Angioplasty apparatus facilitating rapid exchanges

• US 5,451,233 A
• Filed: 03/09/1994
• Issued: 09/19/1995
• Est. Priority Date: 04/15/1986
• Status: Expired due to Term

• Current Assignee: Paul G. Yock
• Original Assignee: Paul G. Yock
• Inventors: Yock, Paul G.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/208,972
• Time in Patent Office: 559 Days
• Field of Search: 606/194, 606/192, 606/193, 606/191, 606/7, 606/15, 604/96, 604/101, 604/102, 604/264, 128/673
• US Class Current: 606/194
• 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 intravascular assembly for performing a procedure at a location within a human patient'"'"'s coronary artery including a guidewire and a catheter which is adapted for rapid exchange over the guidewire without the utilization of an exchange wire or an extension wire, the assembly comprising:

a) an elongated catheter with a catheter shaft which has proximal and distal ends, which is configured for percutaneous introduction into and advancement within the patient'"'"'s vasculature, which is sufficiently long to be advanced through the patient'"'"'s femoral artery and into the patient'"'"'s coronary artery and which has,

a distal shaft section which is configured for advancement within the patient'"'"'s coronary artery,

a distal guidewire opening in the distal end of the catheter shaft,

a proximal guidewire opening spaced a relatively short distance proximally from the distal guidewire opening and a relatively long distance from the proximal end of the catheter shaft,

an inner lumen which extends between the distal guidewire opening and the proximal guidewire opening and which is configured to slidably receive a guidewire therein, and

a proximal shaft section much longer than the distal shaft section;

b) means on the distal shaft section to perform an intravascular procedure which is spaced closer to the distal guidewire opening than the proximal guidewire opening; and

c) a guidewire which is longer than the catheter to extend out of the distal end of the catheter into the patient'"'"'s coronary artery beyond the location therein where the procedure is to be performed and which is slidably disposed within the inner lumen extending between the distal guidewire opening and the proximal guidewire opening.

2. An elongated balloon dilatation catheter assembly for performing an angioplasty procedure at a location within a human patient'"'"'s coronary artery including a guidewire and balloon dilatation catheter which has means for the rapid exchange over the guidewire without the utilization of an exchange wire or an extension wire, comprising:

a) the elongated balloon dilatation catheter being configured for percutaneous introduction into the patient'"'"'s femoral artery and advancement into the patient'"'"'s coronary artery and having

an elongated catheter shaft with proximal and distal ends, an inflation lumen and a guidewire receiving lumen,

a distal guidewire opening in the distal end of the catheter shaft in fluid communication with the guidewire lumen,

a proximal guidewire opening spaced a short distance proximally from the distal guidewire opening and a substantial distance from the proximal end of the catheter shaft and in fluid communication with the guidewire lumen;

an inflatable dilatation balloon on a distal shaft section having proximal and distal ends, with the distal end of the balloon being spaced closer to the distal guidewire opening than the proximal end of the balloon is spaced from the proximal guidewire opening, and having an interior which is in fluid communication with the inflation lumen; and

b) the guidewire being sufficiently long to be advanced through the patient'"'"'s femoral artery and into the patient'"'"'s coronary artery beyond the location therein where the angioplasty procedure is to be performed and being slidably disposed within the guidewire lumen of the balloon dilatation catheter.

3. An elongated balloon dilatation catheter for performing an angioplasty procedure within a human patient'"'"'s coronary artery which has means for the rapid exchange of the catheter over a guidewire without the utilization of an exchange wire or an extension wire, comprising:

a) an elongated catheter shaft having proximal and distal ends and being configured for percutaneous introduction into the patient'"'"'s femoral artery;

b) a distal guidewire opening in the distal end of the catheter shaft;

c) a proximal guidewire opening in the catheter shaft spaced a short distance of at least 10 cm proximally from the distal guidewire opening and a substantial distance from the proximal end of the catheter shaft;

d) a flexible distal shaft section configured to be advanceable within the patient'"'"'s coronary arteries having a guidewire-receiving lumen extending proximally from the distal guidewire opening to the proximal guidewire opening and having an inflation lumen coextensive at least in part with the guidewire-receiving lumen,

e) an inflatable dilatation balloon on the distal shaft section having proximal and distal ends, having an interior which is in fluid communication with the inflation lumen and being spaced closer to the distal end of the catheter shaft than the proximal guidewire opening; and

f) a proximal shaft section much longer than the distal shaft section which is an elongated tubular member with an inner lumen extending therein in fluid communication with the inflation lumen in the distal section and which is suitable to advance the distal shaft section within a patient'"'"'s coronary artery over a guidewire slidably disposed within the guidewire receiving lumen.

4. An elongated balloon dilatation catheter for performing an angioplasty procedure within a human patient'"'"'s coronary artery which has means for the rapid exchange of the catheter over a guidewire without the utilization of an exchange wire or an extension wire, comprising:

a) an elongated catheter shaft having proximal and distal ends and being configured for percutaneous introduction into the patient'"'"'s femoral artery;

b) a distal guidewire opening in the distal end of the catheter shaft;

c) a proximal guidewire opening in the catheter shaft spaced a short distance proximally from the distal guidewire opening and a substantial distance from the proximal end of the catheter shaft;

d) a flexible distal shaft section configured to be advanceable within the patient'"'"'s coronary arteries having

a first inner lumen which extends proximally from the distal guidewire opening to the proximal guidewire opening and which is configured to slidably receive a guidewire therein,

a second inner lumen which is coextensive at least in part with the guidewire-receiving first inner lumen and which is configured to direct inflation fluid therethrough,

a third inner lumen which is coextensive with the first inner lumen and which is configured to be in fluid communication with a second opening in the distal end of the catheter shaft, and

an inflatable dilatation balloon on the distal shaft section having an interior which is in fluid communication with the second inner lumen and being spaced closer to the distal end of the shaft than the proximal guidewire port; and

e) a proximal shaft section much longer than the distal shaft section which is a single elongated tubular member with two inner lumens extending therein, one of the two inner lumens being in fluid communication with the second inner lumen in the distal shaft section and the other inner lumen being in fluid communication with the third inner lumen in the distal shaft section.