Guide catheters for accessing cardiac sites
First Claim
1. A guide catheter for introducing a cardiac lead having a distal fixation mechanism through a pathway from an incision to an implantation site relative to a heart chamber, comprising:
- an elongated catheter body extending between a catheter body proximal end and a catheter body distal end, the catheter body having a catheter body sidewall and comprising a proximal portion and a distal leader extending distally from a distal end of the proximal portion;
the catheter body sidewall enclosing a guide lumen having a guide lumen axis and extending between a guide lumen entry port and the catheter body distal end, the guide lumen diameter sized to receive a guide tool inserted therein to aid in steering the guide catheter body through the pathway;
the proximal portion of the catheter body sidewall enclosing a delivery lumen having a delivery lumen axis and extending between a delivery lumen entry port and a delivery lumen exit port through the catheter body sidewall proximal to the distal leader;
the delivery lumen axis and the guide lumen axis extending in a side-by-side manner along a first segment of the proximal portion and defining a first geometric axis plane; and
the proximal portion of the catheter body sidewall having a cross-sectional shape comprising a first substantially flat major side extending along a second segment of the proximal portion of the catheter body in a plane that is transverse to the first geometric axis plane to cause the proximal portion of the catheter body to preferentially bend as the catheter body tracks a contour of the heart, the catheter body preferentially bending in a direction that the delivery lumen exit port is oriented to thereby bias the delivery lumen exit port toward the heart during advancement through the pathway to facilitate passage of the fixation mechanism of the cardiac lead through a vessel wall into the myocardium;
wherein the first segment is a distal segment of the proximal portion extending to the delivery lumen exit port;
the delivery lumen axis and the guide lumen axis extending in a side-by-side manner along a third segment of the proximal portion, the third segment proximal to the first segment;
the delivery lumen axis and the guide lumen axis extending along the third segment defining a second geometric axis plane transverse to the first geometric axis plane.
1 Assignment
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Accused Products
Abstract
Guide catheters for facilitating implantation of cardiac leads for applying electrical stimulation to and/or sensing electrical activity of the heart through one or more electrodes positioned at an implantation site within a heart chamber or cardiac vessel adjacent a heart chamber. Such a cardiac lead has low torqueability and pushability through a pathway to enable attachment of the cardiac lead at the implantation site. The catheter body comprises a delivery lumen to introduce a small diameter cardiac lead and a guide lumen to receive a guide tool to locate the catheter body distal end at the implantation site. The small diameter lumen within a small diameter guide tube extends distally from the delivery exit port of the delivery lumen. The catheter body is shaped to bias the delivery lumen exit port toward the heart.
92 Citations
23 Claims
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1. A guide catheter for introducing a cardiac lead having a distal fixation mechanism through a pathway from an incision to an implantation site relative to a heart chamber, comprising:
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an elongated catheter body extending between a catheter body proximal end and a catheter body distal end, the catheter body having a catheter body sidewall and comprising a proximal portion and a distal leader extending distally from a distal end of the proximal portion; the catheter body sidewall enclosing a guide lumen having a guide lumen axis and extending between a guide lumen entry port and the catheter body distal end, the guide lumen diameter sized to receive a guide tool inserted therein to aid in steering the guide catheter body through the pathway; the proximal portion of the catheter body sidewall enclosing a delivery lumen having a delivery lumen axis and extending between a delivery lumen entry port and a delivery lumen exit port through the catheter body sidewall proximal to the distal leader; the delivery lumen axis and the guide lumen axis extending in a side-by-side manner along a first segment of the proximal portion and defining a first geometric axis plane; and the proximal portion of the catheter body sidewall having a cross-sectional shape comprising a first substantially flat major side extending along a second segment of the proximal portion of the catheter body in a plane that is transverse to the first geometric axis plane to cause the proximal portion of the catheter body to preferentially bend as the catheter body tracks a contour of the heart, the catheter body preferentially bending in a direction that the delivery lumen exit port is oriented to thereby bias the delivery lumen exit port toward the heart during advancement through the pathway to facilitate passage of the fixation mechanism of the cardiac lead through a vessel wall into the myocardium; wherein the first segment is a distal segment of the proximal portion extending to the delivery lumen exit port; the delivery lumen axis and the guide lumen axis extending in a side-by-side manner along a third segment of the proximal portion, the third segment proximal to the first segment; the delivery lumen axis and the guide lumen axis extending along the third segment defining a second geometric axis plane transverse to the first geometric axis plane. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A guide catheter for introducing a cardiac lead having a distal fixation mechanism through a pathway from an incision to an implantation site relative to a heart chamber, comprising:
