Surgery – Instruments – Internal pressure applicator
Patent
1988-03-02
1990-05-08
Truluck, Dalton L.
Surgery
Instruments
Internal pressure applicator
623 12, A61M 2902
Patent
active
049229052
DESCRIPTION:
BRIEF SUMMARY
The invention refers to a catheter for establishing and dilating connections to or between body cavities, particularly for opening and dilating vessels.
Dilatation catheters are generally known, particularly as balloon catheters with two lumina (so-called Gruentzig catheters), one lumen of which serves for being slid over a guide wire previously inserted into a vessel narrowed or occluded in sectors by a thrombus, whereas the other lumen ends in a balloon sector of a predetermined axial extension and which is radially expandable through the lumen by the admission of pressure media.
When used in the prescribed manner, a dilatation catheter, is introduced into a vessel and advanced to the region of a thrombus, for example, while the process is visually controlled (by radiography). The thrombus is then be compressed by radial expansion of the balloon section as a result of the admission of a pressure medium which, as a rule, leads to a dilation of the vessel wall surrounding the thrombus.
Catheter recanalization or dilatation of arteries will, however, not always lead to satisfactory results. It was found that particularly in cases of arterial occlusion extending over longer sections, reocclusions are likely to form, or that the arterial wall will partly collapse again as a result of a serious sclerosis of the walls. Moreover, after vascular dilation, hyperplastic vascular reaction narrowing the lumen may occur.
Accordingly, it must be the purpose of the invention to create an improved form of catheter for establishing and dilating passages to or between body cavities, particularly for the opening and dilation of vessels in such a manner as to preclude as far as possible any collapse of the vessel walls, or hyperplastic vascular reactions, even with arterial reocclusions extending over greater lengths.
This task has been solved in that at least one radially expandable endoprosthesis, fixable in its expansion site, can be mounted on the catheter to enable the latter to be withdrawn from the newly formed or dilated passage, as for example, from the thrombus region, whereas the endoprosthesis will remain in its position, thus effectively preventing any reocclusion of the patent lumen.
The invention refers to a catheter fitted with an endoprosthesis that can be percutaneously introduced into a diseased vessel or into an opened passage leading to or existing between body cavities, with the endoprosthesis being expandable after placement and fixable in a predetermined expanding position, and being separable from the catheter which can be withdrawn again.
The application of such an endoprosthesis is by no means confined to the treatment of arterial stenosis but is also possible in cases of phlebothrombosis that cannot successfully be treated by balloon dilatation, for example. Likewise, arterial bypasses, arterviovenous and protocaval shunts can be percutaneously accomplished by using the catheter forming part of the invention. In the same way, an endoprosthetic therapy of an arterial aneurysm of, for example the aorta abdominalis and of the large pelvic arteries is also possible, just as the treatment of other cavities such as bile ducts, urinary tract and of cerebrospinal fluid pathways.
Although there exist reports of animal experiments (Andrew W. Cragg et al., "Percutaneous arterial grafting", Radiology 150, 45-49, 1984) where it was tried to insert a radially deformed, helical and spring-like spiral under expanding tension into a vessel, but the pushing ahead of such a spiral inside the catheter lumen did not prove practicable. At the same time, this method called for catheters of undesirably large diameters, nor could the problem of separating from the spirals the means necessary for pushing the latter right through the catheter lumen--after placement of the spirals--be solved.
For the implantation of an endoprosthesis the invention, therefore, suggests the use of a catheter on which a radially expandable endoprosthesis, fixable in its expansion site, is mounted and which can be separated, after its due placem
REFERENCES:
patent: 3868956 (1975-03-01), Alfidi et al.
patent: 4434797 (1984-03-01), Silander
patent: 4448195 (1984-05-01), LeVeen et al.
patent: 4503569 (1985-03-01), Dotter
patent: 4512338 (1985-04-01), Balko et al.
patent: 4580568 (1986-04-01), Gianturco
patent: 4655771 (1987-04-01), Wallsten
patent: 4681110 (1987-07-01), Wiktor
patent: 4762128 (1988-08-01), Rosenbluth
patent: 4762507 (1988-09-01), Fischell et al.
patent: 4776337 (1988-10-01), Palmaz
patent: 4800882 (1989-01-01), Gianturco
Strecker et al., "Experimentelle Untersuchungen mit einer neuen perkutan einfuhrbaren und aufdehnbaren GefaBendoprothese", Fortshr. Rontgenstr. 147, 1987.
Rousseau et al., Radiology, 164:709, 1987, "Self-Expanding Endovascular Prosthesis: An Experimental Study".
Mullins et al., "Implantation of Balloon-Expandable Intravascular Grafts by Catheterization in Pulmonary Arteries and Systemic Veins"-(Circulation, 77, 188, 1988).
Palmaz et al., "Expandable Intrahepatic Portacaval Shunt Stents", AJR, 145:821, 1985.
Palmaz et al., "Expandable Intraluminal Graft: A Preliminary Study", Radiology, 156:73, 1985.
Palmaz et al., "Atherosclerotic Rabbit Aortas: Expandable Intraluminal Grafting", Radiology, 160:723, 1986.
Maass et al., "Radiological Follow-Up of Transluminally Inserted Vascular Endoprostheses: An Experimental Study Using Expanding Spirals", Radiology, 152:659, 1984.
Sigwart et al., "Intravascular Stents to Prevent Occlusion and Restenosis after Transluminal Angioplasty", New England Journal of Medicine, 316:701, 1987.
Dotter, "Transluminally-Placed Coilspring Endarterial Tube Grafts", Invest. Radiol., 4:329, 1969.
Carrel, "Results of the Permanent Intubation of the Thoracic Aorta", Surgery Gyn. and Obs., XV:245, 1912.
Lawrence et al., "Percutaneous Endovascular Graft: Experimental Evaluation", Radiology, 103:357, 1987.
Rousseau et al., "Treatment of Post-Operative Biliary Stenosis by an Auto-Expansible Metallic Endoprostheses", Italy Meeting, May 27, 1987, p. 8.
Cesarini et al., "Experimental Endovascular Reinforcement", Neuroradiology 28:78, 1986.
Cragg et al., "Percutaneous Arterial Grafting", Radioloby 150:45, 1984.
Sugita et al., "Nonsurgical Implantation of a Vascular Ring Prosthesis Using Thermal Shape Memory Ti/Ni Alloy (Nitinol Wire)", Trans. Am. Soc. Artif. Intern. Organs, vol. XXXII, 1986.
Wright et al., "Percutaneous Endovascular Stents: An Experimental Evaluation", Radiology 156:69, 1985.
Wallace et al., "Tracheobronchial Tree: Expandable Metallic Stents Used in Experimental and Clinical Applications", Radiology 158:309, 1986.
Charnsangavej et al., "Stenosis of the Vena Cava: Preliminary Assessment of Treatment with Expandable Metallic Stents", Radiology 161:295, 1986.
Duprat et al., "Self-Expanding Metallic Stents for Small Vessels: An Experimental Evaluation", Radiology 162:469, 1987.
Rosch et al., "Experimental Intrahepatic Portacaval Anastomosis: Use of Expandable Gianturco Stents", Radiology 162:481, 1987.
German Document numbered 706,147 is of unknown origin.
Nawa et al., "Pulmonary Artery Connection in the Fontan Procedure, " Chest, 91:552, (1987).
Rosch et al., Jama, 259:327, 1988.
LandOfFree
Dilatation catheter does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Dilatation catheter, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Dilatation catheter will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-2342678