US20030088209A1 - Multi-lumen extrusion tubing - Google Patents

Abstract

A multi-lumen balloon for use in a fluted balloon centering catheter and method for providing the same. The multi-lumen balloon maintains a radiation source at the center of a cardiovascular artery, has improved blood perfusion capability, and has improved balloon refolding characteristics. The method of fabricating a multi-lumen balloon designed for a radiation centering catheter uses an improved extrusion process that allows the manufacture of the multi-lumen balloon sub-assembly to be done separately from the catheter shaft assembly.

Description

BACKGROUND OF THE INVENTION
• 1. Field of the Invention[0001]
• The present invention relates to medical catheters and more particularly to a multi-lumen balloon for a radiation centering catheter.[0002]
• 2. Description of Related Art[0003]
• Medical catheters generally include elongate tube-like members that may be inserted into the body, either percutaneously or via a body orifice, for any of a wide variety of diagnostic and interventional purposes. Such catheters are particularly useful with regard to certain cardiovascular applications where the object is to deliver a treatment or instrument to a remote lesion.[0004]
• Percutaneous Transluminal Coronary Angioplasty (PTCA or balloon angioplasty) is the predominant treatment for coronary vessel stenosis. In PTCA, catheters are inserted into the cardiovascular system via the femoral artery under local anesthesia. A pre-shaped guiding catheter is positioned in the coronary artery, and a dilatation catheter having a distensible balloon portion is advanced through the guiding catheter into the branches of the coronary artery until the balloon portion traverses or crosses a stenotic lesion. The balloon portion is then inflated with a medium to compress the atherosclerosis in a direction generally perpendicular to the wall of the artery, thus dilating the lumen of the artery. Patients treated by PTCA procedures, however, suffer from a high incidence of restenosis, i.e., the same area of the coronary vessel collapses or becomes obstructed.[0005]
• Recent preclinical and early clinical studies indicate that intervascular radiation after balloon angioplasty can reduce the rate of restenosis caused by intimal hyperplasia. Generally, in an intervascular radiotherapy procedure, a flexible catheter is inserted into the cardiovascular system of a patient and then advanced to the region of the vessel that has been subjected to the angioplasty procedure. A radiation source or a treatment catheter having a radiation source inside it is then advanced through the flexible catheter so that the radiation source reaches the stenosed vascular site and can deliver an effective dose of radiation. After the radiation treatment, the catheter and radiation source are removed.[0006]
• Because for a given radiation source activity, the intensity of the radiation delivered to a vessel wall varies in inverse proportion to the square of the distance between the radiation source and the vessel wall, it is desirable to hold the radiation source at, or reasonably near, the center of the vessel for a given treatment period. If the source is not centered within vessel, the vessel wall nearest the source may receive an excess of radiation, while the portion of the vessel wall farthest from the source may be underexposed to the radiation.[0007]
• There are a number of ways to center a radiation source within a vessel. One such way is using a spiral balloon having a central lumen in which the radiation source is advanced to the stenosed vessel site. In a spiral balloon catheter, the balloon is wrapped or molded in a spiral fashion around a flexible centering lumen. When inflated, the balloon outer diameter pushes against the vessel walls while the inner balloon diameter pushes the radiation source lumen toward the center of the vessel.[0008]
• Spiral balloons have several significant drawbacks when used in intervascular radiotherapy to control restenosis. The first drawback is that because the balloon is wrapped or molded in a spiral shape around the centering lumen of the catheter, the centering effect of the radiation source decreases as the pitch of the turns of the spiral balloon increases. Thus, the fewer turns a spiral balloon has in its configuration, the less centered the radiation source is inside the vessel. Also, if the spiral balloon is over-pressurized, it will lose its spiral shape, thus leading to inconsistent centering of the radiation source. Another drawback with a spiral balloon is that because every spiral is a taper, when the balloon is in a deflated configuration, it creates a stiff catheter with a bulky balloon. This leads to poor access and limits the use of spiral catheters to certain portions of the vascular system. Furthermore, at the end of the intervascular radiation procedure, the tapers create poor refold of the spiral thus making the removal of the balloon catheter difficult for the physician. Another significant disadvantage of using a spiral balloon in intervascular radiation is the spiral balloon's inconsistent blood perfusion ability. Good blood perfusion of the vessel is achieved only when the blood is flowing freely through the spiral cavity created by the balloon. If any portion of the spiral cavity is blocked, then the flow of the blood is also stopped at that point. Thus, blood perfusion may not be adequate.[0009]
• Another way to center a radiation source within a vessel is to use a segmented balloon catheter having a series of peaks and valleys created by segmenting an ordinary balloon catheter. The segmented balloon centers the centering lumen using the same principle as the spiral balloon catheter.[0010]
• An additional way to center a radiation source within a vessel is by using a catheter having an outer balloon and an inner balloon disposed within the outer balloon. Generally, the inner and outer balloons are positioned parallel to each other and axially with the catheter shaft. The inner and outer balloons may have a spiral or a segmented configuration. The inner centering balloon may also be a multiple axial lumen balloon, where the lumens extend parallel to the catheter shaft.[0011]
• Another way to center a radiation source within a vessel is by having a balloon attached to the distal portion of a radioguide catheter. When inflated, the balloon engages the walls of the vessel to center the treatment channel. The balloon may also be configured to include spiral lumens or/and perfusion lumens to permit perfusion of the blood when the balloon is inflated.[0012]
• Segmented balloon catheters and multiple balloon catheters have many of the same drawbacks as those associated with spiral balloon catheters, including inadequate centering of the radiation source, poor balloon refold, catheter stiffness, bulky balloon configuration, inconsistent perfusion, etc. While balloons configured with spiral lumens or perfusion lumens have a better perfusion capability than single-spiral, segmented, or multiple balloon configurations, they still have some disadvantages, including poor balloon foldability, catheter stiffness, and less than optimal perfusion capability.[0013]
• Currently, most radioguide centering catheters used in the industry are of the type known in the industry as “tip RX” (RX being “rapid exchange”). Tip RX radioguide centering catheters are characterized by a short guidewire riding length of approximately 5 mm and a guidewire exit notch distal to the centering balloon. Tip RX catheter assemblies have several disadvantages when used in vascular radiation therapy. First, the trackability of the catheter is not consistent in a challenging vascular anatomy, and can go from excellent to poor for no apparent reason. Poor catheter trackability may make it impossible to place the catheter at the desired treatment site, preventing delivery of the radiation therapy. Pushability is similarly problematic with the tip RX catheter. When withdrawing a tip RX catheter, it is also possible to prolapse the guidewire, complicating the procedure. Another disadvantage is that because the guidewire lumen is distal to the balloon, it adds approximately 10 mm to the overall length of the tip. Cardiologists however, prefer to have the tip of the catheter as short as possible in order to prevent potential injury to the artery distal to the treatment site. Another disadvantage of using a tip RX balloon catheter for vascular radiation therapy is that since the exit notch is distal to the balloon, the guidewire must be left in place, thus creating a small but measurable shadow in the radiation dosimetry.[0014]
• In addition to tip RX balloon catheters, other catheter designs used for vascular radiotherapy employ an “over-the-wire” (“OTW”) guidewire lumen configuration. Currently, these OTW radiation delivery catheters do not provide the capability of centering the radiation source. Furthermore, while an over-the-wire configuration catheter assembly allows for the guidewire to be pulled back during radiation delivery, the guidewire lumen shifts the source away from the center of the catheter, thus making the centering of the radiation source even more problematic.[0015]
• The manufacture of inflated balloons with diameters in a range of approximately 1.0 to 6.0 millimeters (mm) presents another significant issue with current balloon catheter designs. One of the challenges relates to the stiffness of the balloon. For example, some manufacturers have used several separate small diameter balloons and attached them using glue or other bonding material around a central catheter shaft to form a balloon catheter. Because the glue or bonding material is positioned along the catheter shaft, the catheter is stiff and difficult to use in coronary vessels having tortuous paths. Therefore, this design configuration gives sub-par performance. Others have used an extrusion process to manufacture a multiple balloon radiation centering catheter. During the extrusion process, however, excess material is generated which tends to make the catheter stiff. In addition, because the material used for the radiation source lumen has generally been different than the material used for the guidewire lumen or the centering balloons, the extrusion process is extremely difficult to complete successfully.[0016]
SUMMARY OF THE INVENTION
• A multi-lumen tubing and method of manufacturing the same is described. The multi-lumen tubing includes a tubing body having a central lumen and a plurality of outer lumens disposed around the central lumen. The plurality of outer lumens are coupled with the central lumen by a shared wall. The multi-lumen tubing also includes an undercut region disposed the central lumen and the plurality of outer lumens.[0017]
BRIEF DESCRIPTION OF THE DRAWINGS
• The present invention is illustrated by way of example and not limitation in the accompanying figures:[0018]
• FIG. 1 is a side view of one embodiment of a multi-lumen fluted balloon catheter assembly for centering a radiation source, with guidewire lumen extending through one of the outer lumens of the balloon.[0019]
• FIG. 2 is a cross-sectional view of the multi-lumen fluted balloon catheter assembly of FIG. 1 taken along line A-A.[0020]
• FIG. 3 is a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 1 taken along line B-B.[0021]
• FIG. 4 is a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 1 taken along line C-C.[0022]
• FIG. 5 is a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 1 taken along line D-D.[0023]
• FIG. 6 is a side view of a second embodiment of a multi-lumen fluted balloon catheter assembly (standard-RX configuration) for centering radiation source, with proximal and distal slideable seals and without a guidewire lumen.[0024]
• FIG. 7 is a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 6 taken along line E-E.[0025]
• FIG. 8 is a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 6 taken along line F-F.[0026]
• FIG. 9 is a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 6 taken along line G-G.[0027]
• FIG. 10 is a side view of a third embodiment of the multi-lumen fluted balloon catheter assembly (for a tip-RX configuration) for centering a radiation source.[0028]
• FIG. 11 is a cross-sectional view of the multi-lumen fluted balloon catheter assembly of FIG. 10 taken along line H-H.[0029]
• FIG. 12 is a partial longitudinal cross-sectional view of the multi-lumen fluted balloon catheter assembly of FIG. 10 taken along line J-J showing a configuration for inflation/deflation and attachment.[0030]
• FIG. 13 is a side view of an third embodiment of a multi-lumen fluted balloon catheter assembly (for a standard-RX configuration) for centering a radiation source, where the guidewire lumen and source lumen extend through catheter inner member and central balloon lumen.[0031]
• FIG. 14 is a cross-sectional view of the multi-lumen fluted balloon catheter assembly of FIG. 13 taken along line K-K showing a guidewire lumen extending through balloon central lumen.[0032]
• FIG. 15 is a cross-sectional view of the multi-lumen fluted balloon catheter assembly of FIG. 13 taken along line L-L showing guidewire lumen, radiation source lumen, and inflation/deflation lumen within catheter inner member.[0033]
• FIG. 16 is a cross-sectional view of the multi-lumen fluted balloon catheter assembly of FIG. 13 taken along line M-M showing guidewire lumen and radiation source lumen.[0034]
• FIG. 17 is a schematic side view of the proximal and distal balloon seal areas for the fluted balloon radiation centering catheter assembly of FIG. 1.[0035]
• FIG. 18 is a cross-sectional view of a four-lumen balloon for a centering catheter assembly.[0036]
• FIG. 19[0037]ais a cross-sectional view of the four-lumen balloon for a centering catheter assembly with two balloon outer lumens flattened for proximal balloon seal preparation.
• FIG. 19[0038]bis a cross-sectional view of the four-lumen balloon for a centering catheter assembly with a configuration for folding the two balloon outer lumens flattened for balloon proximal seal preparation.
• FIG. 19[0039]cis a cross-sectional view of the four-lumen balloon for a centering catheter assembly with another configuration for folding the two balloon outer lumens flattened for balloon proximal seal preparation.
• FIG. 20[0040]ais a cross-sectional view of a configuration for a completed balloon is proximal seal for a four-lumen balloon.
• FIG. 20[0041]bis a cross-sectional view of a second configuration for a completed balloon proximal seal for a four-lumen balloon.
• FIG. 20[0042]cis a cross-sectional view of a third configuration for a completed balloon proximal seal for a four-lumen balloon.
• FIG. 20[0043]dis a side view of a “football-shape” cross section mandrel used to perform the proximal seal for a multi-lumen balloon.
• FIG. 21[0044]ais a schematic side view of the distal balloon seal area for the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 1.
• FIG. 21[0045]bis a schematic side view of the tip-forming sheath for forming the tip of balloon distal seal for the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 1.
• FIG. 21[0046]cis a schematic side view of the first and second heat shrink tube materials used for the balloon distal seal.
• FIG. 21[0047]dis a schematic side view of the source mandrel having a tapered length.
• FIG. 21[0048]eshows schematic side, top and bottom views of the source mandrel having a ramp length.
• FIG. 22[0049]ais a cross-sectional view of a basic four-lumen (quad-lumen) extrusion tubing with “shared wall” and “fillet radius” regions.
• FIG. 22[0050]bis a cross-sectional view of a tip and die assembly used to make the quad-lumen extrusion tubing of FIG. 22a.
• FIG. 23[0051]ais a cross-sectional view of a second embodiment of a quad-lumen extrusion tubing with “shared wall” and “undercut” regions.
• FIG. 23[0052]bis a cross-sectional view of a tip and die assembly used to make the quad-lumen extrusion tubing of FIG. 23a.
• FIG. 24[0053]ais a cross-sectional view of a third embodiment of a quad-lumen extrusion tubing with “shared wall” and “undercut” regions.
• FIG. 24[0054]bis a cross-sectional view of a tip and die assembly used to make the quad-lumen extrusion tubing of FIG. 24a.
• FIG. 25[0055]ais a cross-sectional view of a fourth embodiment of a quad-lumen extrusion tubing with “standoffs” regions.
• FIG. 25[0056]bis a cross-sectional view of a tip and die assembly used to make the quad-lumen extrusion tubing of FIG. 25a.
• FIG. 26 is a flow chart illustrating a method of manufacture a multi-lumen balloon assembly of the present invention.[0057]
• FIG. 27[0058]ais a side view of another embodiment of a multi-lumen fluted balloon catheter assembly for centering radiation source, with two additional guidewire exits in the catheter shaft and guidewire extending longitudinally outside the balloon.
• FIG. 27[0059]bis a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 27ataken along line A-A.
• FIG. 27[0060]cis a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 27ataken along line B-B.
• FIG. 27[0061]dis a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 27ataken along line C-C.
DETAILED DESCRIPTION OF THE INVENTION
• A multi-lumen balloon for use in a fluted balloon centering catheter and method for providing the same is described. The present invention is a multi-lumen balloon for a radiation centering catheter that maintains a radiation source at the center of a cardiovascular artery, has improved blood perfusion capability, and has improved balloon refolding characteristics. The present invention also provides an improved method of manufacture for a multi-lumen balloon design for a radiation centering catheter, where such method allows the manufacture of the multi-lumen balloon sub-assembly to be done separately from the catheter shaft assembly. Furthermore, the present invention is a multi-lumen balloon centering catheter assembly with an improved guidewire design and method for providing the same. In addition, the present invention provides improved proximal and distal balloon seal designs and method of manufacture for the same.[0062]
