Catheters and related devices for forming passageways between blood vessels or other anatomical structures

• US 7,648,517 B2
• Filed: 07/24/2001
• Issued: 01/19/2010
• Est. Priority Date: 10/13/1995
• Status: Expired due to Fees

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Inventors: Evard, Philip Christopher, Garibotto, John Thomas, Macauley, Patrick Edward, Selfridge, Alan Robert, Machold, Timothy R., Flaherty, J. Christopher, Makower, Joshua, Tumas, Margaret W., Whitt, Jason Brian
• Primary Examiner(s): SWEET, THOMAS
• Application Number:
  US09/912,122
• Publication Number:
  US 20010047165A1
• Time in Patent Office: 3,101 Days
• Field of Search: 604/51, 604/53, 604/96, 604/96.01, 606/159, 606/169, 600/439, 600/459
• US Class Current: 606/169
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 17/0643 with separate closing member, e.g. for interlocking with staple
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 17/3417 Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating syringe needles A61M5/32; dilators A61M29/00
• CPC Class Codes: A61B 17/3439 with means for changing the inner diameter of the cannula, e.g. expandable A61B17/3423, A61B17/3431 take precedence; catheters A61M25/0662
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00504 Tissue welding
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61B 2017/1139 : Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61B 2017/12127 : Double occlusion, e.g. for creating blood-free anastomosis site
• CPC Class Codes: A61B 2017/22067 : Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61B 2017/22068 : Centering
• CPC Class Codes: A61B 2017/22069 : Immobilising; Stabilising
• CPC Class Codes: A61B 2017/22072 : with an instrument channel, e.g. for replacing one instrument by the other in cannulas A61B17/3417
• CPC Class Codes: A61B 2017/306 : holding by means of suction
• CPC Class Codes: A61B 2017/347 : Locking means, e.g. for locking instrument in cannula
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2090/0811 : for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/378 : using ultrasound
• CPC Class Codes: A61B 2090/3925 : ultrasonic
• CPC Class Codes: A61B 2090/3929 : Active markers
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/445 : Details of catheter construction
• CPC Class Codes: A61B 8/4488 : the transducer being a phased array
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61B 90/40 : Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
• CPC Class Codes: A61F 2/2493 : Transmyocardial revascularisation [TMR] devices
• CPC Class Codes: A61F 2002/30079 : magnetic
• CPC Class Codes: A61F 2210/009 : magnetic
• CPC Class Codes: A61M 2025/0076 : Unidirectional valves
• CPC Class Codes: A61M 2025/009 : the needle having a bent tip, i.e. the needle distal tip is angled in relation to the longitudinal axis of the catheter
• CPC Class Codes: A61M 2025/1052 : for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 25/0084 : being one or more injection needles
• CPC Class Codes: A61M 25/0141 : having flexible regions as a result of using materials with different mechanical properties
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/0155 : with hydraulic or pneumatic means, e.g. balloons or inflatable compartments
• CPC Class Codes: A61M 29/00 : Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

The inventions described in this patent application include i) a torqueable introducer sheath which is useable in conjunction with a transvascular passageway forming catheter to effect precise rotational control of the catheter; ii) an anchorable guide catheter which is useable in conjunction with an intravascular imaging catheter and a transvascular passageway-forming catheter to effect precise positioning and aiming of the passageway-forming catheter; iii) a passageway forming catheter having a torqueable proximal portion to facilitate precise rotational positioning of the distal portion of the catheter; iv) a deflectable-tipped passageway forming catheter, v) various markers and other apparatus useable in conjunction with any of the passageway-forming catheters to facilitate precise positioning and aiming of the catheter, and vi) an apparatus which may be formed within a catheter to prevent a member, apparatus of flow of material from being inadvertently advanced through a lumen of the catheter.

Claims

1. A system that is useable to guide the advancement of a guidewire from a location within the lumen of a blood vessel to a target location within or outside of the wall of that blood vessel, said system comprising:

an elongate flexible catheter body that is advanceable through the vasculature into said blood vessel lumen, said catheter body having a side wall and at least one lumen extending longitudinally therethrough;

an opening formed in the side wall of said catheter body;

a single tissue penetrating element having a lumen, a tissue penetrating distal tip and a distal end opening, said tissue penetrating element being alternately disposable in;

a) a first position wherein the tissue penetrating element is substantially within the catheter body; and

b) a second position wherein the tissue penetrating element assumes a predetermined curved configuration and extends out of the opening formed in the side wall of said catheter body so as to penetrate a wall of the blood vessel adjacent to the blood vessel lumen in which the catheter is positioned; and

a guidewire that is advanceable through the lumen of the tissue penetrating element while the tissue penetrating element is in the second position;

an imaging apparatus on or in the catheter body and useable to image the target location; and

an image display apparatus adapted to display an image received from the imaging apparatus in combination with an indication of the trajectory on which the tissue penetrating element is expected to subsequently advance while the tissue penetrating element is still in the first position, thereby facilitating adjustment of the rotational orientation of the catheter body within the blood vessel while the penetrating element is in the first position so that subsequent advancement of the tissue penetrating element to the second position will cause the tissue penetrating element to advance in the direction of the target location.

2. A system according to claim 1 further comprising an anchoring member, said anchoring member being deployable when the catheter body is inserted into an anatomical lumen such that a surface of the anchoring member will engage a wall of the anatomical lumen thereby preventing at least a portion of the catheter body from undergoing substantial movement within the anatomical lumen.

3. A system according to claim 2 wherein the anchoring member comprises a balloon.

4. A system according to claim 2 further comprising a friction enhancing treatment upon a surface of the anchoring member.

5. A system according to claim 4 wherein said friction enhancing treatment is selected from the group of friction enhancing treatments consisting of:

texturing;

adhesive; and

,

woven fabric.

6. A system according to claim 1 wherein the imaging apparatus comprises an intravascular ultrasound imaging apparatus.

7. A system according to claim 1 wherein the catheter body has a lumen into which the imaging apparatus is inserted.