Occlusion Bypassing Apparatus With a Re-Entry Needle and a Stabilization Tube

• US 20170079671A1
• Filed: 09/22/2015
• Published: 03/23/2017
• Est. Priority Date: 09/22/2015
• Status: Active Grant

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Inventors: Morero, Massimo, Vimercati, Claudia
• Granted Patent: US 10,172,632 B2
• Time in Patent Office: Days
• 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 2017/22001 Angioplasty, e.g. PCTA
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61B 2017/22065 Functions of balloons
• CPC Class Codes: A61B 2017/22069 Immobilising; Stabilising
• CPC Class Codes: A61B 2017/22095 accessing a blood vessel true lumen from the sub-intimal space
• CPC Class Codes: A61M 2025/0004 having two or more concentrically arranged tubes for forming a concentric catheter system
• CPC Class Codes: A61M 2025/0095 being one or more needles protruding from the distal tip and which are not used for injection nor for electro-stimulation, e.g. for fixation purposes
• CPC Class Codes: A61M 2025/0197 for creating an artificial passage within the body, e.g. in order to go around occlusions
• CPC Class Codes: A61M 25/0043 characterised by structural features
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool
• CPC Class Codes: A61M 25/0097 characterised by the hub connectors A61M39/10
• CPC Class Codes: A61M 25/0194 Tunnelling catheters
• CPC Class Codes: A61M 25/104 used for angioplasty

Abstract

An occlusion bypassing apparatus for re-entering the true lumen of a vessel after subintimally bypassing an occlusion in a vessel. The apparatus includes an outer shaft component having a needle lumen there-through. A proximal end of the outer shaft component is fixed within a handle of the apparatus at a first attachment point. A stabilization tube of the apparatus is disposed within the needle lumen. A proximal end of the stabilization tube is fixed within the handle at a second attachment point that is spaced apart from the first attachment point and an elongated body and a distal end of the stabilization tube are not attached to the outer shaft component. A needle component of the apparatus is configured to be slidably disposed within the stabilization tube and removable therefrom, and the stabilization tube minimizes resistive forces exerted onto the needle component by the outer shaft component.

Claims

1. An apparatus for bypassing an occlusion in a blood vessel comprising:

a handle;

an outer shaft component having a side port proximal to a distal end thereof, the outer shaft component including a needle lumen there-through that includes a curved distal portion that bends from a longitudinal axis of the apparatus and terminates at the side port of the outer shaft component, wherein a proximal end of the outer shaft component is fixed within the handle at a first attachment point;

a stabilization tube having an elongated body extending between a proximal end and a distal end thereof, the elongated body being disposed within the needle lumen of the outer shaft component, wherein the proximal end of the stabilization tube is fixed within the handle at a second attachment point that is spaced apart from the first attachment point and the elongated body and distal end of the stabilization tube are not attached to the outer shaft component; and

a needle component configured to be slidably disposed within the stabilization tube and removable therefrom, wherein the stabilization tube minimizes resistive forces exerted onto the needle component by the outer shaft component.

2. The apparatus of claim 1, wherein the distal end of the stabilization tube is proximal to a proximal end of a needle housing disposed within the needle lumen of the outer shaft component.

3. The apparatus of claim 2, wherein the needle housing includes a curved distal portion that defines the curved distal portion of the needle lumen and a transition proximal portion that has a variable flexibility along its length that decreases in a distal direction.

4. The apparatus of claim 3, wherein the needle component has a curved distal end with the same curvature as the curved distal portion of the needle lumen of the outer shaft component and a distal tip of the needle component is configured to penetrate a wall of the vessel.

5. The apparatus of claim 4, wherein in a first configuration of the apparatus the curved distal end of the needle component is held in a straightened form within the needle housing and wherein in a second configuration of the apparatus the curved distal end of the needle component extends from the side port of the outer shaft component and bends from the longitudinal axis of the apparatus.

6. The apparatus of claim 2, wherein the needle housing is formed from a tube of a shape memory material.

7. The apparatus of claim 1, wherein the outer shaft component includes at least one balloon disposed proximal to the distal end thereof and an inflation lumen in fluid communication with the at least one balloon.

8. The apparatus of claim 1, wherein the outer shaft component also includes a guidewire lumen that extends along at least a portion of the outer shaft component and terminates at a distal port at the distal end of the outer shaft component, the guidewire lumen of the outer shaft component being configured to slidingly receive a guidewire there-through.

