Apparatus and methods for treating bone structures, tissues and ducts using a narrow gauge cannula system
First Claim
Patent Images
1. A catheter/expandable element assembly with proximal and distal assembly ends for medical applications comprising:
- a single catheter shaft having a long axis and proximal and distal catheter portions;
an expandable element comprising a balloon portion suitable for treating vertebral fractures and related Kyphoplasty-type procedures with a balloon interior and also comprising a proximal neck portion butt-jointed and bonded at a bond juncture to the distal catheter portion wherein the balloon portion and the bond juncture can be passed through an 11-gauge or smaller diameter medical cannula before inflation of the balloon portion and after deflation of the balloon portion after a treatment procedure;
a fluid passageway extending from the proximal catheter portion to the balloon interior; and
,a mandrel element extending through the distal catheter portion and the expandable element wherein a distal mandrel portion beginning inside the catheter shaft and extending through the expandable element is of a reduced diameter relative to a proximal mandrel portion.
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Accused Products
Abstract
Systems, apparatus and methods are disclosed for medical treatment comprising bone access and dilatation and/or cavity creation or enlargement using a narrow gauge, preferably 11-gauge or smaller, cannula wherein a catheter/expandable element assembly meeting medical protocols for such procedures is designed, adapted and fabricated to fit through the interior of the associated 11-gauge or smaller cannula, and further including apparatus and methods for wrapping and/or folding the expandable element either before or after a procedure to reduce its profile to fit through the cannula.
55 Citations
64 Claims
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1. A catheter/expandable element assembly with proximal and distal assembly ends for medical applications comprising:
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a single catheter shaft having a long axis and proximal and distal catheter portions; an expandable element comprising a balloon portion suitable for treating vertebral fractures and related Kyphoplasty-type procedures with a balloon interior and also comprising a proximal neck portion butt-jointed and bonded at a bond juncture to the distal catheter portion wherein the balloon portion and the bond juncture can be passed through an 11-gauge or smaller diameter medical cannula before inflation of the balloon portion and after deflation of the balloon portion after a treatment procedure; a fluid passageway extending from the proximal catheter portion to the balloon interior; and
,a mandrel element extending through the distal catheter portion and the expandable element wherein a distal mandrel portion beginning inside the catheter shaft and extending through the expandable element is of a reduced diameter relative to a proximal mandrel portion. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A catheter/expandable element assembly with proximal and distal assembly ends for medical applications comprising a catheter shaft having a long axis and proximal and distal catheter portions, an expandable element comprising a balloon suitable for treating vertebral fractures and related Kyphoplasty-type procedures with a balloon interior and also comprising a proximal neck portion butt-jointed at a bond juncture to the distal catheter portion, and a fluid passageway extending from the proximal catheter portion to the balloon interior, the assembly being characterized by:
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(A) a balloon having the following properties; (i) the balloon has expansion properties that enable the expansion of the balloon inside a targeted bone region to press against and compress surrounding cancellous bone, or to move cortical bone to a prefracture or other desired condition, or both, prior to failure of the balloon wall, when the balloon is expanded to an elongation at least 50% greater than before expansion; (ii) the balloon has shape properties that enable the balloon to predictably deform during expansion to an expanded shape whereby a desired expanded shape inside the targeted bone region can be selected based on prior analysis of the morphology of the targeted bone region; and
,(iii) the balloon has toughness properties that enable the balloon to resist surface abrasion, tearing and puncture when it is expanded and in contact with cancellous bone, including the properties of;
a Taber Abrasion value of less than approximately 200 mg loss; and
/or an Elmendorf Tear Strength of at least approximately 150 lb.-ft./in.; and
/or a Shore Hardness of less than approximately 75 D; and
,(B) the assembly also being characterized by one or more of the following features; (a) the expandable element comprises a balloon which can be stretched, folded and/or wrapped to a maximum diameter of less than 0.092 inches before inflation of the balloon and after deflation of the balloon after a treatment procedure; (b) the assembly includes both a stretched, folded and/or wrapped balloon and a bond juncture between the catheter shaft and the proximal neck portion that will fit through the interior of a standard 11-gauge medical cannula before inflation of the balloon and after deflation of the balloon after a treatment procedure; (c) the assembly includes both a stretched, folded and/or wrapped balloon and a bond juncture between the catheter shaft and the proximal neck portion that will fit through the interior of a standard 11-gauge medical cannula before inflation of the balloon and after deflation of the balloon after a treatment procedure without the use of any lubricant or similar friction-reducing substance; (d) the expandable element can be stretched, folded and/or