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EP1231969A1 - Dispositif de positionnement de fil-guide - Google Patents

Dispositif de positionnement de fil-guide

Info

Publication number
EP1231969A1
EP1231969A1 EP00975025A EP00975025A EP1231969A1 EP 1231969 A1 EP1231969 A1 EP 1231969A1 EP 00975025 A EP00975025 A EP 00975025A EP 00975025 A EP00975025 A EP 00975025A EP 1231969 A1 EP1231969 A1 EP 1231969A1
Authority
EP
European Patent Office
Prior art keywords
guidewire
positioning device
distal end
lumen
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Withdrawn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
EP00975025A
Other languages
German (de)
English (en)
Inventor
Mark Wilson Ian Webster
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.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Publication of EP1231969A1 publication Critical patent/EP1231969A1/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Withdrawn legal-status Critical Current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
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/013—One-way gripping collars
    • 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
    • A61M25/09—Guide wires
    • A61M2025/09116—Design of handles or shafts or gripping surfaces thereof for manipulating guide wires
    • 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
    • A61M25/09—Guide wires

Definitions

  • This invention relates to a method and device for facilitating the delivery of components along guidewires to branches of a tubular system. It has particular application for the percutaneous treatment of vascular and non-vascular disease, and in particular in the use of balloon angioplasty and for the deployment of balloon-expanded or self- expanding stents.
  • Balloon angioplasty or deployment of stents for lesions at a bifurcation may require that the component (balloon angioplasty or stent) be advanced into position over two guidewires, each of which is positioned in a separate downstream branch vessel. It is important that, when the guidewires are positioned prior to the component delivery, the guidewires do not become entangled or wrapped around each other.
  • a guidewire positioning device for facilitating the delivery of components along guidewires to two or more branches of a tubular system, said device including a shaft and two or more guidewire lumina interconnected to and parallel to one another, each said lumen having an open distal end and an open proximal end on said shaft.
  • the tubular system may be a vascular system and the device may be adapted for facilitating the delivery of components used in the management of vascular disease.
  • the device may be adapted for the delivery of stents to lesions at a bifurcation.
  • a method of positioning guidewires for the delivery of components to two or more branches of a tubular system including the steps of: engaging a first guidewire through a first guidewire lumen of a guidewire positioning device, before or after advancing the first guidewire along the tubular system and into a first branch; advancing one or more further guidewires along one or more further guidewire lumen, interconnected to and parallel to the first guidewire lumen, of the guidewire positioning device, to a distal end of said further guidewire lumen; advancing the guidewire positioning device, with the engaged further guidewire or guidewires, along the first guidewire by means of a shaft of the guidewire positioning device, until said distal end of the or each further guidewire lumen is adjacent the branching of the tubular system; rotating the shaft of the guidewire positioning device so that the distal end of the or each further guidewire lumen is adjacent a second branch of the tubular system; and advancing the, or one of the, further guidewires into the second
  • a method of treating a lesion of lesions at a bifurcation in a blood vessel including the steps of: engaging a first guidewire on a first guidewire lumen of a guidewire positioning device, before or after advancing the first guidewire along the blood vessel and into one down stream branch vessel; advancing a second guidewire to a distal end of a second guidewire lumen, interconnected to and parallel to the first guidewire lumen, of the guidewire positioning device; - securing the second guidewire in relation to the guidewire positioning device; advancing the guidewire positioning device, with the secured second guidewire, along the first guidewire by means of a shaft of the guidewire positioning device until the distal end of the second guidewire lumen is at the bifurcation; rotating the guidewire positioning device, if necessary, to align the distal end of the second guidewire lumen with the second branch vessel; advancing the second guidewire into the second branch vessel; withdrawing the guidewire positioning device along both the first and second
  • Figure 1 Shows a longitudinal section of a guidewire positioning device of the invention in one preferred form
  • Figure 2 shows a perspective view of the device of Figure 1 with a guidewire engaged in the second lumen;
  • Figure 3 shows an enlarged longitudinal section of the distal end of the device of Figure 2;
  • Figure 4 shows longitudinal sections of alternative configurations of the joins between the shaft and the two guidewire lumina of a guidewire positioning device of the invention.
  • Figure 5 shows a cross section through the manipulation aid of the device of Figures 1 and 2, in one preferred form.
  • a guidewire positioning device 1 of the invention has two guidewire lumen which are interconnected to one another and parallel.
  • the first guidewire lumen 4 has an open distal end 1 5 and an open proximal end 1 6.
