Abstract: A method for treating stroke patients includes inducing mild or moderate hypothermia in a patient using one or more closed loop heat exchange catheters positioned either in the patient's central venous system, carotid artery or both when the patient's body temperature and/or brain temperature are above predetermined thresholds. Additional steps for treating and managing a stroke patient can also be undertaken, e.g., infusing paralytics, infusing neuro-protectants, infusing anti-clot and/or clot lysis medications, performing neuro-protection procedures, performing non-catheter-based hypothermia, performing angioplasty, deploying stent, removing clot(s), maintaining a predetermined ICP level such as draining CSF, and/or ventilating the patient.

Abstract: A catheter is adapted to exchange heat with a body fluid, such as blood, flowing in a body conduit, such as a blood vessel. The catheter includes a shaft with a heat exchange region disposed at its distal end. This region may include hollow fibers which are adapted to receive a remotely cooled heat exchange fluid preferably flowing in a direction counter to that of the body fluid. The hollow fibers enhance the surface area of contact, as well as the mixing of both the heat exchange fluid and the body fluid. The catheter can be positioned to produce hypothermia in a selective area of the body or alternatively positioned to systemically cool the entire body system.

Abstract: A method for treating cardiac arrest includes defibrillating the patient and/or ventilating the patient and/or administering a cardiac arrest drug such as epinephrine to resuscitate the patient, and then cooling the patient's body temperature using one or more cooling catheters positioned in the central venous system of the patient and/or particularly cooling the patient's brain temperature using a catheter advanced into the aortic arch or into the carotid artery whereby a bolus of cold saline solution is introduced into the blood supplied to the brain to lower the brain temperature quickly, and further cooling or maintaining the brain temperature at a desired level by pumping coolant in a closed circuit formation between the catheter and the coolant source to remove heat from the blood supplied to the patient's brain.

Abstract: A method for treating cardiac arrest includes defibrillating the patient and/or ventilating the patient and/or administering a cardiac arrest drug such as epinephrine to resuscitate the patient, and then cooling the patient's body temperature using one or more cooling catheters positioned in the central venous system of the patient and/or particularly cooling the patient's brain temperature using a catheter advanced into the aortic arch or into the carotid artery whereby a bolus of cold saline solution is introduced into the blood supplied to the brain to lower the brain temperature quickly, and further cooling or maintaining the brain temperature at a desired level by pumping coolant in a closed circuit formation between the catheter and the coolant source to remove heat from the blood supplied to the patient's brain.

Abstract: A method for treating cardiac arrest includes defibrillating the patient and/or ventilating the patient and/or administering a cardiac arrest drug such as epinephrine to resuscitate the patient, and then cooling the patient's body temperature using one or more cooling catheters positioned in the central venous system of the patient and/or particularly cooling the patient's brain temperature using a catheter advanced into the aortic arch or into the carotid artery whereby a bolus of cold saline solution is introduced into the blood supplied to the brain to lower the brain temperature quickly, and further cooling or maintaining the brain temperature at a desired level by pumping coolant in a closed circuit formation between the catheter and the coolant source to remove heat from the blood supplied to the patient's brain.

Abstract: A catheter using multiple hollow fibers to carry a heating/cooling fluid employs fiber spreading features to improve heat transfer and help prevent clotting of body fluids within which the catheter is immersed. The catheter includes a length of outer tube surrounding an inner tube. The inner tube conveys fluids in one direction, and the passageway between inner and outer tubes conveys fluids in the opposite direction. The inner and outer tubes have proximal distal ends. The distal end is closed, but the proximal end is open to permit introduction of a heating or cooling fluid into the inner tube, and withdrawal of the fluid from the passageway between the inner and outer tubes. At the tubes' distal end resides a proximal fluid transfer housing coupled to multiple hollow heat exchange fibers. The distal ends of these fibers may be commonly connected to a distal fluid transfer housing and optional reservoir, which cooperatively return fluid to the passageway between inner and outer tubes.

Abstract: A system for controlling patient temperature uses a central venous line catheter having axially spaced distal and proximal heat exchange balloons. The central venous line catheter is provided with one or more lumens for providing access to the central blood supply of the patient, and with additional lumens for communicating heat exchange fluid to the balloons. Heat exchange fluid temperature is controlled through a feed back loop in which patient temperature is sensed and used to control a temperature control unit comprising a heating device and/or a cooling device in heat exchange relationship with the heat exchange fluid. A tubing set transports the heat exchange fluid between the central venous line and the temperature control unit, with a pump serving to circulate the fluid in a closed fluid circuit in the system.