• In the following detailed description, numerous specific details are set forth in order to provide a more thorough understanding of the present invention. However, it will be apparent to those skilled in the art to which this invention pertains that the present invention may be practiced without these specific details. In other instances, well-known devices, methods, procedures, and individual components have not been described in detail so as not to unnecessarily obscure aspects of the present invention.[0063]
• The present invention is a multi-lumen fluted balloon radiation centering catheter. FIG. 1 shows an embodiment of the multi-lumen fluted balloon centering[0064]catheter assembly1 of the present invention that includes amulti-lumen balloon10 and aninterventional catheter2 disposed at the proximal end of theballoon10.
• [0065]Balloon10 includes a central lumen and a plurality of outer lumens (or lobes) disposed around the central lumen. The outer lumens are integrally coupled with the central lumen so as to form the multi-lumen balloon. It should be noted that although the multi-lumen balloon configurations illustrated and discussed hereafter make reference to a four-lumen balloon configuration (i.e., balloon with a central lumen and three outer lumens), the multi-lumen balloon of the present invention is not limited to this four-lumen balloon arrangement. As it will be described in the later sections, for some treatment applications and/or vessel treatment area configurations, using a three-lumen balloon having a central lumen and two outer lumens may be desirable. In addition, for some applications, having a balloon with more than four lumens may be desirable.
• The[0066]interventional catheter2 used with themulti-lumen balloon10 may be one of several configurations known in the art, including a standard Rapid Exchange (“RX”) design (as shown in side views in FIGS. 1 and 13) where aguidewire lumen21 passes through theballoon10 and exits proximal to theballoon10; a tip (or distal) RX design (as shown in a side view in FIG. 10) where ashort guidewire lumen21 is provided at a distal tip of theballoon10; or an over-the-wire (“OTW”) design where theguidewire lumen21 extends the full length of the flutedballoon catheter assembly1, including themulti-lumen balloon10 andinterventional catheter2.
• Multi-Lumen Balloon[0067]
• Referring to FIG. 18, a cross sectional view of one embodiment of a[0068]multi-lumen balloon10 for treating abody vessel16 in the vascular system is shown.Balloon10 includes acentral lumen12 and a plurality of outer lumens (or lobes)11 disposed around thecentral lumen12. Theouter lumens11 are integrally coupled with thecentral lumen12 so as to form themulti-lumen balloon10. Each of the balloonouter lumens11 has an inner radial length (or diameter)18 and anouter diameter15, defining balloonouter lumen walls17. Thewalls17 of balloonouter lumens11 are made very thin to allow proper inflation and deflation ofouter lumens11. The thickness of thewalls17 ranges from {fraction (0.5/1000)} in. to about {fraction (3/1000)} in. In one embodiment,wall17 has a thickness of {fraction (0.75/1000)} in.
• The balloon[0069]outer lumens11 can be extruded with either equal diameters15 (as shown in FIG. 18, and FIGS. 3 and 11) or with unequal (i.e., asymmetrical, lopsided, etc.) diameters15 (as shown in FIG. 14). The balloon outer lumen has adiameter15 sized in a range of approximately 0 mm (no balloon lumen) to about 5 mm.
• The balloon[0070]central lumen12 has aninner diameter18a. Thecentral lumen12 is capable of containing a radiation source (with or without a radiation source lumen) therein. Thediameter18aof the ballooncentral lumen12 is sized based on the radiation source outer diameter, for example a radiation source wire having an outer diameter in a range of approximately {fraction (10/1000)} in. to {fraction (50/1000)} in. It should be noted that the ballooncentral lumen diameter18amay be made smaller than {fraction (18/1000)} in. for intervascular radiation treatments using radiation sources having a diameter smaller than {fraction (10/1000)} in. or for radiation sources having a liquid configuration.
• Continuing with reference to FIG. 18, the[0071]multi-lumen balloon10 of the present invention is used in a fluted balloon radiation centeringcatheter assembly1 for treating abody vessel16 in the vascular system. Given the very small diameter of thesebody vessels16, the combined balloon diameter13 (as measured across all balloonouter lumens11 while balloon is in an inflated or deployed state) is kept in a range of approximately 1.5 mm to 6 mm for coronary vessels and in a range of approximately 3 mm to 12 mm for peripheral vessels. In one embodiment (shown in FIG. 3), the combineddiameter13 is in a range of approximately 1.5 mm to 4 mm.
• Referring now to FIG. 3, another embodiment of the multi-lumen balloon of this invention includes a[0072]balloon10 having acentral lumen12 and three outer lumens (or lobes)11 disposed around thecentral lumen12. Theouter lumens11 are integrally coupled with thecentral lumen12 so as to form themulti-lumen balloon10.Balloon10 has aguidewire lumen21 extending lengthwise through one of the balloonouter lumens11. Theguidewire lumen21 is capable of receiving aguidewire45 for positioning the multi-lumen balloon10 (and thus the radiation centering catheter1) within abody vessel16. The ballooncentral lumen12 is capable of containing a radiation source25 (with or without a radiation source lumen22) therein. If aradiation source lumen22 is used with theradiation source25 in the ballooncentral lumen12, theradiation source lumen22 would extend lengthwise through thecentral lumen12.
• It should be noted that the multi-lumen balloon embodiment shown in FIG. 3 is also adapted for receiving the guidewire lumen[0073]21 (with a guidewire45) through itscentral lumen12. In this configuration, since the ballooncentral lumen12 would contain both a radiation source25 (with or without a radiation source lumen22) and aguidewire lumen21, thecentral lumen12 may take an egg-like shape. Theinner diameter18aof the egg-shapedcentral lumen12 would be sized based on the diameter of the radiation source25 (with itsradiation source lumen22 if one is present) and the diameter of theguidewire lumen21. In this configuration, thediameter18aof the ballooncentral lumen12 is sized based on the radiation source outer diameter, for example a radiation source wire having an outer diameter in a range of approximately {fraction (10/1000)} in. to {fraction (50/1000)} in.,and the guidewire lumen diameter. Thus, thediameter18amay be in a range of approximately {fraction (10/1000)} in. to {fraction (75/1000)} in. In one embodiment, thediameter18ais {fraction (62/1000)} in.
• With reference to FIG. 4, for the four-lumen balloon embodiment shown in FIG. 3, three separate inflation lumens ([0074]54b,55b) positioned proximal to theballoon10 in acatheter shaft41 are used to inflate the three balloonouter lumens11. The inflation lumens (54b,55b) communicate directly with each of the balloonouter lumens11. Acommon inflation lumen36, positioned within the catheter shaft outer member46 (shown in FIG. 5), provides a common communication path between the inflation lumens (54b,55b) (and thus the balloon outer lumens11) and an inflation port33 (shown in FIG. 1) to which a balloon inflation means (not shown) is attached. In this configuration, aninflation medium18benters the balloon catheter assembly at theinflation port33, passes through thecommon inflation lumen36 onto the three balloon inflation lumens (54b,55b), and then enters and inflates theouter lumens11 which causes the radiation source lumen22 (and/or radiation source25) to be centered within thebody vessel16. Theouter lumens11 may be inflated at an operating pressure in the range of approximately 0.5-14 atmospheres. In one embodiment, theouter lumens11 may be inflated at an operating pressure in the range of approximately 2-5 atmospheres.
• For the multi-lumen balloon shown in FIG. 3, the[0075]central lumen12 does not have to be pressurized and may not have to be sealed in order to inflate the balloonouter lumens11. It should be noted that having individual inflation lumens for each of the balloon outer lumens allows each balloon outer lumen to be inflated to different pressures. This multi-lumen balloon arrangement is desirable for vessel treatment applications where the particular body vessel (in the area being treated) may not be fully circular (i.e., body vessel area may contain certain obstructions or “deposits” along its walls).
• It should also be noted that it is not necessary to have individual inflation lumens ([0076]54b,55b) for each of the balloonouter lumens11 in order to center toradiation source lumen22 with thevessel16. For balloon designs where individual inflation lumens (54b,55b) are absent, a catheter shaftinner lumen41 a may serve as a common inflation lumen for the balloonouter lumens11.
• Continuing with reference to FIG. 3, the[0077]diameter18aof the ballooncentral lumen12 is sized based on the radiation source outer diameter, for example a radiation source wire having an outer diameter in a range of approximately {fraction (10/1000)} in. to {fraction (50/1000)} in. The combined balloon diameter13 (as measured across all balloonouter lumens11 while balloon is in an inflated or deployed state) is kept in a range of approximately 1.5 mm to 6 mm for coronary vessels and in a range of approximately 3 mm to 12 mm for peripheral vessels. For the embodiment shown in FIG. 3, a balloon having a combineddiameter13 in a range of approximately 1.5 mm to 4 mm is advantageous when treating coronary vessels.
• Referring to FIG. 11, another embodiment of the multi-lumen balloon of this invention is a[0078]balloon10 having acentral lumen12 and a plurality ofouter lumens11 disposed around thecentral lumen12. Theouter lumens11 are integrally coupled with thecentral lumen12 so as to form themulti-lumen balloon10. Bores (or channels)35 are formed between theouter lumens11 and thecentral lumen12. This arrangement allows aninflation medium18bto pass from the ballooncentral lumen12 into theouter lumens11 and inflateouter lumens11, causing aradiation source lumen22 to be centered within abody vessel16. In this configuration, thecentral lumen12 may have to be pressurized in order for theouter lumens11 to properly inflate and center theradiation source lumen22 within thebody vessel16.
• For the balloon configuration shown in FIG. 11, the balloon[0079]central lumen12 is capable of containing a radiation source25 (with or without a radiation source lumen22) therein. The multi-lumen balloon embodiment shown in FIG. 11 is adapted for receiving a guidewire lumen (with a guidewire) through either one of its balloonouter lumens11 or through itscentral lumen12. Because in FIG. 11 theballoon10 is shown as being used with a tip (or distal) Rapid Exchange catheter type (i.e., the guidewire is positioned distal to the balloon), for the balloon embodiment of FIG. 11, the guidewire does not extend through any of theballoon lumens11.
• It should be noted that while the balloon configuration of FIG. 3 shows a guidewire lumen[0080]21 (with guidewire45) extending through one of the balloonouter lumens11, the guidewire45 (with or without its guidewire lumen21) may also be positioned so that it extends through thecentral lumen12 of the multi-lumen balloon10 (as shown in the balloon configuration of FIG. 14). Furthermore, whether a guidewire (and a guidewire lumen) extends through the multi-lumen balloon depends on a number of considerations, such as the type of catheter used, the balloon catheter manufacturing preferences, the treatment site configuration, etc. For example, when considering the type of catheter to be used, for a standard Rapid Exchange or an OTW catheter type, the guidewire45 (with or without a guidewire lumen21) would extend through one of the outer lumens (as shown in FIGS. 3, 6, and17) or through the central lumen (as shown in FIG. 14). For balloon catheter assemblies using a tip (or distal) Rapid Exchange catheter type, because the guidewire (with or without a guidewire lumen) is positioned distal to the balloon, the guidewire would not extend through any of the balloon lumens (as shown in FIG. 11).
• As with the other two balloon arrangements discussed above, for the balloon embodiment shown in FIG. 11 (i.e., having a “tip” or distal guidewire lumen that does not extend through the entire balloon lumen), the[0081]diameter18aof the ballooncentral lumen12 is sized based on the radiation source outer diameter, for example a radiation source wire having an outer diameter in a range of approximately {fraction (10/1000)} in. to {fraction (50/1000)} in. For the balloon embodiment shown in FIG. 14 (i.e., where theguidewire lumen21 is positioned so that it extends through the central lumen12), thediameter18aof the ballooncentral lumen12 is sized based on the radiation source outer diameter and the diameter of theguidewire lumen21. Thus, thediameter18amay be in a range of approximately {fraction (10/1000)} in. to {fraction (75/1000)} in. In one embodiment, thediameter18ais {fraction (62/1000)} in.
• Continuing with reference to FIG. 11, the combined balloon diameter[0082]13 (as measured across all balloonouter lumens11 while balloon is in an inflated or deployed state) is kept in a range of approximately 1.5 mm to 6 mm for coronary vessels and in a range of approximately 3 mm to 12 mm for peripheral vessels. For the embodiment shown in FIG. 11, a balloon having a combineddiameter13 in a range of approximately 1.5 mm to 4 mm is desirable when treating coronary vessels.
• Referring now to FIG. 17, a four-[0083]lumen balloon10 having aguidewire lumen21 extending through one of the balloonouter lumens11 is shown. Note that one of the outer lumens is hidden from view. A radiation source lumen22 (capable of holding a radiation source) extends lengthwise through the ballooncentral lumen12. Theouter lumen11 with theguidewire lumen21 extending through it is also inflated as part of the function of the centering balloon catheter.
• Continuing with reference to FIG. 17, the[0084]multi-lumen balloon10 has adistal seal28 and aproximal seal29.Distal seal28 seals the plurality of distal ends34bof the balloonouter lumens11 to a catheter shaft (formed by theradiation source lumen22 and guidewire lumen21) while theproximal seal29 seals the plurality of proximal ends34aof the balloonouter lumens11 to the catheter shaft. The distal and proximal seals (28,29) may each have a width in a range of approximately 0.5 mm to about 5 mm.
• When balloon outer lumens' distal and proximal ends ([0085]34b,34a) are sealed together into the distal seal and proximal seal respectively (28,29), each of theouter lumens11 takes the form of a “flute” (i.e., an elongated cylinder having tapered ends) when inflated by an inflation medium. The fluted balloon configuration shown in FIG. 17 is representative of balloon configurations of this invention (as shown in balloon catheter assemblies of FIGS. 1, 6,10, and13).
• Referring to FIG. 1, a[0086]treatment area30 is defined between the balloon'sdistal seal28 andproximal seal29. The longitudinal length of theballoon treatment area30 is made to be appropriate for the body vessel to be treated (for example, coronary vessels or peripheral vessels) and for the radiation treatment to be delivered. In one embodiment of the present invention, the balloontreatment area length30 is in a range of approximately 18 mm to 54 mm. For some intervascular gamma radiation treatments, such as treatments on peripheral vessels of the cardiovascular system, the balloontreatment area length30 may be in a range of approximately 10 mm to 250 mm.
• Referring now to FIG. 3, during vascular radiotherapy, when inflated and engaged with the walls of the[0087]body vessel16, the balloonouter lumens11 define a series of straightlongitudinal paths14 that allow for perfusion of blood (not shown) past balloon treatment area30 (shown in FIG. 1).
• The fluted balloon[0088]outer lumens11 can be extruded with either equal diameter15 (as shown in FIGS. 3, 11 and18) or with unequal (or asymmetrical) diameter15 (as shown in FIG. 14). Aballoon10 havingouter lumens11 withequal diameter15 is well suited for a “standard Rapid Exchange” catheter (shown in FIGS. 3 and 6) or an “over-the-wire” catheter type, each having a guidewire lumen21 (and/or a guidewire45) extending through one of the balloon's outer lumens. Aballoon10 havingouter lumens11 withequal diameter15 is also well suited for a “tip Rapid Exchange” catheter type having only the source wire lumen extending through atreatment channel50 contained within the balloon central lumen12 (shown in FIG. 11).
• Referring to FIG. 14, fluted[0089]outer lumens11 withunequal diameter15 would provide the offset necessary to compensate for the slight eccentricity in the location of a treatment channel50 (with the radiationsource wire lumen22 in it) within thecentral lumen12 of theballoon10. A balloon arrangement havingouter lumens11 with unequal diameters (for example, a balloon assembly with one small “flute” and two large “flutes”) is best suited for the “standard RX” or “over-the-wire” catheter designs where the catheter shaft (or inner member)41 includes two parallel lumens: a source lumen22 (for a radiation source25) and a guidewire lumen21 (for a guidewire45). For very small diameter centering balloon catheters, such as the 2 mm diameter balloon catheter designs, the small “flute”11 shown in FIG. 14 may be eliminated to provide for centering of theradiation source lumen22.
• The[0090]multi-lumen balloon10 is manufactured using balloon materials, such as Pebax™, nylon, polyethylene, polyurethane, or polyester. Materials for use in fabricating themulti-lumen balloon10 of the present invention are selected by considering the properties and characteristics (e.g., softness, durability, low stiffness) required by angioplasty balloons, as well as considering properties necessary for successful balloon fabrication (e.g., balloon material compatible with other catheter materials and bonding process, material extruding well, etc.). When deployed (i.e., inflated), themulti-lumen balloon10 is a high strength, flexible, reasonably noncompliant balloon. The fluted shape of the balloon outer lumens allows the balloon to have improved blood perfusion capability as well as improved balloon refolding characteristics (when the inflation medium is removed from the balloon outer lumens).
