CA2232277A1 - Catheter - Google Patents

Catheter Download PDF

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Publication number
CA2232277A1
CA2232277A1 CA002232277A CA2232277A CA2232277A1 CA 2232277 A1 CA2232277 A1 CA 2232277A1 CA 002232277 A CA002232277 A CA 002232277A CA 2232277 A CA2232277 A CA 2232277A CA 2232277 A1 CA2232277 A1 CA 2232277A1
Authority
CA
Canada
Prior art keywords
catheter
lumen
balloon
guide wire
balloons
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
CA002232277A
Other languages
French (fr)
Inventor
Eugen Hofmann
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Schneider Europe GmbH
Original Assignee
Schneider Europe GmbH
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Schneider Europe GmbH filed Critical Schneider Europe GmbH
Publication of CA2232277A1 publication Critical patent/CA2232277A1/en
Abandoned legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M25/1011Multiple balloon catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/01Introducing, guiding, advancing, emplacing or holding catheters
    • A61M2025/0183Rapid exchange or monorail catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1095Balloon catheters with special features or adapted for special applications with perfusion means for enabling blood circulation while the balloon is in an inflated state or in a deflated state, e.g. permanent by-pass within catheter shaft
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1097Balloon catheters with special features or adapted for special applications with perfusion means for enabling blood circulation only while the balloon is in an inflated state, e.g. temporary by-pass within balloon

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Child & Adolescent Psychology (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

A catheter (10) for treatment of a segment of a vessel carrying a body fluid is provided with two balloons (26, 28) carried axially spaced away from each other at the distal end section (14) of the catheter (10) for isolating the segment to be treated. In the catheter (10) at least one lumen (15, 30) for supplying a pressurizing medium to the balloons (26, 28) a further lumen (17, 36) leading to at least one port (38) in the catheter wall between the two balloons (26, 28) for delivering a therapeutic agent and a lumen (40) for receiving a guide wire are provided. The lumen (40) for receiving a guide wire is configured only in the end section (14) of the catheter (10) and extends between a port (42) incorporated in the catheter wall on the proximal side of said proximal balloon (26) and a port (44) located at the distal end of the end section (14).

Description

Catheter The invention relates to a catheter in accordance with the preamble of claim 1.

One such catheter is known from EP-B-0 080 436. In a ve!ssel carrying a body fluid, for example a blood vessel, a segment thereof can be treated with the aid of an agent intended to prevent, for example, the formation of a new constriction in the segment, assisted by two balloons. During this treatment the balloons in the inflated condition isolate the segment to be treated so that the therapeutic agent does not come into contact with the body fluid transported ot:herwise through t:he vessel. After treatment the agent caLn be drained off through the lumen via which it was delivered.

The known catheter is introduced via a guide wire into the vessel, this wire being guided in a lumen extending over the full length of the catheter. Due to this configuration of the catheter it is not possible to quickly replace the catheter by another, since in this case an extension first needs to be attached to the proximal end of the guide wire, this extension enabling the guide wire to be held in place when changing the catheter. In addition, the long length in which the guide wire is located in the catheter detriments facilitated sliding of the catheter.

Although a dilatation catheter is already known from EE'-B-0 203 945 in which the guide wire runs only in the region of the distal end of the catheter, so that changing the catheter can be done quickly without necessitating an elongation of the guide wire, this catheter comprises at its distal end only a single balloon which can be used for dilating vasoconstrictions. Treating a vessel segment with an agent specially devised therefor cannot be done with such a catheter.

rrhe invention is based on the object of configuring a catheter of the aforementioned kind so that it can be easily shifted on its guide wire whilst nevertheless permitting speedy, facilitated changing.

This object is achieved in accordance with the invention by the characterizing clause of claim 1.

Due to the configuration of the catheter in accordance with the invention the guide wire runs only within the distal end in the catheter so that shifting the catheter can be done without having to overcome any major friction forces. Since the distal end segment is only a short segment of the catheter, the catheter can be fully removed along the guide wire from the vessel, as a result of which the guide wire can be gripped both between the punction opening and the tip of the catheter as well as proximally from the proximal port of the guide wire lumen. The catheter can then be replaced safely and reliably by another catheter without any elongation of the guide wire being necessary, because its length in the vessel remains unchanged during replacement. A further advantage of the catheter consists of the cross-section of the catheter being reduced in the complete proximal segment due to the short :Length of the guide wire lumen and thus a larger free cross-section is available for the flow of a contrast agent around the thin catheter stem within the guide catheter.

