WO1999019016A1 - Catheter with improved spray pattern for pharmaco-mechanical thrombolysis therapy - Google Patents

Catheter with improved spray pattern for pharmaco-mechanical thrombolysis therapy Download PDF

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Publication number
WO1999019016A1
WO1999019016A1 PCT/US1998/021619 US9821619W WO9919016A1 WO 1999019016 A1 WO1999019016 A1 WO 1999019016A1 US 9821619 W US9821619 W US 9821619W WO 9919016 A1 WO9919016 A1 WO 9919016A1
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WO
WIPO (PCT)
Prior art keywords
holes
catheter
infusion
hole
length
Prior art date
Application number
PCT/US1998/021619
Other languages
French (fr)
Inventor
Jim Mottola
Steve W. Carlstrom
Andy E. Poursaid
Original Assignee
Merit Medical Systems, 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 Merit Medical Systems, Inc. filed Critical Merit Medical Systems, Inc.
Priority to EP98953463A priority Critical patent/EP1023101A4/en
Priority to AU10832/99A priority patent/AU1083299A/en
Priority to JP2000515646A priority patent/JP2001519214A/en
Publication of WO1999019016A1 publication Critical patent/WO1999019016A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0068Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
    • A61M25/007Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2206/00Characteristics of a physical parameter; associated device therefor
    • A61M2206/10Flow characteristics