9. The apparatus of claim 1, wherein the stabilization tube is formed from a polymeric material.

10. An apparatus for bypassing an occlusion in a blood vessel comprising:

a handle;

an outer shaft component having a side port proximal to a distal end thereof and a distal port at the distal end thereof, the outer shaft component including a needle lumen there-through that includes a curved distal portion that bends from a longitudinal axis of the apparatus and terminates at the side port of the outer shaft component, an inflation lumen there-through for receiving an inflation fluid, and a guidewire lumen that extends along at least a portion of the outer shaft component and terminates at the distal port at the distal end of the outer shaft component, wherein a proximal end of the outer shaft component is fixed within the handle at a first attachment point;

at least one balloon disposed on the outer shaft component proximal to the distal end thereof, wherein the balloon is in fluid communication with the inflation lumen of the outer shaft component;

a stabilization tube having an elongated body extending between a proximal end and a distal end thereof, the elongated body being disposed within the needle lumen of the outer shaft component, wherein the proximal end of the stabilization tube is fixed within the handle at a second attachment point that is spaced apart from the first attachment point and the elongated body and distal end of the stabilization tube are not attached to the outer shaft component; and

a needle component configured to be slidably disposed within the stabilization tube and removable therefrom, wherein the stabilization tube minimizes resistive forces exerted onto the needle component by the outer shaft component.

11. The apparatus of claim 10, wherein the distal end of the stabilization tube is proximal to a proximal end of a needle housing disposed within the needle lumen of the outer shaft component.

12. The apparatus of claim 11, wherein the needle housing includes a curved distal portion that defines the curved distal portion of the needle lumen and a transition proximal portion that has a variable flexibility along its length that decreases in a distal direction.

13. The apparatus of claim 12, wherein the needle component has a curved distal end with the same curvature as the curved distal portion of the needle lumen of the outer shaft component and a distal tip of the needle component is configured to penetrate a wall of the vessel.

14. The apparatus of claim 13, wherein in a first configuration of the apparatus the curved distal end of the needle component is held in a straightened form within the needle housing and wherein in a second configuration of the apparatus the curved distal end of the needle component extends from the side port of the outer shaft component and bends from the longitudinal axis of the apparatus.

15. The apparatus of claim 11, wherein the needle housing is formed from a tube of a shape memory material and the stabilization tube is a polymeric material.

16. An apparatus for bypassing an occlusion in a blood vessel comprising:

a handle;

an outer shaft component having a side port proximal to a distal end thereof, the outer shaft component including a needle lumen there-through that includes a curved distal portion that bends from a longitudinal axis of the apparatus and terminates at the side port of the outer shaft component, wherein a proximal end of the outer shaft component is fixed within the handle at a first attachment point;

a stabilization tube having an elongated body extending between a proximal end and a distal end thereof, the elongated body being disposed within the needle lumen of the outer shaft component, wherein the proximal end of the stabilization tube is fixed within the handle at a second attachment point that is spaced apart from the first attachment point and the elongated body and distal end of the stabilization tube are not attached to the outer shaft component;

a needle housing disposed within the needle lumen of the outer shaft component, the needle housing including a curved distal portion that defines the curved distal portion of the needle lumen and a transition proximal portion that has a variable flexibility along its length that decreases in a distal direction, wherein the distal end of the stabilization tube is proximal to a proximal end of the needle housing; and

a needle component configured to be slidably disposed within the stabilization tube and removable therefrom, the needle component having a curved distal end with the same curvature as the curved distal portion of the needle lumen of the outer shaft component and a distal tip configured to penetrate a wall of the vessel, wherein in a first configuration of the apparatus the curved distal end of the needle component is held in a straightened form within the needle housing and wherein in a second configuration of the apparatus the curved distal end of the needle component extends from the side port of the outer shaft component and bends from the longitudinal axis of the apparatus.

17. The apparatus of claim 16, wherein the needle housing is formed from a tube of a shape memory material.

18. The apparatus of claim 16, wherein the outer shaft component includes at least one balloon disposed proximal to the distal end thereof and an inflation lumen in fluid communication with the at least one balloon.

19. The apparatus of claim 16, wherein the outer shaft component also includes a guidewire lumen that extends along at least a portion of the outer shaft component and terminates at a distal port at the distal end of the outer shaft component, the guidewire lumen of the outer shaft component being configured to slidingly receive a guidewire there-through.

20. The apparatus of claim 16, wherein the stabilization tube is formed from a polymeric material.