US20230355945A1

Movatterモバイル変換

Info

Publication number: US20230355945A1
Application number: US18/196,290
Authority: US
Inventors: Bradley Beach
Original assignee: Covellus LLC
Current assignee: Covellus LLC
Priority date: 2015-07-02
Filing date: 2023-05-11
Publication date: 2023-11-09
Also published as: US20200171295A1; US11660439B2

Abstract

An adapter for a medical device catheter comprises a proximal portion and a distal portion, and an elongated element extending therebetween. An attachment mechanism is positioned at a proximal portion of the elongated element and comprises an interfacing element configured to be completely received inside a lumen at the distal end of a medical device catheter to attach the proximal portion of the adapter to the medical device catheter.

Description

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No. 16/784,423 filed Feb. 7, 2020 (claiming the benefit of U.S. provisional patent application No. 62/803,208 filed on Feb. 8, 2019), and is a continuation-in-part of U.S. application Ser. No. 16/181,805 filed on Nov. 6, 2018 (claiming the benefit of U.S. provisional patent application No. 62/581,998 filed Nov. 6, 2017), which is a continuation-in-part of U.S. application Ser. No. 15/730,946 filed on Oct. 12, 2017 (claiming the benefit of U.S. provisional patent application Nos. 62/453,669 filed Feb. 2, 2017 and 62/407,557 filed Oct. 13, 2016), which is a continuation-in-part of U.S. application Ser. No. 15/196,952 filed on Jun. 29, 2016 (claiming the benefit of U.S. provisional patent application Nos. 62/325,700 filed Apr. 21, 2016; 62/279,858 filed Jan. 18, 2016; 62/249,482 filed Nov. 2, 2015; and 62/188,363 filed Jul. 2, 2015), the entireties of which applications are hereby incorporated by reference into this application.

BACKGROUND OF THEINVENTION1. Field of the Invention

The present invention relates generally to a design of an adapter for a medical device for use in the body and more specifically to an adapter intended to convert or augment the medical device, for example a catheter, such that the purpose or configuration of the medical device is modified or expanded.

2. Description of the Related Art

Catheter type devices are typically long tubular structures with an inner lumen suitable for a guidewire used to navigate the vasculature, inject contrast or therapeutic materials, aspirate thrombus, or provide a means to deliver other devices or therapies to a target site within the vasculature or other body lumen. Catheter type devices are typically inserted through a small opening in the skin or another opening under visual guidance tracked to the target location within the body. Catheters for minimally invasive procedures are typically one-piece, unitary constructions combining structural, therapeutic and diagnostic elements at the distal end of the catheter.

U.S. Patent Application Publication No. 2007/0244440 discloses a medical device including a catheter with an expandable tip for use with at least two different sizes of wire guides. The catheter includes a wire guide lumen sized to receive a first wire guide of a first diameter. The catheter may also include a tip lumen that extends in a distal direction from a first opening in communication with the wire guide lumen to a second opening. The first opening is sized to receive the first wire guide, and the second opening is sized to receive a second wire guide of a smaller diameter than the first wire guide. The catheter also includes one or more longitudinal expansion features capable of radially expanding the tip lumen to receive a wire guide of a diameter up to the first diameter through the second opening.

U.S. Pat. No. 8,100,884 discloses an adapter assembly for connecting a catheter assembly to a tunneler having a generally tubular body having a first end, a second end and a longitudinal axis extending there through between the first end and the second end. The first end of the adapter is constructed to engage the proximal end of a trocar. The second end of the adapter is constructed to releasably engage at least one catheter lumen. A slider is disposed about the adapter and is longitudinally slidable along the adapter. When the slider is slid towards the second end of the adapter, the slider engages a plurality of legs on the adapter and biases the plurality of legs toward each other and the longitudinal axis of the adapter.

U.S. Pat. No. 8,523,840 discloses coupler assemblies to be used with a catheter to connect a proximal end of the catheter to extracorporeal medical equipment. An exemplary coupler assembly includes a spherical linkage coupler for a catheter. The coupler comprises a first cylinder portion for connecting to a structure, and a second cylinder portion for connecting to a distal end of a body of the catheter. The coupler also comprises a spherical linkage including at least two link arms. Each of the two link arms are connected on one end to the first cylinder portion and on the other end to the second cylinder portion. The two link arms connect a portion of the structure to the distal end of the catheter and enable the structure to move relative to the distal end of the catheter in response to an external force exerted on the structure.

U.S. Pat. Nos. 9,282,991; 9,808,276; 7,976,557; and U.S. Publication No. 2006/0259005 describe variations of a method of delivering a therapeutic agent, such as a drug, using a cutting balloon wherein the cutting or scoring members may comprise the therapeutic agent coated thereon. The cutting or scoring members are integral with the construction of the balloon and catheter system itself.

U.S. Publication No. 2008/0275427 describes a catheter connection system to connect catheter tubes together to form a secure and leak resistant connection. As described the connection system includes a threaded connector inserted into an end of a catheter lumen where an inner portion of the catheter lumen is elastically compliant to conform to the threaded structure of the connector.

It is desirable to provide an improved adapter and modular system designed with features that expand, augment, or modify the configuration or intended use of a medical device. The adapter including geometry, mechanical and/or thermal properties to expeditiously attach to the medical device, such as a catheter.

SUMMARY OF THE INVENTION

This summary is provided to introduce a selection of concepts that are further described below in the detailed description. This summary is not intended to identify key or essential features of the claimed subject matter, nor is it intended to be used as an aid in limiting the scope of the claimed subject matter.

In one aspect, an adapter for a medical device catheter comprises a proximal portion and a distal portion, and an elongated element extending therebetween. An attachment mechanism is positioned at a proximal portion of the elongated element and comprises an interfacing element configured to be completely received inside a lumen at the distal end of a medical device catheter to attach the proximal portion of the adapter to the medical device catheter.

In another aspect, a modular medical device catheter system comprises a parent module and an adapter module. The parent module comprises a proximal end for extending outside the body of a patient and a distal end for being inside the body of the patient, and a lumen at the distal end. The adapter module comprises a proximal portion and a distal portion with an elongated element extending therebetween, and an attachment mechanism positioned at a proximal portion of the elongated element and comprising an interfacing element configured to be completely received inside the lumen at the distal end of the parent module to attach the proximal portion of the adapter to the parent module.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing description, as well as further objects, features, and advantages of the present invention will be understood more completely from the following detailed description of presently preferred, but nonetheless illustrative embodiments in accordance with the present invention, with reference being had to the accompanying drawings, in which:

FIG.1A is a schematic, longitudinal, cross-sectional view of an embodiment of an adapter in accordance with the teachings of the present invention and a partial schematic, longitudinal, cross-sectional view of a distal end of a medical device or parent.

FIG.1B is an enlarged detail view ofFIG.1A, showing a proximal end of the adapter.

FIG.1C is an enlarged detailed view ofFIG.1A, showing part of a distal portion of the adapter.

FIG.2 is a schematic, longitudinal, cross-sectional view of the adapter where the coil of the adapter has been elongated in order to reduce the size of the coil prior to insertion into the target medical device or parent. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.3 is a schematic, longitudinal, cross-sectional view of the adapter where the coil of the adapter has been rotated or twisted in order to reduce the size of the coil prior to insertion into the target medical device. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.4 is a schematic, longitudinal, cross-sectional view of an alternate embodiment of an adapter, and a partial schematic, longitudinal, cross-sectional view of a distal end of a medical device or parent. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.5 is a schematic, longitudinal, cross-sectional view of an alternate embodiment of an adapter, and a partial schematic, longitudinal, cross-sectional view of a distal end of a medical device or parent. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.6 is a schematic, longitudinal, cross-sectional view of an alternate embodiment of an adapter, and a partial schematic, longitudinal, cross-sectional view of a distal end of a medical device or parent. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.7 is a schematic, longitudinal, cross-sectional view of an alternate embodiment of an adapter, where a coil of the adapter has been rotated or twisted in order to reduce the size of the coil prior to insertion into the medical device or parent. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.8A is a schematic, longitudinal, cross-sectional view of an adapter according an embodiment of the invention. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.8B is an enlarged detail view ofFIG.8A, showing a distal portion of the adapter.

FIG.8C is an enlarged detail view ofFIG.8A, showing a proximal end of a distal portion of the adapter.

FIG.8D is an enlarged detail view ofFIG.8A, showing a distal end of a distal portion of the adapter.

FIG.8E is an enlarged detail view ofFIG.8A, showing a proximal portion of the adapter.

FIG.8F is an enlarged detail view ofFIG.8A, showing a proximal end of a proximal portion of the adapter.

FIG.9A is a schematic, longitudinal, cross-sectional view of an adapter according an embodiment of the invention. Break line symbols are utilized to reduce the size of the drawing or schematic for clarity.

FIG.9B is an enlarged detail view ofFIG.9A, showing a distal portion of the adapter.

FIG.9C is an enlarged detail view ofFIG.9A, showing a proximal portion of the adapter.

FIG.9D is an enlarged detail view ofFIG.9A, showing a distal end of a distal portion of the adapter.

FIG.9E is an enlarged detail view ofFIG.9A, showing a proximal end of a distal portion of the adapter.

FIG.9F is an enlarged detail view ofFIG.9A, showing a proximal end of a proximal portion of the adapter.

FIG.9G is an enlarged detail view ofFIG.9A, showing middle elements of a proximal portion of the adapter.

FIG.9H is an enlarged detail view ofFIG.9A, showing a distal end of a proximal portion of the adapter.

FIG.10A is a schematic, longitudinal, cross-sectional view of an adapter according to an embodiment of the invention having two coil elements in a proximal portion of the adapter. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.10B is an enlarged detail view ofFIG.10A, showing a distal portion of the adapter.

FIG.10C is an enlarged detail view ofFIG.10A, showing a proximal portion of the adapter.

FIG.10D is an enlarged detail view ofFIG.10A, showing a proximal end of a proximal portion of the adapter.

FIG.10E is an enlarged detail view ofFIG.10A, showing a distal end of a distal portion of the adapter.

FIG.10F is an enlarged detail view ofFIG.10A, showing the proximal coil element, coil located closer to the proximal end of the proximal portion of an adapter.

FIG.10G is an enlarged detail view ofFIG.10A, showing the distal coil element, coil located closer to the distal end of the proximal portion of an adapter.

FIG.11A is a schematic, longitudinal, cross-sectional view of an adapter according an embodiment of the invention where a distal coil element of the adapter has been rotated or twisted in order to reduce the size of the coil prior to insertion into the target catheter or device. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.11B is an enlarged detail view ofFIG.11A, showing a proximal portion of the adapter.

FIG.11C is an enlarged detail view ofFIG.11A, showing a distal end of a proximal portion of the adapter.

FIG.11D is an enlarged detail view ofFIG.11A, showing a distal end of a proximal portion of the adapter and a proximal end of a distal portion of the adapter.

FIG.12A is a schematic, longitudinal, cross-sectional view of an adapter according to an embodiment of the invention and a partial schematic, longitudinal, cross-sectional view of a distal end of a medical device, where a distal coil element of the adapter has been rotated or twisted in order to reduce the size of the coil prior to insertion into the target medical device and the proximal coil element that has been inserted into the medical device causing the proximal coil element to elongate and reduce in diameter. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.12B is an enlarged detail view ofFIG.12A, showing a proximal portion of the adapter.

FIG.12C is an enlarged detail view ofFIG.12A, showing a proximal end of a proximal portion of the adapter, including a proximal coil element.

FIG.12D is an enlarged detail view ofFIG.12A, showing a distal end of a proximal portion of the adapter and a proximal end of a distal portion of the adapter.

FIG.13A is a schematic, longitudinal, cross-sectional view of an adapter according to an embodiment of the invention and a partial schematic, longitudinal, cross-sectional view of a distal end of a medical device or parent, where a distal coil element of the adapter has been rotated or twisted in order to reduce the size of the coil prior to insertion into the medical device then subsequently released to expand to an inner lumen of the medical device, and a proximal coil element that has been inserted into the medical device causing the proximal coil element to elongate and reduce in diameter. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.13B is an enlarged detail view ofFIG.13A, showing a proximal portion of the adapter.

FIG.13C is an enlarged detail view ofFIG.13A, showing a proximal end of a proximal portion of the adapter, including a proximal coil element.

FIG.13D is an enlarged detail view ofFIG.13A, showing a distal end of a proximal portion of an adapter and a proximal end of a distal portion of the adapter.

FIG.14A is a partial schematic, longitudinal, cross-sectional view of an adapter according to an embodiment of the invention and a partial schematic, longitudinal, cross-sectional view of a distal end of a medical device, where a coil element of the adapter has been rotated or twisted in order to reduce the size of the coil prior to insertion into a medical device then subsequently released to expand to an inner lumen of the medical device, and a transverse cross-sectional view Z-Z of a distal portion of the adapter. Break line symbols are utilized to reduce the size of the schematic for clarity.

FIG.14B is an enlarged detail view ofFIG.14A, showing a proximal end of a distal portion of an adapter.

FIG.14C is an enlarged detail view ofFIG.14A, showing a distal end of a distal portion of the adapter and a transverse cross-sectional view Z-Z of a distal portion of the adapter.

FIG.15A is a partial schematic, longitudinal, cross-sectional view of an adapter according an embodiment of the invention and a partial schematic, longitudinal, cross-sectional view of a distal end of a medical device, where a coil element of the adapter has been rotated or twisted in order to reduce the size of the coil prior to insertion into the medical device then subsequently released to expand to an inner lumen of the medical device and a first and second wire, and a transverse cross-sectional view Z-Z of a distal portion of the adapter. Break line symbols are utilized to reduce the size of the schematic for clarity.