Definitions

  • the present invention relates to specialized catheters used in the treatment of thromboembolic occlusions in a patient's circulatory system. More specifically, the present invention relates to improved catheters which deliver thrombolytic fluids to the site of a thrombus or blood clot and which provides an improved lateral dispersion, or spray pattern, of the thrombolytic fluid.
  • a blood clot or thrombus can endanger the health of a patient in at least two significant ways.
  • the clot may restrict or even completely stop essential blood flow to a portion of the patient's body. If the blood flow to the brain or heart for example is restricted the patient's life may be placed in jeopardy. Additionally, a clot may break loose from the site at which it formed and be carried by the blood stream to an organ, such as the heart, where it may cause irreparable damage or even death. Accordingly, when a blood clot is detected, it must be quickly and effectively treated.
  • One method involves surgery to remove the clot and repair the blood vessel, another method mechanically breaks up an existing clot into smaller micro-emboli.
  • a less invasive method uses thrombolytic drugs to break up, or lyse, the thrombus.
  • This method of treating a blood clot consists of inserting a catheter into the patient's circulatory system, preferably near the site of the clot. If the catheter enters the circulatory system near the clot, the catheter alone may be used.
  • the catheter must be inserted into the circulatory system at a distance from the clot, placement of the catheter may be aided by using a guide wire or introducer sheath, which can be used to push and guide the catheter through the vessels or arteries of the circulatory system to reach the clot.
  • a guide wire or introducer sheath which can be used to push and guide the catheter through the vessels or arteries of the circulatory system to reach the clot.
  • a thrombolytic fluid capable of dissolving the clot such as urokinase or streptokinase
  • a thrombolytic fluid capable of dissolving the clot, such as urokinase or streptokinase
  • Conventional catheters have a lumen, i.e., an internal passage, that allows the thrombolytic fluid to flow through the catheter to one or more discharge openings, or sideholes, at or near the distal end of the catheter.
  • the discharged thrombolytic fluid then dissolves or lyses the clot, thus removing the danger to the patient. Not all clots are easily or successfully lysed.
  • Some clots form around arterial lesions, which clots may not be easily lysed or broken up by the thrombolytic fluid and which usually require surgical removal. Additionally, some clots may be extremely thick, extending for a relatively long distance through a blood vessel of the circulatory system. Such a thick clot may require considerable amounts of time and heavy irrigation of thrombolytic fluid to dissolve.
  • a guidewire is used in conjunction with a catheter to facilitate placement of the catheter.
  • the guidewire can also serve to penetrate the clot in order to form a passage therethrough so that the catheter can be inserted within the interior of the clot. This helps to ensure that the thrombolytic fluid is concentrated or focused at the location of the clot, since excessive thrombolytic fluid in the bloodstream can have adverse effects on the patient.
  • the guide wire has been used to create a narrow passage through the clot, particularly a thick clot, the thrombolytic fluid is released through the one or more openings within the catheter.
  • thrombolysis was carried out using a catheter with a single opening at the distal end of the catheter.
  • a catheter having slits or other pressure activated one-way openings arranged radially at 90° intervals around the circumference of the catheter and in sets of four longitudinally spaced intervals along the length of the catheter is disclosed in U.S. Patent No. 5,250,034 to Appling et al.
  • a hollow infusion guidewire having sets of four holes, each hole radially separated by 90° intervals around the circumference of the guidewire and each set of four holes spaced longitudinally along the length of the guidewire is set forth in U.S. Patent No. 5,569, 197 to Helmus et al.
  • infusion holes that are grouped together in sets of four holes spaced at 90° intervals around the catheter or staggered to form a spiral configuration with individually staggered holes spaced at 90° intervals, the result is the same: infusion holes that are arranged along four parallel lines radially spaced at 90° intervals around the catheter wall.
  • hole patterns are superior to a simple catheter having a single hole at the distal end, they are only able to distribute thrombolytic fluids at discrete 90° intervals around the circumference of the catheter. The area between the 90° intervals does not receive as much thrombolytic fluid, thus resulting in a poor overall distribution of thrombolytic fluid.
  • the present invention meets the above-described need in the art for an improved catheter.
  • the present invention to provide an improved catheter which is capable of more completely and evenly dispersing a thrombolytic fluid around the lateral circumference of the catheter to more quickly and completely lyse a thrombus through which the catheter has been passed. It also provides catheters that ensure a more consistent fluid dispersion rate between catheters of different infusion lengths.
  • the catheter of the present invention includes a main lumen through which a thrombolytic fluid can be delivered.
  • the open distal end of the catheter is occluded using, e.g. , a ball wire that has a diameter greater than the inner diameter of the distal end of the catheter.
  • a section referred to as the infusion length, that includes infusion holes that are preferably arranged in a double spiral configuration.
  • the infusion holes allow for passage of thrombolytic fluid from the central lumen to the blood clot being treated.
  • the double spiral configuration creates a more complete dispersion of thrombolytic fluids.
  • the individual infusion holes are preferably spaced along the length of the catheter at regular intervals; for example, at longitudinal intervals of 0.05 inch.
  • the infusion holes are grouped together in sets of holes, typically four holes, which are radially spaced apart at 90° intervals from each preceding hole within the same set.
  • Each successive set of holes is preferably rotated relative to the immediately preceding set of holes by about 18° in order to create a staggered hole arrangement that results in a more diverse spray pattern.
  • each set of holes is staggered relative to an immediately preceding set of holes by about 18°, the holes within successive sets of holes will nevertheless be incrementally and circumferentially spaced apart in 90° intervals as in the first set.
  • the second infusion hole will be circumferentially spaced at an interval of 90° relative to the first infusion hole
  • the third infusion hole will be circumferentially spaced 180° with respect to the first infusion hole
  • the fourth infusion hole will be circumferentially spaced 270° with respect to the first infusion hole.
  • the fifth infusion hole will begin a new group of four holes and will be circumferentially spaced from the first infusion hole by some amount between 1° and 89°, most preferably about
  • the sixth, seventh and eighth holes will be circumferentially spaced at successive 90° intervals relative to each other just like in the first set of holes.
  • the ninth hole will preferably begin the third set of four holes and will be offset from the fifth hole by, e.g., about 18° and the first hole by about 36°. This pattern repeats itself substantially regularly along the entire infusion length of the catheter.
  • Other angles that divide evenly into 360°, but not necessarily 90° or 180° may also be used depending on the desired spray pattern.
  • angles that do not divide evenly into 360° may be used in order to yield an even more randomized spray pattern.
  • fluid dynamics may dictate that the circumferential distance, or angle, of offset be within a certain range in order to ensure substantially even distribution of fluid through each of the holes along the infusion length.
  • the usable catheter length may vary between about 45 to about 135 cm.
  • the infusion length will vary between about 5 to about 50 cm., with generally diminishing hole size as the number of holes is increased in order to maintain substantially even fluid flow through the holes.
  • the catheter will be a 5 French catheter having an outer diameter of 0.068" ⁇ 0.0015" and an inner diameter of 0.048" ⁇ 0.0015".
  • 4 and 3 French catheters may also be used depending on the application.
  • the hole size will generally range between about 0.002"-0.006", with the hole size generally decreasing as the number of holes is increased. Nevertheless, the size of catheter and infusion hole can be altered, as can be the longitudinal spacing between the holes, depending on the intended use of the catheter. Radiopaque marker bands are preferably employed to bracket the infusion length in order to provide the user with means for positioning the infusion length at a desired location within the blood vessel.
  • the double spiral configuration of the present invention provides a significantly improved radial dispersion of thrombolytic fluid around the circumference of the catheter.
  • the result is a more quickly and completely lysed blood clot using a reduced amount of thrombolytic fluid, which greatly contributes to the recovery and well-being of the patient.
  • the holes may be arranged in sets of four holes, with each successive hole being circumferentially spaced from an immediately preceding hole by 90°, other arrangements are possible.
  • the holes within a given set may be separated by a variety of different angles ⁇ , it will be preferable that the number and spacing of the holes within a given set be such that they will complete a cycle of about 360° before beginning the next set of holes.
  • the set includes n holes, then the circumferential spacing between successive holes in a given set will preferably be 360° In.
  • each set of holes will include 4 holes, and the circumferential spacing will be 90° between successive holes within the set.
  • the angle of offset between successive sets of holes is most preferably 18°, any angle that yields a reasonably diverse spray pattern can be used.
  • the offset angle ⁇ will preferably divide evenly into 360°, more preferably ⁇ will divide evenly into 180°, and most preferably ⁇ will divide evenly into 90°. Selecting ⁇ so that it divides evenly into 360°, 180° or 90°, respectively, ensures some regularity of the hole pattern such that it is not overly random.
  • Gradient hole sizes within the infusion length can be used to ensure a more even distribution of fluid, wherein the most proximal hole is the smallest where pressure is the greatest and the most distal hole is the largest where pressure is the smallest.
  • hole size is generally inversely proportional to the number of holes within the infusion length.
  • the fluid source may be connected to the infusion catheter using a luer connector with an increased thread length in order to prevent disconnections within the system.
  • the occluding wire used to seal the end of the infusion catheter during use is typically narrower in diameter to facilitate flow through the catheter and spray distribution through the holes.
  • Figure 1 is a side view of a generalized fluid delivery system used in conjunction with the improved catheters of the present invention.
  • Figure 2 is a breakaway perspective view of a portion of the infusion length of an infusion catheter according to the present invention.
  • Figure 3 is a breakaway perspective view of a portion of an inventive infusion catheter in combination with an occluding ball wire.
  • Figure 4 is a perspective view of a portion of the spray pattern emitted by a preferred infusion catheter of the present invention.
  • Figure 5 is a transverse cross-section view of a prior art infusion catheter showing the spray pattern emitting therefrom.
  • Figure 6 is a transverse cross-section view of a preferred infusion catheter according to the present invention showing the spray pattern emitting therefrom.
  • Figure 7 is a chart showing the spacial relationship between the infusion holes within an infusion catheter according to one embodiment of the present invention.
  • Figure 8 is a chart showing the spacial relationship between the infusion holes in an alternative embodiment of the present invention.
  • the present invention relates to improved infusion catheters used to irrigate selected portions of a person's body, particularly blood vessels occluded by a thrombus or blood clot.
  • the catheters of the present invention have holes arranged in such a manner that a more disperse spray pattern is achieved, which results in the ability to more evenly spread the thrombolytic fluids throughout the blood clot.