The advantageous aspect as characterized by claim 2 permits individualized introduction of the pressurizing medium into the balloon which may be of advantage or even necessary in certain cases of treatment, more particularly when the vasoconstriction first needs to be dilated by means of a balloon te.g. the distal one) before then being isolated for further treatment.

An example embodiment will now be explained in more detail with reference to the drawings in which:

- Fig. 1 is a schematic view of the catheter in accordance with the invention, - Fig. 2 is a sectional view taken along the line
2-2 in Fig. 1, - Fig. 3 is a sectional view taken along the line
3-3 in Fig. 1, - Fig. 4 is a sectional view taken along the line 2-2 of a catheter outwardly identical to the catheter as shown in Fig. 1 but having a modified internal structure, - Fig. 5 is a sectional view taken along the line 3-3 of the catheter having a modified internal structure, and - Fig. 6 is a further aspect of the catheter tip.

The catheter 10 ,~s shown in ~ig. 1 is composed of a proximal section 12 and a distal end section 14. In the proximal section 12 the catheter contains a 2-lumina tube 16 provided at its proximal end with a connector 18. One input 20 of the connector permits delivery of a therapeutic agent in one of the two lumina of the tube 16, whilst via the second input 22 a pressurizing medium can be introduced into the other lumen. These two lumina 15, 17 of the tube 16 are evident from Fig.
2.

The distal end section 14 of the catheter 10 consists of a 3-lumina tube 24, and it carries two ba:Lloons 26, 28 located axially spaced away from each other, as is evident from Fig. 1. These two balloons 26" 28 are configured as occlusion balloons. The lumen ev:Ldent from the sectional view as shown in Fig. 3 is a continuation of the lumen 15 of the catheter section 12 se]ving to supply the pressurizing medium and enters via ports 32, 34 into a balloon 26 and 28 respectively.
The lumen 36 in the catheter section 12 is a continuation of the lumen serving to deliver the therapeutic agent and leads to two ports 38 in the ca-theter wall in the portion between the two balloons 26, 28. The third lumen 40 as evident from the sectional view as shown in Fig. 3 extends in the distal end section 14 between a port 42 located on the proximal side of the proximal balloon 26 and a port 44 at the catheter tip.

In actual practice the catheter 10 has a length overall of, for example, 135 cm, whilst the length of the distal end section, in which the tube 24 comprises the guide wire lumen 40, takes up a length of only 22 cm thereof.

The following description of one embodiment of the present catheter assumes that a vasoconstriction is to be remedied.

In implementing this treatment a guide wire is sited by known ways and means in the vessel in which the constriction to be treated exists. Subsequently the catheter is mounted on the proximal end of the guide wire, mounting beginning at the port 44 in the catheter tip. It is from this port 42 that the guide wire reemerges from the guide wire lumen 40, upon which the catheter is then introduced along the guide wire sufficiently into t:he vessel until the constriction to be treated is sited in the region between the two balloons 26 and 28, whereby the location of the two balloons can be mon.itored radiographically with the aid of two gold markers 46, 48 attached within the balloons. As soon as the balloons 26, 28 are correctly sited, a pressurizing medium is introduced via the input 22 of the connector 18 so that the two balloons isolate the constriction. Via the input 20 of the connector 18 the therapeutic agent, for example a cytostatic, can be delivered which flows from the ports 38 into the isolated space between the two balloons and acts on the tissue surrounding the dilated constriction. The therapeutic agent can be drawn off via the input 20, after which the procedure may be repeated, where nec:essary.