FIG.15B is an enlarged detail view ofFIG.15A, showing a proximal end of a distal portion of the adapter.

FIG.15C is an enlarged detail view ofFIG.15A, showing a distal end of a distal portion of the adapter and a transverse cross-sectional view Z-Z of a distal portion of the adapter.

FIG.16A is a partial schematic, longitudinal, cross-sectional view of an adapter according to an embodiment of the present invention and a partial schematic, longitudinal, cross-sectional view of a distal end of a medical device, where a coil element of the adapter has been rotated or twisted in order to reduce the size of the coil prior to insertion into the medical device then subsequently released to expand to an inner lumen of the medical device, which also includes a first and second wire, and a transverse cross-sectional view Z-Z of a distal portion of the adapter. Break line symbols are utilized to reduce the size of the schematic for clarity.

FIG.16B is an enlarged detail view ofFIG.16A, showing a proximal end of a distal portion of the adapter.

FIG.16C is an enlarged detail view ofFIG.16A, showing a distal end of a distal portion of the adapter and a transverse cross-sectional view Z-Z of a distal portion of the adapter.

FIG.17A is a partial schematic, longitudinal, cross-sectional view of an adapter according to an embodiment of the invention and a partial schematic, longitudinal, cross-sectional view of a distal end of a medical device, where a coil element of the adapter has been rotated or twisted in order to reduce the size of the coil prior to insertion into the target medical device then subsequently released to expand to an inner lumen of the medical device, and a transverse cross-sectional views Z-Z and Y-Y.

FIG.17B is an enlarged detail view ofFIG.17A, showing a proximal end of a distal portion of the adapter.

FIG.17C is an enlarged detail view ofFIG.17A, showing a distal end of a distal portion of the adapter and a transverse cross-sectional views Z-Z and Y-Y.

FIG.18A is a partial schematic, longitudinal, cross-sectional view of a proximal portion of an adapter according to an embodiment of the invention. Break line symbols are utilized to reduce the size of the drawing or schematic for clarity.

FIG.18B is a partial schematic, longitudinal, cross-sectional view of a proximal portion of the adapter shown inFIG.18A, where the adapter and proximal portion has been inserted into a medical device. Break line symbols are utilized to reduce the size of the drawing or schematic for clarity.

FIG.18C is a partial schematic, longitudinal, cross-sectional view of a proximal portion of the adapter shown inFIG.18A, where the adapter and proximal portion has been inserted into a target medical device and a tensile force has been transmitted to a central tube axially compressing a portion of a coil. Break line symbols are utilized to reduce the size of the drawing or schematic for clarity.

FIG.18D is a partial schematic, longitudinal, cross-sectional view of a proximal portion of the adapter, where the adapter and proximal portion has been inserted into a target medical device and a tensile force has been transmitted to a central tube axially compressing a portion of a coil. Break line symbols are utilized to reduce the size of the drawing or schematic for clarity.

FIG.18E is an enlarged detail view ofFIG.18C showing a compressed portion of the coil.

FIG.18F is an enlarged detail view ofFIG.18D showing a compressed portion of the coil.

FIG.19 is a partial schematic, longitudinal, cross-sectional view of a proximal portion of an adapter according to an embodiment of the invention. Break line symbols are utilized to reduce the size of the drawing or schematic for clarity.

FIG.20A is a partial schematic, longitudinal, cross-sectional view of a proximal portion of an adapter according to an embodiment of the invention. Break line symbols are utilized to reduce the size of the drawing or schematic for clarity.

FIG.20B is an enlarged detail view ofFIG.20A.

FIG.21A is a partial schematic, longitudinal, cross-sectional view of an adapter according to an embodiment of the invention, where the adapter has been inserted into a target medical device. Break line symbols are utilized to reduce the size of the drawing or schematic for clarity.

FIG.21B is an enlarged detail view ofFIG.21A.

FIG.22A is a schematic, longitudinal, view of an adapter according to an embodiment of the invention, and includes a schematic representation of a partial portion where the conductors embedded inside the central lumen wall are exposed, and a partial cross-section of the distal portion of the adapter showing the camera module. Break line symbols are utilized to reduce the size of the drawing for clarity

FIG.22B is an enlarged detail view of a portion ofFIG.22A.

FIG.22C is a schematic, longitudinal, view of an adapter according to an embodiment of the invention and includes a schematic representation of a partial portion where the conductors embedded inside the central lumen wall are exposed, and a schematic representation of a distal portion of the adapter including an electrically active element. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.23 is a partial schematic, longitudinal, view of a proximal end of an adapter according to an embodiment of the invention, where the adapter has been inserted into a target medical device.

FIG.24 is a schematic, perspective, view of an adapter according to an embodiment of the invention where the balloon of the adapter is represented as inflated for the purposes of illustration. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.25A is a schematic, longitudinal, view of an adapter according to an embodiment of the invention where the balloon of the adapter is represented as inflated for the purposes of illustration, including a partial cross-section of the distal portion containing the balloon, and partial cross-section of the proximal portion containing the inflation connector. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.25B is an enlarged detail view of a portion ofFIG.25A.

FIG.25C is an enlarged detail view of a portion ofFIG.25B.

FIG.25D is an enlarged detail view of a portion ofFIG.25B.

FIG.25E is an enlarged detail view of a portion ofFIG.25A.

FIG.25F is an enlarged detail view of a portion ofFIG.25E.

FIG.26 is a schematic, perspective, view of an adapter according to an embodiment of the invention, where the balloon of the adapter is represented as inflated for the purposes of illustration, attached to a target balloon medical device which also represented as inflated for the purposes of illustration. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.27 is a partial schematic, perspective, view of an adapter according to an embodiment of the invention, where the balloon of the adapter is represented as inflated for the purposes of illustration, attached to a target balloon medical device which also represented as inflated for the purposes of illustration, with fittings coupled to the proximal ends of both the adapter and target balloon medical device. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.28A is a partial, schematic, longitudinal, view of an adapter according to an embodiment of the invention, where the balloon of the adapter is represented as inflated for the purposes of illustration, attached to a target balloon medical device which also represented as inflated for the purposes of illustration, with fittings coupled to the proximal ends of both the adapter and target balloon medical device, and includes a partial cross-section view of the target balloon medical device and one of the fittings. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.28B is an enlarged detail view of a portion ofFIG.28A.

FIG.29A is a schematic view of an adapter according to an embodiment of the invention, where the adapter includes slender elements running longitudinal from the distal end of the adapter. Break line symbols are utilized to reduce the size of the drawing for clarity. Some adapter elements are obscured by the slender elements.

FIG.29B is a schematic view of an adapter according to an embodiment of the invention represented inFIG.29A, where the slender elements running longitudinal from the distal end of the adapter are omitted to allow the obscured adapter elements to be visible.

FIG.29C is an enlarged detail view of a portion ofFIG.29A, showing a distal end of a distal portion of the adapter.

FIG.29D is a schematic longitudinal orthographic view of an adapter according to an embodiment of the invention, where the adapter includes slender elements running longitudinal from the distal end of the adapter.FIG.29D includes section arrows X-X and Z-Z. Break line symbols are utilized to reduce the size of the drawing for clarity. Some adapter elements are obscured by the slender elements.

FIG.29E is a transverse cross-sectional view X-X of the adapter shown inFIG.29D. View X-X includes a cross section through the slender elements and bonded portion of the slender elements of the adapter.

FIG.29F is a transverse cross-sectional view Z-Z of the adapter shown inFIG.29D. View Z-Z includes a cross section through the central tube and slender elements of the adapter.

FIG.30A is a schematic view of an adapter according to an embodiment of the invention, where the adapter includes slender elements running longitudinal from the distal end of the adapter, and the adapter is attached to a target balloon catheter medical device which is represented as deflated for the purposes of illustration. Break line symbols are utilized to reduce the size of the drawing for clarity. Some adapter elements are obscured by the slender elements.

FIG.30B is a schematic view of an adapter according to an embodiment of the invention, where the adapter includes slender elements running longitudinal from the distal end of the adapter, and the adapter is attached to a target balloon catheter medical device which is represented as inflated for the purposes of illustration. Break line symbols are utilized to reduce the size of the drawing for clarity. Some adapter elements are obscured by the slender elements.

FIG.30C is an enlarged detail view of a portion ofFIG.30B, showing the distal end of the adapter and inflated balloon medical device.

FIG.31A is a schematic longitudinal orthographic view of an adapter according to an embodiment of the invention, where the adapter includes slender elements running longitudinal from the distal end of the adapter. This view is an orthographic projection of the longitudinal orthographic view shown inFIG.31B. Break line symbols are utilized to reduce the size of the drawing for clarity. Some adapter elements are obscured by the slender elements.FIG.31B is a schematic longitudinal orthographic view of an adapter according to an embodiment of the invention, where the adapter includes slender elements running longitudinal from the distal end of the adapter.FIG.31B includes section arrows V-V and W-W indicating cross sections through the slender elements and bonded portion of the slender elements of the adapter at different longitudinal points along the length of the adapter. Break line symbols are utilized to reduce the size of the drawing for clarity. Some adapter elements are obscured by the slender elements.

FIG.31C is an enlarged detail view of a portion ofFIG.31B, showing distal end of the adapter.

FIG.31D is a transverse cross-sectional view V-V of the adapter as shown inFIG.31B. View V-V includes a cross section through the slender elements and bonded portion of the slender elements of the adapter.

FIG.31E is a transverse cross-sectional view W-W of the adapter as shown inFIG.31B. View W-W includes a cross section through the slender elements and bonded portion of the slender elements of the adapter.

FIG.32 is a schematic, perspective, view of an adapter according to an embodiment of the invention, where the interfacing element includes a coil feature.

FIG.33 is a schematic, perspective, view of an adapter according to an embodiment of the invention, where the interfacing element includes a leaf spring feature. The distal portion of the adapter has been truncated to reduce the size of the drawing for clarity.

FIG.34 is a schematic, perspective, view of an adapter according to an embodiment of the invention, where the interfacing element includes a stent strut feature. The distal portion of the adapter has been truncated to reduce the size of the drawing for clarity.

FIG.35 is a schematic, perspective, view of an adapter according to an embodiment of the invention, where the interfacing element includes a left hand and right hand coil features. The distal portion of the adapter has been truncated to reduce the size of the drawing for clarity.

FIG.36 is a schematic, longitudinal orthographic top view, of an adapter according to an embodiment of the invention, where the interfacing element includes a left hand and right hand coil features. The distal portion of the adapter has been truncated to reduce the size of the drawing for clarity.

FIG.37 is a schematic, longitudinal orthographic front view, of an adapter according to an embodiment of the invention, where the interfacing element includes a left hand and right hand coil features. The distal portion of the adapter has been truncated to reduce the size of the drawing for clarity.

FIG.38 is a schematic, longitudinal orthographic front view, of an adapter according to an embodiment of the invention, where the interfacing element includes leaf spring features, and medical device. The adapter is shown being inserted into the distal end of the medical device before the compressible leaf spring elements interface with the lumen of the medical device to compress to a smaller size. The adapter and medical device have been truncated to reduce the size of the drawing for clarity and the medical device is shown in cross-section.

FIG.39 is a schematic, longitudinal orthographic front view, of an adapter according to an embodiment of the invention, where the interfacing element includes leaf spring features, and medical device. The adapter is shown after inserted into the distal end of the medical device after the compressible leaf spring elements interface with the lumen of the medical device to compress to a smaller size. The adapter and medical device have been truncated to reduce the size of the drawing for clarity and the medical device is shown in cross-section.

FIG.40 is a schematic, longitudinal orthographic front view, of an adapter according to an embodiment of the invention, where the interfacing element includes leaf spring features, and medical device. The adapter is shown being inserted into the distal end of the medical device before the compressible leaf spring elements interface with the lumen of the medical device to compress to a smaller size. The medical device is shown with a variable lumen size and the interfacing element engages the lumen and edge created by the change in lumen size. The adapter and medical device have been truncated to reduce the size of the drawing for clarity and the medical device is shown in cross-section.

FIG.41 is a schematic, longitudinal orthographic front view, of an adapter according to an embodiment of the invention, where the interfacing element includes leaf spring features, and medical device. The medical device is shown with a variable lumen size and the interfacing element engages the edge created by the change in lumen size. The medical device adapter also includes a length that extends past the distal end of the medical device lumen. The adapter and medical device have been truncated to reduce the size of the drawing for clarity and the medical device is shown in cross-section.

FIG.42 is partial schematic view of an interfacing element and elongated element embodiment of the invention.

FIG.43A is a schematic, longitudinal view of an adapter according to an embodiment of the invention, and includes a schematic representation of a partial portion with optical fibers embedded inside the central lumen wall of the elongated element, and a transverse cross-sectional view Z-Z of the adapter showing the embedded optic fibers. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.43B is an enlarged detail view of transverse cross-sectional view Z-Z of the adapter ofFIG.43A.

FIG.44 is a partial schematic, longitudinal view of a proximal end of an adapter according to an embodiment of the invention, where the adapter has been inserted into a target medical device.

FIG.45A is a schematic, longitudinal view of an adapter according to an embodiment of the invention, and includes a schematic representation of a partial portion with steering wires within inside the central lumen wall of the elongated element, and a transverse cross-sectional view Z-Z of the adapter showing the steering wires within inside the central lumen wall of the elongated element. Break line symbols are utilized to reduce the size of the drawing for clarity.

