CA2483264A1 - Infusion catheter having an atraumatic tip - Google Patents

Infusion catheter having an atraumatic tip Download PDF

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Publication number
CA2483264A1
CA2483264A1 CA002483264A CA2483264A CA2483264A1 CA 2483264 A1 CA2483264 A1 CA 2483264A1 CA 002483264 A CA002483264 A CA 002483264A CA 2483264 A CA2483264 A CA 2483264A CA 2483264 A1 CA2483264 A1 CA 2483264A1
Authority
CA
Canada
Prior art keywords
proximal
lumen
occlusion
disposed
fluid
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002483264A
Other languages
French (fr)
Other versions
CA2483264C (en
Inventor
Gerald N. M. I. Dorros
Michael Hogendijk
Mark C. Bates
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
WL Gore and Associates Inc
Original Assignee
Arteria Medical Science, Inc.
Gerald N. M. I. Dorros
Michael Hogendijk
Mark C. Bates
Gore Enterprise Holdings, Inc.
W. L. Gore & Associates, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Arteria Medical Science, Inc., Gerald N. M. I. Dorros, Michael Hogendijk, Mark C. Bates, Gore Enterprise Holdings, Inc., W. L. Gore & Associates, Inc. filed Critical Arteria Medical Science, Inc.
Priority to CA2648905A priority Critical patent/CA2648905C/en
Publication of CA2483264A1 publication Critical patent/CA2483264A1/en
Application granted granted Critical
Publication of CA2483264C publication Critical patent/CA2483264C/en
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3203—Fluid jet cutting instruments
    • A61B17/32037—Fluid jet cutting instruments for removing obstructions from inner organs or blood vessels, e.g. for atherectomy
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
    • A61B2017/22042—Details of the tip of the guide wire
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22079—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with suction of debris
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22082—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance
    • A61B2017/22084—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance stone- or thrombus-dissolving
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3205—Excision instruments
    • A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
    • A61B2017/320716—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions comprising means for preventing embolism by dislodged material
    • 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
    • A61M25/008—Strength or flexibility characteristics of the catheter tip
    • A61M2025/0081—Soft tip
    • 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
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes
    • A61M2025/0681—Systems with catheter and outer tubing, e.g. sheath, sleeve or guide 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
    • A61M2025/1043—Balloon catheters with special features or adapted for special applications
    • A61M2025/1047—Balloon catheters with special features or adapted for special applications having centering means, e.g. balloons having an appropriate shape
    • 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
    • A61M2025/1052—Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector
    • 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
    • A61M25/10—Balloon catheters
    • A61M2025/1043—Balloon catheters with special features or adapted for special applications
    • A61M2025/1093—Balloon catheters with special features or adapted for special applications having particular tip characteristics
    • 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
    • A61M25/007—Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
    • 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
    • A61M25/02—Holding devices, e.g. on the body
    • A61M25/04—Holding devices, e.g. on the body in the body, e.g. expansible

Abstract

The present invention is directed to apparatus and methods for treating a vascular occlusion by providing an infusion catheter (10) having an atraumat ic tip (12) and at least one delivery port (14) configured to infuse fluid into the occlusion. The fluid that is infused dilutes the occlusion and reduces adhesion of the occlusion to an intima of the vessel wall, thereby causing t he occlusion to dislodge. Emboli generated in the process are directed into an emboli removal catheter (60) for removal.

Claims (31)

