EP2854703A1 - Configuration d'accès vasculaire - Google Patents

Configuration d'accès vasculaire

Info

Publication number
EP2854703A1
EP2854703A1 EP13793912.0A EP13793912A EP2854703A1 EP 2854703 A1 EP2854703 A1 EP 2854703A1 EP 13793912 A EP13793912 A EP 13793912A EP 2854703 A1 EP2854703 A1 EP 2854703A1
Authority
EP
European Patent Office
Prior art keywords
dilator
adaptor
outer diameter
guidewire
lumen
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.)
Withdrawn
Application number
EP13793912.0A
Other languages
German (de)
English (en)
Other versions
EP2854703A4 (fr
Inventor
Brian Andrew Ellingwood
D. Bruce Modesitt
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.)
Arstasis Inc
Original Assignee
Arstasis Inc
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 Arstasis Inc filed Critical Arstasis Inc
Publication of EP2854703A1 publication Critical patent/EP2854703A1/fr
Publication of EP2854703A4 publication Critical patent/EP2854703A4/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES 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
    • A61M29/00—Dilators with or without means for introducing media, e.g. remedies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes
    • A61M2025/0687—Guide tubes having means for atraumatic insertion in the body or protection of the tip of the sheath during insertion, e.g. special designs of dilators, needles or sheaths
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES 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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes

Definitions

  • the present invention relates generally to vascular access systems and techniques, and more particularly to configurations for providing and/or facilitating elongate instrument access across a vascular wall with minimal disruption to surrounding tissue structures.
  • an elongate instrument such as a catheter is introduced to the vascular system at a convenient access location--such as the femoral, brachial, or subclavian arteries--and guided through the
  • vascular system to a target location to perform therapy or diagnosis.
  • catheter and other vascular access devices When vascular access is no longer required, the catheter and other vascular access devices must be removed from the vascular entrance and bleeding at the puncture site must be stopped.
  • One common approach for providing hemostasis is to apply external force near and upstream from the puncture site, typically by manual compression. This method is time-consuming, frequently requiring one-half hour or more of compression before hemostasis. This procedure is uncomfortable for the patient and frequently requires administering analgesics. Excessive pressure can also present the risk of total occlusion of the blood vessel, resulting in ischemia and/or thrombosis.
  • hemostasis is achieved by manual compression, the patient is required to remain recumbent for six to eighteen hours under observation to assure continued hemostasis. During this time bleeding from the vascular access wound can restart, potentially resulting in major complications. These complications may require blood transfusion and/or surgical intervention.
  • Bioabsorbable fasteners have also been used to stop
  • thrombus can form on the fastener. Thrombus can embolize downstream and/or block normal blood flow at the thrombus site. Implanted fasteners can also cause infection and auto-immune
  • Suturing methods also have used to provide hemostasis after vascular access.
  • the suture-applying device is introduced through the tissue tract with a distal end of the device located at the vascular puncture. Needles in the device draw suture through the blood vessel wall on opposite sides of the punctures, and the suture is secured directly over the
  • suturing methods need to be performed with a precise control.
  • the needles need to be properly directed through the blood vessel wall so that the suture is well anchored in tissue to provide for tight closure.
  • Suturing methods also require additional steps for the physician .
  • vascular access With self-sealing and other configurations of closure devices, it may be desirable to achieve vascular access with relatively small instruments before dilation up to larger working lumens for subsequent diagnostic or interventional steps.
  • a self-sealing access technique may be employed to place a much smaller guidewire, such as an 0.018" diameter guidewire.
  • a relatively small guidewire such as an 0.018" diameter
  • a subsequent process step may be to install an introducer catheter assembly, generally comprising an introducer catheter defining an
  • the dilator member generally will define its own dilator member lumen through which the guidewire may be threaded, to facilitate an "over-the-wire" installation of the distal portions of the introducer catheter and dilator member into the vascular lumen.
  • 0.035" diameter guidewire can result in what may be termed an "annular gap" that may form a mechanical edge at the interface between these structures, and insertion of this gap or edge relative to the vascular tissue to place the dilator member and associated introducer catheter distal tips within the vascular lumen may result in unwanted localized tissue trauma, heightened insertion forces, and undesirable localized stress concentrations on portions of the guidewire, dilator member, and/or introducer catheter.
  • an annular gap may form a mechanical edge at the interface between these structures, and insertion of this gap or edge relative to the vascular tissue to place the dilator member and associated introducer catheter distal tips within the vascular lumen may result in unwanted localized tissue trauma, heightened insertion forces, and undesirable localized stress concentrations on portions of the guidewire, dilator member, and/or introducer catheter.
  • guidewires may be more optimally utilized with relatively small guidewires, such as those having diameters in the range of 0.018 inches, which may be desirable with procedures such as self- sealing vascular access and closure procedures.
  • One embodiment is directed to a geometric adaptor apparatus for assisting with translumenal vascular access, comprising a dilator adaptor member having proximal and distal ends and defining a dilator adaptor lumen therethrough, wherein the dilator adaptor lumen is defined by an inner diameter profile sized to accommodate insertion of one or more portions of a guidewire, and wherein the dilator adaptor is further defined by an outer diameter profile sized to accommodate at least partial insertion of the proximal end of the dilator adaptor into a dilator member lumen formed through a dilator member, the dilator member being coupleable to an introducer catheter member through an introducer member lumen formed through the introducer member.
  • a maximum outer diameter of the guidewire may be substantially smaller than a minimum inner diameter of the dilator member. Without the dilator adaptor interposed between the guidewire and dilator member, an annular gap may be defined at the intersection of the guidewire and a distal end of the dilator member.
  • the maximum outer diameter of the guidewire may be at least about 25% smaller than the minimum inner diameter of the dilator member.
  • the maximum outer diameter of the guidewire may be about 0.018 inches.
  • the minimum inner diameter of the dilator member may be between about 0.035 inches and about 0.040 inches.
  • the dilator adaptor inner and outer diameter profiles may be configured to substantially make up the difference in fit between the guidewire and dilator member.
  • the dilator adaptor may have a minimum inner diameter of about 0.018 inches, and a maximum outer diameter of about 0.050 inches.
