HYBRID MICRO GUIDE CATHETER
A hybrid microguide catheter and method for making and using the same. The catheter may include a first tubular member and a second tubular member. The tubular members may be arranged so that the second tubular member extends distally beyond the first tubular member. Alternatively, the catheter may include a tubular body having a first opening and a second opening. The first opening may be positioned along the tubular body a distance from the second opening.
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This application is a continuation of U.S. application Ser. No. 13/025,381, filed Feb. 11, 2011, now U.S. Pat. No. 8,372,056, which is a continuation of U.S. application Ser. No. 10/827,565, now U.S. Pat. No. 7,887,529; the entire disclosures of which are incorporated herein by reference.
FIELD OF THE INVENTIONThe present invention pertains to medical devices including catheters. More particularly, the present invention pertains to intravascular catheters with a support and visualization portion and a distal access portion.
BACKGROUND OF THE INVENTIONA wide variety of devices have been developed for medical use, for example, intravascular use. Some of these devices include guidewires, catheters, and other such devices that each have certain features and characteristics. Among the known medical devices, each has certain advantages and disadvantages. There is an ongoing need to provide alternative designs and methods for making and using medical devices with desirable characteristics and features.
SUMMARY OF THE INVENTIONThe invention provides design, material, and manufacturing method alternatives for medical devices, for example, catheters. In at least some embodiments, the catheters include a support and visualization portion and a distal access portion. The support and visualization portion may be disposed near the proximal end region of the catheter and the distal access portion may be disposed near the distal end region of the catheter. These and some of the other features and characteristics of example embodiments are described in more detail below.
The following description should be read with reference to the drawings wherein like reference numerals indicate like elements throughout the several views. The detailed description and drawings illustrate example embodiments of the claimed invention.
In at least some embodiments, distal region 14 is adapted and configured so that it provides catheter 10 with distal access to target vascular regions. For example, distal region 14 may extend deeper within blood vessel 20 (which is, for example, exemplified by the narrowing of blood vessel 20 in the lower half of
Catheter 10 may include a first tubular member 30 and a second tubular member 32 as illustrated in
Tubular members 30/32 may be made from any suitable material such as metals, metal alloys, metal-polymer composites, polymers, and the like or any other suitable material. In some embodiments, tubular members 30/32 have the same or similar material composition. In other embodiments, tubular members 30/32 have different material compositions. Below are some lists of materials that can be used to manufacture tubular members 30/32. The lists are not intended to be exhaustive or to be limiting. Some examples of suitable metals and metal alloys include stainless steel, such as 304V, 304L, and 316LV stainless steel; mild steel; nickel-titanium alloy such as linear-elastic or super-elastic nitinol, nickel-chromium alloy, nickel-chromium-iron alloy, cobalt alloy, tungsten or tungsten alloys, MP35-N (having a composition of about 35% Ni, 35% Co, 20% Cr, 9.75% Mo, a maximum 1% Fe, a maximum 1% Ti, a maximum 0.25% C, a maximum 0.15% Mn, and a maximum 0.15% Si), hastelloy, monel 400, inconel 825, or the like; other Co—Cr alloys; platinum enriched stainless steel; or other suitable material.
Some examples of suitable polymers may include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, for example, DELRIN® available from DuPont), polybutylene terephthalate (PBT), polyether block ester, polyurethane, polypropylene (PP), polyvinylchloride (PVC), polyether-ester (for example, a polyether-ester elastomer such as ARNITEL® available from DSM Engineering Plastics), polyester (for example, a polyester elastomer such as HYTREL® available from DuPont), polyamide (for example, DURETHAN® available from Bayer or CRISTAMID® available from Elf Atochem), elastomeric polyamides, block polyamide/ethers, polyether block amide (PEBA, for example, available under the trade name PEBAX®), silicones, polyethylene (PE), Marlex high-density polyethylene, Marlex low-density polyethylene, linear low density polyethylene (for example, REXELL®), polyethylene terephthalate (PET), polyetheretherketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS), polyphenylene oxide (PPO), polysulfone, nylon, perfluoro(propyl vinyl ether) (PFA), other suitable materials, or mixtures, combinations, copolymers thereof, polymer/metal composites, and the like. In some embodiments, tubular members 30/32 can be blended with a liquid crystal polymer (LCP). For example, the mixture can contain up to about 5% LCP. This has been found to enhance torqueability.