  • the second guidewire lumen 5 has an open distal end 1 7 and open proximal 1 8.
  • a radio- opaque marker 8, 9 may be positioned at or close to the distal end 1 5, 17 so that the position of the distal ends may be determined through fluoroscopy.
  • the second guidewire lumen 5 may have a distal end 1 7 a short distance (approximately 1 0mm) proximal to the distal end 1 5 of the first guidewire lumen 4.
  • the second guidewire lumen 5 might extend to the distal end 1 5 of the first guidewire lumen 4, or it may end distally a considerable distance more than 10mm from the distal end 1 5 of the first guidewire lumen 4.
  • the distal end 1 7 of the second guidewire lumen 5 may have an oblique bevelled shape 10, as best seen in Figure 3. This shape aids advancement of the guidewire positioning device 1 into position in the vessel, and also aids advancement of a guidewire from the second guidewire lumen 5 into a branch vessel.
  • the radio-opaque marker 9 at or close to the distal end 1 7 of the second guidewire lumen 5 may have a symmetrical or asymmetrical configuration.
  • An asymmetrical shape, as shown in Figure 3 may aid orientation of the second guidewire lumen 5 in the vessel under fluoroscopy.
  • the guidewire lumen may have a double over-the- wire, double monorail, or combination over-the-wire/monorail configuration.
  • a double monorail configuration would require a separate proximal catheter shaft (as in Figures 1 and 2) .
  • proximal catheter shaft at the proximal end of this shaft 3 there may be a longitudinally enlarged hub 2, or manipulation aid, to aid catheter manipulation.
  • This hub 2 may have a longitudinal recessed groove 7 into which a guidewire may be positioned, as shown in Figures 2 and 5. Slotting a guidewire 6 in place in this groove 7 holds the guidewire in position in relation to the guidewire positioning device, as the device is advanced, withdrawn or rotated to manipulate the distal end of the device.
  • Figure 5 shows that this groove 7 may include ribbing 1 9 or other means, to grip the guidewire 6.
  • one or more additional parallel lumina may be included for use in applications where a parent vessel or tube branches into more than two branches or where more than one separate component is required to be delivered to one particular branch.
  • Figures 1 and 3 show a guidewire positioning device 1 of the invention in a monorail version.
  • the proximal ends 1 6, 1 8 of the guidewire lumina 4, 5 are shown off set in this embodiment, with the proximal end 1 6 of the first guidewire lumen 1 5 proximal of the proximal end 1 8 of the second guidewire lumen 5, consistent with the embodiment of Figure 4B.
  • the embodiment of Figure 4A shows the two proximal ends 1 6, 1 8 at the same proximal position in relation to the shaft 3.
  • Figure 4 also shows of the interconnection between the shaft 3 and the lumina 4, 5.
  • the guidewire positioning device of the invention including the hub 2, shaft 3 and lumina 4, 5 may be integrally formed from plastics material.
  • one method of use after deployment of the guide catheter, is to advance a first guidewire via the first guidewire lumen 4 and along the guide catheter, across the bifurcation lesion and into one downstream branch vessel.
  • the first guidewire may be advanced along the guide catheter first and the first guidewire lumen then engaged on the first guidewire via its proximal end.
  • a second guidewire is then positioned in the second guidewire lumen 5 of the device and advanced until the distal end of the guidewire is close to or adjacent the distal end 1 7 of the second guidewire lumen 5.
  • the proximal portion of the second guidewire is then slotted into the recessed groove 7 in the hub 2 at the proximal end of the catheter shaft 3, to hold that guidewire in position as the guidewire positioning device 1 is subsequently manipulated.
  • the guidewire positioning device 1 and the second guidewire are then advanced as a unit along the first guidewire already positioned in the vessel.
  • the guidewire positioning device 1 is advanced until the distal end 1 5 of the first guidewire lumen 4 is just beyond the bifurcation" and the distal end 1 7 of the second guidewire lumen 5 is almost at the bifurcation. It will be appreciated that in an embodiment of the device in which the distal ends of the guidewire lumina are adjacent one another then both will be positioned substantially at the bifurcation.
  • the guidewire positioning device 1 is then rotated by manipulation of the hub 2 so that the bevelled, marked distal end 1 7 of the second guidewire lumen 5 is aligned with the other branch vessel which does not yet have a guidewire.
  • the second guidewire is then released from the hub and steered into the second branched vessel. Once the second guidewire is in position the guidewire positioning device may be withdrawn, with both guidewires kept in position, one in each downstream branch vessel.
  • Angioplasty balloons or stents can then be advanced over one or both guidewires to treat the lesion in the knowledge that the guidewires are not entangled or wrapped around each other.
  • the guidewire positioning device 1 of the invention provides a relatively simple device which can be used to facilitate the delivery of guidewires to branched regions of a tubular system, such as blood vessels, to enable the delivery of components required in those branches along the guidewires, without the risk of complications associated with multiple guidewires becoming wrapped or entangled with one another.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (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

