Energy delivery catheter and method for the use thereof

• US 6,117,128 A
• Filed: 04/30/1998
• Issued: 09/12/2000
• Est. Priority Date: 04/30/1997
• Status: Expired due to Fees

• Current Assignee: Kenton W. Gregory, Providence Health System - Oregon
• Original Assignee: Kenton W. Gregory, Providence Health System
• Inventors: Gregory, Kenton W.
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): GIBSON, ROY DEAN
• Application Number:
  US09/070,895
• Time in Patent Office: 866 Days
• Field of Search: 606/2, 606/7, 606/13, 606/14-16, 607/88, 607/89, 607/92, 607/93
• US Class Current: 606/7
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/22082 after introduction of a substance
• CPC Class Codes: A61B 2018/206 the laser light passing along a liquid-filled conduit

Abstract

A catheter comprising a flexible tube having a proximal portion and a distal end portion. The proximal portion comprises a first or working lumen and a second lumen for a guidewire. The distal end portion consists of a small-diameter flexible tube having a single lumen. The catheter has a tapered transition portion interconnecting the proximal and distal portions, in which the first and second lumens have openings communicating internally of the catheter to the single lumen in the distal end portion. Coupled to a proximal end of the catheter are means for inserting an ultrasound or optical fiber into the first lumen for transmitting energy from an energy source through the catheter to an emission end near the distal end of the catheter and means for inserting the guidewire through the second lumen. The means for inserting are adapted to permit extension and retraction of the fiber and the guidewire in their respective lumens. The distal end portion containing the single lumen is sized to a diameter suitable for introduction into small cranial vessels, with an outer diameter less than that of the proximal portion containing the first and second lumens. This can be accomplished by sizing the distal end portion with an inner diameter of the single lumen just large enough to receive one of the guidewire and the fiber but not both.

Claims

1. A light energy delivery catheter comprising:

a proximal portion having first and second lumens extending therethrough;

a distal portion having a single lumen extending therethrough; and

a short tapered section interconnecting the proximal and distal portions, said first and second lumens being adapted to receive a guidewire and a light energy guide respectively, said first and second lumens opening internally into said single lumen to permit either the guidewire in said first lumen or the light energy guide in said second lumen to extend into said single lumen in the distal portion, the single lumen being internally reflective to light energy introduced via the light energy guide.

2. A catheter as claimed in claim 1 including a port defined in the proximal portion through which optical or radiographic contrast fluid is applied to flow through one of the said first or second lumens and out through said single lumen.

3. A catheter as claimed in claim 2 wherein said distal portion is formed of a material having a refractive index which is less than that of the contrast fluid.

4. A catheter as claimed in claim 3 wherein the distal portion is formed of a floropolymer material.

5. A catheter as claimed in claim 1 including an optical light energy guide received in said second lumen.

6. A catheter as claimed in claim 1 including a guiderwire in said first lumen.

7. A catheter as claimed in claim 1 wherein a reflective cladding is applied internally to the single lumen of the distal portion.

13. A method as claimed in claim 1 including the step performed before and during step (d) of flowing a contrast fluid through said second lumen and said single lumen to the clot to conduct the light energy through the single lumen and the vessel to the clot.

8. A method for directing light energy therapeutically to a site within a blood vessel of the brain, the method utilizing a catheter having a proximal portion with a first and second lumen extending therethrough, which is attached to a distal portion having a single lumen opening internally into the first and second lumens, a guidewire in said first lumen and a coupled to a light energy guide in said second lumen, and a fluid introduction means for introducing a fluid to the proximal portion, the method comprising the steps of:

inserting the catheter through the blood vessel in the brain;

extending the guidewire through the first lumen and into the single lumen;

guiding the catheter using the guidewire until an end of the distal portion is adjacent the site;

retracting the guidewire from the single lumen and into the first lumen to clear the single lumen of obstruction;

advancing a distal end of the light energy guide partway into the single lumen;

flowing optical fluid through the catheter for discharge adjacent the site at the end of the distal portion; and

transmitting light energy from said light energy source through the light energy guide and through the single lumen via the optical fluid to said site, the inner surface of said single lumen being internally reflective to the light energy to guide the light energy from the distal end of the light energy guide to the site, unobstructed by the guidewire.

