Embolus supply system and method

• US 5,133,731 A
• Filed: 11/09/1990
• Issued: 07/28/1992
• Est. Priority Date: 11/09/1990
• Status: Expired due to Fees

• Current Assignee: Catheter Research Incorporated
• Original Assignee: Catheter Research Incorporated
• Inventors: Butler, James R., Miller, Arnold, McCoy, William C.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US07/612,107
• Time in Patent Office: 627 Days
• Field of Search: 606/200, 606/195, 606/198, 606/151, 606/108, 606/191, 604/104, 128/831, 128/843
• US Class Current: 606/191
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/1214 Coils or wires
• CPC Class Codes: A61B 2017/1205 Introduction devices

Abstract

An apparatus and method is provided for dispensing coil emboli one at a time in a controlled and reliable manner during surgery to embolize several blood vessels or the like in a body. The apparatus includes a magazine that is movable within a dispenser housing to position each of the embolus cartridges contained in the magazine one at a time at a dispensing station on command. A stream of pressurized fluid is injected or a guide wire is inserted into the embolus cartridge held in the dispensing station to dislodge an embolus contained therein and discharge it into an embolus-delivery catheter coupled to the dispenser housing. Afterwards, the magazine is moved within the dispenser housing to remove the just-emptied embolus cartridge from the dispensing station and load a fresh embolus cartridge into the dispensing station.

Claims

1. An apparatus for supplying an embolus to a delivery tube, the apparatus comprising

a magazine containing a plurality of emboli,

means for moving the magazine relative to the delivery tube to place a selected one of the emboli in the magazine in communication with the delivery tube, and

means for discharging said selected one of the emboli from the magazine into the delivery tube.

2. The apparatus of claim 1, wherein the moving means includes means for using a stream of pressurized fluid to advance the magazine in a direction toward the delivery tube.

3. The apparatus of claim 2, wherein the using means includes cylinder means for receiving a stream of pressurized fluid and piston means in the cylinder means for advancing the magazine to couple with the delivery tube in response to input of fluid having a pressure in excess of a predetermined pressure into the cylinder means so that the selected one of the emboli in the magazine can be discharged into the delivery tube.

4. The apparatus of claim 1, wherein the moving means includes means for using a stream of pressurized fluid to advance the magazine incrementally in a predetermined indexed manner relative to the delivery tube so that each embolus in the magazine is moved therewith according to a predetermined sequence to an embolus-discharging position communicating with the delivery tube and the embolus in the embolus-discharging position can be discharged into the delivery tube by the discharging means.

5. The apparatus of claim 4, wherein the moving means includes cylinder means for receiving a stream of pressurized fluid, linkage means for advancing the magazine along a path relative to the delivery tube, and piston means for operating the linkage means to advance the magazine incrementally along its path in response to input of fluid having a pressure in excess of a predetermined pressure into the cylinder means.

6. The apparatus of claim 1, wherein the moving means includes a hollow housing containing the magazine, means for guiding the magazine as it moves within the hollow housing to place each selected one of the emboli in communication with the delivery tube, a linkage coupled to the hollow housing and to the magazine, and means for actuating the linkage to move the magazine within the hollow housing to place sequentially each embolus in the magazine in communication with the delivery tube.

7. The apparatus of claim 6, wherein the hollow housing includes an interior wall, the magazine is formed to include a guide slot, and the guiding means includes at least one guide rail appended to the interior wall and configured to extend into the guide slot of the magazine and define a path along which the magazine is capable of traveling through the hollow housing under the control of the moving means.

8. An apparatus for supplying an embolus to a delivery tube, the apparatus comprising

a magazine containing a plurality of hollow cartridges, each cartridge containing an embolus therein and including outlet means for communicating with the delivery tube,

means for moving the magazine relative to the delivery tube to place a selected one of the cartridges in the magazine in communication with the delivery tube, and

means for discharging the embolus in the selected one of the cartridges from the magazine into the delivery tube, each cartridge further including inlet means for communicating with the discharging means.

