Surgery – Truss – Pad
Patent
1992-04-10
1993-08-03
Aschenbrenner, Peter A.
Surgery
Truss
Pad
604280, 128658, A61M 2500
Patent
active
052319946
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND OF THE INVENTION
The invention relates to a hose or tubular guide catheter to accommodate and guide a balloon catheter for dilatation of coronary arteries of the heart.
From a printed source due to the firm of Schneider Medintag, Zurich, "Guide catheter with atraumatic tip," "Soft Touch" type, a hose or guide catheter of the kind in question is known whose end has an annular edge extending substantially axial to the axis of the catheter. In the immediate region of its end, the catheter has a more or less curved form, to facilitate insertion of the end from the aorta into the opening of a coronary artery, or at least render it possible. The guide catheter is moved manually so that its tip will enter a coronary artery and remain there, whereafter a guide wire is passed through the guide catheter into the coronary artery, and then a balloon catheter is introduced over the guide wire and through the guide catheter until the balloon arrives in the region of a constriction of the coronary artery, where the balloon, limited in diameter, is inflated and the constricted place in the coronary artery is thereby dilated and enlarged.
The diameter of the guide catheter is relatively large so that, with adequate wall thickness, a balloon catheter will pass through. This comparatively large diameter of the guide catheter leads in many cases to its tightly closing the entrance opening of the coronary artery, so that the blood supply of the coronary artery is blocked. The myocardium is thereby rendered ischemic with a risk of mortification.
To avoid this disadvantage, the said company print also mentions a guide catheter having lateral holes at some distance from its tip, through which blood is to enter the guide catheter from the aorta and pass on into the coronary artery. If these lateral openings are too close to the anterior edge of the guide catheter, there is danger that the openings will be located in the region of the coronary artery and thus be closed off by its walls, so that they cannot serve their purpose. If the lateral holes are more distant from the anterior edge of the tip of the guide catheter, blood can indeed flow in, but then there is the disadvantage that contrast medium to be injected into the coronary artery through the guide catheter for X-ray visualization of the artery will leak out of the lateral holes, be lost for purposes of visualizing the coronary artery, and impede or at least impair the X-ray image by entering the aorta. Besides, there is the disadvantage that the lateral holes tend to be clogged by blood clots.
SUMMARY OF THE INVENTION
The object of the invention is to provide a guide catheter of the kind in question, not subject to the disadvantages portrayed, that is, avoiding interruption of the blood supply to the coronary artery and the loss of contrast medium from the guide catheter into the aorta and at the same time not losing the desired guiding function.
That object of the invention is accomplished by the teaching specified in the characterizing clause of Claim 1.
The fundamental idea of that teaching is to provide the wall of the guide catheter in the anterior region with a slit, which may for example be prepared by simply cutting the catheter away laterally. If such a guide catheter is inserted in the entrance opening of a coronary artery just so far that the posterior end of the recess or slit is still located within the region of the aorta, than blood can flow from the aorta into the catheter and through it into the coronary artery. In this insertion position, the guide catheter can already perform its guiding function fully. If contrast media are to be introduced, the guide catheter may be advanced again briefly so that the recess or slit lies in the region of the entrance opening of the coronary artery throughout its full length, and is therefore largely closed off by the artery wall. This advance may take place briefly when contrast medium is injected. Then the guide catheter may be withdrawn again somewhat, so that blood can again enter as previously descri
REFERENCES:
patent: 3508554 (1970-04-01), Sheridan
patent: 4490138 (1984-12-01), Lipsky et al.
patent: 4531943 (1985-07-01), Van Tassel et al.
patent: 4801297 (1989-01-01), Mueller
patent: 4863441 (1989-09-01), Lindsay et al.
USCI a Division of C. R. Bard Inc., Pamphlet on Extracorporeal Circ. Cannulae & Vinyl Specialty Cath. p. 3.
Akers Lawrence C.
Aschenbrenner Peter A.
LaPierre John L.
Richardson Peter C.
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