Device for directing a wire guide

• US 20040073108A1
• Filed: 05/29/2003
• Published: 04/15/2004
• Est. Priority Date: 05/29/2002
• Status: Active Grant

• Current Assignee: Cook Medical Technologies, LLC (Cook Group Incorporated)
• Original Assignee: Wilson-Cook Medical Incorporated (Cook Group Incorporated)
• Inventors: Surti, Vihar C., Saeed, Zahid
• Granted Patent: US 7,182,756 B2
• Time in Patent Office: Days
• US Class Current: 600/431
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61M 2025/018 Catheters having a lateral opening for guiding elongated means lateral to the catheter
• CPC Class Codes: A61M 25/01 Introducing, guiding, advancing, emplacing or holding catheters A61M25/10 takes precedence
• CPC Class Codes: A61M 25/09041 Mechanisms for insertion of guide wires

Abstract

A device for directing a wire guide into a bodily passageway such as a branch of the biliary tree or other difficult to access bodily passageway. The device includes a member, such as an inflatable balloon or a self-expanding basket, for obstructing a first passage. Once the balloon is inflated, or the basket expanded, the wire guide can be reliably directed or deflected into a preferred adjacent passageway in order to cannulate the preferred adjacent passageway. A procedure for cannulating a preferred passageway by obstructing a passageway in the natural flow-path of a wire guide is also provided.

Claims

1. A medical device for directing an elongate member, comprising:

an elongate sheath comprising a proximal end, a distal end and a longitudinal axis extending therebetween;

an expandable obstruction member operatively connected to the elongate sheath;

a first passageway extending along the longitudinal axis from the proximal end to the obstruction member;

a second passageway extending along the longitudinal axis from the proximal end to a portion proximal to the obstruction member, the second passageway terminating at an exit port; and

an elongate member slidable within the second passageway, wherein the obstruction member is capable of deflecting the elongate member away from the longitudinal axis.

2. The medical device of claim 1, wherein the obstruction member is inflatable.

3. The medical device of claim 2, wherein the obstruction member is an inflatable balloon.

4. The medical device of claim 1, further comprising:

a third passageway extending along the longitudinal axis from the proximal end to the distal end, the third passageway terminating at an exit port; and

a second elongate member axially slidable within the third passageway.

5. The medical device of claim 4, further comprising a hub operably connected to the proximal end.

6. The medical device of claim 5 wherein the hub comprises a first access port corresponding with the first passageway, a second access port corresponding with the second passageway, and a third access port corresponding with the third passageway.

7. The medical device of claim 6, further comprising an fluid control element operably connected to the first access port, and an inflation device operably connected to the fluid control element.

8. The medical device of claim 7, wherein the second access port comprises a side-arm port for infusion of fluid through the second passageway and the third access port comprises a side-arm port for infusion of fluid through the third passageway.

9. The medical device of claim 8, further comprising a plurality of radiopaque markers connected to the elongate sheath.

10. The medical device of claim 1, further comprising an internal deflecting member located within the second passageway, wherein the internal deflecting member is configured to deflect the elongate member through the exit port.

11. The medical device of claim 1, wherein the elongate member engages a rearward portion of the obstruction member.

12. The medical device of claim 1, wherein the obstruction member is disposed in a first body lumen passageway and a distal end of the elongate member is disposed in a second body lumen passageway adjacent the first body lumen passageway.

13. The medical device of claim 1, wherein the elongate inner member is a wire guide.

14. The medical device of claim 1, wherein the exit port is a scive configured to deflect the elongate member away from the longitudinal axis.

15. A medical device, comprising:

an elongate outer member having a proximal end, a distal end and a longitudinal axis therebetween, the elongate outer member comprising;

a first outer member passageway extending along the longitudinal axis from the proximal end to the distal end;

a second outer member passageway extending along the longitudinal axis from the proximal end to the distal end;

an elongate inner member slidable axially through the second outer member passageway; and

an elongate sheath slidable within the first outer member passageway, the elongate sheath comprising an obstruction operatively connected to the elongate sheath, wherein the obstruction member is configured to deflect the elongate inner member in a desired direction.

