Catheter system for vascular re-entry from a sub-intimal space

• US 20060094930A1
• Filed: 12/13/2005
• Published: 05/04/2006
• Est. Priority Date: 12/05/2000
• Status: Abandoned Application

• Current Assignee: Cordis Corporation (Cardinal Health, Inc.)
• Original Assignee: Cordis Corporation (Cardinal Health, Inc.)
• Inventors: Clark, Benjamin J., Kupiecki, David J., Emery, Jeffrey L., Seybold, Brent D., Sparks, Kurt D., Salinas, Sergio, Pinson, C. Danielle, Madsen, Allen W., Keleher, Michael D., Selmon, Matthew R.
• Application Number:
  US11/304,662
• Publication Number:
  US 20060094930A1
• Time in Patent Office: Days
• US Class Current: 600/104
• 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 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61B 2017/22095 accessing a blood vessel true lumen from the sub-intimal space
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation

Abstract

A catheter system and corresponding methods are provided for accessing a blood vessel true lumen from a sub-intimal plane of the vessel. The catheter system includes visualization elements for determining the orientation of the true lumen with respect to the sub-intimal plane at an identified entry site from a position in the sub-intimal plane. The entry site is distal to a chronic total occlusion (CTO). The catheter system also includes a system for physically securing tissue of the sub-intimal plane at the entry site to the catheter system. The attaching system reduces or eliminates catheter float within the sub-intimal space. The catheter system further includes re-entry devices to establish and maintain a path from the sub-intimal plane back into the vessel true lumen.

Claims

1. A method for accessing a true lumen of a blood vessel from a sub-intimal plane of the vessel, comprising:

identifying a site to enter the true lumen from a position in the sub-intimal plane distal to a chronic total occlusion (CTO);

determining an orientation of the true lumen with respect to the sub-intimal plane at the selected site;

physically securing tissue of the sub-intimal plane at the selected site; and

establishing a path from the sub-intimal plane into the vessel true lumen.

2. A method for crossing a chronic total occlusion (CTO) in vasculature, comprising:

forming a track from a true lumen into a sub-intimal space of a blood vessel, wherein the track extends from a position proximal to the CTO in the true lumen to a position distal to the CTO in the sub-intimal space;

determining an orientation of the true lumen with respect to the sub-intimal plane at an identified re-entry site from a position in the sub-intimal plane, wherein the re-entry site is distal to the CTO;

physically securing tissue of the sub-intimal plane at the selected site; and

selectively forming a path from the sub-intimal plane back into the true lumen.

3. A catheter system for accessing a true lumen of a blood vessel from a sub-intimal plane of the vessel, comprising:

at least one visualization element for determining an orientation of the true lumen with respect to the sub-intimal plane at an identified entry site from a position in the sub-intimal plane distal to a chronic total occlusion (CTO);

at least one system for physically securing tissue of the sub-intimal plane at the entry site to the catheter system; and

at least one re-entry device for establishing and maintaining a path from the sub-intimal plane into the vessel true lumen.

4. A catheter system for crossing chronic total occlusions (CTOs) in vasculature, comprising:

means for forming a track from a true lumen into a sub-intimal space of a blood vessel, wherein the track extends from a position proximal to the CTO in the true lumen to a position distal to the CTO in the sub-intimal space;

means for determining an orientation of the true lumen with respect to the sub-intimal plane at an identified re-entry site, wherein the re-entry site is distal to the CTO;

means for physically securing tissue of the sub-intimal plane at the selected site; and

means for selectively forming a path from the sub-intimal plane back into the true lumen.