Guidewire replacement method

• US 5,984,945 A
• Filed: 06/07/1995
• Issued: 11/16/1999
• Est. Priority Date: 01/09/1992
• Status: Expired due to Fees

• Current Assignee: Advanced Cardiovascular Systems Incorporated (Abbott Laboratories)
• Original Assignee: Advanced Cardiovascular Systems Incorporated (Abbott Laboratories)
• Inventors: Sirhan, Motasim Mahmoud
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/482,123
• Time in Patent Office: 1,623 Days
• Field of Search: 606/192, 606/194, 606/1, 604/96, 604/284
• US Class Current: 606/194
• CPC Class Codes: A61M 2025/0063 having means, e.g. stylets, mandrils, rods or wires to reinforce or adjust temporarily the stiffness, column strength or pushability of catheters which are already inserted into the human body
• CPC Class Codes: A61M 2025/0183 Rapid exchange or monorail catheters
• CPC Class Codes: A61M 25/0172 Exchanging a guidewire while keeping the catheter in place
• CPC Class Codes: A61M 25/104 used for angioplasty

Abstract

A guidewire replacement device having an elongated catheter shaft with an inner lumen extending within the catheter shaft, a proximal guidewire port spaced at least 1 cm from the distal end of the catheter which is in fluid communication with the inner lumen and a distal guidewire port in the distal end of the catheter which is also in fluid communication with the inner lumen. The proximal end of an in-place guidewire is inserted through the distal guidewire port and advanced through the inner lumen until the proximal end of the guidewire extends through the proximal guidewire port. The exchange device is advanced over the guidewire until the distal end of the exchange device is seated within the proximal guidewire port in the readily exchangeable dilatation catheter. With the distal end of the exchange device well seated within the proximal guidewire port of the dilatation catheter, the in-place guidewire can be withdrawn from the patient. A replacement guidewire is advanced through the inner lumen of the exchange device until it exits the distal guidewire port of the exchange device into the inner guidewire receiving lumen of the dilatation catheter. Once the replacement guidewire is properly placed, the exchange device can then be withdrawn from the patient.

Claims

1. A method for exchanging a guidewire during an angioplasty procedure wherein a readily exchangeable dilatation catheter having a short guidewire receiving inner lumen in the distal portion thereof extending between a distal guidewire port in the distal end of the dilatation catheter and a proximal guidewire port spaced at least 10 cm from the distal guidewire port, is disposed within a patient'"'"'s vasculature and wherein a first guidewire having proximal and distal ends extends through the short guidewire receiving inner lumen within the distal portion of dilatation catheter, the method comprising:

a) providing a guidewire exchange device comprising an elongated shaft with a guidewire receiving inner lumen extending therein, a proximal section, a distal section, a first guidewire port in the proximal section, a second guidewire port in the distal end of the exchange device, and a third guidewire port spaced at least 7 cm from the distal end of the exchange device between the first and second guidewire ports, said guidewire ports being in fluid communication with the inner lumen of the exchange device, and the distal end of the guidewire exchange device being adapted to enter the proximal guidewire port of the dilatation catheter;

b) mounting the guidewire exchange device onto the proximal end of the first guidewire;

c) advancing the guidewire exchange device over the first guidewire with the guidewire extending through the second and third guidewire ports;

d) advancing the distal end of the exchange device into the proximal guidewire port of the dilatation catheter;

e) withdrawing the first guidewire through the guidewire exchange device distal section and out the third guidewire port thereof by pulling the first guidewire from its proximal end; and

f) advancing a second guidewire through the inner lumen of the guidewire exchange device, through the short guidewire receiving inner lumen in distal extremity of the dilatation catheter and out the distal end thereof.

2. A method for exchanging a guidewire disposed within a short guidewire receiving inner lumen in the distal portion of an intravascular catheter which is placed within a patient during an intravascular procedure comprising:

a) providing a guidewire replacement device which has a proximal tubular section having proximal and distal ends, a first lumen extending therein, and a port on the distal end, and a distal tubular section having proximal and distal ends, a proximal guidewire port and a distal guidewire port, and a second lumen extending therein, with the distal end of the proximal tubular section being secured to the distal tubular section at a location between the proximal and distal guidewire ports of the distal tubular section, with the first lumen in the proximal tubular section intercommunicating with the second lumen in the distal tubular section, with the distal end of the distal tubular section being adapted to be seated into a proximal guidewire port of an intravascular catheter;

b) advancing the guidewire replacement device over the guidewire so that the guidewire extends within the proximal and distal guidewire ports in the distal tubular section, and advancing the distal end of the guidewire replacement device within the proximal guidewire port in the catheter through which the guidewire exits;

c) withdrawing the in-place guidewire through the guidewire replacement device distal tubular section;

d) advancing a replacement guidewire through a lumen extending within the guidewire replacement device, through the distal port in the distal tubular section, and through the proximal guidewire port in the catheter and out a distal guidewire port in the catheter;

e) withdrawing the guidewire replacement device from the patient;

f) peeling the guidewire replacement device from the replacement guidewire through a slit provided in the wall of the proximal tubular section of the guidewire replacement device as it exits the patient; and

g) further withdrawing the guidewire replacement device over the replacement guidewire until the distal end of the replacement device exits the patient, manually securing the exposed portion of the replacement guidewire distal to the distal end of the replacement device and then removing the replacement device from the replacement guidewire.