In some embodiments, a coating, for example, a lubricious, a hydrophilic, a protective, or other type of coating may be applied over portions or all of tubular members 30/32, or other portions of catheter 10. Hydrophobic coatings such as fluoropolymers provide a dry lubricity which improves catheter handling and device exchanges. Lubricious coatings improve steerability and improve lesion crossing capability. Suitable lubricious polymers are well known in the art and may include silicone and the like, hydrophilic polymers such as high-density polyethylene (HDPE), polytetrafluoroethylene (PTFE), polyarylene oxides, polyvinylpyrolidones, polyvinylalcohols, hydroxy alkyl cellulosics, algins, saccharides, caprolactones, and the like, and mixtures and combinations thereof. Hydrophilic polymers may be blended among themselves or with formulated amounts of water insoluble compounds (including some polymers) to yield coatings with suitable lubricity, bonding, and solubility. Some other examples of such coatings and materials and methods used to create such coatings can be found in U.S. Pat. Nos. 6,139,510 and 5,772,609, which are incorporated herein by reference.
In some embodiments, first tubular member 30 and/or second tubular member 32 may include one or more cuts or grooves formed therein (e.g., by micro-machining). Micro-machining tubular members 30/32 may be desirable because it allows a stiffer starting material (e.g., stainless steel, nickel-titanium alloy, etc.) to be used in the manufacturing of tubular members 30/32 that can be smaller, thinner, or otherwise have a lower profile than less stiff materials. This stiff material can then be micro-machined in order to impart the desired level of flexibility. Further discussion on the use of forming cuts, slots, or grooves as well micro-machining can be found in U.S. Patent Publication No. 2004/0193140, in U.S. Pat. No. 6,428,489, and in U.S. Patent Publication No. 2002/0013540, the entire disclosures of which are herein incorporated by reference.
Tubular members 30/32 may be coupled to one another in a number of different manners. For example,
Alternatively, tubular members 30/32 may be coupled during manufacturing via an extrusion process as seen in
As suggested above, catheter 10 may take the form of a hybrid “micro guide” catheter. This nomenclature reflects the fact that catheter 10 may be a hybridization of some of the desirable characteristics and structure of typical microcatheters with some of the desirable characteristics and structure of typical guide catheters. For example, catheter 10 includes proximal region 12 that may have a proximal stiffness (similar to that of guide catheters) so as to provide a suitable level of pushability and torqueability when advancing catheter 10 through the vasculature. In addition, catheter 10 includes distal region 14 that can provide distal access to vascular targets and may have a distal flexibility (similar to that of microcatheters) suitable for navigating the tortuous vasculature. Distal region 14 can also serve as a guidewire or guiding structure over which other medical devices can be passed.
Because of the arrangement which second tubular member 32 extends distally from first tubular member 30, catheter 10 may be well suited for neurological applications. This is because the length (i.e., distance D) of tubular member 32 is typically long enough and suitably flexible so that it can navigate into the target neurological vasculature while proximal region 12 remains disposed in a more proximal location away from the head. Thus, the larger bore proximal region 12 can remain in larger vessels, while the smaller bore distal region 14 can advance through the smaller, more sensitive neuro-vasculature. Moreover, because first opening 40 of first tubular member 30 is set back distance D from second opening 38, contrast media can still be infused into the blood vessel (via lumen 16) that will travel within the blood stream toward the target site. Distance D may range from about 10 cm. to about 50 cm. For a preferred use in neurological applications, distance D is about 20 cm. to about 40 cm.
