Telescoping guide catheter system
First Claim
1. A method of performing recanalization of a stenosed coronary artery of interest comprising the steps of:
- introducing a first elongated, hollow, flexible, plastic, relatively large diameter, reinforced-wall torque-transmitting guide catheter having a proximal end and a distal end at a predetermined location in the vascular system and advancing the first guide catheter until the distal end thereof reaches the coronary ostia;
inserting a second, elongated, hollow, flexible, plastic, relatively smaller diameter unreinforced guide catheter having a tubular core a polytetrafluoroethylene polymeric material sheathed in an outer cylindrical coating of a second polymeric material and a distal tip member of a material of relatively low durometer relative to the other materials of the second guide catheter affixed to the distal end of the second guide catheter, wherein the tip member is further characterized by a distal end shaped to encounter and minimize damage to the endothelial lining of coronary artery of interest by the advancing second guide catheter;
advancing the second guide catheter until the distal end of the second catheter passes beyond the distal end of the first guide catheter and into the coronary artery of interest adjacent the stenosis to be canalized;
slidably introducing a working catheter having a proximal end and a distal end into the hollow tubular core of the second guide catheter and advancing the working catheter therealong until the distal end of the working catheter passes through and extends beyond the distal end of the second guide catheter and into the stenosed area of the coronary artery of interest; and
using the working catheter to accomplish recanalization.
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Accused Products
Abstract
The guide catheter system for use in the treatment of coronary artery disease includes a first single-lumen catheter of a relatively large internal diameter to pass a second guide catheter therethrough. The first guide catheter comprises an elongated flexible tube having a stainless steel braid embedded in the wall thereof for imparting desired torqueability characteristics to it. The first guide catheter is intended to be inserted at an appropriate point in the vascular system and then advanced until its distal end reaches the coronary ostium. The second guide catheter is fabricated by extruding a plastic, such as polyurethane thermoplastic resin over a tubular Teflon® core and because it is to be used within the lumen of the first catheter, it need not include a braided structure within its walls to prevent it from kinking. This allows the second catheter to be sufficiently slim to permit it to be advanced into a coronary artery while allowing fluids to be perfused between the outer wall of the second guide and the inner wall of the first guide catheter while still providing a sufficiently large inner lumen to pass a working catheter, e.g., an angioplasty or atherectomy catheter. An atraumatic tip is attached to the distal end of the second guide catheter.
306 Citations
19 Claims
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1. A method of performing recanalization of a stenosed coronary artery of interest comprising the steps of:
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introducing a first elongated, hollow, flexible, plastic, relatively large diameter, reinforced-wall torque-transmitting guide catheter having a proximal end and a distal end at a predetermined location in the vascular system and advancing the first guide catheter until the distal end thereof reaches the coronary ostia; inserting a second, elongated, hollow, flexible, plastic, relatively smaller diameter unreinforced guide catheter having a tubular core a polytetrafluoroethylene polymeric material sheathed in an outer cylindrical coating of a second polymeric material and a distal tip member of a material of relatively low durometer relative to the other materials of the second guide catheter affixed to the distal end of the second guide catheter, wherein the tip member is further characterized by a distal end shaped to encounter and minimize damage to the endothelial lining of coronary artery of interest by the advancing second guide catheter; advancing the second guide catheter until the distal end of the second catheter passes beyond the distal end of the first guide catheter and into the coronary artery of interest adjacent the stenosis to be canalized; slidably introducing a working catheter having a proximal end and a distal end into the hollow tubular core of the second guide catheter and advancing the working catheter therealong until the distal end of the working catheter passes through and extends beyond the distal end of the second guide catheter and into the stenosed area of the coronary artery of interest; and using the working catheter to accomplish recanalization. - View Dependent Claims (2)
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3. A telescoped dual guide catheter system for use in performing artery transluminal angioplasty or atherectomy procedures in a coronary artery of interest having the ability to navigate coronary arteries comprising:
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an outer guide catheter comprising an elongated, flexible plastic tuber having a proximal end and a distal end, having an outside diameter small enough to pass through the arterial vascular system from an introducer site to the coronary ostia, the outer guide catheter further describing an internal lumen of a relatively large size extending from the proximal end to the distal end and having a tube wall characterized by reinforcing means internal to the tube wall for providing the necessary torque transmission required to enable routing of the outer guide catheter through the arterial vascular system; and an inner elongated guide catheter adapted to be telescopingly received within and passed through the lumen of the outer guide catheter and including flexible tubular core of a lubricous material constructed without reinforcing means surrounded by an outer coating of a polymeric material and having a proximal end, a distal end and an outside diameter sufficiently small to fit with a predetermined clearance within the lumen of the outer guide catheter; wherein the distal end of the unreinforced inner guide catheter is adapted to pass beyond the distal end of the outer guide catheter and navigate vascular areas beyond the distal end of the outer guide catheter through which the outer guide catheter itself cannot be safely passed including the area beyond the coronary ostia into a coronary artery of interest to be recanalized; and wherein the lumen of the tubular core of the inner guide catheter is of sufficient diameter to pass a working catheter therethrough. - View Dependent Claims (4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. A telescoped dual guide catheter system for use in performing artery transluminal angioplasty or atherectomy procedures in a coronary artery of interest having the ability to navigate coronary arteries comprising:
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an outer guide catheter comprising an elongated, flexible plastic tube having a proximal end and a distal end, having an outside diameter small enough to pass through the arterial vascular system from an introducer site to the coronary ostia, the outer guide catheter further describing an internal lumen of a relatively large size extending from the proximal end to the distal end and having a tube wall characterized by a braided metal reinforcing layer internal to the tube wall for providing the necessary torque transmission required to enable routing of the first guide catheter through the arterial vascular system; and an inner elongated guide catheter adapted to be telescopingly accommodated by, received within, and passed through the lumen of the outer guide catheter and including an unreinforced flexible tubular core of a lubricous polytetrafluoroethylene surrounded by an outer coating of a polyurethane blend material and having a proximal end, a distal end and an outside diameter sufficiently small to fit with a predetermined clearance within the lumen of the outer guide catheter; wherein the distal end of the unreinforced inner guide catheter is adapted to pass beyond the distal end of the outer guide catheter and navigate vast vascular areas beyond the distal end of the outer guide catheter through which the outer guide catheter itself cannot be safely passed including the area beyond the coronary ostia into a coronary artery of interest to be recanalized; wherein the lumen of the tubular core of the inner guide catheter is of sufficient diameter to pass a working catheter therethrough; a tubular tip member of a polymer material of relatively low durometer polyurethane affixed to the distal end of the inner guide catheter, the tip member being further characterized by a rounded distal end to encounter and minimize damage to the endothelial lining of the coronary artery of interest.
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Specification