Surgery – Diagnostic testing – Flexible catheter guide
Reexamination Certificate
2000-05-31
2001-12-11
Hindenburg, Max (Department: 3736)
Surgery
Diagnostic testing
Flexible catheter guide
Reexamination Certificate
active
06328702
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates generally to intravascular guide wires for use in procedures such as angioplasty. More specifically, the present invention relates to an extendable guide wire useful for effecting catheter exchanges.
BACKGROUND OF THE INVENTION
Guide wires are currently used to position catheters within the arterial system for procedures such as angioplasty and angiography. The guide wire is typically advanced within the vasculature of a patient to a desired position, followed by a catheter, advanced over the guide wire. It is often necessary to remove a first catheter from the patient and advance a second catheter into position. When the catheter is in position within the patient, a proximal segment of guide wire extends from the patient. The extending proximal segment can be grasped and used to maintain the position of the guide wire.
Withdrawing a catheter over an in-place guide wire typically requires a guide wire extending from the patient for a length at least as long as the catheter guide wire lumen. This is required so as to present an uncovered portion of the guide wire to grasp. “Over-the-wire” catheters have a guide wire lumen over substantially the entire catheter length. “Single-operator-exchange” catheters can have a shorter guide wire lumen, extending only through the catheter distal region. Withdrawing an over-the-wire catheter over the guide wire would completely cover a standard length guide wire, presenting a problem. This problem has been dealt with in several ways.
The original guide wire can be withdrawn and replaced by a double length, exchange guide wire, providing a graspable guide wire portion during the exchange. This can complicate the procedure as the in-place guide wire must be removed and another inserted. Alternatively, a double length guide wire can be used from the start. This can be awkward as the portion of the guide wire extending from the patients body can be unwieldy, and may be unnecessary, if only the first catheter is needed.
In another method, an extension guide wire is provided and crimped or otherwise joined to the in-place guide wire, thereby creating a double length guide wire for effecting a catheter exchange. The crimping adds an additional step and requires the joining of two extremely small wires in the operating room. Crimping also raises the possibility of wire separation during catheter exchange. What remains to be provided is a guide wire that is not a double length guide wire, yet does not require the joining of an extension guide wire to effect an over-the-wire catheter exchange.
SUMMARY OF THE INVENTION
The present invention includes an extendable guide wire for performing catheter exchanges. The extendable guide wire makes possible over-the-wire catheter exchanges without requiring either a double long guide wire for the entire procedure or the coupling of an extension wire to the guide wire. The guide wire of the present invention includes a distal member and a proximal member, the proximal member distal end being coupled to the proximal end of the distal member. A substantial portion of the distal member extends into the patient.
The proximal member has a first, compressed or shortened state and a second, extended or lengthened state. The proximal member extended length is substantially longer than the proximal member shortened length. One guide wire in accordance with the present invention includes wire strands wound into a coil in the proximal member. The wire strands can be pulled proximally, drawing out the coiled strands into substantially straighter and longer strands. The proximal member can have one coil counter-wound within another coil, which can increase the number of strands present in the lengthened, proximal member. In one embodiment, the strands in the proximal member are braided about one another.
One proximal member includes two, 0.0035 inch diameter wires forming an outer coil, counter-wound over an inner coil formed of two, 0.0025 inch diameter wires. Another proximal member includes two, 0.003 inch diameter wires forming an outer coil, counter-wound over an inner coil formed of a single, 0.0025 inch diameter wire. In one proximal member, the proximal member distal wire ends are secured to the distal member proximal end, and the wire free proximal ends to each other, utilizing brazing. Another proximal member secures the proximal member distal wire ends to the distal member proximal end, and the proximal wire free ends to each other, by inserting the wires within hypotubes and affixing the wires with solder. In one embodiment, a sheath is provided to slide over the proximal member wires after extension, providing a stronger member to advance and retract catheters over.
In use, the guide wire, with proximal member in a shortened, coiled state, is advanced into the patient, leaving the proximal member substantially outside of the body. A first catheter can be advanced over the guide wire distal member. When removal of the first catheter is desired, the proximal guide wire member can be grasped at the proximal end and pulled proximally, thereby elongating the proximal member by drawing out the proximal coil members to a length substantially greater than the compressed shorter length. The proximal member, after lengthening, includes one or more wires which can retain some of three dimensional coil structure and can be intertwined, providing support for sliding catheters thereover. With the proximal member lengthened, the first catheter can be withdrawn proximally over the distal and proximal members, and a second catheter advanced distally over both proximal and distal members.
In one catheter exchange method, a sheath is provided and advanced distally to substantially cover the lengthened proximal wires prior to sliding any catheters thereover. The sheath provides added strength to support the advancement and withdrawal of catheters over the lengthened proximal wires. The strengthening sheath allows use of smaller diameter wires or a smaller number of wires, which can allow for a smaller, compressed proximal member outside diameter and/or compressed length than possible without the sheath.
REFERENCES:
patent: 4779628 (1988-10-01), Machek
patent: 4827941 (1989-05-01), Taylor et al.
patent: 4846193 (1989-07-01), Tremulis et al.
patent: 4875489 (1989-10-01), Messner et al.
patent: 4907332 (1990-03-01), Christain et al.
patent: 4917103 (1990-04-01), Gambale et al.
patent: 4922923 (1990-05-01), Gambale et al.
patent: 4966163 (1990-10-01), Kraus et al.
patent: 5060660 (1991-10-01), Gambale et al.
patent: 5109867 (1992-05-01), Twyford et al.
patent: 5113872 (1992-05-01), Jahrmarkt et al.
patent: 5117838 (1992-06-01), Palmer et al.
patent: 5133364 (1992-07-01), Palermo et al.
patent: 5139032 (1992-08-01), Jahrmarkt et al.
patent: 5188621 (1993-02-01), Samson
patent: 5191888 (1993-03-01), Palmer et al.
patent: 5195535 (1993-03-01), Shank
patent: 5197486 (1993-03-01), Frassica
patent: 5267573 (1993-12-01), Evans et al.
patent: 5271415 (1993-12-01), Foerster et al.
patent: 5275173 (1994-01-01), Samson et al.
patent: 5282478 (1994-02-01), Fleischhaker, Jr. et al.
patent: 5295492 (1994-03-01), Sellers
patent: 5361777 (1994-11-01), Sellers
patent: 5365944 (1994-11-01), Gambale
patent: 5415178 (1995-05-01), Hsi et al.
patent: 5421348 (1995-06-01), Larnard
patent: 5441055 (1995-08-01), Ales et al.
patent: 5513650 (1996-05-01), Johansen
patent: 5546958 (1996-08-01), Thorud et al.
Crompton Seager & Tufte LLC
Hindenburg Max
Sci-Med Life Systems, Inc.
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