Method and apparatus for the guided bypass of coronary occlusions
First Claim
1. A method for bypassing an occlusion in a vascular system, comprising the steps of:
- providing a catheter apparatus comprising,an elongated flexible catheter shaft having a distal end zone and a working element disposed in the distal end, and wherein the catheter shaft is formed with a lumen that includes a tissue-penetrating wire at least partially disposed in the lumen of the catheter shaft; and
a locator comprising an imaging tube and an imaging device operatively disposed therein;
placing the working element in the lumen of the first blood vessel, and activating the locator to observe an image of a first blood vessel, the working element therein and a second blood vessel;
manipulating the working element using a steering member comprising a plurality of steering wires slidably disposed in the catheter shaft and coupled to a retaining ring disposed in the distal end zone, wherein braid-reinforced tubes confine each of the plurality of steering wires; and
advancing the working element to establish a path fluidly connecting the lumen of the first blood vessel to the lumen of the second blood vessel.
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Accused Products
Abstract
Described herein is a catheter method and apparatus for the guided intraluminal bypass of a coronary occlusion. A method is described employing an intraluminally operable catheter shaft including an optionally steerable working element, combined with an extraluminally operable locator including an imaging device, to selectively direct the working element to create a fluid path from the artery proximal to the occlusion into the vein and further from the vein back into the artery distal to the occlusion, to perfuse myocardium distal to the occlusion. Methods are described for creating a fluid path from the artery proximal to the occlusion into an adjacent vein and thereafter either stent grafting the fluid path to the vein, directing arterial blood distally within the vein, or stenting the fluid path and occluding the vein proximal thereto, in either case arterializing the venous system distal to the stent or stent graft. A catheter shaft is described for creating and perfusing the fluid path. Conical, guide wire and tissue-penetrating working elements are described. A scanning acoustic transducer and flexible imaging tube, and suction devices for anchoring are described for the locator. A signal-emitting working element and signal-detecting locator cooperating therewith are described.
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Citations
20 Claims
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1. A method for bypassing an occlusion in a vascular system, comprising the steps of:
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providing a catheter apparatus comprising, an elongated flexible catheter shaft having a distal end zone and a working element disposed in the distal end, and wherein the catheter shaft is formed with a lumen that includes a tissue-penetrating wire at least partially disposed in the lumen of the catheter shaft; and a locator comprising an imaging tube and an imaging device operatively disposed therein; placing the working element in the lumen of the first blood vessel, and activating the locator to observe an image of a first blood vessel, the working element therein and a second blood vessel; manipulating the working element using a steering member comprising a plurality of steering wires slidably disposed in the catheter shaft and coupled to a retaining ring disposed in the distal end zone, wherein braid-reinforced tubes confine each of the plurality of steering wires; and advancing the working element to establish a path fluidly connecting the lumen of the first blood vessel to the lumen of the second blood vessel. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. An arterial catheter apparatus comprising:
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an elongated flexible catheter shaft having a distal end zone and at least one longitudinal lumen extending along at least a portion of the catheter shaft and the distal end zone; a working element disposed at the distal end zone of the catheter shaft; a steering member comprising a plurality of steering wires slidably disposed in the catheter shaft and coupled to a retaining ring disposed in the distal end zone, wherein braid-reinforced tubes confine each of the plurality of steering wires; a tissue-penetrating wire at least partially disposed in the lumen of the catheter shaft and extendable into the distal end zone; and a locator with an imaging device to provide guidance for the working element and tissue-penetrating wire during treatment of an occlusion. - View Dependent Claims (20)
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Specification