  • the distal end of the dilator adaptor may have a tapered geometry with an outer diameter minimum at its distal tip.
  • At least a portion of the dilator adaptor may have a proximally tapered geometry with an outer diameter minimum located adjacent its proximal end.
  • a friction fit may be formed between the proximally tapered geometry of the dilator adaptor and the dilator member lumen of the dilator member when loading the dilator adaptor into the dilator member lumen.
  • the proximally tapered geometry may be selected such that one size of dilator adaptor can form a friction fit with a range of dilator member lumen geometries.
  • the dilator adaptor when viewed from distal end to proximal end, may comprise a distal section with a substantially constant outer diameter for a distal section length, tapering up to a midsection with a substantially constant outer diameter for a midsection length, tapering down to a proximal section with a substantially constant outer diameter for a proximal section length, ending in the proximal end.
  • the substantially constant outer diameter of the proximal section may be greater than that of the distal section and less than that of the midsection.
  • Each of the distal section, midsection, and proximal sections may have a substantially homogeneous inner diameter defining the dilator adaptor lumen.
  • the maximum outer diameter of the guidewire may be at least about 0.01 inches smaller than the minimum inner diameter of the dilator member.
  • the dilator adaptor may comprise a polymer selected from the group
  • polyethylene terepthalate polyethylene, high density polyethylene, polypropylene, polytetrafluoroethylene, expanded polytetrafluoroethylene, poly (ethylene-co-vinyl acetate), poly (butyl methacrylate) , and co-polymers thereof.
  • a dilator-introducer assembly comprising a dilator member having proximal and distal ends and defining a dilator lumen therethrough, and an introducer member having proximal and distal ends and defining an introducer lumen therethrough, wherein the introducer lumen is defined by an inner diameter profile sized to accommodate insertion of one or more portions of the dilator member; a guidewire having an outer shape defined by a guidewire outer diameter profile; and a dilator adaptor having proximal and distal ends and defining a dilator adaptor lumen therethrough, wherein the dilator adaptor lumen is defined by an inner diameter profile sized to accommodate insertion of one or more portions of the dilator member; a guidewire having an outer shape defined by a guidewire outer diameter profile; and a dilator adaptor having proximal and distal ends and defining a dilator adaptor lumen therethrough, wherein the dilator adaptor lumen
  • the dilator adaptor is further defined by an outer diameter profile sized to accommodate insertion of one or more portions of the guidewire, and wherein the dilator adaptor is further defined by an outer diameter profile sized to
  • the guidewire may be advanced at least in part through the dilator adaptor lumen, the dilator adaptor may be advanced at least in part through the dilator member lumen, and the dilator member may be advanced at least in part through the introducer lumen to form an instrument assembly capable of forming substantially atraumatic outer shape profile configuration defined by
  • a maximum outer diameter of the guidewire may be substantially smaller than a minimum inner diameter of the dilator member. Without the dilator adaptor interposed between the guidewire and dilator member, an annular gap may be defined at the intersection of the guidewire and a distal end of the dilator member. The maximum outer diameter of the guidewire may be at least about 25% smaller than the minimum inner diameter of the dilator member. The maximum outer
  • the diameter of the guidewire may be about 0.018 inches.
  • the minimum inner diameter of the dilator member may be between about 0.035 inches and about 0.040 inches.
  • the dilator adaptor inner and outer diameter profiles may be configured to
  • the dilator adaptor may have a minimum inner diameter of about 0.018 inches, and a maximum outer diameter of about 0.050 inches.
  • the introducer member distal end may have a tapered geometry with an outer diameter minimum at its distal tip.
  • the dilator member distal end may have a tapered geometry with an outer diameter minimum at its distal tip.
  • the distal end of the dilator adaptor may have a tapered geometry with an outer diameter minimum at its distal tip.
  • At least a portion of the dilator adaptor may have a proximally tapered geometry with an outer diameter minimum located adjacent its proximal end.
  • a friction fit may be formed between the proximally tapered geometry of the dilator adaptor and the dilator member lumen of the dilator member when loading the dilator adaptor into the dilator member lumen.
  • proximally tapered geometry may be selected such that one size of dilator adaptor can form a friction fit with a range of dilator member lumen geometries.
  • the dilator adaptor when viewed from distal end to proximal end, may comprise a distal section with a substantially constant outer diameter for a distal section length, tapering up to a midsection with a substantially constant outer diameter for a midsection length, tapering down to a proximal section with a substantially constant outer diameter for a proximal section length, ending in the proximal end.
  • the substantially constant outer diameter of the proximal section may be greater than that of the distal section and less than that of the midsection.
  • Each of the distal section, midsection, and proximal sections may have a substantially homogeneous inner diameter defining the dilator adaptor lumen.
  • the maximum outer diameter of the guidewire may be at least about 0.01 inches smaller than the minimum inner diameter of the dilator member.
  • the dilator adaptor may comprise a polymer selected from the group consisting of:
  • polyethylene polyethylene, polypropylene, polytetrafluoroethylene, expanded polytetrafluoroethylene, poly (ethylene-co-vinyl acetate) , poly (butyl methacrylate) , and co-polymers thereof.
  • Figure 1A illustrates a geometric misfit scenario wherein relatively small guidewire is interfaced with a conventionally- sized dilator-introducer assembly.
