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 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;
wherein said guide element comprises an introducing guidewire having a maximum outer diameter of 0.038-inch or less; 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 having a distally-facing annular surface with an opening into said interior bore,said dilator distal tip having an inner diameter less than said second diameter, such that when assembled together said dilator cannot pass distally beyond said step,said dilator distal tip having an outer diameter substantially equal to said second outer diameter, such that that when assembled together with said dilator distal tip abutting said step their respective outer diameters match one another to provide precise shielding of said dilator distal tip and a smooth transition from said introducing guide element distal segment outer diameter to said dilator distal tip outer diameter, thereby permitting said dilator distal tip to smoothly enter said opening without resistance from said wall of said blood vessel or anatomic structure.
0 Assignments
0 Petitions
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.
59 Citations
52 Claims
-
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 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;
wherein said guide element comprises an introducing guidewire having a maximum outer diameter of 0.038-inch or less; anda 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 having a distally-facing annular surface with an opening into said interior bore, said dilator distal tip having an inner diameter less than said second diameter, such that when assembled together said dilator cannot pass distally beyond said step, said dilator distal tip having an outer diameter substantially equal to said second outer diameter, such that that when assembled together with said dilator distal tip abutting said step their respective outer diameters match one another to provide precise shielding of said dilator distal tip and a smooth transition from said introducing guide element distal segment outer diameter to said dilator distal tip outer diameter, thereby permitting said dilator distal tip to smoothly enter said opening without resistance from said wall of said blood vessel or anatomic structure. - 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. An apparatus for percutaneously dilating an opening in the wall of a blood vessel or other anatomic structure comprising:
-
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 an proximally-facing surface such that said step creates a discrete transition between said proximal segment and said distal segment, said distal segment having a portion of maximum outer diameter that is at least 3 millimeters in length to block the flow of fluid through said opening when said portion of maximum outer diameter resides within said opening; and a dilator 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 having a distally-facing annular surface with an opening into said interior bore, said dilator distal tip having an inner diameter less than said second diameter, such that when assembled together said dilator cannot pass distally beyond said step. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34)
-
-
35. A kit containing components of an apparatus for percutaneously creating and accessing an opening in the wall of a blood vessel or other anatomical structure comprising, in combination:
-
a tubular device having a sharp distal tip and a hollow bore for percutaneous puncture of said wall to create said opening; and an elongate introducing guide element for passage through said tubular device to access said opening, said 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 step creates a discrete transition between said proximal segment and said distal segment, said distal segment having a portion of maximum outer diameter, said maximum outer diameter matched to the diameter of the hollow bore of said tubular device, thereby blocking the flow of fluid through said hollow bore when said portion of maximum outer diameter resides within said hollow bore, said portion of maximum outer diameter being at least 3 millimeters in length to block the flow of fluid through said opening when said needle is removed and said portion of maximum outer diameter resides within said opening. - View Dependent Claims (36, 37, 38, 39)
-
-
40. A kit containing components of an apparatus for percutaneously creating and dilating an opening in the wall of a blood vessel or other anatomical structure comprising:
-
a needle having a hollow bore for percutaneous puncture of said wall to create said opening; and an elongate introducing guide element for passage through said needle to access said opening, said 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 step creates a discrete transition between said proximal segment and said distal segment, said distal segment comprising one or more portions having an outer diameter matched to the diameter of said hollow bore of said needle to permit it to block the flow of fluid through the hollow bore of said needle when said distal segment is positioned therein; and a dilator 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 having a distally-facing annular surface 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 said dilator cannot pass distally beyond said step, said dilator distal tip having an outer diameter substantially equal to said second outer diameter, such that that when assembled together with said dilator distal tip abutting said step their respective outer diameters match one another to provide precise shielding of said dilator distal tip and a smooth transition from said introducing guide element distal segment outer diameter to said dilator distal tip outer diameter, thereby permitting said dilator distal tip to smoothly enter said opening without resistance from said wall of said blood vessel or anatomic structure. - View Dependent Claims (41, 42, 43, 44, 45, 46)
-
-
47. A kit containing components of an apparatus for percutaneously creating and dilating an opening in the wall of a blood vessel or other anatomical structure comprising:
-
a needle having a hollow bore for percutaneous puncture of said wall to create said opening; an elongate introducing guide element 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 step creates a discrete transition between said proximal segment and said distal segment, said distal segment having a portion of maximum outer diameter that is at least 3 millimeters in length and of a diameter to permit it to block the flow of fluid through said hollow bore of said needle when positioned therein and to block the flow of fluid from said opening when said needle is removed and said portion of maximum outer diameter resides within said opening; and a dilator having an interior bore of sufficient size to permit dilator to slide over the entire proximal segment of said introducing guide element, said dilator having a distal tip having a distally-facing annular surface with an opening to said interior bore, said dilator distal tip having an inner diameter smaller than said second diameter, such that when assembled together said dilator cannot pass distally beyond said step. - View Dependent Claims (48, 49, 50, 51, 52)
-
Specification