US20100114022A1 - Spiral balloon catheter - Google Patents

Spiral balloon catheter Download PDF

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Publication number
US20100114022A1
US20100114022A1 US12/593,226 US59322608A US2010114022A1 US 20100114022 A1 US20100114022 A1 US 20100114022A1 US 59322608 A US59322608 A US 59322608A US 2010114022 A1 US2010114022 A1 US 2010114022A1
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US
United States
Prior art keywords
balloon
catheter
spiral
conduit
deflated
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
US12/593,226
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English (en)
Inventor
Eran Hirszowicz
Hila Yaron
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.)
Intratech Medical Ltd
Original Assignee
Intratech Medical Ltd
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 Intratech Medical Ltd filed Critical Intratech Medical Ltd
Priority to US12/593,226 priority Critical patent/US20100114022A1/en
Publication of US20100114022A1 publication Critical patent/US20100114022A1/en
Assigned to INTRATECH MEDICAL LTD. reassignment INTRATECH MEDICAL LTD. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: HIRSZOWICZ, ERAN, YARON, HILA
Abandoned legal-status Critical Current

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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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A61M25/1002—Balloon catheters characterised by balloon shape
    • 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
    • A61M25/10—Balloon catheters
    • A61M25/1011—Multiple balloon catheters
    • 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
    • A61M29/02—Dilators made of swellable material
    • 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
    • A61M25/10—Balloon catheters
    • A61M25/1011—Multiple balloon catheters
    • A61M2025/1013—Multiple balloon catheters with concentrically mounted balloons, e.g. being independently inflatable
    • 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
    • A61M25/10—Balloon catheters
    • A61M2025/1043—Balloon catheters with special features or adapted for special applications
    • A61M2025/109—Balloon catheters with special features or adapted for special applications having balloons for removing solid matters, e.g. by grasping or scraping plaque, thrombus or other matters that obstruct the flow
    • 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
    • A61M25/10—Balloon catheters
    • A61M25/1006—Balloons formed between concentric tubes

