Retractable catheter systems and associated methods

• US 6,743,218 B2
• Filed: 12/04/2001
• Issued: 06/01/2004
• Est. Priority Date: 01/15/1999
• Status: Expired due to Fees

• Current Assignee: Maginot Catheter Technologies, Inc.
• Original Assignee: Cathlogic, Inc.
• Inventors: Maginot, Thomas J., Maginot, Paul J.
• Primary Examiner(s): Casler, Brian L.
• Assistant Examiner(s): MAYNARD, JENNIFER J
• Application Number:
  US10/006,799
• Publication Number:
  US 20020087108A1
• Time in Patent Office: 910 Days
• Field of Search: 604/4.01, 604/6.16, 604/19, 604/27-29, 604/43, 604/500, 604/506-508, 604/510, 604/93.01, 604/158, 604/163, 604/164.01, 604/164.02, 604/164.04, 604/164.08, 604/164.09, 604/165.01, 604/165.02, 604/167.01, 604/167.04, 604/174, 604/263, 604/264, 604/523, 604/533, 604/540-544
• US Class Current: 604/510
• CPC Class Codes: A61M 1/16 with membranes
• CPC Class Codes: A61M 1/3659 Cannulae pertaining to extracorporeal circulation
• CPC Class Codes: A61M 25/0194 Tunnelling catheters

Abstract

A method of performing dialysis with a catheter system which includes (i) a working catheter having a distal working orifice, and (ii) a guide catheter having a guide lumen and a distal guide orifice is disclosed. The method includes the step of locking the working catheter in an operative position in which (i) the working catheter extends through the guide lumen of the guide catheter and out of the distal guide orifice of the guide catheter, and (ii) the distal working orifice of the working catheter is positioned outside of the guide catheter. The method further includes the step of performing a dialysis procedure including advancing and withdrawing blood through the working catheter while the working catheter is locked in the operative position. Moreover, the method includes the step of, after the dialysis procedure performing step, locking the working catheter in a stowed position in which (i) the working catheter extends into the guide lumen of the guide catheter, and (ii) the distal working orifice of the working catheter is positioned within the guide lumen of the guide catheter.

Claims

1. A method of performing dialysis with a catheter system which includes (i) a working catheter having a distal working orifice, and (ii) a guide catheter having a guide lumen and a distal guide orifice, comprising the steps of:

locking said working catheter in an operative position in which (i) said working catheter extends through said guide lumen of said guide catheter and out of said distal guide orifice of said guide catheter, and (ii) said distal working orifice of said working catheter is positioned outside of said guide catheter;

performing a dialysis procedure including advancing and withdrawing blood through said working catheter while said working catheter is locked in said operative position; and

after said dialysis procedure performing step, locking said working catheter in a stowed position in which (i) said working catheter extends into said guide lumen of said guide catheter, and (ii) said distal working orifice of said working catheter is positioned within said guide lumen of said guide catheter.

2. The method of claim 1, further comprising the step of advancing a quantity of blood clot dissolving liquid within said guide lumen of said guide catheter when said working catheter is locked in said stowed position.

3. The method of claim 2, wherein said blood clot dissolving liquid contacts said working catheter at said distal working orifice when said working catheter is locked in said stowed position.

4. The method of claim 3, wherein said blood clot dissolving liquid includes urokinase.

5. The method of claim 1, further comprising the step of:

inhibiting advancement of blood into contact with said working catheter at said distal working orifice with a distal valve while said working catheter is locked in said stowed position.

6. The method of claim 5, wherein said inhibiting step includes the step of inhibiting advancement of blood from a first location outside of said guide lumen to a second location inside of said guide lumen with said distal valve while said working catheter is locked in said stowed position.

7. The method of claim 6, wherein:

said distal working orifice is positioned on a proximal side of said distal valve when said working catheter is locked in said stowed position, and

said distal working orifice is positioned on a distal side of said distal valve when said working catheter is locked in said operative position.

