Method of using a readily exchangeable perfusion dilatation catheter

• US 6,451,043 B1
• Filed: 11/18/1996
• Issued: 09/17/2002
• Est. Priority Date: 02/07/1990
• Status: Expired due to Fees

• Current Assignee: Advanced Cardiovascular Systems Incorporated (Abbott Laboratories)
• Original Assignee: Advanced Cardiovascular Systems Incorporated (Abbott Laboratories)
• Inventors: Sirhan, Motasim M., McInnes, Peter R.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/751,353
• Time in Patent Office: 2,129 Days
• Field of Search: 606/192-194, 604/96, 604/101, 604/102, 604/96.01, 604/102.02, 604/103.04
• 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 2025/107 having a longitudinal slit in the balloon
• CPC Class Codes: A61M 2025/1097 with perfusion means for enabling blood circulation only while the balloon is in an inflated state, e.g. temporary by-pass within balloon
• CPC Class Codes: A61M 25/09 Guide wires
• CPC Class Codes: A61M 25/104 used for angioplasty

Abstract

A perfusion-type dilatation catheter which can be rapidly exchanged for another catheter without the need for exchange wires or guidewire extension wire. The dilatation catheter has an elongated catheter body with a distal guidewire port in the distal end of the catheter and a proximal guidewire port at least 10 cm but not more than 50 cm from the distal port. The catheter body has a first inflation lumen which extends from the proximal end of the catheter body to the interior of a dilatation balloon adjacent the distal end of the catheter body. A second, much shorter inner lumen is disposed between the proximal and distal guidewire ports and is adapted to slidably receive a guidewire. A plurality of perfusion ports are provided both proximal and distal to the balloon which are in fluid communication with the second inner lumen so that when the balloon is inflated within a patient'"'"'s vascular system, blood will flow through the proximal perfusion ports and the second inner lumen and out the distal perfusion ports to minimize ischemic conditions distal to the catheter. A stiffening member is disposed within. the catheter body proximal to the proximal guidewire port to provide improved pushability. The distal portion of the inflation lumen should have a transverse cross-sectional area of about 3 to about 20×10⁻⁵ inch² and should not be greater than one-third the cross-sectional area of the perfusion lumen.

Claims

1. A method of performing an intravascular procedure wherein a patient'"'"'s artery is occluded, comprising:

a) disposing within the patient'"'"'s vasculature a guiding catheter having a proximal end, a distal ends a port in the distal end, and an inner lumen extending between the proximal and distal ends, with the distal end of the guiding catheter being disposed proximal to a location within the patient'"'"'s artery where the procedure is to be performed;

b) slidably disposing a guidewire within the inner lumen of the guiding catheter with a distal extremity of the guidewire extending out of the port in the distal end of the guiding catheter and beyond a desired arterial location where the procedure is to be performed;

c) providing an elongated intravascular catheter having proximal and distal shaft sections, an expandable occluding member on the distal shaft section, a distal guidewire port in a distal end of the catheter, a proximal guidewire port spaced proximal to the expandable occluding member and at least 12 cm proximally of the distal end, a relatively short guidewire receiving lumen extending between the distal guidewire port and the proximal guidewire port, a relatively long inner lumen which has a proximal section with a transverse cross-section, and which has a distal section with a transverse cross-section, the distal section being much shorter than the proximal section, the distal section having a transverse cross-sectional area that is substantially less than the transverse cross-sectional area of the proximal section and extending at least about 10 cm proximally from the expandable occluding member, and a first plurality of proximal perfusion ports in the distal shaft section in fluid communication with the short guidewire receiving inner lumen positioned between the proximal guidewire port and the expandable occluding member and a second plurality of distal perfusion ports in the distal shaft section in fluid communication with the short guidewire receiving inner lumen positioned between the expandable occluding member and the distal end of the catheter shaft;

d) mounting the intravascular catheter onto the guidewire with the guidewire slidably;

disposed within the short guidewire receiving inner lumen of the intravascular catheter;

e) advancing the intravascular catheter within the patient'"'"'s arterial system over the guidewire until the expandable occluding member on the intravascular catheter is disposed at the location where the procedure is to be performed, the proximal guidewire port being disposed within the inner lumen of the guiding catheter and the portion of the intravascular catheter having perfusion ports extending outside the port in the distal end of the guiding catheter and into the patient'"'"'s artery;

f) expanding the expandable occluding member on the intravascular catheter to at least. partially occlude the patient'"'"'s artery, thereby causing blood to flow from the patient'"'"'s artery into the guidewire receiving inner lumen through the plurality of proximal perfusion ports, through the inner lumen and out the plurality of distal perfusion ports distal to the catheter; and

g) contracting the expanded expandable member to facilitate removal of the catheter from the patient over the guidewire.

2. The method of claim 1, wherein the guidewire is at least partially removed from the portion of the distal shaft section having perfusion ports to avoid impending blood flow through the short guidewire receiving inner lumen.

3. The method of claim 1, wherein:

a) the catheter is removed from the patient by holding the guidewire in place at a first holding location outside of the patient and proximally moving the catheter over the guidewire until the proximal guidewire port thereof is immediately;

;

and distally adjacent said first holding location; and

b) holding the guidewire at a second location outside of the patient distally adjacent the distal guidewire port of the catheter and then removing the catheter from the guidewire.