• Fluted Balloon Radiation Centering Catheter Assembly[0091]
• With reference to FIGS.[0092]1-16, four types of fluted balloon radiation centering catheter assemblies are illustrated. In FIGS.1-5, a fluted balloon radiation centeringcatheter assembly1 for a “standard Rapid Exchange” catheter with aguidewire lumen21 extending through one of the outer lumens is shown. In FIGS.5-9, a fluted balloon radiation centeringcatheter assembly1 for a standardRapid Exchange catheter2 with proximal and distal slideable seals is shown. In FIGS.10-12, a fluted balloon radiation centeringcatheter assembly1 for a “tip (or distal) Rapid Exchange”catheter2 is illustrated. Finally, in FIGS.13-16, a fluted balloon radiation centeringcatheter assembly1 for a standardRapid Exchange catheter2 with aguidewire lumen21 extending through thecentral lumen12 is shown.
• Multi-Lumen Balloon Catheter Having a Guidewire Lumen Through Balloon Outer Lumen[0093]
• Referring to FIG. 1, a multi-lumen fluted balloon radiation centering[0094]catheter assembly1 with theballoon10 in an inflated state is shown. The fluted balloon radiation centeringcatheter assembly1 includes amulti-lumen balloon10 and aninterventional catheter2.Interventional catheter2 has ashaft41 disposed proximate theballoon10. Theballoon10 includes a plurality of inflatableouter lumens11 disposed around acentral lumen12, the plurality ofouter lumens11 integrally coupled with thecentral lumen12 so as to form themulti-lumen balloon10. Theballoon10 has adistal seal28 and aproximal seal29.Distal seal28 seals the plurality of distal ends34bof the balloonouter lumens11 to thecatheter shaft41 while theproximal seal29 seals the plurality of proximal ends34aof the balloonouter lumens11 to thecatheter shaft41. Each of theouter lumens11 takes the form of a “flute” (i.e., an elongated cylinder having tapered ends) when inflated by aninflation medium18b(shown in FIG. 3 for this balloon catheter assembly). A fluted balloon configuration is shown in FIG. 17, which is a representative illustration of balloon configurations of this invention (as revealed in balloon catheter assemblies of FIGS. 1, 6,10, and13).
• Referring now to FIG. 3, the multi-lumen[0095]balloon catheter assembly1 has aradiation source lumen22 that extends longitudinally through thecentral lumen12 of the four-lumen balloon10. In one embodiment, for a “standard Rapid Exchange” (standard RX) or an “over-the-wire” (OTW) catheter type, a guidewire lumen21 (capable of containing a guidewire45) extends through one of the balloon outer lumens (as shown in FIG. 3). Theguidewire45 allows positioning the multi-lumen centering catheter1 (including its radiation source lumen22) on the stenosedbody vessel area16 for patient treatment.
• The balloon radiation centering catheter assembly shown in FIG. 3 may also be used with a “tip (or distal) Rapid Exchange” catheter type, with a[0096]guidewire lumen21 is distally positioned to themulti-lumen balloon10 and thus would not pass through theballoon10.
• For a “Standard RX” catheter type, the guidewire exists the catheter shaft at a distance in a range of approximately 15-35 cm from the distal tip of the catheter. For a “tip RX” catheter type, the guidewire exists the catheter shaft at a distance in a range of approximately 3-20 mm from the distal tip of the catheter. Note that for a tip RX catheter type, the guidewire does not enter the balloon. For the “OTW” catheter type, the guidewire extends through the catheter shaft. The distance from the distal tip of the catheter to the inflation port may be in a range of approximately 75-135 cm for coronary applications and in a range of approximately 75-145 cm for peripheral applications. For any catheter type, if an afterloader (i.e., radiation therapy device) is to be used, the guidewire may be extended an additional 15-125 cm. In one embodiment, when using the afterloader the guidewire extension may be in a range of approximately 70-80 cm.[0097]
• Continuing with reference to FIG. 3, as mentioned above, the[0098]radiation source lumen22 extends longitudinally through the balloon central lumen and the standardRX guidewire lumen21 extends longitudinally through one of the balloonouter lumens11. The remaining twoouter lumens11 are then sealed onto theradiation source lumen22 and theguidewire lumen21 for maintaining inflation pressure in the balloon. When inflated by aninflation medium18b, the balloonouter lumens11 form flutes positioned parallel to theradiation source lumen22 and theguidewire lumen21. During vascular radiotherapy, when inflated and engaged with the walls of thebody vessel16, the balloonouter lumens11 define a series of straightlongitudinal paths14 that allow for perfusion of blood (not shown) past balloon treatment area30 (shown in FIG. 1).
• The fluted balloon[0099]outer lumens11 can be extruded with either equal diameter15 (as shown in FIGS. 3, 11 and18) or with unequal (or asymmetrical) diameter15 (as shown in FIG. 14). Aballoon10 havingouter lumens11 withequal diameter15 is well suited for a “standard Rapid Exchange” catheter (shown in FIGS. 3 and 6) or an “over-the-wire” catheter type, each having a guidewire lumen21 (and/or a guidewire45) extending through one of the balloon's outer lumens. Aballoon10 havingouter lumens11 withequal diameter15 is also well suited for a “tip Rapid Exchange” catheter type having only the source wire lumen extending through atreatment channel50 contained within the balloon central lumen12 (shown in FIG. 11).
• Continuing with reference to FIG. 3, the[0100]diameter18aof the ballooncentral lumen12 is sized based on the radiation source outer diameter, for example a radiation source wire having an outer diameter in a range of approximately {fraction (10/1000)} in. to {fraction (50/1000)} in. The combined balloon diameter13 (as measured across all balloonouter lumens11 while balloon is in an inflated or deployed state) is kept in a range of approximately 1.5 mm to 6 mm for coronary vessels and in a range of approximately 3 mm to 12 mm for peripheral vessels. For the embodiment shown in FIG. 3, a balloon having a combineddiameter13 in a range of approximately 1.5 mm to 4 mm is advantageous when treating coronary vessels.
• Referring to FIG. 4 (which represents a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 1 taken along line C-C), the[0101]catheter shaft41 includes aninner lumen41 a that extends longitudinally through at least a portion of thecatheter shaft41 proximate theballoon10 and connects to thecentral lumen12 of theballoon10. The catheter shaftinner lumen41ais adapted for receiving aradiation source lumen22 with aradiation source25 and aguidewire lumen21 capable of containing aguidewire45 for positioning the multi-lumen balloonradiation centering catheter1 within a body vessel. Both theradiation source lumen22 and theguidewire lumen21 are manufactured as co-extrusions having an inner layer made of a material such as polyethylene and an outer layer made of a material such as Pebax, nylon, or Primacor.
• Continuing with reference to FIG. 4, the catheter shaft[0102]inner lumen41ais further adapted to receive at least one inflation lumen (54b,55b) that is in fluid communication with each of the balloon outer lumens to allow an inflation fluid to enter and inflate theouter lumens11 and thus, center theradiation source lumen22 within abody vessel16. The inflation lumen(s) (54b,55b) in the catheter shaftinner lumen41aare generally formed when themulti-lumen balloon10 is bonded to thecatheter shaft41 during the catheterproximal seal29 construction (explained in more detail in the Proximal Seal section).
• As mentioned above, having individual inflation lumens for each of the balloon outer lumens allows each balloon outer lumen to be inflated to different pressures. However, it is not necessary to have individual inflation lumens for each of the balloon outer lumens in order to center to radiation source lumen with the vessel. For balloon catheter designs where individual inflation lumens ([0103]54b,55b) are absent, the catheter shaftinner lumen41 a may serve as an inflation lumen for the balloonouter lumens11.
• Referring to FIG. 5 (which represents a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 1 taken along line D-D), at the region of the balloon catheter[0104]proximal seal29, an elongated flexible catheterouter member46 is placed over thecatheter shaft41. The catheter outer member may be manufactured of materials such as nylon, Pebax, polyurethane, etc. Catheterouter member46 includes alumen50athat extends longitudinally therein. Near the catheterproximal seal29 region, thelumen50abecomes the catheter shaftinner lumen41a.Lumen50ais adapted for receiving acommon inflation lumen36 for inflating and pressurizing the balloonouter lumens11 with an inflation medium (or means)18b. Theinflation medium18bcould include any inflation medium known in the art of balloon angioplasty, such as air, saline solution, or contrast fluid.
• Continuing with reference to FIG. 5, the catheter outer member[0105]inner lumen50ais adapted for receiving aradiation source lumen22 with aradiation source25. If a Standard RX (Rapid Exchange) or an OTWinterventional catheter assembly2 is used, the catheterouter member lumen50ais further adapted for receiving a guidewire lumen21 (and/or a guidewire45).
• Referring now to FIG. 1, the multi-lumen balloon has a[0106]treatment area30 is defined between the balloon'sdistal seal28 andproximal seal29. The longitudinal length of theballoon treatment area30 is made to be appropriate for the body vessel to be treated (for example, coronary vessels or peripheral vessels) and for the radiation treatment to be delivered. In one embodiment of the present invention, the balloontreatment area length30 is in a range of approximately 18 mm to 54 mm. For some intervascular gamma radiation treatments, such as treatments on peripheral vessels of the cardiovascular system, the balloontreatment area length30 may be in a range of approximately 10 mm to 250 mm.
• Continuing with reference to FIG. 1, in one embodiment, the[0107]radiation source lumen22 is sealed at itsdistal end23 withplug24 to allow aradiation source25 to be placed inside theradiation source lumen22. In another embodiment, theradiation source lumen22 is left open at its distal end23 (i.e., it does not have a plug24) so that a radiation source25 (placed inside the radiation source lumen22) can be distally advanced past themulti-lumen balloon10. Furthermore, not having theradiation source lumen22 sealed with theplug24 decreases the stiffness of the multi-lumen balloon even further.
• It should be noted that it is not necessary to have a[0108]radiation source lumen22 as part of the multi-lumen balloon centeringcatheter assembly1. In some applications, it may be desirable to place theradiation source25 directly within thecentral lumen12 of theballoon10, without employing asource lumen22. Not having aradiation source lumen22 in the ballooncentral lumen12 reduces the size of the multi-lumen balloon and decreases the stiffness of the multi-lumen balloon (since theradiation source lumen22 is a co-extruded shaft), thus allowing the balloon to cross tortuous paths more easily along the body vessel.
• The[0109]radiation source25, which may be shaped in the form of a wire, seed, pellets, ribbon, etc., is positioned insideradiation source lumen22 and is then advanced longitudinally along aprescribed vessel length16 during patient treatment. In one embodiment of this invention, the multi-lumen balloon centeringcatheter assembly1 uses a Phosphorus-32 radiation source as aradiation source24. However, the multi-lumen balloon of this invention can be used with any radiation source employed in vascular radiotherapy, which includes gamma radiation emitting sources and beta radiation emitting sources known in the art.
• Continuing with reference to FIG. 1, two radio-opaque markers, a[0110]distal marker37 and aproximal marker38, may be attached to theradiation source lumen22. The radio-opaque markers37 and38 are used for positioning theinterventional catheter1 under fluoroscopy, as well as for assisting the stepping (via manual or automatic means) of theradiation source25 over the entire prescribed region of thevessel16 to be treated. Themarkers37 and38 are made of any materials known in the art of radio-opaque markers, such as silver, gold, platinum, tungsten, that allow markers to become visible under fluoroscopy. In one embodiment, the radio-opaque markers (37,38) are attached within the limits of the balloon'streatment area30. In one configuration, thedistal marker37 is incorporated into theplug24 of thesource lumen22. In another configuration, radio-opaque markers (37,38) may be part of a separate device (not shown) that is independent of the balloon catheter assembly.
• A[0111]soft tip26 is attached to thedistal end27 of theguidewire lumen21 to improve trackability and reduce trauma to the body vessel. The length of thesoft tip26 depends on the type of catheter design used, however, the length of the tip is generally in a range of approximately 0.5 mm to 10 mm.
• With reference to FIG. 1, the[0112]balloon10 is attached tocatheter shaft41 of thecatheter assembly2. The balloon'sproximal seal29 is attached at aproximal end44 offlexible catheter shaft41, near the inflation/deflation port33. The balloondistal seal28 is attached to thecatheter shaft41 adjacent to the location where theradiation source lumen22 ends. In one embodiment, theballoon10 andassembly2 are attached by using a laser bond technique. Bonds may also be done using other balloon bonding techniques known in the art, such as thermal or ultrasonic welds, adhesive welds, or other conventional means. The distal and proximal seals (28,29) may each have a width in a range of approximately 0.5 mm to about 5 mm.
• Multi-Lumen Balloon Catheter Having a Slideable Proximal Seal and a Slideable Distal Seal[0113]
• Referring to FIGS.[0114]6-9, a fluted balloon radiation centering catheter assembly for a standard Rapid Exchange catheter with proximal and distal slideable seals is shown. In the embodiment disclosed herein, the tubing used to form the guidewire lumen is eliminated, and is replaced by proximalslideable seal29aand distalslideable seal28aas shown in FIG. 6. Eliminating the guidewire tubing reduces the material used and lowers the balloon catheter proximal seal outer diameter. These improvements make the catheter less stiff, allowing the balloon catheter to cross tortuous paths more easily along the body vessel. Furthermore, eliminating the guidewire tubing allows the proximal seal to become less complicated during seal manufacturing (as discussed in more detail in a later section).
• With reference to FIG. 6, the path of the rapid exchange guidewire[0115]45 starts at thedistal tip26 of thecatheter1 by entering anannular space45b(shown in FIG. 7) formed between thecatheter shaft41 and the distal end of theradiation source lumen22. This is where the slideabledistal seal28ais located. Theguidewire45 then longitudinally passes through one of the balloonouter lumens11, where the balloonouter lumen11 itself acts as a guidewire lumen. Theguidewire45 then runs in the annular space52 (shown in FIG. 8) between the shaftouter member46 and thesource lumen22 until it reaches anexit notch29bwith a slideableproximal seal29a. Theseannular spaces45band52 are also used to inflate and deflate the multi-lumen balloon, so “slideable” seals are used at both thecatheter tip26 and at theguidewire exit notch29b.
• Referring to FIG. 7, as stated above, the[0116]guidewire45 enters anannular space45b(shown in FIG. 7) formed between thecatheter shaft41 and the distal end of theradiation source lumen22. To create the slideabledistal seal28a, theannular space45bis made to be a “close fit” by having a minimal distance clearance between the outer diameter of theguidewire45 and the inner diameter of the balloon seal (formed when the balloon is being bonded to the catheter shaft).
• Referring to FIG. 8, after exiting the balloon outer lumen, the[0117]guidewire45 then enters an annular space52 (shown in FIG. 8) formed in the catheter shaftouter member46. The annular space (or lumen)52 serves both as a lumen for theguidewire45 and as an inflation lumen for the balloon outer lumen that has the guidewire contained therein.
• The slideable distal and proximal seals ([0118]28a,29a) prevent the balloon inflation media (for example, saline) (not shown) from leaking out of thecatheter2. However, the slideable seals (28a,29a) to theguidewire45 are not fixed, rather the design allows the guidewire to slide axially relative to thecatheter2 and also allows theguidewire45 to be rotated relative to the catheter. In one embodiment, the combination of a sealing capability with relative motion is obtained by having minimal clearances between the outer diameter of theguidewire45 and theinner diameter45aaof the seal formed between the balloon and the catheter shaft (as shown in FIG. 7).
• Another embodiment of the slideable proximal and distal seals uses a[0119]hydrogel material45a(shown in FIG. 7), positioned either on theguidewire45 or integral to the slideable distal and proximal seals (28a,29a) to maintain the pressure seal while providing smoother movement of theguidewire45. To insure that the seals (28a,29a) hold pressure, thecatheter2 may be used with guidewires that have a polymer jacket rather than an intermediate wire coil. In a yet another embodiment, the hydrogel material in the slideable proximal and distal seals is substituted with an O-ring45a(shown in FIG. 9). This O-ring is positioned either on theguidewire45 or integral to the slideable distal and proximal seals (28a,29a) to maintain the pressure seal while providing smoother movement of theguidewire45.