8. The method of claim 1, wherein:

said working catheter is a multiple lumen catheter which includes an advancement lumen and a withdrawal lumen, and

said dialysis procedure performing step includes the steps of (i) advancing blood from a proximal end of said working catheter toward a distal end of said working catheter through said advancement lumen, and (ii) withdrawing blood from said distal end of said working catheter toward said proximal end of said working catheter through said withdrawal lumen.

9. The method of claim 1, wherein:

said working catheter includes a distal working segment in which said distal working orifice is defined,

said distal working segment extends out of said distal guide orifice of said guide catheter so that said distal working orifice is positioned outside of said guide lumen when said working catheter is locked in said operative position, and

said distal working segment is positioned completely within said guide catheter such that said distal working orifice is positioned within said guide lumen when said working catheter is locked in said stowed position.

10. The method of claim 1, further comprising the steps of:

advancing said guide catheter into a body of a patient so that (i) said distal guide orifice of said guide catheter is positioned within a blood vessel of said body, and (ii) a tissue ingrowth member is positioned in subcutaneous tissue of said body; and

leaving said guide catheter within said body for a period of time sufficient to cause said subcutaneous tissue to become affixed to said tissue ingrowth member,

wherein said tissue ingrowth member is secured to an outer surface of said guide catheter and configured to facilitate fibrous tissue growth therein, and

wherein said guide catheter advancing step is performed prior to said dialysis procedure performing step.

11. A method of performing a series of dialysis procedures on a body of a patient with a catheter system which includes (i) a working catheter having a distal working orifice, and (ii) a guide catheter having a guide lumen and a distal guide orifice, comprising the steps of:

(a) locking said working catheter in an operative position in which (i) said working catheter extends through said guide lumen of said guide catheter and out of said distal guide orifice of said guide catheter, and (ii) said distal working orifice of said working catheter is positioned outside of said guide catheter;

(b) after step (a), performing an initial dialysis procedure on said body of said patient which includes advancing and withdrawing fluid through said working catheter while said working catheter is locked in said operative position, said working catheter being coupled to a dialysis machine during said initial dialysis procedure;

(c) after step (b), locking said working catheter in a stowed position in which (i) said working catheter extends into said guide lumen of said guide catheter, and (ii) said distal working orifice of said working catheter is positioned within said guide lumen of said guide catheter;

(d) after step (c), maintaining said working catheter in said stowed position during an idle period during which said catheter system is decoupled from said dialysis machine, said catheter system being located at least partially within said body of said patient throughout the entirety of said idle period;

(e) after step (d), locking said working catheter in said operative position; and

(f) after step (e), performing a subsequent dialysis procedure on said body of said patient which includes advancing and withdrawing fluid through said working catheter while said working catheter is locked in said operative position, said working catheter being coupled to said dialysis machine during said subsequent dialysis procedure.

12. The method of claim 11, further comprising the step of:

inhibiting advancement of blood into contact with said working catheter at said distal working orifice with a distal valve while said working catheter is locked in said stowed position.

13. The method of claim 12, wherein said inhibiting step includes the step of inhibiting advancement of blood from a first location outside of said guide lumen to a second location inside of said guide lumen with said distal valve while said working catheter is locked in said stowed position.

14. A method of performing dialysis on a body of a patient with a catheter system which includes (i) a conduit having a distal working orifice, and (ii) a guide catheter having a guide lumen and a distal guide orifice, comprising the steps of:

locking said conduit to said guide catheter in an operative position in which said distal working orifice of said conduit is positioned outside of said guide catheter;

performing an initial dialysis procedure including advancing and withdrawing blood through said conduit while said conduit is locked in said operative position; and

after said initial dialysis procedure, locking said conduit to said guide catheter in a stowed position in which said distal working orifice of said conduit is positioned within said guide lumen of said guide catheter.

15. The method of claim 14, further comprising the step of performing a subsequent dialysis procedure including advancing and withdrawing blood through said conduit while said conduit is locked in said operative position, wherein:

said catheter system is at least partially located at least partially within said body continuously between completion of said initial dialysis procedure and commencement of said subsequent dialysis procedure.