1. Apparatus suitable for disrupting a vascular occlusion adhered to a vessel wall, the apparatus comprising:
an infusion catheter having proximal and distal ends and a lumen extending therebetween, an atraumatic tip disposed at the distal end, and at least one delivery port disposed proximal of the atraumatic tip in fluid communication with the lumen, wherein the infusion catheter is configured to infuse fluid into the occlusion so that the fluid reduces adhesion of the occlusion to an intima of the vessel wall.
2. The apparatus of claim 1 wherein the atraumatic tip comprises a platinum coil.
3. The apparatus of claim 1 wherein at least one delivery port delivers a jet of fluid that forms an oblique angle relative to a longitudinal axis of the infusion catheter.
4. The apparatus of claim 3 wherein the delivery port causes fluid to be ejected in a proximal direction.
5. The apparatus of claim 1 wherein the delivery port comprises a circular configuration.
6. The apparatus of claim 1 wherein the infusion catheter further comprises at least one radiopaque marker band disposed proximal of the atraumatic tip.
7. The apparatus of claim 6 wherein a first radiopaque marker band is disposed proximal of the delivery port and a second radiopaque marker band is disposed distal of the delivery port.
8. The apparatus of claim 1 wherein the fluid is saline.
9. The apparatus of claim 1 further comprising a removable stylet that is configured to be longitudinally advanced within the lumen of infusion catheter.
10. The apparatus of claim 1 further comprising an infusion pump configured to regulate the pressure of fluid infused into the lumen of the infusion catheter.
11. The apparatus of claim 1 further comprising an emboli removal catheter having proximal and distal ends and a lumen extending therebetween, and further comprising an occlusive element disposed at the distal end, wherein the lumen of the emboli removal catheter is sized to permit the longitudinal advancement of the infusion catheter.
12. The apparatus of claim 11 wherein the lumen of the emboli removal catheter is in.fluid communication with a patient's venous system.
13. The apparatus of claim 11 further comprising a venous return sheath having proximal and distal ends and a lumen extending therebetween, wherein the venous return sheath is in fluid communication with the lumen of the emboli removal catheter and is adapted to be disposed in a patient's venous system.
14. The apparatus of claim 13 further comprising a valve disposed between the emboli removal catheter and the venous return sheath, wherein the valve is configured to selectively inhibit fluid communication between the lumen of the emboli removal catheter and the lumen of the venous return sheath.
15. The apparatus of claim 14 further comprising a filter disposed between the emboli removal catheter and the venous return sheath.
16. Apparatus suitable for treating an occlusion adhered to a vessel wall, the apparatus comprising:
an infusion catheter having proximal and distal ends and a lumen extending therebetween, an atraumatic tip disposed at the distal end, and at least one delivery port disposed proximal of the atraumatic tip in fluid communication with the lumen; and a centering device having proximal and distal ends and a lumen extending therebetween, the centering device comprising a plurality of deployable struts disposed at the distal end, the lumen adapted to permit the infusion catheter to pass therethrough, wherein the infusion catheter is configured to infuse fluid into the occlusion so that the fluid reduces adhesion of the occlusion to an intima of the vessel wall.
17. The apparatus of claim 16 further comprising an outer sheath having proximal and distal ends and a lumen extending therebetween, the outer sheath being configured to constrain the deployable struts in a contracted state within the outer sheath.
18. The apparatus of claim 16 wherein the deployable struts are sized to engage the vessel wall in a deployed state.
19. The apparatus of 16 wherein the deployable struts comprise a nickel-titanium alloy.
20. The apparatus of claim 16 wherein at least one delivery port delivers a jet of fluid that forms an oblique angle relative to a longitudinal axis of the infusion catheter.
21. The apparatus of claim 20 wherein the delivery port causes fluid to be ejected in a proximal direction.
22. The apparatus of claim 16 wherein the infusion catheter further comprises at least one radiopaque marker band disposed proximal of the atraumatic tip.
23. The apparatus of claim 22 wherein a first radiopaque marker band is disposed proximal of the delivery port and a second radiopaque marker band is disposed distal of the delivery port.
24. The apparatus of claim 16 further comprising an emboli removal catheter having proximal and distal ends and a lumen extending therebetween, and further comprising an occlusive element disposed at the distal end, wherein the lumen of the emboli removal catheter is sized to permit the longitudinal advancement of the centering device.
25. A method for treating an occlusion adhered to a vessel wall, the method comprising:
providing an infusion catheter having proximal and distal ends, a lumen extending therebetween, an a,traumatic tip disposed at the distal end, and at least one delivery port disposed proximal of the atraumatic tip in fluid communication with the lumen;
advancing the atraumatic tip through the occlusion;
positioning the delivery port at a desired location within the occlusion; and infusing fluid into the occlusion via the delivery port so that the fluid reduces adhesion of the occlusion to an intima of the vessel wall.
26. The method of claim 25 wherein positioning the delivery port at a desired location within the occlusion comprises:
providing at least one radiopaque marker band disposed on the infusion catheter at a location proximal of the atraumatic tip; and using the radiopaque marker band to determine the position of the delivery port within the occlusion.
27. The method of claim 25 wherein fluid is infused into the occlusion, at a controlled pressure using an infusion pump.
28. The method of claim 25 further comprising:
providing an emboli removal catheter having proximal and distal ends and a lumen extending therebetween, and further comprising an occlusive element disposed at the distal end, wherein the lumen of the emboli removal catheter is sized to permit the longitudinal advancement of the infusion catheter;
deploying occlusive element to occlude antegrade flow in a vessel;
establishing retrograde flow through the lumen of the emboli removal catheter to influence flow characteristics in a treatment vessel; and causing emboli generated during the infusion of fluid into the occlusion to be directed into the emboli removal catheter.
29. The method of claim 25 wherein fluid is infused into the occlusion in a proximal direction.
30. The method of claim 25 further comprising:
providing a centering device having proximal and distal ends, a lumen extending therebetween, and a plurality of deployable struts disposed at the distal end in a contracted state;
positioning the centering device at a location proximal of the occlusion;
deploying the plurality of deployable struts; and advancing the infusion catheter through the lumen of the centering device.
31. The method of claim 25 wherein deploying the plurality of deployable struts comprises proximally retracting an outer sheath that is used to constrain the deployable struts in the contracted state.
CA002483264A 2002-04-25 2003-04-17 Infusion catheter having an atraumatic tip Expired - Fee Related CA2483264C (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CA2648905A CA2648905C (en) 2002-04-25 2003-04-17 Infusion catheter having an atraumatic tip