• Referring to FIG. 6, a multi-lumen fluted balloon radiation centering[0120]catheter assembly1 with theballoon10 in an inflated state is shown. The fluted balloon radiation centeringcatheter assembly1 includes amulti-lumen balloon10 and aninterventional catheter2.Interventional catheter2 has ashaft41 disposed proximate to theballoon10. Theballoon10 includes a plurality of inflatableouter lumens11 disposed around acentral lumen12, the plurality ofouter lumens11 integrally coupled with thecentral lumen12 so as to form themulti-lumen balloon10. Theballoon10 has a slideabledistal seal28aand a slideableproximal seal29a. Slideabledistal seal28aseals the plurality of distal ends34bof the balloonouter lumens11 to thecatheter shaft41 while the slideableproximal seal29aseals the plurality of proximal ends34aof the balloonouter lumens11 to thecatheter shaft41.
• Each of the[0121]outer lumens11 takes the form of a “flute” (i.e., an elongated cylinder having tapered ends) when inflated by an inflation medium. A fluted balloon configuration is shown in FIG. 17, which is a representative illustration of balloon configurations of this invention. During vascular radiotherapy, when inflated and engaged with the walls of thebody vessel16, the balloonouter lumens11 define a series of straight longitudinal paths that allow for perfusion of blood past a balloon treatment area30 (shown in FIG. 6). The longitudinal length of theballoon treatment area30 is made to be appropriate for the body vessel to be treated (for example, coronary vessels or peripheral vessels) and for the radiation treatment to be delivered. In one embodiment of the present invention, the balloontreatment area length30 is in a range of approximately 18 mm to 54 mm. For some intervascular gamma radiation treatments, such as treatments on peripheral vessels of the cardiovascular system, the balloontreatment area length30 may be in a range of approximately 10 mm to 250 mm.
• The fluted balloon[0122]outer lumens11 can be extruded with either equal diameter15 (as shown in FIGS. 3, 11 and18) or with unequal (or asymmetrical) diameter15 (as shown in FIG. 14).
• Continuing with reference to FIG. 6, the balloon[0123]central lumen12 is sized based on the radiation source outer diameter, for example a radiation source wire having an outer diameter in a range of approximately {fraction (10/1000)} in. to {fraction (50/1000)} in. The combined balloon diameter13 (as measured across all balloonouter lumens11 while balloon is in an inflated or deployed state) is kept in a range of approximately 1.5 mm to 6 mm for coronary vessels and in a range of approximately 3 mm to 12 mm for peripheral vessels. For the embodiment shown in FIG. 6, a balloon having a combineddiameter13 in a range of approximately 1.5 mm to 4 mm is advantageous when treating coronary vessels.
• Continuing with reference to FIG. 6, the multi-lumen[0124]balloon catheter assembly1 has aradiation source lumen22 that extends longitudinally through thecentral lumen12 of the four-lumen balloon10. In this embodiment, aguidewire45 without a guidewire lumen tubing extends through one of the balloon outer lumens (as shown in FIG. 6). Theguidewire45 allows positioning the multi-lumen centering catheter1 (including its radiation source lumen22) on the stenosed body vessel area for patient treatment.
• Continuing with reference to FIG. 6, in one embodiment, the[0125]radiation source lumen22 is sealed at its distal end withplug24 to allow aradiation source25 to be placed inside theradiation source lumen22. In another embodiment, theradiation source lumen22 is left open at its distal end23 (i.e., it does not have a plug24) so that a radiation source25 (placed inside the radiation source lumen22) can be distally advanced past themulti-lumen balloon10. Furthermore, not having theradiation source lumen22 sealed with theplug24 decreases the stiffness of the multi-lumen balloon even further.
• It should be noted that it is not necessary to have a[0126]radiation source lumen22 as part of the multi-lumen balloon centeringcatheter assembly1. In some applications, it may be desirable to place theradiation source25 directly within thecentral lumen12 of theballoon10, without employing asource lumen22. Not having aradiation source lumen22 in the ballooncentral lumen12 reduces the size of the multi-lumen balloon and decreases the stiffness of the multi-lumen balloon (since theradiation source lumen22 is a co-extruded shaft), thus allowing the balloon to cross tortuous paths more easily along the body vessel.
• The[0127]radiation source25, which may be shaped in the form of a wire, seed, pellets, ribbon, etc., is positioned insideradiation source lumen22 and is then advanced longitudinally along aprescribed vessel length16 during patient treatment. In one embodiment of this invention, the multi-lumen balloon centeringcatheter assembly1 uses a Phosphorus-32 radiation source as aradiation source24. However, the multi-lumen balloon of this invention can be used with any radiation source employed in vascular radiotherapy, which includes gamma radiation emitting sources and beta radiation emitting sources known in the art.
• Continuing with reference to FIG. 6, two radio-opaque markers, a[0128]distal marker37 and aproximal marker38, may be attached to theradiation source lumen22. The radio-opaque markers37 and38 are used for positioning theinterventional catheter1 under fluoroscopy, as well as for assisting the stepping (via manual or automatic means) of theradiation source25 over the entire prescribed region of thevessel16 to be treated. Themarkers37 and38 are made of any materials known in the art of radio-opaque markers, such as silver, gold, platinum, tungsten, that allow markers to become visible under fluoroscopy. In one embodiment, the radio-opaque markers (37,38) are attached within the limits of the balloon'streatment area30. In one configuration, thedistal marker37 is incorporated into theplug24 of thesource lumen22. In another configuration, radio-opaque markers (37,38) may be part of a separate device (not shown) that is independent of the balloon catheter assembly.
• A soft tip[0129]26 (shown in FIG. 6) is attached to thedistal end27 of theguidewire45 to improve trackability and reduce trauma to the body vessel. The length of thesoft tip26 depends on the type of catheter design used, however, the length of the tip is generally in a range of approximately 0.5 mm to 10 mm.
• Referring now to FIG. 8 (which represents a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 6 taken along line F-F), the[0130]catheter shaft41 includes aninner lumen41athat extends longitudinally through at least a portion of thecatheter shaft41 proximate theballoon10 and connects to thecentral lumen12 of theballoon10. The catheter shaftinner lumen41ais adapted for receiving aradiation source lumen22 with aradiation source25. Theradiation source lumen22 is manufactured as a co-extruded shaft having an inner layer made of a material such as polyethylene and an outer layer made of a material such as Pebax, nylon, or Primacor.
• Continuing with reference to FIG. 8, the catheter shaft[0131]inner lumen41ais further adapted to receive a plurality of inflation lumens (51,52) that are in fluid communication with each of the balloon outer lumens to allow an inflation fluid to enter and inflate theouter lumens11 and thus, center theradiation source lumen22 within abody vessel16. Note thatlumen52 serves as both an inflation lumen and as a guidewire lumen. The inflation lumens (51,52) in the catheter shaftinner lumen41aare generally formed when themulti-lumen balloon10 is bonded to thecatheter shaft41 during the catheter slideableproximal seal29aconstruction. As mentioned above, having individual inflation lumens for each of the balloon outer lumens allows each balloon outer lumen to be inflated to different pressures.
• Referring to FIG. 9 (which represents a cross-sectional view of the multi-lumen fluted balloon radiation centering catheter assembly of FIG. 6 taken along line G-G), at the region of the balloon catheter slideable[0132]proximal seal29a, an elongated flexible catheterouter member46 is placed over thecatheter shaft41. Catheterouter member46 includes alumen50athat extends longitudinally therein. Past the catheter slideableproximal seal29aregion, thelumen50abecomes the catheter shaftinner lumen41a.
• [0133]Lumen50ais adapted for receiving acommon inflation lumen36 for inflating and pressurizing the balloonouter lumens11 with an inflation medium (or means)18b. Theinflation medium18bcould include any inflation medium known in the art of balloon angioplasty, such as air, saline solution, or contrast fluid. The catheter outer memberinner lumen50ais further adapted for receiving a radiation source lumen22 (with a radiation source) and aguidewire lumen21. At the slideableproximal seal29a, to ensure a tight and close fit, theguidewire lumen21 in the catheterouter member46 is adapted for receiving a hydrogel material or an O-ring45a. The catheterouter member46 may be manufactured of materials such as nylon, Pebax, polyurethane, etc.
• Multi-Lumen Balloon Catheter Having a Balloon with Communication Bores Between Central and Outer Lumens and a Tip Rapid Exchange Guidewire Lumen[0134]
• With reference to FIGS.[0135]10-16, two embodiments of a multi-lumen fluted balloon radiation centering catheter assembly are shown. Both catheter assemblies include a multi-lumen balloon having communication bores between the central lumen and the outer lumens. In FIGS.10-12, a fluted balloon radiation centering catheter assembly for a “tip (or distal) Rapid Exchange”catheter2 is illustrated, while in FIGS.13-16, a fluted balloon radiation centeringcatheter assembly1 for a standard Rapid Exchange catheter with a guidewire lumen extending through the central lumen is shown.
• Referring to FIG. 10, a multi-lumen fluted balloon radiation centering[0136]catheter assembly1 with theballoon10 in an inflated state is shown. The fluted balloon radiation centeringcatheter assembly1 includes amulti-lumen balloon10 and aninterventional catheter2.Interventional catheter2 has a shaft disposed proximate theballoon10. Theballoon10 includes a plurality of inflatableouter lumens11 disposed around acentral lumen12, the plurality ofouter lumens11 integrally coupled with thecentral lumen12 so as to form themulti-lumen balloon10. Theballoon10 has adistal seal28 and aproximal seal29.Distal seal28 seals the plurality of distal ends34bof the balloonouter lumens11 to thecatheter shaft41 while theproximal seal29 seals the plurality of proximal ends34aof the balloonouter lumens11 to thecatheter shaft41. The distal and proximal seals (28,29) may each have a width in a range of approximately 0.5 mm to about 5 mm.
• Each of the[0137]outer lumens11 takes the form of a “flute” (i.e., an elongated cylinder having tapered ends) when inflated by aninflation medium18b(shown in FIG. 11 for this balloon catheter assembly). A fluted balloon configuration is shown in FIG. 17, which is a representative illustration of balloon configurations of this invention (as revealed in balloon catheter assemblies of FIGS. 1, 6,10, and13).
• Continuing with reference to FIG. 10, the catheter shaft includes an[0138]inner tubular member41 having adistal treatment section42 with adistal end43 and aproximal end44, and a proximate section (not shown). Theinner tubular member41 has aninner lumen41a. The catheter shaft further includes a flexible elongate outertubular member46 having adistal section47 with adistal end48, and a proximate section (not shown). Elongate innertubular member41 extends coaxially within the elongate outertubular member46.
• Referring now to FIG. 11, the balloon[0139]central lumen12 is capable of containing a radiation source25 (with or without a radiation source lumen22) therein. The multi-lumen balloon embodiment shown in FIG. 11 is adapted for receiving a guidewire lumen (with a guidewire) through its central lumen12 (as shown in FIG. 14). Because in FIG. 11 theballoon10 is shown as being used with a tip (or distal) Rapid Exchange catheter type (i.e., the guidewire is positioned distal to the balloon), for the balloon embodiment of FIG. 11, the guidewire does not extend through any of theballoon lumens11.
• For the balloon configuration shown in FIG. 11, the[0140]balloon10 includes bores (or channels)35 that are formed between theouter lumens11 and thecentral lumen12. This arrangement allows aninflation medium18bto pass from the ballooncentral lumen12 into theouter lumens11 and inflateouter lumens11, causing aradiation source lumen22 to be centered within abody vessel16. In this configuration, thecentral lumen12 is pressurized in order for theouter lumens11 to properly inflate and center theradiation source lumen22 within thebody vessel16. The catheterinner lumen41ais adapted to serve as an inflation lumen for the ballooncentral lumen12 and theouter lumens11.
• Continuing with reference to FIG. 11, as mentioned above, the[0141]radiation source lumen22 extends longitudinally through the balloon central lumen. When using a tip RX radiation catheter type, the plurality ofouter lumens11 are sealed onto theradiation source lumen22 for maintaining inflation pressure in the balloon. When inflated by aninflation medium18b, the balloonouter lumens11 form flutes positioned parallel to theradiation source lumen22. During vascular radiotherapy, when inflated and engaged with the walls of thebody vessel16, the balloonouter lumens11 define a series of straightlongitudinal paths14 that allow for perfusion of blood (not shown) past balloon treatment area30 (shown in FIG. 10).
• The fluted balloon[0142]outer lumens11 can be extruded with either equal diameter15 (as shown in FIG. 11) or with unequal (or asymmetrical) diameter15 (as shown in FIG. 14). Aballoon10 havingouter lumens11 withequal diameter15 is well suited for a “tip Rapid Exchange” catheter type having only the source wire lumen extending through atreatment channel50 contained within the balloon central lumen12 (shown in FIG. 11).
• Continuing with reference to FIG. 11, the[0143]diameter18aof the ballooncentral lumen12 is sized based on the radiation source outer diameter, for example a radiation source wire having an outer diameter in a range of approximately {fraction (10/1000)} in. to {fraction (50/1000)} in. The combined balloon diameter13 (as measured across all balloonouter lumens11 while balloon is in an inflated or deployed state) is kept in a range of approximately 1.5 mm to 6 mm for coronary vessels and in a range of approximately 3 mm to 12 mm for peripheral vessels. For the embodiment shown in FIG. 11, a balloon having a combineddiameter13 in a range of approximately 1.5 mm to 4 mm is advantageous when treating coronary vessels.
• Referring now to FIG. 10, the multi-lumen balloon has a[0144]treatment area30 is defined between the balloon'sdistal seal28 andproximal seal29. The longitudinal length of theballoon treatment area30 is made to be appropriate for the body vessel to be treated (for example, coronary vessels or peripheral vessels) and for the radiation treatment to be delivered. In one embodiment of the present invention, the balloontreatment area length30 is in a range of approximately 18 mm to 54 mm. For some intervascular gamma radiation treatments, such as treatments on peripheral vessels of the cardiovascular system, the balloontreatment area length30 may be in a range of approximately 10 mm to 250 mm.
• Continuing with reference to FIG. 10, in one embodiment, the[0145]radiation source lumen22 is sealed at itsdistal end23 withplug24 to allow aradiation source25 to be placed inside theradiation source lumen22. In another embodiment, theradiation source lumen22 is left open at its distal end23 (i.e., it does not have a plug24) so that a radiation source25 (placed inside the radiation source lumen22) can be distally advanced past themulti-lumen balloon10. Furthermore, not having theradiation source lumen22 sealed with theplug24 decreases the stiffness of the multi-lumen balloon even further.
• It should be noted that it is not necessary to have a[0146]radiation source lumen22 as part of the multi-lumen balloon centeringcatheter assembly1. In some applications, it may be desirable to place theradiation source25 directly within thecentral lumen12 of theballoon10, without employing asource lumen22. Not having aradiation source lumen22 in the ballooncentral lumen12 reduces the size of the multi-lumen balloon and decreases the stiffness of the multi-lumen balloon (since theradiation source lumen22 is a co-extruded shaft), thus allowing the balloon to cross tortuous paths more easily along the body vessel.
• The[0147]radiation source25, which may be shaped in the form of a wire, seed, pellets, ribbon, etc., is positioned insideradiation source lumen22 and is then advanced longitudinally along aprescribed vessel length16 during patient treatment. In one embodiment of this invention, the multi-lumen balloon centeringcatheter assembly1 uses a Phosphorus-32 radiation source as aradiation source24. However, the multi-lumen balloon of this invention can be used with any radiation source employed in vascular radiotherapy, which includes gamma radiation emitting sources and beta radiation emitting sources known in the art.
• Continuing with reference to FIG. 10, two radio-opaque markers, a[0148]distal marker37 and aproximal marker38, may be attached to theradiation source lumen22. The radio-opaque markers37 and38 are used for positioning theinterventional catheter1 under fluoroscopy, as well as for assisting the stepping (via manual or automatic means) of theradiation source25 over the entire prescribed region of thevessel16 to be treated. Themarkers37 and38 are made of any materials known in the art of radio-opaque markers, such as silver, gold, platinum, tungsten, that allow markers to become visible under fluoroscopy. In one embodiment, the radio-opaque markers (37,38) are attached within the limits of the balloon'streatment area30. In one configuration, thedistal marker37 is incorporated into theplug24 of thesource lumen22. In another configuration, radio-opaque markers (37,38) may be part of a separate device (not shown) that is independent of the balloon catheter assembly.