9. The apparatus of claim 8, wherein the discharging means includes means for conducting a stream of pressurized fluid at a predetermined velocity into the selected cartridge in the magazine through the inlet means of the selected cartridge to discharge the embolus contained therein from the cartridge into the delivery tube through the outlet means of the selected cartridge.

10. The apparatus of claim 9, wherein the moving means includes means for using said stream of pressurized fluid to advance the magazine in a direction toward the delivery tube to cause the outlet means of the selected cartridge to communicate with the delivery tube so that the stream of pressurized fluid can flow from the selected cartridge into the delivery tube through the outlet means.

11. The apparatus of claim 9, wherein the moving means includes means for using said stream of pressurized fluid to advance the magazine incrementally in a predetermined indexed manner relative to the delivery tube so that each cartridge is moved to an embolus-discharging position communicating with the delivery tube according to a predetermined sequence.

12. The apparatus of claim 8, wherein the magazine is formed to include a series of elongated, open-ended magazine chambers extending therethrough, a cartridge is disposed in each magazine chamber to position its inlet means in a first opening of the magazine chamber and its outlet means in a second opening of the magazine chamber, and the moving means includes means for sequentially coupling each magazine chamber in the series to both of the discharging means and the delivery tube to place the inlet means of a cartridge situated in a selected magazine chamber in communication with the discharging means and the outlet means of the cartridge situated in the selected magazine chamber in communication with the delivery tube.

13. The apparatus of claim 12, wherein the discharging means includes means for conducting a stream of pressurized fluid into the selected magazine chamber after the inlet means of the cartridge in the selected magazine chamber is coupled to the discharging means and the outlet means of the cartridge in the selected magazine chamber is coupled to the delivery tube to discharge the embolus contained in the cartridge in the selected magazine chamber from the cartridge into the delivery tube.

14. An apparatus for supplying an embolus to a delivery tube, the apparatus comprising

a magazine containing a plurality of emboli,

means for moving the magazine relative to the delivery tube to place a selected one of the emboli in the magazine in communication with the delivery tube, and

means for discharging said selected one of the emboli from the magazine into the delivery tube, the moving means including a hollow housing containing the magazine, means for guiding the magazine as it moves within the hollow housing to place each selected one of the emboli in communication with the delivery tube, and means for using a stream of pressurized fluid to move the magazine within the hollow housing to place each embolus in the magazine sequentially in communication with the delivery tube so that each embolus can be discharged into the delivery tube one at a time by the discharging means.

15. The apparatus of claim 14, wherein the guiding means includes at least one rail situated within the hollow housing and means for yieldably biasing the magazine into slidable engagement with the at least one rail.

16. The apparatus of claim 15, wherein the using means includes means for slidably advancing the magazine within the hollow housing in a first direction along the at least one rail, cylinder means for receiving the stream of pressurized fluid therein, and piston means for using pressurized fluid received in the cylinder means to move the advancing means relative to the magazine so that the magazine advances along the at least one rail in the first direction while it is biased against said at least one rail by the biasing means.

17. The apparatus of claim 16, wherein the magazine contains a plurality of hollow cartridges, each hollow cartridge is formed to include inlet means for communicating with the discharging means and outlet means for communicating with the delivery tube, each hollow cartridge contains an embolus, and the discharging means includes means extending through an aperture formed in the piston means for conducting the stream of pressurized fluid received in the cylinder means into a selected hollow cartridge in the magazine through the inlet means of the selected hollow cartridge to discharge the embolus contained therein into the delivery tube through the outlet means of the selected hollow cartridge.

18. The apparatus of claim 15, wherein the using means includes drive means for moving the magazine away from the at least one guide rail against a biasing force provided by the biasing means, cylinder means for receiving the stream of pressurized fluid therein, and piston means for using pressurized fluid received in the cylinder means to move the drive means into engagement with the magazine so that the magazine moves away from the at least one rail.

