Methods of using a deflectable telescoping guide catheter

• US 20030195525A1
• Filed: 05/08/2003
• Published: 10/16/2003
• Est. Priority Date: 12/11/2001
• Status: Active Grant

• Current Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Original Assignee: Cardiac Pacemakers Incorporated (Boston Scientific Corporation)
• Inventors: Peterson, Charles R., Manning, Frank E.
• Granted Patent: US 6,953,454 B2
• Time in Patent Office: Days
• US Class Current: 606/129
• CPC Class Codes: A61M 2025/0161 wherein the distal tips have two or more deflection regions
• CPC Class Codes: A61M 25/0041 pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04
• CPC Class Codes: A61M 25/0147 with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/0152 with pre-shaped mechanisms, e.g. pre-shaped stylets or pre-shaped outer tubes

Abstract

Methods of accessing a destination vessel involve use of a catheter having an outer guide and an inner guide. The outer guide includes an outer guide lumen, a distal end, a proximal end, and a predetermined deflection location proximate the distal end. The inner guide includes an inner guide lumen, a pre-formed distal end, and a proximal end. An access method can involve axially displacing the inner guide beyond the distal end of the outer guide, axially rotating the inner guide relative to the outer guide, and changing a bend angle at the predetermined deflection location of the outer guide to direct the pre-formed distal end of the inner guide for finding and cannulating the destination vessel. A payload can be delivered into the destination vessel via the inner guide, or via the outer guide upon removal of the inner guide.

Claims

1. A method of accessing a coronary sinus of a patient'"'"'s heart, comprising:

providing a catheter, comprising;

an outer guide including an outer guide lumen, a distal end, a proximal end, and a predetermined deflection location proximate the distal end; and

an inner guide including an inner guide lumen, a pre-formed distal end, and a proximal end, the inner guide movable within the outer guide lumen and displaceable beyond the distal end of the outer guide;

delivering the distal end of the catheter through a patient'"'"'s right atrium via an access vessel;

distally displacing the inner guide beyond the distal end of the outer guide and changing a bend angle at the predetermined deflection location to direct the pre-formed distal end of the inner guide for finding and cannulating the coronary sinus;

distally advancing the outer guide over the inner guide to seat the outer guide in the coronary sinus;

proximally retracting the inner guide to remove the inner guide from the catheter; and

advancing a payload through the proximal end of the outer guide such that the payload is delivered into the coronary sinus;

2. A method according to claim 1, wherein the payload comprises a cardiac lead.

3. A method according to claim 1, wherein the payload comprises a cardiac pacing lead.

4. A method according to claim 1, wherein the payload comprises a radio-opaque dye.

5. A method according to claim 1, wherein the payload comprises an ablation device.

6. A method according to claim 1, wherein the catheter comprises one or more electrodes located at the distal end of at least one of the inner guide and outer guide, the method further comprising detecting electrical cardiac activity using the one or more electrodes.

7. A method according to claim 1, wherein the catheter comprises one or more steering tendons attached to the distal end of one or both of the inner and outer guides, the method further comprising actuating the one or more steering tendons for finding and cannulating the coronary sinus.

8. A method of accessing a coronary sinus of a patient'"'"'s heart, comprising:

providing a catheter, comprising;

an outer guide including an outer guide lumen, a distal end, a proximal end, and a predetermined deflection location proximate the distal end; and

an inner guide including an inner guide lumen, a pre-formed distal end, and a proximal end, the inner guide movable within the outer guide lumen and displaceable beyond the distal end of the outer guide;

delivering the distal end of the catheter through a patient'"'"'s right atrium via an access vessel;

axially displacing the inner guide beyond the distal end of the outer guide and changing a bend angle at the predetermined deflection location to direct the pre-formed distal end of the inner guide for finding and cannulating the coronary sinus; and

advancing a payload through the proximal end of the inner guide such that the payload is delivered into the coronary sinus.

9. A method according to claim 8, wherein the payload comprises a cardiac lead.

10. A method according to claim 8, wherein the payload comprises a cardiac pacing lead.

11. A method according to claim 8, wherein the payload comprises a radio-opaque dye.

12. A method according to claim 8, wherein the payload comprises an ablation device.

13. A method according to claim 8, wherein the catheter comprises one or more electrodes located at the distal end of at least one of the inner guide and outer guide, the method further comprising detecting electrical cardiac activity using the one or more electrodes.

14. A method according to claim 8, wherein the catheter comprises one or more steering tendons attached to the distal end of one or both of the inner and outer guides, the method further comprising actuating the one or more steering tendons for finding and cannulating the coronary sinus.

15. A method of accessing a destination vessel of a patient'"'"'s heart, comprising:

providing a catheter, comprising;

an outer guide including an outer guide lumen, a distal end, a proximal end, and a predetermined deflection location proximate the distal end; and

an inner guide including an inner guide lumen, a pre-formed distal end, and a proximal end, the inner guide movable within the outer guide lumen and displaceable beyond the distal end of the outer guide;

delivering the distal end of the catheter through a patient'"'"'s heart chamber via an access vessel; and

axially displacing the inner guide beyond the distal end of the outer guide, axially rotating the inner guide relative to the outer guide, and changing a bend angle at the predetermined deflection location of the outer guide to direct the pre-formed distal end of the inner guide for finding and cannulating the destination vessel.

16. A method according to claim 15, wherein the catheter comprises one or more electrodes located at the distal end of at least one of the inner guide and outer guide, the method further comprising detecting electrical cardiac activity using the one or more electrodes.

17. A method according to claim 15, wherein the catheter comprises one or more steering tendons attached to the distal end of one or both of the inner and outer guides, the method further comprising actuating the one or more steering tendons for finding and cannulating the destination vessel.

18. A method according to claim 15, further comprising advancing a payload through the proximal end of the inner guide such that the payload is delivered into the destination vessel.

19. A method according to claim 18, wherein the payload comprises a cardiac lead.

20. A method according to claim 18, wherein the payload comprises a cardiac pacing lead.

21. A method according to claim 18, wherein the payload comprises a radio-opaque dye.

22. A method according to claim 18, wherein the payload comprises an ablation device.