• A[0149]soft tip26 is attached to thedistal end27 of theguidewire lumen21 to improve trackability and reduce trauma to the body vessel. The length of thesoft tip26 depends on the type of catheter design used, however, the length of the tip is generally in a range of approximately 0.5 mm to 10 mm.
• With reference to FIG. 10, the[0150]balloon10 is attached tocatheter shaft41 of thecatheter assembly2. The balloon'sproximal seal29 is attached at aproximal end44 offlexible catheter shaft41, near the inflation/deflation port33. The balloondistal seal28 is attached to thecatheter shaft41 adjacent to the location where theradiation source lumen22 ends. In one embodiment, theballoon10 andassembly2 are attached by using a laser bond technique. Bonds may also be done using other balloon bonding techniques known in the art, such as thermal or ultrasonic welds, adhesive welds, or other conventional means.
• Multi-Lumen Balloon Catheter Having a Balloon with Communication Bores Between Central and Outer Lumens and a Guidewire Lumen Through the Central Lumen[0151]
• In FIGS.[0152]13-16, a fluted balloon radiation centeringcatheter assembly1 for a standard Rapid Exchange catheter with a guidewire lumen extending through the central lumen of a multi-lumen balloon is shown.
• Referring to FIG. 13, a multi-lumen fluted balloon radiation centering[0153]catheter assembly1 with theballoon10 in an inflated state is shown. The fluted balloon radiation centeringcatheter assembly1 includes amulti-lumen balloon10 and aninterventional catheter2.Interventional catheter2 has a shaft disposed proximate theballoon10. Theballoon10 includes a plurality of inflatableouter lumens11 disposed around acentral lumen12, the plurality ofouter lumens11 integrally coupled with thecentral lumen12 so as to form themulti-lumen balloon10. Theballoon10 has adistal seal28 and aproximal seal29.Distal seal28 seals the plurality of distal ends34bof the balloonouter lumens11 to thecatheter shaft41 while theproximal seal29 seals the plurality of proximal ends34aof the balloonouter lumens11 to thecatheter shaft41. The distal and proximal seals (28,29) may each have a width in a range of approximately 0.5 mm to about 5 mm.
• Each of the[0154]outer lumens11 takes the form of a “flute” (i.e., an elongated cylinder having tapered ends) when inflated by aninflation medium18b(shown in is FIG. 14 for this balloon catheter assembly). A fluted balloon configuration is shown in FIG. 17, which is a representative illustration of balloon configurations of this invention (as revealed in balloon catheter assemblies of FIGS. 1, 6,10, and13).
• Continuing with reference to FIG. 13, the catheter shaft includes an[0155]inner tubular member41 having aninner lumen41a. The catheter shaft further includes a flexible elongate outertubular member46. Elongate innertubular member41 extends coaxially within the elongate outertubular member46.
• Referring now to FIG. 14, the balloon[0156]central lumen12 is capable of containing a radiation source25 (with or without a radiation source lumen22) therein. The multi-lumen balloon embodiment shown in FIG. 14 is further adapted for receiving a guidewire lumen (with a guidewire45) through itscentral lumen12.
• For the balloon configuration shown in FIG. 14, the[0157]balloon10 includes bores (or channels)35 that are formed between theouter lumens11 and thecentral lumen12. This arrangement allows aninflation medium18bto pass from the ballooncentral lumen12 into theouter lumens11 and inflateouter lumens11, causing aradiation source lumen22 to be centered within abody vessel16. In this configuration thecentral lumen12 is pressurized in order for theouter lumens11 to properly inflate and center theradiation source lumen22 within thebody vessel16. The catheterinner lumen41ais adapted to serve as an inflation lumen for the ballooncentral lumen12 and the outer lumens11 (as shown in FIG. 16).
• Continuing with reference to FIG. 14, when using a standard RX or an over-the-wire radiation catheter type, the[0158]radiation source lumen22 and theguidewire lumen21 extend longitudinally through the balloon central lumen. The plurality ofouter lumens11 are sealed onto theradiation source lumen22 and theguidewire lumen21 for maintaining inflation pressure in the balloon. When inflated by aninflation medium18b, the balloonouter lumens11 form flutes positioned parallel to theradiation source lumen22. During vascular radiotherapy, when inflated and engaged with the walls of thebody vessel16, the balloonouter lumens11 define a series of straightlongitudinal paths14 that allow for perfusion of blood (not shown) past balloon treatment area30 (shown in FIG. 13).
• The fluted balloon[0159]outer lumens11 can be extruded with either equal diameter15 (as shown in FIG. 11) or with unequal (or asymmetrical) diameter15 (as shown in FIG. 14). A balloon arrangement havingouter lumens11 with unequal diameters (for example, a balloon assembly of FIG. 14 with one small “flute” and two large “flutes”) is best suited for the “standard RX” or “over-the-wire” catheter designs where the catheter shaft (or inner member)41 includes two parallel lumens: a source lumen22 (for a radiation source25) and a guidewire lumen21 (for a guidewire45). For very small diameter centering balloon catheters, such as the 2 mm diameter balloon catheter designs, the small “flute”11 shown in FIG. 14 may be eliminated to provide for centering of theradiation source lumen22.
• Continuing with reference to FIG. 14, the[0160]diameter18aof the ballooncentral lumen12 is sized based on the radiation source outer diameter and the guidewire lumen outer diameter, for example a radiation source wire having an outer diameter in a range of approximately {fraction (10/1000)} in. to {fraction (50/1000)} in and a guidewire lumen having an outer diameter in a range of approximately {fraction (10/1000)} in. to {fraction (15/1000)}. The combined balloon diameter13 (as measured across all balloonouter lumens11 while balloon is in an inflated or deployed state) is kept in a range of approximately 1.5 mm to 6 mm for coronary vessels and in a range of approximately 3 mm to 12 mm for peripheral vessels. For the embodiment shown in FIG. 14, a balloon having a combineddiameter13 in a range of approximately 1.5 mm to 4 mm is advantageous-when treating coronary vessels.
• Referring now to FIG. 13, the multi-lumen balloon has a[0161]treatment area30 is defined between the balloon'sdistal seal28 andproximal seal29. The longitudinal length of theballoon treatment area30 is made to be appropriate for the body vessel to be treated (for example, coronary vessels or peripheral vessels) and for the radiation treatment to be delivered. In one embodiment of the present invention, the balloontreatment area length30 is in a range of approximately 18 mm to 54 mm. For some intervascular gamma radiation treatments, such as treatments on peripheral vessels of the cardiovascular system, the balloontreatment area length30 may be in a range of approximately 10 mm to 250 mm.
• Continuing with reference to FIG. 13, in one embodiment, the[0162]radiation source lumen22 is sealed at itsdistal end23 withplug24 to allow aradiation source25 to be placed inside theradiation source lumen22. In another embodiment, theradiation source lumen22 is left open at its distal end23 (i.e., it does not have a plug24) so that a radiation source25 (placed inside the radiation source lumen22) can be distally advanced past themulti-lumen balloon10. Furthermore, not having theradiation source lumen22 sealed with theplug24 decreases the stiffness of the multi-lumen balloon even further.
• It should be noted that it is not necessary to have a[0163]radiation source lumen22 as part of the multi-lumen balloon centeringcatheter assembly1. In some applications, it may be desirable to place theradiation source25 directly within thecentral lumen12 of theballoon10, without employing asource lumen22. Not having aradiation source lumen22 in the ballooncentral lumen12 reduces the size of the multi-lumen balloon and decreases the stiffness of the multi-lumen balloon (since theradiation source lumen22 is a co-extruded shaft), thus allowing the balloon to cross tortuous paths more easily along the body vessel.
• The[0164]radiation source25, which may be shaped in the form of a wire, seed, pellets, ribbon, etc., is positioned insideradiation source lumen22 and is then advanced longitudinally along aprescribed vessel length16 during patient treatment. In one embodiment of this invention, the multi-lumen balloon centeringcatheter assembly1 uses a Phosphorus-32 radiation source as aradiation source24. However, the multi-lumen balloon of this invention can be used with any radiation source employed in vascular radiotherapy, which includes gamma radiation emitting sources and beta radiation emitting sources known in the art.
• Continuing with reference to FIG. 13, two radio-opaque markers, a[0165]distal marker37 and aproximal marker38, may be attached to theradiation source lumen22. The radio-opaque markers37 and38 are used for positioning theinterventional catheter1 under fluoroscopy, as well as for assisting the stepping (via manual or automatic means) of theradiation source25 over the entire prescribed region of thevessel16 to be treated. Themarkers37 and38 are made of any materials known in the art of radio-opaque markers, such as silver, gold, platinum, tungsten, that allow markers to become visible under fluoroscopy. In one embodiment, the radio-opaque markers (37,38) are attached within the limits of the balloon'streatment area30. In one configuration, thedistal marker37 is incorporated into theplug24 of thesource lumen22. In another configuration, radio-opaque markers (37,38) may be part of a separate device (not shown) that is independent of the balloon catheter assembly.
• A[0166]soft tip26 is attached to the distal end of theguidewire lumen21 to improve trackability and reduce trauma to the body vessel. The length of thesoft tip26 depends on the type of catheter design used, however, the length of the tip is generally in a range of approximately 0.5 mm to 10 mm.
• With reference to FIG. 13, the[0167]balloon10 is attached tocatheter shaft41 of thecatheter assembly2. The balloonproximal seal29 is positioned at aproximal end44 offlexible catheter shaft41, near the inflation/deflation port33. The balloondistal seal28 is positioned to thecatheter shaft41 adjacent to the location where theradiation source lumen22 ends. In one embodiment, theballoon10 andassembly2 are coupled using a laser bond technique. Bonds may also be done using other balloon bonding techniques known in the art, such as thermal or ultrasonic welds, adhesive welds, or other conventional means.
• Multi-Lumen Balloon Catheter Having a Balloon with or without Communication Bores Between Central and Outer Lumens and A Guidewire Longitudinally Extending Outside the Fluted Balloon Lumens[0168]
• In FIGS. 27[0169]a-27d, a fluted balloon radiation centeringcatheter assembly1 for a catheter with a guidewire longitudinally extending outside the multi-lumen balloon is shown.
• Referring to FIG. 27[0170]a, a multi-lumen fluted balloon radiation centeringcatheter assembly1 with theballoon10 in an inflated state is shown. The fluted balloon radiation centeringcatheter assembly1 includes amulti-lumen balloon10 and aninterventional catheter2.Interventional catheter2 has a shaft disposed proximate theballoon10. Theballoon10 includes a plurality of inflatableouter lumens11 disposed around acentral lumen12, the plurality ofouter lumens11 integrally coupled with thecentral lumen12 so as to form themulti-lumen balloon10. Theballoon10 has adistal seal28 and aproximal seal29.Distal seal28 seals the plurality of distal ends34bof the balloonouter lumens11 to thecatheter shaft41 while theproximal seal29 seals the plurality of proximal ends34aof the balloonouter lumens11 to thecatheter shaft41. The distal and proximal seals (28,29) may each have a width in a range of approximately 0.5 mm to about 5 mm.
• Each of the[0171]outer lumens11 takes the form of a “flute” (i.e., an elongated cylinder having tapered ends) when inflated by aninflation medium18b(shown in FIG. 14 for this balloon catheter assembly). A fluted balloon configuration is shown in FIG. 17, which is a representative illustration of balloon configurations of this invention (as revealed in balloon catheter assemblies of FIGS. 1, 6,10,13 and27a).
• Continuing with reference to FIG. 27[0172]a, the catheter shaft includes aninner tubular member41 having aninner lumen41a(shown in FIG. 27b). Thecatheter shaft41 further includes a flexible elongate outertubular member46. Elongate innertubular member41 extends coaxially within the elongate outertubular member46.
• Still referring to FIG. 27[0173]a, two additional guidewire exits (45b1 and45b2) are notched (or cut out) along the catheter shaft (which includes the tubular member41) to permit aguidewire45 to extend lengthwise outside the multi-lumen balloon10 (see FIG. 27b) from an existingguidewire exit notch45b3 to aguidewire exit notch45b2. At the point of theguidewire exit notch45b2, theguidewire45 enters the catheter shaft'tubular member41, extends lengthwise through a portion of the shaft and then exits the shaft at the secondguidewire exit notch45b1. The profile of the fluted balloon with standard RX configuration is {fraction (50/1000)} in. by {fraction (60/1000)} in., while the profile of the fluted balloon without the guidewire lumen is about {fraction (51/1000)} in.
• Through this balloon catheter embodiment, the guidewire riding length is extended over the “tip RX” design. This design arrangement has a number of benefits over prior art designs, including (a) maintaining the multi-lumen balloon profile for the “standard RX” design, (b) reducing the profile of the balloon proximal seal, (c) allowing the bore communication between the central lumen and the plurality of outer lumens for an improved centering of the radiation source, and (d) reduces radial shielding effect.[0174]
• Balloon Treatment Area Markers[0175]
• As described and shown in figures above, the multi-lumen balloon catheters of this invention may include radio-opaque markers for positioning the[0176]interventional catheter1 under fluoroscopy, as well as for assisting the stepping (via manual or automatic means) of theradiation source25 over the entire prescribed region of thevessel16 to be treated. Generally, the markers include adistal marker37 and aproximal marker38.Markers37 and38 may be attached to theradiation source lumen22 by adhesive bonding. Markers may also be swaged onto the radiation source lumen.
• In yet another embodiment,[0177]markers37 and38 may be attached directly onto the fluted balloon using a sputtering or vapor deposition process. In this process, a marker material such as gold is deposited onto the balloon using any sputtering or vapor deposition techniques known in the field. It should be noted that the marker material deposition is not limited to a specific area of the multi-lumen balloon; the marker material may be deposited onto the central lumen of the balloon, around the entire circumference of the multi-lumen balloon, or any other balloon area desired.
• The[0178]markers37 and38 may made of any materials known in the art of radio-opaque markers, such as silver, gold, platinum, tungsten, that allow markers to become visible under fluoroscopy. In one embodiment, the radio-opaque markers (37,38) are attached within the limits of the balloon'streatment area30.
• Balloon Proximal Seal[0179]
• A unique proximal seal geometry used to seal a multi-lumen fluted balloon to a catheter shaft and method for manufacturing same is described. In one embodiment (described herein), the proximal seal geometry is used to seal a four-lumen fluted balloon to a shaft containing both a radiation source lumen and a guidewire lumen. In another embodiment (not shown), where the radiation source is used without a radiation source lumen, the proximal seal geometry is used to seal a four-lumen fluted balloon to a shaft containing only a guidewire lumen. In yet another embodiment (not shown), where the catheter type is a “tip RX” (i.e., the guidewire lumen does not pass through any of the balloon lumens), the proximal seal geometry is used to seal a four-lumen fluted balloon to a shaft containing only a radiation source lumen.[0180]
• Referring to FIG. 18, a cross sectional view of a multi-lumen[0181]fluted balloon10 for treating abody vessel16 in the vascular system is shown.Balloon10 includes acentral lumen12 and a plurality of outer lumens (or lobes)11 disposed around thecentral lumen12. Theouter lumens11 are integrally coupled with thecentral lumen12 so as to form themulti-lumen balloon10. Each of the balloonouter lumens11 has an inner radial length (or diameter)18 and anouter diameter15, defining balloonouter lumen walls17. Thewalls17 of balloonouter lumens11 are made very thin to allow proper inflation and deflation ofouter lumens11.
• The[0182]multi-lumen balloon10 is manufactured of balloon materials, such as Pebax™, nylon, polyethylene, polyurethane, or polyester. Materials for use in fabricating themulti-lumen balloon10 of the present invention are selected by considering the properties and characteristics (e.g., softness, durability, low stiffness) required by angioplasty balloons, as well as considering properties necessary for successful balloon fabrication (e.g., balloon material compatible with other catheter materials and bonding process, material extruding well, etc.).
• In the embodiment illustrated in FIG. 17, a[0183]radiation source lumen22 is placed into thecentral lumen12 of the flutedmulti-lumen balloon10, theradiation source lumen22 extending lengthwise through thecentral lumen12. Aguidewire lumen21 is also placed into one of the balloon's outer lumens11 (thirdouter lumen11 of the balloon is hidden in FIG. 17), theguidewire lumen21 extending lengthwise through the balloon outer lumen. The balloonouter lumen11 containing theguidewire lumen21 is labeled the guidewire outer lumen. Both theradiation source lumen22 and theguidewire lumen21 are manufactured as co-extrusions having an inner layer made of a material such as polyethylene and an outer layer made of a material such as Pebax, nylon, or Primacor.