19. The apparatus of claim 18, wherein the magazine contains a plurality of hollow cartridges, each hollow cartridge is formed to include inlet means for communicating with the discharging means and outlet means for communicating with the delivery tube, each hollow cartridge contains an embolus, and the discharging means includes means extending through apertures formed in the piston means and drive means for conducting the stream of pressurized fluid received in the cylinder means into a selected hollow cartridge in the magazine through the inlet means of the selected hollow cartridge to discharge the embolus contained therein into the delivery tube through the outlet means of the selected hollow cartridge

20. An apparatus for supplying an embolus to a delivery tube, the apparatus comprising

a hollow housing formed to include an inlet and outlet,

a magazine containing a plurality of spaced-apart embolus cartridges arranged in a series, each embolus cartridge being formed to include a passageway extending therethrough and containing an embolus therein,

means for moving the magazine inside the housing to align each embolus cartridge in the series in sequence one at a time in an embolus-discharging position within the housing so that the passageway of the embolus cartridge situated in the embolus-discharging position interconnects the housing inlet and outlet, and

means for discharging the embolus contained in the passageway of the embolus cartridge situated in the embolus-discharging position from the embolus cartridge through the housing outlet so that the embolus is supplied to the delivery tube connected to the housing outlet.

21. The apparatus of claim 20, wherein the moving means includes means for generating a stream of pressurized fluid and means for using the stream of pressurized fluid to move the magazine inside the housing to align each embolus cartridge in the series in sequence one at a time in the embolus-discharging position within the housing

22. The apparatus of claim 20, wherein the discharging means includes means for generating a stream of pressurized fluid and means for conducting the stream of pressurized fluid into the passageway of the embolus cartridge situated in the embolus-discharging position within the housing so that the embolus in the passageway is discharged into the delivery tube connected to the housing outlet along with the stream of pressurized fluid.

23. The apparatus of claim 20, wherein the moving means includes cylinder means for receiving a stream of pressurized fluid and a piston disposed in the cylinder means for movement therein.

24. The apparatus of claim 23, wherein the moving means further includes spring return means for yieldably biasing the piston to a first position in the cylinder means, the piston is configured to move to a second position in the cylinder means upon input of the stream of pressurized fluid into the cylinder means, the magazine is formed to include a serpentine groove, and the piston includes a drive bar extending into the hollow housing and pawl means coupled to the drive bar for riding in the serpentine groove in response to movement of the piston between its first and second position in the cylinder means so that the magazine moves a first incremental distance in a first direction with respect to the hollow housing in response to movement of the piston from its first position to it second position and a second incremental distance in said first direction with respect to the hollow housing in response to movement of the piston from its second position to its first position.

25. The apparatus of claim 23, wherein the piston is formed to include an aperture extending therethrough and the discharging means includes means extending through the aperture formed in the piston means for conducting the stream of pressurized fluid from the cylinder means into the passageway of the embolus cartridge situated in the embolus-discharging position and means for sealingly coupling said passageway to the housing outlet so that the embolus and the stream of pressurized fluid in said passageway are discharged simultaneously from the magazine into the delivery tube.

26. The apparatus of claim 25, wherein the conducting means includes a fluid-conducting conduit coupled to the piston aperture, a valve movable in the conduit between aperture-opening and aperture-closing positions, and means for yieldably biasing the valve to its aperture-closing position to block flow of pressurized fluid from the cylinder means into the passageway in the embolus cartridge until the pressure of fluid in the cylinder means exceeds a predetermined threshold level and the passageway in the embolus cartridge situated in the embolus-discharging position is coupled to the delivery tube through the housing outlet.

27. The apparatus of claim 20, wherein the moving means includes means for guiding the magazine along a guide path passing through the embolus-discharging position and means for using a stream of pressurized fluid to move the magazine within the hollow housing to place each embolus cartridge one at a time in the embolus-discharging position

28. The apparatus of claim 27, wherein the discharging means includes means for conducting said stream of pressurized fluid into the passageway formed in the embolus cartridge placed in the embolus-discharging position to discharge the embolus contained therein into the delivery tube.

