Method for accessing the coronary arteries from the radial or brachial artery in the arm
First Claim
1. A method for accessing human arteries without the use of an introducer sheath, the method comprising the following steps:
- (a) percutaneously inserting an arterial access needle through an arterial access site on the skin until the needle point is situated within the artery;
(b) place a guide wire through the access needle and into the arterial lumen;
(c) remove the access needle leaving the guide wire in place;
(d) advance a guiding catheter system over the guide wire and into the arterial lumen, the guiding catheter system comprising;
an elongated hollow tube having a central passageway throughout its entire length and also having proximal and distal ends and a distal section, the hollow tube'"'"'s distal end being tapered for easy introduction into a blood vessel and the distal section having a bend adapted to facilitate introduction into and retention within the ostium of an artery; and
a dilator having an elongated body and having a central passageway throughout its entire length which central passageway is adapted to slide snuggly over a guide wire, the dilator also having proximal and distal ends and a distal section and also having a handle located at the dilator'"'"'s proximal end, the dilator being tapered at its distal end, the dilator being adapted to slide snuggly through the central passageway of the elongated tube;
(e) remove the dilator and guide wire from the elongated tube;
(f) advance the distal end of the guiding catheter system into the ostium of an artery;
(g) perform an artery opening or angiographic procedure; and
(h) remove the guiding catheter system from the patient'"'"'s arterial system.
4 Assignments
0 Petitions
Accused Products
Abstract
The present invention is a method for using an improved guiding catheter that eliminates the need for an introducer sheath or a separate Tuohy-Borst "Y" adaptor, thus reducing the time and expense for performing artery opening procedures. Furthermore, the guiding catheter with straightening dilator as described herein allows the hole in the wall of the femoral artery in the groin, or even more advantageously, the radial artery in the arm to be approximately 2 French sizes smaller in diameter as compared to the hole that would be created if an introducer sheath is also used. The advantages of the present invention are accomplished by utilizing a guiding catheter with a dilator that has a stiffened and/or curved distal section that can be used to straighten the distal section of the guiding catheter as it is advanced through the arterial system. The guiding catheter plus dilator can then be used in a manner similar to an introducer sheath to percutaneously enter the artery by being advanced over a previously placed guide wire. Once the distal ends of the dilator and the guiding catheter are placed near the ostium of the coronary artery, the dilator and guide wire are withdrawn which allows the guiding catheter to assume its normal bent shape (e.g., a Judkin'"'"'s bend) near its distal end. The cardiologist can then, by well known techniques, place the guiding catheter'"'"'s distal end in the ostium of a coronary artery. Any of several well known procedures can then be performed including angiography, balloon angioplasty, atherectomy or stent placement.
198 Citations
19 Claims
-
1. A method for accessing human arteries without the use of an introducer sheath, the method comprising the following steps:
-
(a) percutaneously inserting an arterial access needle through an arterial access site on the skin until the needle point is situated within the artery; (b) place a guide wire through the access needle and into the arterial lumen; (c) remove the access needle leaving the guide wire in place; (d) advance a guiding catheter system over the guide wire and into the arterial lumen, the guiding catheter system comprising; an elongated hollow tube having a central passageway throughout its entire length and also having proximal and distal ends and a distal section, the hollow tube'"'"'s distal end being tapered for easy introduction into a blood vessel and the distal section having a bend adapted to facilitate introduction into and retention within the ostium of an artery; and a dilator having an elongated body and having a central passageway throughout its entire length which central passageway is adapted to slide snuggly over a guide wire, the dilator also having proximal and distal ends and a distal section and also having a handle located at the dilator'"'"'s proximal end, the dilator being tapered at its distal end, the dilator being adapted to slide snuggly through the central passageway of the elongated tube; (e) remove the dilator and guide wire from the elongated tube; (f) advance the distal end of the guiding catheter system into the ostium of an artery; (g) perform an artery opening or angiographic procedure; and (h) remove the guiding catheter system from the patient'"'"'s arterial system. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
-
Specification