wrapped to sufficiently reduce the cross-sectional profile of the assembly before inflation of the balloon and after deflation of the balloon after a treatment procedure to be compatible with the use of a narrow gauge cannula; (e) the expandable element can be stretched, folded and/or wrapped to sufficiently reduce the cross-sectional profile of the assembly before inflation of the balloon and after deflation of the balloon after a treatment procedure to be compatible with the use of an 11-gauge or smaller-diameter cannula; (f) the catheter shaft is a single lumen catheter shaft and the assembly includes both a stretched, folded and/or wrapped balloon and a bond juncture between the catheter shaft and the proximal neck portion that will fit through the interior of a standard 11-gauge medical cannula before inflation of the balloon and after deflation of the balloon after a treatment procedure; (g) the proximal neck portion is butt jointed to the distal end of the distal catheter portion by a bonding procedure selected from the group consisting of an adhesive bonding procedure, a solvent bonding procedure and a thermal bonding procedure; (h) the expandable element comprises a distal neck portion having a sealed tip, and the sealed tip contains the only radiopaque marker along the expandable element; (i) the expandable element comprises one or more bands of a radiopaque material under the balloon with or without radiopaque material at a distal tip of the expandable element; (j) the assembly comprises a feature selected from features (a) to (g), and additionally comprises a floating mandrel element that extends through the distal catheter portion, and through the expandable element to an interior distal portion of the expandable element; (k) the assembly comprises a feature selected from features (a) to (g), and additionally comprises a floating mandrel element that extends through the distal catheter portion, and through the expandable element to an interior distal portion of the expandable element and further wherein the mandrel element has a free, unbonded proximal mandrel end and a distal mandrel end bonded to an interior distal portion of the expandable element; (l) the assembly comprises a feature selected from features (a) to (g), and additionally comprises a sleeve section of the distal catheter portion that accommodates limited axial movement of a mandrel inside the sleeve section and a free, unbonded proximal end of the mandrel is of an enlarged size such that the proximal end of the mandrel is retained in the sleeve section; (m) the assembly comprises a feature selected from features (a) to (g), and additionally comprises a floating mandrel element that extends through the distal catheter portion, and through the expandable element to an interior distal portion of the expandable element, and further wherein a distal end of the mandrel is bonded to a distal portion of the expandable element and an unbonded proximal end of the mandrel has an enlarged geometrical feature that can move axially along or parallel to the axis of the catheter shaft but only within a sleeve section bounded by a mandrel retaining structure; (n) the assembly comprises a feature selected from features (a) to (g), and additionally comprises a mandrel that extends through the distal catheter portion, and through the expandable element to an interior distal portion of the expandable element, wherein a distal portion of the mandrel beginning inside the catheter shaft and extending through the expandable element is of a reduced diameter relative to a proximal portion of the mandrel; (o) the assembly additionally comprises a mandrel element that extends through the distal catheter portion, and into the expandable element, wherein at least a portion of the mandrel inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon portion; (p) the assembly additionally comprises a mandrel element that extends through the distal portion of the catheter shaft, and into the expandable element, wherein at least a portion of the mandrel element inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon, and additionally comprising an elongated spring element with spring coils that surround the mandrel element beginning at a location proximal of the expandable element and extending into the expandable element to a distal tip of the expandable element where the distal end of the spring is bonded, and furthermore wherein the hooked mandrel tip engages one or more of the spring coils; (q) the assembly additionally comprises a mandrel element that extends through the distal portion of the catheter shaft, and into the expandable element, wherein at least a portion of the mandrel element inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon, and additionally comprising an elongated spring element with spring coils that surround the mandrel element beginning at a location proximal of the expandable element and extending into the expandable element to a distal tip of the expandable element where the distal end of the spring is bonded, and furthermore wherein the hooked mandrel tip engages one or more of the spring coils, and also wherein there is greater spacing between adjacent spring coils along a distal spring portion than along a proximal spring portion; (r) the assembly additionally comprises a mandrel element that extends through the distal portion of the catheter shaft, and into the expandable element, wherein at least a portion of the mandrel element inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon, and additionally comprising an elongated spring element with spring coils that surround the mandrel element beginning at a location proximal of the expandable element and extending into the expandable element to a distal tip of the expandable element where the distal end of the spring is bonded, and furthermore wherein the hooked mandrel tip engages one or more of the spring coils, and also