US20130137977A1 - Hybrid micro guide catheter - Google Patents

Abstract

A hybrid microguide catheter and method for making and using the same. The catheter may include a first tubular member and a second tubular member. The tubular members may be arranged so that the second tubular member extends distally beyond the first tubular member. Alternatively, the catheter may include a tubular body having a first opening and a second opening. The first opening may be positioned along the tubular body a distance from the second opening.

Description

RELATED APPLICATIONS
• This application is a continuation of U.S. application Ser. No. 13/025,381, filed Feb. 11, 2011, now U.S. Pat. No. 8,372,056, which is a continuation of U.S. application Ser. No. 10/827,565, now U.S. Pat. No. 7,887,529; the entire disclosures of which are incorporated herein by reference.
FIELD OF THE INVENTION
• The present invention pertains to medical devices including catheters. More particularly, the present invention pertains to intravascular catheters with a support and visualization portion and a distal access portion.
BACKGROUND OF THE INVENTION
• A wide variety of devices have been developed for medical use, for example, intravascular use. Some of these devices include guidewires, catheters, and other such devices that each have certain features and characteristics. Among the known medical devices, each has certain advantages and disadvantages. There is an ongoing need to provide alternative designs and methods for making and using medical devices with desirable characteristics and features.
SUMMARY OF THE INVENTION
• The invention provides design, material, and manufacturing method alternatives for medical devices, for example, catheters. In at least some embodiments, the catheters include a support and visualization portion and a distal access portion. The support and visualization portion may be disposed near the proximal end region of the catheter and the distal access portion may be disposed near the distal end region of the catheter. These and some of the other features and characteristics of example embodiments are described in more detail below.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1 is partial cross-sectional side view of an example catheter disposed in the blood vessel;
• FIG. 2 is a cross-sectional view of the catheter shown inFIG. 1;
• FIG. 3 is a cross-sectional view of the catheter shown inFIG. 2 taken through line3-3;
• FIG. 4 is an alternative cross-sectional view of the catheter shown inFIG. 1;
• FIG. 5 is a cross-sectional view of another example catheter;
• FIG. 6 is a cross-sectional view of another example catheter;
• FIG. 7 is a cross-sectional view of another example catheter;
• FIG. 8 is a cross-sectional view of another example catheter;
• FIG. 9 is a side view of another example catheter; and
• FIG. 10 is a cross-sectional view of another example catheter.
DETAILED DESCRIPTION
• The following description should be read with reference to the drawings wherein like reference numerals indicate like elements throughout the several views. The detailed description and drawings illustrate example embodiments of the claimed invention.
• FIG. 1 is partial cross-sectional side view of anexample catheter10.Catheter10 may include aproximal region12 and adistal region14. In at least some embodiments,proximal region12 is adapted and configured so that it providescatheter10 with a desirable amount of proximal stiffness. In addition,proximal region12 may be used to enhance catheter visualization. For example,proximal region12 may include a lumen16 (better seen inFIG. 2) that can be used to infuse contrast media18 (as a part of a standard fluoroscopy technique) into ablood vessel20. Of course, other substances can be passed throughlumen16 as desired, including pharmacological agents.
• In at least some embodiments,distal region14 is adapted and configured so that it providescatheter10 with distal access to target vascular regions. For example,distal region14 may extend deeper within blood vessel20 (which is, for example, exemplified by the narrowing ofblood vessel20 in the lower half ofFIG. 1) to an area near an intravascular lesion22. Once positioned, amicrocatheter24 may be passed through alumen26 defined indistal region14.Microcatheter24 may be any of a number of different known microcatheters such as guide catheters, balloon catheters, cutting balloon catheters, atherectomy catheters, stent delivery catheters, filter delivery catheters, and the like, or any other suitable medical device. Advancingmicrocatheter24 throughlumen26 may include advancingmicrocatheter24 over aguidewire28 in the manner typically used in the art. Guidewire28 may be similar to typical guidewires used in the art.
