Reentry catheter and method thereof

• US 9,814,862 B2
• Filed: 06/29/2012
• Issued: 11/14/2017
• Est. Priority Date: 06/30/2011
• Status: Active Grant

• Current Assignee: Spectranetics Corporation (Koninklijke Philips N.V.)
• Original Assignee: Spectranetics Corporation (Koninklijke Philips N.V.)
• Inventors: Alvarez, Jeffery B., Godleski, Christine, Bowe, Wade A., Carver, Rob, Dwelle, Paola A., Lindstrom, Jeff, Nevrla, David S., Matin, Shahriar, Magee, Matthew M.
• Primary Examiner(s): Hayman, Imani
• Assistant Examiner(s): Ponton, James D
• Application Number:
  US14/128,050
• Publication Number:
  US 20140371718A1
• Time in Patent Office: 1,964 Days
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 2017/22044 with a pointed tip
• CPC Class Codes: A61B 2017/22095 accessing a blood vessel true lumen from the sub-intimal space
• CPC Class Codes: A61M 2025/0004 having two or more concentrically arranged tubes for forming a concentric catheter system
• CPC Class Codes: A61M 2025/0008 having visible markings on its surface, i.e. visible to the naked eye, for any purpose, e.g. insertion depth markers, rotational markers or identification of type
• CPC Class Codes: A61M 2025/0037 characterized by lumina being arranged side-by-side
• CPC Class Codes: A61M 2025/0079 Separate user-activated means, e.g. guidewires, guide tubes, balloon catheters or sheaths, for sealing off an orifice, e.g. a lumen or side holes, of a catheter
• CPC Class Codes: A61M 2025/018 Catheters having a lateral opening for guiding elongated means lateral to the catheter
• CPC Class Codes: A61M 2025/0183 Rapid exchange or monorail catheters
• CPC Class Codes: A61M 2025/0197 for creating an artificial passage within the body, e.g. in order to go around occlusions
• CPC Class Codes: A61M 25/003 characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves catheter tips A61M25/0067
• CPC Class Codes: A61M 25/005 with embedded materials for reinforcement, e.g. wires, coils, braids
• CPC Class Codes: A61M 25/0069 Tip not integral with tube
• CPC Class Codes: A61M 25/0074 Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
• CPC Class Codes: A61M 25/0108 using radio-opaque or ultrasound markers
• CPC Class Codes: A61M 25/0172 Exchanging a guidewire while keeping the catheter in place
• CPC Class Codes: A61M 25/0194 Tunnelling catheters

Abstract

Embodiments of the invention are directed towards a rapid exchange catheter configured for insertion into a subintimal space and crossing an occlusion in a subintimal space. The catheter includes a proximal end, a distal end, a first lumen configured to receive a first wire, the first lumen extending longitudinally through a least a lateral port of the catheter, and a second lumen having at least a portion distal of the lateral port and extending through at least the distal end of the catheter. The catheter also includes an exchange port arranged on a exterior portion of the catheter configured to the receive a second wire and second rapid exchange port in communication with the second lumen. Moreover, other embodiments of the invention are directed towards methods for using the rapid exchange catheter to cross an obstruction in a vessel, e.g., a total or partial occlusion, in a subintimal space.

Claims

1. A method for forming a pathway in a subintimal space within a blood vessel and to a lumen of the blood vessel, comprising the steps of:

advancing a first wire into the subintimal space;

advancing a rapid exchange catheter system over the first wire into the subintimal space, wherein the rapid exchange catheter system comprises;

a shaft having an inner lumen and an exchange port fluidly coupled with the inner lumen, and

a rigid shroud coupled to the shaft, the rigid shroud comprising a second lumen and a lateral port fluidly coupled with the second lumen, wherein the rapid exchange catheter system is advanced over the first wire by receiving the first wire in the exchange port, and the exchange port is disposed in the subintimal space as a result of advancing the rapid exchange catheter system over the first wire;

advancing a second wire through the second lumen of the rapid exchange catheter system;

advancing the second wire through the lateral port of the rapid exchange catheter system into the lumen of the blood vessel;

wherein, as viewed from an end view of the rapid exchange catheter system;

the lateral port, the exchange port, and a center of the rigid shroud define an angle, the angle having a vertex at the center of the rigid shroud, a first side intersecting the center of the rigid shroud and the lateral port, and a second side intersecting the center of the rigid shroud and a center of the exchange port,

the exchange port is exterior of the rigid shroud,

and the angle is less than 180 degrees.

2. The method of claim 1, further comprising the step of actuating an actuator to mechanically advance a cannula a predetermined distance out of the lateral port.

3. The method of claim 1, wherein the exchange port and the lateral port are disposed distally relative to an occlusion in the lumen of the blood vessel as a result of advancing the rapid exchange catheter system over the first wire.

4. A method for forming a pathway in a subintimal space within a blood vessel and to a lumen of the blood vessel, comprising the steps of:

advancing a first wire into the subintimal space;

advancing a rapid exchange catheter system over the first wire into the subintimal space, wherein the rapid exchange catheter system comprises;

a shaft having an inner lumen and an exchange opening fluidly coupled with the inner lumen, the exchange opening arranged on a distal portion of the rapid exchange catheter system, and

a rigid shroud coupled to the shaft, the rigid shroud comprising a second lumen and a lateral port fluidly coupled with the second lumen, wherein the first wire is advanced through the inner lumen and the exchange opening;

advancing a second wire through the second lumen of the rapid exchange catheter system;

advancing the second wire through the lateral port of the rapid exchange catheter system into the lumen of the blood vessel;

wherein, as viewed from an end view of the rapid exchange catheter system;

the lateral port, the exchange opening, and a center of the rigid shroud define an angle, the angle having a vertex at the center of the rigid shroud, a first side intersecting the center of the rigid shroud and the lateral port, and a second side intersecting the center of the rigid shroud and a center of the exchange opening,

the exchange opening is exterior of the rigid shroud,

and the angle is less than 180 degrees.

5. The method of claim 4, further comprising the step of actuating an actuator to mechanically advance a cannula a predetermined distance out of the lateral port.