FIG.45B is an enlarged detail view of transverse cross-sectional view Z-Z of the adapter ofFIG.45A.

FIG.45C is an enlarged detail schematic, longitudinal view of an adapter ofFIG.45A showing the articulating element of the adapter and associated steering wires.

FIG.46 is a partial schematic, longitudinal view of a proximal end of an adapter according to an embodiment of the invention, where the adapter has been inserted into a target medical device.

DETAILED DESCRIPTION

Reference will now be made in greater detail to various embodiments of the invention, examples of which are illustrated in the accompanying drawings.

In accordance with the present invention, an adapter is constructed to have a proximal portion that interfaces with a medical device and a distal portion that modifies, augments or extends the configuration or intended use of the medical device. As an example, the medical device can be a catheter. The proximal portion of the adapter interfaces with the internal lumen of the medical device in a manner to secure the adapter to the medical device during use. The distal portion of the adapter is generally outside the lumen of the catheter or device and is designed with features that expand, augment, or modify the configuration or intended use of the medical device.

The proximal portion of the adapter is designed to couple, such as through an interference fit, with an internal lumen of the medical device such that during subsequent use the adapter remains secure. The proximal portion is additionally designed to be easily inserted into the internal lumen of medical device. The proximal portion of the adapter includes an attachment mechanism, more completely described below, that provides securement between the adapter and medical device. The adapter and medical device comprise two modules of a modular medical device catheter system. The attachment mechanism allows an adapter module and a medical device module, also referred to as the parent module, to be combined as required by the physician or physician's staff in the operating room during a medical procedure to create a modular medical device catheter. Varying combinations of adapter modules, or adapters and parent modules or parents, allows multiple variants of a medical device catheter to be created. This modular medical device catheter system provides the physician with flexibility benefit to construct a medical device catheter, combining structural, therapeutic and diagnostic elements at the distal end for a specific procedural need and the hospital with inventory benefit, i.e. more medical device catheter variants from fewer inventory items or modules. The medical device or parent module typically has a proximal end that remains outside the body of the patient and a distal end that goes inside the body of the patient. Examples of parent modules include balloon catheters, stent delivery system catheters, transcatheter replacement valves, stent graft delivery catheters, dissection repair catheters, atherectomy catheters, ablation catheters, and thrombectomy catheters.

In one example, the proximal portion of the adapter includes a coil structure having geometry and mechanical/thermal properties such that the structure is slightly smaller than the internal lumen to fit within the internal lumen in the operating room environment temperature and then expands to a larger size to secure the adapter to the internal lumen of the medical device when it is in-vivo closer to body temperature. For example, the coil structure can be formed of nitinol at a predetermined austentic finish (AF) temperature less than body temperature but greater than the temperature typically expected in an operating room or catheter lab. Alternatively, the coil structure can be physically restrained to have a size smaller than the internal lumen in the operating room environment and then expands to interface with the internal lumen of the medical device once the adapter is seated with the medical device and the physical restraint is removed. Alternatively, the coil structure can be configured to compress as it is inserted into the internal lumen of the medical device and provide securement.

The proximal portion can include an internal lumen to preserve a path for a guidewire, or for contrast injection for example. The proximal portion can include a braided structure or slotted tube stent-like geometry which can be compressed to a smaller size and then expanded to secure the adapter to the internal lumen of the catheter or other device.

The distal portion of the adapter can be used to modify the configuration of the medical device, for example, to convert a medical device from a single guidewire device to a two (2) guidewire device.

In another example, the distal portion of the adapter can include one or more slender elements such as wires or fibers that extend proximally from the distal portion along the medical device or parent module. In one example, the adapter is attached to a balloon such that the slender elements external to the balloon create a scoring effect on a target tissue when inflated. In another example, the slender elements are coated or infused with a medical therapy or therapeutic agent, (pharmacological molecule, stem cell, or another therapeutic agent) to deliver the therapy to a body tissue. In another example, the slender elements include receptor sites to collect cells, tissue or molecules for diagnostic purposes.

If the adapter module of a modular medical device catheter includes an internal lumen, additional adapter modules can be added using this internal lumen to further add features, creating an enhanced modular medical device catheter, such as a parent plus a plurality of adapters. The modular arrangement allows a parent and adapter combination to become a parent in a new parent and adapter combination.

FIG.1A,FIG.1B, andFIG.1C illustrates one embodiment ofadapter10 coupled todistal end213 ofmedical device200. An example of a suitablemedical device200 is a catheter.Medical device200 can be referred to as a parent.Adapter10 includesdistal portion20 andproximal portion30.Proximal portion30 is predominately or entirely insidelumen211 of targetmedical device200.Distal portion20 ofadapter10 is predominately outside of targetmedical device200.Adapter10 is co-axial withmedical device200 as shown bylongitudinal axis11.Proximal portion30 ofadapter10 includescoil12. Preferablycoil12 can be made of nitinol.Coil12 can be comprised of wire with a cross-sectional size wound to form a general coil shape.

As an example of an interfacing element,coil12 interfaces withlumen211 ofmedical device200 in a manner that securesadapter10 tomedical device200.Adapter10 can be secured tomedical device200 by an interference fit ofcoil12 withlumen211.Surface220 ofcoil12 can directly engagesurface212 oflumen211.Coil12 can have an austenitic finish temperature (Af) less than body temperature, such as an average of 37° C. of normal body temperature, and greater than a temperature typically expected in an operating room or catheter lab, for example about 25 degrees to about 30degrees C. Coil12 can be twisted and or elongated to reduce a size or diameter ofcoil12 such thatcoil12 has a smaller size or diameter than a size or diameter oflumen211 to facilitatepositioning adapter10 insidemedical device200. Asadapter10 warms to body temperature during use in-vivo,coil12 can expand to provide additional securement tomedical device200.

Alternatively,coil12 can be designed to be physically restrained or constrained to have a size or diameter smaller thaninternal lumen211 ofmedical device200 in an operating room environment andcoil12 can expand to interface with theinternal lumen211 of the target catheter ordevice200 when the physical restraint is removed, once theadapter10 is seated withinmedical device200.Coil12 is shown with a constant round cross-section, alternatively thecoil12 can have a rectangular cross-section of a flat wire coil design. A flat wire design provides the benefit of alower profile coil12 but still provides sufficient securement through an interference fit withlumen211. The cross-section can be variable along the length ofcoil12. Avariable cross-section coil12 design provides the advantage of biased securement towards either one of the ends ofadapter10.Coil12 can have variable flexibility and bending aboutlongitudinal axis11.

In one embodiment,coil12 provides additional reinforcement ofmedical device200 to improve the kink resistance.Adapter10 includestube16, coupled todistal portion20 ofadapter10 and is co-axial withcoil12.Tube16 is an elongated element.Tube16 hasfunnel portion13 located atproximal end30 ofadapter10.Funnel portion13 can facilitate tracking of a guide wire from a proximal end (not shown) ofmedical device200 todistal portion20 ofadapter10.Tube16 preferably is a polymer tube and can include braiding or other reinforcement.Coil12 includesproximal end15 that is coupled, bonded or otherwise attached nearproximal end19 oftube16.Proximal end15 ofcoil12 can be retained to a size smaller than a size oflumen211 to facilitate loading ofadapter10 intomedical device200 in use.Distal end14 ofcoil12 can be retained to a size smaller than a size oflumen211. For example,proximal end15 ordistal end14 can be heat shaped or formed to a smaller size than the size oflumen211.

Distal end

14 provides a location oncoil12 that can be grabbed or held in order to twist and orelongate coil12 to make it smaller in size to facilitate positioning theadapter10 insidemedical device200.Distal portion20 ofadapter10 is preferably made from a thermoplastic elastomer. Example thermoplastic elastomers or soft polymers include but are not limited to, polyether urethane and polyether block amide, such as for example ˜40D PEBAX manufactured by Arkema.

In this embodiment,distal portion20 is designed to modifymedical device200 that has a single guidewire access to have a two guidewire access.Distal portion20 includesfirst lumen21 for a first guidewire andsecond lumen22.Second lumen22 connects to lumen211 ofmedical device200 by way oftube16 ofadapter10. This allows the user extra flexibility, for example to exchange guidewires, or to administer contrast or medications through the target catheter ordevice lumen211. The path of a first guidewire is illustrated byfirst lumen centerline23 and the path of a second guidewire is illustrated by thesecond lumen centerline24. Accordingly, the path oflumen centerline23 is outside ofdevice200.

Distal portion

20 includes reducedsize portion17 atproximal end26 ofdistal portion20 which is designed through choice of materials, for example thermoplastic elastomers or soft polymers, and of a geometry to interface withlumen211 ofmedical device200. A slight interference fit between reducedsize portion17 andlumen211 provides a stable structure during introduction of the coupledadapter10 andmedical device200 into a body cavity or vessel.Adapter10 can include a tapereddistal end27 ofdistal portion20 which facilitates tracking themedical device200 with attachedadapter10 inside a body lumen.

FIG.2 illustratesadapter10 in a configuration wherecoil12 has been reduced to a smaller size by elongatingcoil12.FIG.3 illustratesadapter10 in a configuration where thecoil12 has been reduced to a smaller size by rotating or twistingcoil12. An alternate embodiment ofadapter10 is where a combination ofcoil12 twisting and elongating reduces the size ofcoil10 such that it can fit withinmedical device200. Distance Ds2 betweendistal end14 ofcoil12 andproximal end26 ofdistal portion20 inFIG.2 andFIG.3 is smaller than distance Ds1 betweendistal end14 ofcoil12 andproximal end26 ofdistal portion20 as illustrated inFIG.1C. In an alternate embodiment ofadapter10, if the user twists and or elongatescoil12 such thatdistal end14 ofcoil12 is within a predetermined distance ofproximal end26 ofdistal portion20, then the user would knowadapter10 is safe to insert intomedical device200. For example,tube16 can be marked to indicate the appropriate location ofdistal end14 ofcoil12.

FIG.4 illustrates an alternate embodiment of the present invention shown asadapter40.Adapter40 hasdistal portion41 andproximal portion42 similar todistal portion20 andproximal portion30 ofadapter10 as shown inFIGS.1A,1B and1C.Adapter40 includestube16 withfunnel portion13 located atproximal portion42 ofadapter40.Tube16 is coupled todistal portion41.Coil12 is also coupled todistal portion41 and interfaces withlumen211 ofmedical device200 in a manner that securesadapter40 tomedical device200. Securement can be achieved in a similar manner as previously described foradapter10.

FIG.5 illustrates an alternate embodiment of the present invention shown asadapter50.Adapter50 hasdistal portion51 and proximal portion52 similar todistal portion20 andproximal portion30 ofadapter10 as shown inFIGS.1A,1B and1C.Adapter50 is similar toadapter40, exceptportion53 ofcoil12 that interfaces withlumen211 has a larger pitch than that ofadapter40. For example, the pitch can be in the range of about 2 to about 10 times the size of the coil-sectional size of the wire ofcoil12.Adapter50 also includesproximal end25 ofcoil12 which is similar todistal end14 ofadapter10 in both use and form, exceptcoil12 is elongated and or twisted toward the proximal portion52 ofadapter50 to make the size ofcoil12 smaller to facilitate insertion ofadapter50 intomedical device200.

FIG.6 illustrates an alternate embodiment of the present invention shown asadapter60.Adapter60 hasdistal portion61 andproximal portion62 similar todistal portion20 andproximal portion30 ofadapter10 as shown inFIGS.1A,1B and1C, as well as other similar features.Proximal portion62 includescoil12 which has a reducedsized portion18 such that it gripstube16.Coil12 can be heat shaped or formed with a portion that interfaces withlumen211 ofmedical device200. Reducedsized portion18 has an inside diameter dial smaller than outside diameter dia2 oftube16 to contact andgrip tube16 during use. Reduceddiameter portion18 ofcoil12 can be bonded, glued, or heat reflowed totube16, for example, tofurther couple coil12 toproximal portion62.

FIG.7 illustrates anadapter70 in a configuration wherecoil12 has been reduced to a smaller size by elongating and or twistingcoil12, similarly illustrated inFIG.2 andFIG.3.Adapter70 hasdistal portion71 andproximal portion72 similar todistal portion20 andproximal portion30 ofadapter10 as shown inFIGS.1A,1B and1C.Distal portion71 includessingle lumen tip73, co-axial withlongitudinal axis11.Single lumen tip73 has been reinforced withreinforcement section74. For example,reinforcement section74 can be a coil or braid.Reinforcement section74 includesproximal coil portion75 which extends past the proximal end ofsingle lumen tip73.Proximal coil portion75 provides a slight interference fit withlumen211 and a stable interface during initial insertion ofadapter70 intomedical device200 by the user.Reinforcement section74 reinforcesdistal portion71 and can facilitate trackingmedical device200 through a tight lesion.