• Catheter10 may include a firsttubular member30 and a secondtubular member32 as illustrated inFIG. 2. According to this embodiment, the combination of firsttubular member30 and secondtubular member32 may defineproximal region12. A portion of secondtubular member32 may extend distally a distance D from firsttubular member30 in order to definedistal region12. Distance D may reflect the distance between a first opening40 (through which, for example, contrast media or other substances can be infused) of firsttubular member30 and a second opening38 (through which, for example, a microcatheter can be advanced) of secondtubular member32. In some embodiments, the length of distance D may be in the range about 1 to about 50 centimeters. In other embodiments, the length of distance D may be in the range about 10 to about 40 centimeters. In still other embodiments, the length of distance D may be in the range about 20 to about 40 centimeters. It should be noted that the form and arrangement oftubular members30/32 need not be exactly as stated, because a number of other arrangements are contemplated. For example, secondtubular member32 need not be disposed as illustrated atproximal region12, as it may be positioned anywhere inlumen16.
• Tubular members30/32 may be made from any suitable material such as metals, metal alloys, metal-polymer composites, polymers, and the like or any other suitable material. In some embodiments,tubular members30/32 have the same or similar material composition. In other embodiments,tubular members30/32 have different material compositions. Below are some lists of materials that can be used to manufacturetubular members30/32. The lists are not intended to be exhaustive or to be limiting. Some examples of suitable metals and metal alloys include stainless steel, such as 304V, 304L, and 316LV stainless steel; mild steel; nickel-titanium alloy such as linear-elastic or super-elastic nitinol, nickel-chromium alloy, nickel-chromium-iron alloy, cobalt alloy, tungsten or tungsten alloys, MP35-N (having a composition of about 35% Ni, 35% Co, 20% Cr, 9.75% Mo, a maximum 1% Fe, a maximum 1% Ti, a maximum 0.25% C, a maximum 0.15% Mn, and a maximum 0.15% Si), hastelloy, monel 400, inconel 825, or the like; other Co—Cr alloys; platinum enriched stainless steel; or other suitable material.
• Some examples of suitable polymers may include polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE), fluorinated ethylene propylene (FEP), polyoxymethylene (POM, for example, DELRIN® available from DuPont), polybutylene terephthalate (PBT), polyether block ester, polyurethane, polypropylene (PP), polyvinylchloride (PVC), polyether-ester (for example, a polyether-ester elastomer such as ARNITEL® available from DSM Engineering Plastics), polyester (for example, a polyester elastomer such as HYTREL® available from DuPont), polyamide (for example, DURETHAN® available from Bayer or CRISTAMID® available from Elf Atochem), elastomeric polyamides, block polyamide/ethers, polyether block amide (PEBA, for example, available under the trade name PEBAX®), silicones, polyethylene (PE), Marlex high-density polyethylene, Marlex low-density polyethylene, linear low density polyethylene (for example, REXELL®), polyethylene terephthalate (PET), polyetheretherketone (PEEK), polyimide (PI), polyetherimide (PEI), polyphenylene sulfide (PPS), polyphenylene oxide (PPO), polysulfone, nylon, perfluoro(propyl vinyl ether) (PFA), other suitable materials, or mixtures, combinations, copolymers thereof, polymer/metal composites, and the like. In some embodiments,tubular members30/32 can be blended with a liquid crystal polymer (LCP). For example, the mixture can contain up to about 5% LCP. This has been found to enhance torqueability.
• In some embodiments, a coating, for example, a lubricious, a hydrophilic, a protective, or other type of coating may be applied over portions or all oftubular members30/32, or other portions ofcatheter10. Hydrophobic coatings such as fluoropolymers provide a dry lubricity which improves catheter handling and device exchanges. Lubricious coatings improve steerability and improve lesion crossing capability. Suitable lubricious polymers are well known in the art and may include silicone and the like, hydrophilic polymers such as high-density polyethylene (HDPE), polytetrafluoroethylene (PTFE), polyarylene oxides, polyvinylpyrolidones, polyvinylalcohols, hydroxy alkyl cellulosics, algins, saccharides, caprolactones, and the like, and mixtures and combinations thereof. Hydrophilic polymers may be blended among themselves or with formulated amounts of water insoluble compounds (including some polymers) to yield coatings with suitable lubricity, bonding, and solubility. Some other examples of such coatings and materials and methods used to create such coatings can be found in U.S. Pat. Nos. 6,139,510 and 5,772,609, which are incorporated herein by reference.
• In some embodiments, firsttubular member30 and/or secondtubular member32 may include one or more cuts or grooves formed therein (e.g., by micro-machining). Micro-machiningtubular members30/32 may be desirable because it allows a stiffer starting material (e.g., stainless steel, nickel-titanium alloy, etc.) to be used in the manufacturing oftubular members30/32 that can be smaller, thinner, or otherwise have a lower profile than less stiff materials. This stiff material can then be micro-machined in order to impart the desired level of flexibility. Further discussion on the use of forming cuts, slots, or grooves as well micro-machining can be found in U.S. Patent Publication No. 2004/0193140, in U.S. Pat. No. 6,428,489, and in U.S. Patent Publication No. 2002/0013540, the entire disclosures of which are herein incorporated by reference.
