Method and apparatus for centering a microcatheter within a vasculature

• US 10,426,510 B2
• Filed: 04/27/2016
• Issued: 10/01/2019
• Est. Priority Date: 10/22/2012
• Status: Active Grant

• Current Assignee: Roxwood Medical, Inc. (Boston Scientific Corporation)
• Original Assignee: Roxwood Medical, Inc. (Boston Scientific Corporation)
• Inventors: Farhangnia, Mehrdad, Taber, Mark, Yang, Mark C.
• Primary Examiner(s): Eiseman, Adam J
• Application Number:
  US15/139,936
• Publication Number:
  US 20160235429A1
• Time in Patent Office: 1,252 Days
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• CPC Class Codes: A61B 2017/22044 with a pointed tip
• CPC Class Codes: A61B 2017/22069 Immobilising; Stabilising
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61B 2017/3405 using mechanical guide means
• CPC Class Codes: A61F 2/915 with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61M 2025/0042 Microcatheters, cannula or the like having outside diameters around 1 mm or less
• CPC Class Codes: A61M 2025/1047 having centering means, e.g. balloons having an appropriate shape
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: F04C 2270/041 Controlled or regulated

Abstract

The invention is directed to methods and apparatus for centering a microcatheter within a vasculature. In one aspect, the methods and apparatus can be used to support centering and to facilitate a guidewire to cross through a chronic total occlusion. In one embodiment, the catheter apparatus includes: a microcatheter having a lumen, a distal opening and a distal end; one or more guidewires for passing through the lumen of the microcatheter; an inner shaft having a lumen, a distal opening and a distal end for passing the inner shaft over the microcatheter; an outer shaft having a lumen, a distal opening and a distal end for passing the outer shaft over the inner shaft; and a self-expandable scaffold structure disposed towards the distal end of the inner shaft. The self-expandable scaffold structure is preferably non-occluding thereby allowing blood to flow through the scaffold. Preferably, the inner shaft and microcatheter are capable of being independently operable.

Claims

1. A method of centering a microcatheter in a vessel comprising:

inserting a catheter into the vessel, wherein the catheter comprises

a hollow shaft with a distal end and a proximal end,

a non-occluding self-expandable scaffold having a distal end, a proximal end, and a central longitudinal axis, the self-expandable scaffold being disposed at the distal end of the catheter, wherein a portion of the distal end of the catheter is disposed at least in part inside the self-expandable scaffold, and wherein the proximal end of the scaffold is permanently affixed to the hollow shaft and the distal end of the scaffold is configured to be slidable along the hollow shaft, and

a sheath

wherein the distal end is slidable along the hollow shaft,

wherein the scaffold is configured to be coupled to the distal end of the catheter, wherein at least a portion of the distal end of the catheter is disposed substantially along the central axis of the self-expandable scaffold structure,

wherein the hollow shaft is covered by the sheath; and

inserting a microcatheter into the catheter; and

withdrawing the sheath to expand the self-expandable scaffold structure whereby expansion of the scaffold centers the microcatheter along the central longitudinal axis of the scaffold thereby centering the microcatheter in the vessel.

2. The method of claim 1 further comprising inserting a guidewire through the microcatheter.

3. The method of claim 1, wherein the vessel has a chronic occlusion and wherein the method further comprises advancing the microcatheter in contact with the chronic occlusion.

4. The method of claim 1, wherein the self-expandable scaffold comprises loops which project inwardly from the cylindrical plane of the scaffold to the central longitudinal axis of the self-expandable scaffold structure.

5. The method of claim 4, wherein the loops position the shaft approximately along the central longitudinal axis of the self-expandable scaffold structure.

6. The method of claim 1, wherein the hollow shaft is an inner shaft and the sheath is an outer shaft, wherein the inner shaft, outer shaft, and microcatheter are slideably operable independently of each other.

7. The method of claim 6, wherein the inner shaft telescopes in and out of the outer shaft and the microcatheter telescopes in and out of the inner shaft.

8. The method of claim 6, further comprising telescoping at least one of the inner shaft, the outer shaft and a guidewire.

9. The method of claim 1, further comprising inserting a guidewire through the microcatheter and withdrawing the catheter from the vessel lumen while the guidewire remains in the vessel lumen.

10. The method of claim 1, further comprising accessing the vessel with the microcatheter.