  • the inventive hole pattern is referred to as a "double spiral configuration," which is a vast improvement over typical spiral configurations in which successive holes within a group are circumferentially spaced apart at 90° intervals along the entire infusion length of the catheter.
  • the double spiral configuration results in a more quickly and completely lysed blood clot using a reduced amount of thrombolytic fluid, which reduces harm to the patient that could result from the infusion of excessive thrombolytic agents.
  • thrombolytic agents used according to the present invention include any agent that can be used to lyse or break up a blood clot.
  • preferred thrombolytic fluids include urokinase, streptokinase, and tissue plasminogen activator (TPA).
  • TPA tissue plasminogen activator
  • the fluid source system 12 includes a fluid reservoir 14 in communication with a fluid pump 15, which in turn communicates with a fluid delivery tube 16, which is in turn connected to a three-way connector 18.
  • the three-way connector 18 connects together the fluid source system 12 and the fluid infusion system 20.
  • the three-way connector 18 includes a first end 22, a second end 24 and an occluding wire port 26.
  • the fluid delivery tube 16 is connected to the first end 22.
  • the fluid infusion system 20 includes a single lumen catheter 28 that is attached to the second end 24 by means of a connector 30.
  • the usable length of catheter 28 may vary between about 45 to about 135 cm.
  • Near the distal end of the catheter 28 is an infusion length 32 that includes systematically placed infusion holes 34, which are spaced in an approximate double spiral configuration. Alternatively, the infusion length may be situated anywhere along the usable length of the catheter.
  • the infusion length also preferably includes radiopaque marker bands (not shown) to assist in placing the infusion length in the
  • the infusion holes are longitudinally spaced apart at substantially regular intervals along the length of the infusion length 32 of the catheter 28.
  • the holes are grouped together in sets of four holes, with successive sets being circumferentially offset by an angular distance of, e.g., about 18°, relative to immediately preceding sets.
  • the holes 34 are arranged in a configuration such that each of the first set of four holes are incrementally spaced apart by a circumferential distance of about 90° in addition to being longitudinally spaced at substantially regular intervals of, e.g., 0.050".
  • the next set of four holes is circumferentially offset by about 18° relative to the first set of four holes.
  • each successive hole in the second set is circumferentially offset from the immediately preceding hole by a circumferential distance of about 90° and longitudinally spaced at intervals of about 0.050".
  • the four holes of the second set will not line up with the first set of four holes.
  • the first hole of the second set of holes which is the fifth hole, is rotated about 18° relative to the first hole of the first set.
  • the sixth hole is rotated about 18° relative to the second hole
  • the seventh hole is rotated about 18° relative to the third hole
  • the eighth hole is rotated about 18° relative to the fourth hole.
  • the third set of four holes is likewise offset by a circumferential distance of about 18° relative to the second set of four hole, such that they are circumferentially offset by about 36° relative to the first set of holes.
  • the ninth infusion hole is offset by 36° relative to the first hole and 18° relative to the fifth hole and so on.
  • This pattern repeats itself such that each successive group of four holes is oriented an additional 18° relative to the previous set of four holes. Because it takes five sets offset by 18° to complete a cycle of 90°, it is not until the sixth set of holes that the holes are aligned at the same angular orientation as the holes of the first group.
  • the infusion catheter 28 is first inserted as desired into a desired location within a patient's artery or vein in order to infuse a liquid therein.
  • the infusion catheter 28 can simply be inserted by itself or its insertion may be assisted by an introducer sheath (not shown) or a guidewire (not shown).
  • An opening 36 at the distal end of the catheter 28 allows free passage of the guidewire therethrough to assist in placement of the catheter 28.
  • the catheter 28 can be connected to the three-way port 18 to provide fluid communication between the fluid source system 12 and the catheter 28.
  • the opening 36 at the distal end of the catheter must be occluded prior to irrigating a liquid through the infusion length 32. This may be accomplished by inserting an occluding ball wire 38 ( Figure 3) through the occluding wire port 26 of the three-way port 18.
  • the occluding ball wire 38 includes a wire portion 40 and a sealing ball portion 42. Nevertheless, any occluding means known in the art may be used to seal the opening 36. However, it is preferable to use an occluding ball wire having a more narrow diameter to improve flow through the catheter 28 and improve the distribution pattern through holes 34.
  • the occluding ball wire 38 when inserted substantially all the way through the catheter 28 and beyond the infusion length 32, is able to form a liquid-tight seal at the distal end of the catheter 28. Because the inner diameter of the catheter 28 is significantly larger than the diameter of the wire portion 40 of the occluding ball wire 38, there is ample space within the infusion catheter 28 for the passage of a liquid therethrough towards the infusion end 32. The inner diameter of the catheter 28 is reduced at the distal end such that the sealing ball portion 42 of the occluding ball wire 38 is able to seat against the inner wall of the catheter 28 and thereby effectively seal the opening 36. Thus, any liquid forced through the catheter 28 is caused to exit through the infusion hole 34 rather than the opening 36.
  • Figure 4 depicts the actual spray pattern made possible by the hole arrangement of the preferred infusion catheter depicted in Figures 2-4. Because of the double spiral configuration resulting from the distribution of holes as described above, the individual lines of spray are more completely dispersed compared to the prior art wherein the holes are aligned at strict 90° intervals.
  • Figures 5 and 6 show the difference in radial spray pattern between infusion catheters according to the prior art ( Figure 5) and the preferred infusion catheter of the present invention ( Figure 6).
  • the differently shaded arrows represent successive radial cycles, or groups of four holes, along the length of the catheter.
  • each successive cycle lines up along one of only four angular positions (0°, 90°, 180° and 270°) such that fluid is only infused through the catheter at each of the four angular positions around the circumference of the catheter.
  • the spray pattern according to the present invention delivers fluid at much tighter intervals, preferably at about 18° intervals. The result is far better distribution of thrombolytic fluid within the person's blood vessel being treated.
  • the infusion holes 34 can be spaced at substantially regular longitudinal intervals, such as 0.050", it may be desirable in some cases to space the holes apart at somewhat irregular intervals. Moreover, the interval length between the holes can vary between about 0.030" to about 0.400" in order to provide varying concentrations of holes along the infusion length 32 of the infusion catheter 28. Nevertheless, it is generally preferred that the spacing be regular and that the interval be about 0.050".
  • the diameter of the infusion holes 34 may vary depending on the infusion length 32, which in turn affects the preferred number of holes along the infusion length.
  • hole size will vary between about 0.002" to about 0.006".
  • an infusion hole diameter of about 0.005" is preferred.
  • the preferred hole diameter is about 0.004".
  • the preferred hole diameter is about 0.003".
  • the preferred hole diameter is about 0.002".
  • Reducing the hole diameter as the number of holes is increased helps to maintain a more consistent rate of delivery between catheters of varying infusion length.
  • a hole gradient of incrementally increasing hole size along the infusion length could alternately be employed to create a more even distribution of fluid through the holes.
  • slightly increasing the hole size can nevertheless allow for more consistent outflow of fluid from all the holes.
  • hole diameters are dictated by fluid dynamics in order to maintain a desired level of pressure within the catheter in order to ensure a substantially even distribution of thrombolytic fluid through each of the infusion holes 34 along the infusion length 32. If the holes are too large, then too much fluid will tend to escape out of the more proximal holes, which lowers the downstream fluid pressure such that too little fluid will tend to pass through the more distal holes.
  • a catheter having an infusion length of 5 cm will have 40 infusion holes.
  • a catheter having an infusion length of 10 cm will generally have 80 infusion holes.
  • For an infusion length of 20 cm there will generally be 160 holes.
  • For an infusion length of 30 cm there will be 240 holes.
  • there will be approximately 40 holes for every 5 cm of infusion length.
  • Infusion lengths of up to 50 cm could also be employed.
  • the preferred catheter diameter is 5 French, although catheters of varying diameter
  • the preferred outer diameter is 0.068" ⁇ 0.0015" while the inner diameter is preferably about 0.048" ⁇ 0.0015".
  • the infusion holes are preferably drilled using an excimer laser, although any known hole drilling techniques known in the art may be adapted and employed to form the infusion holes 34.
  • Figure 7 is a chart which shows the actual mathematical or spacial relationships between the infusion holes within a catheter according to a preferred embodiment of the present invention.
  • each successive set of four holes is circumferentially offset relative to the immediately preceding set of four holes by 18°.
  • the pattern repeats itself, or comes around to the starting point (0°), every sixth set.
  • every five sets of four infusion holes, or every twenty holes, are angularly spaced apart such that no two holes are circumferentially aligned or arranged at the same angular orientation along the catheter.
  • the outer wall of the infusion catheter 20 has a much more even distribution of holes thereabout in order to provide a more diverse spray pattern of thrombolytic fluids compared to prior art catheters.
  • Figure 8 depicts the angular orientation of the infusion holes in an alternative embodiment of the present invention.
  • each successive set of four holes is circumferentially offset from the preceding set of four holes by 12°. Since 12° does not evenly divide into 90°, but instead 180°, the hole placement does not repeat itself until after sixteen sets of holes, or 64 infusion holes, have been exhausted. The result is a tighter spray pattern compared to the spray pattern of the catheter mathematically depicted in Figure 4. Nevertheless, it is within the scope of the present invention to provide sets of holes that are circumferentially spaced or offset by any amount between 1° and 89°, although an angular distance of 18° is preferred. The result is varying amounts of angular offset that result in widely varying spray patterns.
  • any angular offset away from holes rigidly aligned along 90° intervals, as in the prior art, would be an improvement over the prior art and provide an improved spray pattern.
  • sets of holes could also be angularly offset from immediately preceding sets by any amount between 91-179°, 181-269°, and 271-359°.
  • the only limitation is that the angular offset provide a more diverse spray patter than where all the holes are spaced apart at regular 90° intervals.
  • the holes may be arranged in sets of four holes, with each successive hole being circumferentially spaced from an immediately preceding hole by 90°, other arrangements are possible.
  • the holes within a given set may be separated by a variety of different angles ⁇ , it will be preferable that the number and spacing of the holes within a given set be such that they will complete a cycle of about
  • the radial spacing between successive holes in a given set will preferably be 360° 'In.
  • the radial spacing will be 90° between successive holes within the set.
  • the angle of offset between successive sets of holes is most preferably 18°, any angle that yields a reasonably diverse spay pattern can be used.
  • the offset angle ⁇ will preferably divide evenly into 360°, more preferably ⁇ will divide evenly into 180°, and most preferably ⁇ will divide evenly into 90°. Note that 18° divides evenly into 90°. Selecting ⁇ so that it divides evenly into 360°, 180° or 90°, respectively, ensures some regularity of the hole pattern such that it is not overly random.

