Guide wire following tunneling catheter system and method for transluminal arterial atherectomy
First Claim
1. A guide wire following tunneling catheter system for percutaneous transluminal atherectomy, comprising:
- a guide wire with distal and proximal ends and adapted to be advanced within a patient'"'"'s arterial system and to penetrate through an arterial stenosis;
a tunneling catheter with distal and proximal ends having for most of its length a single, thin walled, cylindrical tube with a single inner cylindrical surface extending for most of the length of said tunneling catheter, said inner cylindrical surface being adapted to fit around said guide wire so that said tunneling catheter can be advanced along said guide wire to said arterial stenosis, and wherein a passageway is formed between said inner cylindrical surface of said tunneling catheter and the outer surface of said guide wire, said passageway being in fluid communication between said distal and proximal ends of said tunneling catheter, said distal end of said tunneling catheter including a centering means operably attached to said tunneling catheter for centering the distal end of said tunneling catheter around said guide wire and within the interior passageway of the stenosis, wherein said centering means is a centering cylindrical member whose outer diameter is smaller than that of said tunneling catheter, wherein the distal end of said centering cylindrical member extends out from the distal end of said tunneling catheter and wherein the proximal end of said centering cylindrical member is operably attached to said distal end of said tunneling catheter; and
,a cutting means located near the distal end of said tunneling catheter for cutting through said arterial stenosis as said tunneling catheter is advanced along guide wire.
1 Assignment
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Accused Products
Abstract
An atherectomy catheter is advanced over a guide wire in the anterograde direction to the site of an arterial stenosis. The distal end of the catheter is centered around the guide wire which has been previously advanced through the stenotic lumen. The catheter is then advanced over the guide wire with its sharpened distal end cutting through the stenosis. The atherectomy catheter can also employ rotation or vibration or an electrocautery current to enhance the catheter'"'"'s cutting action. Suction applied at the catheter'"'"'s proximal end is used to enhance the collection of plaque cut from the stenosis at the catheter'"'"'s distal end so that the cut plaque enters a single passageway that lies between the outer surface of the guide wire and the inner surface of the cylindrical catheter.
448 Citations
36 Claims
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1. A guide wire following tunneling catheter system for percutaneous transluminal atherectomy, comprising:
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a guide wire with distal and proximal ends and adapted to be advanced within a patient'"'"'s arterial system and to penetrate through an arterial stenosis; a tunneling catheter with distal and proximal ends having for most of its length a single, thin walled, cylindrical tube with a single inner cylindrical surface extending for most of the length of said tunneling catheter, said inner cylindrical surface being adapted to fit around said guide wire so that said tunneling catheter can be advanced along said guide wire to said arterial stenosis, and wherein a passageway is formed between said inner cylindrical surface of said tunneling catheter and the outer surface of said guide wire, said passageway being in fluid communication between said distal and proximal ends of said tunneling catheter, said distal end of said tunneling catheter including a centering means operably attached to said tunneling catheter for centering the distal end of said tunneling catheter around said guide wire and within the interior passageway of the stenosis, wherein said centering means is a centering cylindrical member whose outer diameter is smaller than that of said tunneling catheter, wherein the distal end of said centering cylindrical member extends out from the distal end of said tunneling catheter and wherein the proximal end of said centering cylindrical member is operably attached to said distal end of said tunneling catheter; and
,a cutting means located near the distal end of said tunneling catheter for cutting through said arterial stenosis as said tunneling catheter is advanced along guide wire. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A guide wire following catheter system for percutaneous transluminal atherectomy, comprising:
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a guide wire with distal and proximal ends, and adapted to be advanced within a patient'"'"'s arterial system and to penetrate through an arterial stenosis, said guide wire being essentially flexible throughout its length that lies within the stenotic artery and being free of any substantial protuberance at its said distal end; and a tunneling catheter with distal and proximal ends and having for most of its length a single, thin wall tube having an outer cylindrical surface and an inner cylindrical surface, said inner cylindrical surface forming an interior lumen and being adapted to fit around said guide wire so that said tunneling catheter can be advanced along said guide wire to said arterial stenosis; and
,a cutting means located at the distal portion of said tunneling catheter for cutting through said arterial stenosis as said tunneling catheter is advanced along said guide wire, said cutting means having at least one cutting edge and having at least one opening into which the cut plaque enters as said cutting means is advanced through the stenotic plaque, and wherein none of said cutting edges extends outward from said outer cylindrical surface of said tunneling catheter and wherein said cutting means is precluded from cutting through said guide wire during rotation of said tunneling catheter as a result of said inner cylindrical surface of said tunneling catheter being a smooth cylindrical surface and being free of a cutting edge which could cut through said guide wire and wherein the inner diameter of said distal end of said tunneling catheter is only slightly larger than the outside diameter of said guide wire so that said distal end of said tunneling catheter is substantially centered about said guide wire; and
wherein said tunneling catheter has a passageway formed between said inner cylindrical surface of said tunneling catheter and the outer surface of said guide wire, said passageway being in fluid communication between said distal and proximal ends of said tunneling catheter and being a means for collecting and removing cut plaque as said cutting means is advanced over said guide wire so as to cut the stenotic plaque. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A guide wire following tunneling catheter system for percutaneous transluminal atherectomy, comprising:
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a guide wire with distal and proximal ends, and adapted to be advanced within a patient'"'"'s arterial system and to penetrate through an arterial stenosis, said guide wire being essentially flexible throughout its length that lies within the stenotic artery; and a tunneling catheter with distal and proximal ends and having for most of its length a single, thin walled tube having an outer cylindrical surface and an inner cylindrical surface, said inner cylindrical surface forming an interior lumen and being adapted to fit around said guide wire so that said tunneling catheter can be advanced along said guide wire to said arterial stenosis; and a cutting means located at the distal portion of said tunneling catheter for cutting through said arterial stenosis as said tunneling catheter is advanced along said guide wire, said cutting means having at least one cutting edge and having at least one opening into which the cut plaque enters as said cutting means is advanced through the stenotic plaque; and
wherein said tunneling catheter has a passageway formed between said inner cylindrical surface of said tunneling catheter and the outer surface of said guide wire, said passageway being in fluid communication between said distal and proximal ends of said tunneling catheter and being a means for collecting and removing the cut plaque as said cutting means is advanced over said guide wire so as to cut the stenotic plaque; and
wherein said tunneling catheter has a radial motion restraining means at its most distal extremity for limiting the radial motion of said cutting means relative to said guide wire, said radial restraining means having a cylindrical hole, the diameter of said hole being substantially smaller than the diameter of said inner cylindrical surface of said tunneling catheter and said hole having a smooth interior cylindrical surface to prevent said cutting means from cutting said guide wire during rotation of said tunneling catheter, and said hole being sized to form a sliding fit over said guide wire so as to center said distal end of said cutting means around said guide wire as said cutting means is advanced through the stenotic plaque. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28)
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29. A percutaneous transluminal atherectomy procedure comprising the steps of:
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advancing a guide wire with distal and proximal ends through a patient'"'"'s arterial system and penetrating through an arterial stenosis, said guide wire being essentially flexible throughout that portion of its length that lies within the stenotic artery and being free of any substantial protuberance at its said distal end; advancing a tunneling catheter with distal and proximal ends over said guide wire, said tunneling catheter having for most of its length a single, thin walled, cylindrical tube having an outer cylindrical surface and an inner cylindrical surface, said inner cylindrical surface forming an interior lumen and being adapted to fit around said guide wire thus forming a passageway between said inner cylindrical surface of said tunneling catheter and the outer surface of said guide wire and having said outer cylindrical surface of said tunneling catheter free of protuberances wherever it lies within the arterial system, said distal end of said tunneling catheter including a centering means operably attached to said tunneling catheter for centering the distal end of said tunneling catheter around said guide wire and within the interior passageway of the stenosis, wherein said centering means is a centering cylindrical member whose outer diameter is substantially smaller than the outer diameter of said tunneling catheter, wherein the distal end of said centering cylindrical member extends out from the distal end of said tunneling catheter and wherein the proximal end of said centering cylindrical member is operably attached to said distal end of said tunneling catheter; advancing a cutting means located at the distal portion of said tunneling catheter through said arterial stenosis as said tunneling catheter is advanced along said guide wire, said cutting means having at least one cutting edge and having at least one opening into which the cut plaque enters as said cutting means is advanced through the stenotic plaque; and
having none of said cutting edges extending outward from said outer cylindrical surface of said tunneling catheter; andcollecting and removing the cut plaque as said cutting means is advanced over said guide wire so as to cut through said arterial stenosis. - View Dependent Claims (30, 31, 32, 33, 34, 35)
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36. A guide wire following tunneling catheter system for percutaneous transluminal atherectomy, comprising:
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a guide wire with distal and proximal ends and adapted to be advanced within a patient'"'"'s arterial system and to penetrate through an arterial stenosis; a tunneling catheter with distal and proximal ends and having for most of its length a single, thin walled, cylindrical tube having an outer cylindrical surface and an inner cylindrical surface, said inner cylindrical surface forming an interior lumen being adapted to fit around said guide wire thus forming a passageway between said inner cylindrical surface and the outer surface of said guide wire and having said outer cylindrical surface of said tunneling catheter free of protuberances wherever it lies within the arterial system, said tunneling catheter being capable of being advanced along said guide wire to said arterial stenosis, said distal end of said tunneling catheter including a centering means operably attached to said tunneling catheter for centering the distal end of said tunneling catheter around said guide wire and within the interior passageway of the stenosis, wherein said centering means is a centering cylindrical member whose outer diameter is substantially smaller than the outer diameter of said tunneling catheter and whose inner diameter is sized to be just slightly larger than the outside diameter of said guide wire so as to move slideably along said guide wire; a cutting means located near the distal end of said tunneling catheter for cutting through said arterial stenosis as said tunneling catheter is advanced along said guide wire; a suction means operably attached to said tunneling catheter at its proximal end which is adapted to extend external to said patient; and
,a rotating means operably attached to said tunneling catheter at its proximal end which is adapted to extend external to the patient for rotating said tunneling catheter while simultaneously applying suction and advancing said tunneling catheter over said guide wire and through said arterial stenosis.
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Specification