayaraman | Delivery mechanism for balloons, drugs, stents and other physical/mechanical agents and method of use |
US6159195A (en) * | 1998-02-19 | 2000-12-12 | Percusurge, Inc. | Exchange catheter and method of use |
CA2319517A1 (en) | 1998-02-19 | 1999-08-26 | Curon Medical, Inc. | Electrosurgical sphincter treatment apparatus |
AU3672299A (en) | 1998-04-30 | 1999-11-16 | Stuart D Edwards | Electrosurgical sphincter treatment apparatus |
US6238332B1 (en) * | 1998-05-07 | 2001-05-29 | Uni-Cath Inc. | Radiation device with shield portion |
US6740104B1 (en) | 1998-05-15 | 2004-05-25 | Advanced Cardiovascular Systems, Inc. | Enhanced catheter with alignment means |
AU764958B2 (en) | 1998-05-15 | 2003-09-04 | X Technologies, Inc. | Enhanced balloon dilatation system |
US6447501B1 (en) | 1998-05-15 | 2002-09-10 | X Technologies Inc. | Enhanced stent delivery system |
US6780199B2 (en) | 1998-05-15 | 2004-08-24 | Advanced Cardiovascular Systems, Inc. | Enhanced stent delivery system |
JPH11342208A (en) * | 1998-06-02 | 1999-12-14 | Buaayu:Kk | Balloon catheter |
US6149680A (en) * | 1998-06-04 | 2000-11-21 | Scimed Life Systems, Inc. | Stent loading tool |
US6129738A (en) * | 1998-06-20 | 2000-10-10 | Medtronic Ave, Inc. | Method and apparatus for treating stenoses at bifurcated regions |
US6153252A (en) * | 1998-06-30 | 2000-11-28 | Ethicon, Inc. | Process for coating stents |
US20020007145A1 (en) | 1998-10-23 | 2002-01-17 | Timothy Stivland | Catheter having improved bonding region |
US6123718A (en) * | 1998-11-02 | 2000-09-26 | Polymerex Medical Corp. | Balloon catheter |
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US6146372A (en) * | 1998-12-24 | 2000-11-14 | Datascope Investment Corp | Apparatus and method for the percutaneous insertion of a pediatric intra-aortic balloon catheter |
US6432102B2 (en) | 1999-03-15 | 2002-08-13 | Cryovascular Systems, Inc. | Cryosurgical fluid supply |
US6648879B2 (en) | 1999-02-24 | 2003-11-18 | Cryovascular Systems, Inc. | Safety cryotherapy catheter |
US6514245B1 (en) | 1999-03-15 | 2003-02-04 | Cryovascular Systems, Inc. | Safety cryotherapy catheter |
US6348045B1 (en) * | 1999-07-12 | 2002-02-19 | Impulse Dynamics N.V. | Catheter with distal-end engaging means |
US7175644B2 (en) * | 2001-02-14 | 2007-02-13 | Broncus Technologies, Inc. | Devices and methods for maintaining collateral channels in tissue |
US6702802B1 (en) | 1999-11-10 | 2004-03-09 | Endovascular Technologies, Inc. | Catheters with improved transition |
US6530899B1 (en) * | 2000-03-27 | 2003-03-11 | Jomed Inc. | Catheter having a spear shaped tip |
US8236048B2 (en) | 2000-05-12 | 2012-08-07 | Cordis Corporation | Drug/drug delivery systems for the prevention and treatment of vascular disease |
US20050002986A1 (en) * | 2000-05-12 | 2005-01-06 | Robert Falotico | Drug/drug delivery systems for the prevention and treatment of vascular disease |
US7238168B2 (en) * | 2000-06-02 | 2007-07-03 | Avantec Vascular Corporation | Exchangeable catheter |
US6569180B1 (en) * | 2000-06-02 | 2003-05-27 | Avantec Vascular Corporation | Catheter having exchangeable balloon |
US20030055377A1 (en) * | 2000-06-02 | 2003-03-20 | Avantec Vascular Corporation | Exchangeable catheter |
US7008535B1 (en) * | 2000-08-04 | 2006-03-07 | Wayne State University | Apparatus for oxygenating wastewater |
CA2424029C (en) * | 2000-09-29 | 2008-01-29 | Cordis Corporation | Coated medical devices |
US7261735B2 (en) * | 2001-05-07 | 2007-08-28 | Cordis Corporation | Local drug delivery devices and methods for maintaining the drug coatings thereon |