Abstract

An improved catheter (28) includes a double spiral configuration of infusion holes (34) around the circumference and along the length (32) of the catheter (28) which provides an improved lateral dispersion of a thrombolytic fluid to more completely and quickly lyse a clot through which the catheter (28) is passing. The double spiral configuration consists of groups or sets of infusion holes (34), typically groups of four. The holes (34) in each set are longitudinally spaced from each other at substantially regular intervals along the length (32) of the catheter (28). Each successive hole in a given group is circumferentially spaced by an angular distance of about 90° around the circumference of the catheter (28) relative to the immediately preceding hole (34). Each group of holes (34) is circumferentially spaced or offset by an angular distance of between 1° and 89° relative to the immediately preceding group of holes (34). Typically, the angular spacing between successive groups of holes is 18°.

Description

CATHETER WITH IMPROVED SPRAY PATTERN
FOR PHARMACO-MECHANICAL THROMBOLYSIS THERAPY
BACKGROUND OF THE INVENTION
1. The Field of the Invention
The present invention relates to specialized catheters used in the treatment of thromboembolic occlusions in a patient's circulatory system. More specifically, the present invention relates to improved catheters which deliver thrombolytic fluids to the site of a thrombus or blood clot and which provides an improved lateral dispersion, or spray pattern, of the thrombolytic fluid.
2. The Relevant Technology
A reasonably common and dangerous medical condition arises when a blood clot develops in a patient's circulatory system. A blood clot or thrombus can endanger the health of a patient in at least two significant ways. First, the clot may restrict or even completely stop essential blood flow to a portion of the patient's body. If the blood flow to the brain or heart for example is restricted the patient's life may be placed in jeopardy. Additionally, a clot may break loose from the site at which it formed and be carried by the blood stream to an organ, such as the heart, where it may cause irreparable damage or even death. Accordingly, when a blood clot is detected, it must be quickly and effectively treated.
One method involves surgery to remove the clot and repair the blood vessel, another method mechanically breaks up an existing clot into smaller micro-emboli. A less invasive method uses thrombolytic drugs to break up, or lyse, the thrombus. This method of treating a blood clot consists of inserting a catheter into the patient's circulatory system, preferably near the site of the clot. If the catheter enters the circulatory system near the clot, the catheter alone may be used. If, for a variety of reasons, the catheter must be inserted into the circulatory system at a distance from the clot, placement of the catheter may be aided by using a guide wire or introducer sheath, which can be used to push and guide the catheter through the vessels or arteries of the circulatory system to reach the clot.
Once the catheter is positioned at the site of the clot, a thrombolytic fluid capable of dissolving the clot, such as urokinase or streptokinase, is delivered to the site of the clot by means of the catheter. Conventional catheters have a lumen, i.e., an internal passage, that allows the thrombolytic fluid to flow through the catheter to one or more discharge openings, or sideholes, at or near the distal end of the catheter. The discharged thrombolytic fluid then dissolves or lyses the clot, thus removing the danger to the patient. Not all clots are easily or successfully lysed. Some clots form around arterial lesions, which clots may not be easily lysed or broken up by the thrombolytic fluid and which usually require surgical removal. Additionally, some clots may be extremely thick, extending for a relatively long distance through a blood vessel of the circulatory system. Such a thick clot may require considerable amounts of time and heavy irrigation of thrombolytic fluid to dissolve.
Typically, a guidewire is used in conjunction with a catheter to facilitate placement of the catheter. The guidewire can also serve to penetrate the clot in order to form a passage therethrough so that the catheter can be inserted within the interior of the clot. This helps to ensure that the thrombolytic fluid is concentrated or focused at the location of the clot, since excessive thrombolytic fluid in the bloodstream can have adverse effects on the patient. After the guide wire has been used to create a narrow passage through the clot, particularly a thick clot, the thrombolytic fluid is released through the one or more openings within the catheter. In the beginning stages of thrombolytic therapy, thrombolysis was carried out using a catheter with a single opening at the distal end of the catheter. McNamara, T., "Role of Thrombolysis in Peripheral Arterial Occlusion," Am. J. Med.. Vol. 83 (Suppl. 2 A), pp. 6-10, August 24, 1987. Methods employing a simple catheter required movement of the catheter from one end of the clot to the other while dispensing the thrombolytic fluid in order to adequately distribute the fluid over the entire length of the thrombus.
Subsequent improvements have been made in an attempt to create a more uniform distribution of thrombolytic fluids along the length of the blood clot. A catheter having slits or other pressure activated one-way openings arranged radially at 90° intervals around the circumference of the catheter and in sets of four longitudinally spaced intervals along the length of the catheter is disclosed in U.S. Patent No. 5,250,034 to Appling et al. A hollow infusion guidewire having sets of four holes, each hole radially separated by 90° intervals around the circumference of the guidewire and each set of four holes spaced longitudinally along the length of the guidewire is set forth in U.S. Patent No. 5,569, 197 to Helmus et al. Catheters having holes individually spaced at regular intervals along the length of the catheter and spaced radially at 90° intervals relative to each previous hole are set forth in U.S. Patent Nos. 4,968,307 and 4,927,418 to Dake et al.
Whether the infusion holes are grouped together in sets of four holes spaced at 90° intervals around the catheter or staggered to form a spiral configuration with individually staggered holes spaced at 90° intervals, the result is the same: infusion holes that are arranged along four parallel lines radially spaced at 90° intervals around the catheter wall. Although such hole patterns are superior to a simple catheter having a single hole at the distal end, they are only able to distribute thrombolytic fluids at discrete 90° intervals around the circumference of the catheter. The area between the 90° intervals does not receive as much thrombolytic fluid, thus resulting in a poor overall distribution of thrombolytic fluid.
Accordingly, there exists a need in the art for improved catheters which can more completely and evenly disperse thrombolytic fluid around the circumference of a catheter in order to more effectively and efficiently lyse blood clots in a patient's blood vessel.
There also exists a need for improved catheters which ensure a more consistent dispersion rate between catheters of different infusion lengths.
SUMMARY OF THE INVENTION Accordingly, the present invention meets the above-described need in the art for an improved catheter. The present invention to provide an improved catheter which is capable of more completely and evenly dispersing a thrombolytic fluid around the lateral circumference of the catheter to more quickly and completely lyse a thrombus through which the catheter has been passed. It also provides catheters that ensure a more consistent fluid dispersion rate between catheters of different infusion lengths. These and other features of the present invention will become more fully apparent from the following description and appended claims, or may be learned by the practice of the invention as set forth hereinafter.
The catheter of the present invention includes a main lumen through which a thrombolytic fluid can be delivered. The open distal end of the catheter is occluded using, e.g. , a ball wire that has a diameter greater than the inner diameter of the distal end of the catheter. Anywhere along the usable length of the catheter, preferably near the distal end of the catheter, is a section, referred to as the infusion length, that includes infusion holes that are preferably arranged in a double spiral configuration. The infusion holes allow for passage of thrombolytic fluid from the central lumen to the blood clot being treated. The double spiral configuration creates a more complete dispersion of thrombolytic fluids. The individual infusion holes are preferably spaced along the length of the catheter at regular intervals; for example, at longitudinal intervals of 0.05 inch. The infusion holes are grouped together in sets of holes, typically four holes, which are radially spaced apart at 90° intervals from each preceding hole within the same set. Each successive set of holes is preferably rotated relative to the immediately preceding set of holes by about 18° in order to create a staggered hole arrangement that results in a more diverse spray pattern. Although each set of holes is staggered relative to an immediately preceding set of holes by about 18°, the holes within successive sets of holes will nevertheless be incrementally and circumferentially spaced apart in 90° intervals as in the first set.
Thus, in a preferred embodiment, the second infusion hole will be circumferentially spaced at an interval of 90° relative to the first infusion hole, the third infusion hole will be circumferentially spaced 180° with respect to the first infusion hole, while the fourth infusion hole will be circumferentially spaced 270° with respect to the first infusion hole. However, rather than being spaced at 360° (or 0°) relative to the first hole, the fifth infusion hole will begin a new group of four holes and will be circumferentially spaced from the first infusion hole by some amount between 1° and 89°, most preferably about
18°, since this value divides evenly into the 360° (and 90°) so that a very regular yet well spaced arrangement of holes can be attained.
Thereafter, the sixth, seventh and eighth holes will be circumferentially spaced at successive 90° intervals relative to each other just like in the first set of holes. The ninth hole will preferably begin the third set of four holes and will be offset from the fifth hole by, e.g., about 18° and the first hole by about 36°. This pattern repeats itself substantially regularly along the entire infusion length of the catheter. Other angles that divide evenly into 360°, but not necessarily 90° or 180° may also be used depending on the desired spray pattern. In addition, angles that do not divide evenly into 360° may be used in order to yield an even more randomized spray pattern. However, fluid dynamics may dictate that the circumferential distance, or angle, of offset be within a certain range in order to ensure substantially even distribution of fluid through each of the holes along the infusion length.
While the usable catheter length may vary between about 45 to about 135 cm., the infusion length will vary between about 5 to about 50 cm., with generally diminishing hole size as the number of holes is increased in order to maintain substantially even fluid flow through the holes. In general, the catheter will be a 5 French catheter having an outer diameter of 0.068" ± 0.0015" and an inner diameter of 0.048" ± 0.0015". Of course, 4 and 3 French catheters may also be used depending on the application.
The hole size will generally range between about 0.002"-0.006", with the hole size generally decreasing as the number of holes is increased. Nevertheless, the size of catheter and infusion hole can be altered, as can be the longitudinal spacing between the holes, depending on the intended use of the catheter. Radiopaque marker bands are preferably employed to bracket the infusion length in order to provide the user with means for positioning the infusion length at a desired location within the blood vessel. The double spiral configuration of the present invention provides a significantly improved radial dispersion of thrombolytic fluid around the circumference of the catheter.
The result is a more quickly and completely lysed blood clot using a reduced amount of thrombolytic fluid, which greatly contributes to the recovery and well-being of the patient.
Although it may be preferred for the holes to be arranged in sets of four holes, with each successive hole being circumferentially spaced from an immediately preceding hole by 90°, other arrangements are possible. Although the holes within a given set may be separated by a variety of different angles θ, it will be preferable that the number and spacing of the holes within a given set be such that they will complete a cycle of about 360° before beginning the next set of holes. Thus, if the set includes n holes, then the circumferential spacing between successive holes in a given set will preferably be 360° In.
Thus, in the preferred embodiment, each set of holes will include 4 holes, and the circumferential spacing will be 90° between successive holes within the set.
Moreover, although the angle of offset between successive sets of holes is most preferably 18°, any angle that yields a reasonably diverse spray pattern can be used. However, the offset angle δ will preferably divide evenly into 360°, more preferably δ will divide evenly into 180°, and most preferably δ will divide evenly into 90°. Selecting δ so that it divides evenly into 360°, 180° or 90°, respectively, ensures some regularity of the hole pattern such that it is not overly random.
There are other features that can aid the ability of the improved catheters of the present invention to perform their function of providing better delivery of thrombolytic fluids. Gradient hole sizes within the infusion length can be used to ensure a more even distribution of fluid, wherein the most proximal hole is the smallest where pressure is the greatest and the most distal hole is the largest where pressure is the smallest. As stated above, hole size is generally inversely proportional to the number of holes within the infusion length. In order to use increased pressures, the fluid source may be connected to the infusion catheter using a luer connector with an increased thread length in order to prevent disconnections within the system. In addition, the occluding wire used to seal the end of the infusion catheter during use is typically narrower in diameter to facilitate flow through the catheter and spray distribution through the holes. BRIEF DESCRIPTION OF THE DRAWINGS
In order that the manner in which the above-recited and other advantages of the invention are obtained, a more particular description of the invention briefly described above will be rendered by reference to a specific embodiment thereof which is illustrated in the appended drawings. Understanding that these drawing depict only a typical embodiment of the invention and are not therefore to be considered to be limiting of its scope, the invention will be described and explained with additional specificity and detail through the use of the accompanying drawings in which:
Figure 1 is a side view of a generalized fluid delivery system used in conjunction with the improved catheters of the present invention. Figure 2 is a breakaway perspective view of a portion of the infusion length of an infusion catheter according to the present invention.
Figure 3 is a breakaway perspective view of a portion of an inventive infusion catheter in combination with an occluding ball wire.
Figure 4 is a perspective view of a portion of the spray pattern emitted by a preferred infusion catheter of the present invention. Figure 5 is a transverse cross-section view of a prior art infusion catheter showing the spray pattern emitting therefrom.
Figure 6 is a transverse cross-section view of a preferred infusion catheter according to the present invention showing the spray pattern emitting therefrom. Figure 7 is a chart showing the spacial relationship between the infusion holes within an infusion catheter according to one embodiment of the present invention.