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an elongated catheter body extending between a catheter body proximal end and a catheter body distal end, the catheter body having a catheter body sidewall and comprising a proximal portion and a distal leader extending distally from a distal end of the proximal portion; the catheter body sidewall enclosing a guide lumen having a guide lumen axis and extending between a guide lumen entry port and the catheter body distal end, the guide lumen diameter sized to receive a guide tool inserted therein to aid in steering the guide catheter body through the pathway; the proximal portion of the catheter body sidewall enclosing a delivery lumen having a delivery lumen axis and extending between a delivery lumen entry port and a delivery lumen exit port through the catheter body sidewall proximal to the catheter body distal end, wherein the delivery lumen and the guide lumen extend in side-by-side relation through a first segment of the proximal portion and define a first geometric axis plane, the delivery lumen shifted out of the side-by-side relation in a distal segment of the proximal portion to orient the delivery lumen exit port in a direction transverse to the first geometric axis plane, the catheter body sidewall comprising a cross-sectional shape having at least one substantially flat major side that extends along at least a segment of the proximal portion of the catheter body in a plane that is parallel to the first geometric axis plane thereby causing the catheter proximal portion to bend in the direction of the delivery lumen exit port as the catheter body tracks a contour of the heart and thereby bias the delivery lumen exit port toward a blood vessel wall at the implantation site; wherein the first segment is a distal segment of the proximal portion extending to the delivery lumen exit port; the delivery lumen axis and the guide lumen axis extending in a side-by-side manner along a second segment of the proximal portion, the second segment proximal to the first segment; the delivery lumen axis and the guide lumen axis extending along the second segment defining a second geometric axis plane transverse to the first geometric axis plane. - View Dependent Claims (17, 18, 19, 20, 21, 22)
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23. A guide catheter for introducing a cardiac lead having a distal fixation mechanism through a pathway from an incision to an implantation site relative to a heart chamber, comprising:
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an elongated catheter body extending between a catheter body proximal end and a catheter body distal end, the catheter body having a catheter body sidewall and comprising a proximal portion and a distal leader extending distally from a distal end of the proximal portion; the catheter body sidewall enclosing a guide lumen having a guide lumen axis and extending between a guide lumen entry port and the catheter body distal end, the guide lumen diameter sized to receive a guide tool inserted therein to aid in steering the guide catheter body through the pathway; and the proximal portion of the catheter body sidewall enclosing a delivery lumen having a delivery lumen axis and extending between a delivery lumen entry port and a delivery lumen exit port through the catheter body sidewall proximal to the catheter body distal end; the guide lumen axis and the delivery lumen axis extending in a side-by-side manner along a first segment of the proximal portion and defining a first geometric axis plane; the proximal portion of the catheter body sidewall having a cross-sectional shape comprising at least one substantially flat major side that extends along at least a segment of the proximal portion of the catheter body in a plane that is transverse to the first geometric axis plane to cause the proximal portion of the catheter body to preferentially bend as the catheter body tracks a contour of the heart, the catheter body preferentially bending in a direction that the delivery lumen exit port is oriented, the catheter body sidewall comprising a curved inner wall forming a guide bend just proximal to the delivery lumen exit port to bias the delivery lumen exit port away from the guide lumen and toward the heart during advancement through the pathway to facilitate passage of the fixation mechanism of the cardiac lead through a vessel wall into the myocardium; wherein the first segment is a distal segment of the proximal portion extending to the delivery lumen exit port; the delivery lumen axis and the guide lumen axis extending in a side-by-side manner along a second segment of the proximal portion, the second segment proximal to the first segment; the delivery lumen axis and the guide lumen axis extending along the second segment defining a second geometric axis plane transverse to the first geometric axis plane.
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Specification