FIG.8A,FIG.8B,FIG.8C,FIG.8D,FIG.8E, andFIG.8F illustrate an alternate embodiment of the present invention shown asadapter100.Adapter100 hasdistal portion170 andproximal portion110.Proximal portion110 includescoil130.Coil130 is wound fromwire136 and has multiple diameters along its length. In one embodiment,wire136 is flat with a rectangular or square cross-section. For example,coil130 can have awound length A131 at adiameter øA137 at proximal end ofcoil130. The wound pitch ofwire136 alongwound length A131 is variable, not constant, and changes from a pitch that is approximately twice thewidth162 offlat wire136 at proximal end of thewound length A131, to a pitch that is approximately equal to a width offlat wire136, such thatwire136 is close wrapped at distal end ofwound length A131. A variable pitched wound length has advantages in that the farther spaced pitched coil can be more flexible, and the close wrapped coil can be stiffer and stronger in torsion or bending. A variable pitched wound length also has advantages in that the farther spaced pitched coil can also provide a better bonding geometry such that a bonding agent or adhesive can flow between wraps ofcoil130. Aswire136 is wound distally to formcoil130, the diameter of thecoil130 transitions from asize øA137 to alarger size øB138 overlength transition132.Wire136 is wound overlength B133 at asize øB138. The wound pitch ofwire136 alongwound length B133 is variable, not constant, and changes from a pitch that is approximately equal towidth162 ofwire136, such thatwire136 is close wrapped, to a significantly wider pitch that is approximately more than 5 times the close wrapped pitch. A dramatic or rapid change in pitch from close wrapped to more than 5times width162 offlat wire136 is advantageous because it creates a wedge whencoil130 is constrained withininternal lumen211 ofmedical device200 during use and can improve the interference fit and retention properties ofadapter100 withinmedical device200. Typically,øA137 would be dimensionally smaller thanlumen211 of the targetmedical device200 andøB138 would be dimensionally larger thanlumen211 of themedical device200. Aswire136 is wound distally to formcoil130 the diameter ofcoil130 transitions from asize øB138 to asmaller size øD139 overlength transition134. The wound pitch ofwire136 alongwound length transition134 is approximately uniform.

In an alternate embodiment, the wound pitch ofwire136 alongwound length transition134 is variable.Wire136 is wound distally fromlength transition134 to continue to formcoil130 at asize øD139 over awound length D135. Typically,øD139 would be dimensionally smaller thanlumen211 ofmedical device200. A portion ofwound length D135 ofcoil130 at asize øD139 is within

cavities

178 and177 ofdistal portion170 ofadapter100.Cavity177 is sized to interface with a distal end ofmedical device200 andcavity178 is sized to accommodate thecoil130 at asize øD139.Cavity178 is sized to allowwound length D135 ofcoil130 to move freely withincavity178 when there is not an external mechanism gripping, pinching or clamping proximal end ofdistal portion170 in the area ofcavity178. When there is an external mechanism gripping, pinching or clamping the proximal end ofdistal portion170 in the area ofcavity178,cavity178 is sized to prevent a portion ofcoil130 inwound length D135 from rotating or moving, holdingcoil130, which has been previously rotated/twisted to a smaller size state to facilitate insertion ofproximal portion110 ofadapter100 intomedical device200.

Coil

130 can be made from Nitinol and have an austentic finish temperature (Af) approximately equal to or less than an ambient temperature of the operating room or catheter lab environment socoil130 will expand when released from a smaller size state after insertion intomedical device200. Alternatively,coil130 can be made from Nitinol and have an austenitic finish temperature (Af) less than body temperature but greater than the temperature typically expected in an operating room or catheter lab, for example about 25 C-30 C, except inzone T161 wherecoil130 has been selectively heat treated to have an austentic finish temperature (Af) approximately equal to or less than an ambient temperature operating room or catheter lab environment, for example less than about ˜18 C, to enablezone T161 ofNitinol coil130 to expand when released from a smaller size state after insertion intomedical device200 in the catheter lab environment.Coil130 having multi-zone or variable thermal properties has advantages in that it can be easier to insertadaptor100 intomedical device200 with some ofcoil130 having a higher Af temperature. The selectively heat treated portion ofcoil130 inzone T161 is biased to engageinternal lumen211 ofmedical device200 more than the rest ofcoil130 to facilitate creating the wedge, as described above, aftercoil130 is released from a smaller size state and constrained withininternal lumen211 ofmedical device200. Asadapter100 warms to body temperature during use in-vivo the zone T is161 ofcoil130 provides additional securement and structure toadapter100.Zone T161 as shown includes portion oflength A131,transition132 and portion oflength B133. Alternatively,zone T161 can include just a portion oftransition132 and a portion oflength B133 or other combinations.

Coil

130 is coupled to, bonded to or otherwise attached tocentral tube182 ofcentral lumen183 ofadapter100 at part or all of thewound length A131 atøA137.Proximal end120 ofproximal portion110 ofadapter100 includesinner element122 andouter element121.Inner element122 andouter element121 can form a funnel shape.Outer element121 can be radiopaque or partially radiopaque to provide a landmark forproximal end120 ofadapter100 when used in-vivo. The funnel shape ofproximal end120 of theadapter100 can facilitate the back loading of a guidewire through themedical device200 andadapter100 during use.Proximal end120 ofadapter100 is coupled, bonded or otherwise attached to thecentral tube182. In one embodiment,central tube182 can be unitary withinner element122.

Central tube

182 connects proximal end ofcoil130, in the area ofLength A131 andproximal end120 todistal portion170.Distal portion170 ofadapter100 has anouter body179 that is typically cylindrical or a revolved shape. Alternatively, outer body can have a non-revolved profile in portions or entirely.Outer body179 can be made from a polymer. Outer body can be reinforced with metal, polymer or ceramic fibers, wire, laser cut hypotube and the like.Outer body179 can be a laminated structure which can include multiple tube elements or materials.Outer body179 can have a stepped tapered shape with firstoutside diameter185 and secondoutside diameter184 connected by tapered portions.Distal portion170 hasfirst exit lumen186 ofcentral lumen183 andsecond exit lumen187 ofcentral lumen183 at opposite each other inouter body179.First exit lumen186 is angled at angle A1 towardproximal portion110 ofadapter100 from the central axis ofcentral lumen183. An angle in a direction of angle A1 can be advantageous when a guidewire is tracked throughcentral lumen183 starting atdistal tip181 ofdistal portion170, exiting throughfirst exit lumen186.Second exit lumen187 is angled at angle A2 toward distal end ofadapter100 from the central axis ofcentral lumen183. An angle in a direction of angle A2 can be advantageous when a guidewire is tracked throughcentral lumen183 atproximal end120 ofproximal portion110, exiting throughsecond exit lumen187.Central tube182 terminates proximal todistal tip181 such that a portion ofcentral lumen183 is formed only byouter body179. Alternatively,central tube182 could extend todistal tip181 or terminate at a more proximal location withinouter body179.Central tube182 can formcentral lumen183 for a majority of the length ofdistal portion170 to add strength and rigidity if required, for example ifcentral tube182 was a braided or wire reinforced structure.

In one embodiment,coil130 has been rotated or twisted about the longitudinal axis ofcoil130 andcentral tube182, whilecentral tube182 and a portion ofwound length A131 atøA137 attached tocentral tube182 are held fixed to decrease its size, specifically intransition132,length B133, andtransition134. Aftercoil130 has been rotated or twisted to decrease the size oftransition132,length B133, andtransition134, a portion ofdistal end198 ofcoil130,length D135, which is already at a small diameter, can be held and fixed relative todistal portion170 and coupledcentral tube182 such that thecoil130 will remain at a reduced diameter. When a portion ofdistal end198 ofcoil130,length D135 that was held is released,coil130 will expand back from the small size state to its unconstrained size state and this expansion will tend to happen starting at unattacheddistal end197,length D135 ascoil130 starts to expand/unwind from the distal end and progressively expands/unwinds moving proximal. In one embodiment, ascoil130 progressively expands/unwinds fromdistal end197 to proximal end ofcoil130, distal elements ofcoil130 do not substantially inhibit the expansion and engagement of theportion transition132 andLength B133 tointernal lumen211 ofmedical device200, to facilitate creating the wedge.

FIG.9A,FIG.9B,FIG.9C,FIG.9D,FIG.9E,FIG.9G andFIG.9H illustrate an alternate embodiment of the present invention shown asadapter101.Adapter101 is similar toAdapter100 and hasdistal portion171 andproximal portion111.Proximal portion111 includescoil140 which is similar tocoil130.Coil140 is wound fromwire136 and has multiple diameters along the length ofcoil140.Coil140 as shown has awound length A141 at adiameter øA137 atproximal end157 ofcoil140. The wound pitch ofwire136 alongwound length A141 is variable, not constant, and changes from a pitch that is approximately twice thewidth162 offlat wire136 at the proximal end of thewound length A141, to a pitch that is approximately equal to thewidth162 ofwire136, such thatwire136 is close wrapped at the distal end ofwound length A141. A variable pitched wound length has advantages that the farther spaced pitched coil can be more flexible, and the close wrapped coil can be stiffer and stronger in torsion or bending. A variable pitched wound length can have advantages in that the farther spaced pitched coil can also provide an improved bonding geometry such that a bonding agent or adhesive could flow between wraps ofcoil140. Aswire136 is wound distally to formcoil140, the diameter of thecoil140 transitions from asize øA137 to alarger size øB138 overlength transition160.Wire136 is wound over alength B133 at asize øB138. The wound pitch ofwire136 alongwound length B133 is variable, not constant, and changes from a pitch that is approximately equal towidth162 ofwire136, such thatwire136 is close wrapped, to a significantly wider pitch that is approximately more than 5times width162 of theflat wire136. A dramatic or rapid change in pitch from close wrapped to more than 5 times thewidth162 ofwire136 as shown is advantageous because it creates a wedge whencoil140 is constrained withininternal lumen211 ofmedical device200 during use and can improve the interference fit and retention properties ofadapter101 within the catheter ordevice200. Typically,øA137 would be dimensionally smaller thanlumen211 ofmedical device200 andøB138 would be dimensionally larger thanlumen211 of themedical device200. Aswire136 is wound distally to formcoil140 the diameter ofcoil140 transitions fromsize øB138 to asmaller size øC144 overlength transition142, the wound pitch ofwire136 alongwound length transition142 is substantially uniform. Alternatively, wound pitch ofwire136 alongwound length transition142 is variable.Wire136 is wound distally fromlength transition142 to continue to formcoil140 at asize øC144 overwound length C143.øC144 can be dimensionally similar to or slightly smaller thanlumen211 ofmedical device200 so that ascoil140 was unconstrained from a small size state in use to secureadapter101 tointernal lumen211, woundlength C143 ofcoil140 atsize øC144 would be less likely to inhibitwound length B133 ofcoil140 atsize øB138 from engaging and securingcoil140 tointernal lumen211 ofmedical device200. Aswire136 is wound distally to formcoil140 the diameter ofcoil140 transitions fromsize øC144 to asmaller size øD139 overlength transition146, the wound pitch ofwire136 alongwound length transition146 is substantially uniform. Alternatively, wound pitch ofwire136 alongwound length transition146 is variable.Wire136 is wound distally fromlength transition146 to continue to formcoil140 at asize øD139 overwound length D145. Typically,øD139 would be dimensionally smaller thanlumen211 ofmedical device200. A portion of thewound length D145 ofcoil140 at asize øD139 is within

cavities

178 and177 atproximal end199 ofdistal portion171 ofadapter101.Cavity177 is sized to interface with distal end (not shown) ofmedical device200 andcavity178 is sized to accommodatecoil140 at asize øD139.

Cavity

178 is sized to allowwound length D145 ofcoil140 to move freely withincavity178 when there is not an external mechanism gripping, pinching or clampingproximal end199 ofdistal portion171 in the area ofcavity178. When there is an external mechanism gripping, pinching or clampingproximal end199 ofdistal portion170 in the area ofcavity178,cavity178 sized to prevent a portion ofcoil140 inwound length D145 from rotating or moving, holdingcoil140, which has been previously rotated/twisted to a smaller size state to facilitate insertion ofproximal portion111 ofadapter101 intomedical device200.

Coil

140 is coupled to, bonded to or otherwise attached tosecond tube element190 forming a portion ofsecond lumen191 ofadapter101 at or along part or all of thewound length141 atøA137. It may be advantageous forwound length141 to be attached tosecond tube element190 predominately close to transition160 such that an uncoupled portion ofwound length141 could extend proximally to add more structure and support toadapter101 andmedical device200.Proximal end120 ofadapter101 is attached tosecond tube element190 in a similar manner asproximal end120 ofadapter100 is attached tocentral tube182.

Distal portion

171 ofadapter101 hasouter body179 that is typically cylindrical or a revolved shape. Alternatively,distal portion171 ofadapter101 hasouter body179 that has a non-revolved profile in portions or throughout, similar toouter body179 ofadapter100 shown inFIG.8A.Second tube element190 is attached or coupled toouter body179, thereby connecting proximal end ofcoil140 in the area ofLength A141 andproximal end120 todistal portion171.Distal portion171 hasfirst tube element188 which forms a portion offirst lumen189. As shown,first tube element188 terminates proximal todistal tip181 such that a portion offirst lumen189 is formed only by theouter body179.First tube element188 could extend todistal tip181 or terminate at a more proximal location withinouter body179.Second lumen191 andfirst lumen189 exitouter body179 in a manner similar tosecond exit lumen187 andfirst exit lumen186.Second tube element190 andfirst tube element188 are shown extending to edge230 ofouter body179 ofdistal portion171. Alternatively,second tube element190 andfirst tube element188 can terminate beforeedge230 and such that a portion ofsecond lumen191 andfirst lumen189 can be formed byouter body179 ofdistal portion171.