• A[0184]first mandrel22ais then inserted through theradiation source lumen22 and asecond mandrel21ais inserted through theguidewire lumen21. It should be noted that if the catheter type does not require for aguidewire lumen21 to extend through the multi-lumen balloon (for example, a “tip RX” catheter type or a catheter assembly having slideable distal and proximal seals, as discussed above), thesecond mandrel21amay not be necessary and would not have to be inserted through one of the balloonouter lumens11. For balloon catheter embodiments where a radiation source lumen is not used (i.e., a radiation source would be positioned directly within the balloon central lumen during the intervascular radiotherapy procedure), thefirst mandrel22amay be inserted directly through the ballooncentral lumen12.
• After the[0185]first mandrel22ais inserted through theradiation source lumen22 and thesecond mandrel21ais inserted through theguidewire lumen21, the twoouter lumens11 not occupied by theguidewire lumen21 are compressed so as to give the outer lumens11 (and thus the balloon proximal seal) a more compact configuration. Note that FIG. 18 shows a cross-section of theouter lumens11 shape before the outer lumens are compressed. As part of the compressing operation, the proximal ends of the twoouter lumens11 are flattened (see FIG. 19a), thus forming flattened outer lumens.
• If a more packed configuration is desired for the flattened[0186]outer lumens11, the ends53 of the flattenedouter lumens11 are folded back over themselves (see FIG. 19c), thus creating folded outer lumens. It is necessary to fold theends53 of the flattenedouter lumens11 back over themselves to ensure that there is enough balloon material outside of theinflation lumens54b,55b(shown in FIG. 20a, and discussed in more detail below) of theouter lumens11 to maintain the inflation pressure. Alternative folding patterns of the flattened outer lumens may also be used if there is ample thickness in the catheterouter member46 to ensure that the inflation lumens (54b,55b) will not leak. In one approach, the flattenedouter lumens11 may be left in the flattened profile shown in FIG. 19aor both ends53 of the outer lumens may be folded towards the guidewire outer lumen (i.e., theouter lumen11 containing the guidewire lumen21) (see FIG. 19b). Folding the flattenedouter lumens11 may be performed manually, using full automation techniques, or using a combination of manual and automated sub-steps.
• If the flattened outer lumens are folded manually, many different approaches may be taken. For example, to achieve the embodiment shown in FIG. 19[0187]b, the flattened outer lumens are folded by simply using the thumb and forefinger to push down (or up, depending on the up or down orientation of the guidewire outer lumen) the two flattened outer lumens. The embodiment shown in FIG. 19cis done by using a pair of tweezers to fold over the ends of each of the two flattened outer lumens (one side at the time) until the desired fold configuration is achieved.
• After folding the flattened balloon[0188]outer lumens11, a catheterouter member46 is placed over the central lumen12 (with radiation source lumen22) and the guidewire outer lumen11 (with the guidewire lumen21). The catheterouter member46 also overlaps the twoouter lumens11 of themulti-lumen balloon10 not occupied by theguidewire lumen21. The catheterouter member46 may be manufactured from materials such as nylon, Pebax, polyurethane, etc.
• [0189]Inflation lumen mandrels54aand55aare then inserted to form and maintain individual lumens (54b,55b) for inflation of theouter lumens11. The inflation lumen mandrels (54a,55a) are generally inserted from the balloon distal end28 (see FIG. 17), however, the insertion of the inflation lumen mandrels may also be accomplished from the balloonproximal end29.
• The[0190]inflation lumen mandrels54a(shown in FIG. 20d) have a “football”-shape cross-section54aato better contour with the shape of theouter member46 and prevent leaking of theinflation medium18 through theinflation lumens54a. In current prior art balloon seal processes, which use mandrels having a straight edged configuration (such as a flattened round wire mandrel), seal leaking can occur because the “sharp” edges of the flattened round wire mandrels protrude out of the seal, thus causing the inflation medium to leak out of the seal.
• Referring to FIG. 20[0191]d, theinflation lumen mandrels54ainclude ashaft54a1 having a substantially football-shaped cross section. Theshaft54a1 has a solid center, however, it may also have ahollow center54a2 extending lengthwise therein. The “football” shapedinflation lumen mandrels54aare also symmetrical (i.e., they do not have a “front”, “back”, “top”, or a “bottom”) to eliminate any dependence on a specific orientation and for ease of use during the manufacture of the proximal seal. The dimensions (i.e., length and cross-section “diameter”) of theinflation lumen mandrels54avary depending for example, on the diameter of the balloon lumens, the type of material the mandrel is made of, etc.
• Referring to FIGS. 20[0192]a-20c, FIG. 20ashows a cross-section view of the completed balloon proximal seal showing theinflation lumens54bcreated by the “football” shapedinflation lumen mandrels54afor the two outer lumens not occupied by the guidewire lumen, and theinflation lumen55bcreated by the flattened round wireinflation lumen mandrel55afor theguidewire lumen21. The flattened round wireinflation lumen mandrel55acan be replaced with a “football” shapedinflation mandrel56a(see FIG. 20b) or a triangular shapedmandrel56b(see FIG. 20c). Following the insertion of the first and second mandrels (21a,22a) to retain theradiation source lumen22 and theguidewire lumen21, and the inflation lumen mandrels (54a,55a) to retain the inflation lumens (54b,55b), the proximal end of the multi-lumenfluted balloon10 is bonded to the distal end of the catheterouter lumen46.
• For the embodiment shown in FIG. 20[0193]a, a square-wave laser pattern bond is used to bond theouter member46 to theballoon10. Aheat shrink tube57b(shown in FIG. 21c) is temporarily used during the square-wave laser bond process. Theheat shrink tube57bis positioned over the balloon catheter “proximal seal assembly”, which includes the proximal end of the multi-lumen balloon (with the radiation source lumen and the guidewire lumen if catheter assembly so requires it), the distal end of the catheter outer member, and all the mandrels. When heat from the laser beam is applied onto the heat shrinktube57b, the tube compresses radially onto the balloon catheter proximal seal assembly. The shrink tube compression causes the materials of the balloon proximal end and the outer member distal end to closely fuse together, creating a leak-tight balloon proximal seal. The heat shrink tube is then removed. It should be noted that the heat shrink tubing may be substituted with heat shrink materials having other shapes, such as heat shrink sheaths, etc.
• The shrink tubing is made from materials known in the art of catheter balloon manufacture. For one embodiment, the shrink tubing has a[0194]diameter57b1 of 2.5 mm, however, thediameter57b1 of the shrink tubing to be used depends on a number of factors, such as the size of the balloon catheter to be manufactured, the degree of folding performed on the balloon outer lumens, whether the balloon catheter includes a radiation source lumen and/or a guidewire lumen extending through the balloon, etc.
• In the present invention, laser bonding techniques, such as laser bonding using a square-wave laser pattern (or design) are desired. However, bonds may also be done using other balloon bonding techniques known in the art, such as thermal bonding, ultrasonic bonding, adhesive bonding (for example using a glue-type material), or other conventional means.[0195]
• Following the laser bonding of the[0196]outer member46 to theballoon10, theinflation lumen mandrels54aand55aare removed from the balloon proximal seal assembly.
• Given the “egg-shape” like configuration, the completed balloon proximal seal cross-section may have a “small diameter”[0197]46d1 (i.e., measured horizontally across the seal) in the range of approximately 35-50 mm, while the “large diameter”46d2 (i.e., measured vertically across the seal) in the range of approximately 60-80 mm. In one embodiment, the proximal seal cross section has a “small diameter”46d1 of about 47 mm and a “large diameter”46d2 of about 62 mm.
• “Football”-Shaped Mandrels[0198]
• As mentioned above, “football”-shaped mandrels are used in the manufacture of the multi-lumen balloon centering catheter proximal seal. Mandrels having a “football”-shape cross-section are not just limited to the manufacture of centering catheters. “Football”-shape cross section mandrels can also be used in fabricating other medical interventional devices, such as atherectomy devices, delivery systems (stent or drug) and other devices requiring a tight seal configuration.[0199]
• Referring to FIG. 20[0200]d, a “football”-shape cross section mandrel includes ashaft54a1 having a substantially football-shaped cross section. Theshaft54a1 has a solid center, however, it may also have ahollow center54a2 extending lengthwise therein. The “football”-shapedmandrel shaft54a1 is made to be symmetrical (i.e., the shaft does not have a “front”, “back”, “top”, or a “bottom”) to eliminate any dependence on a specific orientation and for ease of use. The “football”-shapedmandrel54amay be manufactured out of metal, of a non-stick material such as Teflon, or of any non-metal materials that will not melt at the same temperature as the materials used for manufacturing the particular medical device. The dimensions (i.e., length and cross-section “diameter”) of the “football”-shapedmandrel54avary depending for example, on the diameter of the balloon lumens, the type of material the mandrel is made of, etc. In one embodiment, the “football”-shapedmandrel54ahas a “large diameter”54aa1 (see FIG. 20d) in a range of approximately {fraction (4/1000)}-{fraction (30/1000)} in. to a “small diameter”54aa2 in a range of approximately {fraction (2/1000)}-{fraction (20/1000)} in.
• Balloon Distal Seal[0201]
• A unique balloon distal seal geometry used to seal a multi-lumen fluted balloon to a catheter shaft is described. The present invention provides a solution to the problem of bundling together a multi-lumen shaft at the distal end of a multi-lumen balloon without using additional materials that could increase the stiffness of the distal tip. The balloon distal seal is completed following the completion of the balloon proximal seal (as discussed above).[0202]
• In one embodiment (described herein), the balloon distal seal geometry is used to seal a four-lumen fluted balloon to a shaft containing both a radiation source lumen and a guidewire lumen extending through the balloon lumens. It should be noted that for a “tip RX” catheter type (i.e., where the guidewire lumen does not extend through any of the balloon lumens), the balloon distal seal geometry is used to seal a four-lumen fluted balloon to a shaft containing a radiation source lumen and a short guidewire lumen distally positioned to the multi-lumen balloon. In another embodiment (not shown), where the radiation source is used without a radiation source lumen, the balloon distal seal geometry is used to seal a four-lumen fluted balloon to a shaft containing only a guidewire lumen.[0203]
• Referring to FIG. 18, a cross sectional view of a multi-lumen[0204]fluted balloon10 for treating abody vessel16 in the vascular system is shown.Balloon10 includes acentral lumen12 and a plurality of outer lumens (or lobes)11 disposed around thecentral lumen12. Theouter lumens11 are integrally coupled with thecentral lumen12 so as to form themulti-lumen balloon10. Themulti-lumen balloon10 is manufactured of balloon materials, such as Pebax™, nylon, polyethylene, polyurethane, or polyester.
• Referring to FIG. 17, a[0205]radiation source lumen22 is placed into thecentral lumen12 of the flutedmulti-lumen balloon10, theradiation source lumen22 extending lengthwise through thecentral lumen12. Aguidewire lumen21 is also placed into one of the balloon's outer lumens11 (thirdouter lumen11 of the balloon is hidden in FIG. 17), theguidewire lumen21 extending lengthwise through the balloon outer lumen. The balloonouter lumen11 containing theguidewire lumen21 is labeled the guidewire outer lumen. Both theradiation source lumen22 and theguidewire lumen21 are manufactured as co-extrusions having an inner layer made of a material such as polyethylene and an outer layer made of a material such as Pebax, nylon, or Primacor.
• Referring to FIG. 21 a, a completed balloon[0206]distal seal28 is illustrated. As discussed above, the balloon distal seal is completed following the completion of the balloon proximal seal.
• To complete the[0207]distal seal28 for a multi-lumen balloon radiation centering catheter, the following sub-steps are performed. First, afirst source mandrel22ais inserted into theradiation source lumen22 and afirst guidewire mandrel21ais inserted into theguidewire lumen21. Mandrels22aand21aform a first set of source and guidewire mandrels. In one embodiment of this invention, thefirst source mandrel22ahas a diameter of 0.0225 in., while thefirst guidewire mandrel21ahas a diameter of 0.017 in. The diameters of the first source and guidewire mandrels may vary depending on a number of factors, such as the type of source used, the size of the multi-lumen balloon when inflated (e.g., 2 mm, 3 mm balloon overall diameter), etc.
• Next, a[0208]soft tip material26 is placed over thefirst guidewire mandrel21aso as to overlap theguidewire lumen21. Thesoft tip material26 is attached to thedistal end27 of theguidewire lumen21 to improve trackability and reduce trauma to the body vessel. The length of thesoft tip26 depends on the type of catheter design used. However, when completed, the length of thesoft tip26 is generally in a range of approximately 0.5 mm to 10 mm. The soft tip is manufactured from materials generally known in the field of balloon angioplasty.
• Next, to prepare the balloon distal seal for laser bonding, a first shrinkable material, such as a[0209]shrink tube57bis positioned over the balloon distal seal sub-assembly. The sub-assembly includes the distal end of the multi-lumen balloon (with the radiation source lumen and the guidewire lumen, if catheter assembly so requires it) and both mandrels (21a,22a). The distal seal sub-assembly is then fastened using a hot box device (not shown). The balloondistal end34bis then sealed using a laser device (not shown). It should be noted that the heat shrinktube57bis only temporarily used during the laser bond process.
• When heat from the laser beam is applied onto the heat shrink tube, the tube compresses radially onto the balloon catheter distal seal assembly. The shrink tube compression causes the materials of the balloon[0210]distal end34bto closely fuse together, creating a leak-tight balloon distal seal. Theheat shrink tube57bis then removed.
• It should be noted that the heat shrink tube may be substituted with heat shrink materials having other shapes, such as heat shrink sheaths, etc. The[0211]shrink tube57bis made from materials known in the art of catheter balloon manufacture. For one embodiment, theshrink tube57bhas adiameter57b1 of 2.5 mm, however, the diameter of the shrink tube to be used depends on a number of factors, such as the size of the balloon catheter to be manufactured, the degree of folding performed on the balloon outer lumens, whether the balloon catheter includes a radiation source lumen and/or a guidewire lumen extending through the balloon, etc.
• After removing the[0212]first shrink tube57b, atip jacket57 is placed over both theguidewire lumen21 andradiation source lumen22. A second shrinkable material, such as ashrink tube57cis placed over thetip jacket57. Thesecond shrink tube57cis made from materials known in the art of catheter balloon manufacture. For one embodiment, theshrink tubing57chas adiameter57b1 of 2.0 mm, however, the diameter may range in a range of approximately 1.0-3.0 mm. The distal seal sub-assembly (with the tip jacket57) is then sealed using a laser device (not shown).
• The multi-lumen fluted balloon distal seal sub-assembly is laser sealed using a conventional helical-wave laser design. In the present invention, laser sealing or bonding techniques such as the square-wave laser design may be desirable. However, bonds may also be done using other balloon bonding techniques known in the art, such as thermal or ultrasonic welds, adhesive bonds (for example glue), or other conventional means.[0213]
• Following the laser bonding of the[0214]tip jacket57, thesecond shrink tubing57cis removed. The first set of source and guidewire mandrels (22a,21a) is then replaced with a second set of source and guidewire mandrels (22aa,21aa) having smaller diameters thanmandrels22aand21a. In one embodiment of this invention, thesecond source mandrel22aahas a diameter of 0.0205 in., while thesecond guidewire mandrel21aahas a diameter of 0.016 in. The diameters of the second source and guidewire mandrels may vary depending on a number of factors, such as the type of source used, the size of the multi-lumen balloon when inflated (e.g., 2 mm, 3 mm balloon overall diameter), etc.
• Once the source and guidewire mandrels are replaced with smaller-diameter mandrels, a tip-forming[0215]sheath57a(shown in FIG. 21b) is placed over the laser-sealedtip jacket57. Using the tip-formingsheath57a, a guidewire soft tip (shown in FIGS. 1, 6,10, and13) is formed using by placing the balloon seal sub-assembly into a hot box (not shown). At the completion of thedistal seal28, thesecond source mandrel22aaand thesecond guidewire mandrel21aaare removed from the balloon seal sub-assembly.
• Alternative Source Mandrel Designs for Distal Seal[0216]
• The source mandrels presented above refer to a mandrel design having a circular cross-section. However, the circular cross-section design for the source mandrels may be substituted by using two additional source mandrel designs: (1) a tapered-shape mandrel, and (2) a ramped-shape mandrel. These two embodiments of this invention are now discussed[0217]