Should it prove necessary to replace the catheter 10 by another during treatment, due to, for instance, balloons of another size or located away from each ot.her differingly being required, the catheter 10 can be! retracted, fol].owing drainage of the pressurizing me!dium, along the guide wire sufficiently until the di.stal end section 14 is fully located outside of the vessel. In this arrangement the guide wire continues to be accessible at both the proximal end on one side of thLe end section 14 and at the distal end on the other si.de of the end section 14 so that it can be reliably retained in place during the change, i.e. without requiring the attachment of an elongation to permit changing the cathet:er.

The described catheter 10 thus permits vessel segment therapy with the object of preventing a reconstriction of an expanded constriction whilst simultaneously permitting speedy and simple replacement of the catheter should this prove necessary during treatment.

For durably remedying a vascoconstriction it may also be desirable to intially dilate the constriction with the aid of a balloon and then to isolate the dilated constriction with the aid of both balloons and to retard its reversal by delivering a therapeutic aglent via the lumen 17. To make this method of treatment possible the treatment catheter is converted as shown in Fig. 1 so that the distal balloon 28 is configured as a dilatation balloon and the catheter is configured with three lumina in its proximally section, i.e. featuring in addition to a treatment lumen 50 two lumina 52 and 54 leading to the two balloons 26 and 28 respectively. A section view through the proximal section 12 of this catheter is illustrated in Fig. 4.
Due to this inner structure of the treatment catheter it is possible to supply the pressurizing medium individually to the two balloons.

In the treatment of a constriction the catheter is initially advanced to such a degree that the distal balloon is sited in the region of the constriction enabling it to be dilated by supplying the pressurizing medium to this balloon. After dilation the catheter is advanced further until the dilated constriction is sited between the two balloons. By supplying pressurizing medium to the two balloons the constriction is isolated and the therapeutic agent can then be delivered via the lumen 50 into the isolated region between the two balloons.

Configuring the distal balloon as a dilatation balloon can be done by selecting the balloon material so that is satisfies the particular requirements of a dilatation balloon as regards strength, dimensions, etc.

Fig. 5 is a sectional view taken along the line 3-3 through the distal section 14 of the catheter having the modified inner structure, the catheter in this distal section 14 comprising four lumina, namely the usual guide wire lumen 40 and the three lumina 50, 52 and 54 already evident from Fig. 4.

In both embodiments of the treatment catheter described a flow connection is provided between the proximal side of the proximal balloon 26 and the distal side of the distal. balloon 28, this connection being produced by the guide wire lumen 40. The guide wire fails namely to completely fill up this lumen 40 so that this guide wire lumen in this segment of the catheter simultaneously has the function of a perfusion lumen. This prevents the fluid flowing in the vessel, which may be blood for example when a blood vessel is being treated, cont.inuing to flow through the vessel by means of the catheter during treatment. If the restricted fluid f:low through the guide wire lumen 40 is insufficient, a separate perfusion lumen may be provided so that the distal section 14 of the treatment catheter then comprises a total of five lumina. This changed configuration is illustrated in Fig. 5 by a parting wall 56 being indicated by broken lines. In this way an additional lumen materializes which can be used as the perfusi.on lumen.

At the proximal side of the proximal balloon 26 the catheter wall comprises inlet ports 58 which connect th.e outer portion of the catheter stem to the perfusion lu.men.

As an alternative or supplementary to an additional perfusion lumen the guide wire may be retracted up to a radio-opaque marker 60 to make the complete cross-section of the guide wire lumen 40 available for the perfusion. In this arrangement the radio-opaque marker 60 is applied to a location from which the guide wire can be re-advancecl through the wire lumen with no problem. In this embodiment the catheter wall comprises likewise side inlet and outlet ports 62 connecting the guide wire lumen used for perfusion outside of the treatment segment to the perfused vessel tissue surrounding the catheter stem.

To enlargen the outflow cross-section from the perfusion lumen the tip of the catheter distal to the distal balloon 28 may be configured elongated and further side outlet ports of the perfusion lumen 58a and guide wire lumen 62a respectively may be provided in the catheter wall. In this case the catheter tip is provided with a radio-opaque marker to permit monitoring, for instance in the case of a vessel branch, whether the tip also ports into the side branch to be supplied.