It should be noted that in addition to contrast media, a number of different substances may be passed through lumen 16. The substance may be generally described as a drug, chemotherapeutic, antibiotic, etc. Some examples of appropriate substances may include anti-thrombogenic agents and/or anticoagulants such as heparin, heparin derivatives, urokinase, and PPack (dextrophenylalanine proline arginine chloromethylketone) D-Phe-Pro-Arg chloromethyl keton, an RGD peptide-containing compound, antithrombin compounds, platelet receptor antagonists, anti-thrombin antibodies, anti-platelet receptor antibodies, aspirin, prostaglandin inhibitors, platelet inhibitors, and tick antiplatelet peptides; anti-proliferative agents such as enoxaprin, angiopeptin, or monoclonal antibodies capable of blocking smooth muscle cell proliferation, hirudin, and acetylsalicylic acid; anti-inflammatory agents such as dexamethasone, prednisolone, corticosterone, budesonide, estrogen, sulfasalazine, and mesalamine; antineoplastic/antiproliferative/anti-miotic agents such as paclitaxel, 5-fluorouracil, cisplatin, vinblastine, vincristine, epothilones, endostatin, angiostatin and thymidine kinase inhibitors; anesthetic agents such as lidocaine, bupivacaine, and ropivacaine; vascular cell growth inhibitors such as growth factor inhibitors, growth factor receptor antagonists, transcriptional repressors, translational repressors, replication inhibitors, inhibitory antibodies, antibodies directed against growth factors, bifunctional molecules consisting of a growth factor and a cytotoxin, bifunctional molecules consisting of an antibody and a cytotoxin; cholesterol-lowering agents; vasodilating agents; agents which interfere with endogenous vascoactive mechanisms; anti-sense DNA and RNA; and DNA coding for (and the corresponding proteins) anti-sense RNA, tRNA or rRNA to replace defective or deficient endogenous molecules, angiogenic factors including growth factors such as acidic and basic fibroblast growth factors, vascular endothelial growth factor, epidermal growth factor, transforming growth factor a and B, platelet-derived endothelial growth factor, platelet-derived growth factor, tumor necrosis factor a, hepatocyte growth factor and insulin like growth factor, cell cycle inhibitors including CD inhibitors, thymidine kinase (“TK”) and other agents useful for interfering with cell proliferation, and the family of bone morphogenic proteins (“BMP's”) including BMP-2, BMP-3, BMP-4, BMP-5, BMP-6 (Vgr-1), BMP-7 (OP-1), BMP-8, BMP-9, BMP-10, BMP-11, BMP-12, BMP-13, BMP-14, BMP-15, BMP-16, “hedgehog” proteins.
Coils 142/146 and/or braids 144/148 may be similar to those typically seen in the art and can be made from any of the materials disclosed herein. Generally, coils 142/146 and/or braids 144/148 are provided as a reinforcing structure that can, for example, stiffen and/or strengthen the structure to which they are coupled. Because the distribution of support structures (i.e., coils 142/146, braids 144/148, etc.) can vary along the lengths of tubular members 130/132, regions having different flexibilities can be defined along catheter 110. Other structural modifications may also be present such as tapering of tubular members 130/132 in a regular, irregular, step-wise, or other manner. In some embodiments, coils 142/146 and/or braids 144/148 can be added subsequent an extrusion process or prior to an extrusion process (which would extrude another layer or material over coils 142/146 and/or braids 144/148). Of course, coils 142/146 and/or braids 144/148 are optional features that may be omitted from extrusion processes or other catheter manufacturing processes.
Coils 142/146 and/or braids 144/148 can also be used for other reasons including visualization. For example, coils 142/146 and/or braids 144/148 may be made from or otherwise include a radiopaque material. Radiopaque materials are understood to be materials capable of producing a relatively bright image on a fluoroscopy screen or another imaging technique during a medical procedure. This relatively bright image aids the user of catheter 10 in determining its location. Some examples of radiopaque materials can include, but are not limited to, gold, platinum, palladium, tantalum, tungsten alloy, plastic material loaded with a radiopaque filler, and the like. Likewise, other radiopaque structures may also be incorporated into catheter 10, such as marker bands 150.
The length, steepness or pitch, and position of tapered regions 554/556 may vary. For example, tapered regions 554/556 could extend along any portion (or all) of the length of catheter 510. In addition, any suitable steepness or abruptness in the amount of tapering can be utilized. Although overlapping tapered regions 554/556 are shown in
Similar to the other disclosed embodiments, catheter 310 includes first opening 340 and second opening 338 that are separated by a distance D′. Again, separating openings 340/338 by distance D′ allows contrast media or other substances to be infused through catheter 310 and into the blood vessel through opening 340 and allows a microcatheter or other media device to be advanced through opening 338. This feature may be desirable, for example, in neurological applications where the vasculature may shift from relatively large vessels to small and/or sensitive vessels at or near the to neurological treatment site.