US6746773B2 (en) | 2000-09-29 | 2004-06-08 | Ethicon, Inc. | Coatings for medical devices |
US20020111590A1 (en) * | 2000-09-29 | 2002-08-15 | Davila Luis A. | Medical devices, drug coatings and methods for maintaining the drug coatings thereon |
US6669662B1 (en) * | 2000-12-27 | 2003-12-30 | Advanced Cardiovascular Systems, Inc. | Perfusion catheter |
US6934589B2 (en) | 2000-12-29 | 2005-08-23 | Medtronic, Inc. | System and method for placing endocardial leads |
US7160270B2 (en) * | 2001-03-26 | 2007-01-09 | Curon Medical, Inc. | Systems and methods employing a bite block insert for positioning and stabilizing external instruments deployed within the body |
US7077841B2 (en) | 2001-03-26 | 2006-07-18 | Curon Medical, Inc. | Systems and methods employing a guidewire for positioning and stabilizing external instruments deployed within the body |
US7247313B2 (en) | 2001-06-27 | 2007-07-24 | Advanced Cardiovascular Systems, Inc. | Polyacrylates coatings for implantable medical devices |
NO20024056L (en) * | 2001-08-27 | 2003-02-28 | Medinol Ltd | Stentsystem |
US20030065345A1 (en) * | 2001-09-28 | 2003-04-03 | Kevin Weadock | Anastomosis devices and methods for treating anastomotic sites |
US20030073961A1 (en) * | 2001-09-28 | 2003-04-17 | Happ Dorrie M. | Medical device containing light-protected therapeutic agent and a method for fabricating thereof |
US7108701B2 (en) * | 2001-09-28 | 2006-09-19 | Ethicon, Inc. | Drug releasing anastomosis devices and methods for treating anastomotic sites |
US7229431B2 (en) * | 2001-11-08 | 2007-06-12 | Russell A. Houser | Rapid exchange catheter with stent deployment, therapeutic infusion, and lesion sampling features |
US20030199914A1 (en) * | 2002-04-23 | 2003-10-23 | Juan-Carlos Diaz | Coaxial balloon catheter |
US7005137B1 (en) | 2002-06-21 | 2006-02-28 | Advanceed Cardiovascular Systems, Inc. | Coating for implantable medical devices |
US7396539B1 (en) * | 2002-06-21 | 2008-07-08 | Advanced Cardiovascular Systems, Inc. | Stent coatings with engineered drug release rate |
US7217426B1 (en) | 2002-06-21 | 2007-05-15 | Advanced Cardiovascular Systems, Inc. | Coatings containing polycationic peptides for cardiovascular therapy |
US7491233B1 (en) | 2002-07-19 | 2009-02-17 | Advanced Cardiovascular Systems Inc. | Purified polymers for coatings of implantable medical devices |
JP4321019B2 (en) * | 2002-08-01 | 2009-08-26 | 株式会社カネカ | Suction catheter |
US20040063805A1 (en) * | 2002-09-19 | 2004-04-01 | Pacetti Stephen D. | Coatings for implantable medical devices and methods for fabrication thereof |
US6824543B2 (en) * | 2002-12-11 | 2004-11-30 | Cryocor, Inc. | Guidance system for a cryocatheter |
US7300415B2 (en) * | 2002-12-20 | 2007-11-27 | Advanced Cardiovascular Systems, Inc. | Balloon catheter having an external guidewire |
US7563454B1 (en) | 2003-05-01 | 2009-07-21 | Advanced Cardiovascular Systems, Inc. | Coatings for implantable medical devices |
US8791171B2 (en) | 2003-05-01 | 2014-07-29 | Abbott Cardiovascular Systems Inc. | Biodegradable coatings for implantable medical devices |
US8685053B2 (en) * | 2003-05-22 | 2014-04-01 | Boston Scientific Scimed, Inc. | Tether equipped catheter |
US8206320B2 (en) * | 2003-07-31 | 2012-06-26 | Cook Medical Technologies Llc | System and method for introducing multiple medical devices |
US7367967B2 (en) * | 2003-09-17 | 2008-05-06 | Boston Scientific Scimed, Inc. | Catheter with sheathed hypotube |
JP3894224B2 (en) * | 2003-11-07 | 2007-03-14 | 株式会社カネカ | Suction catheter |
