Dynamic cannula

• US 20050107817A1
• Filed: 12/16/2002
• Published: 05/19/2005
• Est. Priority Date: 12/14/2001
• Status: Active Grant

• Current Assignee: The General Hospital Corporation (Mass General Brigham, Inc.)
• Original Assignee: The General Hospital Corporation (Mass General Brigham, Inc.)
• Inventors: White, Jennifer Keane, Titus, James Sidney
• Granted Patent: US 7,799,046 B2
• Time in Patent Office: Days
• US Class Current: 606/191
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61M 2025/0024 Expandable catheters or sheaths
• CPC Class Codes: A61M 2025/0057 Catheters delivering medicament other than through a conventional lumen, e.g. porous walls or hydrogel coatings
• CPC Class Codes: A61M 2025/1097 with perfusion means for enabling blood circulation only while the balloon is in an inflated state, e.g. temporary by-pass within balloon
• CPC Class Codes: A61M 25/00 Catheters; Hollow probes dilators A61M29/00; peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00 ; for measuring or testing A61B; materials for catheters A61L29/00
• CPC Class Codes: A61M 25/0023 by the form of the lumen, e.g. cross-section, variable diameter
• CPC Class Codes: A61M 25/0045 multi-layered, e.g. coated coating materials A61L29/08

Abstract

A perfusion cannula constructed of a wire mesh or other structure having an expandable portion capable of expanding from a constricted state to an expanded state such that a vessel is stented open while permitting fluid flow through a cannula into the vessel.

Claims

1. An expandable cannula having a first constricted diameter position and capable of being expanded in situ to a second expanded diameter position, comprising:

a. a tube having at least a portion of its length expandable from a first diameter to a second diameter, said tube having

i) a proximal end; and

ii) a distal end,

whereby when said cannula is deployed in situ at least a portion of said tube can be constricted radially.

2. The expandable cannula of claim 1, wherein at least a portion of said tube is coated with a fluid impermeable coating.

3. The expandable cannula of claim 1, wherein at least a portion of said tube is coated with an at least partially permeable coating.

4. The expandable cannula of claim 1, wherein at least a portion of the inside of said tube is coated with a first coating and at least a portion of the outside of said tube is coated with a second coating.

5. The expandable cannula of claim 1, further comprising a joining of expandable materials at one end.

6. The expandable cannula of claim 1, wherein there is an end cap

7. The expandable cannula of claim 1, wherein the end cap is solid.

8. The expandable cannula of claim 1, wherein the end cap has an opening defined therein.

9. The expandable cannula of claim 1, wherein the tube is funnel shaped.

10. The expandable cannula of claim 1, wherein the tube is tapered.

11. The expandable cannula of claim 1, wherein said tube is capable of self-expansion.

12. The expandable cannula of claim 1, wherein said tube expands in response to a mechanical force.

13. The expandable cannula of claim 1, wherein said tube contracts in response to a mechanical force.

14. The expandable cannula of claim 1, wherein said tube expands in response to an electrical stimulus.

15. The expandable cannula of claim 1, wherein said tube contracts in response to an electrical stimulus.

16. The expandable cannula of claim 1, wherein said tube expands in response to a thermodynamic stimulus.

17. The expandable cannula of claim 1, wherein said tube contracts in response to a thermodynamic stimulus.

18. The expandable cannula of claim 1, wherein the mesh material is impregnated with a therapeutic agent.

19. The expandable cannula of claim 1, wherein the cannula is constructed of a biodegradable material.

20. The expandable cannula of claim 1, wherein said distal end incorporates a flared, portion, said flare being about 7 degrees from the central axis of said cannula.

21. An expandable cannula, comprising:

a tube having an open proximal end and all open distal end, at least a portion of said tube length constructed of a material expandable from a natural state having first diameter to a constricted state having second diameter, said natural state tube diameter expanding from a point in proximity to said proximal end to said distal end.

22. The expandable cannula of claim 21, wherein said expanded diameter section having a flare at its widest point of about 7 degrees from the central axis of said tube.

23. The expandable cannula of claim 21, wherein said flared end, when positioned within a vessel having an internal wall having a diameter, substantially expands to said internal wall diameter.