  • Figure IB illustrates an assembly featuring a dilator adaptor to address a geometric misfit scenario such as that depicted in Figure 1A.
  • Figure 2A illustrates one aspect of a vascular access configuration in accordance with the present invention wherein relatively small guidewire may be utilized in concert with a conventionally-sized dilator-introducer assembly.
  • Figure 2B illustrates one aspect of a vascular access configuration in accordance with the present invention wherein relatively small guidewire may be utilized in concert with a conventionally-sized dilator-introducer assembly.
  • Figure 2C illustrates one aspect of a vascular access configuration in accordance with the present invention wherein relatively small guidewire may be utilized in concert with a conventionally-sized dilator-introducer assembly.
  • Figure 2D illustrates one aspect of a vascular access configuration in accordance with the present invention wherein relatively small guidewire may be utilized in concert with a conventionally-sized dilator-introducer assembly.
  • Figure 2E illustrates one aspect of a vascular access configuration in accordance with the present invention wherein relatively small guidewire may be utilized in concert with a conventionally-sized dilator-introducer assembly.
  • Figure 2F illustrates one aspect of a vascular access configuration in accordance with the present invention wherein relatively small guidewire may be utilized in concert with a conventionally-sized dilator-introducer assembly.
  • Figure 2G illustrates one aspect of a vascular access configuration in accordance with the present invention wherein relatively small guidewire may be utilized in concert with a conventionally-sized dilator-introducer assembly.
  • Figure 2H illustrates one aspect of a vascular access configuration in accordance with the present invention wherein relatively small guidewire may be utilized in concert with a conventionally-sized dilator-introducer assembly.
  • Figure 21 illustrates one aspect of a vascular access configuration in accordance with the present invention wherein relatively small guidewire may be utilized in concert with a conventionally-sized dilator-introducer assembly.
  • Figure 3A illustrates a longitudinal cross sectional view of one embodiment of a dilator adaptor in accordance with the present invention.
  • Figure 3B illustrates a longitudinal cross sectional view of another embodiment of a dilator adaptor in accordance with the present invention.
  • Figure 4 illustrates a technique conducting a procedure involving a vascular access configuration in accordance with the present invention wherein a relatively small guidewire may be utilized in concert with a conventionally-sized dilator- introducer assembly.
  • Figure 5 illustrates a technique conducting a procedure involving a vascular access configuration in accordance with the present invention wherein a relatively small guidewire may be utilized in concert with a conventionally-sized dilator- introducer assembly.
  • a geometric mismatch scenario is depicted wherein a relatively small guidewire (6), such as a guidewire having a diameter in the range of 0.018 inches, is being utilized in concert with a conventionally-sized dilator- introducer assembly comprising a dilator member (4) coupled through an introducer catheter (2) .
  • the dilator member (4) may define a lumen therethrough which has a diameter sized for larger guidewires, in the range of 0.035 inches.
  • the geometric mismatch between the guidewire (6) and the inner diameter of the dilator member (4) creates an annular gap (8) or step in geometry, which may unfavorably affect the function of the overall apparatus relative to the nearby pertinent tissue structures.
  • the mismatch issue may be substantially, if not completely, mitigated, to produce a desired closely- toleranced fit at the junction (12) between the guidewire (6) and adaptor (10), and at the junction (14) between the adaptor (10) and the dilator member (4) .
  • FIGS 2A-2I various aspects of a vascular access system and procedure related thereto are illustrated.
  • Figures 3 and 4 illustrate in a flowchart fashion various embodiments of medical procedures involving such vascular access technology .
  • a conventional dilator member / introducer catheter set is depicted in a disassembled form, comprising a dilator member (4) having proximal (22) and distal (20) ends, a lumen (28) defined therethrough, and a fitting (36) proximally to assist with manipulating and coupling the dilator member (4) .
  • the conventional dilator member / introducer catheter set also comprises an introducer catheter or introducer sheath (2) having proximal (26) and distal (24) ends, a lumen
  • Typical dilator member / introducer catheter sets for vascular access are designed to have outer introducer catheter diameters (34) in the range of about 6 French, and have inner dilator member lumen diameters of between about 0.035" and about 0.038".
  • the outer diameter (32) of the dilator member (4) typically is configured to be easily slideable through the lumen (30) of the introducer (2), without significant leakage between the two elongate bodies when assembled.
  • the distal end (20) of the dilator (4) may be advanced through the proximal end valve fitting (16) of the introducer catheter (2) and into the lumen (30) of the introducer catheter (2), to form an assembly as shown in Figures 2C and 2D, wherein the distal end (20) of the dilator member (4) may be configured to have a tapered geometry and to extend distally past the distal end (24) of the
  • introducer catheter (2) which also may have a tapered distal geometry.
  • fit (38) at the interface between the dilator member (4) and introducer catheter (2) is manufactured to be closely toleranced by the manufacturer of the
  • a tubular dilator adaptor member 10 may be added to an assembly to mitigate the
  • the dilator adaptor (10) has proximal (42) and distal (40) ends and comprises a small lumen (44) defined therethrough to accommodate passage of a small instrument such as a guidewire. As shown in Figure 2F, in one embodiment, the dilator adaptor (10) is configured to be