9. The method of claim 8, further including transmitting light energy from said energy source through said second lumen and to said site contemporaneously with flowing a dose of the pharmacological agent to the site from a drug source coupled to one of the first and second lumens.

10. The method of claim 8, wherein said light energy source is a laser.

11. The method as claimed in claim 8, further including:

retracting the light guide from the single lumen so that it is fully within said second lumen and advancing the guidewire through the single lumen to extend from the distal end thereof;

using the guidewire to reposition the distal end of the catheter relative to a clot in the blood vessel; and

repeating the advancing, flowing and transmitting steps as necessary for treatment.

12. A method for removing a blood clot in the brain, the method utilizing a light delivery catheter having a proximal portion with a first and second lumen extending therethrough, which is attached to a distal portion having a single lumen opening internally into the first and second lumens, a guidewire in said first lumen and a light guide having a distal end in said second lumen, the method comprising:

(a) inserting said catheter into an artery in the brain with the guidewire extending through said single lumen and out a short distance from the distal end of the catheter, and utilizing said guidewire to advance the catheter to the clot;

(b) retracting the guidewire from the single lumen so that it is fully within said first lumen,

(c) advancing the light guide into the single lumen to position the distal end thereof partway into the single lumen; and

(d) applying light energy through the light guide and single lumen to the clot.

14. A method as claimed in claim 12 including the steps performed after step (d) of:

(e) retracting the light guide from the single lumen so that it is fully within said second lumen and advancing the guidewire through the single lumen to extend from the distal end thereof;

(f) using the guidewire to reposition the catheter relative to the clot; and

(g) repeating steps (b), (c) and (d).

15. A method as claimed in claim 12 including the step performed after each performance of step (d) of:

(e) terminating step (d) and flowing a thrombolytic drug through one of the first or second lumens and the single lumen to the clot.

16. The method as claimed in claim 12 in which step (d) includes flowing an optical fluid through one of the first and second lumens, through the single lumen and out the distal end to transmit the light energy to the clot.

17. A catheter assembly for treating blood clots formed in a vessel in the brain comprising:

a flexible tube having a proximal portion and a distal portion, said proximal portion comprising a first lumen and a second lumen and said distal portion forming a single lumen communicating with said first and second lumens;

a guidewire received in said first lumen and retractably received in said single lumen for guiding said catheter into a vessel to position a distal end of the single lumen adjacent a blood clot;

a light energy source coupled to the second lumen; and

light energy transmission means within the second lumen for transmitting light energy from said light energy source to the distal portion of the flexible tube;

the distal portion being internally reflective to guide the light energy though the single lumen to the clot.

18. A catheter as claimed in claim 17 wherein said distal portion is flexible.

19. A catheter as claimed in claim 17 wherein the distal portion is tapered to enhance flexibility.

20. A catheter as claimed in claim 17 wherein said distal portion is approximately 1 to 50 cm long.

21. A catheter as claimed in claim 17 wherein said distal portion is approximately 1 to 40 cm long.

22. A catheter as claimed in claim 17 wherein said distal portion is approximately 5 to 20 cm long.

23. The catheter assembly according to claim 17 wherein said energy source includes a laser.

24. The catheter assembly according to claim 23 wherein the energy transmission means includes a light transmissive liquid forming a light wave guide in the distal portion.

25. The catheter assembly according to claim 23 wherein the energy transmission means includes at least one optical fiber.

26. The catheter assembly according to claim 17, further including means for introducing a pharmacological agent into the single lumen for discharge into the vessel adjacent the blood clot contemporaneously with the transmission of energy out the distal portion of the flexible tube.

27. The catheter assembly described in claim 17, further including fluid introduction means for flowing fluid through at least one of the proximal lumens and through the single lumen.

28. The catheter assembly for treating blood clots formed in a vessel in the brain as claimed in claim 17, wherein a tapered transition junction permits the joining of:

a distal portion subassembly sized and arranged to extend into a small, tortuous cranial vessel and for propagation of the light energy from the said light energy source to the blood clot; and

a proximal portion subassembly particularly suited for the accommodation of the light energy transmission means within the second lumen to convey light energy into the distal portion subassembly.

29. The catheter assembly for treating blood clots formed in a vessel in the brain as claimed in claim 17, wherein said light energy transmission means includes means for introducing optical fluid through one of the first and second lumens, through the single lumen and out the distal end to transmit the light energy to the clot.