Method and apparatus for intramural delivery of a substance
First Claim
1. An intramural substance delivery system for delivering a therapeutic or diagnostic lining penetration infusate as a plurality of lining penetration jets through a body vessel wall lining and intramurally into the body vessel wall comprising:
- an infusion catheter having a side wall and catheter lumen extending between a catheter proximal end and a catheter distal end, an elongated infusion segment having a plurality of closely spaced apart, infusion holes in said side wall that extend from said catheter lumen to the outer surface, said spaced apart infusion holes having a diameter of about 0.01 cm and distributed over a length of the infusion segment of about 0.2 cm to about 2.0 cm in a helical pattern and in a density of 20-32 infusion holes per centimeter length of said helical pattern, and a valve in said catheter distal end that is normally closed to close the catheter lumen distal end and penetrable by a guidewire for receiving said guidewire and allowing advancement of said infusion catheter over the guidewire to orient the infusion segment side wall of the infusion catheter with respect to a section of the body vessel wall and for allowing withdrawal of the guidewire proximally from said valve to allow said valve to close and from said catheter lumen to allow said catheter lumen to be filled with the lining penetration infusate; and
means for injecting a predetermined bolus of the lining penetration infusate at a predetermined rate into said catheter lumen at a pressure that effects ejection of the lining penetration infusate at high velocity through said infusion holes as fine lining penetration jets of lining penetration infusate to mechanically penetrate the lining of the vessel wall.
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Accused Products
Abstract
An infusion catheter is formed with a catheter lumen extending from a proximal end connector assembly to a distal end valve that is normally closed but is penetrable to allow introduction of a guidewire through the catheter lumen and distal end valve and to thereby allow advancement of the infusion catheter over the guidewire, thereby allowing access of a distal infusion segment to a wide number of locations in the body. A plurality of, closely spaced, side wall infusion holes infusion holes extend from the catheter lumen through the catheter side wall in a high strength, catheter distal end, infusion segment. A therapeutic or diagnostic substance is pumped in a pulsatile manner through the catheter lumen under high pressure after removal of the guidewire and closure of the distal end valve. The infusion segment is preferably moved back and forth as jets of the therapeutic or diagnostic substance are emitted. In one embodiment, the infusion catheter is used in thrombectomy methods and apparatus for removing a thrombus from a blood vessel by high velocity injection of a therapeutic or diagnostic substance, e.g., a plasminogen activator, through the side wall infusion holes as power lysis jets that lyse the adjacent thrombin. In another embodiment, the infusion catheter is used in intramural infusate injection, wherein a therapeutic or diagnostic lining penetration infusate is ejected from the infusion holes as a plurality of lining penetration jets that penetrate through a body vessel wall lining and intramurally into the body vessel wall.
180 Citations
22 Claims
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1. An intramural substance delivery system for delivering a therapeutic or diagnostic lining penetration infusate as a plurality of lining penetration jets through a body vessel wall lining and intramurally into the body vessel wall comprising:
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an infusion catheter having a side wall and catheter lumen extending between a catheter proximal end and a catheter distal end, an elongated infusion segment having a plurality of closely spaced apart, infusion holes in said side wall that extend from said catheter lumen to the outer surface, said spaced apart infusion holes having a diameter of about 0.01 cm and distributed over a length of the infusion segment of about 0.2 cm to about 2.0 cm in a helical pattern and in a density of 20-32 infusion holes per centimeter length of said helical pattern, and a valve in said catheter distal end that is normally closed to close the catheter lumen distal end and penetrable by a guidewire for receiving said guidewire and allowing advancement of said infusion catheter over the guidewire to orient the infusion segment side wall of the infusion catheter with respect to a section of the body vessel wall and for allowing withdrawal of the guidewire proximally from said valve to allow said valve to close and from said catheter lumen to allow said catheter lumen to be filled with the lining penetration infusate; and
means for injecting a predetermined bolus of the lining penetration infusate at a predetermined rate into said catheter lumen at a pressure that effects ejection of the lining penetration infusate at high velocity through said infusion holes as fine lining penetration jets of lining penetration infusate to mechanically penetrate the lining of the vessel wall. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. An intramural substance delivery system for delivering a therapeutic or diagnostic lining penetration infusate as a plurality of lining penetration jets through a body vessel wall lining and intramurally into the body vessel wall comprising:
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an infusion catheter having a side wall and catheter lumen extending between a catheter proximal end and a catheter distal end, an elongated infusion segment having a plurality of closely spaced apart, infusion holes in said side wall that extend from said catheter lumen to the outer surface, and a valve in said catheter distal end that is normally closed to close the catheter lumen distal end and penetrable by a guidewire for receiving said guidewire and allowing advancement of said infusion catheter over the guidewire to orient the infusion segment side wall of the infusion catheter with respect to a section of the body vessel wall and for allowing withdrawal of the guidewire proximally from said valve to allow said valve to close and from said catheter lumen to allow said catheter lumen to be filled with the lining penetration infusate; and
means for injecting a bolus of about 5 ml of therapeutic or diagnostic substance at a rate of about 25 ml per second into said catheter lumen at a pressure that effects ejection of the therapeutic or diagnostic substance through said plurality of infusion holes as fine lining penetration jets of lining penetration infusate to mechanically penetrate the lining of the vessel wall. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22)
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Specification