Definitions

  • the present invention relates to a balloon catheter device for use inside blood vessels and other body passages. More specifically, the presently-disclosed invention is a catheter device comprising a balloon that is capable of adopting a spiral conformation upon inflation.
  • Balloon catheters have, over the course of the last few decades, found use in the diagnosis and treatment of many medical conditions. While different versions of these devices have been designed and constructed for use in many different body passages—such as the urinary tract, uterus and fallopian tubes and gastrointestinal tract—the intravascular use of balloon catheters is arguably their fastest-growing field of application. Thus, balloon catheters have been used in various angioplasty procedures, stent implantation, thrombus-crossing, embolic protection, and so on.
  • a balloon catheter system that has been designed for use in removing thrombotic material and other intravascular particulate matter from the body is that disclosed in U.S. Pat. No. 4,762,130 (Fogarty). While several different embodiments of the catheter are described in the patent, a feature common to all of these embodiments is that a balloon is advanced into the region of the thrombus to be treated and then expanded into a helical or spiral configuration, thereby engaging said thrombus within the spiral channels of the inflated balloon. The spiral balloon is then withdrawn from the body with the thrombus still attached thereto.
  • a particular disadvantage of this prior art system is that the catheter is usually inflated distally to the thrombus (or other particulate matter) and is then pulled back in order to facilitate collection of the thrombotic material by the balloon. This procedure can be traumatic for the blood vessel. Furthermore the balloon does not always completely seal the vessel and some of the debris escapes into the blood stream and is not removed.
  • a further key problem associated with the aforementioned prior art system is the fact that during balloon inflation, the blood flow through the vessel is blocked. Indeed, in many balloon catheter systems, the volume taken up by the balloon when inflated is problematic. In addition, many existing catheter balloons, even when in their deflated state present an unacceptably large cross-sectional profile, thereby causing problems in the insertion and maneuvering of the catheter within the vasculature.
  • compliant tubes i.e. balloons or sheaths
  • the compliant tubes of the present invention are able to adopt spiral conformations upon inflation without the need for any additional structural features such as external restraining bands or intraluminal spiral-forming wires.
  • the balloons of the present invention have an intrinsic ability to adopt a spiral shape upon inflation, said ability being a function of the materials used in the construction of the balloon, the dimensions of the balloon, and the attachment of the balloon at each of its ends to a catheter shaft.
  • This novel form of compliant balloon has significant advantages in relation to prior art balloons, in terms of possessing both an extremely low cross sectional profile when deflated, and a helical or spiral shape when inflated.
  • the present invention in its most general form, is a balloon catheter device comprising a tubular compliant balloon that is attached at its distal and proximal extremities to a catheter tube.
  • the balloon Upon inflation, the balloon, which is incapable of any significant elongation in a proximal-distal direction (due to its terminal attachment to the catheter shaft), adopts a spiral or helical conformation.
  • the balloon in its deflated state, the balloon appears as a conventional, low profile, linear (i.e. non-spiral) sheath surrounding the conduit to which it is attached. It is only during inflation that this linear sheath adopts a spiral conformation.
  • the present invention is therefore primarily directed to a balloon catheter system comprising one or more conduits to which is/are attached a compliant balloon having a non-helical shape in its deflated state, wherein said balloon is constructed such that upon inflation, it is capable of adopting a spiral or helical conformation, and wherein said balloon does not require the use of any ancillary structures such as wires, bands or formers in order to adopt said helical shape upon inflation.
  • proximal and distal are defined from the physician's (or other operator's) perspective.
  • proximal is used to refer to the side or end of a device or portion thereof that is closest to the external body wall and/or the operator, while the term “distal” refers to the side or end of a structure that is in an opposite direction to the external body wall and/or operator.
  • the distal and proximal necks of the balloon are attached to a single catheter conduit.
  • the distal neck of the balloon is attached to one catheter conduit while the proximal neck thereof is attached to a second conduit, wherein said first and second conduits are arranged such that at least a portion of the shaft of one of the conduits is disposed within the lumen of the other conduit.
  • the balloon catheter system further comprises an aspiration element.
  • the general form of this element is a low-profile suction tube, the proximal end of which is connected to a negative pressure source, and the open distal end of which is located close to the proximal neck of the balloon.
  • the aspiration element is bound to the catheter conduit.
  • the present invention is directed to a method for removing particulate matter from a body passage in a patient in need of such treatment, comprising the steps of:
  • the particulate matter to be removed is thrombotic or embolic in origin.
  • the present invention also provides a method for removing thrombotic material from a body passage in a patient in need of such treatment, comprising the steps of:
  • the present invention further provides a method for removing a thrombus from a body passage in a patient in need of such treatment, comprising the steps of:
  • FIG. 1 depicts the balloon catheter of the present invention with the compliant balloon in its collapsed, deflated state.
  • FIG. 2 illustrates the catheter of the present invention following inflation of the balloon.
  • FIG. 3 illustrates one preferred embodiment of the balloon catheter of the present invention having an aspiration element that ends on the proximal side of the balloon (shown inflated).
  • FIG. 4 is a schematic longitudinal section view of a balloon catheter of the present invention in its deflated state, in which various critical balloon design parameters are defined.
  • FIG. 5 is a schematic longitudinal section view of a balloon catheter of the present invention in its inflated state, in which various critical balloon design parameters are defined.
  • FIG. 6 shows a longitudinal section of a spiral-forming balloon (deflated) mounted on a single-lumen stainless steel tube.
  • FIG. 7 shows a longitudinal section of a spiral-forming balloon (deflated) mounted on a guidewire state having a sliced distal portion.
  • FIG. 8 depicts a longitudinal section of a spiral-forming balloon (deflated) having a stainless steel wire welded to the distal end of a stainless steel conduit.
  • FIG. 9 depicts a longitudinal section of a spiral-forming balloon (deflated) featuring a side-hole for the injection of contrast agents, thrombolytic agents or other fluids.
  • FIG. 10 shows a longitudinal section of an embodiment of the present invention in which a specially-designed guidewire is used to block the distal catheter exit.
  • FIG. 11 shows a longitudinal section of an alternative embodiment of the device of the present invention, in which the inner catheter lumen has a narrowed distal end, thereby allowing the distal catheter exit to be blocked by a standard guidewire.
  • the invention is based on the use of a compliant balloon which is fitted over a catheter conduit in a conventional (i.e. non-spiral) and manner, the distal and proximal ends of said balloon being attached to said conduit.
  • the balloon In its deflated state ( FIG. 1 ), the balloon is in the form of a tube of compliant material with a diameter, in one preferred embodiment, of up to 1/15 of the final crossing profile of the inflated balloon.
  • the tube can be constructed with a uniform wall thickness or with a wall thickness which varies along its length.
  • the collapsed balloon is indicated in FIG. 1 by part number 12 attached to catheter shaft 10 .
  • the balloon can be made from one material. Alternatively, it may be constructed from two or more different materials, thereby producing a non-uniform spiral balloon upon inflation. Suitable materials for use in constructing the compliant balloon include (but are not limited to): silicones and thermoplastic elastomers (TPEs) such as (but not limited to) Evoperene and Monoprene.
  • TPEs thermoplastic elastomers
  • the balloon may be manufactured from these materials using standard balloon production techniques well known to the skilled artisan in this field.
  • the balloon 12 is bound at two points to a rigid or semi-rigid conduit 10 which is threaded through the balloon. Since the balloon is made of a compliant material it elongates during inflation.
  • the attachment of the balloon to the catheter conduit may be achieved using any of the standard bonding techniques and materials well known in the art, for example adhesion using biocompatible glues such as silicone glue.
  • the balloon 12 Since the balloon 12 is bound at both its ends, its longitudinal elongation is restrained. Provided certain balloon-related design parameter criteria are met (as will be discussed hereinbelow), said balloon 12 will then buckle and assume a spiral shape as shown in FIGS. 2 and 3 .
  • FIG. 3 illustrates a preferred embodiment of the balloon catheter which further comprises an aspiration element 14 .
  • the general form of this element is a low-profile suction tube, the proximal end of which is connected to a negative pressure source, and the open distal end of which is located close to the proximal neck of the balloon.
  • the aspiration element is bound to the catheter conduit by means of loops, ties or any other suitable method.
  • the aspiration element may be unattached to the catheter conduit.
  • the aspiration tube may be made from any suitable biocompatible material such as (but not limited to) Pebax and Nylon.
  • the aspiration tube may have an external diameter of 6 Fr and an internal diameter of 0.070′′.
  • Typical aspiration pressures are in the order of 640 to 680 mmHg, and may be provided by standard negative pressure sources such as are available in hospitals and other health-care centers.
  • the critical balloon and catheter tube parameters are defined in FIG. 4 (deflated state) and FIG. 5 (inflated state), and in the following list:
  • N the number of spiral threads
  • N the number of spiral threads
  • a compliant balloon having a length of 30 mm, an outer diameter of 1 mm and a wall thickness of 0.25 mm readily adopts a spiral conformation upon inflation, provided that both ends of said balloon are bound to a rigid conduit.
  • the compliant balloon will have a length in the range of 15 mm to 50 mm and a wall thickness in the range of 100 micron to 400 micron. It should be emphasized that the preceding dimensions (and all other dimensions that appear herein) are exemplary values only, and should not be construed as limiting the size of the presently-disclosed device in any way.
  • the catheter is constructed of a single-lumen stainless steel tube with a distally assembled spiral balloon ( FIG. 6 ).
  • the deflated cross profile ranges between 0.4 and 0.8 mm.
  • the tube may be delivered to the target through a 2.4 Fr or 3.8 Fr microcatheter.
  • the catheter tube 18 can have a laser cut (spiral cut or grooves) at its distal section or all along its length to increase its flexibility.
  • a thin (approximately 0.0005′′) polymeric jacket 19 (for example, PET or PTFE) is applied over the tube (e.g. by a heat-shrink process).
  • An aperture 26 is created at the distal section of the hypotube for the inflation of the spiral balloon.