Claims (5)

What is claimed is:
1.A catheter (10) for treatment of a segment of a vessel carrying a body fluid, comprising two balloons (26, 28) carried axially spaced away from each other at the distal end section (14) of the catheter (10) for isolating the segment to be treated, at least one lumen (15, 30) for supplying a pressurizing medium to the balloons (26, 28), a further lumen (17, 36) leading to at least one port (38) in the catheter wall between the two balloons (26, 28) for delivering a therapeutic agent and a lumen (40) for receiving a guide wire being provided in the catheter (10), wherein said lumen (40) for receiving a guide wire is configured only in said end section (14) of said catheter (10) and extending between a port (42) incorporated in said catheter wall on the proximal side of said proximal balloon (26) and a port (44) located at the distal end of said end section (14).
2.The catheter as set forth in claim 1, wherein a separate lumen for supplying said pressurizing medium is provided for each balloon (26, 28).
3.The catheter as set forth in any of the preceding claims, wherein said distal balloon (28) is configured as a dilatation balloon and said proximal balloon (26) is configured as an occlusion balloon.
4.The catheter as set forth in any of the preceding claims, wherein a perfusion lumen extends through said end section (14) of said treatment catheter, said perfusion lumen being open at the proximal side of said proximal balloon (26) towards the outer side of said catheter and leading to a port in the tip of said catheter.
5.The catheter as set forth in claim 4, wherein said guide wire lumen and said perfusion lumen are elongated beyond said distal balloon (28) and each comprising side outlet ports (58a, 62a).
CA002232277A 1997-04-15 1998-03-17 Catheter Abandoned CA2232277A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
EP97106195.7 1997-04-15
EP97106195A EP0872257A3 (en) 1997-04-15 1997-04-15 Catheter

Publications (1)

Publication Number Publication Date
CA2232277A1 true CA2232277A1 (en) 1998-10-15

Family

ID=8226698

Family Applications (1)

Application Number Title Priority Date Filing Date
CA002232277A Abandoned CA2232277A1 (en) 1997-04-15 1998-03-17 Catheter

Country Status (4)

Country Link
EP (1) EP0872257A3 (en)
JP (1) JPH10295820A (en)
AU (1) AU5944898A (en)
CA (1) CA2232277A1 (en)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8162879B2 (en) 2008-09-22 2012-04-24 Tyco Healthcare Group Lp Double balloon catheter and methods for homogeneous drug delivery using the same

Families Citing this family (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1525898A1 (en) * 2003-10-23 2005-04-27 Acrostak Corp. Method and system for an application catheter
AU2008320980A1 (en) 2007-11-16 2009-05-22 Synthes Gmbh Porous containment device and associated method for stabilization of vertebral compression fractures
KR20120028873A (en) 2009-04-09 2012-03-23 신세스 게엠바하 Minimally invasive spine augmentation and stabilization system and method
WO2011012575A1 (en) * 2009-07-27 2011-02-03 Scarcell Therapeutics Balloon catheter device
JP2015231396A (en) * 2012-09-28 2015-12-24 テルモ株式会社 Medical appliance
US9539041B2 (en) 2013-09-12 2017-01-10 DePuy Synthes Products, Inc. Minimally invasive biomaterial injection system

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0584304A (en) * 1990-02-07 1993-04-06 Advanced Cardiovascular Syst Inc Blood vessel catheter
WO1995005209A1 (en) * 1993-08-18 1995-02-23 Technology Development Center Treatment chamber catheter
US5514092A (en) * 1994-08-08 1996-05-07 Schneider (Usa) Inc. Drug delivery and dilatation-drug delivery catheters in a rapid exchange configuration
DE19526784A1 (en) * 1995-07-21 1997-01-23 Bavaria Med Tech Double balloon catheter

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8162879B2 (en) 2008-09-22 2012-04-24 Tyco Healthcare Group Lp Double balloon catheter and methods for homogeneous drug delivery using the same
US8603064B2 (en) 2008-09-22 2013-12-10 Covidien Lp Double balloon catheter and methods for homogeneous drug delivery using the same

Also Published As

Publication number Publication date
EP0872257A3 (en) 1999-12-01
AU5944898A (en) 1998-10-22
JPH10295820A (en) 1998-11-10
EP0872257A2 (en) 1998-10-21

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