Device for Crossing Occlusions and Method of Use Thereof

• US 20100049137A1
• Filed: 08/20/2008
• Published: 02/25/2010
• Est. Priority Date: 08/20/2008
• Status: Abandoned Application

• Current Assignee: Cook Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Incorporated (Cook Group Incorporated)
• Inventors: Fischer, Frank J. JR.
• Application Number:
  US12/194,584
• Publication Number:
  US 20100049137A1
• Time in Patent Office: Days
• US Class Current: 604/164.130
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• 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 2017/00469 for insertion of instruments, e.g. guide wire, optical fibre
• CPC Class Codes: A61B 2017/22044 with a pointed tip
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61M 25/0172 Exchanging a guidewire while keeping the catheter in place

Abstract

The present invention generally relates to a medical device and specifically to a catheter and wire guide for crossing an occlusion in a body lumen and a method of use thereof. In one embodiment, the catheter includes an incremental positioning mechanism positioned distally of the catheter body. In another embodiment, a lumen containing the wire guide extends through the incremental positioning mechanism and the catheter body. The incremental positioning mechanism allows for adjustment of the axial position of the wire guide relative to the distal end of the catheter body.

Claims

1. A method of treating a occlusion within a body lumen, comprising:

inserting a device into the body lumen, wherein the device comprises;

a catheter body and an incremental positioning mechanism positioned proximally of the catheter body, wherein a lumen extends from the proximal end of the incremental positioning mechanism to a distal end of the catheter body, and

a wire guide positioned within the lumen and extending from the proximal end of the catheter body to the distal end of the incremental positioning mechanism, wherein the incremental positioning mechanism allows for adjustment of the axial position of the wire guide relative to the distal end of the catheter body,

adjusting of the axial position of the wire guide relative to the distal end of the catheter body to position a distal end of the wire guide beyond the distal end of the catheter body,

positioning the distal end of the wire guide near the occlusion within the body vessel,

advancing the device distally to contact the distal end of the wire guide with the occlusion,

moving the distal end of the wire guide proximally with the incremental positioning mechanism to position the distal end of the wire guide closer to the distal end of the catheter body, and

advancing the device distally, whereby the distal end of the wire guide crosses the occlusion.

2. The method of claim 1, wherein the incremental positioning mechanism comprises:

a first handle element attached proximally of the catheter body and having a threaded proximal portion,

a second handle element positioned attached proximally to the first handle element and having a threaded distal portion, wherein the second handle element further comprises a locking mechanism allowing the axial position of the wire guide to be fixed within the lumen of the second handle element,

wherein the threaded proximal portion of the first handle element engages the threaded distal portion of the second handle element.

3. The method of claim 2, wherein moving the distal end of the wire guide proximally with the incremental positioning mechanism comprises:

fixing the axial position of the wire guide with respect to the second handle element by engaging the locking mechanism, and

rotating the second handle element with respect to the first handle element, whereby the second handle element moves in a proximal direction with respect to the first handle element.

4. The method of claim 1, further comprising observing the position of the distal end of the wire guide, wherein the wire guide further comprises a radio opaque marker positioned near the distal end to allow visualization of the position of the distal end.

5. The method of claim 1, wherein moving the distal end of the wire guide proximally with the incremental positioning mechanism to position the distal end of the wire guide closer to the distal end of the catheter results in an increase in pushability of that portion of the wire guide extending distally of the distal end of the catheter.

6. The method of claim 1, wherein moving the distal end of the wire guide proximally with the incremental positioning mechanism is performed at least two times during the advancement of the distal end of the wire guide across the occlusion.

7. The method of claim 2, wherein the threaded proximal portion of the first handle element comprises a threaded outside surface of the first handle element and the threaded distal portion of the second handle element comprises a surface of the lumen extending through the second handle element.

8. The method of claim 1, wherein the body lumen is a vascular vessel.

9. The method of claim 8, wherein the occlusion is calcified.

10. A device for treating an occlusion within a body vessel, the device comprising:

a catheter body,

a first handle element attached proximally of the catheter body, the first handle element having a threaded proximal portion, and

a second handle element attached proximally to the first handler element, the second handle element having a threaded distal portion, wherein the threaded proximal portion of the first handle element engages the threaded distal portion of the second handle element,

wherein a lumen extends through the catheter body from a distal end of the catheter body and through the first handle element and the second handle element.

11. The device of claim 10, the second handle element further comprising a locking mechanism allowing the axial position of a wire guide to be fixed within the lumen extending through the second handle element.

12. The device of claim 10, wherein the threaded proximal portion of the first handle element comprises a threaded outside surface of the first handle element and the threaded distal portion of the second handle element comprises a surface of the lumen extending through the second handle element.

13. The device of claim 10, further comprising graduated markings allowing observation of the relative axial positions of the first handle element and the second handle element.

14. A device for treating an occlusion within a body vessel, the device comprising:

a catheter body,

a first handle element attached proximally of the catheter body, the first handle element having a threaded proximal portion,

a second handle element attached proximally to the first handler element, the second handle element having a threaded distal portion, wherein the threaded proximal portion of the first handle element engages the threaded distal portion of the second handle element, and wherein a lumen extends through the catheter body from a distal end of the catheter body and through the first handle element and the second handle element, and

a wire guide extending within the lumen from the distal end of the catheter body through the first handle element and the second handle element to a proximal end of the second handle element.

15. The device of claim 14, further comprising graduated markings allowing observation of the relative axial positions of the first handle element and the second handle element.

16. The device of claim 14, the second handle element further comprising a locking mechanism allowing the axial position of the wire guide to be fixed within the lumen extending through the second handle element.

17. The device of claim 14, wherein the threaded proximal portion of the first handle element comprises a threaded outside surface of the first handle element and the threaded distal portion of the second handle element comprises a surface of the lumen extending through the second handle element.

18. The device of claim 17, wherein the threaded proximal portion of the first handle element further comprises graduated markings indicating the relative axial positions of the first handle element and the second handle element.

19. The device of claim 14, wherein rotation of the second handle element relative to the first handle element allows for adjustment of the axial position of a distal end of the wire guide relative to the distal end of the catheter body.

20. The device of claim 16, wherein the locking mechanism comprises a friction lock engaging the wire guide within the lumen of the second handle element.