29. An apparatus for supplying an embolus to a delivery tube, the apparatus comprising

a magazine containing a plurality of embolus cartridges arranged in a series, each embolus cartridge being formed to include a fluid-conducting passageway extending therethrough,

a hollow housing providing an embolus-discharge station therein and including a housing inlet and outlet and means for guiding the magazine along a guide path intersecting the embolus-discharge station as the magazine moves inside the hollow housing, the housing outlet providing means for connecting to the delivery tube,

means for passing a stream of pressurized fluid through the housing inlet into the fluid-conducting passageway in an embolus cartridge temporarily positioned to lie in the embolus-discharge station in communication with both of the housing inlet and outlet so that an embolus provided in the fluid-conducting passageway of the embolus cartridge is discharged through the housing outlet into the delivery tube at least at a predetermined velocity to empty the embolus cartridge positioned in the embolus-discharge station, and

means for moving the magazine within the hollow housing along the guide path a predetermined distance to move a just-emptied embolus cartridge out of the embolus-discharge station and a next embolus cartridge in the series of embolus cartridges into the embolus-discharge station to lie in communication with both of the housing inlet and outlet ready to receive the stream of pressurized fluid provided by the passing means.

30. The apparatus of claim 29, wherein the moving means includes cylinder means for receiving the stream of pressurized fluid, linkage means for advancing the magazine along the guide path, and piston means for operating the linkage means to advance the magazine along the guide path in response to input of fluid having a pressure in excess of a predetermined pressure into the cylinder means.

31. The apparatus of claim 30, wherein the passing means includes means for conducting the stream of pressurized fluid through a conduit from the cylinder means into the passageway of the embolus cartridge situated in the embolus-discharge station, a valve movable in the conducting means between a conduit-opening and conduit-closing positions, and means for yieldably biasing the valve to its conduit-closing position to block flow of pressurized fluid from the cylinder means into the passageway of the embolus cartridge situated in the embolus-discharge station until the pressure of fluid in the cylinder means exceeds a predetermined threshold level.

32. A method of delivering an embolus to a destination, the method comprising the steps of

inserting a catheter into a body, the catheter being formed to include an inlet, an outlet, and a lumen connecting the inlet to the outlet,

guiding the catheter through the body to aim the outlet of the catheter toward the destination,

connecting a device containing a plurality of emboli to the inlet of the catheter,

providing a stream of pressurized fluid, and

using the stream of pressurized fluid to flush one embolus at a time out of the device and move the flushed embolus into and through the lumen to reach the destination.

33. The method of claim 32, wherein the using step includes the steps of aiming the stream of pressurized fluid at said one embolus and conducting said one embolus and the stream of pressurized fluid into the lumen through the inlet formed in the catheter.

34. The method of claim 32, wherein the using step further includes the steps of providing a supply of fluid and pressurizing fluid from the supply at a predetermined rate to generate the stream of pressurized fluid.

35. The method of claim 32, wherein the using step includes the step of introducing the stream of pressurized fluid into the device for a predetermined length of time through an inlet port formed in the device to discharge said one embolus from the device through an outlet port formed in the device into the inlet of the catheter.

36. The method of claim 32, wherein the providing step includes the step of connecting a syringe means having a body filled with fluid to an inlet port formed in the device and moving a plunger in the body to discharge a stream of pressurized fluid from the syringe means into the device through the inlet port.

37. The method of claim 32, wherein the embolus is a coiled spring uncoiled to assume a straightened, packed position in the hollow cartridge and configured to exert a predetermined force against an interior wall of the device to retain the embolus in an initial position within the hollow cartridge, and the providing step includes the steps of supplying a liquid and pressurizing the liquid at a predetermined rate to generate the stream of pressurized fluid and provide a predetermined amount of work needed to overcome frictional forces between said one embolus and the interior wall of the device.

38. The method of claim 32, wherein the guiding step includes the step of conducting the outer catheter through a vein in a body an inserting the outer catheter into a side branch of the vein to position the outlet of the outer catheter in the side branch, the moving step includes the step of positioning the embolus-discharging outlet of the inner catheter in the side branch of the vein, and said one embolus is flushed out of the inner catheter and into the side branch to occlude the side branch during the using step.