Abstract: A central venous catheter includes coolant supply and return lumens which communicate coolant to and from first and second heat exchange membranes arranged along the distal segment of the catheter. The coolant in the heat exchange membranes removes heat from the patient. Additional lumens are provided for conventional central venous catheter uses.

Abstract: A method for treating cardiac arrest includes defibrillating the patient and/or ventilating the patient and/or administering a cardiac arrest drug such as epinephrine to resuscitate the patient, and then cooling the patient using one or more cooling catheter positioned in the central venous system of the patient.

Abstract: An infusion guidewire that can be used either as a guidewire or an infusion catheter having an integral, tapered core wire within an infusion lumen formed of the aligned lumens of the conduit of a proximal connector housing, a proximal inner sheath in a proximal guidewire portion and a distal coil wire in a distal guidewire portion. The core wire proximal end is attached to the connector housing, and the core wire distal end is connected to the distal end of the distal wire coil. An outer sheath is attached to the connector housing and formed over the proximal inner sheath and the distal wire coil. A plurality of infusion side holes are formed in a distal infusion segment of the outer sheath in fluid communication with the infusion lumen.

Abstract: A catheter for retroprofusing a venous junction formed by first, second and third veins, includes an elongate tube having a plurality of channels including a through-lumen extending between a proximal end and a distal end. A proximal balloon is inflatable to partially occlude the third vein, while a distal balloon is inflatable to partially occlude the second vein. An operative region of the catheter between the first and second balloons is adapted to pressurize the venous junction with arterial blood to produce retrograde blood flow in the first vein.

Abstract: A miniaturized brush and method of making same having a hollow lumen for introducing an agent for dissolving a soft fibrinous obstruction, such as a recently formed thrombus, within a patient's vascular system. The brush has soft, flexible bristles extending outward from the drive shaft distal section, the bristles being sufficiently resilient and dimensioned for enabling compression and passage of the brush out of and back into the distal end of an introducer lumen and to mix into the fibrin of the soft thrombus, yet not damage the vessel wall. The brush assembly is formed of a proximal section comprising an elongated proximal tube and a distal section comprising a distal tube extension, the proximal and distal sections having an aligned lumen and forming a drive shaft or brush body.

Abstract: An infusion guidewire or catheter for introduction through a selected path in a patient's vascular system to a site in a blood vessel and for infusing a drug or agent into the blood vessel. An elongated tubular body extends between a proximal and a distal end having an infusion device lumen formed therein extending to a plurality of infusion ports formed in a distal infusion segment of the elongated tubular body. The distal infusion segment is pre-biased to assume an infusion configuration when positioned in a blood vessel that tends to present the infusion port toward the blood vessel wall in a low blood flow rate zone and defining a generally centrally disposed perfusion lumen for perfusing blood therethrough.

Abstract: A guidewire extender particularly suited for use in percutaneous transluminal coronary angioplasty. A tubular connector member attaches to the proximal end of a steerable guidewire. A helical coil bonded to a male insertion segment of a proximal extension member contacts an inward depression on the tubular connector. The extension member mates with the tubular connector to extend the guidewire by rotating the extension member to advance the helical coil past the depression. Some axial play between the coupled components is possible. The extension member locks to the guidewire without special tools. Manufacture and assembly are simplified.

Abstract: A guide wire for an intravascular catheter is disclosed. In one embodiment, the guide wire has Doppler means positioned on the distal end, with preferred Doppler means being piezoelectric ceramics or piezoelectric polymeric materials, both having electrical leads connected thereto. In another embodiment, the guide wire has a Laser Doppler means.

Abstract: An invasive, fluid velocity measuring wire guide particularly adapted and of a size (less than 0.030 inch) for subselective placement in the coronary arterial tree, which includes a Doppler mechanism for determining the blood flow velocity in the region of the distal end of the wire guide. Although the wire guide is particularly adapted for diagnosing coronary arterial disease subselectively; it is of such a size and manipulability to be useful in other blood flow and biological fluid flow analyses. Preferably, the wire guide is flexible and steerable for precise placement. The wire guide includes an elongated wire member having a Doppler crystal attached in longitudinal alignment at its distal end. Electrical leads extend from the Doppler crystal along the wire member to the appropriate test equipment for measuring the fluid flow velocity in the region of the Doppler crystal. Preferred embodiments of the Doppler means include piezoelectric crystals and piezoelectric polymers.