16. The method of claim 15, further comprising the step of:

prior to said initial dialysis procedure performing step, attaching said catheter system to said body, wherein said catheter system remains attached to said body continuously between completion of said initial dialysis procedure performing step and commencement of said subsequent dialysis procedure performing step.

17. The method of claim 15, wherein:

said initial dialysis procedure is an initial hemodialysis procedure, and

said subsequent dialysis procedure is a subsequent hemodialysis procedure.

18. The method of claim 15, wherein:

said initial dialysis procedure is an initial peritoneal dialysis procedure, and

said subsequent dialysis procedure is a subsequent peritoneal procedure.

19. The method of claim 18, wherein said conduit is a working catheter.

20. The method of claim 14, further comprising the step of advancing a quantity of blood clot dissolving liquid within said guide lumen of said guide catheter when said conduit is locked in said stowed position.

21. The method of claim 20, wherein said blood clot dissolving liquid contacts said conduit at said distal working orifice when said conduit is locked in said stowed position.

22. The method of claim 21, wherein said blood clot dissolving liquid includes urokinase.

23. The method of claim 14, further comprising the step of:

inhibiting advancement of blood into contact with said conduit at said distal working orifice with a distal valve while said conduit is locked in said stowed position.

24. The method of claim 23, wherein said inhibiting step includes the step of inhibiting advancement of blood from a first location outside of said guide lumen to a second location inside of said guide lumen with said distal valve while said conduit is locked in said stowed position.

25. The method of claim 24, wherein:

said distal working orifice is positioned on a proximal side of said distal valve when said conduit is locked in said stowed position, and

said distal working orifice is positioned on a distal side of said distal valve when said conduit is locked in said operative position.

26. The method of claim 14, wherein:

said conduit is a multiple lumen catheter which includes an advancement lumen and a withdrawal lumen, and

said initial dialysis procedure performing step includes the steps of (i) advancing blood from a proximal end of said conduit toward a distal end of said conduit through said advancement lumen, and (ii) withdrawing blood from said distal end of said conduit toward said proximal end of said conduit through said withdrawal lumen.

27. The method of claim 14, wherein:

said conduit includes a distal working segment in which said distal working orifice is defined,

said distal working segment extends out of said distal guide orifice of said guide catheter so that said distal working orifice is positioned outside of said guide lumen when said conduit is locked in said operative position, and

said distal working segment is positioned completely within said guide catheter such that said distal working orifice is positioned within said guide lumen when said conduit is locked in said stowed position.

28. A method of performing a series of medical procedures on a body of a patient, comprising the steps of:

securing a catheter system to said body using a tunneled catheter technique;

performing an initial medical procedure on said body after said securing step, said initial medical procedure including advancing fluid through a distal orifice of a conduit of said catheter system, and said distal orifice being located outside of a guide lumen of a guide catheter of said catheter system during said initial medical procedure performing step;

after said initial medical procedure performing step, locking said distal orifice of said conduit within said guide lumen of said guide catheter of said catheter system; and

performing a subsequent medical procedure on said body after said locking step, said subsequent medical procedure including advancing fluid though said distal orifice of said conduit of said catheter system, and said distal orifice being located outside of said guide lumen of said guide catheter of said catheter system during said subsequent medical procedure performing step.

29. The method of claim 28, wherein:

said initial medical procedure is an initial dialysis procedure, and

said subsequent medical procedure is a subsequent dialysis procedure.

30. The method of claim 29, wherein:

said initial dialysis procedure is an initial hemodialysis procedure, and

said subsequent dialysis procedure is a subsequent hemodialysis procedure.

31. The method of claim 29, wherein:

said initial dialysis procedure is an initial peritoneal dialysis procedure, and

said subsequent dialysis procedure is a subsequent peritoneal procedure.

32. The method of claim 28, wherein:

said initial medical procedure is an initial plasmapheresis procedure, and

said subsequent medical procedure is a subsequent plasmapheresis procedure.