US7022104B2 (en) | 2003-12-08 | 2006-04-04 | Angioscore, Inc. | Facilitated balloon catheter exchange |
US7316709B2 (en) * | 2004-01-13 | 2008-01-08 | Advanced Cardiovascular Systems, Inc. | Balloon catheter having a textured member for enhancing balloon or stent retention |
US20050177130A1 (en) * | 2004-02-10 | 2005-08-11 | Angioscore, Inc. | Balloon catheter with spiral folds |
US8252014B2 (en) | 2004-03-03 | 2012-08-28 | Innovational Holdings Llc. | Rapid exchange balloon catheter with braided shaft |
US9050437B2 (en) * | 2004-03-04 | 2015-06-09 | YMED, Inc. | Positioning device for ostial lesions |
US7780715B2 (en) * | 2004-03-04 | 2010-08-24 | Y Med, Inc. | Vessel treatment devices |
US7753951B2 (en) * | 2004-03-04 | 2010-07-13 | Y Med, Inc. | Vessel treatment devices |
US7766951B2 (en) * | 2004-03-04 | 2010-08-03 | Y Med, Inc. | Vessel treatment devices |
JP4722122B2 (en) * | 2004-03-17 | 2011-07-13 | クック インコーポレイテッド | Second wire device and mounting procedure |
US7244443B2 (en) * | 2004-08-31 | 2007-07-17 | Advanced Cardiovascular Systems, Inc. | Polymers of fluorinated monomers and hydrophilic monomers |
US9005138B2 (en) * | 2005-08-25 | 2015-04-14 | Cook Medical Technologies Llc | Wire guide having distal coupling tip |
US8075497B2 (en) * | 2005-08-25 | 2011-12-13 | Cook Medical Technologies Llc | Wire guide having distal coupling tip |
US7758565B2 (en) * | 2005-10-18 | 2010-07-20 | Cook Incorporated | Identifiable wire guide |
US7731693B2 (en) * | 2005-10-27 | 2010-06-08 | Cook Incorporated | Coupling wire guide |
US8137291B2 (en) * | 2005-10-27 | 2012-03-20 | Cook Medical Technologies Llc | Wire guide having distal coupling tip |
US7637933B2 (en) * | 2005-11-01 | 2009-12-29 | Cordis Corporation | Method for preparing and employing an implant delivery apparatus |
US7811238B2 (en) * | 2006-01-13 | 2010-10-12 | Cook Incorporated | Wire guide having distal coupling tip |
US7798980B2 (en) * | 2006-01-31 | 2010-09-21 | Cook Incorporated | Wire guide having distal coupling tip for attachment to a previously introduced wire guide |
US7785275B2 (en) * | 2006-01-31 | 2010-08-31 | Cook Incorporated | Wire guide having distal coupling tip |
US20070191790A1 (en) * | 2006-02-16 | 2007-08-16 | Cook Incorporated | Wire guide having distal coupling tip |
ES2303433B1 (en) * | 2006-03-16 | 2009-06-05 | Iberhospitex S.A. | PERFECTED CATHETER OF HELP DURING PRIMARY ANGIOPLASTIA PROCEDURES. |
US8486025B2 (en) * | 2006-05-11 | 2013-07-16 | Ronald J. Solar | Systems and methods for treating a vessel using focused force |
US7901378B2 (en) * | 2006-05-11 | 2011-03-08 | Y-Med, Inc. | Systems and methods for treating a vessel using focused force |
US8133190B2 (en) * | 2006-06-22 | 2012-03-13 | Cook Medical Technologies Llc | Weldable wire guide with distal coupling tip |
US9028859B2 (en) * | 2006-07-07 | 2015-05-12 | Advanced Cardiovascular Systems, Inc. | Phase-separated block copolymer coatings for implantable medical devices |
US9867530B2 (en) | 2006-08-14 | 2018-01-16 | Volcano Corporation | Telescopic side port catheter device with imaging system and method for accessing side branch occlusions |
MX2009007779A (en) * | 2007-01-22 | 2009-07-30 | Taylor Medical Inc | Catheter with guidewire lumen with tubular portion and sleeve. |
EP2117632A1 (en) * | 2007-02-26 | 2009-11-18 | Cook Incorporated | Wire guide having distal coupling tip |
US9387308B2 (en) * | 2007-04-23 | 2016-07-12 | Cardioguidance Biomedical, Llc | Guidewire with adjustable stiffness |