24. The expandable cannula of claim 21, wherein at least a portion of said tube is comprised of a wire mesh material.

25. The expandable cannula of claim 21, wherein at least a portion of said tube is fluid impermeable.

27. The expandable cannula of claim 23, wherein said expanded diameter section having a flare at its widest point of about 7 degrees from the central axis of said tube.

28. The expandable cannula of claim 25, wherein said flared end, when positioned within a vessel having all internal wall having a diameter, substantially expands to said internal wall diameter.

29. The expandable cannula of claim 21, wherein at least a portion of said tube is comprised of a wire mesh material.

30. The expandable cannula of claim 21, wherein at least a portion of said tube is fluid impermeable.

38. The method of claim 24, wherein at least a portion of said outer tube is made of a wire mesh material.

40. The expandable cannula of claim 38, wherein perfusion fluid enters said proximal end of said inner tube and flows toward said distal end of said inner tube.

26. An expandable cannula, comprising:

a tube having at least a portion thereof constructed of a material expandable from a natural state having first diameter to a constricted state having second diameter, said tube comprising,

a. an open proximal end;

b. a middle portion having a uniform diameter; and

,

c. an open distal end, said natural state tube diameter expanding from a point between said middle portion and said distal end.

31. An expandable cannula, comprising:

a tube having at least a portion thereof constructed of a material expandable from a natural state having first diameter to a constricted state having second diameter, said tube comprising,

a. a first segment having a proximal end and a distal end, at least a portion said first segment having a flared diameter increasing from said proximal end to said distal end, and at least a portion of said first segment being fluid impermeable, and,

b. a second segment having a proximal end and a distal end, at least a portion of said second segment having a tapered diameter decreasing from said proximal end toward said distal end, least a portion of said second segment being fluid permeable,

said first segment distal end being associated with said second segment proximal end, and,

said area proximate to the junction of said first second distal end and said second section proximal end having a diameter in a natural state substantially equivalent to the diameter of a vessel in which said tube can be inserted.

32. An expandable cannula, comprising:

a tube having at least a portion thereof constructed of a material expandable from a natural state having first diameter to a constricted state having second diameter, said tube comprising,

a. a first segment having a proximal end and a distal end, at least a portion said first segment having a flared diameter increasing from said proximal end to said distal end, and at least a portion of said first segment being fluid impermeable, and,

b. a second segment having a proximal end and a distal end, at least a portion of said second segment having a tapered diameter decreasing from said proximal end toward said distal end, least a portion of said second segment being fluid permeable,

said first segment distal end being associated with said second segment proximal end, and,

said area proximate to the junction of said first second distal end and said second section proximal end having a diameter in a natural state being greater than the diameter of a vessel in which said tube can be inserted.

33. An expandable cannula, comprising:

a. an inner tube, at least a portion of which is fluid impermeable;

b. an outer tube, at least a portion of which is fluid permeable, said inner tube fitting within at least a portion of said outer tube;

c. at least a portion of said outer tube being expandable from a constricted state having a first diameter to a natural state having a second diameter, said outer tube when in said natural state being expandable to substantially the same diameter of the inner wall of a vessel in which said expandable cannula can be inserted.

34. The expandable cannula of claim 33, wherein said distal end of said outer tube terminates in a tip and is fluid permeable.

35. The expandable cannula of claim 33, wherein said inner tube distal end flares from a first diameter to a wider second diameter when in a natural state and when in a vessel.

36. The expandable cannula of claim 35, wherein the permeable portion of said outer tube begins proximate to the tip of said distal end of said inner tube and terminates at the tip of said distal end of said outer tube.

37. A method of stenting a vessel while permitting fluid flow, comprising the steps of:

a. providing an expandable cannula comprising,

i) an inner tube having a proximal end and a distal end, at least a portion of which is fluid impermeable;

ii) an outer tube having a proximal end and a distal end, at least a portion of which is fluid permeable, said inner tube fitting within at least a portion of said outer tube;

iii) at least a portion of said outer tube being expandable from a constricted state having a first diameter to a natural state having a second diameter, said outer tube when in said natural state being expandable to substantially the same diameter of the inner wall of a vessel in which said expandable cannula can be inserted;

b. inserting said expandable cannula through an opening in said vessel;

c. permitting said outer tube to expand from constricted state to a natural state such that at least a substantial portion of said outer tube expanding to have a diameter substantially the same as or greater than the diameter of said vessel inner wall so as to stent at least a portion of said vessel open; and

,

d. permitting fluid to flow from said outer tube distal end toward the direction of said outer tube proximal end and into said distal end of said inner tube.