• Tapered Mandrel[0218]
• Referring to FIG. 21[0219]d,a tapered mandrel is formed by having a gradual taper of one end of the mandrel (22aor22aa) while keeping the round cross-sectional shape concentric to the mandrel. The tapered mandrel has agradual taper length21a1 that may vary from 0 cm (i.e., flat ended mandrel) to ataper length21a1 of 10 cm. This gradual taper shapes the end of thesource lumen22 to direct the radiation source (such as a wire) directly at center of the lumen.
• Ramped Mandrel[0220]
• Referring to FIG. 21[0221]e, a ramped mandrel (22aor22aa) is shown. In the ramped mandrel design, a round is first made to one end of the mandrel. Then a flat ramp is cut into the same end of the mandrel on one side (see FIG. 21e). The ramped mandrel has aramp length22a2 that may vary from 0 cm (i.e., flat ended mandrel) to aramp length22a2 of 5 cm. This ramped feature shapes the end of the source lumen to direct the source wire slightly downwards and away from exiting through the top of the lumen.
• Method of Manufacture[0222]
• Multi-Lumen Tubing[0223]
• Referring to FIGS. 22[0224]a-25a, the multi-lumenfluted balloon10 of this invention is fabricated by blowing amulti-lumen tubing60 created using an extrusion process. The multi-lumen extrudedtubing60 has atubing body61, acentral lumen62, and at least oneouter lumen63 disposed adjacent to thecentral lumen62. Generally, a plurality ofouter lumens63 are disposed adjacent to thecentral lumen62. Theouter lumen63 is coupled with thecentral lumen62 by a shared wall67 (as shown in FIGS. 22a-25a). In one embodiment, themulti-lumen tubing60 has threeouter lumens63 disposed adjacent to thecentral lumen62.
• Referring the FIGS. 23[0225]aand24a, in one embodiment of the present invention, themulti-lumen tubing60 has at least oneouter lumen63 disposed adjacent to thecentral lumen62. Theouter lumen63 is coupled with thecentral lumen62 by a sharedwall67. Themulti-lumen tubing60 further includes an undercutradius region65 disposed between thecentral lumen62 and theouter lumen63. The sharedwall67 may have a sharedwall thickness67bin the range of approximately 50%-200% of the outerlumen wall thickness67c(as shown in FIG. 23a). In one embodiment, the sharedwall67 may have a sharedwall thickness67bin the range of approximately 80%-120% of the outerlumen wall thickness67c(as shown in FIG. 24a).
• Referring to FIG. 22[0226]a, in another embodiment of the present invention, themulti-lumen tubing60 has at least oneouter lumen63 disposed adjacent to thecentral lumen62. Theouter lumen63 is coupled with thecentral lumen62 by a sharedwall67. Themulti-lumen tubing60 includes afillet radius region66 instead of the undercutregion65 shown in the embodiments of FIG. 23aand24a. Thefillet radius region66 is disposed between thecentral lumen62 and theouter lumens63. The sharedwall67 may have a sharedwall thickness67bin the range of approximately 50%-200% of the outerlumen wall thickness67c. In one embodiment, the sharedwall67 may have a sharedwall thickness67bin the range of approximately 80%-120% of the outerlumen wall thickness67c(as shown in FIG. 23a).
• Referring to FIG. 25[0227]a, in a third embodiment of the present invention, themulti-lumen tubing60 includes astandoff region64 disposed between thecentral lumen62 and theouter lumens63. In this configuration, thestandoff region64 is the same as the shared wall67 (i.e., thestandoff region64 has the same shape and length as the shared wall67). Thestandoff region64 may have astandoff region thickness67bbin the range of approximately 50%-200% of the outerlumen wall thickness67c. In one embodiment, thestandoff region64 may have astandoff region thickness67bbin the range of approximately 86%-120% of the outerlumen wall thickness67c(as shown in FIG. 25a).
• The[0228]multi-lumen tubing60 of the present invention may have anoverall diameter68 in the range of approximately {fraction (20/1000)} in. and {fraction (50/1000)} in. In one embodiment of this invention, themulti-lumen tubing60 may have anoverall diameter68 in a range of approximately about {fraction (34/1000)} in. to {fraction (48/1000)} in.
• The[0229]central lumen62 of themulti-lumen tubing60 may have an inner diameter (69a-69d,as shown in FIGS. 22a-25d) in a range of approximately about {fraction (7/1000)} in. to {fraction (13/1000)} in. In one embodiment of this invention, thecentral lumen62 of themulti-lumen tubing60 has an inner diameter of about {fraction (10/1000)} in.
• The[0230]outer lumens63 of themulti-lumen tubing60 may have an outerlumen wall thickness67cin a range of approximately {fraction (2/1000)} in. to {fraction (8/1000)} in. In one embodiment of this invention, theouter lumens63 may have an outerlumen wall thickness67cin a range of approximately {fraction (3.5/1000)} in. to {fraction (6/1000)} in.
• The[0231]multi-lumen tubing60 is manufactured using balloon materials, such as resin, Pebax™, nylon, polyethylene, polyurethane, or polyester. Materials for use in fabricating themulti-lumen extrusion tubing60 of the present invention are selected by considering the properties and characteristics (e.g., softness, durability, low stiffness) required by angioplasty balloons, as well as considering properties necessary for successful balloon fabrication (e.g., balloon material compatible with other catheter materials and bonding process, material extruding well, etc.).
• Multi-Lumen Tubing—Method of Manufacture: Extrusion[0232]
• FIG. 26 is a flow chart illustrating the steps of fabricating a multi-lumen extruded tubing of one embodiment of the present invention, such as the multi-lumen extruded tubing for the radiation centering catheter shown in FIGS. 1, 6,[0233]10, and13.
• Referring to FIG. 26, the first step in the extruded tubing manufacture process is to select an appropriate material from which the extruded tubing (and thus the balloon) will be manufactured (step[0234]100). Recall that the multi-lumen extruded tubing is made of balloon materials known in the art of balloon angioplasty, such as Pebax™, nylon, polyethylene, polyurethane or polyester. Generally, any resin-type material may be used to manufacture the multi-lumen extruded tubing. Materials for use in fabricating the multi-lumen extruded tubing of the present invention are selected by considering the properties and characteristics (e.g., softness, durability) required by angioplasty balloons, as well as considering properties necessary for successful balloon fabrication (e.g., balloon material compatible with other catheter materials and bonding process, material extruding well, etc.).
• At[0235]step200 in the multi-lumen extruded tubing fabrication process, the resin material is placed into a hopper (or a similar purpose receptacle) and is then gradually brought to a molten state.
• The next three steps ([0236]Steps300,400, and500) are performed concurrently during the multi-lumen extruded tubing manufacture process. InStep300, the molten resin material is run through a tip and die assembly such that at least one multi-lumen shaft is formed. As part ofStep400, a pressurized medium (such as air or other gas) is applied into each of the lumens of the multi-lumen shaft (or the plurality of single lumen shafts) formed as part ofStep300 to maintain and/or control the inner diameter of the lumens (or bores)63 formed lengthwise along the centerline of the shaft (or along a centerline of each of the plurality of shafts). If a pressurized gas is used, the pressurized gas applied to the plurality of resin material shafts may done at a pressure in the range of approximately 0-30 inches of water. In one embodiment, the pressurized gas applied to the plurality of resin material shafts is at a pressure of 2 inches of water.
• [0237]Step500 includes pulling the shaft (or depending on the extrusion die configuration, a plurality of shafts) away from the extrusion die (using a puller or similar device) so as to form the multi-lumen extruded tubing having the desired lumen inner diameter, lumen wall thickness, shared wall thickness, outer tubing shape, etc. Pulling the plurality of shafts away from the extrusion die (Step500) may be done while the resin material is at a melt temperature in the range of about 370° F. to 440° F. In one embodiment, pulling the plurality of shafts away from the extrusion die is done while the resin material is at a melt temperature in the range of about 380° F. to 410° F. Pulling the plurality of resin material shafts away from the extrusion die may be done at a pulling rate of about 25-100 feet per minute. In one embodiment, pulling the plurality of resin material shafts away from the extrusion die is done at a pulling rate of about 45-65 feet per minute.
• For extrusion die configurations that permit a plurality of shafts to be formed instead of a single shaft (as discussed below),[0238]Step500 includes pulling the plurality of shafts away from the extrusion die so as to cause the plurality of shafts to fuse together lengthwise into the multi-lumen extrusion tubing having a central lumen and at least one outer lumen disposed adjacent to the central lumen.
• Referring to FIGS. 22[0239]b-25b, several embodiments of a tip and die assembly of the present invention are shown. Each tip and die assembly includes an extrusion die (shown as70,170,270,370 in FIGS. 22b-25b) and a plurality of extrusion tip hypo-tubes (identified as71a,171a,271a,371ain the figures) through which a pressurized medium (such as air, an inert gas, liquid, etc.) is introduced into the shaft's lumen to maintain and/or control the inner diameter of the lumen. The extrusion die may have a single common exit hole (item76 in FIG. 22banditem376 in FIG. 25b) or a plurality of exit holes (items171,172 in FIG. 23banditems71,72 in FIG. 24b). The hypo-tubes may take the form of mandrels (items271a,171a,71a,and371ain FIGS. 22b-25b) having a bore extending lengthwise through the center of the mandrels.
• Continuing with reference to FIG. 22[0240]b, the extrusion die270 is used in the manufacture of the multi-lumen extrudedtubing60 shown in FIG. 22a. The extrusion die270 includes a singlecommon exit hole76 having a profile such that a multi-lumen extrudedtubing60 with afillet radius region66 disposed between thecentral lumen62 and the plurality ofouter lumens63 is formed. The extrusion die270 may be manufactured out of a metal, a hard plastic, or any other type of material used in medical extrusion tubing processes. Using a die with a single common exit hole simplifies the overall tubing extrusion process, thus permitting a multi-lumen single shaft to be more easily manufactured.
• Referring to FIG. 23[0241]b, in a second embodiment of this invention, the extrusion die170 is used in the manufacture of the multi-lumen extrudedtubing60 shown in FIG. 23a. The extrusion die170 has at least oneouter exit hole171 disposed around acentral exit hole172. Theouter exit hole171 may be positioned atvarious distances175 from thecentral exit hole172. It may be desirable to place theouter exit hole171 as close as possible to thecentral exit hole172 in order to minimize the amount of resin material of the sharedwall thickness67b(shown in FIG. 23a). Having less resin material as part of the shared wall permits the multi-lumen tubing to blow better during the balloon forming process and ultimately leads to a less stiff balloon. The extrusion die170 may be manufactured out of a metal, a hard plastic, or any other type of material used in medical extrusion tubing processes.
• Referring to FIG. 24[0242]b, in a third embodiment of this invention, the extrusion die70 is used in the manufacture of the multi-lumen extrudedtubing60 shown in FIG. 24a. The extrusion die70 includes at least oneouter exit hole71 disposed around to acentral exit hole72. Theouter exit hole71 has a substantially flat shape across apart73 of a periphery where theouter exit hole71 is disposed adjacent to thecentral exit hole72. Thecentral exit hole72 also has a substantially flat shape across apart74 of a periphery where thecentral exit hole72 is disposed adjacent to theouter exit hole71.
• The extrusion die[0243]70 may be configured so that theouter exit hole71 could be positioned at various die region thicknesses (or distances)75 on the die region between thecentral exit hole72 andouter exit hole71. Thedie region thickness75 may range from 0 in. to {fraction (10/1000)} in. In one embodiment, thedie region thickness75 between thecentral exit hole72 and theouter exit hole71 is about {fraction (5/1000)} in. It may be desirable to keep thedie region thickness75 to a thickness width such that when formed, the sharedwall thickness67bof the multi-lumen60 is approximately equal to the outerlumen wall thickness67c(see FIG. 24a). Having a shared wall thickness in the range of approximately 80% and 120% of the outerlumen wall thickness67cminimizes the resin material of the shared wall and permits the multi-lumen tubing to blow better during the balloon forming process and ultimately leads to a less stiff balloon. The extrusion die70 may be manufactured out of a metal, a hard plastic, or any other type of material used in medical extrusion tubing processes.
• Referring to FIG. 25[0244]b, in a fourth embodiment of this invention, the extrusion die370 is used in the manufacture of the multi-lumen extrudedtubing60 shown in FIG. 25a. The extrusion die370 includes a singlecommon exit hole376 having a profile such that a multi-lumen extrudedtubing60 with at least onestandoff region64 disposed between thecentral lumen62 and theouter lumens63 is formed (see FIG. 25a). The extrusion die370 may be manufactured out of a metal, a hard plastic, or any other type of material used in medical extrusion tubing processes. Using a die with a single common exit hole and having a profile with at least one standoff region minimize the amount of resin material between thecentral lumen62 and plurality of outer lumens63 (shown in FIG. 25a). Having less resin material permits themulti-lumen tubing60 to blow better during the balloon forming process and ultimately leads to a less stiff balloon. Furthermore, using a die with a single common exit hole simplifies the overall tubing extrusion process, thus permitting a multi-lumen single shaft to be more easily manufactured.
• The next step in the fabrication process, Steps[0245]610 and620, is to form the final balloon shape with multiple lumens. This is achieved by placing the multi-lumen extruded tubing obtained after completion of Steps300-500 into a steel cylinder that is configured to have the appropriate shape of the final balloon.
• Once the multi-lumen balloon is formed and shaped to the desired dimensions and configurations, the next steps include preparing the balloon and catheter assembly for the balloon proximal seal (Step[0246]710) and performing the balloon proximal seal (Step720). Step810 includes preparing the balloon and catheter assembly for the balloon distal seal, whileStep820 includes performing the balloon distal seal.
• In one embodiment of the present invention, laser bonding techniques are used to perform the proximal and distal seals. However, any seal bonding techniques known in the art of manufacture of angioplasty balloon catheters may be employed to achieve the seals.[0247]
• Multi-Lumen Tubing—Alternate Method of Manufacture: Dip Coating[0248]
• An alternate method of manufacture of the multi-lumen balloon is by using a “Dip Coating” process. A description of this process and how the multi-lobed, multi-lumen balloon is made is presented herein.[0249]
• First, a “mandrel” is obtained. The mandrel includes component elements (such as pins) that are sized and arranged such that they define the lumens (i.e., interior void spaces) of the intended multi-lumen balloon.[0250]
• Next, the physical balloon elements (i.e., balloon lumens, thickness of balloon walls, etc.) are defined by applying a thin film of a pre-selected polymer (analogous to applying paint) on and about the pin. In one embodiment, the application of the thin film polymer is achieved by immersing the mandrel into a bath of the desired polymer. The polymer may be any polymer with properties that would lend themselves to dip coating such as the ability to go into solution or suspension with subsequent recovery of adequate film properties. Materials already used in this manner are for example: poly-urethanes, siloxanes or silicones, and latexes.[0251]
• The thickness of the film (balloon wall) may be controlled by such factors as the viscosity of the bath solution and/or the number of times the mandrel is dipped into the solution. The “carrier” or “solvent” is then driven off (evaporated) by normal means such as time in ambient air or forced convection with or without added heat.[0252]
• The balloon, if appropriate to the polymer selected, may be further processed to impart enhanced or additional properties such as irradiation to increase cross-linking. This can be achieved either before or after removing from the mandrel as appropriate to the material and/or properties and/or process.[0253]
• In the next step, the film that is the balloon is then “stripped off” the mandrel through any appropriate means such as: using compressed air ported through the pins that make up the mandrel, swelling the balloon material with some other solvent which frees the balloon material from the mandrel and this solvent is then driven off returning the balloon to the original dimensions, mechanically stripping off the balloon, etc.[0254]
• Finally, the balloon is trimmed and prepped as necessary for integration with the remaining catheter components.[0255]
• A multi-lumen balloon for use in a fluted balloon centering catheter and method for providing the same has been described. Although specific embodiments, including specific parameters, methods, and materials have been described, various modifications to the disclosed embodiments will be apparent to one of ordinary skill in the art upon reading this disclosure. Therefore, it is to be understood that such embodiments are merely illustrative of and not restrictive on the broad invention and that this invention is not limited to the specific embodiments shown and described.[0256]