US7981148B2 (en) * | 2007-05-16 | 2011-07-19 | Boston Scientific Scimed, Inc. | Stent delivery catheter |
JP5436800B2 (en) * | 2007-06-15 | 2014-03-05 | オリンパスメディカルシステムズ株式会社 | Medical instruments |
WO2009009802A1 (en) | 2007-07-12 | 2009-01-15 | Volcano Corporation | Oct-ivus catheter for concurrent luminal imaging |
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US8216498B2 (en) | 2008-09-10 | 2012-07-10 | Boston Scientific Scimed, Inc. | Catheter having a coextruded fluoropolymer layer |
US20100094075A1 (en) * | 2008-10-10 | 2010-04-15 | Hologic Inc. | Expandable medical devices with reinforced elastomeric members and methods employing the same |
US20100094074A1 (en) * | 2008-10-10 | 2010-04-15 | Hologic Inc. | Brachytherapy apparatus and methods employing expandable medical devices comprising fixation elements |
WO2010121049A1 (en) * | 2009-04-15 | 2010-10-21 | Microvention, Inc. | Implant delivery system |
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US9324141B2 (en) | 2012-10-05 | 2016-04-26 | Volcano Corporation | Removal of A-scan streaking artifact |
US9367965B2 (en) | 2012-10-05 | 2016-06-14 | Volcano Corporation | Systems and methods for generating images of tissue |
US9307926B2 (en) | 2012-10-05 | 2016-04-12 | Volcano Corporation | Automatic stent detection |
US9286673B2 (en) | 2012-10-05 | 2016-03-15 | Volcano Corporation | Systems for correcting distortions in a medical image and methods of use thereof |
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US10070827B2 (en) | 2012-10-05 | 2018-09-11 | Volcano Corporation | Automatic image playback |
US9840734B2 (en) | 2012-10-22 | 2017-12-12 | Raindance Technologies, Inc. | Methods for analyzing DNA |
EP2931132B1 (en) | 2012-12-13 | 2023-07-05 | Philips Image Guided Therapy Corporation | System for targeted cannulation |
US11406498B2 (en) | 2012-12-20 | 2022-08-09 | Philips Image Guided Therapy Corporation | Implant delivery system and implants |
US10939826B2 (en) | 2012-12-20 | 2021-03-09 | Philips Image Guided Therapy Corporation | Aspirating and removing biological material |
US10942022B2 (en) | 2012-12-20 | 2021-03-09 | Philips Image Guided Therapy Corporation | Manual calibration of imaging system |
EP2934310A4 (en) | 2012-12-20 | 2016-10-12 | Nathaniel J Kemp | Optical coherence tomography system that is reconfigurable between different imaging modes |
WO2014099899A1 (en) | 2012-12-20 | 2014-06-26 | Jeremy Stigall | Smooth transition catheters |
CA2895770A1 (en) | 2012-12-20 | 2014-07-24 | Jeremy Stigall | Locating intravascular images |
EP2934323A4 (en) | 2012-12-21 | 2016-08-17 | Andrew Hancock | System and method for multipath processing of image signals |
US10058284B2 (en) | 2012-12-21 | 2018-08-28 | Volcano Corporation | Simultaneous imaging, monitoring, and therapy |
US9486143B2 (en) | 2012-12-21 | 2016-11-08 | Volcano Corporation | Intravascular forward imaging device |
WO2014100162A1 (en) | 2012-12-21 | 2014-06-26 | Kemp Nathaniel J | Power-efficient optical buffering using optical switch |
US10413317B2 (en) | 2012-12-21 | 2019-09-17 | Volcano Corporation | System and method for catheter steering and operation |
US9612105B2 (en) | 2012-12-21 | 2017-04-04 | Volcano Corporation | Polarization sensitive optical coherence tomography system |
WO2014100606A1 (en) | 2012-12-21 | 2014-06-26 | Meyer, Douglas | Rotational ultrasound imaging catheter with extended catheter body telescope |
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AU2017292751B2 (en) | 2016-07-06 | 2022-05-05 | Bayer Healthcare Llc | Contrast heating system with in-line contrast warmer |