FIG.10A,FIG.10B,FIG.10C,FIG.10D,FIG.10E,FIG.10F andFIG.10G illustrate an alternate embodiment of the present invention,adapter102.Adapter102 is similar toadapter100 and hasdistal portion172 andproximal portion112.Proximal portion112 includescoil130 located closer todistal portion172 andcoil147 located closer toproximal end123.Coil130 is a left handed helix andcoil147 is a right handed helix.Coil130 has been described as part ofadapter100.Coil147 is similar tocoil130.Coil147 is wound fromwire153 and has multiple diameters along the length of thecoil147.Wire153 can be a flat wire.Coil147 as shown has awound length E148 at a diameter (ø)øE151 at the proximal end ofcoil147. Aswire153 is wound distally to formcoil147 the diameter ofcoil147 transitions from asize øE151 to alarger size øF152 over alength transition149.Wire153 is wound over alength F150 at asize øF152. The wound pitch of153 alongwound length F150 is variable, not constant, and changes from a pitch that is approximately equal to the width ofwire153, such thatwire153 is close wrapped, to a significantly wider pitch that is approximately more than 5 times the width ofwire153. A dramatic or rapid change in pitch from close wrapped to more than 5 times the width ofwire153 is advantageous because it creates a wedge whencoil147 is constrained withininternal lumen211 ofmedical device200 during use and can improve the interference fit and retention properties ofadapter102 withinmedical device200. Typically,øE151 would be dimensionally smaller thanlumen211 ofmedical device200 and theøF152 would be dimensionally larger thanlumen211 ofmedical device200.

Adapter

Coil

147 is attached, bonded or otherwise coupled to the reinforcingtube member194 at all or a portion oflength E148. This could be accomplished using an adhesive to attach a portion oflength E148 to reinforcingtube member194. In a similar manner as previously described, a portion or all of thelength A131 ofcoil130 is bonded or attached to reinforcingtube member194. The inside diameter ofcoil130 at a size oføD139 is typically larger than the outside diameter ofsecond tube element190 orcentral tube182 or reinforcingtube member194.

FIG.11A,FIG.11B,FIG.11C, andFIG.11D, illustrateadapter102 whilecoil130 has been rotated or twisted in a manner that wraps or winds it down to asmaller diameter øB155.Coil130 has been rotated or twisted such thattransition132, woundlength B133 andtransition134 have been made to be held in a state at asmaller diameter øB155 over a combined wound length oftransitions132 andlength B154.Diameter øB155 is approximately equal to or smaller thaninternal lumen211 ofmedical device200 to facilitate insertingadapter102. Temporary constrainingelement195 is positioned around this portion ofcoil130 to securecoil130 atsmaller diameter øB155. Temporary constrainingelement195 is advantageous to allowcoil130 to be held insmaller diameter øB155 without the need to hold or restrain from movinglength D135 section ofcoil130.Length D135 is not attached or coupled to reinforcingtube member194.

FIG.11A,FIG.11B,FIG.11C, andFIG.11D show clampingelement196 pinching or holding a portion ofLength D135 from rotating such that temporary constrainingelement195 can be removed andcoil130 would still be held in a state that includessmaller diameter øB155. It may be advantageous to include a temporary constrainingelement195 such that only temporary constrainingelement195 holdscoil130 in a state at asmaller diameter øB155 in an adapter packaging suitable for terminal sterilization and or shipping, transportation and inventory at the customer site, which would minimize the amount of time the load at the attached portion ofcoil130 inLength A131 would need to be reacted. When the adapter is ready to be used in an operating room or catheter lab, clampingelement196 can be applied and temporary constrainingelement195 can be removed to allow insertion intomedical device200.

FIG.12A,FIG.12B,FIG.12C, andFIG.12D, illustrateadapter102 after it has been initially inserted intomedical device200 whilecoil130 has been rotated or wound down to asmaller diameter øB155 and held in that position by clampingelement196.Coil147 is shown after it has been inserted ininternal lumen211 ofmedical device200. Ascoil147 is inserted the portion oflength F150 andtransition149 as shown inFIG.11A,FIG.11B,FIG.11C, andFIG.11D conforms to the size ofinner lumen211 ofmedical device200 and becomes a smaller diameter ø″159 by elongating and or rotating. Similarly to as described previously, a dramatic or rapid increase in pitch from close wrapped to more than 5 times the close wrap pitch, which is approximately the width ofwire153, as shown, is advantageous because it creates a wedge with anangle A127, equal to or greater than approximately 15 degrees, whencoil147 is constrained withininternal lumen211 ofmedical device200 during use, and can improve the interference fit and retention properties ofadapter100 withinmedical device200. In the embodiment ofadapter102,coil147 is the leading coil inserted intointernal lumen211 ofmedical device200. Ascoil147 is inserted intointernal lumen211, the wraps ofwire153 that are at a size approximately equal tointernal lumen211, located withintransition149 andlength F150, engagesurface212 ofinternal lumen211 and reduce in size by elongating and rotating (predominately elongating) such that the transition andlength F158 is longer than the combination oftransition149 andlength F150, and theentire coil147 can be inserted intomedical device200. This mode of action is different than that ofcoil130.

As shown inFIG.13A,FIG.13B,FIG.13C, andFIG.13D, afteradapter102 is inserted into target device orcatheter200 and clampingelement196 is removed,coil130 will rotate and expand to the size ofinternal lumen211 to engagesurface212 ofinternal lumen211 over a combined wound length oflength B156, which includes portions oftransition132,length B133, andtransition134.Coil130 is designed such that, upon expansion to conform tointernal lumen211 as described, withincoil130 geometry there is a dramatic or rapid increase in pitch from close wrapped to more than 5 times the close wrap pitch, which is approximately the width ofwire136, and which creates a wedge with anangle B163 equal to or greater than approximately 15 degrees. An advantage to the mode of action ofcoil130 versus the mode of action ofcoil147 is that by predominantly rotatingcoil130 to conform to theinternal lumen211 instead of predominately elongatingcoil147 to conform to theinternal lumen211,coil130 will be less likely to have axial re-coil when allowed to expand, and the force to insert adapter is removed.Coil147 can be pulled into thelumen211 ofmedical device200 asadapter102 is inserted intomedical device200 via the bonded connection inLength A131 to reinforcingtube member194. Afteradapter102 has been inserted intomedical device200,coil147 will tend to axially re-coil toward distal end ofadapter102, whereascoil130 rotates into position without an external pulling force. Including both modes of action in one adapter is advantageous because it provides redundancy in case one mode is less effective than the other in retainingadapter102 inmedical device200. Additionally,coil130 andcoil147 are wound in opposite directions such that ifadapter102 is placed under an external torsional load,adapter102 optimally reacts in either direction of an external torsional load.

FIG.14A,FIG.14B, andFIG.14C illustrateadapter103 after it has been inserted intomedical device200, andcoil130 has been deployed to engageinternal lumen211 securingadapter103.Adapter103 includesdistal portion173 andproximal portion113 very similar to the previously describedproximal portion110 andproximal portion111.Distal portion173 ofadapter103 hasouter body179 that is typically cylindrical or a revolved shape. Alternatively,distal portion173 ofadapter103 can have a non-revolved profile in portions or throughout.Outer body179 has a stepped tapered shape with firstoutside profile185, secondoutside profile184 and thirdoutside profile180 connected by tapered portions.Distal portion173 hasfirst tube element188 which forms a portion offirst lumen189.First tube element188 terminates proximal todistal tip181 such that a portion offirst lumen189 is formed only byouter body179.First tube element188 could extend todistal tip181 or terminate at a more proximal location withinouter body179.Second tube element190, which forms a portion ofsecond lumen191, connectscoil element130 ofproximal portion113 todistal portion173.Second lumen191 andfirst lumen189 exitouter body179 in a manner similar tosecond exit lumen187 andfirst exit lumen186.Second tube element190 andfirst tube element188 are shown partially extending to edge230 ofouter body179 ofdistal portion173 where a portion ofsecond tube element190 andfirst tube element188 terminate before230 edge ofouter body179, such that a portion ofsecond lumen191 andfirst lumen189 are formed byouter body179 ofdistal portion173. Third outsideprofile180 ofouter body179 includesfirst cavity166 andsecond cavity169, as shown in longitudinal cross section and transverse cross section Z-Z.First cavity166 andsecond cavity169 are shown as open cavities. Alternatively,first cavity166 andsecond cavity169 can be a closed cavity, such as a circle shaped cavity.First cavity166 andsecond cavity169 are shown to be180 degrees opposite each other. Alternatively,first cavity166 andsecond cavity169 can have alternative orientations.

FIG.15A,FIG.15B, andFIG.15C illustrateadapter103, as shown inFIG.14A,FIG.14B, andFIG.14C with the addition offirst wire167 andsecond wire168. Preferably,first wire167 originates with a first end outside the patient (not shown) and extends distally along the outside ofmedical device200, then throughfirst cavity166 andfirst lumen189, exitingdistal end181 ofdistal portion173 and extends tosecond end231 offirst wire167. Preferably,second wire168 originates with a first end outside the patient (not shown) and extends distally through proximal end (not shown) ofmedical device200 and continues insidelumen211 ofmedical device200, throughsecond lumen191 then wrapping to extend back proximally throughsecond cavity169 extending proximally along the outside ofmedical device200, and extends to second end (not shown) ofsecond wire168. Second end (not shown) ofsecond wire168 can terminate outside the patient body.Adapter103 can be advantageous whenmedical device200 is a percutaneous transluminal angioplasty balloon, for example.First wire167 can act a guide wire to trackmedical device200 which is a percutaneous transluminal angioplasty balloon to the site of an arterial lesion or blockage as well as provide a mechanism to induce a stress concentration into the wall of the artery and lesion, preferentially dissecting or disrupting the lesion to improve dilation performance of the balloon at the target lesion. Second end ofsecond wire168 can extend proximally past the balloon inmedical device200 such thatsecond wire168 also provides a mechanism to induce a stress concentration similar tofirst wire167.Second wire168 can havecurve164. For example,second wire168 can be manufactured from Nitinol and be heat treated to set a shape withcurve164. Alternately,second wire168 can be designed to be readily shaped tocurve164. For example,second wire168 can be manufactured from Nitinol and be heat treated to have an Af temperature such thatsecond wire168 is easily bent tocurve164 and stays in that shape during use, for example at an Af temperature above body temperature (37C).Second wire168 can be positioned intoadapter103 andmedical device200 of a balloon prior to introduction ofadapter103 andmedical device200 into the patient. After the ballooning procedure is completed,second wire168 can be withdrawn from proximal end (not shown) ofmedical device200. Alternatively,second wire168 is tracked throughmedical device200 and positioned in-vivo.

FIG.16A,FIG.16B, andFIG.16C, illustrateadapter104 which is similar toadapter103.Adapter104 includesdistal portion174 which includes thirdoutside profile126 ofouter body179.Second wire125 includesfirst end232 which is coupled or attached toouter body179 at top or edge233 of thirdoutside profile126.Second wire125 extends proximally fromouter body179 anddistal portion174 along the outside ofmedical device200 and extends to second end (not shown) ofsecond wire125. Second end (not shown) ofsecond wire125 can terminate within the artery or body vessel in a loop or fold to minimize any chance of incidental vessel trauma, or extend all the way proximally exiting the patient. As shown in transverse cross section view Z-Z of thirdoutside profile126, there is no cavity in thirdoutside portion126 forfirst wire167.First wire167 alternatively extends distally alongside thirdoutside profile126.

The size of firstoutside profile185, secondoutside profile184, and thirdoutside portion126 generally increase in size from firstoutside profile185 to thirdoutside profile126. However, thirdoutside profile126 has a reducedsize portion165 which is approximately equal in size to secondoutside profile184. This can be advantageous in that there would be room forsecond wire125 to fold back and extend distally asmedical device200 andadapter104 is withdrawn from the artery and patient.

FIG.17A,FIG.17B, andFIG.17C illustrateadapter105 which is similar toadapter101.Adapter105 includesdistal portion175.Distal portion175 hasouter body179 that is typically made from a soft polymer or elastomeric polymer.Distal portion175 incorporatesfirst tube element188 that forms a portion offirst lumen189 inouter body179.First lumen189 exitsouter body179 distally atdistal tip181.First lumen189 is formed partially byfirst tube element188 andouter body179.First lumen189 exitsouter body179 proximally atexit253 which is proximal todistal exit254 ofsecond lumen191 fromouter body179.Second lumen191 is formed partially bysecond tube element190 andouter body179. As shown in section Y-Y,second lumen191 transitions from a closed section as it exitsouter body179.Tube element188 andtube element190 are side by side and overlap forlength251 withinouter body179.First lumens189 andsecond lumen191 overlap for length255. An alternate embodiment ofdistal portion175 includesfirst lumen189 formed entirely byouter body179 withouttube element188.Distal portion179 also includes a hole orpassage252 intocavity178 close todistal end234 ofcavity178.Hole252 can be beneficial to facilitate flushing air out ofcavity178 prior to use.Hole252 can also provide an additional conduit to deliver fluids or contrast throughlumen211 ofmedical device200.

FIG.18A,FIG.18B,FIG.18C,FIG.18D,FIG.18E, andFIG.18F illustrate alternate embodiments ofcoil257 ofproximal portion113 of anadapter105 of the present invention.Coil257 has a variable diameter and pitch. Similar to the other coil embodiments,coil257 has a proximal diameter (ø)øE151 and a larger diameter (ø)øF152 atdistal end270 ofcoil257.Coil257 transitions in diameter fromøE151 toøF152.Coil257 is bonded or otherwise attached tocentral tube263 that forms a portion of a central lumen271 similar tocentral tube182 over alength G258. The unbonded distal portion,Length H1272, ofcoil257 includes a portion at adiameter øE151, a portion atdiameter øF152 and a portion where the diameter transitions between those two diameters. The unbonded distal portion,Length H1272, ofcoil257 is shown with a variable pitch that are not close wrapped, but could include close wrapped pitch. A close wrapped pitch in the unbondeddistal portion272 at the smaller diameter and in the transition to the larger diameter can be advantageous as there can be less axial movement ofcentral tube263 under an axial load after theadapter105 is attached to a targetmedical device200.FIG.18B illustratescoil257 ofproximal portion113 of anadapter105 afteradapter105 has been inserted and seated intomedical device200 withlumen211 as previously described. Ascoil257 is inserted, the unbonded distal portion elongates to alength H2259, such that a portion ofcoil257 forms anangle A127 as previously described.Proximal portion113 also includesproximal end120 and is comprised ofinner element122 that forms a funnel andouter element256.Outer element256 is similar toouter element121 and could be radiopaque or partially radiopaque to provide a landmark for the proximal end of the adapter in-vivo, but is shorter and doesn't fully coverinner element122, and is longitudinally shorter in length thaninner element122.

