KR930003423Y1 - Pressure monitor catheter for use with monorail system - Google Patents

Abstract

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Description

Pressure monitor catheter for use in monorail systems

1 is a side view of the blood pressure monitor catheter according to the present invention.

FIG. 2 shows the distal end of the blood pressure monitor catheter of FIG.

3 is a cross-sectional view of the catheter taken along line 3-3 of FIG.

4 is a side view of the catheter in its original location.

5 is a flow chart illustrating the method of the present invention.

* Explanation of symbols for main parts of the drawings

12: inside the two-two tube 14: distal end

22: guide wire port 26: plastic hub

34: guide catheter 38: guide wire

The present invention relates to a surgical device for use in performing a transluminal angioplasty or transluminal angioplasty procedure, and more particularly to a blood pressure monitor catheter, in particular a monorail ( Trade name) and a structure for use in a catheter system.

In the diagnosis and treatment of coronary artery disease, a technique called coronary angioplasty has been used to assess the extent and nature of the enhancement of stenosis lesions in the vascular system.

One important variable useful for such assessment is the pressure gradient across the stenosis. If the pressure gradient is small, it can be seen that the stenosis does not severely block blood vessels.

However, if the pressure gradient is high, the occlusion is significant and it can be seen that immediate treatment is required.

One method of treating stenosis in the vascular system is to use so-called transluminal ballon angioplasty. In carrying out this method, an elongated flexible plastic catheter with an expandable elongate member proximal to the distal tip is inserted into an appropriate site in the vasculature, usually the femoral artery, through the vascular system to the constriction to be treated. Lose. When the unexpanded kidney is positioned across the stenosis to be treated, the appropriate fluid is injected into the distal end of the catheter and flows to expand the balloon, compressing the stenosis toward the walls of the vessel.

Two types of catheter systems are known in the art. One of them is referred to as an over-the-wire catheter in which the catheter has a lumen extending its entire length from the distal end to the proximal end. After insertion of the guide catheter through the vasculature so that the distal end is positioned adjacent to the site to be treated, the guide wire is routed through the guide catheter, and the proximal end of the guide wire is manipulated to fix the distal end of the stenosis to be treated. Try to traverse The balun blood vessel catheter is then fitted over the guide wire as it has a guide wire that passes through the lumen extending the full length of the catheter. Such over-the-wire catheter has proved difficult in operation, especially when it is necessary to exchange one movable catheter for another. In addition, since the guide wire is completely embedded within the entire length of the movable catheter, there is a tendency for relatively high frictional resistance to occur when the movable catheter is advanced or retracted with respect to the guide wire. In practice, the frictional drag causes the surgeon to perform the redeployment process again because the guide wire actually escapes from the site where it intersects the stenosis lesion during the replacement operation.

In order to solve the problem with the over-the-wire catheter system, the assignee's subsidiary company developed a monorail catheter system. Rather than fully embedding the guide wire along the inner lumen of the movable catheter, a fairly short tubular segment is installed at the distal end of the movable catheter to receive the guide wire. Thus, instead of completely surrounding the wall of the movable catheter over its entire length, in a monorail system only a very short tubular shape surrounds the guide wire adjacent the distal end of the movable catheter. The guide wire then extends parallel along the outer diameter side of the movable catheter as two extend in the base direction through the guide catheter. The detailed structure of the monorail catheter is described in US Patent No. 4,762,120 to Bonzel, and for further explanation regarding the general features and benefits of the monorail catheter, see the patent.

The present invention is directed to a blood pressure monitor catheter specifically designed for use in a monorail system for measuring pressure gradient across a stenosis. The blood pressure monitor catheter of the present invention thus comprises an elongated flexible plastic double lumen protruding tubular member having a guide wire port extending through the wall to intersect any one of the two lumens, the port being Relatively close to the distal end of the tubular member. In the vicinity of the guide wire port a plug is inserted into one lumen.

The other lumen of the double lumen catheter extends the entire length of the tubular member from its distal end to the proximal end. The proximal end fits into a molded plastic hub to easily attach the catheter to an aid used to measure blood pressure, monitor and record blood pressure readings.

In use, when the guide wire is placed past the stenosis lesion to measure blood pressure, the proximal end of the guide wire is inserted into the distal end of the first lumen until the guide wire exits the guide wire port. When caught in the proximal end of the guide wire, the doctor pushes the blood pressure monitor catheter through the guide catheter so that the blood pressure monitor catheter moves along the guide wire until its distal end reaches one side or the other side of the stenosis lesion. Can be. Next, the proximal end of the blood pressure monitor catheter is connected to the blood pressure measuring device to perform the first reading. The blood pressure monitor catheter is then repositioned on the opposite side of the stenosis lesion and a second reading is performed. By taking two readings, the pressure gradient across the stenosis is measured.

