Medical guide element with diameter transition
First Claim
1. An apparatus for percutaneously dilating an opening in the wall of a blood vessel or other anatomic structure comprising, in combination:
- an elongate, introducing guide element having a proximal segment and a distal segment which meet at a juncture, said proximal segment having a first outer diameter at said juncture and said distal segment having a second outer diameter at said juncture greater than said first outer diameter thereby forming an abrupt, circumferential step comprising a proximally-facing surface such that said circumferential step creates a discrete transition between said proximal segment and said distal segment,said distal segment comprising a distal tip and an elongate portion extending from said step to said distal tip of said distal segment, said elongate portion having an outer diameter that is substantially constant over the entire length of said elongate portion and equal to said second outer diameter; and
a dilator matched to said introducing guide element having an interior bore of sufficient size to permit said dilator to slide over the entire proximal segment of said introducing guide element,said dilator comprising a distal tip with an opening to said interior bore, said dilator distal tip having an inner diameter less than said second diameter and an outer diameter substantially equal to said second diameter, such that when assembled together with said dilator distal tip abutting said step, said dilator cannot pass distally beyond said step.
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Accused Products
Abstract
Improved medical filaments for use with dilators to be inserted into a patient, for example into the vascular lumen, are provided, as well as combinations of filaments and dilators. Methods for use of such filaments and filament-dilator combinations are also described. The filament includes a proximal segment and a distal segment. The diameter of the distal segment is greater than the diameter of the proximal segment. The change in diameter is abrupt, providing a discrete step transition at a point along the filament which presents a proximally-facing surface on the distal segment. When the proximal segment of the filament is fully inserted into a dilator having a distal tip adapted for insertion into a patient, the dilator distal tip firmly abuts the proximally-facing end surface of the distal segment. The relative dimensions of the dilator tip and the discrete stepped transition of the filament provides full shielding or over shielding of the dilator tip, thereby facilitating passage of the dilator tip along the tissue track, through the puncture hole and into the orifice.
67 Citations
66 Claims
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1. An apparatus for percutaneously dilating an opening in the wall of a blood vessel or other anatomic structure comprising, in combination:
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an elongate, introducing guide element having a proximal segment and a distal segment which meet at a juncture, said proximal segment having a first outer diameter at said juncture and said distal segment having a second outer diameter at said juncture greater than said first outer diameter thereby forming an abrupt, circumferential step comprising a proximally-facing surface such that said circumferential step creates a discrete transition between said proximal segment and said distal segment, said distal segment comprising a distal tip and an elongate portion extending from said step to said distal tip of said distal segment, said elongate portion having an outer diameter that is substantially constant over the entire length of said elongate portion and equal to said second outer diameter; and a dilator matched to said introducing guide element having an interior bore of sufficient size to permit said dilator to slide over the entire proximal segment of said introducing guide element, said dilator comprising a distal tip with an opening to said interior bore, said dilator distal tip having an inner diameter less than said second diameter and an outer diameter substantially equal to said second diameter, such that when assembled together with said dilator distal tip abutting said step, said dilator cannot pass distally beyond said step. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29)
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30. A kit containing components of an apparatus for percutaneously creating and dilating an opening in the wall of a blood vessel or other anatomic structure comprising:
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a needle having a hollow bore; an elongate, introducing guide element matched for use with said needle, having a proximal segment and a distal segment which meet at a juncture, said proximal segment having a first outer diameter at said juncture and said distal segment having a second outer diameter at said juncture greater than said first outer diameter thereby forming an abrupt, circumferential step comprising a proximally-facing surface such that said circumferential step creates a discrete transition between said proximal segment and said distal segment, said distal segment comprising a distal tip and an elongate portion extending from said step to said distal tip of said distal segment, said elongate portion having an outer diameter that is substantially constant over the entire length of said elongate portion and equal to said second outer diameter; and a dilator matched to said introducing guide element having an interior bore of sufficient size to permit said dilator to slide over the entire proximal portion of said introducing guide element, said dilator comprising a distal tip with an opening to said interior bore, said dilator distal tip having an inner diameter less than said second diameter and an outer diameter substantially equal to said second diameter, such that when assembled together with said dilator distal tip abutting said step, said dilator cannot pass distally beyond said step. - View Dependent Claims (31, 32, 33, 34)
