Low Profile Catheters and Methods for Treatment of Chronic Total Occlusions and Other Disorders
First Claim
1. A catheter device comprising:
- an elongate catheter body having a lumen with a distal end opening and a side opening;
a tubular member having a lumen and an open distal end, said tubular member being moveable back and forth between a) a retracted position where the open distal end of the tubular member is within the lumen of the catheter body and b) an extended position wherein a distal portion of the tubular member is advanced out of the side opening of the catheter body.
1 Assignment
0 Petitions
Accused Products
Abstract
A catheter having a lumen with a distal end opening and a side opening. A tubular member (e.g., needle or other cannula) is moveable between a retracted position where it is within the catheter lumen proximal to the side opening and an extended position where it extends out of the side opening. When the tubular member is in its retracted position its lumen is substantially coaxial with the catheter lumen such that a guidewire may extend through the lumen of the tubular member and out of the distal end opening of the catheter. The guidewire may then be retracted into the lumen of the tubular member and the tubular member may ten be advanced out of the side opening. Thereafter, the same guidewire (or a different guidewire) may be advanced out of the distal end of the tubular member. Also disclosed are methods for using such catheter to redirect a guidewire or other member and for bypassing an obstruction in a blood vessel such as a chronic total occlusion (CTO) of an artery.
112 Citations
28 Claims
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1. A catheter device comprising:
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an elongate catheter body having a lumen with a distal end opening and a side opening; a tubular member having a lumen and an open distal end, said tubular member being moveable back and forth between a) a retracted position where the open distal end of the tubular member is within the lumen of the catheter body and b) an extended position wherein a distal portion of the tubular member is advanced out of the side opening of the catheter body. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method for bypassing an obstruction in a blood vessel that has a true lumen and a vessel wall, and wherein the vessel wall has an intima, said method comprising the steps of:
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(A) providing a guidewire that has a proximal end and a distal end; (B) positioning the guidewire such that its distal end is within a subintimal space and its proximal end is outside of the subject'"'"'s body; (C) providing a catheter device that comprises i) an elongate catheter body having a lumen with a distal end opening and a side opening; and ii) a tubular member having a lumen and an open distal end, said tubular member being moveable back and forth between a) a retracted position where the open distal end of the tubular member is within the lumen of the catheter body and b) an extended position wherein a distal portion of the tubular member is advanced out of the side opening of the catheter body; (D) inserting the proximal end of the guidewire into the distal end opening of the catheter body and advancing the catheter over the guidewire while the tubular member is in its retracted position, thereby causing the proximal end of the guidewire to pass through the lumen of the tubular member; (E) retracting the guidewire to a position where the distal end of the guidewire is proximal to the distal end of the tubular member; (F) moving the tubular member to its extended position such that the open distal end of the tubular member enters the true lumen of the blood vessel distal to the obstruction; (G) advancing the guidewire out of the open distal end of tubular member and into the true lumen of the blood vessel distal to the obstruction; (H) retracting the tubular member to its retracted position; (I) removing the catheter device, leaving the guidewire in place; and (J) advancing at least one working device over the guidewire and using said at least one working device to modify the subintimal space to create a patent bypass channel through which blood may flow around the obstruction. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 26, 27, 28)
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25. A method for redirecting a guidewire from a first position within the body of a human or animal subject to a second position within the body of the subject, said method comprising the steps of:
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(A) providing a catheter device that comprises iii) an elongate catheter body having a lumen with a distal end opening and a side opening; and iv) a tubular member having a lumen and an open distal end, said tubular member being moveable back and forth between a) a retracted position where the open distal end of the tubular member is within the lumen of the catheter body and b) an extended position wherein a distal portion of the tubular member is advanced out of the side opening of the catheter body; (B) inserting the proximal end of the guidewire into the distal end opening of the catheter body and advancing the catheter over the guidewire while the tubular member is in its retracted position, thereby causing the proximal end of the guidewire to pass through the lumen of the tubular member; (C) retracting the guidewire to a position where the distal end of the guidewire is proximal to the distal end of the tubular member; (D) moving the tubular member to its extended position such that the open distal end of the tubular member is at or in substantial alignment with the second location; (E) advancing the guidewire out of the open distal end of tubular member and into the second location.
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Specification