• Tubular members30/32 may be coupled to one another in a number of different manners. For example,FIG. 3 illustrates thattubular members30/32 may be coupled by directly securing firsttubular member30 with secondtubular member32. For example, anouter surface36 oftubular member32 may be attached to aninner wall34 oftubular member30. The attachment may be manifested through the use of an adhesive, thermal bond, weld, mechanical connector, or any other suitable means. In alternative embodiments,tubular members30/32 may have a different arrangement that may vary the manner in which they are bonded. For example,tubular member32 could be coaxially disposed withintubular member30, irregularly disposed withintubular member30, include regions disposed in differing manner, disposed along the exterior oftubular member30, and the like, or disposed in any other suitable arrangement.
• Alternatively,tubular members30/32 may be coupled during manufacturing via an extrusion process as seen inFIG. 4. According to this embodiment, catheter10 (indicated inFIG. 4 ascatheter10′) can be co-extruded so as to define “dual lumens” (i.e.,lumens16/26) alongproximal region12 and a single lumen (i.e., lumen26) alongdistal region14. The dual lumenproximal region12 may define firsttubular member30 and secondtubular member32. The single lumenproximal region14 would, therefore, define distance D of secondtubular member32 extending distally fromproximal region12. These alternative arrangements may entail alternative bonding strategies. In some embodiments, co-extrusion may take place in concert with the addition of other support structures (such as those seen inFIG. 5) or in the absence of such structures.
• As suggested above,catheter10 may take the form of a hybrid “micro guide” catheter. This nomenclature reflects the fact thatcatheter10 may be a hybridization of some of the desirable characteristics and structure of typical microcatheters with some of the desirable characteristics and structure of typical guide catheters. For example,catheter10 includesproximal region12 that may have a proximal stiffness (similar to that of guide catheters) so as to provide a suitable level of pushability and torqueability when advancingcatheter10 through the vasculature. In addition,catheter10 includesdistal region14 that can provide distal access to vascular targets and may have a distal flexibility (similar to that of microcatheters) suitable for navigating the tortuous vasculature.Distal region14 can also serve as a guidewire or guiding structure over which other medical devices can be passed.
• Because of the arrangement whichsecond tubular member32 extends distally from firsttubular member30,catheter10 may be well suited for neurological applications. This is because the length (i.e., distance D) oftubular member32 is typically long enough and suitably flexible so that it can navigate into the target neurological vasculature whileproximal region12 remains disposed in a more proximal location away from the head. Thus, the larger boreproximal region12 can remain in larger vessels, while the smaller boredistal region14 can advance through the smaller, more sensitive neuro-vasculature. Moreover, because first opening40 of firsttubular member30 is set back distance D fromsecond opening38, contrast media can still be infused into the blood vessel (via lumen16) that will travel within the blood stream toward the target site. Distance D may range from about 10 cm. to about 50 cm. For a preferred use in neurological applications, distance D is about 20 cm. to about 40 cm.
• It should be noted that in addition to contrast media, a number of different substances may be passed throughlumen16. The substance may be generally described as a drug, chemotherapeutic, antibiotic, etc. Some examples of appropriate substances may include anti-thrombogenic agents and/or anticoagulants such as heparin, heparin derivatives, urokinase, and PPack (dextrophenylalanine proline arginine chloromethylketone) D-Phe-Pro-Arg chloromethyl keton, an RGD peptide-containing compound, antithrombin compounds, platelet receptor antagonists, anti-thrombin antibodies, anti-platelet receptor antibodies, aspirin, prostaglandin inhibitors, platelet inhibitors, and tick antiplatelet peptides; anti-proliferative agents such as enoxaprin, angiopeptin, or monoclonal antibodies capable of blocking smooth muscle cell proliferation, hirudin, and acetylsalicylic acid; anti-inflammatory agents such as dexamethasone, prednisolone, corticosterone, budesonide, estrogen, sulfasalazine, and mesalamine; antineoplastic/antiproliferative/anti-miotic agents such as paclitaxel, 5-fluorouracil, cisplatin, vinblastine, vincristine, epothilones, endostatin, angiostatin and thymidine kinase