33. The method of claim 28, wherein:

said initial medical procedure is an initial total parenteral nutrition administration procedure, and

said subsequent medical procedure is a subsequent total parenteral nutrition administration procedure.

34. The method of claim 28, wherein:

said initial medical procedure is an initial chemotherapy administration procedure, and

said subsequent medical procedure is a subsequent chemotherapy administration procedure.

35. The method of claim 28, wherein:

said initial medical procedure is an initial blood transfusion procedure, and

said subsequent medical procedure is a subsequent blood transfusion procedure.

36. The method of claim 28, wherein:

said initial medical procedure is an initial blood sampling procedure, and

said subsequent medical procedure is a subsequent blood sampling procedure.

37. The method of claim 28, wherein said securing step includes the steps of:

advancing said guide catheter into said body so that (i) said distal guide orifice of said guide catheter is positioned within a blood vessel of said body, and (ii) a tissue ingrowth member which is secured to an outer surface of said guide catheter is positioned in subcutaneous tissue of said body; and

leaving said guide catheter within said body for a period of time sufficient to cause said subcutaneous tissue to become affixed to said tissue ingrowth member.

38. The method of claim 28, wherein said catheter system is located within said body continuously between completion of said initial medical procedure performing step and commencement of said subsequent medical procedure performing step.

39. The method of claim 28, wherein said catheter system remains attached to said body continuously between completion of said initial medical procedure performing step and commencement of said subsequent medical procedure performing step.

40. The method of claim 28, further comprising the step of advancing a quantity of blood clot dissolving liquid within said guide lumen of said guide catheter while said distal orifice of said conduit is locked within said guide lumen of said guide catheter.

41. The method of claim 40, wherein said blood clot dissolving liquid contacts said conduit at said distal working orifice while said distal orifice of said conduit is locked within said guide lumen of said guide catheter.

42. The method of claim 41, wherein said blood clot dissolving liquid includes urokinase.

43. The method of claim 28, further comprising the step of:

inhibiting advancement of blood into contact with said conduit at said distal working orifice with a distal valve while said distal orifice of said conduit is locked within said guide lumen of said guide catheter.

44. The method of claim 43, wherein said inhibiting step includes the step of inhibiting advancement of blood from a first location outside of said guide lumen to a second location inside of said guide lumen with said distal valve while said distal orifice of said conduit is locked within said guide lumen of said guide catheter.

45. The method of claim 44, wherein:

said distal working orifice is positioned on a proximal side of said distal valve while said distal orifice of said conduit is locked within said guide lumen of said guide catheter, and

said distal working orifice is positioned on a distal side of said distal valve during (i) said initial medical procedure performing step, and (ii) said subsequent medical procedure performing step.

46. The method of claim 28, wherein:

said conduit is a multiple lumen catheter which includes an advancement lumen and a withdrawal lumen, and

said medical procedure performing step includes the steps of (i) advancing blood from a proximal end of said conduit toward a distal end of said conduit through said advancement lumen, and (ii) withdrawing blood from said distal end of said conduit toward said proximal end of said conduit through said withdrawal lumen.

47. The method of claim 28, wherein:

said conduit includes a distal working segment in which said distal working orifice is defined,

said distal working segment extends out of said distal guide orifice of said guide catheter so that said distal working orifice is positioned outside of said guide lumen during said initial medical procedure performing step, and

said distal working segment is positioned completely within said guide catheter such that said distal working orifice is positioned within said guide lumen while said distal orifice of said conduit is locked within said guide lumen of said guide catheter.

48. The method of claim 28, wherein:

said guide catheter further has a proximal guide orifice, and

said conduit extends through said proximal guide orifice, said guide lumen, and said distal guide orifice during said initial medical procedure performing step.