  • a resulting assembly is depicted, with the dilator adaptor (10) inserted through the working lumen of the dilator member (4), which is inserted through the working lumen of the introducer catheter (2) .
  • a small working lumen (44) is maintained through the dilator adaptor (10) to accommodate passage of a guidewire or other small instrument.
  • geometry of the dilator adaptor (10) comprises a proximal taper (tapering to smaller outer diameter as one measures
  • the proximal taper geometry of the dilator adaptor (10) is configured to not only accommodate one guidewire/dilator mismatch scenario (i.e., such as one wherein an 0.018" outer diameter guidewire is to be utilized with a dilator member having an inner lumen diameter of about 0.035"), but also a substantially broad range of mismatch scenarios (including one wherein an 0.018" outer diameter guidewire is to be utilized with a dilator member having an inner lumen diameter of about 0.038", as well as a myriad of other mismatch scenarios which may be greater in mismatch dimensions) .
  • one guidewire/dilator mismatch scenario i.e., such as one wherein an 0.018" outer diameter guidewire is to be utilized with a dilator member having an inner lumen diameter of about 0.035
  • mismatch scenarios including one wherein an 0.018" outer diameter guidewire is to be utilized with a dilator member having an inner lumen diameter of about 0.038"
  • mismatch scenarios including
  • an assembly of the dilator adaptor (10), dilator member (4), and introducer catheter (2) may be advanced in an "over-the-wire" technique to place at least a portion of such assembly within the vascular lumen (48) .
  • a closer view is presented in Figure 21.
  • the assembly may be further advanced until the distal end of the introducer catheter is positioned within the vascular lumen (48), after which the dilator member (4) and dilator adaptor (10) may be withdrawn proximally to make room for other diagnostic and/or
  • the trans-vascular access point across the vessel wall (50) may be configured to be a self-sealing access point, which is designed to self-seal after withdrawal of the pertinent instrumentation.
  • a longitudinal cross sectional view of one embodiment of a dilator adaptor (10) is depicted with dimensions in inches.
  • the most distal portion starting from the distal end (40) may comprise a tapered geometry (56) to
  • a mid-portion (60) may have a substantially homogeneous outer diameter for a given length.
  • proximally tapered portion (58) may assist with establishing a friction fit with an associated inner lumen geometry of a dilator member, as described above.
  • a most proximal portion (62) up to the proximal end (42) may have a substantially constant outer diameter for a given length.
  • a longitudinal cross sectional view of another embodiment of a dilator adaptor (10) is depicted with dimensions in inches.
  • the most distal portion starting from the distal end (40) may comprise a tapered geometry (64), followed by a portion (66) having a substantially constant outer diameter for a given length, followed by another tapered portion (68), a midportion (70) which may have a mild taper either proximally or distally or be substantially constant in outer diameter for a given length, followed by a proximally tapered portion (72) which may assist with establishing a friction fit with an associated inner lumen geometry of a dilator member, as
  • proximal end (42) may have a substantially constant outer diameter for a given length.
  • the dilator adaptor may comprise a polymer selected from the group consisting of: polyethylene terepthalate, polyethylene, high density polyethylene,
  • polytetrafluoroethylene poly (ethylene-co-vinyl acetate) , poly (butyl methacrylate) , and co-polymers thereof.
  • access may be created (for example, by crossing with an access needle and leaving behind a guidewire, as in a Seldinger technique) (82) .
  • An operational assembly may be formed which combines the at least a portion of the guidewire through the dilator adaptor lumen, at least a portion of the dilator adaptor through the dilator member lumen, and at least a portion of the dilator member through the
  • Such an assembly may be accomplished by first assembling the adaptor and dilator member together, then placing this assembly into the introducer for further advancement over the guidewire into the vessel, as shown in the embodiment of Figure 4 (elements 84, 86); referring to Figure 5 (102), such a sub-process may comprise combining the adaptor into an already-assembled dilator member - introducer catheter subassembly. The dilator-adaptor / dilator member / introducer assembly may then be advanced in an "over-the-wire"
  • the dilator member and dilator adaptor may be withdrawn (92) along with the guidewire, and other instrumentation may be advanced through the working lumen of the introducer catheter or sheath (94) to conduct a procedure (96), after which the instrumentation may be withdrawn out of the introducer (98), and the remaining introducer may be withdrawn to complete the closure, which preferably has been set up to be a self-sealing closure (100) .
  • kits may further include instructions for use and be packaged in sterile trays or containers as commonly employed for such purposes.
  • the invention includes methods that may be performed using the subject devices.
  • the methods may comprise the act of
  • Such provision may be
  • the "providing" act merely requires the end user obtain, access, approach, position, set-up, activate, power-up or otherwise act to provide the requisite device in the subject method.
  • Methods recited herein may be carried out in any order of the recited events which is logically possible, as well as in the recited order of events.
  • lubricious coatings e.g., hydrophilic polymers such as polyvinylpyrrolidone-based
  • compositions, fluoropolymers such as tetrafluoroethylene, hydrophilic gel or silicones may be used in connection with various portions of the devices, such as relatively large interfacial surfaces of movably coupled parts, if desired, for example, to facilitate low friction manipulation or advancement of such objects relative to other portions of the devices.

