Guidewire retrieval member for catheter insertion

• US 20030093090A1
• Filed: 11/06/2002
• Published: 05/15/2003
• Est. Priority Date: 01/09/2001
• Status: Active Grant

• Current Assignee: Argon Medical Devices
• Original Assignee: REX Medical LP
• Inventors: McGuckin, James F. Jr., Hinchliffe, Peter W. J., Paris, Michael W., Tashjian, Paul
• Granted Patent: US 7,097,635 B2
• Time in Patent Office: Days
• US Class Current: 606/138
• CPC Class Codes: A61M 1/285 Catheters therefor
• CPC Class Codes: A61M 1/3661 for haemodialysis
• CPC Class Codes: A61M 2025/0031 characterized by lumina for withdrawing or delivering, i.e. used for extracorporeal circuit treatment
• CPC Class Codes: A61M 2025/0034 characterized by elements which are assembled, connected or fused, e.g. splittable tubes, outer sheaths creating lumina or separate cores making of catheters A61M25/0009
• CPC Class Codes: A61M 2025/0036 with more than four lumina
• CPC Class Codes: A61M 2025/0078 for fluid inflow from the body into the catheter lumen
• CPC Class Codes: A61M 2025/09116 Design of handles or shafts or gripping surfaces thereof for manipulating guide wires
• CPC Class Codes: A61M 25/0028 characterized by features relating to at least one lumen located at the proximal part of the catheter, e.g. alterations in lumen shape or valves catheter hubs A61M25/0097
• CPC Class Codes: A61M 25/0029 characterized by features relating to least one lumen located at the middle part of the catheter, e.g. slots, flaps, valves, cuffs, apertures, notches, grooves or rapid exchange ports catheter shaft surface irregularities A61M2025/006
• CPC Class Codes: A61M 25/0032 characterized by at least one unconventionally shaped lumen, e.g. polygons, ellipsoids, wedges or shapes comprising concave and convex parts
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool
• CPC Class Codes: A61M 25/0097 characterised by the hub connectors A61M39/10
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/09041 Mechanisms for insertion of guide wires

Abstract

An apparatus for passing a guidewire through a subcutaneous tissue tunnel to enable over-the wire insertion of a catheter through the tissue tunnel. The apparatus comprises an elongated member having a distal end portion having a tip configured to advance through the tissue tunnel and an opening extending longitudinally with respect to the apparatus and dimensioned to receive the guidewire. The guidewire is inserted through the opening to pass the guidewire through the tunnel to enable subsequent insertion of the catheter.

Claims

1. An apparatus for passing a guidewire through a subcutaneous tissue tunnel to enable over-the-wire insertion of a catheter through the tissue tunnel, the apparatus comprising an elongated member having a distal end portion and an opening, the distal end portion having a tip configured to advance through the tissue tunnel, the opening extending longitudinally with respect to the apparatus and dimensioned to receive the guidewire, wherein the guidewire is inserted through the opening to thereby pass the guidewire through the tunnel to enable subsequent over-the-wire insertion of the catheter.

2. The apparatus of claim 1, wherein the opening extends from the tip of the apparatus to a proximal end portion.

3. The apparatus of claim 1, wherein the opening is formed in a side wall of the apparatus.

4. The apparatus of claim 4, wherein the apparatus includes a handle and the opening extends through the handle.

5. An apparatus for passing a guidewire through a subcutaneous tissue tunnel to enable over-the wire insertion of a catheter through the tunnel and into the patient'"'"'s vessel, the apparatus comprising an elongated member having a distal end portion and guidewire retaining structure, the distal end portion having a tip configured to advance through the tissue tunnel, the guidewire retaining structure engaging the guidewire and retaining the guidewire during movement of the apparatus through the tissue tunnel to thereby enable passage of the guidewire through the tunnel to enable subsequent insertion of the catheter over the guidewire.

6. The apparatus of claim 5, wherein the guidewire retaining structure comprises a hook at the distal end portion of the apparatus.

7. The apparatus of claim 5, wherein the guidewire retaining structure comprises a through hole the distal end of the trocar.

8. The apparatus of claim 5, wherein the retaining structure comprises a flexible band.

9. A system for placement of a dialysis catheter comprising a trocar and a stiffener, the trocar having a distal tip configured to dissect tissue and an structure to receive a guidewire, the trocar providing passage of the guidewire through a subcutaneous tissue tunnel, the stiffener removably insertable into a lumen of the dialysis catheter to provide increased rigidity to the dialysis catheter to enhance pushability of the dialysis catheter over the guidewire through the tissue tunnel.

10. The system of claim 9, wherein the stiffener comprises a rod having engaging structure abutting an internal wall of the catheter.

11. The system of claim 9, wherein the sturcture for receiving a guidewire comprises an opening extending along a substantial length of the trocar.

12. The system of claim 11, wherein the stiffener includes a threaded proximal portion for releasable engagement with the dialysis catheter.

13. A kit for inserting a dialysis catheter through a subcutaneous tissue tunnel into a patient'"'"'s vessel, the kit comprising:

a guidewire passer for passing a guidewire through a subcutaneous tissue tunnel so the guidewire extends from the vessel through a proximal opening of the tissue tunnel to enable a dialysis catheter to be inserted through the tissue tunnel over the guidewire; and

a stiffener insertable into a lumen of the catheter to stiffen at least a portion of the catheter to facilitate advancement of the catheter over the guidewire through the subcutaneous tissue tunnel and through the vessel.

14. The kit of claim 13, wherein the trocar includes a longitudinal passageway dimensioned to receive the guidewire

15. The kit of claim 13, wherein the stiffener includes a threaded proximal portion for releasable engagement with the dialysis catheter.

16. The kit of claim 15, wherein the stiffener includes a protruding surface on an outer wall for engagement with an internal wall of the dialysis catheter.

17. The kit of claim 15, wherein the stiffener includes a longitudinal lumen for receipt of the guidewire.

18. A method for over the wire placement of a catheter through a tissue tunnel and into a vessel comprising;

inserting a guidewire into the vessel so a proximal portion extends proximally of a patient'"'"'s body;

providing a guidewire retrieval member;

passing the guidewire through the tissue tunnel via the guidewire retrieval member so a proximal end of the guidewire extends through a proximal opening of the tissue tunnel and outside the patient'"'"'s body; and

advancing a catheter over the guidewire through the subcutaneous tissue tunnel and into the patient'"'"'s vessel.

19. The method of claim 18, further comprising the step of advancing the guidewire retrieval member distally through the subcutaneous tissue tunnel prior to passing the guidewire through the tissue tunnel.

20. The method of claim 18, further comprising the step of threading the guidewire through a longitudinal opening in the retrieval member.

21. A method for determining a length of catheter for insertion over a guidewire extending through a tissue tunnel and into a vessel comprising;

inserting the guidewire into the vessel so a proximal portion extends proximally of a patient'"'"'s body;

passing the guidewire through the tissue tunnel so a proximal end of the guidewire extends through a proximal opening of the tissue tunnel and outside the patient'"'"'s body; and

advancing a device over the guidewire through the subcutaneous tissue tunnel and into the patient'"'"'s vessel to determine a length of catheter.

22. The method of claim 21, wherein the device contains markings and the step of advancing the device to determine the length of the catheter includes viewing the markings to provide an indicator of the length of the catheter.

23. The method of claim 22, wherein the device comprises a dilator and the step of advancing the device includes advancing the dilator to dilate tissue.

24. The method of claim 21, wherein the device comprises a stiffener rod and the step of advancing the device includes advancing the stiffener rod.