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US10/134,237 US6855136B2 (en) 2002-04-03 2002-04-25 Infusion catheter having an atraumatic tip
US10/134,237 2002-04-25
PCT/US2003/012227 WO2003090831A2 (en) 2002-04-25 2003-04-17 Infusion catheter having an atraumatic tip

Related Child Applications (1)

Application Number Title Priority Date Filing Date
CA2648905A Division CA2648905C (en) 2002-04-25 2003-04-17 Infusion catheter having an atraumatic tip

Publications (2)

Publication Number Publication Date
CA2483264A1 true CA2483264A1 (en) 2003-11-06
CA2483264C CA2483264C (en) 2009-12-08

Family

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Application Number Title Priority Date Filing Date
CA2648905A Expired - Fee Related CA2648905C (en) 2002-04-25 2003-04-17 Infusion catheter having an atraumatic tip
CA002483264A Expired - Fee Related CA2483264C (en) 2002-04-25 2003-04-17 Infusion catheter having an atraumatic tip

Family Applications Before (1)

Application Number Title Priority Date Filing Date
CA2648905A Expired - Fee Related CA2648905C (en) 2002-04-25 2003-04-17 Infusion catheter having an atraumatic tip

Country Status (8)

Country Link
US (1) US6855136B2 (en)
EP (2) EP1970093A1 (en)
JP (2) JP4723189B2 (en)
AT (1) ATE414553T1 (en)
AU (1) AU2003234142B2 (en)
CA (2) CA2648905C (en)
DE (1) DE60324780D1 (en)
WO (1) WO2003090831A2 (en)

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US6855136B2 (en) 2005-02-15
US20030191434A1 (en) 2003-10-09
JP2011019941A (en) 2011-02-03
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EP1496972A4 (en) 2007-04-18
AU2003234142B2 (en) 2009-02-26
CA2483264C (en) 2009-12-08
WO2003090831A2 (en) 2003-11-06
JP4723189B2 (en) 2011-07-13
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EP1496972B1 (en) 2008-11-19
ATE414553T1 (en) 2008-12-15

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