wherein the spring is covered by a polymeric sleeve; (s) the assembly additionally comprises a mandrel element that extends through the distal portion of the catheter shaft, and into the expandable element, wherein at least a portion of the mandrel element inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon, and additionally comprising an elongated spring element with spring coils that surround the mandrel element beginning at a location proximal of the expandable element and extending into the expandable element to a distal tip of the expandable element where the distal end of the spring is bonded, and furthermore wherein the hooked mandrel tip engages one or more of the spring coils, and also wherein the mandrel can be axially tensioned to compress the spring where the hooked mandrel tip engages the spring coils causing the distal end of the expandable element to deflect from an axial orientation while the mandrel is axially tensioned; 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,(t) the assembly additionally comprises a mandrel element that extends through the distal portion of the catheter shaft, and into the expandable element, wherein at least a portion of the mandrel element inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon, and additionally comprising an elongated spring element with spring coils that surround the mandrel element beginning at a location proximal of the expandable element and extending into the expandable element to a distal tip of the expandable element where the distal end of the spring is bonded, and furthermore wherein the hooked mandrel tip engages one or more of the spring coils, and also comprising a mandrel tensioning assembly consisting of two threadably-engaged mandrel tensioning elements whereby the threadably-engaged tensioning elements provide an axial channel in which one of the mandrel tensioning elements can slide such that rotating one tensioning element relative to the other causes one of the tensioning elements to move in a proximal direction relative to the second tensioning element thereby applying axial tensioning to the mandrel while the axial tensioning is applied. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48)
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49. A catheter/expandable element assembly with proximal and distal assembly ends for medical applications comprising a catheter shaft having a long axis and proximal and distal catheter portions, an expandable element comprising a balloon suitable for treating vertebral fractures and related Kyphoplasty-type procedures with a balloon interior and also comprising a proximal neck portion butt-jointed at a bond juncture to the distal catheter portion, and a fluid passageway extending from the proximal catheter portion to the balloon interior, the assembly being characterized by:
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(A) a balloon having the following properties; (i) the balloon has expansion properties that enable the expansion of the balloon inside a targeted bone region to press against and compress surrounding cancellous bone, or to move cortical bone to a prefracture or other desired condition, or both, prior to failure of the balloon wall, when the balloon is expanded to an elongation at least 50% greater than before expansion; (ii) the balloon has shape properties that enable the balloon to predictably deform during expansion to an expanded shape whereby a desired expanded shape inside the targeted bone region can be selected based on prior analysis of the morphology of the targeted bone region; and
,(iii) the balloon has toughness properties that enable the balloon to resist surface abrasion, tearing and puncture when it is expanded and in contact with cancellous bone, including the properties of;
a Taber Abrasion value of less than approximately 200 mg loss; and
/or an Elmendorf Tear Strength of at least approximately 150 lb.-ft./in.; and
/or a Shore Hardness of less than approximately 75 D;(B) a floating mandrel element that extends through the distal catheter portion and through the expandable element to an interior distal portion of the expandable element and further wherein the mandrel element has a free, unbonded proximal mandrel end and a distal mandrel end bonded to an interior distal portion of the expandable element and (C) the assembly also being characterized by one or more of the following features; (a) the expandable element comprises a balloon which can be stretched, folded and/or wrapped to a maximum diameter of less than 0.092 inches before inflation of the balloon and after deflation of the balloon after a treatment procedure; (b) the assembly includes both a stretched, folded and/or wrapped balloon and a bond juncture between the catheter shaft and the proximal neck portion that will fit through the interior of a standard 11-gauge medical cannula before inflation of the balloon and after deflation of the balloon after a treatment procedure; (c) the assembly includes both a stretched, folded and/or wrapped balloon and a bond juncture between the catheter shaft and the proximal neck portion that will fit through the interior of a standard 11-gauge medical cannula before inflation of the balloon and after deflation of the balloon after a treatment procedure without the use of any lubricant or similar friction-reducing substance; (d) the expandable element can be stretched, folded and/or wrapped to sufficiently reduce the cross-sectional profile of the assembly before inflation of the balloon and after deflation of the balloon after a treatment procedure to be compatible with the use of a narrow gauge cannula; (e) the expandable element can be stretched, folded and/or wrapped to sufficiently reduce the cross-sectional profile of the assembly before inflation of the balloon and after deflation of the balloon after a treatment procedure to be compatible with the use of an 11-gauge or