FIG.18C shows an embodiment ofproximal portion113 andcoil257 such that after inserting and seating into atarget device200 as described and thecentral tube263 is placed under anaxial load F261, the unbonded distal portion,Length H3260, ofcoil257 becomes shorter than thelength H2259 prior to theaxial load F261. Additionally, a portion of the unbonded coil wraps that formed unbonded distal portion length H2 compress together axially under theaxial load F261 and touch each other, effectively completing the wedge formed byangle A127, as illustrated in the enlarged detail viewFIG.18E.

FIG.18D shows yet another embodiment of theproximal portion113 andcoil257 such that after inserting and seating intomedical device200 as described and thecentral tube263 is placed under anaxial load F261, the unbonded distal portion,Length H4262, ofcoil257 becomes shorter than thelength H2259 prior to theaxial load F261. Additionally, a portion of the unbonded coil wraps that formed unbonded distalportion length H2259 compress together axially under theaxial load F261 and touch each other as well as nest inside or invaginate, effectively completing the wedge formed byangle A127, as illustrated in the enlarged detail viewFIG.18F. Nested coil wraps as illustrated inFIG.18D andFIG.18F may be advantageous as it may increase the securement of the adapter.

It could be envisioned that multiple coils similar tocoil257 could be bonded to acentral tube263 in series to createproximal portion113.Proximal portion113 of this design can increase the robustness of the securement of the adapter tomedical device200. A multiple coil configuration of this nature can include both left and right hand coils as previously described to minimize a bias or potential securement issue whencentral tube263 is place under a torsional load.

FIG.19 illustrates an embodiment ofproximal portion114 of an adapter that includes acoil264 similar tocoil257.Coil264 includes all the elements ofcoil257 plus a section ofunbonded length J265 that transitions from alarger diameter øF152 to a smaller diameter that is preferentially smaller than the diameter of theinner lumen211 ofmedical device200, similar to adiameter øE151. A coil design of this nature can be advantageous as it allowsproximal portion114 to be removed frommedical device200.Proximal portion114 can be removed by a user gripping a coil wrap inlength J265 and pulling distally elongating and orrotating coil264, releasing the wedge securement at the inside diameter oflumen211 oftarget device200. For example, if aproximal portion114 were coupled to a distal portion similar to102 to form an adapter, and a portion oflength J265 ofcoil264 extended intocavity178 afterproximal portion114 were inserted and seated intomedical device200, similar tolength D135 as shown inFIG.13D, effectively extending out thedistal end213 ofmedical device200, the user could cutdistal portion102 at a point alongcavity178, effectively separatingdistal portion102 fromproximal portion114 such that the user can grip and pull distally a coil wrap inlength J265, removingproximal portion114 frommedical device200. It is understood that a length ofwire153 or an extension ofwire153 extending out ofmedical device200 is gripped to removeproximal portion114.

FIG.20A andFIG.20B showproximal portion115 withcoil266 that is similar tocoil130.Coil266 includes atransition267 that varies in diameter and pitch.Coil266 also includes alength K268 at adiameter øB138 that is predominately a wider spaced pitch and a variable pitch transition to adiameter øD139. A design similar to this may have an advantage in securement when inserted intomedical device200 as described forcoil130. It is understood that coils constructed similar tocoil130 andcoil266 can alternatively be inserted intomedical device200, similarly tocoil257, and still provide securement after insertion.

FIG.21A andFIG.21B illustrate an alternate embodiment of adistal portion176 ofadapter106.Adapter106 includesdistal portion176.Adapter106 has been inserted intomedical device200.Distal portion176 includes first lumen273,outer body179, andsecond tube element190 forming a portion ofsecond lumen191 ofadapter106. First lumen273 exitsouter body179 proximally atexit253 which is proximal todistal exit254 ofsecond lumen191 fromouter body179.Outer body179 includestaper portion274 to proximally interface and engage withsurface212 of distalinner lumen211 ofmedical device200.Taper portion274 interfaces and engages withmedical device200 and can reduce the overall size or profile ofadapter106.Distal portion176 includes reinforcingcoil275 which spanstransition portion276 betweenmedical device200 anddistal portion176. Reinforcingcoil275 can reduce the chance of themedical device200 oradapter106 kinking at or neartransition276. Reinforcingcoil275 is smaller in size or diameter thaninner lumen211 and is partially attached toouter body179 anddistal portion176.Distal portion176 also includesdistal tip181. When attached to amedical device200, the first lumen273 can be used as a guide for a first guidewire, while thesecond lumen191 can be used to introduce a second guidewire or other accessory into the patient. For example, an accessory with drill bit like features or characteristics that could be used to penetrate the cap of a completely occluded lesion may be advantageous.

FIG.22A,FIG.22B,FIG.22C, andFIG.23 illustrateadapter107.Adapter107 includesdistal portion277, which is similar todistal portion176 as shown inFIG.21A, but includes an embedded or incorporatedcamera module280 inouter body179 and aproximal portion117.Outer body179 is typically made from a polymer or elastomeric polymer.Outer body179 includes a portion with adiameter øB286 that is less than the diameter ofinner lumen211 such that a portion of theouter body179 can fit withininner lumen211.Adapter107 includescentral tube281 that formscentral lumen282, similar totube190 andlumen191 shown inFIG.21A.Central tube281 connectsdistal portion277 andproximal portion117 ofadapter107.Proximal portion117 is similar to the previously described proximal portions and includes acoil283, similar tocoil257 previously described with reference toFIG.18A.Central tube281 includes one or moreelectrical conductors284 embedded inwall285 ofcentral tube281, for illustration purposes a portion ofcentral tube281 is shown with the conductors exposed. For example,electrical conductors284 could be embedded in Polyimide or Polyimide and PEBAX to formcentral tube281.Electrical conductors284 can also run longitudinal along the X axis ofcentral tube281 instead of spiraling as shown. In one embodiment six (6) conductors are shown embedded inwall285 ofcentral tube281 and spiral around the x axis ofcentral tube281 connectingcamera module280 toconnector289 nearproximal end287 ofcentral tube281. It will be appreciated that the numbers of conductors can include those required to supply power tocamera module280 and send signals fromcamera module280 and could be more or less than six. As illustrated inFIG.23,proximal end287 ofcentral tube281 andadapter107 extend outproximal end292 of targetmedical device200. It is common for a proximal end of a medical device to terminate with a luer fitting. As shown,connector289 has six (6)pads293 that individually connect to six (6)conductors284 that spiral alongcentral tube281.Connector289 can be designed such that a cable (not shown) with the appropriate mating connectors can couplecamera module280 to an appropriate viewing device or device that can interpret the electrical signals and interface withcamera module280. Thediameter øC290 ofconnector289 must be smaller than the lumen of the targetmedical device200. Also shown isproximal end291 ofadapter107.Proximal end291 is designed to potentially interface with a syringe for flushing of liquids through thecentral lumen282 and allow access of guidewires or other devices and equipment through thecentral lumen282 as shown inFIGS.22A and22B.Camera module280 incorporates elements that allow visualization both distally throughdistal viewing port279 and in the proximal direction throughproximal viewing port278. In a similar manner as the described with regard tocamera module280 andadapter107, electrically activatedelement294 could be embedded, incorporated or attached todistal portion277 ofadapter107. Electrically activated elements can be, for example, sensors or transducers.Connector289 andconductors284 electrically connectdistal portion277 ofadapter107 to the outside of the patient, proximal to the medical device, orparent200. For example, electrically activatedelement294 can be one or more electrically activated elements including a sensor or transducer. For example, electrically activatedelement294 can be an IntraVascular UltraSound (IVUS) sensor/transducer, Optical Coherence Tomography (OCT) sensor/transducer, pressure transducer, flow transducer, or other imaging or sensor technology could be attached and electrically coupled to a suitable interface device as described. An electrically activatedelement294 that incorporates advanced imaging technology such as IVUS, would be advantageous when used with a stent delivery system catheter or similar as theparent module200 for targeted treatment of vessel dissections. Therapeutic ablation electrodes are another electrically activatedelement294 that could be used to create modular catheter solutions to treat a range of clinical conditions, including conditions of irregular heartbeat or denervation arterial tissue. Other ultrasonic or lithotripsy transducers could be incorporated into electrically activatedelements294 to create modular catheter solutions treating calcium deposits in the body. In an alternate embodiment, theconductors284 could exit theouter body179 and alternatively extend proximally along the outside of theparent module200 to a position proximal to the body of the patient such that a proximal electrical connector could interface with electrical components or equipment outside the patient body. This would bypass at least some of thewall285 ofcentral tube281.

FIGS.24,25A,25B,25C, and25D illustrateadapter108.Adapter108 includesdistal portion310 andproximal portion118.Adapter108 includescentral tube315 that is co-axial withinside tube322 whereinside tube322 formscentral lumen326 as shown inFIG.25B, similar totube190 andlumen191 as shown inFIG.21A. Referring toFIG.24,central tube315 connectsdistal portion310 andproximal portion118 ofadapter108.Proximal portion118 is similar to the previously described proximal portions and includescoil313, similar to coils previously described, bonded, coupled or otherwise attached tocentral tube315.Distal portion310 ofadapter108 includesballoon assembly311.Balloon assembly311 includesballoon312 coupled tocentral tube315 and insidetube322 throughpolymer body316 atproximal end320 ofballoon312 andpolymer tip330 atdistal end181 ofadapter108.Polymer body316 extends proximally fromballoon312 and includeschannel317 that runs longitudinally along the length ofpolymer body316.Polymer body316,balloon312, andcentral tube315 are coupled, bonded or otherwise attached together to create sealedballoon assembly311 atproximal end320.Distal end339 ofballoon312 is similarly coupled, bonded or otherwise attached toinside tube322 throughdistal tip330. In this embodiment,central tube315 terminates proximally toinside tube322, and end337 ofcentral tube315 can be plugged byseal element329.Seal element329 being bonded, coupled or attached to outside surface ofinside tube322.Seal element329 could also be unitary withproximal end338 ofpolymer body316, for pluggingend337 ofcentral tube315. In an alternate embodiment,central tube315 can extend to distal end ofballoon312 such thatdistal tip330 also plugs and seals end337 ofcentral tube315. In this alternate embodiment, polymer body could extend distally and be unitary or joined withdistal tip330.Space327 betweenoutside surface351 ofinside tube322 and insidesurface352 ofcentral tube315 is a conduit to pressurizeballoon312.Space327 can form a lumen.Space327 runs betweenballoon312 andconnector assembly314. Water, saline or other fluid/gas can be injected intospace327 atconnector assembly314 to pressurizeballoon312 throughopening328 incentral tube315 andpolymer body316. In an alternate embodiment,polymer body316 is optional or terminates proximal to opening328 incentral tube315 which allows the pressurizing media intoballoon312.Connector assembly314 near proximal end of theadapter108 is comprised ofouter member323 with adistal end325 and aproximal end324. Insidetube322 runs coaxial toouter member323 and along the entire length ofouter member323.Distal end325 andproximal end324 seal the ends ofouter member323. Insidetube322 is shown terminating distal to theproximal edge344 ofproximal end324. Alternately, insidetube322 can extend to or beyondproximal edge344 ofproximal end324.Space327 to inject the pressurizing media intoballoon312 connects to space345 between outside surface ofinside tube322 and inside surface ofouter member323. Opening318 inouter member323 allows the pressurizing media to be injected intospace345, which is connected tospace327, which is in turn connected to inside ofballoon312, allowingballoon312 to be inflated.Space345 can be a lumen. In one embodiment,outer member323 of connector assembly is metallic, such as stainless steel, wheredistal end325 andproximal end324 are polymers. Alternatively,outer member323 and ends324 and325 could be of unitary construction, for example made of a polymer such as PEEK. The cross-sectional view illustratescentral axis347 ofadapter108.

FIG.26 illustratesadapter108 afteradapter108 has been attached to targetmedical device200 that hascentral lumen211. For the purposes of illustration,FIG.26 illustratesadapter108 attached toballoon catheter201 ofmedical device200.Balloon catheter201 is comprised ofballoon214,tubular member218 that makes up the bulk length ofballoon catheter201, andfitting assembly215.Fitting assembly215 includesport216 that connects tocentral lumen211 intubular member218, andport217 that connects an inflation lumen (not shown) intubular member218 toballoon214.Fitting assembly215 can be composed of a plastic or polymer with

ports

217 and216 terminated with a luer fitting for connection to a syringe or inflation device.FIG.26 showsadapter108 attached toballoon catheter201 such that there isgap321 betweendistal end319 ofballoon catheter201 andproximal end320 ofballoon312. In this illustration,polymer body316 withchannel317 extends fromballoon312 intodistal end319 ofcentral lumen211 ofballoon catheter201, spanning thegap321.Channel317 is connected tocentral lumen211, which is connected toport216.Adapter108 extends all the way throughballoon catheter201 such thatopening318 ofconnector assembly314 is beyond proximal end219 ofballoon catheter port216.