39. A method of delivering an embolus to a selected destination, the method comprising the steps of

inserting an outer catheter into a body, the outer catheter being formed to include a lumen having an inlet and an outlet,

guiding the outer catheter through the body to aim the outlet of the lumen at the selected destination,

inserting an inner catheter into the lumen of the outer catheter, the inner catheter being formed to include an embolus-conducting lumen having an embolus-admitting inlet and an embolus-discharging outlet,

moving the inner catheter in the lumen of the outer catheter to project the embolus-discharging outlet through the outlet of the outer catheter so that an embolus discharged from the embolus-conducting lumen is deposited at the selected destination,

connecting a device containing a plurality of emboli to the embolus-admitting inlet of the inner catheter, and

using a fluid to flush one embolus at a time out of the device and move the flushed embolus into and through the embolus-conducting lumen to reach the selected- destination.

40. The method of claim 39, wherein the using step further includes the steps of providing a supply of fluid and pressurizing a predetermined volume of fluid from the supply at a predetermined rate to generate the stream of pressurized fluid.

41. The method of claim 39, wherein the connecting step further includes the steps of providing a device containing a plurality of hollow cartridges, each hollow cartridge being formed to include a passageway containing an embolus lodged temporarily therein in frictional engagement with a wall defining the passageway and moving the hollow cartridges within the device to connect the passageway of one of the hollow cartridges at a time to the lumen of the catheter to permit the movement of an embolus therebetween through the inlet, and the using step further includes the steps of providing a supply of fluid, pressurizing a predetermined volume of fluid from the supply at a predetermined rate to generate the stream of pressurized fluid, and aiming the stream of pressurized fluid to apply a predetermined amount of work to the embolus in said one of the hollow cartridges to overcome frictional forces between the embolus and the wall of the passageway and dislodge the embolus during the using step.

42. The method of claim 41, wherein the connecting step further includes the steps of providing a spring having a coiled shape to serve as the embolus, uncoiling the spring to cause it to move to assume a straightened shape, and packing the spring of straightened shape into the passageway, which passageway is sized to block the spring from reforming to its shape so that the spring is lodged temporarily in a fixed position in the passageway by frictional engagement of the spring and a wall defining the passageway and the using step includes the steps of providing a supply of fluid, pressurizing a predetermined volume of fluid from the supply at a predetermined rate to generate the stream of pressurized fluid, and employing the stream of pressurized fluid to apply a predetermined amount of work to the spring to overcome frictional forces between the spring and the wall of the passageway and propel the spring from its fixed position in the passageway through the lumen of the catheter so that the spring exits the outlet and reforms to assume its coiled shape at the destination.

43. A method of delivery an embolus to a destination, the method comprising the steps of

inserting a catheter into a body, the catheter being formed to include an inlet, an outlet, and a lumen connecting the inlet to the outlet,

guiding the catheter through the body to aim the outlet of the catheter toward the destination,

connecting a device containing a plurality of emboli to the inlet of the catheter, and

discharging one embolus at a time out of the device into and through the lumen of the catheter to reach the destination.

44. The method of claim 43, wherein the discharging step includes the step of injecting pressurized fluid into the device through an inlet formed in the device.

45. The method of claim 44, wherein the discharging step further includes the steps of positioning a single embolus in a predetermined position in the device and confining the pressurized fluid introduced into the device during the injecting step to impact said single embolus and carry it out of the device through an outlet formed in the device into the lumen of the catheter.

46. The method of claim 43, wherein the discharging step includes the step of using a guide wire to move each embolus out of the device into and through the lumen of the catheter.

47. The method of claim 43, wherein the discharging step includes the steps of connecting a syringe means having a body filled with fluid to an inlet formed in the device and operating the syringe means to discharge pressurized fluid from the body into the device through an inlet formed in the device.

48. The method of claim 47, wherein the discharging step further includes the steps of positioning a single embolus in a predetermined position in the device and confining the pressurized fluid introduced into the device during the operating step to impact said single embolus and carry it out of the device through an outlet formed in the device into the lumen of the catheter.