L'invention concerne un dispositif (1) permettant de faciliter l'administration, le long de fil-guides, de composants vers des ramifications d'un système tubulaire. Le dispositif convient tout particulièrement pour le traitement percutané de maladies vasculaires et non vasculaires, et plus spécialement pour l'angioplastie transluminale ou pour le déploiement d'endoprothèses vasculaires. Le dispositif comprend une tige (3) et deux ou plusieurs lumières (4, 5) de fil-guide interconnectées et parallèles les unes aux autres. Chaque lumière présente une extrémité distale ouverte et une extrémité proximale ouverte sur la tige (3). Dans une conception recommandée, le dispositif comprend un élément d'aide (2) à la manipulation placé à une extrémité proximale de la tige (3) pouvant entrer en contact avec l'un des fil-guides (6) et facilitant la rotation du dispositif. L'invention concerne également un procédé de positionnement des fil-guides en vue de l'introduction ultérieure de composants tels que des endoprothèses vasculaires dans des lésions, à une bifurcation, à l'aide du dispositif de positionnement de fil-guide.
EP00975025A 1999-10-26 2000-10-26 Dispositif de positionnement de fil-guide Withdrawn EP1231969A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
NZ50058299 1999-10-26
NZ50058299 1999-10-26
PCT/NZ2000/000210 WO2001030433A1 (fr) 1999-10-26 2000-10-26 Dispositif de positionnement de fil-guide

Publications (1)

Publication Number Publication Date
EP1231969A1 true EP1231969A1 (fr) 2002-08-21

Family

ID=19927590

Family Applications (1)

Application Number Title Priority Date Filing Date
EP00975025A Withdrawn EP1231969A1 (fr) 1999-10-26 2000-10-26 Dispositif de positionnement de fil-guide

Country Status (3)

Country Link
EP (1) EP1231969A1 (fr)
AU (1) AU1313301A (fr)
WO (1) WO2001030433A1 (fr)

