CATHETER APPARATUS AND METHODS FOR TREATING VASCULATURES

• US 20150126967A1
• Filed: 01/14/2015
• Published: 05/07/2015
• Est. Priority Date: 06/26/2007
• Status: Active Grant

• Current Assignee: Roxwood Medical, Inc. (Boston Scientific Corporation)
• Original Assignee: Roxwood Medical, Inc. (Boston Scientific Corporation)
• Inventors: Taber, Mark
• Granted Patent: US 10,471,234 B2
• Time in Patent Office: Days
• US Class Current: 604/510
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61M 2025/0046 Coatings for improving slidability
• CPC Class Codes: A61M 2025/0293 Catheter, guide wire or the like with means for holding, centering, anchoring or frictionally engaging the device within an artificial lumen, e.g. tube natural lumen, e.g. vessels A61M25/04
• CPC Class Codes: A61M 2025/0681 Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube
• CPC Class Codes: A61M 2025/1045 for treating bifurcations, e.g. balloons in y-configuration, separate balloons or special features of the catheter for treating bifurcations
• CPC Class Codes: A61M 2025/109 having balloons for removing solid matters, e.g. by grasping or scraping plaque, thrombus or other matters that obstruct the flow
• CPC Class Codes: A61M 25/0026 Multi-lumen catheters with stationary elements catheter assemblies comprising a catheter in combination with a guide tube, sheath or sleeve A61M2025/0681; catheters comprising telescoping coaxial elements A61M2025/0175
• CPC Class Codes: A61M 25/0068 Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
• CPC Class Codes: A61M 25/0071 Multiple separate lumens multiple separate lumens throughout the catheter A61M25/0026
• CPC Class Codes: A61M 25/0074 Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
• CPC Class Codes: A61M 25/008 Strength or flexibility characteristics of the catheter tip
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool
• CPC Class Codes: A61M 25/01 Introducing, guiding, advancing, emplacing or holding catheters A61M25/10 takes precedence
• CPC Class Codes: A61M 25/02 Holding devices, e.g. on the body
• CPC Class Codes: A61M 25/04 in the body, e.g. expansible A61M25/10, A61M16/0488 take precedence
• CPC Class Codes: A61M 25/09041 Mechanisms for insertion of guide wires
• CPC Class Codes: A61M 25/1002 characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 25/1011 Multiple balloon catheters

Abstract

A catheter apparatus may have a flexible shaft, guidewire lumens passing through the shaft, and a positioning device for positioning the guidewires relative to an external lumen. The positioning device may be an expansible scaffold covered with a retractable sheath. The positioning device may also be one or more balloons that are inflated through an inflation port in the shaft. The catheter apparatus may be operated by inserting a guide catheter into a vasculature with a chronic total occlusion, inserting the catheter apparatus into the guide catheter, and advancing the guidewires through the guidewire lumens and into contact with a chronic total occlusion. The positioning device may be activated before and/or between attempts to pass the guidewires through the chronic total occlusion to interrogate various parts of the chronic total occlusion.

Claims

1. A catheter apparatus comprising:

a flexible shaft,

guidewire lumens passing longitudinally through the shaft, and

a positioning means for positioning distal ends of the guidewire lumens relative to an inner wall of an external lumen.

2. The apparatus of claim 1, further comprising a retractable sheath surrounding the guidewire lumens.

3. The apparatus of claim 1, wherein the positioning means is an expansible scaffold.

4. The apparatus of claim 3, wherein the guidewire lumens are coupled to the expansible scaffold.

5. The apparatus of claim 1, wherein the positioning means is one or more sponges.

6. The apparatus of claim 5, wherein the guidewire lumens are embedded in the one or more sponges.

7. The apparatus of claim 1, wherein the positioning means is a shape-memory means integrated with the guidewire lumens.

8. The apparatus of claim 1, wherein the positioning means is a deflectable tip.

9. The apparatus of claim 1, wherein the positioning means is one or more balloons.

10. The apparatus of claim 9, wherein the one or more balloons are inflated through an inflation port running longitudinally in the shaft.

11. The apparatus of claim 9, wherein the one or more balloons is a balloon with a substantially planar distal surface.

12. The apparatus of claim 11, wherein the guidewire lumens are extruded through the distal surface of the balloon.

13. The apparatus of claim 9, wherein the one or more balloons surround distal ends of the guidewire lumens.

14. The apparatus of claim 1, wherein the positioning means is a rotatable core within the shaft.

15. The apparatus of claim 1, wherein the guidewire lumens are adapted to be positioned eccentrically relative to an inner wall of an external lumen.

16. A method of operating a catheter apparatus comprising:

providing a catheter apparatus comprising;

a flexible shaft,

guidewire lumens passing longitudinally through the shaft, and

a positioning means,

inserting a guide catheter into a vasculature with a chronic total occlusion,

inserting the catheter apparatus into the guide catheter,

activating the positioning means for positioning distal ends of the guidewire lumens relative to the chronic total occlusion, and

advancing guidewires through the guidewire lumens and into contact with the chronic total occlusion.

17. The method of claim 16, further comprising withdrawing the catheter apparatus from the vasculature and not withdrawing the guidewires.

18. The method of claim 16, further comprising withdrawing the guidewires from contact with the chronic total occlusion and advancing the guidewires through the guidewire lumens into contact with the chronic total occlusion repeatedly at different locations until a suitable site for passing the guidewires through the chronic total occlusion is found.

19. The method of claim 18, further comprising activating the positioning means before each advancing the one or more guidewires through the one or more guidewire lumens into contact with the chronic total occlusion.

20. The method of claim 16, wherein the positioning means is an expansible distal end.

21. The method of claim 16, wherein the positioning means is a deflectable tip on the one or more guidewires.

22. The method of claim 16, wherein the positioning means is a rotatable core within the shaft.

23. The method of claim 16, wherein the positioning means is adapted to position the distal ends of the guidewire lumens eccentrically relative to the chronic total occlusion.