16. The medical device of claim 15, wherein the obstruction member is inflatable.

17. The medical device of claim 15, wherein the obstruction member is self-expanding.

18. The medical device of claim 17, wherein the obstruction member is a wire basket.

19. The medical device of claim 18, wherein the wire basket is longitudinally compressed.

20. The medical device of claim 18, further comprising a covering located over a portion of the obstruction member, the covering being configured to deflect the elongate inner member in a desired direction.

21. The medical device of claim 20, wherein the covering is a tightly-knit mesh.

22. The medical device of claim 20, wherein the wire basket is formed of either nitinol or spring stainless steel.

23. The medical device of claim 18, wherein the wire basket is configured to deflect the elongate member in a desired direction.

24. The medical device of claim 15, wherein the elongate inner member is a wire guide.

25. A method of directing a wire guide, the method comprising the steps of:

a) providing a medical device comprising

an elongate sheath comprising a proximal end, a distal end and a longitudinal axis extending therebetween;

an obstruction member, the obstruction being operatively connected to the elongate sheath;

a first passageway extending along the longitudinal axis from the proximal end to the the obstruction member;

a second passageway extending along the longitudinal axis from the proximal end to a portion proximal to the obstruction member, the second passageway terminating at an exit port; and

an elongate member slidable within the second passageway, wherein the obstruction member is configured to deflect the elongate member toward a desired direction away from the longitudinal axis;

b) inserting the elongate sheath into a branching body lumen having a first branch and a second branch adjacent to the first branch;

c) advancing a portion of the elongate sheath into the first branch, thereby positioning the obstruction member partially within the first branch;

d) expanding the obstruction within the first branch, thereby obstructing entry into the first branch;

e) advancing the elongate member distally through the exit port;

f) directing the elongate member toward the second branch by causing the elongate member to deflect off of the obstruction; and

g) cannulating the second branch with the elongate member.

26. The method of claim 25, further comprising the steps of:

h) collapsing the obstruction; and

i) withdrawing the elongate sheath from the body lumen while maintaining the elongate member within the second branch.

27. A method of accessing a desired passageway branching from a body lumen, the method comprising the steps of:

a) providing a medical device comprising

a wire guide, and

a catheter having an inflatable balloon configured to deflect the wire guide;

b) inserting a portion of the catheter into a first branch of the body lumen;

c) inflating the balloon within the first branch, thereby obstructing the first branch;

d) advancing the wire guide through the body lumen, thereby causing the wire guide to deflect off of the balloon in a desired direction; and

e) advancing the wire guide into the desired passageway.

28. A method of accessing a desired passageway branching from a body lumen, the method comprising the steps of:

a) providing a medical device comprising;

an elongate outer member having a proximal end, a distal end and a longitudinal axis therebetween, the elongate outer member comprising;

a first outer member passageway extending along the longitudinal axis from the proximal end to the distal end;

a second outer member passageway extending along the longitudinal axis from the proximal end to the distal end;

an elongate sheath slidable within the first outer member passageway, the elongate sheath comprising an obstruction member operatively connected to the elongate sheath; and

an elongate inner member slidable axially through the second outer member passageway, wherein the obstruction member is configured to deflect the elongate inner member toward a predetermined direction away from the longitudinal axis;

b) inserting a portion of the elongate outer member into a body lumen;

c) advancing the elongate sheath distally into a first branch of the body lumen;

d) obstructing entry into the first branch of the body lumen with the obstruction member;

e) advancing the elongate inner member distally through the body lumen, thereby causing the elongate inner member to deflect off of the balloon in a desired direction; and

f) advancing the elongate inner member into the desired passageway.

29. The method of claim 28, further comprising the steps of:

g) collapsing the obstruction; and

h) withdrawing the elongate sheath from the first branch.