Figure 8 is a chart showing the spacial relationship between the infusion holes in an alternative embodiment of the present invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention relates to improved infusion catheters used to irrigate selected portions of a person's body, particularly blood vessels occluded by a thrombus or blood clot. The catheters of the present invention have holes arranged in such a manner that a more disperse spray pattern is achieved, which results in the ability to more evenly spread the thrombolytic fluids throughout the blood clot. The inventive hole pattern is referred to as a "double spiral configuration," which is a vast improvement over typical spiral configurations in which successive holes within a group are circumferentially spaced apart at 90° intervals along the entire infusion length of the catheter. The double spiral configuration results in a more quickly and completely lysed blood clot using a reduced amount of thrombolytic fluid, which reduces harm to the patient that could result from the infusion of excessive thrombolytic agents.
The preferred thrombolytic agents used according to the present invention include any agent that can be used to lyse or break up a blood clot. Examples of preferred thrombolytic fluids include urokinase, streptokinase, and tissue plasminogen activator (TPA). In order to illustrate the benefits of the catheters according to the present invention, reference is now made to the drawings. Figure 1 depicts a generalized fluid delivery system that may be used in conjunction with the improved catheters of the present invention. As shown in Figure 1, a fluid delivery system 10 comprises two subsystems, a fluid source system generally depicted as element 12 and a fluid infusion system generally depicted as element 20. The fluid source system 12 includes a fluid reservoir 14 in communication with a fluid pump 15, which in turn communicates with a fluid delivery tube 16, which is in turn connected to a three-way connector 18. The three-way connector 18 connects together the fluid source system 12 and the fluid infusion system 20. The three-way connector 18 includes a first end 22, a second end 24 and an occluding wire port 26. The fluid delivery tube 16 is connected to the first end 22. The fluid infusion system 20 includes a single lumen catheter 28 that is attached to the second end 24 by means of a connector 30. The usable length of catheter 28 may vary between about 45 to about 135 cm. Near the distal end of the catheter 28 is an infusion length 32 that includes systematically placed infusion holes 34, which are spaced in an approximate double spiral configuration. Alternatively, the infusion length may be situated anywhere along the usable length of the catheter. The infusion length also preferably includes radiopaque marker bands (not shown) to assist in placing the infusion length in the proper location within the blood vessel.
The infusion holes are longitudinally spaced apart at substantially regular intervals along the length of the infusion length 32 of the catheter 28. In a preferred embodiment, the holes are grouped together in sets of four holes, with successive sets being circumferentially offset by an angular distance of, e.g., about 18°, relative to immediately preceding sets.
In a preferred arrangement depicted in Figure 2, the holes 34 are arranged in a configuration such that each of the first set of four holes are incrementally spaced apart by a circumferential distance of about 90° in addition to being longitudinally spaced at substantially regular intervals of, e.g., 0.050". The next set of four holes is circumferentially offset by about 18° relative to the first set of four holes. However, as in the first set, each successive hole in the second set is circumferentially offset from the immediately preceding hole by a circumferential distance of about 90° and longitudinally spaced at intervals of about 0.050".
Due to their being offset by an angular distance of about 18° relative to the first set, the four holes of the second set will not line up with the first set of four holes. Thus, the first hole of the second set of holes, which is the fifth hole, is rotated about 18° relative to the first hole of the first set. Likewise, the sixth hole is rotated about 18° relative to the second hole, the seventh hole is rotated about 18° relative to the third hole, and the eighth hole is rotated about 18° relative to the fourth hole. The third set of four holes is likewise offset by a circumferential distance of about 18° relative to the second set of four hole, such that they are circumferentially offset by about 36° relative to the first set of holes. Thus, the ninth infusion hole is offset by 36° relative to the first hole and 18° relative to the fifth hole and so on. This pattern repeats itself such that each successive group of four holes is oriented an additional 18° relative to the previous set of four holes. Because it takes five sets offset by 18° to complete a cycle of 90°, it is not until the sixth set of holes that the holes are aligned at the same angular orientation as the holes of the first group. This creates a double spiral configuration that results in a more diversified spray pattern compared to where all the holes line up at 90° intervals, which occurs where there is no staggering, as in the prior art. This allows for much more evenly defused liquid through the infusion length 32.
In practice, the infusion catheter 28 is first inserted as desired into a desired location within a patient's artery or vein in order to infuse a liquid therein. The infusion catheter 28 can simply be inserted by itself or its insertion may be assisted by an introducer sheath (not shown) or a guidewire (not shown). An opening 36 at the distal end of the catheter 28 allows free passage of the guidewire therethrough to assist in placement of the catheter 28. Once the catheter 28 has been properly placed, the guidewire or introducer sheath can be removed from the patient. Thereafter, the catheter 28 can be connected to the three-way port 18 to provide fluid communication between the fluid source system 12 and the catheter 28.
The opening 36 at the distal end of the catheter must be occluded prior to irrigating a liquid through the infusion length 32. This may be accomplished by inserting an occluding ball wire 38 (Figure 3) through the occluding wire port 26 of the three-way port 18. The occluding ball wire 38 includes a wire portion 40 and a sealing ball portion 42. Nevertheless, any occluding means known in the art may be used to seal the opening 36. However, it is preferable to use an occluding ball wire having a more narrow diameter to improve flow through the catheter 28 and improve the distribution pattern through holes 34.
As depicted in Figure 3, the occluding ball wire 38, when inserted substantially all the way through the catheter 28 and beyond the infusion length 32, is able to form a liquid-tight seal at the distal end of the catheter 28. Because the inner diameter of the catheter 28 is significantly larger than the diameter of the wire portion 40 of the occluding ball wire 38, there is ample space within the infusion catheter 28 for the passage of a liquid therethrough towards the infusion end 32. The inner diameter of the catheter 28 is reduced at the distal end such that the sealing ball portion 42 of the occluding ball wire 38 is able to seat against the inner wall of the catheter 28 and thereby effectively seal the opening 36. Thus, any liquid forced through the catheter 28 is caused to exit through the infusion hole 34 rather than the opening 36.
Figure 4 depicts the actual spray pattern made possible by the hole arrangement of the preferred infusion catheter depicted in Figures 2-4. Because of the double spiral configuration resulting from the distribution of holes as described above, the individual lines of spray are more completely dispersed compared to the prior art wherein the holes are aligned at strict 90° intervals.
Figures 5 and 6 show the difference in radial spray pattern between infusion catheters according to the prior art (Figure 5) and the preferred infusion catheter of the present invention (Figure 6). The differently shaded arrows represent successive radial cycles, or groups of four holes, along the length of the catheter. In prior art catheters, each successive cycle lines up along one of only four angular positions (0°, 90°, 180° and 270°) such that fluid is only infused through the catheter at each of the four angular positions around the circumference of the catheter. In contrast, the spray pattern according to the present invention delivers fluid at much tighter intervals, preferably at about 18° intervals. The result is far better distribution of thrombolytic fluid within the person's blood vessel being treated. Whereas the infusion holes 34 can be spaced at substantially regular longitudinal intervals, such as 0.050", it may be desirable in some cases to space the holes apart at somewhat irregular intervals. Moreover, the interval length between the holes can vary between about 0.030" to about 0.400" in order to provide varying concentrations of holes along the infusion length 32 of the infusion catheter 28. Nevertheless, it is generally preferred that the spacing be regular and that the interval be about 0.050".
The diameter of the infusion holes 34 may vary depending on the infusion length 32, which in turn affects the preferred number of holes along the infusion length.
Typically, hole size will vary between about 0.002" to about 0.006". For an infusion length of 5 cm, it has been found that an infusion hole diameter of about 0.005" is preferred. For a catheter having an infusion length of 10 cm, which will effectively double the number of holes assuming constant longitudinal spacing, the preferred hole diameter is about 0.004". For an infusion length of 20 cm, which will double the number of holes again, the preferred hole diameter is about 0.003". For a catheter having an infusion length of 30 cm the preferred hole diameter is about 0.002".
Reducing the hole diameter as the number of holes is increased helps to maintain a more consistent rate of delivery between catheters of varying infusion length. A hole gradient of incrementally increasing hole size along the infusion length could alternately be employed to create a more even distribution of fluid through the holes. As fluid pressure decreases longitudinally down the length of the catheter, slightly increasing the hole size can nevertheless allow for more consistent outflow of fluid from all the holes.
The foregoing hole diameters are dictated by fluid dynamics in order to maintain a desired level of pressure within the catheter in order to ensure a substantially even distribution of thrombolytic fluid through each of the infusion holes 34 along the infusion length 32. If the holes are too large, then too much fluid will tend to escape out of the more proximal holes, which lowers the downstream fluid pressure such that too little fluid will tend to pass through the more distal holes.
In general, a catheter having an infusion length of 5 cm will have 40 infusion holes. A catheter having an infusion length of 10 cm will generally have 80 infusion holes. For an infusion length of 20 cm there will generally be 160 holes. For an infusion length of 30 cm there will be 240 holes. Hence, for systems where infusion holes are spaced apart at 0.050" intervals, there will be approximately 40 holes for every 5 cm of infusion length. Infusion lengths of up to 50 cm could also be employed. The preferred catheter diameter is 5 French, although catheters of varying diameter
(such as 3 or 4 French catheters) are possible depending on the size of the blood vessel being treated. For a 5 French catheter, the preferred outer diameter is 0.068" ± 0.0015" while the inner diameter is preferably about 0.048" ± 0.0015".
The infusion holes are preferably drilled using an excimer laser, although any known hole drilling techniques known in the art may be adapted and employed to form the infusion holes 34. In order to more precisely depict the preferred angular orientation of the infusion holes, reference is made to Figure 7. Figure 7 is a chart which shows the actual mathematical or spacial relationships between the infusion holes within a catheter according to a preferred embodiment of the present invention. In Figure 7, each successive set of four holes is circumferentially offset relative to the immediately preceding set of four holes by 18°. Thus, it can be seen that the pattern repeats itself, or comes around to the starting point (0°), every sixth set. Thus, every five sets of four infusion holes, or every twenty holes, are angularly spaced apart such that no two holes are circumferentially aligned or arranged at the same angular orientation along the catheter. Thus, the outer wall of the infusion catheter 20 has a much more even distribution of holes thereabout in order to provide a more diverse spray pattern of thrombolytic fluids compared to prior art catheters.
Figure 8 depicts the angular orientation of the infusion holes in an alternative embodiment of the present invention. In Figure 8, each successive set of four holes is circumferentially offset from the preceding set of four holes by 12°. Since 12° does not evenly divide into 90°, but instead 180°, the hole placement does not repeat itself until after sixteen sets of holes, or 64 infusion holes, have been exhausted. The result is a tighter spray pattern compared to the spray pattern of the catheter mathematically depicted in Figure 4. Nevertheless, it is within the scope of the present invention to provide sets of holes that are circumferentially spaced or offset by any amount between 1° and 89°, although an angular distance of 18° is preferred. The result is varying amounts of angular offset that result in widely varying spray patterns. Any angular offset away from holes rigidly aligned along 90° intervals, as in the prior art, would be an improvement over the prior art and provide an improved spray pattern. Hence, sets of holes could also be angularly offset from immediately preceding sets by any amount between 91-179°, 181-269°, and 271-359°. The only limitation is that the angular offset provide a more diverse spray patter than where all the holes are spaced apart at regular 90° intervals.
Moreover, it is certainly within the scope of the invention to include more or less than 4 holes within the sets of holes discussed above. For instance, one may wish to design a spray pattern in which, e.g. , three holes are circumferentially spaced apart by a radial distance of 90°, with the next set of three holes being offset by, e.g., 10° such that the second hole is radially spaced from the first by 90°, the third from the second by 90°, the fourth from the third by 100°, the fifth from the fourth by 90°, and so on. The important thing is that such arrangements yield a more diverse spray pattern than where all the holes are spaced apart at 90° intervals.
Although it may be preferred for the holes to be arranged in sets of four holes, with each successive hole being circumferentially spaced from an immediately preceding hole by 90°, other arrangements are possible. Although the holes within a given set may be separated by a variety of different angles θ, it will be preferable that the number and spacing of the holes within a given set be such that they will complete a cycle of about
360° before beginning the next set of holes. Thus, if the set includes n holes, then the radial spacing between successive holes in a given set will preferably be 360° 'In. Thus, in the preferred embodiment, wherein each set of holes includes 4 holes, the radial spacing will be 90° between successive holes within the set. Moreover, although the angle of offset between successive sets of holes is most preferably 18°, any angle that yields a reasonably diverse spay pattern can be used. However, the offset angle δ will preferably divide evenly into 360°, more preferably δ will divide evenly into 180°, and most preferably δ will divide evenly into 90°. Note that 18° divides evenly into 90°. Selecting δ so that it divides evenly into 360°, 180° or 90°, respectively, ensures some regularity of the hole pattern such that it is not overly random.
The present invention may be embodied in other specific forms without departing from its spirit or essential characteristics. The described embodiments are to be considered in all respects only as illustrated and not restrictive. The scope of the invention is, therefore, indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.
What is claimed and desired to be secured by United States Letters Patent is:

Claims

1. A catheter for introducing a liquid into the vascular system comprising: an elongated tubular body having a single lumen therethrough and an infusion length near a distal end thereof. a plurality of infusion holes disposed along the infusion length of the tubular body, said infusion holes being longitudinally spaced along the infusion length of the tubular body at substantially regular intervals, said infusion holes belonging to a plurality of successive sets of holes, each successive hole within a given set being radially spaced apart from each immediately preceding hole within the given set by an angular distance of about ╬╕, each set of holes having a first hole and a last hole, each successive set of holes being circumferentially offset from an immediately preceding set by an angular distance ╬┤ such that the first hole of an immediately succeeding set is circumferentially offset from the last hole of an immediately preceding set by an angle other than a multiple of ╬╕.
2. A catheter as defined in claim 1, wherein θ = 360°/«, wherein n is an integer greater than 1.
3. A catheter as defined in claim 2, wherein n is equivalent to the number of holes within each set of holes.
4. A catheter as defined in claim 3, wherein n - 4 such that ╬╕ = 90┬░ and each set of holes includes 4 infusion holes.
5. A catheter as defined in claim 1, wherein ╬┤ is an angle in a range selected from the group consisting of 1-89┬░, 91-179┬░, 181-269┬░ and 271-359┬░.
6. A catheter as defined in claim 5, wherein ╬┤ divides evenly into 360┬░.
7. A catheter as defined in claim 5, wherein ╬┤ divides evenly into 90┬░.
8. A catheter as defined in claim 5, wherein ╬┤ equals 18┬░.
9. A catheter as defined in claim 1, wherein the infusion holes are longitudinally spaced at regular intervals of about 0.05 inch.
10. A catheter as defined in claim 1 , wherein the infusion holes have a diameter in a range from about 0.002 inch to about 0.006 inch.
11. A catheter as defined in claim 1, wherein the infusion holes have a size gradient such that in an infusion length having a first hole and a last hole the last hole has a diameter greater than the diameter of the first hole.
12. A catheter as defined in claim 1 , wherein the infusion length includes from between about 40 to about 240 holes.
13. A catheter for introducing a liquid into the vascular system comprising: an elongated tubular body having a single lumen therethrough and an infusion length near a distal end thereof. a plurality of infusion holes disposed along the infusion length of the tubular body, said infusion holes being longitudinally spaced along the infusion length of the tubular body at substantially regular intervals, said infusion holes belonging to a plurality of successive sets of n holes, each successive hole within a given of set of holes being radially spaced apart from each immediately preceding hole within the given set by an angular distance of about 360 ra, each set of holes having a first hole and an rath hole, each successive set of holes being circumferentially offset from an immediately preceding set by an angular distance of about JC┬░ such that the first hole of an immediately succeeding set is circumferentially offset from the rath hole of an immediately preceding set by an angle of about 360┬░/ra + x┬░.
14. A catheter as defined in claim 13 , wherein ra equals an integer greater than 1.
15. A catheter as defined in claim 13, wherein ra = 4 and x = 18.
16. A catheter as defined in claim 13, wherein ra = 5 and x = 15.
17. A catheter for introducing a liquid into the vascular system comprising: an elongated tubular body having a single lumen therethrough and an infusion length near a distal end thereof. a plurality of infusion holes disposed along the infusion length of the tubular body, said infusion holes being longitudinally spaced along the infusion length of the tubular body at substantially regular intervals, said infusion holes belonging to a plurality of successive sets of four holes such that each successive hole within a given set is radially spaced apart from each immediately preceding hole within the given set by an angular distance of about 90┬░, each set of holes having a first hole and a fourth hole, each successive set of holes being circumferentially offset from an immediately preceding set by an angular distance of x┬░ such that the first hole of an immediately succeeding set is circumferentially offset from the fourth hole of an immediately preceding set by an angle of about 90┬░ + x┬░, wherein x┬░ divides evenly into 90┬░.
18. A catheter as defined in claim 17, wherein x┬░ is equal to 18┬░.
19. A catheter as defined in claim 17, wherein the infusion holes are longitudinally spaced at regular intervals of about 0.05 inch.
20. A catheter as defined in claim 17, wherein the infusion holes have a diameter in a range from about 0.002 inch to about 0.006 inch.
PCT/US1998/021619 1997-10-14 1998-10-14 Catheter with improved spray pattern for pharmaco-mechanical thrombolysis therapy WO1999019016A1 (en)

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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6547769B2 (en) 1999-12-20 2003-04-15 Tricardia Llc Catheter apparatus with weeping tip and method of use
US6814742B2 (en) 2000-10-16 2004-11-09 Olympus Corporation Physiological tissue clipping apparatus, clipping method and clip unit mounting method
US6969373B2 (en) 2001-04-13 2005-11-29 Tricardia, Llc Syringe system
EP2698119A1 (en) * 2012-08-13 2014-02-19 Covidien LP Apparatus and methods for clot disruption and evacuation
US9332999B2 (en) 2012-08-13 2016-05-10 Covidien Lp Apparatus and methods for clot disruption and evacuation