inhibitors; anesthetic agents such as lidocaine, bupivacaine, and ropivacaine; vascular cell growth inhibitors such as growth factor inhibitors, growth factor receptor antagonists, transcriptional repressors, translational repressors, replication inhibitors, inhibitory antibodies, antibodies directed against growth factors, bifunctional molecules consisting of a growth factor and a cytotoxin, bifunctional molecules consisting of an antibody and a cytotoxin; cholesterol-lowering agents; vasodilating agents; agents which interfere with endogenous vascoactive mechanisms; anti-sense DNA and RNA; and DNA coding for (and the corresponding proteins) anti-sense RNA, tRNA or rRNA to replace defective or deficient endogenous molecules, angiogenic factors including growth factors such as acidic and basic fibroblast growth factors, vascular endothelial growth factor, epidermal growth factor, transforming growth factor a and B, platelet-derived endothelial growth factor, platelet-derived growth factor, tumor necrosis factor a, hepatocyte growth factor and insulin like growth factor, cell cycle inhibitors including CD inhibitors, thymidine kinase (“TK”) and other agents useful for interfering with cell proliferation, and the family of bone morphogenic proteins (“BMP's”) including BMP-2, BMP-3, BMP-4, BMP-5, BMP-6 (Vgr-1), BMP-7 (OP-1), BMP-8, BMP-9, BMP-10, BMP-11, BMP-12, BMP-13, BMP-14, BMP-15, BMP-16, “hedgehog” proteins.
• FIG. 5 illustrates anotherexample catheter110.Catheter110 is similar tocatheter10 except that firsttubular member130 and/or secondtubular member132 may include a variety of additional structural elements. For example, firsttubular member130 may include acoil142, abraid144, or multiples of either or both. Althoughcoil142 and braid144 are depicted as being disposed atproximal region112, this is not intended to be limiting as these structures could be disposed at essentially any position along firsttubular member130. Similarly, secondtubular member132 may also include acoil146, abraid148, or multiples of either or both. Again, the position ofcoil146 andbraid148 may vary so as to be included at essentially any position along secondtubular member132.
• Coils142/146 and/orbraids144/148 may be similar to those typically seen in the art and can be made from any of the materials disclosed herein. Generally, coils142/146 and/orbraids144/148 are provided as a reinforcing structure that can, for example, stiffen and/or strengthen the structure to which they are coupled. Because the distribution of support structures (i.e., coils142/146,braids144/148, etc.) can vary along the lengths oftubular members130/132, regions having different flexibilities can be defined alongcatheter110. Other structural modifications may also be present such as tapering oftubular members130/132 in a regular, irregular, step-wise, or other manner. In some embodiments, coils142/146 and/orbraids144/148 can be added subsequent an extrusion process or prior to an extrusion process (which would extrude another layer or material overcoils142/146 and/orbraids144/148). Of course, coils142/146 and/orbraids144/148 are optional features that may be omitted from extrusion processes or other catheter manufacturing processes.
• Coils142/146 and/orbraids144/148 can also be used for other reasons including visualization. For example, coils142/146 and/orbraids144/148 may be made from or otherwise include a radiopaque material. Radiopaque materials are understood to be materials capable of producing a relatively bright image on a fluoroscopy screen or another imaging technique during a medical procedure. This relatively bright image aids the user ofcatheter10 in determining its location. Some examples of radiopaque materials can include, but are not limited to, gold, platinum, palladium, tantalum, tungsten alloy, plastic material loaded with a radiopaque filler, and the like. Likewise, other radiopaque structures may also be incorporated intocatheter10, such asmarker bands150.
• FIG. 6 illustrates anotherexample catheter510.Catheter510 is similar to other catheters described herein except that firsttubular member530 and secondtubular member532 are arranged side-by-side and each include tapered regions. For example, firsttubular member530 may include taperedregion554 that tapers from “thick” to “thin” in the distal direction and secondtubular member532 may include taperedregion556 that tapers from “thin” to “thick” in the distal direction and mates with taperedregion554. This arrangement allows the flexibility characteristics oftubular member530 to blend with those oftubular member532. For example,tubular member530 may be less flexible thantubular member532 so that the overlapping tapered arrangement blends these flexibilities and creates a smooth transition in flexibility. Additionally, the overlapping arrangement may also allow for torque control or torqueability to be blended or otherwise progressively controlled.