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US6190352B1 (en) * 1997-10-01 2001-02-20 Boston Scientific Corporation Guidewire compatible port and method for inserting same
US6482217B1 (en) 1998-04-10 2002-11-19 Endicor Medical, Inc. Neuro thrombectomy catheter
US8328829B2 (en) 1999-08-19 2012-12-11 Covidien Lp High capacity debulking catheter with razor edge cutting window
US7713279B2 (en) 2000-12-20 2010-05-11 Fox Hollow Technologies, Inc. Method and devices for cutting tissue
US7771444B2 (en) 2000-12-20 2010-08-10 Fox Hollow Technologies, Inc. Methods and devices for removing material from a body lumen
US6299622B1 (en) 1999-08-19 2001-10-09 Fox Hollow Technologies, Inc. Atherectomy catheter with aligned imager
US7708749B2 (en) 2000-12-20 2010-05-04 Fox Hollow Technologies, Inc. Debulking catheters and methods
JP2004275435A (ja) * 2003-03-14 2004-10-07 Terumo Corp カテーテル
US8246640B2 (en) 2003-04-22 2012-08-21 Tyco Healthcare Group Lp Methods and devices for cutting tissue at a vascular location
GB2432319A (en) * 2005-11-21 2007-05-23 Taunton & Somerset Nhs Trust Probing catheters for intravascular procedures
US20070276419A1 (en) 2006-05-26 2007-11-29 Fox Hollow Technologies, Inc. Methods and devices for rotating an active element and an energy emitter on a catheter
US8784440B2 (en) 2008-02-25 2014-07-22 Covidien Lp Methods and devices for cutting tissue
EP2358282B1 (fr) 2008-10-13 2017-12-06 Covidien LP Dispositifs de manipulation d'un axe de cathéter
AU2010241801B2 (en) 2009-04-29 2013-04-11 Covidien Lp Methods and devices for cutting and abrading tissue
EP2429423B1 (fr) 2009-05-14 2015-11-11 Covidien LP Cathéter d'athérectomie facilement nettoyable
CN104490454A (zh) 2009-12-02 2015-04-08 泰科保健集团有限合伙公司 用于切割组织的方法和装置
WO2011072149A1 (fr) 2009-12-11 2011-06-16 Fox Hollow Technologies, Inc. Dispositif de retrait de matériau doté d'une efficacité de capture de matériau améliorée et procédés d'utilisation afférents
KR101493138B1 (ko) 2010-06-14 2015-02-12 코비디엔 엘피 물질 제거 장치
AU2011319797B2 (en) 2010-10-28 2015-04-09 Covidien Lp Material removal device and method of use
EP2637567B1 (fr) 2010-11-11 2017-03-08 Covidien LP Cathéters flexibles de réduction du volume dotés de dispositifs d'imagerie et procédés de fabrication de ceux-ci
US8992717B2 (en) 2011-09-01 2015-03-31 Covidien Lp Catheter with helical drive shaft and methods of manufacture
US9579157B2 (en) 2012-09-13 2017-02-28 Covidien Lp Cleaning device for medical instrument and method of use
EP2916751B1 (fr) 2012-11-08 2016-09-28 Covidien LP Cathéter de retrait de tissu comprenant un mécanisme de commande fonctionnelle
US9943329B2 (en) 2012-11-08 2018-04-17 Covidien Lp Tissue-removing catheter with rotatable cutter
US9526519B2 (en) 2014-02-03 2016-12-27 Covidien Lp Tissue-removing catheter with improved angular tissue-removing positioning within body lumen
US9456843B2 (en) 2014-02-03 2016-10-04 Covidien Lp Tissue-removing catheter including angular displacement sensor
WO2015200702A1 (fr) 2014-06-27 2015-12-30 Covidien Lp Dispositif de nettoyage pour cathéter, et cathéter le comprenant
US10314667B2 (en) 2015-03-25 2019-06-11 Covidien Lp Cleaning device for cleaning medical instrument
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US10314664B2 (en) 2015-10-07 2019-06-11 Covidien Lp Tissue-removing catheter and tissue-removing element with depth stop
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Also Published As

Publication number Publication date
AU1313301A (en) 2001-05-08
WO2001030433A1 (fr) 2001-05-03

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