Alternatively, the catheter has two blood pressure measuring lumens, one exiting the distal end of the catheter, the other terminating at a predetermined distance from the distal end, extending through the wall of the catheter in fluid communication with the relatively short lumen Has a port. Readings can be taken simultaneously through two lumens without moving the catheter.

The above-described features, objects, and advantages of the present invention can be clearly understood by those skilled in the art from the following detailed description of the preferred embodiments with reference to the accompanying drawings, in which like reference characters designate corresponding parts in the accompanying drawings. It was.

Referring to FIG. 1, a catheter device specifically designed for use in a monorail catheter system that measures blood pressure in a red blood vessel in the blood system of a living person or animal is shown by reference numeral 10. The catheter itself has a relatively small diameter elongated flexible plastic double lumen tubular member 12, suitably formed by any of a variety of known extrusion techniques. For reference, the catheter 10 is shown to include a distal end 14 and a proximal end 16.

The two lumens of the double lumen catheter are indicated at 18 and 20, respectively. Guide wire ports 22 penetrating to intersect the lumen 18 are formed, penetrating the walls of the tubular member 12 only a few inches from the distal end 14 of the catheter 10. Referring to the cross-sectional view of FIG. 3 taken along line 3-3 at the base of the guide wire port 22, it can be seen that the plug 24 was used to block the lumen 18. However, lumen 20 extends from distal end 14 to proximal end 16. The same effect can be achieved by using a single lumen tube for the entire length of the catheter and combining a short double lumen segment with an external port in communication with the lumen attached to the distal end of the single lumen catheter. A molded plastic hub 26 is attached to the proximal end 16 of the catheter to facilitate catheter connection to the particular electronic module used to obtain and record blood pressure readings.

To facilitate positioning of the distal end 14 of the blood pressure monitor catheter in the vasculature, a makdr band 28 of radiopaque material such as gold is attached to the catheter using a roentgen test technique. can do.

The blood pressure monitor catheter has an outer diameter of 1.2 mm and the lumens 18 and 20 are 0.3 mm and 0.4 mm in diameter, respectively. The port 22 is 10 cm away from the distal end 14.

4 and 5, a method of using the blood pressure catheter of the present invention is described. In this regard, reference numeral 30 denotes a blood vessel portion having a stenosis lesion 32 on the inner wall. Guide catheter 34 is injected into the vasculature until the distal end 36 is substantially close to the constriction site to be treated. Guide catheter 34 has a guide wire 38 extending across the stenosis 32 through the lumen.

If it is necessary to take a pressure reading on the base side of the stenosis lesion 32, the blood pressure measuring catheter 10 inserts the proximal end of the guide wire 38 into the distal end of the lumen 18 and the proximal end impinges on the plug 24. It is pinched in the guide wire by advancing the catheter 10 along the guide wire until healed, and thus the proximal end of the guide wire is found at the outlet of the wire 22. When held at the proximal end of the guide wire 38, the surgeon begins feeding the blood pressure monitor catheter 12 down the lumen of the guide catheter 34 and the distal end necessarily travels by the presence of the guide wire 38. Suppressed. Using the fluorescent projection value, the physician can determine when the distal end with the marker band 28 is in a predetermined position relative to the stenosis 32 to be measured.

A similar reading can be obtained after moving the blood pressure catheter tip to the other side of the stenosis lesion. Knowing two readings, one can determine the pressure gradient across the stenosis. This is possible before or after the expansion phase, firstly to determine the need for expansion and secondly to determine the efficiency of the expansion process.

In general, the blood pressure measurement lumen 20 is filled with an incompressible fluid, such as saline, so that the blood pressure present at the distal end of the catheter is transmitted through the fluid to the proximal end 16 of the catheter and from there to the blood pressure measurement device (not shown). Can be delivered. A piexoelectric cryxtral end of the other pressure catheter and an electrical conductor that senses fluctuations due to pressure changes and drives the circuit extends through the lumen 20 of the catheter.

The present invention has been described in detail herein in order to provide those skilled in the art with information necessary to comply with utility model law and to apply new principles and to assemble and use specific components as needed. However, it will be appreciated that the subject innovation may be carried out in particular with other equipment and apparatuses and that various changes, such as the details of the equipment and the operating process, may be accomplished without departing from the spirit of the subject innovation.

Claims (3)

There is a distal end 14 and a proximal end 16, a pressure sensitive lumen 20 extending from the proximal end 16 to a pressure sensing port located adjacent the distal end 14, and a relatively short end of the distal end 14. A pressure monitor catheter comprising a guide wire lumen 18 extending from the distal end 14 to a guide wire port 22 extending through the side wall of the tubular member 12 at an adjacent location of a predetermined distance. . The pressure monitor according to claim 1, wherein a molded plastic hub (26) is attached to the proximal end (16) of the tubular member (12) to couple the pressure sensing lumen (20) to a blood pressure measuring device. Catheter. Pressure monitor catheter according to claim 1, characterized in that a radiopaque transmitter means (28) is located on the tubular member (12) adjacent the distal end of the tubular member (12).