• The length, steepness or pitch, and position oftapered regions554/556 may vary. For example,tapered regions554/556 could extend along any portion (or all) of the length ofcatheter510. In addition, any suitable steepness or abruptness in the amount of tapering can be utilized. Although overlappingtapered regions554/556 are shown inFIG. 6 as being disposed atproximal portion512, this feature is not intended to be limiting. For example, overlappingtapered regions554/556 could be disposed atdistal portion514 or bothproximal portion512 anddistal portion514. Moreover, a number of additional overlapping tapered regions may be defined at essentially any position alongcatheter510.
• FIG. 7 illustrates anotherexample catheter610.Catheter610 is similar to other catheters described herein except that only one tubular member, for exampletubular member630, includes a taperedregion658.Tapered region658 may help blend the flexibilities oftubular members630/632 as well add a number of other significant features as described above.Tapered region658 may vary as described above in relation to taperedregions554/556. For example, taperedregion658 may be disposed alongproximal portion612,distal portion614, combinations thereof, or at any suitable location. Moreover, taperedregion658 could also be embodied by a taper defined intubular member632.
• FIG. 8 illustrates anotherexample catheter210.Catheter210 is similar to other catheters described herein except that firsttubular member230 and secondtubular member232 are disposed parallel to one another with firsttubular member230 being truncated relative to secondtubular member232. According to this embodiment,tubular members230/232 can be secured together via any typical bonding technique (including those disclosed herein) or secured together with a mechanical connector such as asheath252. Generally,sheath252 is disposed atproximal region212 ofcatheter210 and extends around at least a portion of bothtubular members230/232. The form and material composition ofsheath252 may vary. For example,sheath252 may be made from a polymer such as those listed above. In a manner similar to the other disclosed embodiments, secondtubular member232 extends distally beyond firsttubular member230 to definedistal region214. The length of the distal region D can be selected as to discussed above, especially for neurological applications.
• FIG. 9 illustrates anotherexample catheter310.Catheter310 includesproximal region312 anddistal region314. The form ofcatheter310 differs from the other catheters disclosed herein because rather than including multiple tubes,catheter310 is generally formed of a singular, tapered tubular member. The taper defines variable outer diameter proximal anddistal regions312/314.Proximal region312 may have an outer diameter suitable to impart the desired amount of stiffness. By virtue of being narrower,distal region314 may impart the desired distal flexibility characteristics and distal access abilities described above. These and other features can be varied in a number of ways, such as by adding additional structures (such as coils and/or braids as seen inFIG. 3) to vary the flexibility. In some embodiments,distal region314 may ultimately taper so that the inner diameter ofdistal region314 corresponds to about the outer diameter of the microcatheter intended to extend therethrough. This feature can essentially “seal”catheter310 so that contrast media can be essentially prevented from passing throughopening338. Alternatively,distal region314 may remain slightly larger than the microcatheter so that fluid can pass throughopening338.
• Similar to the other disclosed embodiments,catheter310 includesfirst opening340 andsecond opening338 that are separated by a distance D′. Again, separatingopenings340/338 by distance D′ allows contrast media or other substances to be infused throughcatheter310 and into the blood vessel throughopening340 and allows a microcatheter or other media device to be advanced throughopening338. This feature may be desirable, for example, in neurological applications where the vasculature may shift from relatively large vessels to small and/or sensitive vessels at or near the to neurological treatment site.
• As described above,catheter310 may be a singular tubular member. However, this need not be the case. For example,FIG. 10 illustrates anothercatheter410 that is similar tocatheter310 except that it includes a firsttubular member430 and a secondtubular member432. According to this embodiment,proximal portion412 may include bothtubular members430/432 similarly to some of the other embodiments described above.Tubular member430 may terminate at opening440 whereastubular member432 may terminate at opening438 (which are separated a distance D′ in essentially the same manner as shown inFIG. 9). This allowscatheter410 to function in a manner that is substantially similar tocatheter310.
• It should be understood that this disclosure is, in many respects, only illustrative. Changes may be made in details, particularly in matters of shape, size, and arrangement of steps without exceeding the scope of the invention. The invention's scope is, of course, defined in the language in which the appended claims are expressed.

