Angioplasty apparatus facilitating rapid exchanges and method

• US 5,300,085 A
• Filed: 01/27/1993
• Issued: 04/05/1994
• Est. Priority Date: 04/15/1986
• Status: Expired due to Term

• Current Assignee: Advanced Cardiovascular Systems Incorporated (Abbott Laboratories)
• Original Assignee: Advanced Cardiovascular Systems Incorporated (Abbott Laboratories)
• Inventors: Yock, Paul G.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/010,458
• Time in Patent Office: 433 Days
• Field of Search: 604/96, 604/101, 604/102, 606/192-194, 606/191
• US Class Current: 606/191
• CPC Class Codes: A61B 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61M 2025/0034 characterized by elements which are assembled, connected or fused, e.g. splittable tubes, outer sheaths creating lumina or separate cores
• CPC Class Codes: A61M 2025/004 characterized by lumina being arranged circumferentially
• CPC Class Codes: A61M 2025/0183 Rapid exchange or monorail catheters
• CPC Class Codes: A61M 2025/1093 having particular tip characteristics
• CPC Class Codes: A61M 25/0021 characterised by the form of the tubing A61M25/0054 takes precedence
• CPC Class Codes: A61M 25/0029 characterized by features relating to least one lumen located at the middle part of the catheter, e.g. slots, flaps, valves, cuffs, apertures, notches, grooves or rapid exchange ports catheter shaft surface irregularities A61M2025/006
• CPC Class Codes: A61M 25/0032 characterized by at least one unconventionally shaped lumen, e.g. polygons, ellipsoids, wedges or shapes comprising concave and convex parts
• CPC Class Codes: A61M 25/0045 multi-layered, e.g. coated coating materials A61L29/08
• CPC Class Codes: A61M 25/0071 Multiple separate lumens multiple separate lumens throughout the catheter A61M25/0026
• CPC Class Codes: A61M 25/104 used for angioplasty

Abstract

Apparatus for introduction into the vessel of a patient comprising a guiding catheter adapted to be inserted into the vessel of the patient and a device adapted to be inserted into the guiding catheter. The device includes a flexible elongate member and a sleeve carried by the flexible elongate member near the distal extremity thereof and extending from a region near the distal extremity to a region spaced from the distal extremity of the flexible elongate element. The device also includes a guide wire adapted to extend through the sleeve so that the guide wire extends rearwardly of the sleeve extending alongside of and exteriorally of the flexible elongate element into a region near the proximal extremity of the flexible elongate element.

Claims

1. An elongated catheter for perfusing blood distal to an occlusion within a coronary artery which facilitates the rapid advancement or exchange thereof over a guidewire having a distal portion disposed across the occlusion without the utilization of an exchange wire or an extension wire, comprising:

a) an elongated catheter shaft having proximal and distal ends, a first inner lumen extending therein, one or more distal perfusion ports located at or near the distal end of the catheter shaft, one or more proximal perfusion ports spaced proximally from the distal perfusion ports a distance of at least equal the length of the occlusion and spaced distally a substantial distance from the proximal end of the catheter shaft, both the proximal and the distal perfusion ports being in fluid communication with the first inner lumen; and

b) a second inner lumen which is adapted to slidably receive a guidewire therein and which extends proximally through a distal portion of the catheter shaft from a first guidewire port in the distal end of the catheter shaft to a second guidewire port spaced at least about 10 cm proximally from the distal end and a substantial distance from the proximal end of the catheter shaft.

2. An elongated catheter which has proximal and distal ends and which is provided with means to perfuse blood distally through a distal portion of the catheter across an occlusion in a patient'"'"'s coronary artery to minimize ischemic conditions distal to the catheter, the catheter including:

a guidewire receiving lumen which extends from a first port in the distal end of the catheter located distal to the means to perfuse blood to a second port in the catheter spaced proximally a relatively short distance from the distal end of the catheter and the means to perfuse blood and spaced distally a relatively long distance from the proximal end of the catheter shaft which allows the catheter to be rapidly mounted onto a guidewire disposed within a patient with a distal portion of the guidewire within the patient'"'"'s coronary artery and to be slidably advanced over the guidewire to a desired location within the patient'"'"'s coronary artery to facilitate the perfusion of blood through the distal portion of the catheter across the occlusion.

3. A method of perfusing blood in a patient'"'"'s coronary artery across an occlusion therein to minimize ischemic conditions distal to the occlusion, comprising:

a) providing an elongated catheter which has proximal and distal ends, which has means to perfuse blood through the catheter and which has a guidewire receiving inner lumen which extends proximally within a distal portion of the catheter from a first port in the distal end of the catheter shaft to a second port spaced proximally a relatively short distance from the distal end of the catheter shaft and the means to perfuse blood and spaced distally a relatively long distance from the proximal end of the catheter shaft;

b) advancing the catheter over a guidewire which has a distal end disposed at a location within the patient'"'"'s coronary artery distal to the occlusion, with the guidewire slidably disposed within the guidewire receiving inner lumen; and

c) perfusing blood from a location within the patient'"'"'s coronary artery proximal to the occlusion through the means to perfuse blood in a distal portion of the catheter to a location within the patient'"'"'s coronary artery distal to the occlusion so as to minimize ischemic conditions therein.