Families Citing this family (98)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040215168A1 (en) * 1997-04-30 2004-10-28 Beth Israel Deaconess Medical Center Kit for transvenously accessing the pericardial space via the right atrium
US6063069A (en) * 1997-05-19 2000-05-16 Micro Therapeutics Inc. Method and apparatus for power lysis of a thrombus
US6635027B1 (en) * 1997-05-19 2003-10-21 Micro Therepeutics, Inc. Method and apparatus for intramural delivery of a substance
US6387037B1 (en) * 1997-10-09 2002-05-14 Orqis Medical Corporation Implantable heart assist system and method of applying same
US5968017A (en) 1997-10-14 1999-10-19 Merit Medical Systems, Inc. Pulse fluid infusion systems
US9586023B2 (en) 1998-02-06 2017-03-07 Boston Scientific Limited Direct stream hydrodynamic catheter system
US6074374A (en) * 1998-07-31 2000-06-13 Angiodynamics, Inc. Catheter with lumen occluding means
ES2253907T3 (en) * 1998-11-17 2006-06-01 Henri Mehier DEVICE INTENDED TO ENSURE THE RELEASE OF AN ACTIVE SUBSTANCE DIRECTLY IN THE BANK OF A CELL FABRIC, MEANS OF IMPLEMENTATION OF THE DEVICE AND DEVICES APPLIED TO THE INJECTION OF ACTIVE SUBSTANCE IN SUCH DEVICE.
DE19912844A1 (en) * 1999-03-22 2000-09-28 Saphir Medical Products Gmbh Use of a cutting device, which uses a fluid as cutting medium, for surgical treatment
US7547302B2 (en) * 1999-07-19 2009-06-16 I-Flow Corporation Anti-microbial catheter
US6350253B1 (en) 1999-07-19 2002-02-26 I-Flow Corporation Catheter for uniform delivery of medication
US7004923B2 (en) * 1999-07-19 2006-02-28 I-Flow Corporation Catheter for uniform delivery of medication
US6596235B2 (en) 1999-09-30 2003-07-22 Therox, Inc. Method for blood oxygenation
US6524300B2 (en) * 2000-01-03 2003-02-25 Angiodynamics, Inc. Infusion catheter with non-uniform drug delivery density
US6663613B1 (en) 2000-01-25 2003-12-16 Bacchus Vascular, Inc. System and methods for clot dissolution
US6929633B2 (en) 2000-01-25 2005-08-16 Bacchus Vascular, Inc. Apparatus and methods for clot dissolution
US6945969B1 (en) * 2000-03-31 2005-09-20 Medtronic, Inc. Catheter for target specific drug delivery
US6551290B1 (en) 2000-03-31 2003-04-22 Medtronic, Inc. Catheter for target specific drug delivery
US7232425B2 (en) * 2001-03-02 2007-06-19 Sorenson Development, Inc. Apparatus and method for specific interstitial or subcutaneous diffusion and dispersion of medication
US20030088240A1 (en) * 2001-11-02 2003-05-08 Vahid Saadat Methods and apparatus for cryo-therapy
US6755813B2 (en) * 2001-11-20 2004-06-29 Cleveland Clinic Foundation Apparatus and method for performing thrombolysis
US6749619B2 (en) * 2001-11-20 2004-06-15 The Cleveland Clinic Foundation Apparatus and method for eliminating dislodged thrombus
US20030181864A1 (en) * 2002-03-21 2003-09-25 Deniega Jose Castillo Catheter for uniform delivery of medication
US6855136B2 (en) * 2002-04-03 2005-02-15 Gore Enterprise Holdings, Inc. Infusion catheter having an atraumatic tip
US20030191453A1 (en) * 2002-04-03 2003-10-09 Velez Omar E. Catheter assembly
US7613503B2 (en) * 2002-08-09 2009-11-03 Boston Scientific Scimed, Inc. Device with infusion holes for imaging inside a blood vessel
US7326196B2 (en) * 2002-10-14 2008-02-05 Breg, Inc. Catheter assemblies for controlled movement of fluid
US20040260271A1 (en) * 2003-06-18 2004-12-23 Huyser Richard F. Extended fenestration catheter with internal coil and method of making the same
WO2005049110A2 (en) * 2003-11-15 2005-06-02 Medrad, Inc. Catheter for diagnostic imaging and therapeutic procedures
WO2005069415A1 (en) * 2004-01-16 2005-07-28 Mitsubishi Materials Corporation Separator for fuel cell, method of producing separator, and solid oxide fuel cell
US20080275393A1 (en) * 2004-08-24 2008-11-06 Bonnette Michael J Isolation thrombectomy catheter system
CA2601136C (en) * 2005-03-18 2011-06-07 Wilson-Cook Medical Inc. Wire guides having novel outer surface areas and reservoirs for enhancing hydrophilic properties and delivering therapeutic agents
US20060229573A1 (en) * 2005-04-08 2006-10-12 Mckinley Medical L.L.L.P. Adjustable infusion catheter
US8002725B2 (en) * 2005-07-18 2011-08-23 Novostent Corporation Embolic protection and plaque removal system with closed circuit aspiration and filtering
US8608703B2 (en) 2007-06-12 2013-12-17 Medrad, Inc. Infusion flow guidewire system
US20070106245A1 (en) * 2005-11-08 2007-05-10 Kerberos Proximal Solutions, Inc. Infusion guidewire
US8162878B2 (en) 2005-12-05 2012-04-24 Medrad, Inc. Exhaust-pressure-operated balloon catheter system
US8961491B2 (en) * 2006-04-21 2015-02-24 Bayer Medical Care Inc Catheters and related equipment
US8876754B2 (en) * 2006-08-31 2014-11-04 Bayer Medical Care Inc. Catheter with filtering and sensing elements
CA2677343C (en) 2007-02-05 2016-06-21 Boston Scientific Limited Thrombectomy apparatus and method
WO2009009367A2 (en) 2007-07-06 2009-01-15 Allievion Medical, Inc. Constrained fluid delivery device
WO2009079539A1 (en) 2007-12-17 2009-06-25 Medrad, Inc. Rheolytic thrombectomy catheter with self-inflation distal balloon
WO2009082669A1 (en) * 2007-12-26 2009-07-02 Medrad, Inc. Rheolytic thrombectomy catheter with self-inflating proximal balloon with drug infusion capabilities
DE112009000700T5 (en) 2008-03-20 2011-02-10 Medrad, Inc. Hydrodynamic direct current catheter system
US9510854B2 (en) 2008-10-13 2016-12-06 Boston Scientific Scimed, Inc. Thrombectomy catheter with control box having pressure/vacuum valve for synchronous aspiration and fluid irrigation
US11331424B2 (en) 2009-01-26 2022-05-17 Incube Labs, Llc Apparatus, systems and methods for delivery of medication to the brain to treat neurological conditions
WO2010113159A1 (en) * 2009-03-30 2010-10-07 Medingo Ltd. Devices and methods for enhancing drug absorption rate
US10772717B2 (en) 2009-05-01 2020-09-15 Endologix, Inc. Percutaneous method and device to treat dissections
US9579103B2 (en) 2009-05-01 2017-02-28 Endologix, Inc. Percutaneous method and device to treat dissections
WO2011017123A2 (en) 2009-07-27 2011-02-10 Endologix, Inc. Stent graft
US20110112511A1 (en) * 2009-11-09 2011-05-12 Singer Jonathan E Method and apparatus for administering anesthetics to peripheral nerve regions
US9468435B2 (en) * 2009-12-23 2016-10-18 Cook Medical Technologies Llc Wound closure device
US20110196302A1 (en) * 2010-02-06 2011-08-11 Gildersleeve Michael R Cannula apparatus
US8951229B2 (en) * 2010-02-22 2015-02-10 Boston Scientific Limited Pressure actuated catheter seal and method for the same
EP2566557B1 (en) 2010-05-04 2014-03-19 Cook Medical Technologies LLC Method of treating an intravascular site in a patient, and thrombolysis catheter therefor
US9265913B2 (en) 2010-09-22 2016-02-23 Vital 5, Llc Catheter assembly
EP2603254A4 (en) 2010-08-12 2016-08-24 Boston Scient Ltd Infusion flow system and fluid coupling
US9446224B2 (en) 2010-09-22 2016-09-20 Vital 5, L.L.C. Barrier catheter
WO2012068298A1 (en) 2010-11-17 2012-05-24 Endologix, Inc. Devices and methods to treat vascular dissections
CA3192660A1 (en) 2011-05-18 2012-11-22 Solo-Dex, Inc. Continuous anesthesia nerve conduction apparatus, system and method
US8986283B2 (en) 2011-05-18 2015-03-24 Solo-Dex, Llc Continuous anesthesia nerve conduction apparatus, system and method thereof
US8702678B2 (en) * 2011-08-03 2014-04-22 Venous Therapy, Inc. Assemblies, systems, and methods for infusing therapeutic agents into the body
USD679804S1 (en) 2011-09-22 2013-04-09 Vital 5, Llc Catheter
CN104159636B (en) * 2011-11-21 2017-05-03 因库博实验室有限责任公司 Cardiac muscle drug delivery apparatus and method
US10213187B1 (en) 2012-01-25 2019-02-26 Mubin I. Syed Method and apparatus for percutaneous superficial temporal artery access for carotid artery stenting
US10639179B2 (en) 2012-11-21 2020-05-05 Ram Medical Innovations, Llc System for the intravascular placement of a medical device
US20140276452A1 (en) * 2013-03-13 2014-09-18 Medrad, Inc. Fluid efficient spike
EP2913017A1 (en) * 2014-02-27 2015-09-02 Osypka Ag. Irrigated ablation catheter
US9433427B2 (en) 2014-04-08 2016-09-06 Incuvate, Llc Systems and methods for management of thrombosis
US9883877B2 (en) 2014-05-19 2018-02-06 Walk Vascular, Llc Systems and methods for removal of blood and thrombotic material
ES2907571T3 (en) * 2015-03-02 2022-04-25 Accurate Medical Therapeutics Ltd Prevention of non-target embolization
US9636244B2 (en) 2015-04-09 2017-05-02 Mubin I. Syed Apparatus and method for proximal to distal stent deployment
US10561440B2 (en) 2015-09-03 2020-02-18 Vesatek, Llc Systems and methods for manipulating medical devices
EP3352814B1 (en) * 2015-09-22 2024-04-10 Thomas Jefferson University Continuous subcutaneous insulin infusion catheter
US20170100142A1 (en) 2015-10-09 2017-04-13 Incuvate, Llc Systems and methods for management of thrombosis
US11020256B2 (en) 2015-10-30 2021-06-01 Ram Medical Innovations, Inc. Bifurcated “Y” anchor support for coronary interventions
US10327929B2 (en) 2015-10-30 2019-06-25 Ram Medical Innovations, Llc Apparatus and method for stabilization of procedural catheter in tortuous vessels
US10492936B2 (en) 2015-10-30 2019-12-03 Ram Medical Innovations, Llc Apparatus and method for improved access of procedural catheter in tortuous vessels
US10779976B2 (en) 2015-10-30 2020-09-22 Ram Medical Innovations, Llc Apparatus and method for stabilization of procedural catheter in tortuous vessels
US9980838B2 (en) 2015-10-30 2018-05-29 Ram Medical Innovations Llc Apparatus and method for a bifurcated catheter for use in hostile aortic arches
US10226263B2 (en) 2015-12-23 2019-03-12 Incuvate, Llc Aspiration monitoring system and method
US10492805B2 (en) 2016-04-06 2019-12-03 Walk Vascular, Llc Systems and methods for thrombolysis and delivery of an agent
JP7092680B2 (en) 2016-04-15 2022-06-28 テンプル・ユニバーシティ-オブ・ザ・コモンウェルス・システム・オブ・ハイアー・エデュケイション Infusion catheter and how to use
US11871977B2 (en) 2016-05-19 2024-01-16 Csa Medical, Inc. Catheter extension control
EP3756721B1 (en) * 2016-06-09 2022-09-14 Boston Scientific Scimed Inc. Infusion catheter
US10173031B2 (en) * 2016-06-20 2019-01-08 Mubin I. Syed Interchangeable flush/selective catheter
WO2018013825A2 (en) * 2016-07-13 2018-01-18 Boston Scientific Scimed, Inc. Infusion catheter with high pressure capabilities
US10413658B2 (en) 2017-03-31 2019-09-17 Capillary Biomedical, Inc. Helical insertion infusion device
EP3661455A4 (en) 2017-07-31 2021-04-28 Loria Products Llc Hair implants comprising enhanced anchoring and medical safety features
US11564789B2 (en) 2017-07-31 2023-01-31 Loria Products Llc Hair implants comprising enhanced anchoring and medical safety features
US10105154B1 (en) 2017-11-09 2018-10-23 Pebble Hill Partners, Llc Basket for a catheter device
US10857014B2 (en) 2018-02-18 2020-12-08 Ram Medical Innovations, Llc Modified fixed flat wire bifurcated catheter and its application in lower extremity interventions
JP2021514711A (en) 2018-02-21 2021-06-17 ユナイテッド ステイツ エンドスコピー グループ,インコーポレイテッド Devices and methods for fluid distribution from catheters
US11678905B2 (en) 2018-07-19 2023-06-20 Walk Vascular, Llc Systems and methods for removal of blood and thrombotic material
US11369392B2 (en) * 2019-04-05 2022-06-28 Traverse Vascular, Inc. Intravascular catheter with fluoroscopically visible indicium of rotational orientation
USD917050S1 (en) * 2019-08-26 2021-04-20 Loria Products Llc Hair implant
US11129968B2 (en) * 2019-09-13 2021-09-28 Ethicon, Inc. Methods of making and implanting barbed microcatheters having fluid egress openings for infusing therapeutic fluids
WO2022140304A1 (en) * 2020-12-21 2022-06-30 Pacific Diabetes Technologies Inc. Long-lived insulin delivery cannula

