Re-entry catheters and related methods
Inventors
Copeta, Luca • Guala, Carlo • Morero, Massimo • Silvestro, Claudio
Assignees
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Publication Number
US-9278192-B2
Publication Date
2016-03-08
Expiration Date
Abstract
Catheter devices and methods useable for directing a guidewire from a subintimal position within the wall of an artery into the true lumen of that artery or other applications wherein it is desired to direct a guidewire or other elongate device from one location to another location within a subject's body.
Core Innovation
The document describes a guidewire directing device that transitions between a first configuration and a second configuration to direct a guidewire re-entry. The device includes an elongate shaft having a distal portion with a distal end and a lumen extending to a distal outlet opening. An expandable member is provided on the distal portion of the shaft, and the expandable member has an expanded configuration and a nonexpanded configuration.
The device further includes at least one navigation apparatus comprising a loop shaped structure with a right side member and a left side member and an open space between the right and left side members. Proximal ends of the right and left side members are attached to the elongate shaft at locations proximal to the expandable member. Distal ends of the right and left side members are conjoined or commonly connected to a unitary distal end member at a location distal to the expandable member, so that the expandable member extends into the space between the right and left side members when the expandable member is non-expanded.
In the first configuration, the expandable member is non-expanded and the distal portion of the device shaft is substantially straight so that the device can advance over an entrapped guidewire. In the second configuration, the expandable member is expanded, causing the expandable member to displace in a direction above or below the right and left side members according to whichever direction presents the least resistance to expansion. This displacement results in curvature of the distal portion of the device shaft in the direction to which the expandable member has displaced, thereby aiming the distal opening to direct the guidewire into the true lumen.
Claims Coverage
The independent claims provided identify the inventive concept in a guidewire directing device that transitions between a substantially straight configuration and a curved configuration based on expandable-member displacement within a loop-shaped navigation apparatus. The main inventive features are concentrated in the structure of the elongate shaft, the expandable member, and the loop-shaped navigation apparatus with a conjoined unitary distal end member.
Transition between straight and expanded configurations based on expandable-member displacement
A device transitionable between a first configuration wherein the expandable member is non-expanded and the distal portion of the device shaft is substantially straight, and a second configuration wherein the expandable member is expanded, thereby causing the expandable member to displace in a direction above or below the right and left side members, whichever direction presents the least resistance to expansion, with such displacement resulting in curvature of the distal portion of the device shaft in the direction to which the expandable member has displaced.
Expandable member and distal shaft lumen terminating at a distal outlet opening
An elongate shaft having a distal portion with a distal end and a lumen that extends to a distal outlet opening, and an expandable member on the distal portion of the shaft, the expandable member having an expanded configuration and a nonexpanded configuration.
Loop-shaped navigation apparatus with right and left side members and conjoined unitary distal end member
At least one navigation apparatus comprising a loop shaped structure having a right side member and a left side member with open space between, wherein proximal ends of the right and left side members are attached to the elongate shaft at locations proximal to the expandable member and, when in its non-expanded configuration, the expandable member extends into the space between the right and left side members, and distal ends of the right and left side members are conjoined or commonly connected to a unitary distal end member at a location distal to the expandable member.
Overall claim coverage focuses on a guidewire directing device that uses a lumen-bearing elongate shaft with an expandable member and a loop-shaped navigation apparatus. The expandable member transitions from non-expanded to expanded to displace toward the least-resistance direction above or below the loop sides, thereby curving the distal shaft toward directing the guidewire into the true lumen.
Stated Advantages
Directs the guidewire into the true lumen without needing additional guidewires.
Documented Applications
True-lumen re-entry for coronary and peripheral chronic total occlusions (CTOs) when a guidewire is entrapped in a subintimal tract.
Re-entry and delivery of balloon/stent therapy over the re-entered wire.
Peripheral Arterial Disease (PAD).
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