  • the distal end of the hypotube 28 is plugged by using a plasma weld process, laser weld process or adhesive process.
  • the compliant balloon 24 is shown in this figure and in the figures that follow in its deflated state.
  • a reduced cross-section profile of the distal portion of the hypotube 20 (i.e. in the region of the balloon attachment) is obtained by longitudinally slicing said portion, thereby creating a reduced diameter tube region 22 of approximately semi-circular cross sectional form.
  • a stainless steel wire 30 having a diameter of, for example, 0.2 mm may be welded to the distal end of the tube 20 .
  • a balloon 24 with a smaller ID may be used, thereby leading to a distal section having a significantly smaller cross section profile.
  • the catheter may be delivered (in either over-the-wire or rapid exchange mode) over a coronary 0.014′′ guidewire ( FIG. 9 ).
  • the minimum cross sectional profile of the catheter may be in the order of 0.8-1.0 mm.
  • the balloon 24 depicted in the longitudinal section shown in FIG. 9 is mounted in a conventional manner on a two-conduit coaxial design catheter similar to standard balloon catheters known in art, with the proximal end of the balloon 24 being attached to the outer tube 34 and the distal end thereof being attached to the inner tube 32 .
  • Both the inner tube and the outer tube may be constructed by the use of extrusion techniques from materials commonly used in the art including Nylon, Pebax, PET and Polyurethane.
  • the balloon 24 is inflated in a conventional manner well known to skilled artisans in the field, through an inflation lumen formed by the space between the inner and outer tubes.
  • the lumen of the inner conduit functions primarily as a guidewire lumen.
  • the presence of one or more side exits (or apertures) 38 proximal to the balloon that communicate between said guidewire lumen 36 and the area surrounding the outer tube permit said lumen to be additionally used for the delivery of liquid substances of various types to the region of the blood vessel that is in proximity to said exit(s).
  • the guidewire lumen may used for injecting liquids (including, but not limited to standard contrast media and thrombolytic agents, such as tPA) through both the side exit and distal exit of the lumen.
  • liquids including, but not limited to standard contrast media and thrombolytic agents, such as tPA
  • fluid injection takes place while the guidewire is still indwelling.
  • the aforementioned side aperture 38 will generally be sized such that its surface area will be approximately equal to the cross-sectional area of the inner tube lumen.
  • the aperture is formed by means of a laser cut, and the side walls of said aperture are sealed by thermo-bonding methods, in order to prevent seepage between the inner and outer tubes.
  • the conduits used to construct the catheter device of the present invention may be made of any suitable material including (but not limited to) a biocompatible polymer such as polyurethane or nylon or PET, or a biocompatible metal such as stainless steel, and may be manufactured utilizing conventional methods, such as extrusion and laser cutting.
  • the diameter of the conduits is generally in the range of 0.5-2.0 mm, and their length is generally in the range of 100-2000 mm.
  • the compliant balloon may be inflated by introducing a pressurized inflation media via an inflation fluid port that is in fluid connection with a source of pressurized media and a pumping device or syringe.
  • the inflation media passes through openings in the wall of the catheter shaft located between the proximal and distal attachment points of the balloon.
  • the inflation media passes via an inflation fluid lumen formed between the inner wall of the outer conduit and the outer surface of the inner conduit.
  • the balloon of the present invention may be assembled onto a two-conduit catheter, wherein the inner conduit is movable in relation to the outer conduit.
  • the cross-sectional profile of the non-inflated balloon may be reduced even further by means of moving the inner tube distally prior to insertion of the catheter into the vasculature, thereby stretching the balloon and thus reducing its wall thickness.
  • the pressure in the balloon when fully inflated with an expansion medium such as saline or a contrast medium is in the range of 0.5-4 atmospheres, and often in the range of 1.5-2 atmospheres.
  • the spiral-forming balloon catheter of the present invention has many different applications, in addition to the use in thrombus removal described above.
  • the expanded spiral balloon may be used for anchoring a catheter (or other elongate device) within a blood vessel, without blocking blood flow in the region of the anchoring balloon.
  • the spiral balloon may be used for the purpose of cooling or heating tissue or blood in the immediate vicinity of said balloon.
  • the balloon may be covered or partly covered with a network of thin filaments, thereby creating a distal protection element, which may serve to enhance the ability of the spiral balloon to trap thrombotic material during withdrawal of the catheter.
  • a further application for the spiral-forming balloon of the present invention is in the treatment and/or remodeling of vascular aneurysms (including, but not limited to, cerebral aneurysms).
  • vascular aneurysms including, but not limited to, cerebral aneurysms.
  • Prior art methods of treatment generally use an inflated catheter balloon as a ‘floor’ or base during the insertion of coils into the aneurysm that is being re-modeled.
  • one drawback of the use of conventional balloons in this situation is that blockage (total or near-total) of blood flow in the region of the aneurysm. This blockage may clearly have serious negative implications, particularly when dealing with a cerebral aneurysm.
  • the use of a spiral-forming balloon of the present invention permits blood flow to continue through and around the spiral channels, thereby preventing ischemic and hypoxic damage to sensitive tissues distal to the treatment site.