Claims (20)

What is claimed is:

1. A catheter, comprising:

an inner tube having a distal end, an outer surface, and defining an infusion lumen;

an outer tube having a distal end, an inner surface, and defining a catheter lumen; and

wherein the outer surface of the inner tube is bonded to the inner surface of the outer tube; and

wherein the distal end of the inner tube extends distally beyond the distal end of the outer tube.

2. The catheter ofclaim 1, wherein the outer tube includes a tapered outer surface.

3. The catheter ofclaim 1, wherein the inner tube, the outer tube, or both have a plurality of slots formed therein.

4. The catheter ofclaim 1, wherein the inner tube, the outer tube, or both have a reinforcing coil disposed therein.

5. The catheter ofclaim 1, wherein the inner tube, the outer tube, or both have a reinforcing braid disposed therein.

6. The catheter ofclaim 1, wherein the distal end of the inner tube extends 10 centimeters or more distally beyond the distal end of the outer tube.

7. The catheter ofclaim 1, wherein a portion of the inner tube is disposed coaxially within the outer tube.

8. The catheter ofclaim 1, wherein:

a first portion of the inner tube is disposed coaxially within the outer tube; and

a second portion of the inner tube is disposed non-coaxially within the outer tube.

9. The catheter ofclaim 1, further comprising:

a microcatheter extending through the catheter lumen.

10. A hybrid micro guide catheter, comprising:

a catheter tube having an outer surface and a microcatheter lumen;

a microcatheter extending through the microcatheter lumen, the microcatheter being configured to access a neurovascular portion of the anatomy of a patient; and

a contrast media tube having an inner surface; and

wherein the outer surface of the catheter tube is secured to the inner surface of the contrast media tube.

11. The hybrid micro guide catheter ofclaim 10, wherein the contrast media tube includes a tapered outer surface.

12. The hybrid micro guide catheter ofclaim 10, wherein the catheter tube, the contrast media tube, or both have a plurality of slots formed therein.

13. The hybrid micro guide catheter ofclaim 10, wherein the catheter tube, the contrast media tube, or both have a reinforcing coil disposed therein.

14. The hybrid micro guide catheter ofclaim 10, wherein the catheter tube, the contrast media tube, or both have a reinforcing braid disposed therein.

15. The hybrid micro guide catheter ofclaim 10, wherein a distal end of the catheter tube extends 10 centimeters or more distally beyond a distal end of the contrast media tube.

16. The hybrid micro guide catheter ofclaim 10, wherein a portion of the catheter tube is coaxial within the contrast media tube.

17. The hybrid micro guide catheter ofclaim 10, wherein the outer surface of the catheter tube is secured to the inner surface of the contrast media tube with a thermal bond.

18. The hybrid micro guide catheter ofclaim 10, wherein the outer surface of the catheter tube is secured to the inner surface of the contrast media tube with an adhesive bond.

19. The hybrid micro guide catheter ofclaim 10, wherein the outer surface of the catheter tube is secured to the inner surface of the contrast media tube with a mechanical connector.

20. A method for using a catheter including a first tubular member having a proximal end region, a distal end region, and a first lumen extending at least partially therethrough, a second tubular member coupled to the first tubular member, the second tubular member having a proximal end region, a distal end region, and a second lumen extending at least partially therethrough, and wherein the distal end region of the second tubular member extends distally beyond the distal end region of the first tubular member, comprising:

disposing the catheter in a blood vessel so that the distal end region of the second tubular member is disposed adjacent a target region;

infusing contrast media into the blood vessel through the first lumen of the first tubular member; and

advancing a microcatheter through the second lumen of the second tubular member to access a neurovascular portion of the anatomy of a patient.

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