smaller-diameter cannula; (f) the catheter shaft is a single lumen catheter shaft and the assembly includes both a stretched, folded and/or wrapped balloon and a bond juncture between the catheter shaft and the proximal neck portion that will fit through the interior of a standard 11-gauge medical cannula before inflation of the balloon and after deflation of the balloon after a treatment procedure; (g) the proximal neck portion is butt jointed to the distal end of the distal catheter portion by a bonding procedure selected from the group consisting of an adhesive bonding procedure, a solvent bonding procedure and a thermal bonding procedure; (h) the expandable element comprises a distal neck portion having a sealed tip, and the sealed tip contains the only radiopaque marker along the expandable element; (i) the expandable element comprises one or more bands of a radiopaque material under the balloon with or without radiopaque material at a distal tip of the expandable element; (j) the assembly comprises a feature selected from features (a) to (g), and additionally comprises a sleeve section of the distal catheter portion that accommodates limited axial movement of a mandrel inside the sleeve section and a free, unbonded proximal end of the mandrel is of an enlarged size such that the proximal end of the mandrel is retained in the sleeve section; (k) the assembly comprises a feature selected from features (a) to (g), and additionally comprises a floating mandrel element that extends through the distal catheter portion, and through the expandable element to an interior distal portion of the expandable element, and further wherein a distal end of the mandrel is bonded to a distal portion of the expandable element and an unbonded proximal end of the mandrel has an enlarged geometrical feature that can move axially along or parallel to the axis of the catheter shaft but only within a sleeve section bounded by a mandrel retaining structure; (l) the assembly comprises a feature selected from features (a) to (g), and additionally comprises a mandrel that extends through the distal catheter portion, and through the expandable element to an interior distal portion of the expandable element, wherein a distal portion of the mandrel beginning inside the catheter shaft and extending through the expandable element is of a reduced diameter relative to a proximal portion of the mandrel; (m) the assembly additionally comprises a mandrel element that extends through the distal catheter portion, and into the expandable element, wherein at least a portion of the mandrel inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon; (n) the assembly additionally comprises a mandrel element that extends through the distal portion of the catheter shaft, and into the expandable element, wherein at least a portion of the mandrel element inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon, and additionally comprising an elongated spring element with spring coils that surround the mandrel element beginning at a location proximal of the expandable element and extending into the expandable element to a distal tip of the expandable element where the distal end of the spring is bonded, and furthermore wherein the hooked mandrel tip engages one or more of the spring coils; (o) the assembly additionally comprises a mandrel element that extends through the distal portion of the catheter shaft, and into the expandable element, wherein at least a portion of the mandrel element inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon, and additionally comprising an elongated spring element with spring coils that surround the mandrel element beginning at a location proximal of the expandable element and extending into the expandable element to a distal tip of the expandable element where the distal end of the spring is bonded, and furthermore wherein the hooked mandrel tip engages one or more of the spring coils, and also wherein there is greater spacing between adjacent spring coils along a distal spring portion than along a proximal spring portion; (p) the assembly additionally comprises a mandrel element that extends through the distal portion of the catheter shaft, and into the expandable element, wherein at least a portion of the mandrel element inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon, and additionally comprising an elongated spring element with spring coils that surround the mandrel element beginning at a location proximal of the expandable element and extending into the expandable element to a distal tip of the expandable element where the distal end of the spring is bonded, and furthermore wherein the hooked mandrel tip engages one or more of the spring coils, and also wherein the spring is covered by a polymeric sleeve; (q) the assembly additionally comprises a mandrel element that extends through the distal portion of the catheter shaft, and into the expandable element, wherein at least a portion of the mandrel element inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon, and additionally comprising an elongated spring element with spring coils that surround the mandrel element beginning at a location proximal of the expandable element and extending into the expandable element to a distal tip of the expandable element where the distal end of the spring is bonded, and furthermore wherein the hooked mandrel tip engages one or more of the spring coils, and also wherein the mandrel can be axially tensioned to compress the spring where the hooked mandrel tip engages the spring coils causing the distal end of the expandable element to deflect from an axial orientation while the mandrel is axially tensioned; 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,(r) the assembly additionally comprises a mandrel element that extends through the distal portion of the catheter shaft, and into the expandable element, wherein at least a portion of the mandrel element inside