Angioplasty apparatus facilitating rapid exchanges

• US 6,575,993 B1
• Filed: 06/07/1995
• Issued: 06/10/2003
• Est. Priority Date: 04/15/1986
• Status: Expired due to Term

• Current Assignee: Paul G. Yock
• Original Assignee: Paul G. Yock
• Inventors: Yock, Paul G.
• Primary Examiner(s): Thaler, Michael H.
• Application Number:
  US08/485,397
• Time in Patent Office: 2,925 Days
• Field of Search: 606/194, 606/192, 606/193, 606/191, 604/96, 604/103.04
• US Class Current: 606/194
• CPC Class Codes: A61B 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61M 2025/0034 characterized by elements which are assembled, connected or fused, e.g. splittable tubes, outer sheaths creating lumina or separate cores making of catheters A61M25/0009
• CPC Class Codes: A61M 2025/004 characterized by lumina being arranged circumferentially
• CPC Class Codes: A61M 2025/0183 Rapid exchange or monorail catheters
• CPC Class Codes: A61M 2025/1093 having particular tip characteristics
• CPC Class Codes: A61M 25/0021 characterised by the form of the tubing A61M25/0054 takes precedence
• CPC Class Codes: A61M 25/0029 characterized by features relating to least one lumen located at the middle part of the catheter, e.g. slots, flaps, valves, cuffs, apertures, notches, grooves or rapid exchange ports catheter shaft surface irregularities A61M2025/006
• CPC Class Codes: A61M 25/0032 characterized by at least one unconventionally shaped lumen, e.g. polygons, ellipsoids, wedges or shapes comprising concave and convex parts
• CPC Class Codes: A61M 25/0045 multi-layered, e.g. coated coating materials A61L29/08
• CPC Class Codes: A61M 25/0071 Multiple separate lumens multiple separate lumens throughout the catheter A61M25/0026
• CPC Class Codes: A61M 25/104 used for angioplasty

Abstract

Apparatus for introduction into the vessel of a patient comprising a guiding catheter adapted to be inserted into the vessel of the patient and a device adapted to be inserted into the guiding catheter. The device includes a flexible elongate member and. a sleeve carried by the flexible elongate member near the distal extremity thereof and extending from a region near the distal extremity to a region spaced from the distal extremity of the flexible elongate element. The device also includes a guide wire adapted to extend through the sleeve so that the guide wire extends rearwardly of the sleeve extending alongside of and exteriorally of the flexible elongate element into a region near the proximal extremity of the flexible elongate element.

Claims

1. An intravascular assembly for performing a therapeutic or diagnostic procedure within a human patient'"'"'s body and which is configured for percutaneous introduction into and advancement within the patient'"'"'s vasculature to the location where the procedure is to be performed, comprising:

a) an intravascular catheter having

an elongated catheter shaft which has proximal and distal ends,

a distal shaft section which is configured for advancement through the patient'"'"'s vasculature to a location within the patient'"'"'s body where the procedure is to be performed,

a proximal shaft section which is much longer than the distal shaft section and which is configured to have a distal portion within the patient and a proximal portion thereof extending out of the patient during the procedure,

a distal guidewire opening in the distal end of the shaft,

a proximal guidewire opening spaced at least about 10 cm proximally from the distal end of the catheter shaft and a relatively long distance distally from the proximal end of the catheter shaft so as to remain within the patient during the procedure,

a therapeutic or diagnostic member on the distal shaft section to perform the procedure which is configured for percutaneous introduction into and advancement through the patient'"'"'s vasculature to the location where the procedure is to be performed and which is spaced closer to the distal end of the catheter shaft than to the proximal guidewire opening,

a guidewire passageway which extends between and is in fluid communication with the distal guidewire opening and the proximal guidewire opening; and

b) a guidewire which has an elongated shaft and a flexible distal extremity, which is configured for advancement within the patient'"'"'s vasculature, which is longer than the intravascular catheter and which is slidably disposed within the guidewire passageway of the intravascular catheter to facilitate delivery of the catheter thereover to the location within the patient'"'"'s body where the procedure is to be performed.