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4927418A (en) 1989-01-09 1990-05-22 Advanced Cardiovascular Systems, Inc. Catheter for uniform distribution of therapeutic fluids
US4968307A (en) 1989-01-09 1990-11-06 Advanced Cardiovascular Systems, Inc. Catheter for uniform distribution of therapeutic fluids
US5069673A (en) * 1990-02-07 1991-12-03 Cordis Corporation Catheter with double step-down bore
US5156597A (en) * 1989-12-30 1992-10-20 B. Braun Melsungen Ag Transcutaneous implantation catheter
US5250034A (en) 1990-09-17 1993-10-05 E-Z-Em, Inc. Pressure responsive valve catheter
US5480392A (en) * 1993-02-04 1996-01-02 Cordis Corporation Angiography catheter
US5569197A (en) 1994-12-21 1996-10-29 Schneider (Usa) Inc Drug delivery guidewire
US5738649A (en) * 1996-04-16 1998-04-14 Cardeon Corporation Peripheral entry biventricular catheter system for providing access to the heart for cardiopulmonary surgery or for prolonged circulatory support of the heart
US5800407A (en) * 1995-12-21 1998-09-01 Eldor; Joseph Multiple hole epidural catheter

Family Cites Families (21)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4280500A (en) * 1978-03-31 1981-07-28 Kazuaki Ono Tubular flexible medical instrument
US4256102A (en) * 1979-05-14 1981-03-17 Monaco Anthony P Subcutaneous dialysis system
US4491126A (en) * 1982-07-06 1985-01-01 Wilbur D. Smith Method and apparatus for monitoring body parts of animals
US5098413A (en) * 1989-03-13 1992-03-24 Sil-Med Corporation Peritoneal catheter
US5090960A (en) * 1990-01-12 1992-02-25 Don Michael T Anthony Regional perfusion dissolution catheter
US5052998A (en) * 1990-04-04 1991-10-01 Zimmon David S Indwelling stent and method of use
US5236413B1 (en) * 1990-05-07 1996-06-18 Andrew J Feiring Method and apparatus for inducing the permeation of medication into internal tissue
WO1992019311A1 (en) * 1991-04-24 1992-11-12 Baxter International Inc. Exchangeable integrated-wire balloon catheter
CA2074304C (en) * 1991-08-02 1996-11-26 Cyril J. Schweich, Jr. Drug delivery catheter
US5141499A (en) * 1991-10-09 1992-08-25 Zappacosta Anthony R Peritoneal dialysis catheter
US5304214A (en) * 1992-01-21 1994-04-19 Med Institute, Inc. Transurethral ablation catheter
US5254089A (en) * 1992-04-02 1993-10-19 Boston Scientific Corp. Medication dispensing balloon catheter
US5380307A (en) 1992-09-30 1995-01-10 Target Therapeutics, Inc. Catheter with atraumatic drug delivery tip
US5643226A (en) * 1993-02-24 1997-07-01 Minnesota Mining And Manufacturing Low velocity aortic cannula
US5389074A (en) * 1993-10-27 1995-02-14 The Regents Of The University Of California Body insertion tube with anesthetic jacket
US5462521A (en) * 1993-12-21 1995-10-31 Angeion Corporation Fluid cooled and perfused tip for a catheter
US5425723A (en) 1993-12-30 1995-06-20 Boston Scientific Corporation Infusion catheter with uniform distribution of fluids
US5409012A (en) * 1993-12-30 1995-04-25 Boston Scientific Corporation Sample collection using catheter with expandable member
US5713861A (en) * 1994-10-17 1998-02-03 Vanarthos; William Trauma urethral catheter and method of using same
US5997487A (en) * 1995-10-11 1999-12-07 Micro Therapeutics, Inc. Infusion wire having fixed core wire
JP3527378B2 (en) * 1997-01-31 2004-05-17 テルモ株式会社 Contrast catheter

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4927418A (en) 1989-01-09 1990-05-22 Advanced Cardiovascular Systems, Inc. Catheter for uniform distribution of therapeutic fluids
US4968307A (en) 1989-01-09 1990-11-06 Advanced Cardiovascular Systems, Inc. Catheter for uniform distribution of therapeutic fluids
US5156597A (en) * 1989-12-30 1992-10-20 B. Braun Melsungen Ag Transcutaneous implantation catheter
US5069673A (en) * 1990-02-07 1991-12-03 Cordis Corporation Catheter with double step-down bore
US5250034A (en) 1990-09-17 1993-10-05 E-Z-Em, Inc. Pressure responsive valve catheter
US5480392A (en) * 1993-02-04 1996-01-02 Cordis Corporation Angiography catheter
US5569197A (en) 1994-12-21 1996-10-29 Schneider (Usa) Inc Drug delivery guidewire
US5800407A (en) * 1995-12-21 1998-09-01 Eldor; Joseph Multiple hole epidural catheter
US5738649A (en) * 1996-04-16 1998-04-14 Cardeon Corporation Peripheral entry biventricular catheter system for providing access to the heart for cardiopulmonary surgery or for prolonged circulatory support of the heart

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See also references of EP1023101A4 *

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6547769B2 (en) 1999-12-20 2003-04-15 Tricardia Llc Catheter apparatus with weeping tip and method of use
US6855132B2 (en) 1999-12-20 2005-02-15 Tricardia, Llc Apparatus with weeping tip and method of use
US6949087B2 (en) 1999-12-20 2005-09-27 Tricardia, Llc Apparatus with weeping tip and method of use
US7252654B2 (en) 1999-12-20 2007-08-07 Tricardia, Llc Apparatus with weeping tip and method of use
US6814742B2 (en) 2000-10-16 2004-11-09 Olympus Corporation Physiological tissue clipping apparatus, clipping method and clip unit mounting method
US6969373B2 (en) 2001-04-13 2005-11-29 Tricardia, Llc Syringe system
EP2698119A1 (en) * 2012-08-13 2014-02-19 Covidien LP Apparatus and methods for clot disruption and evacuation
US9332999B2 (en) 2012-08-13 2016-05-10 Covidien Lp Apparatus and methods for clot disruption and evacuation
US9332998B2 (en) 2012-08-13 2016-05-10 Covidien Lp Apparatus and methods for clot disruption and evacuation
US9808266B2 (en) 2012-08-13 2017-11-07 Covidien Lp Apparatus and methods for clot disruption and evacuation

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US5957901A (en) 1999-09-28
US6179816B1 (en) 2001-01-30

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