US10751514B2 (en) | 2016-12-09 | 2020-08-25 | Teleflex Life Sciences Limited | Guide extension catheter |
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US20220040454A1 (en) * | 2020-08-06 | 2022-02-10 | Canon U.S.A., Inc. | Optimized Catheter Sheath for Rx Catheter |
Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0344530A1 (en) * | 1988-05-27 | 1989-12-06 | Advanced Cardiovascular Systems, Inc. | Vascular catheter assembly with a guiding sleeve |
Family Cites Families (18)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4976689A (en) * | 1984-09-18 | 1990-12-11 | Medtronic Versaflex, Inc. | Outer exchange catheter system |
DE3442736A1 (en) * | 1984-11-23 | 1986-06-05 | Tassilo Dr.med. 7800 Freiburg Bonzel | DILATATION CATHETER |
US5061273A (en) * | 1989-06-01 | 1991-10-29 | Yock Paul G | Angioplasty apparatus facilitating rapid exchanges |
US5040548A (en) * | 1989-06-01 | 1991-08-20 | Yock Paul G | Angioplasty mehtod |
US5046497A (en) * | 1986-11-14 | 1991-09-10 | Millar Instruments, Inc. | Structure for coupling a guidewire and a catheter |
US4771777A (en) * | 1987-01-06 | 1988-09-20 | Advanced Cardiovascular Systems, Inc. | Perfusion type balloon dilatation catheter, apparatus and method |
US4748982A (en) * | 1987-01-06 | 1988-06-07 | Advanced Cardiovascular Systems, Inc. | Reinforced balloon dilatation catheter with slitted exchange sleeve and method |
US4988356A (en) * | 1987-02-27 | 1991-01-29 | C. R. Bard, Inc. | Catheter and guidewire exchange system |
US4824435A (en) * | 1987-05-18 | 1989-04-25 | Thomas J. Fogarty | Instrument guidance system |
US4944745A (en) * | 1988-02-29 | 1990-07-31 | Scimed Life Systems, Inc. | Perfusion balloon catheter |
FR2638364A1 (en) * | 1988-10-27 | 1990-05-04 | Farcot Jean Christian | APPARATUS FOR PERFORMING PROLONGED ANGIOPLASTY |
US5035686A (en) * | 1989-01-27 | 1991-07-30 | C. R. Bard, Inc. | Catheter exchange system with detachable luer fitting |
US5180367A (en) * | 1989-09-06 | 1993-01-19 | Datascope Corporation | Procedure and balloon catheter system for relieving arterial or veinal restrictions without exchanging balloon catheters |
US5024234A (en) * | 1989-10-17 | 1991-06-18 | Cardiovascular Imaging Systems, Inc. | Ultrasonic imaging catheter with guidewire channel |
DE3934695A1 (en) * | 1989-10-18 | 1991-04-25 | Rupprecht Hans Juergen | Balloon type catheter - has longitudinal slit in wall to facilitate replacement of guide wire |
US5084010A (en) * | 1990-02-20 | 1992-01-28 | Devices For Vascular Intervention, Inc. | System and method for catheter construction |
US5395332A (en) * | 1990-08-28 | 1995-03-07 | Scimed Life Systems, Inc. | Intravascualr catheter with distal tip guide wire lumen |
US5324257A (en) * | 1992-05-04 | 1994-06-28 | Cook, Incorporated | Balloon catheter having an integrally formed guide wire channel |
-
1992
- 1992-11-12 US US07/975,456 patent/US5383853A/en not_active Expired - Fee Related
-
1993
- 1993-11-12 WO PCT/US1993/010989 patent/WO1994011048A1/en not_active Application Discontinuation
-
1996
- 1996-01-19 US US08/591,252 patent/US5667521A/en not_active Expired - Fee Related
Patent Citations (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0344530A1 (en) * | 1988-05-27 | 1989-12-06 | Advanced Cardiovascular Systems, Inc. | Vascular catheter assembly with a guiding sleeve |
Cited By (27)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5571086A (en) * | 1992-11-02 | 1996-11-05 | Localmed, Inc. | Method and apparatus for sequentially performing multiple intraluminal procedures |