49. The method of claim 28, wherein said conduit is a working catheter.

50. A method of performing a series of dialysis procedures on a body of a patient, comprising the steps of:

performing an initial dialysis procedure on said body including advancing blood through a distal orifice of a conduit of a catheter system, and said distal orifice being located outside of a guide lumen of a guide catheter of said catheter system during said initial dialysis procedure performing step;

after said initial dialysis procedure performing step, locking said distal orifice of said conduit within said guide lumen of said guide catheter of said catheter system; and

performing a subsequent dialysis procedure on said body after said locking step, said dialysis procedure including advancing blood though said distal orifice of said conduit of said catheter system, and said distal orifice being located outside of said guide lumen of said guide catheter of said catheter system during said subsequent dialysis procedure performing step.

51. The method of claim 50, wherein said conduit is located within said body continuously between completion of said initial dialysis procedure performing step and commencement of said subsequent dialysis procedure performing step.

52. The method of claim 50, further comprising the step of:

prior to said initial dialysis procedure performing step, attaching said catheter system to said body, wherein said working catheter remains attached to said body continuously between completion of said initial dialysis procedure performing step and commencement of said subsequent dialysis procedure performing step.

53. The catheter system of claim 50, wherein said conduit is a working catheter.

54. The method of claim 50, wherein:

said initial dialysis procedure is an initial hemodialysis procedure, and

said subsequent dialysis procedure is a subsequent hemodialysis procedure.

55. The method of claim 50, wherein:

said initial dialysis procedure is an initial peritoneal dialysis procedure, and

said subsequent dialysis procedure is a subsequent peritoneal procedure.

56. The method of claim 50, wherein said initial dialysis procedure performing step, said locking step, and said subsequent dialysis procedure performing step are each performed while said catheter system is secured to said body using said tunneled catheter technique.

57. The method of claim 52, wherein said attaching step includes the steps of:

attaching said catheter system to an attachment mechanism which includes at least one extension, and

suturing said at least one extension to said body.

58. The method of claim 52, wherein said attaching step includes the step of securing said catheter system to said body using a tunneled catheter technique.

59. The method of claim 50, further comprising the step of advancing a quantity of blood clot dissolving liquid within said guide lumen of said guide catheter while said distal orifice of said conduit is locked within said guide lumen of said guide catheter.

60. The method of claim 59, wherein said blood clot dissolving liquid contacts said conduit at said distal working orifice while said distal orifice of said conduit is locked within said guide lumen of said guide catheter.

61. The method of claim 59, wherein said blood clot dissolving liquid includes urokinase.

62. The method of claim 50, further comprising the step of:

inhibiting advancement of blood into contact with said conduit at said distal working orifice with a distal valve while said distal orifice of said conduit is locked within said guide lumen of said guide catheter.

63. The method of claim 62, wherein said inhibiting step includes the step of inhibiting advancement of blood from a first location outside of said guide lumen to a second location inside of said guide lumen with said distal valve while said distal orifice of said conduit is locked within said guide lumen of said guide catheter.

64. The method of claim 63, wherein:

said distal working orifice is positioned on a proximal side of said distal valve while said distal orifice of said conduit is locked within said guide lumen of said guide catheter, and

said distal working orifice is positioned on a distal side of said distal valve during (i) said initial dialysis procedure performing step, and (ii) said subsequent dialysis procedure performing step.

65. The method of claim 50, wherein:

said conduit is a multiple lumen catheter which includes an advancement lumen and a withdrawal lumen, and

said initial dialysis procedure performing step includes the steps of (i) advancing blood from a proximal end of said conduit toward a distal end of said conduit through said advancement lumen, and (ii) withdrawing blood from said distal end of said conduit toward said proximal end of said conduit through said withdrawal lumen.

66. The method of claim 50, wherein:

said conduit includes a distal working segment in which said distal working orifice is defined,

said distal working segment extends out of a distal guide orifice of said guide catheter so that said distal working orifice is positioned outside of said guide lumen during said initial dialysis procedure performing step, and

said distal working segment is positioned completely within said guide catheter such that said distal working orifice is positioned within said guide lumen while said distal orifice of said conduit is locked within said guide lumen of said guide catheter.

67. The method of claim 50, wherein:

said guide catheter further has a proximal guide orifice, and

said conduit extends through said proximal guide orifice, said guide lumen, and said distal guide orifice during said initial dialysis procedure performing step.