2. In an intravascular assembly for performing a therapeutic or diagnostic procedure within a region of a human patient'"'"'s body which is configured for percutaneous introduction into the patient'"'"'s vasculature and for intravascular delivery to a region within the patient'"'"'s body where the procedure is to be performed, the combination comprising:

a) an elongated catheter which has

an elongated catheter shaft with proximal and distal ends, a distal shaft section which is configured to be introduced into and advanced within the patient'"'"'s vasculature and a proximal shaft section which is much longer than the distal shaft section and which is configured to have a distal portion within the patient and a proximal portion thereof extending out of the patient during the procedure,

a distal guidewire port in the distal end of the shaft,

a proximal guidewire port spaced a relatively short distance of at least 10 cm proximally from the distal end of the shaft and a relatively long distance distally from the proximal end of the shaft so as to be disposed within the patient when the procedure is performed,

a means to perform the procedure on the distal shaft section which is configured for percutaneous introduction and advancement within the patient'"'"'s vasculature and which is spaced closer to the distal end of the shaft than to the proximal guidewire port, and

a guidewire passageway which extends between the distal guidewire port and the proximal guidewire port; and

b) an elongated guidewire which has an elongated shaft and a flexible distal extremity, which is longer than the catheter, and which is slidably disposed within the guidewire passageway to facilitate advancement of the catheter over the guidewire through the patient'"'"'s vasculature to said region while maintaining the position of the guidewire within the patient'"'"'s vasculature.

3. The intravascular assembly of claim 2 wherein the means to perform the procedure is in communication with an exterior portion of the distal shaft section.

4. In a balloon dilatation catheter assembly for performing an angioplasty procedure within a region of a human patient'"'"'s coronary artery which is configured for percutaneous introduction into the patient'"'"'s vasculature and for intravascular delivery to the coronary artery where the procedure is to be performed, the combination comprising:

a) an elongated catheter which has

an elongated shaft with proximal and distal ends, a distal shaft section which is configured to be percutaneously introduced into and advanced within the patient'"'"'s vasculature, a proximal shaft section much longer than the distal shaft section which is configured to have a distal portion within the patient and a proximal portion out of the patient during the procedure and an inflation lumen extending within the proximal and distal shaft sections,

a distal guidewire port in the distal end of the shaft,

a proximal guidewire port spaced a relatively short distance proximally from the distal end of the shaft and a relatively long distance from the proximal end of the shaft so as to be disposed within the patient'"'"'s vasculature during the procedure,

a dilatation balloon on the distal shaft section which has an interior in fluid communication with the inflation lumen and which is spaced closer to the distal end of the shaft than to the proximal guidewire port, and

a guidewire passageway which extends between the distal guidewire port and the proximal guidewire port; and

b) an elongated guidewire which is longer than the catheter, and which is disposed within the guidewire passageway to facilitate advancement of the catheter through the patient'"'"'s vasculature over the guidewire to the patient'"'"'s coronary artery while maintaining the position of the guidewire within the patient'"'"'s vasculature.

5. An intravascular catheter for performing a procedure within a region of a human patient'"'"'s body, comprising:

a) an elongated shaft which is configured for percutaneous introduction into the patient'"'"'s vasculature, which is long enough for advancement through the patient'"'"'s vasculature to the region of the patient'"'"'s body where the procedure is to be performed and which has proximal and distal ends;

b) a distal shaft section which is configured along its length to be percutaneously introduced into and advanced within the patient'"'"'s vasculature;

c) a proximal shaft section which is much longer than the distal shaft section and which is configured to have a distal portion within the patient and a proximal portion thereof extending out of the patient during the procedure;

d) a distal guidewire opening in the distal end of the shaft;

e) a proximal guidewire opening in the elongated shaft which is spaced at least 10 cm proximally from the distal end of the shaft and a substantially greater distance from the proximal end of the catheter shaft;

f) a therapeutic or diagnostic member on the distal shaft section to perform the procedure which is configured for percutaneous introduction and advancement within the patient'"'"'s vasculature and which is spaced closer to the distal end of the shaft than the proximal guidewire opening; and

g) a guidewire passageway which extends between the distal guidewire opening and the proximal guidewire opening and configured to slidably receive a guidewire therein.