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

Abstract

Selon un mode de réalisation, l'invention concerne un appareil adaptateur géométrique qui permet d'aider un accès vasculaire transluminal, qui comporte un élément adaptateur de dilatateur ayant des extrémités proximale et distale et définissant une lumière d'adaptateur de dilatateur à travers celui-ci, la lumière d'adaptateur de dilatateur étant définie par un profil de diamètre interne dimensionné pour recevoir l'introduction d'une ou de plusieurs parties d'un fil-guide, l'adaptateur de dilatateur étant en outre défini par un profil de diamètre externe dimensionné pour recevoir l'introduction au moins partielle de l'extrémité proximale de l'adaptateur de dilatateur dans une lumière d'élément de dilatateur formée à travers un élément de dilatateur, l'élément de dilatateur pouvant être couplé à un élément de cathéter d'introduction à travers une lumière d'élément d'introduction formée à travers l'élément d'introduction.
EP13793912.0A 2012-05-25 2013-05-24 Configuration d'accès vasculaire Withdrawn EP2854703A4 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US201261652104P 2012-05-25 2012-05-25
US201261652112P 2012-05-25 2012-05-25
PCT/US2013/042743 WO2013177564A1 (fr) 2012-05-25 2013-05-24 Configuration d'accès vasculaire

Publications (2)

Publication Number Publication Date
EP2854703A1 true EP2854703A1 (fr) 2015-04-08
EP2854703A4 EP2854703A4 (fr) 2016-01-27

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EP13793912.0A Withdrawn EP2854703A4 (fr) 2012-05-25 2013-05-24 Configuration d'accès vasculaire

Country Status (7)

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EP (1) EP2854703A4 (fr)
JP (2) JP6318148B2 (fr)
CN (1) CN104470469A (fr)
AU (3) AU2013266115A1 (fr)
CA (1) CA2874671C (fr)
IL (2) IL235845B (fr)
WO (1) WO2013177564A1 (fr)

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US10758717B2 (en) * 2015-07-13 2020-09-01 Cti Vascular Ag Mechanically actuated and functionally integratable catheter system for treating vascular and non-vascular diseases and related methods

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Also Published As

Publication number Publication date
JP2015518749A (ja) 2015-07-06
AU2017251835A1 (en) 2017-11-16
AU2019253792A1 (en) 2019-11-14
WO2013177564A1 (fr) 2013-11-28
IL235845A0 (en) 2015-01-29
AU2013266115A1 (en) 2014-12-18
CN104470469A (zh) 2015-03-25
EP2854703A4 (fr) 2016-01-27
IL235845B (en) 2020-03-31
IL271383A (en) 2020-01-30
JP2018134440A (ja) 2018-08-30
CA2874671C (fr) 2020-07-07
CA2874671A1 (fr) 2013-11-28
JP6318148B2 (ja) 2018-04-25
AU2017251835B2 (en) 2019-07-25

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