the expandable element tapers to a flattened distal mandrel end that terminates in an unbonded angled or hooked mandrel tip at a location proximate to the distal end of the balloon, and additionally comprising an elongated spring element with spring coils that surround the mandrel element beginning at a location proximal of the expandable element and extending into the expandable element to a distal tip of the expandable element where the distal end of the spring is bonded, and furthermore wherein the hooked mandrel tip engages one or more of the spring coils, and also comprising a mandrel tensioning assembly consisting of two threadably-engaged mandrel tensioning elements whereby the threadably-engaged tensioning elements provide an axial channel in which one of the mandrel tensioning elements can slide such that rotating one tensioning element relative to the other causes one of the tensioning elements to move in a proximal direction relative to the second tensioning element thereby applying axial tensioning to the mandrel while the axial tensioning is applied. - View Dependent Claims (50, 51, 52, 53, 54, 55, 56, 57, 58)
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59. A catheter/expandable element assembly with proximal and distal assembly ends for medical applications comprising:
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a catheter shaft having a long axis and proximal and distal catheter portions; an expandable element comprising a balloon portion suitable for treating vertebral fractures and related Kyphoplasty-type procedures with a balloon interior and also comprising a proximal neck portion bonded at a bond juncture to the terminal end of the distal catheter portion, wherein the balloon portion and the bond juncture can be passed through an 11-gauge or smaller diameter medical cannula before inflation of the balloon portion and after deflation of the balloon portion after a treatment procedure, and also wherein the distal catheter portion and the proximal neck portion are butt-jointed and bonded to each other at the bond juncture; a fluid passageway extending from the proximal catheter portion through the distal catheter portion to the balloon interior; and
,a floating mandrel that extends through the distal catheter portion and through the expandable element to a distal portion of the expandable element, wherein the floating mandrel comprises a distal mandrel portion beginning inside the catheter shaft and extending through the expandable element of a reduced diameter relative to a proximal mandrel portion, a distal end of the mandrel is bonded to the expandable element and a proximal end of the mandrel is a free, unbonded end, and the floating mandrel can move axially within a limited range of axial movement along or parallel to the long axis of the catheter shaft. - View Dependent Claims (60, 61)
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62. A catheter/expandable element assembly with proximal and distal assembly ends for medical applications comprising:
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a single catheter shaft having a long axis and proximal and distal catheter portions; an expandable element comprising a balloon portion suitable for treating vertebral fractures and related Kyphoplasty-type procedures with a balloon interior and also comprising a proximal neck portion butt-jointed and bonded at a bond juncture to the distal catheter portion wherein the balloon portion and the bond juncture can be passed through an 11-gauge or smaller diameter medical cannula before inflation of the balloon portion and after deflation of the balloon portion after a treatment procedure; a fluid passageway extending from the proximal catheter portion to the balloon interior; and
,a mandrel element extending through the distal catheter portion and the expandable element wherein a distal mandrel portion beginning inside the catheter shaft and extending through the expandable element is of a reduced diameter relative to a proximal mandrel portion; and further wherein an inner diameter of the distal catheter portion, a diameter of the fluid passageway, and an inner diameter of the proximal neck portion at the bond juncture are substantially the same size, and also wherein an outer diameter of the distal catheter portion and an outer diameter of the proximal neck portion at the bond juncture are substantially the same size so as to form a smooth, uninterrupted outer surface at the bond juncture.
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63. A catheter/expandable element assembly with proximal and distal assembly ends for medical applications comprising:
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a single catheter shaft having a long axis and proximal and distal catheter portions; an expandable element comprising a balloon portion suitable for treating vertebral fractures and related Kyphoplasty-type procedures with a balloon interior and also comprising a proximal neck portion butt-jointed and bonded at a bond juncture to the distal catheter portion wherein the balloon portion and the bond juncture can be passed through an 11-gauge or smaller diameter medical cannula before inflation of the balloon portion and after deflation of the balloon portion after a treatment procedure; a fluid passageway extending from the proximal catheter portion to the balloon interior; and
,a mandrel element extending through the distal catheter portion and the expandable element wherein a distal mandrel portion beginning inside the catheter shaft and extending through the expandable element is of a reduced diameter relative to a proximal mandrel portion; and further wherein the mandrel element is a floating mandrel that comprises a distal mandrel end bonded to the expandable element and a free, unbonded proximal mandrel end. - View Dependent Claims (64)
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Specification