6. A balloon catheter for performing an angioplasty procedure within a human patient'"'"'s coronary artery, comprising:

a) an elongated catheter shaft with proximal and distal ends, a distal shaft section which is configured to be percutaneously introduced into and advanced within the patient'"'"'s vasculature, a proximal shaft section which is much longer than the distal shaft section, which is configured to have a distal portion within the patient and a proximal portion thereof extending out of the patient during the procedure and which has an inflation lumen extending within the proximal and distal shaft sections;

b) a distal guidewire opening in the distal end of the shaft;

c) a proximal guidewire opening in the elongated shaft spaced at least about 10 cm proximally from the distal end of the shaft and a substantially greater distance from the proximal end of the shaft;

d) a balloon on the distal shaft section having an interior in fluid communication with the inflation lumen and being spaced closer to the distal end of the shaft than the proximal guidewire port; and

e) a guidewire passageway which extends between the distal guidewire opening and the proximal guidewire opening and which is configured to slidably receive a guidewire therein.

7. A balloon dilatation catheter assembly for performing an angioplasty procedure within a region of a human patient'"'"'s coronary artery comprising

a) a guiding catheter having a proximal and a distal end, a shaped distal extremity configured to seat within an ostia of the coronary artery in which the angioplasty procedure is to be performed, a port in the distal end, an inner lumen extending within the guiding catheter to the port in the distal end;

and

b) an elongated dilatation catheter having

an elongated shaft with proximal and distal ends, a distal shaft section, a proximal shaft section which is much longer than the distal shaft section, which is configured to have a distal portion within the patient and a proximal portion thereof extending out of the patient during the procedure and which has an inflation lumen extending therein,

a distal guidewire port in the distal end of the shaft,

a proximal guidewire port in the distal shaft section spaced a relatively short distance proximally from the distal end of the shaft and a substantially greater distance from the proximal end of the shaft,

a dilatation balloon on the distal shaft section which has an interior in fluid communication with the inflation lumen and which is spaced closer to the distal end of the shaft than to the proximal guidewire port, and

a guidewire passageway which extends between the distal guidewire port and the proximal guidewire port,

the dilatation catheter being slidably disposed within the inner lumen of the guiding catheter and positioned therein so that at least part of the distal shaft section of the dilatation catheter extends out the distal port of the guiding catheter and the proximal guidewire port of the dilatation catheter remains within the inner lumen of the guiding catheter.

8. A balloon catheter which is configured for percutaneous introduction and advancement into a patient'"'"'s vasculature, comprising:

a) an elongated catheter shaft with

proximal and distal ends,

a distal shaft section which is configured to be percutaneously introduced into and advanced within the patient'"'"'s vasculature, which includes a first tubular member defining at least in part an inflation lumen and a second tubular member defining at least in part a guidewire passageway,

a proximal shaft section which is much longer than the distal shaft section, which is configured to have a distal portion within the patient and a proximal portion extending out of the patient during the procedure;

b) a distal guidewire opening in the distal end of the shaft which is in fluid communication with the guidewire passageway;

c) a proximal guidewire opening in the elongated shaft which is in fluid communication with the guidewire passageway and which is spaced at least about 10 cm proximally from the distal end of the shaft and a substantially greater distance from the proximal end of the shaft; and

d) a balloon on the distal shaft section having an interior in fluid communication with the inflation lumen.

9. The balloon catheter of claim 8 wherein the first tubular member is disposed about the second tubular member.

10. The balloon catheter of claim 9 wherein the first tubular member is at least in part secured to an exterior portion of the second tubular member.