Claims (85)

What is claimed is:

1. A multi-lumen tubing, comprising:

a tubing body having a central lumen and at least one outer lumen disposed around the central lumen, the outer lumen coupled with the central lumen by a shared wall; and

an undercut region disposed between the central lumen and the at least one outer lumen.

2. The multi-lumen tubing ofclaim 1, wherein the outer lumen has an outer lumen wall thickness in a range of approximately 0.002-0.008 in.

3. The multi-lumen tubing ofclaim 1, wherein the outer lumen has an outer lumen wall thickness in a range of approximately 0.0035-0.006 in.

4. The multi-lumen tubing ofclaim 2, wherein the shared wall has a shared wall thickness greater than 1% of the outer lumen wall thickness.

5. The multi-lumen tubing ofclaim 2, wherein the shared wall has a shared wall thickness in the range of approximately 80% to 120% of the outer lumen wall thickness.

6. The multi-lumen tubing ofclaim 1, wherein the multi-lumen tubing has an overall diameter in a range of approximately 0.020-0.050 in.

7. The multi-lumen tubing ofclaim 1, wherein the multi-lumen tubing has an overall diameter in a range of approximately 0.034-0.048 in.

8. The multi-lumen tubing ofclaim 1, wherein the central lumen has an inner diameter in a range of approximately 0.007-0.013 in.

9. The multi-lumen tubing ofclaim 1, wherein the central lumen has an inner diameter of about 0.010 in.

10. The multi-lumen tubing ofclaim 1, wherein the multi-lumen tubing is manufactured from a material selected from the group consisting of resin, nylon, Pebax, polyethylene, polyurethane and polyester.

11. A multi-lumen tubing, comprising:

a tubing body having a central lumen and at least one outer lumen disposed around the central lumen, the at least outer lumen coupled with the central lumen by a shared wall; and

a fillet radius region disposed between the central lumen and the at least one outer lumen.

12. The multi-lumen tubing ofclaim 11, wherein the outer lumen has an outer lumen wall thickness in a range of approximately 0.002-0.008 in.

13. The multi-lumen tubing ofclaim 11, wherein the outer lumen has an outer lumen wall thickness in a range of approximately 0.0035-0.006 in.

14. The multi-lumen tubing ofclaim 12, wherein the shared wall has a shared wall thickness greater than 1% of the outer lumen wall thickness.

15. The multi-lumen tubing ofclaim 12, wherein the shared wall has a shared wall thickness in the range of approximately 80% to 120% of the outer lumen wall thickness.

16. The multi-lumen tubing ofclaim 12, wherein the multi-lumen tubing has an overall diameter in a range of approximately 0.020-0.050 in.

17. The multi-lumen tubing ofclaim 11, wherein the multi-lumen tubing has an overall diameter in a range of approximately 0.034-0.048 in.

18. The multi-lumen tubing ofclaim 11, wherein the central lumen has an inner diameter in a range of approximately 0.007-0.013 in.

19. The multi-lumen tubing ofclaim 11, wherein the central lumen has an inner diameter of about 0.010 in.

20. The multi-lumen tubing ofclaim 11, wherein the multi-lumen tubing is manufactured from a material selected from the group consisting of resin, nylon, Pebax, polyethylene, polyurethane and polyester.

21. A multi-lumen tubing, comprising:

a tubing body having a central lumen and at least one outer lumen disposed around the central lumen, the outer lumen coupled with the central lumen by a shared wall; and

a standoff region disposed between the central lumen and the at least one outer lumen.

22. The multi-lumen tubing ofclaim 21, wherein the outer lumen has an outer lumen wall thickness in a range of approximately 0.002-0.008 in.

23. The multi-lumen tubing ofclaim 21, wherein the outer lumen has an outer lumen wall thickness in a range of approximately 0.0035-0.006 in.

24. The multi-lumen tubing ofclaim 22, wherein the shared wall has a shared wall thickness greater than 1% of the outer lumen wall thickness.

25. The multi-lumen tubing ofclaim 22, wherein the shared wall has a shared wall thickness in the range of approximately 80% to 120% of the outer lumen wall thickness.

26. The multi-lumen tubing ofclaim 21, wherein the multi-lumen tubing has an overall diameter in a range of approximately 0.020-0.050 in.

27. The multi-lumen tubing ofclaim 21, wherein the multi-lumen tubing has an overall diameter in a range of approximately 0.034-0.048 in.

28. The multi-lumen tubing ofclaim 21, wherein the central lumen has an inner diameter in a range of approximately 0.007-0.013 in.

29. The multi-lumen tubing ofclaim 21, wherein the central lumen has an inner diameter of about 0.010 in.

30. The multi-lumen tubing ofclaim 21, wherein the multi-lumen tubing is manufactured from a material selected from the group consisting of resin, nylon, Pebax, polyethylene, polyurethane and polyester.

31. A multi-lumen tubing, the multi-lumen tubing having been made by a method comprising:

pushing a molten resin material through a tip and die assembly such that a plurality of resin material shafts are formed, the tip and die assembly including an extrusion die and a plurality of mandrels, wherein the extrusion die has at least one outer exit hole disposed adjacent to a central exit hole;

applying a pressurized medium to the plurality of resin material shafts so as to maintain a lumen running lengthwise along the plurality of resin material shafts; and

pulling the plurality of resin material shafts away from the extrusion die so as to cause the plurality of resin material shafts to fuse together lengthwise into the multi-lumen extrusion tubing having a central lumen and at least one outer lumen disposed adjacent to the central lumen.

32. The method ofclaim 31, wherein the at least one outer exit hole has a substantially flat shape across a part of a periphery where the at least one outer exit hole is disposed adjacent to the central exit hole.

33. The method ofclaim 31, wherein the central exit hole has a substantially flat shape across a part of a periphery where the central exit hole is disposed adjacent to the at least outer exit hole.

34. The method ofclaim 31 wherein said pulling the plurality of resin material shafts away from the extrusion die is done while the resin material is at a melt temperature in the range of about 370° F. to 440° F.

35. The method ofclaim 31 wherein said pulling the plurality of resin material shafts away from the extrusion die is done while the resin material is at a melt temperature in the range of about 380° F. to 410° F.

36. The method ofclaim 31 wherein the resin material is nylon.

37. The method ofclaim 31 wherein the resin material is polyethylene.

38. The method ofclaim 31 wherein the resin material is polyester.

39. The method ofclaim 31 wherein the pressurized medium comprises a pressurized gas.

40. The method ofclaim 31 wherein the pressurized medium comprises air.

41. The method ofclaim 39 wherein the pressurized gas applied to the plurality of resin material shafts is applied at a pressure of in a range of approximately 0-30 inches of water.

42. The method ofclaim 39 wherein the pressurized gas applied to the plurality of resin material shafts is applied at a pressure of 2 inches of water.

43. The method ofclaim 31 wherein said pushing a molten resin material through an extrusion die and said applying a pressurized fluid to the plurality of resin material shafts so as to maintain a lumen are performed concurrently.

44. The method ofclaim 31 wherein said pulling the plurality of resin material shafts away from the extrusion die is done at a pulling rate of about 25-100 feet per minute.

45. The method ofclaim 31 wherein said pulling the plurality of resin material shafts away from the extrusion die is done at a pulling rate of about 45-65 feet per minute.

46. The method ofclaim 31 wherein the at least one outer lumen has an outer lumen wall thickness in a range of approximately 0.0035-0.006 in.

47. The method ofclaim 31 wherein the multi-lumen tubing has an overall diameter in a range of approximately {fraction (34/1000)} in. to {fraction (48/1000)} in.

48. A multi-lumen tubing, the multi-lumen tubing having been made by a method comprising:

pushing a molten resin material through an tip and die assembly such that a multi-lumen resin material shaft having a radial cross-section that includes at least one fillet radius region is formed, wherein the tip and die assembly includes an extrusion die having a single exit hole profile and a plurality of mandrels; and

applying a pressurized medium to the multi-lumen resin material shaft so as to maintain a central lumen and at least one outer lumen disposed adjacent to a central lumen, the central lumen and the at least one outer lumen running lengthwise along the resin material shaft.

49. The method ofclaim 48, further comprising:

pulling the multi-lumen resin material shaft away from the extrusion die.

50. The method ofclaim 49 wherein said pulling the multi-lumen resin material shaft away from the extrusion die is done while the resin material is at a melt temperature in the range of about 370° F. to 440° F.

51. The method ofclaim 49 wherein said pulling the multi-lumen resin material shaft away from the extrusion die is done while the resin material is at a melt temperature in the range of about 380° F. to 410° F.

52. The method ofclaim 48 wherein the resin material is nylon.

53. The method ofclaim 48 wherein the resin material is polyethylene.

54. The method ofclaim 48 wherein the resin material is polyester.

55. The method ofclaim 48 wherein the pressurized medium comprises a pressurized gas.

56. The method ofclaim 55 wherein the pressurized medium comprises air.

57. The method ofclaim 55 wherein the pressurized gas applied to the multi-lumen resin material shaft is applied at a pressure of in a range of approximately 0-30 inches of water.

58. The method ofclaim 55 wherein the pressurized gas applied to the multi-lumen resin material shaft is applied at a pressure of 2 inches of water.

59. The method ofclaim 48 wherein said pushing a molten resin material through a tip and die assembly and said applying a pressurized medium to the multi-lumen resin material shaft so as to maintain a central lumen and at least one outer lumen are performed concurrently.

60. The method ofclaim 49 wherein said pulling the multi-lumen resin material shaft away from the extrusion die is done at a pulling rate of about 25-100 feet per minute.

61. The method ofclaim 49 wherein said pulling the multi-lumen resin material shaft away from the extrusion die is done at a pulling rate of about 45-65 feet per minute.

62. The method ofclaim 48 wherein the at least one outer lumen has an outer lumen wall thickness in a range of approximately 0.0035-0.006 in.

63. The method ofclaim 48 wherein the multi-lumen tubing has an overall diameter in a range of approximately {fraction (34/1000)} in. to {fraction (48/1000)} in.

64. A multi-lumen tubing, the multi-lumen tubing having been made by a method comprising:

pushing a molten resin material through an tip and die assembly such that a multi-lumen resin material shaft having a radial cross-section that includes at least one standoff region is formed, wherein the tip and die assembly includes an extrusion die having a single exit hole profile and a plurality of mandrels; and

applying a pressurized medium to the multi-lumen resin material shaft so as to maintain a central lumen and at least one outer lumen disposed adjacent to a central lumen, the central lumen and the at least one outer lumen running lengthwise along the resin material shaft.

65. The method ofclaim 64, further comprising:

pulling the multi-lumen resin material shaft away from the extrusion die.

66. The method ofclaim 65 wherein said pulling the multi-lumen resin material shaft away from the extrusion die is done while the resin material is at a melt temperature in the range of about 370° F. to 440° F.

67. The method ofclaim 65 wherein said pulling the multi-lumen resin material shaft away from the extrusion die is done while the resin material is at a melt temperature in the range of about 380° F. to 410° F.

68. The method ofclaim 64 wherein the resin material is nylon.

69. The method ofclaim 64 wherein the resin material is polyethylene.

70. The method ofclaim 64 wherein the resin material is polyester.

71. The method ofclaim 64 wherein the pressurized medium comprises a pressurized gas.

72. The method ofclaim 71 wherein the pressurized medium comprises air.

73. The method ofclaim 71 wherein the pressurized gas applied to the multi-lumen resin material shaft is applied at a pressure of in a range of approximately 0-30 inches of water.

74. The method ofclaim 71 wherein the pressurized gas applied to the multi-lumen resin material shaft is applied at a pressure of 2 inches of water.

75. The method ofclaim 64 wherein said pushing a molten resin material through a tip and die assembly and said applying a pressurized medium to the multi-lumen resin material shaft so as to maintain a central lumen and at least one outer lumen are performed concurrently.

76. The method ofclaim 65 wherein said pulling the multi-lumen resin material shaft away from the extrusion die is done at a pulling rate of about 25-100 feet per minute.

77. The method ofclaim 65 wherein said pulling the multi-lumen resin material shaft away from the extrusion die is done at a pulling rate of about 45-65 feet per minute.

78. The method ofclaim 64 wherein the at least one outer lumen has an outer lumen wall thickness in a range of approximately 0.0035-0.006 in.

79. The method ofclaim 64 wherein the multi-lumen tubing has an overall diameter in a range of approximately {fraction (34/1000)} in. to {fraction (48/1000)} in.

80. An extruder die, comprising:

at least one outer exit hole disposed adjacent to a central exit hole, the outer exit hole having a substantially flat shape across a part of an outer exit hole periphery where the outer exit hole is disposed adjacent to the central exit hole, the central exit hole having a substantially flat shape across a part of a central exit hole periphery where the central exit hole is disposed adjacent to the outer exit hole.

81. The extruder die ofclaim 80, wherein a die region separating the outer exit hole from the central exit hole has a thickness in a range of approximately 0-{fraction (10/1000)} in.

82. The extruder die ofclaim 80, wherein a die region separating the outer exit hole from the central exit hole has a thickness of about {fraction (5/1000)} in.

83. An extruder die, comprising at least one outer exit hole disposed adjacent to a central exit hole, the outer exit hole separated from the central exit hole by an extruder die region having a thickness in a range of approximately 0-{fraction (10/1000)}.

84. An extruder die, comprising:

a single exit hole profile such that a resin material shaft having a radial cross-section that includes at least one fillet radius region is formed.

85. An extruder die, comprising:

a single exit hole profile such that a resin material shaft having a radial cross-section that includes at least one standoff region is formed.

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