FIGS.27,28A and28B illustrateadapter108 attached toballoon catheter201 as shown inFIG.26, along with fitting340 coupled toport216 and fitting331 coupled toconnector assembly314. Fitting340 includesport341 to couple toport216 of fitting assembly215 (Y-fitting) ofballoon catheter201. In one embodiment,port341 can be a male luer fitting that is compatible withfemale luer fitting216. Fitting340 also includes sealingmechanisms343 atproximal end342 of fitting340.Sealing mechanism343 can be a Tuohy borst valve or hemostasis valve, O-ring, or other seal. Fitting340 also includes a side port such that fluids can be introduced to the space (lumen)346 between the outside surface ofcentral tube315 andlumen211. Fitting340 can be available valve assemblies, such as a standard Hemostasis valve with locking seal described in U.S. Pat. No. 5,591,137. Fitting331 includesside port333 withdistal sealing mechanism336 andproximal sealing mechanism335 on either side ofside port333.

Sealing mechanisms

335 and336 seal onouter member323, effectively isolatingopening318. Once opening318 is isolated,side port333 can be used to pressurize theballoon312 viaopening318,space345,space327 andopening328.

Sealing mechanisms

335 and336 can be O-rings, hemostasis valves, Tuohy borst valves or other seals. Fitting331 also includesend port332 that connects to lumen326 ofinside tube322. As shown, fitting331 is an assembly of two (2) seals,end port332,side port333, andend cap334 to holdseal336 in place. Fitting331 in one embodiment can be manufactured from three (3) molded plastic components bonded, coupled or joined together holding

sealing mechanism

336 and335 in place.Adapter108 effectively partitions lumen211 ofmedical device200, shown asballoon catheter201 into three lumens,346,326, and327.Sealing mechanism343 of fitting340 is shown sealing aroundcentral tube315. Alternatively,sealing mechanism343 can seal aroundouter member323 ofconnector assembly314.

FIGS.29A,29B,29C,29D,29E and29F illustrate anadapter360 prior to being attached toballoon catheter201.FIG.29A illustratesadapter360 which includes a plurality ofslender elements364 that extend proximally from theouter body363 of thedistal portion361 past theproximal end120 ofproximal portion362 ofadapter360.Slender elements364 obscure some of the elements ofadapter360. Accordingly, for clarity,FIG.29B shows a view wherein theslender elements364 are omitted, and illustrates the obscured elements not shown or visible inFIG.29A.FIG.29B shows theproximal portion362 which includes a righthanded coil370, similar tocoil257 previously described with reference toFIG.18A, and a lefthanded coil371 also similar tocoil257 previously described with reference toFIG.18A.

Coils

370 and371 are bonded or attached tocentral tube365.Adapter360 includescentral tube365 that formscentral lumen366, similar totube190 andlumen191 shown inFIG.21A.Outer body363 is typically made from a polymer or elastomeric polymer, but may be manufactured from metallic elements or include metallic elements, such as a stainless steel braid, nitinol coil or similar material.Outer body363 includes aportion372 with a diameter that is less than the diameter ofinner lumen211 ofmedical device201 such that a portion of theouter body179 can fit withininner lumen211.Proximal portion362 also includes aproximal end120.Distal portion361 also includes adistal tip181.Slender elements364 may be fibers or wires manufactured from metals such as stainless steel or Nitinol, or manufactured from a polymer such as PEEK or PVDF or other suitable material.Slender elements364 may be a single constituent or a composite structure. As non-limiting examples, theslender elements364 may include features or characteristics that improve scoring of the target artery or lesion, may include texture or features such as a reservoir for delivering a therapeutic agent, or may include receptors for gathering tissue, cells or other molecules for diagnostic purposes.

FIGS.29D,29E and29F illustrate the cross section ofadapter360 to better illustrate theslender elements364 and thecentral tube365, withcoil370 omitted for clarity. The cross section views show an example of thirty (30) individualslender elements364 attached toouter body363 and that traverse past theproximal portion362 ofadapter360.Slender elements364 are shown in acircular pattern368 and unconnected to each other except at theouter body363 of thedistal portion361 and in thespiral bond portion369. In thespiral bond portion369, the side by sideslender elements364 may be welded, fused, bonded, glued or attached in a spiral configuration as shown, or other suitable organized configuration. As shown in cross section X-X ofFIG.29E, at any given cross section in thespiral bond portion369, three (3) of the side by sideslender elements364 are bonded together by abonding element367.Bonding element367 can be a composed of a different material than theslender element364 or the same material as theslender element364 as in a welded or fused junction or joint. Thespiral bond portion369 is shown progressing twice around and with a constant pitch. Thespiral bond portion369 could include a plurality of turns and a variable or constant pitch.Adapter360 could also include a plurality ofspiral bond portions369. The cross section of theslender elements364 are shown circular but could also be other shapes, for example a triangular shape may be advantageous when scoring a lesion or artery. Additionally, theslender elements364 may form acircular pattern368 as shown or a non-circular pattern, and any number ofslender elements364 may be bonded together to form a suitably stable arrangement facilitating the joining of theadapter360 with aballoon catheter201, as illustrated inFIGS.30A,30B and30C for example.

FIGS.30A,30B and30C illustrateadapter360 attached toballoon catheter201. As shown inFIG.30A, theballoon214 is not inflated, which would be the case whilemedical device200 andadapter360 would be tracked to and from the inflation site by the user. The parent module or medical device module, such as theballoon catheter201, is a physically separate module from theadapter360, and only theadapter360 is physically integrated withslender elements364 through attachment toouter body363 ofadapter360 as described previously. When the parent module is attached to theadapter360 of an adapter module, at least a portion of the parent module will reside inside and underneath a circumference defined by theslender elements364, and such thatslender elements364 are presented on the outside of the assembled parent andadapter360 module. In an example where the parent module or medical device module is aballoon catheter201, once connected toadapter360, theballoon214 is placed underneath or inside a circumference defined by theslender elements364, and while aninner lumen211 ofballoon214 will be coupled toadapter360 such as via

coils

370,371 or other mechanisms as described previously, the balloon's outer surface will not be physically joined or otherwise directly integrated with theslender elements364, though the elements may or may not be in physical contact or communication with the outer surface when theballoon214 is in a deflated state. This enables, as shown inFIGS.30B and30C, theslender elements364 to flexibly and freely separate and space apart from each other equidistantly around the outer surface ofballoon214 when it is inflated, through the action of the outer surface ofballoon214 radially pushing against theslender elements364 equally in all directions. In another example, depending on the number and positioning of theslender elements364, one or more of theslender elements364 may flexibly but unevenly distribute around the outer surface ofballoon214 when it is inflated. Either configuration may have utility depending on the type of tissue scoring or cutting desired.

FIGS.31A,31B,31C,31D, and31E illustrate anadapter380 prior to being attached toballoon catheter201.Adapter380 is similar toadapter360 which includesdistal portion381, similar todistal portion361, and proximal portion362 (obscured/not shown) which is the same proximal portion ofadapter360. As shown inFIGS.31A and31B,adapter380 includes a plurality ofslender elements382 that extend proximally from theouter body363 of thedistal portion381 past theproximal end120 ofproximal portion362 ofadapter380.Slender elements382 obscure some of the elements ofadapter380, and in this example comprise a rectangular cross-sectional geometry as opposed to the circular geometry ofslender elements364. For example, this rectangular cross-sectional geometry may further facilitate the cutting or scoring of target tissue. It may be appreciated that other cross-sectional geometries, including triangular, etc. are possible.

As shown in the orthographic views ofFIGS.31A,31B and31C and cross sections V-V and W-W ofFIGS.31D and31E,slender elements382 are attached to each other by a plurality ofbonding elements367. As shown inFIGS.31D and31E, theslender elements382 are attached to each other by bondingelements367 in abond pattern384 around theadapter380. As shown inFIGS.31A,31B, and31C, abond pattern384 ofbonding elements367 connecting or attachingslender elements382 around theadapter380 occurs at different points along the length of theadapter380. As shown, thebond pattern384 alternates along the length of theadapter380 which encourages theslender elements382 to remain approximately evenly disposed around the balloon as the balloon is inflated, i.e. not gathered on one side of the balloon, similar to as shown inFIG.30C.

As shown inFIGS.31A and31B, theslender elements382 extend proximally from theouter body363 in lengths that create a gradual reduction in the number ofslender elements382 extending proximally. Two pairs of orthogonalslender elements382 extend completely proximal, such that they would extend out of the patient body. As shown, aslender element382 extension stops at abonding element367. This eliminates free proximal edges of theslender elements382, which could inhibit withdrawing the targetmedical device catheter201 and attachedadapter380 from the patient body. In the illustrative embodiment ofFIGS.31A,31B,31C,31D, and31E, there are shown an example of sixteen (16)slender elements382 disposed around thecentral tube365 of theadapter380. As shown inFIG.31E, every otherslender element382 is attached to a neighboringslender element382 by abonding element367, for a total of eight (8) bond joints for a full complement of slender elements to create abond pattern384. The longitudinallyadjacent bond pattern384 ofbonding elements367, or bond joints, have an alternating pattern of side by sideslender element382 connections or bonds viabonding element367 around theadapter380.

In the longitudinal position along the adapter as depicted inFIG.31D, Section V-V, there is shown an example of eight (8)slender elements382 attached in pairs by four (4)bonding elements367. However, any suitable number of bonds is envisioned to optimize the functionality ofadapter380 with aballoon catheter201 such thatslender elements382 are sufficiently stable and organized during use. In alternate embodiments, the

slender elements

360,382 could be replaced by a mesh structure or weave/braid of fibers. The described

slender element

360,382

bonding element

367 configuration could includevaried bond patterns384 organized along the length of theadapter380.

FIG.32 show anadapter390 similar to previous adapters, with adistal portion399 andproximal portion400.Proximal portion400 includes a central tube, orelongated element398, and aninterfacing coil element395.Interfacing coil element395 includes a length ofcoil element396 that is coupled to, bonded to otherwise attached tocentral tube398, and a length ofcoil element397 that is not attached or free from thecentral tube398. The length ofcoil element397 not attached to thecentral tube398 or characterized as free is positioned distal to the length ofcoil element396 attached tocentral tube398. Thecentral tube398 has aproximal end394 and connects the interfacingcoil element395 to thedistal portion399. The length ofcoil element397 that is not attached to or free from thecentral tube398 compresses to a smaller size as it is inserted into adistal end213 of themedical device200

internal lumen

211. A portion of the length ofcoil element397 that is not attached to or free from thecentral tube398 engages or interfaces aninner lumen211 of themedical device module200 to secure theadapter390 to adistal end213 of amedical device module200

inner lumen

211.

FIG.33 show anadapter391 similar to previous adapters, with adistal portion399 andproximal portion401.Proximal portion401 includes a central tube, orelongated element398, and an interfacingleaf spring element405. Interfacingleaf spring element405 includes a length ofleaf spring element406 that is coupled to, bonded to otherwise attached tocentral tube398, and a length ofleaf spring element407 that is not attached or free from thecentral tube398. The length ofleaf spring element407 not attached to thecentral tube398 or characterized as free is positioned distal to the length ofleaf spring element406 attached tocentral tube398. Thecentral tube398 has aproximal end394 and connects the interfacingleaf spring element405 to thedistal portion399. The length ofleaf spring element407 that is not attached to or free from thecentral tube398 compresses to a smaller size as it is inserted into adistal end213 of themedical device200

internal lumen

211. A portion of the length ofleaf spring element407 that is not attached to or free from thecentral tube398 engages or interfaces with aninner lumen211 of themedical device200 to secure theadapter391 at thedistal end213 of amedical device200

inner lumen

213. Interfacingleaf spring element405, includes a plurality of leaf spring features408. The length ofleaf spring element406 that is coupled to, bonded to otherwise attached tocentral tube398 is shown as a solid tube, this length could also include perforations, slots, a coil length, likeelement395, or other features to facilitate attaching to thecentral tube398.

In an alternate configuration, the interfacing element can be formed integral with the elongated element, for example, such that the interfacing element comprises the same material as the elongated element and is created therefrom, as shown for example inFIG.42. As shown inFIG.42,elongated element377 includes integral leafspring interfacing elements378.Elongated element377 can be a tube.

FIG.34 show anadapter392 similar to previous adapters, with adistal portion399 andproximal portion402.Proximal portion402 includes a central tube, orelongated element398, and an interfacingstent strut element410. Interfacingstent strut element410 includes a length ofstent strut element411 that is coupled to, bonded to otherwise attached tocentral tube398, and a length ofstent strut element412 that is not attached or free from thecentral tube398. The length ofstent strut element412 not attached to thecentral tube398 or characterized as free is positioned distal to the length ofstent strut element411 attached tocentral tube398. Thecentral tube398 has aproximal end394 and connects the interfacingstent strut element410 to thedistal portion399. The length ofstent strut element412 that is not attached to or free from thecentral tube398 compresses to a smaller size as it is inserted into adistal end213 of themedical device200

internal lumen

211. A portion of the length ofstent strut element412 that is not attached to or free from thecentral tube398 engages or interfaces with aninner lumen211 of themedical device200 to secure theadapter392 to adistal end213 of amedical device200

inner lumen

211. Interfacingstent strut element410, includes a plurality of stent strut features413 and connectingfeatures414 connecting to the length ofstent strut element412. Connecting feature can be like the leaf spring features408 ofadapter391.