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35. An apparatus for percutaneously dilating an opening in the wall of a blood vessel or other anatomic structure created by a hollow cylindrical needle comprising, in combination:
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an elongate, introducing guide element having a proximal segment and a distal segment which meet at a juncture, said proximal segment having a first outer diameter at said juncture and said distal segment having a second outer diameter at said juncture greater than said first outer diameter thereby forming an abrupt, circumferential step comprising a proximally-facing surface such that said circumferential step creates a discrete transition between said proximal segment and said distal segment, said distal segment comprising a distal tip and an elongate portion extending from said step to said distal tip of said distal segment, said elongate portion having an outer diameter that is substantially constant over the entire length of said elongate portion and equal to said second outer diameter; and a dilator matched to said introducing guide element having an interior bore of sufficient size to permit said dilator to slide over the entire proximal segment of said introducing guide element, said dilator comprising a distal tip with an opening to said interior bore, said dilator distal tip having an inner diameter less than said second diameter, such that when assembled together with said dilator distal tip abutting said step, said dilator cannot pass distally beyond said step, and said dilator distal tip having an outer diameter substantially equal to or smaller than the outer diameter of said hollow cylindrical needle. - View Dependent Claims (36, 37, 38, 39, 40, 41)
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42. An apparatus for percutaneously dilating an opening in the wall of a blood vessel or other anatomic structure comprising, in combination:
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an elongate, introducing guide element having a proximal segment and a distal segment which meet at a juncture, said proximal segment having a first outer diameter at said juncture and said distal segment having a second outer diameter at said juncture greater than said first outer diameter thereby forming an abrupt, circumferential step comprising a proximally-facing surface such that said circumferential step creates a discrete transition between said proximal segment and said distal segment, said distal segment comprising a distal tip and an elongate portion extending from said step to said distal tip of said distal segment, said elongate portion having an outer diameter that is substantially constant over the entire length of said elongate portion and equal to said second outer diameter; and a dilator matched to said introducing guide element having an interior bore of sufficient size to permit said dilator to slide over the entire proximal segment of said introducing guide element, said dilator comprising a distal tip with an opening to said interior bore, said dilator distal tip having an outer diameter smaller than said second diameter, such that when assembled together with said dilator distal tip abutting said step, said dilator cannot pass distally beyond said step. - View Dependent Claims (43, 44, 45, 46, 47)
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48. A kit containing components of an apparatus for percutaneously creating and dilating an opening in the wall of a blood vessel or other anatomic structure comprising:
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a needle having a hollow bore; an elongate, introducing guide element matched for use with said needle, having a proximal segment and a distal segment which meet at a juncture, said proximal segment having a first outer diameter at said juncture and said distal segment having a second outer diameter at said juncture greater than said first outer diameter thereby forming an abrupt, circumferential step comprising a proximally-facing surface such that said circumferential step creates a discrete transition between said proximal segment and said distal segment, said distal segment comprising a distal tip and an elongate portion extending from said step to said distal tip of said distal segment, said elongate portion having an outer diameter that is substantially constant over the entire length of said elongate portion and equal to said second outer diameter; and a dilator matched to said introducing guide element having an interior bore of sufficient size to permit said dilator to slide over the entire proximal portion of said introducing guide element, said dilator comprising a distal tip with an opening to said interior bore, said dilator distal tip having an outer diameter smaller than said second diameter, such that when assembled together with said dilator distal tip abutting said step, said dilator cannot pass distally beyond said step. - View Dependent Claims (49, 50, 51, 52, 53)
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54. A kit containing components of an apparatus for percutaneously creating, accessing and dilating an opening in the wall of a blood vessel or other anatomic structure comprising:
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a tubular device having a sharp distal tip and a hollow bore; an elongate, introducing guide element having a proximal segment and a distal segment which meet at a juncture, said proximal segment having a first outer diameter at said juncture and said distal segment having a second outer diameter at said juncture greater than said first outer diameter thereby forming an abrupt, circumferential step comprising a proximally-facing surface such that said circumferential step creates a discrete transition between said proximal segment and said distal segment, said distal segment comprising a distal tip and an elongate portion extending from said step to said distal tip of said distal segment, said outer diameter of said elongate portion being substantially constant from said step extending distally for a distance of at least 30 millimeters towards said distal tip of said distal segment; and a dilator comprising an elongate cylindrical body and a distal end portion tapering towards a distal tip, said dilator matched to said introducing guide element having an interior bore of sufficient size to permit said dilator to slide over the entire proximal segment of said introducing guide element, said dilator comprising a distal tip with an opening to said interior bore, said dilator distal tip having an inner diameter less than said second diameter, such that when assembled together with said dilator distal tip abutting said step, said dilator cannot pass distally beyond said step, and said dilator distal tip having an outer diameter substantially equal to or less than the outer diameter of said tubular device. - View Dependent Claims (55, 56, 57, 58)
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59. An apparatus for percutaneously dilating an opening in the wall of a blood vessel or other anatomic structure, in combination:
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an elongate, introducing guide filament having a proximal segment and a distal segment which meet at a juncture, said proximal segment having a first outer diameter at said juncture and said distal segment having a second outer diameter at said juncture greater than said first outer diameter thereby forming an abrupt, circumferential step comprising a proximally-facing annular surface such that said circumferential step creates a discrete transition between said proximal segment and said distal segment, said annular surface having an outer diameter equal said second outer diameter and an inner diameter equal to said first outer diameter, said distal segment comprising a distal tip and an elongate portion extending from said step to said distal tip of said distal segment, said outer diameter of said elongate portion being substantially constant from said step extending distally for a distance of at least 30 millimeters towards said distal tip of said distal segment; and a dilator comprising an elongate cylindrical body and a distal end portion tapering towards a distal tip, said dilator having an interior bore of sufficient size to permit said dilator to slide over the entire proximal segment of said introducing guide filament, said dilator distal tip comprising a distally-facing annular surface matched to said proximally-facing annular surface of said introducing guide filament such that the outer diameter of said distally facing surface of said dilator is substantially equal to said outer diameter of said proximally-facing annular surface of said introducing guide filament, such that when assembled together with said dilator distal tip abutting said step, said dilator cannot pass distally beyond said step. - View Dependent Claims (60, 61, 62)
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63. An apparatus for percutaneously dilating an opening in the wall of a blood vessel or other anatomic structure, in combination:
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an elongate, introducing guide filament having a proximal segment and a distal segment which meet at a juncture, said proximal segment having a first outer diameter at said juncture and said distal segment having a second outer diameter at said juncture greater than said first outer diameter thereby forming an abrupt, circumferential step comprising a proximally-facing annular surface such that said circumferential step creates a discrete transition between said proximal segment and said distal segment, said annular surface having an outer diameter equal said second outer diameter and an inner diameter equal to said first outer diameter, said distal segment comprising a distal tip and an elongate portion extending from said step to said distal tip of said distal segment, said outer diameter of said elongate portion being substantially constant from said step extending distally for a distance of at least 30 millimeters towards said distal tip of said distal segment; and a dilator comprising an elongate cylindrical body and a distal end portion tapering towards a distal tip, said dilator having an interior bore of sufficient size to permit said dilator to slide over the entire proximal segment of said introducing guide filament, said dilator distal tip comprising a distally-facing annular surface matched to said proximally-facing annular surface of said introducing guide filament such that the outer diameter of said distally-facing surface of said dilator is less than said outer diameter of said proximally-facing annular surface of said introducing guide filament, such that when assembled together with said dilator distal tip abutting said step, said dilator cannot pass distally beyond said step. - View Dependent Claims (64, 65, 66)
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Specification