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US12/593,226 2007-03-27 2008-03-27 Spiral balloon catheter Abandoned US20100114022A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US12/593,226 US20100114022A1 (en) 2007-03-27 2008-03-27 Spiral balloon catheter

Applications Claiming Priority (5)

Application Number Priority Date Filing Date Title
US92014507P 2007-03-27 2007-03-27
US97812207P 2007-10-07 2007-10-07
US3879508P 2008-03-24 2008-03-24
US12/593,226 US20100114022A1 (en) 2007-03-27 2008-03-27 Spiral balloon catheter
PCT/IB2008/051158 WO2008117256A2 (en) 2007-03-27 2008-03-27 Spiral balloon catheter

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US20100114022A1 true US20100114022A1 (en) 2010-05-06

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Application Number Title Priority Date Filing Date
US12/593,226 Abandoned US20100114022A1 (en) 2007-03-27 2008-03-27 Spiral balloon catheter
US12/593,211 Abandoned US20100137793A1 (en) 2007-03-27 2008-03-27 Spiral balloon catheter
US12/078,191 Active 2028-04-25 US7766871B2 (en) 2007-03-27 2008-03-27 Spiral balloon catheter
US12/822,865 Expired - Fee Related US8079978B2 (en) 2007-03-27 2010-06-24 Spiral balloon catheter

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Application Number Title Priority Date Filing Date
US12/593,211 Abandoned US20100137793A1 (en) 2007-03-27 2008-03-27 Spiral balloon catheter
US12/078,191 Active 2028-04-25 US7766871B2 (en) 2007-03-27 2008-03-27 Spiral balloon catheter
US12/822,865 Expired - Fee Related US8079978B2 (en) 2007-03-27 2010-06-24 Spiral balloon catheter

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US (4) US20100114022A1 (enExample)
EP (2) EP2136869B1 (enExample)
JP (4) JP2010522601A (enExample)
CN (2) CN101743032B (enExample)
CA (2) CA2681925C (enExample)
ES (1) ES2884648T3 (enExample)
WO (2) WO2008117257A2 (enExample)

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