FIGS.35,36 and37 show anadapter393 similar to previous adapters, with adistal portion399 andproximal portion403.Proximal portion403 includes a central tube, orelongated element398, and aninterfacing coil element415.Interfacing coil element415 includes a length ofcoil element416 that is coupled to, bonded to otherwise attached tocentral tube398, and a length ofcoil element417 that is not attached or free from thecentral tube398. The length ofcoil element417 not attached to thecentral tube398 or characterized as free is positioned distal to the length ofcoil element416 attached tocentral tube398. Thecentral tube398 has aproximal end394 and connects or couples the interfacingcoil element415 to thedistal portion399. The length ofcoil element417 that is not attached to or free from thecentral tube398 compresses to a smaller size as it is inserted into adistal end213 of amedical device200

internal lumen

211. A portion of the length ofcoil element417 that is not attached to or free from thecentral tube398 engages or interfaces with aninner lumen211 of themedical device200 to secure theadapter393 to adistal end213 of amedical device200

inner lumen

211. The length ofcoil element417, includesleft hand coil418 andright hand coil419 to form a bidirectional coil feature.

FIG.38 showsadapter391 as it is being inserted into adistal end213 of amedical device200

internal lumen

211. As shown, leaf spring features408 have not been compressed.

FIG.39 showsadapter391 after it has been inserted into adistal end213 of amedical device200

internal lumen

211. As shown, leaf spring features408 have been compressed and a portion of the length ofleaf spring element407 engages thelumen211.

Similar toFIG.39,FIG.40 showsadapter391 after it has been inserted into adistal end213 of amedical device200

internal lumen

211. As shown, leaf spring features408 have been compressed and a portion of the length ofleaf spring element407 that engages thelumen211. In the case ofFIG.401 alumen211 ofmedical device200 has multiple and variable sizes, “2”387 and “1”386. Theleaf spring feature408 engages anedge389 created at the change in size of thelumen211. Lumen size “2”387 is larger than lumen size “1”386.

FIG.41 is similar toFIG.39, also showingadapter391, howeverinternal lumen211 has a third size “3”388 which is larger than the expanded size of the length ofleaf spring element407. Theleaf spring feature408 engages anedge389 created at the change in size of thelumen211. Lumen size “3”388 is larger than lumen size “2”387. Lumen size “2”387 is smaller than the expanded size of the length ofleaf spring element407. The expanded size of the length ofleaf spring element407 is compressed to engage aninner lumen211. As shown inFIG.41, aportion376 of themedical device200 extends past adistal end213 of amedical device200

internal lumen

211.

FIG.43A,FIG.43B, andFIG.44 illustrate an example ofadapter420.Adapter420 includesdistal portion421, which includes embedded or incorporated opticallyactive elements423 inouter body179 and aproximal portion422.Outer body179 is typically made from a polymer or elastomeric polymer.Outer body179 includes a portion with adiameter øB429 that is less than the diameter ofinner lumen211 such that a portion of theouter body179 can fit withininner lumen211.Adapter420 includescentral tube424 that formscentral lumen425, similar totube190 andlumen191 shown inFIG.21A.Central tube424 connectsdistal portion421 andproximal portion422 ofadapter420.Proximal portion422 is similar to the previously described proximal portions and includes acoil426, similar tocoil257 previously described with reference toFIG.18A.Central tube424 includes one or moreoptical fibers427 embedded inwall428 ofcentral tube424.FIG.43B, which is a transverse cross-sectional view ofadapter420, illustrates theoptical fibers427 embedded inwall428 ofcentral tube424. For example,optical fibers427 could be embedded in Polyimide or Polyimide and PEBAX to formcentral tube424. In one embodiment, four (4)optical fibers427 are shown embedded inwall428 ofcentral tube424 connectingoptical element423 tooptical connector431 nearproximal end430 ofcentral tube424. It will be appreciated that the numbers of optical fibers can include those required foroptical element423 and could be more or less than four. As illustrated inFIG.44,proximal end430 ofcentral tube424 andadapter420 extend outproximal end292 of targetmedical device200. It is common for a proximal end of a medical device to terminate with a luer fitting.Optical connector431 can be designed such that an interface (not shown) with the appropriate mating elements can coupleoptical element423 to an appropriate device that can interpret or transmit the optical signal or wavelengths. Optically active elements can be, for example, sensors, transducers, optics to direct light, elements to transmit laser light, etc.Connector431 andoptical fibers427 optically connectdistal portion421 ofadapter420 to the outside of the patient, proximal to the medical device, orparent200. An optically activatedelement423 that incorporates advanced imaging technology, would be advantageous when used with a stent delivery system catheter or similar as theparent module200 for targeted treatment of vessel dissections. Therapeutic laser ablation is another area that could utilize optically activatedelement423 to create modular catheter solutions to treat a range of clinical conditions. In an alternate embodiment, theoptical fibers427 could exit theouter body179 and alternatively extend proximally along the outside of theparent module200 to a position proximal to the body of the patient such that a proximal optical connector could interface with the optical equipment outside the patient body. This would bypass at least some of thewall428 ofcentral tube424.

FIG.45A,FIG.45B,FIG.45C, andFIG.46 illustrate an example ofadapter440.Adapter440 includesdistal portion441, which includes articulating orsteerable elements443 inouter body179 and aproximal portion442.Outer body179 is typically made from a polymer or elastomeric polymer.Outer body179 includes a portion with adiameter øB449 that is less than the diameter ofinner lumen211 such that a portion of theouter body179 can fit withininner lumen211.Adapter440 includescentral tube444 that formscentral lumen445, similar totube190 andlumen191 shown inFIG.21A.Central tube444 connectsdistal portion441 andproximal portion442 ofadapter440.Proximal portion442 is similar to the previously described proximal portions and includes acoil446, similar tocoil257 previously described with reference toFIG.18A.Central tube444 includes one ormore steering wires447, housed in thelumen452 inwall448 ofcentral tube444.FIG.45B, which is a transverse cross-sectional view ofadapter440, illustrates thesteering wires447 running throughlumen452 inwall448 ofcentral tube444. For example, steeringwires447 could extend through alumen452 within a Polyimide or Polyimide andPEBAX wall448 to formcentral tube444. In one embodiment two (2)steering wires447 are shown withinlumen452 ofwall448 ofcentral tube444 connecting steerable or articulatingelements443 toproximal end451 of steeringwires447 nearproximal end450 ofcentral tube444. It will be appreciated that the number ofsteering wires447 can include those required for steerable or articulatingelements443 and could be more or less than two. As illustrated inFIG.46,proximal end450 ofcentral tube444 andadapter440 extend outproximal end292 of targetmedical device200. It is common for a proximal end of a medical device to terminate with a luer fitting.Proximal end451 of steeringwires427 can be designed such that an interface (not shown) with the appropriate mating elements can couple steeringwires447 to an appropriate device that can transmit steering movements to steerable or articulatingelements443 at thedistal portion441. Steerable or articulatingelements443 can include, for example,slots453 that enable the steerable or articulatingelement443 to bend as thesteering wires447 are put under tension at theproximal end451 by the interface, not shown. It is appreciated that thesteering wires447 can move freely through lumens, not shown, in theouter body179.Steering wires447 mechanically connectdistal portion441 ofadapter440 to the outside of the patient, proximal to the medical device, orparent module200. A steerable or articulatingelement443 would be advantageous when used to guide a catheter orsimilar parent module200 through tortuous anatomy. In an alternate embodiment, thesteering wires447 could exit theouter body179 and alternatively extend proximally along the outside of theparent module200 to a position proximal to the body of the patient such that the proximal ends451 of steeringwires447 could engage an interface to mechanically manipulate thesteering wires447, moving or steering the articulating orsteerable elements443. This would bypass at least some of thelumen452 ofwall448 ofcentral tube444.

It is to be understood that the above-described embodiments are illustrative of only a few of the many possible specific embodiments, which can represent applications of the principles of the invention. Numerous and varied other arrangements can be readily devised in accordance with these principles by those skilled in the art without departing from the spirit and scope of the invention.

For example, the nitinol coil structure could be replaced by a braided wire structure as it could readily change size by elongating to facilitate insertion intomedical device200. A braided wire structure can be manufactured from nitinol and have similar thermal-mechanical properties as the nitinol coil or can be made from a more traditional alloy, such as stainless steel and be designed to collapse to a smaller diameter as it is inserted or prior to insertion intomedical device200. A braid structure could be designed to have a similar wedge geometry when inserted into the lumen of a target catheter.

Further, instead of the user reducing the size of the nitinol coil or similar, the adapter can be manufactured and delivered to the customer pre-constrained in that shape and ready to be inserted into the target catheter or device. This would remove some of the burden from the user and possibly make it easier to use. The coil could also be a more traditional alloy without shape memory or superelastic thermal-mechanical properties such as stainless steel. The coil could be manufactured from a polymer such as PEEK or polyimide. The coil itself could be coated with a polymer.

Additionally, for configurations where the nitinol coil is coupled to the distal portion of adapter, the tube could be optional.

Although the distal portion of the adapter described herein is generally shown to be a similar size as the target catheter or device, this is not required, but may be desired. Similarly, the distal portion of the adapter can be smaller than the inner lumen of the target medical device or parent and be inserted completely within the parent device, not extending distally from the target medical device or parent at all.

If a second lumen or central lumen is not required, the elongated element that the proximal portion of coil structure is attached to could be solid as in a wire or mandrel instead of a tube. The elongated element could include conductors to transmit electrical signals from outside the patient body to the distal end of the parent device. One application of this may be an adapter with a distal portion that includes electrodes powered or activated in a manner similar to an electrophysiology catheter. The conductor in electrophysiology catheters are sometimes fine scale copper magnet wire, e.g. 53 gauge, or other polymer coated wire conductors, and similar conductors could be used in an electrophysiology adapter. Conductors could be housed inside the central tube, electrically connecting the distal portion of the adapter to outside the patient. The tube, wire or mandrel could extend proximally all the way out the proximal end of the target catheter or device. Further, the outer body of the distal portion could have multiple and varied profiles. Lumens exiting outer body of the distal portion could be at varied angles instead of 180 degrees opposite each other, including on the same side of the outer body of the distal portion.

Claims

1. An adapter for a medical device catheter, said adapter comprises:

a proximal portion and a distal portion, and an elongated element extending therebetween; and

an attachment mechanism positioned at a proximal portion of the elongated element and comprising an interfacing element configured to be completely received inside a lumen at the distal end of a medical device catheter to attach the proximal portion of the adapter to the medical device catheter.

2. The adapter ofclaim 1, wherein the interfacing element comprises a first portion attached to an outer surface of the elongated element and a second portion free from the outer surface of the elongated element.

3. The adapter ofclaim 2, wherein the second portion of the interfacing element is distal to the first portion of the interfacing element.

4. The adapter ofclaim 3, wherein the second portion of the interfacing element is configured to engage an inner surface of the lumen at the distal end of the medical device catheter.

5. The adapter ofclaim 1, wherein the interfacing element is configured to compress within the lumen at the distal end of the medical device catheter when the adapter is attached to the medical device catheter.

6. The adapter ofclaim 1, wherein the interfacing element is configured to form an interference fit within the lumen at the distal end of the medical device catheter when the adapter is attached to the medical device catheter.

7. The adapter ofclaim 1, wherein the interfacing element is configured to longitudinally expand within the lumen at the distal end of the medical device catheter when the adapter is attached to the medical device catheter.

8. The adapter ofclaim 1, wherein the interfacing element comprises a coil, and the elongated element is attached to and extends through the coil.

9. The adapter ofclaim 8, wherein a first diameter of the coil is larger than a diameter of the lumen at the distal end of the medical device catheter prior to attachment of the adapter to the medical device catheter.

10. The adapter ofclaim 9, wherein a second diameter of the coil is smaller than the diameter of the lumen at the distal end of the medical device catheter prior to attachment of the adapter to the medical device catheter.

11. The adapter ofclaim 1, further comprising one or more slender elements extending proximally from a distal portion of the elongated element.

12. The adapter ofclaim 11, wherein the one or more slender elements extend along an outer surface of the medical device catheter when the adapter is attached to the medical device catheter.

13. The adapter ofclaim 12, wherein the one or more slender elements comprise a wire or fiber.

14. The adapter ofclaim 1, wherein the elongated element further comprises a conductor configured to electrically connect the distal portion of the adapter to the outside of a patient.

15. The adapter ofclaim 14, wherein the elongated element further comprises an electrical connector electrically coupled to the conductor.

16. The adapter ofclaim 1, wherein the elongated element further comprises optical fibers configured to optically connect the distal portion of the adapter to the outside of a patient.

17. The adapter ofclaim 16, wherein the distal portion of the adapter comprises a camera connected to the optical fibers.

18. The adapter ofclaim 1, wherein the elongated element further comprises a steering wire configured to mechanically connect the distal portion of the adapter to the outside of a patient.

19. The adapter ofclaim 18, wherein the distal portion of the adapter comprises an articulating element connected to the steering wire.

20. The adapter ofclaim 1, further comprising a balloon assembly at the distal portion of the adapter.

21. A modular medical device catheter system, comprising:

a parent module comprising a proximal end for extending outside the body of a patient and a distal end for being inside the body of the patient, and a lumen at the distal end; and an adapter module comprising a proximal portion and a distal portion with an elongated element extending therebetween, and an attachment mechanism positioned at a proximal portion of the elongated element and comprising an interfacing element configured to be completely received inside the lumen at the distal end of the parent module to attach the proximal portion of the adapter to the parent module.