US5713860A (en) * | 1992-11-02 | 1998-02-03 | Localmed, Inc. | Intravascular catheter with infusion array |
US5609574A (en) * | 1992-11-02 | 1997-03-11 | Localmed, Inc. | Intravascular catheter with infusion array |
US5980484A (en) * | 1993-04-29 | 1999-11-09 | Scimed Life Systems, Inc. | Dilation balloon for a single operator exchange catheter or similar device |
US5718683A (en) * | 1993-04-29 | 1998-02-17 | Scimed Life Systems, Inc. | Dilation balloon for a single operator exchange intravascular catheter or similar device |
US5752932A (en) * | 1993-04-29 | 1998-05-19 | Scimed Life Systems, Inc. | Intravascular catheter with a recoverable guide wire lumen and method of use |
US6068610A (en) * | 1993-04-29 | 2000-05-30 | Scimed Life Systems, Inc. | Intravascular catheter with a recoverable guide wire lumen and method of use |
US5549553A (en) * | 1993-04-29 | 1996-08-27 | Scimed Life Systems, Inc. | Dilation ballon for a single operator exchange intravascular catheter or similar device |
US5562620A (en) * | 1994-04-01 | 1996-10-08 | Localmed, Inc. | Perfusion shunt device having non-distensible pouch for receiving angioplasty balloon |
US5536250A (en) * | 1994-04-01 | 1996-07-16 | Localmed, Inc. | Perfusion shunt device and method |
US5599306A (en) * | 1994-04-01 | 1997-02-04 | Localmed, Inc. | Method and apparatus for providing external perfusion lumens on balloon catheters |
WO1996004034A1 (en) * | 1994-08-05 | 1996-02-15 | Medtronic, Inc. | Catheter balloon distal bond |
US5458639A (en) * | 1994-08-05 | 1995-10-17 | Medtronic, Inc. | Catheter balloon distal bond |
WO1996010434A1 (en) * | 1994-10-04 | 1996-04-11 | Medtronic, Inc. | Rapid exchange catheter |
US6056719A (en) * | 1998-03-04 | 2000-05-02 | Scimed Life Systems, Inc. | Convertible catheter incorporating a collapsible lumen |
FR2782926A1 (en) * | 1998-09-05 | 2000-03-10 | Smiths Industries Plc | INTRODUCER FOR AN ASSEMBLY COMPRISING A MEDICAL TUBE |
GB2341102A (en) * | 1998-09-05 | 2000-03-08 | Smiths Industries Plc | A tracheostomy tube obturator |
US6286509B1 (en) | 1998-09-05 | 2001-09-11 | Smiths Group Plc | Introducers and tube assemblies |
GB2341102B (en) * | 1998-09-05 | 2003-05-28 | Smiths Industries Plc | Introducers and tube assemblies |
US9119739B2 (en) | 2001-03-29 | 2015-09-01 | J.W. Medical Systems Ltd. | Balloon catheter for multiple adjustable stent deployment |
US9980839B2 (en) | 2001-03-29 | 2018-05-29 | J.W. Medical Systems Ltd. | Balloon catheter for multiple adjustable stent deployment |
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US9198784B2 (en) | 2005-06-08 | 2015-12-01 | J.W. Medical Systems Ltd. | Apparatus and methods for deployment of multiple custom-length prostheses |
US10219923B2 (en) | 2005-06-08 | 2019-03-05 | J.W. Medical Systems Ltd. | Apparatus and methods for deployment of multiple custom-length prostheses (III) |
US11439524B2 (en) | 2005-06-08 | 2022-09-13 | J.W. Medical Systems Ltd. | Apparatus and methods for deployment of multiple custom-length prostheses (III) |
EP2326381A2 (en) * | 2008-08-26 | 2011-06-01 | Silicon Valley Medical Instruments, Inc. | Distal section for monorail catheter |
EP2326381A4 (en) * | 2008-08-26 | 2011-09-21 | Silicon Valley Medical Instr Inc | Distal section for monorail catheter |
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US5667521A (en) | 1997-09-16 |
US5383853A (en) | 1995-01-24 |
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