39. An expandable cannula perfusing a vessel, said vessel having an inner wall with a diameter, said expandable cannula, comprising:

a. an inner tube having

i) an outer wall,

ii) an inner wall,

iii) a proximal section, at least a portion of which is fluid impermeable, and

iv) a distal section, at least a portion of which has a plurality of apertures defined therein for permitting the flow of fluid therethrough, said inner tube having a diameter sufficiently smaller than said vessel so that fluid in said vessel can pass between said vessel inner wall and said inner tube outer wall;

h. an outer tube, at least a portion of which is fluid permeable, said inner tube fitting within at least a portion of said outer tube;

c. at least a portion of said outer tube being expandable from a constricted state having a first diameter to a natural state having a second diameter, said outer tube when in said natural state being expandable to substantially the same or greater than the diameter of the inner wall of said vessel in which said expandable cannula can be inserted.

41. An expandable cannula, comprising a tube expandable from a first diameter to a second diameter and having a proximal end and a distal end, said distal end including all inner expandable tube segment associated therewith.

42. An expandable cannula kit, comprising:

a. a tube expandable from a first diameter to a second diameter and having a proximal end and a distal end, said distal end including an inner expandable tube segment associated therewith; and

,

b. a trocar having a diameter sized to fit within said tube and over said inner expandable tube segment.

43. A method of cannulating a vessel, comprising the steps of:

a. providing a tube expandable from a first diameter to a second diameter and having a proximal end and a distal end, said distal end including an inner expandable tube segment associated therewith; and

.

b. providing a trocar having a proximal end and a distal end;

c. inserting said trocar in said tube so that said trocar distal end contacts and fits over at least a portion of said inner expandable tube;

d. introducing said tube and trocar into a vessel; and

,

e. removing said trocar such that said tube radially expands to said second diameter.

44. An expandable cannula, comprising

a. an outer tube expandable from a first diameter to a second diameter and having a proximal end and a distal end;

and

b. an inner tube expandable from a first diameter to a second diameter and having a proximal end, middle segment and a distal end, said inner tube distal end being associated with said outer tube distal end and said inner tube proximal end extending beyond said outer tube proximal end, said inner tube middle segment and distal end being disposed within said outer tube.

45. An expandable cannula kit, comprising

a. an outer tube expandable from a first diameter to a second diameter and having a proximal end and a distal end;

b. an inner tube expandable from a first diameter to a second diameter and having a proximal end, middle segment and a distal end, said inner tube distal end being associated with said outer tube distal end and said inner tube proximal end extending beyond said outer tube proximal end, said inner tube middle segment and distal end being disposed within said outer tube; and

,

c. a trocar having a diameter sized to fit within said outer tube and over said inner tube.

46. An expandable cannula, comprising:

a. a tube expandable from a first diameter to a second diameter and having a proximal end and a distal end;

b. a deployment trocar having a proximal end, a distal end and a middle segment, said trocar distal end being attached to said tube distal end and said trocar middle portion being removably associated at at least one point with said tube proximal end, such that when said trocar is pulled from distal to proximal end said tube distal end can move toward said trocar proximal end.

47. An expandable cannula, comprising:

a. a tube having at least a portion thereof being fluid impermeable, said tube expandable from a first diameter to a second diameter and having a proximal end and a distal end, said distal end being closed but at least partial permeable;

b. a deployment trocar having a proximal end, a distal end and a middle segment, said trocar distal end being attached to said tube distal end, said trocar being, generally centered axially within said tube, such that when said trocar is pulled from distal to proximal end said tube distal end can move toward said trocar proximal end.

48. An expandable blood vessel access catheter kit, comprising:

a. a needle;

b. an actuator comprising an elongated member; and

,

c. a catheter comprising a tube having at least a portion of its length constructed of a material capable of expanding from a first diameter to a second diameter, said tube having a proximal end and a distal end.