As described above, catheter 310 may be a singular tubular member. However, this need not be the case. For example,
It should be understood that this disclosure is, in many respects, only illustrative. Changes may be made in details, particularly in matters of shape, size, and arrangement of steps without exceeding the scope of the invention. The invention's scope is, of course, defined in the language in which the appended claims are expressed.
Claims
1. A catheter, comprising:
- an inner tube having a distal end, an outer surface, and defining an infusion lumen;
- an outer tube having a distal end, an inner surface, and defining a catheter lumen; and
- wherein the outer surface of the inner tube is bonded to the inner surface of the outer tube; and
- wherein the distal end of the inner tube extends distally beyond the distal end of the outer tube.
2. The catheter of claim 1, wherein the outer tube includes a tapered outer surface.
3. The catheter of claim 1, wherein the inner tube, the outer tube, or both have a plurality of slots formed therein.
4. The catheter of claim 1, wherein the inner tube, the outer tube, or both have a reinforcing coil disposed therein.
5. The catheter of claim 1, wherein the inner tube, the outer tube, or both have a reinforcing braid disposed therein.
6. The catheter of claim 1, wherein the distal end of the inner tube extends 10 centimeters or more distally beyond the distal end of the outer tube.
7. The catheter of claim 1, wherein a portion of the inner tube is disposed coaxially within the outer tube.
8. The catheter of claim 1, wherein:
- a first portion of the inner tube is disposed coaxially within the outer tube; and
- a second portion of the inner tube is disposed non-coaxially within the outer tube.
9. The catheter of claim 1, further comprising:
- a microcatheter extending through the catheter lumen.
10. A hybrid micro guide catheter, comprising:
- a catheter tube having an outer surface and a microcatheter lumen;
- a microcatheter extending through the microcatheter lumen, the microcatheter being configured to access a neurovascular portion of the anatomy of a patient; and
- a contrast media tube having an inner surface; and
- wherein the outer surface of the catheter tube is secured to the inner surface of the contrast media tube.
11. The hybrid micro guide catheter of claim 10, wherein the contrast media tube includes a tapered outer surface.
12. The hybrid micro guide catheter of claim 10, wherein the catheter tube, the contrast media tube, or both have a plurality of slots formed therein.
13. The hybrid micro guide catheter of claim 10, wherein the catheter tube, the contrast media tube, or both have a reinforcing coil disposed therein.
14. The hybrid micro guide catheter of claim 10, wherein the catheter tube, the contrast media tube, or both have a reinforcing braid disposed therein.
15. The hybrid micro guide catheter of claim 10, wherein a distal end of the catheter tube extends 10 centimeters or more distally beyond a distal end of the contrast media tube.
16. The hybrid micro guide catheter of claim 10, wherein a portion of the catheter tube is coaxial within the contrast media tube.
17. The hybrid micro guide catheter of claim 10, wherein the outer surface of the catheter tube is secured to the inner surface of the contrast media tube with a thermal bond.
18. The hybrid micro guide catheter of claim 10, wherein the outer surface of the catheter tube is secured to the inner surface of the contrast media tube with an adhesive bond.
19. The hybrid micro guide catheter of claim 10, wherein the outer surface of the catheter tube is secured to the inner surface of the contrast media tube with a mechanical connector.
20. A method for using a catheter including a first tubular member having a proximal end region, a distal end region, and a first lumen extending at least partially therethrough, a second tubular member coupled to the first tubular member, the second tubular member having a proximal end region, a distal end region, and a second lumen extending at least partially therethrough, and wherein the distal end region of the second tubular member extends distally beyond the distal end region of the first tubular member, comprising:
- disposing the catheter in a blood vessel so that the distal end region of the second tubular member is disposed adjacent a target region;
- infusing contrast media into the blood vessel through the first lumen of the first tubular member; and
- advancing a microcatheter through the second lumen of the second tubular member to access a neurovascular portion of the anatomy of a patient.
Type: Application
Filed: Feb 11, 2013
Publication Date: May 30, 2013
Applicant: BOSTON SCIENTIFIC SCIMED, INC. (Maple Grove, MN)
Inventor: BOSTON SCIENTIFIC SCIMED, INC. (Maple Grove, MN)
Application Number: 13/764,059
International Classification: A61M 25/00 (20060101); A61M 5/00 (20060101);