CA1305385C - Catheter for opening constricted regions in the cardiovascular system - Google Patents

Catheter for opening constricted regions in the cardiovascular system

Info

Publication number
CA1305385C
CA1305385C CA000505120A CA505120A CA1305385C CA 1305385 C CA1305385 C CA 1305385C CA 000505120 A CA000505120 A CA 000505120A CA 505120 A CA505120 A CA 505120A CA 1305385 C CA1305385 C CA 1305385C
Authority
CA
Canada
Prior art keywords
dilatation
catheter
elements
support tube
cardiovascular system
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.)
Expired - Lifetime
Application number
CA000505120A
Other languages
French (fr)
Inventor
Eugen Hofmann
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.)
Schneider Medintag AG
Original Assignee
Schneider Medintag AG
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 Schneider Medintag AG filed Critical Schneider Medintag AG
Application granted granted Critical
Publication of CA1305385C publication Critical patent/CA1305385C/en
Anticipated expiration legal-status Critical
Expired - Lifetime legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M25/1002Balloon catheters characterised by balloon shape
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743Type of operation; Specification of treatment sites
    • A61B2017/00778Operations on blood vessels
    • A61B2017/00783Valvuloplasty
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M25/1011Multiple balloon catheters
    • A61M2025/1013Multiple balloon catheters with concentrically mounted balloons, e.g. being independently inflatable
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M2025/1043Balloon catheters with special features or adapted for special applications
    • A61M2025/1072Balloon catheters with special features or adapted for special applications having balloons with two or more compartments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/10Balloon catheters
    • A61M25/1011Multiple balloon catheters

Abstract

P.C. 7029 CATHETER FOR OPENING CONSTRICTED REGIONS
IN THE CARDIOVASCULAR SYSTEM

Abstract A catheter for opening constricted regions in the cardiovascular system includes an expandable dilatation zone comprising three dilatation elements arranged around a support tube. The dilatation elements are of tubular configuration, and each communicates at one end with a passage in the support tube leading to a pressure-suction pump. Constricted regions in the cardiovascular system may be enlarged or opened by introducing the dilatation zone into the affected site in a folded condition and expanding it peripherally therein. Upon expansion of the dilatation elements flow passages are formed between these elements, through which body fluid (for example blood) can pass with little resistance. The supply of body fluid to organs and tissues downstream of the affected site is thereby maintained. Interruption of the dilatation treatment is not required to insure this supply, thus permitting a substantial reduction in the overall duration of the medical procedure. The catheter may be employed, for example, to dilate blood vessels constricted by arteriosclerotic lesions and in valvuloplasty procedures, and may also be employed for treating constrictions in the esophagus,

Description

3~

P.C. 7029 CATHETER FOR OPENING CONST.RICTED REGIONS
IN TEIE CARDIOVASCULAR SYSTEM
__ _ The present invention relates to a catheter for opening constricted regions in the cardiovascular system of a patient.
Catheters of this kind have been in use for some time, for example to treat arterioscleEotic vascular co strictions. Such catheters have an expandable balloon at the distal end, to be brought into the region of constriction in a folded condition. By means of a passage accessible from the outside of the catheter, the balloon is filled with ~luid so that it expands peripherally, and the tissue bringing about the constriction is pressed outward into the vessel wall.
The expanded balloon blocks the vessel completely, so that the treatment must be periodically interrupt~d after brief intervals, for example to preverlt distal ischemia. Owing to the necessary interruptions, the over-all duration of treatment is correspondingl~
lengthened .
It is an object of the present invention to provide a catheter of the aforementioned kind whereby, even cluring a prolonged dilatation of the constrictic)n, the continuous supply of blood and oxygell to the downstream organs and tissues is maintained, which catheter is economical in manufacture and yet dependable in operation.
This and other objects of the invention are achieved with a novel catheter including an expandable -2~ S

dila~atiorl zone comprislng a plurality of dilatation eleme~ts arr~.nged around an elongated support tube, with the walls of the expanded di.latation elements, ta~en together, exhibiting a generally circular cross--section.
In the expanded condition, the dilatation elements and the wall of the treated vessel form several pass2ges through which body fluid or a gas can freely pass. Thus, in the case of three dilatation elements ~-~ arranged side-by-side around the support tube, three of sv.ch passageC. are ormed peripherallv hetween the wall of the treated vessel and the walls of adjacent dilatation e].ements, each of these passages extending ~hrough the dilatation ~one in the lengthwise direction ~5 of the catheter. Passage of the body fluid through the di.latation zone is assured even if some of the passages are blocked.
Since, instead of one large dilatation element, a plurality oE correspondingly smaller dilatation elem.nts are employedl a higher dilatation pressure is obtainable. This is because smaller dilatation elements can be subjected to a higher internal pressure. Thus, for example, a tubular dilatation elernent about 18 mrn in diameter may be subjected to an internal pressure of only about 200,000 Pa, wher~as a simiJ.ar d.ilatation element about 8 mm ln cli.ameter will withstand an internal pressure of about 800,000 Pa.
Compared to the known catheters of this kind, the overall duration of treatment can be shortened subst~.ntially, because dilatation of the constriction need not be interrupted periodically to insure an adequate supply of body fluid to tissues and or~ans.
~urther advantageous features and refinements of the invention are described elsewhere in the present application.
-3~ S

~ n embodimerl~ of the in~ention will ~e desc~ibed in more c,etail, hy way of example only, wi-th reference to ~he dra~in-ls. In the clrawinys:
FIG. l shows a catheter of the invention having three dilataticn elements to a yxeatly enlarged scale;
FIGS. 2a and 2b show cross-sections of alternative suppo.^t tubes taken at the line II-II in FIG. l;
F.G. 3a shows a cross-section of an unexpanded dilatation zone wlth folded walls taken at the line IIX-I:[I i.n FIG. 1 and, schematically, the wall of a constrlcted body vessel;
FIG. 3b is identical to FIG. 3a, except that the dilatation elements are expanded peripherally; and E'IG. 4 shows a longitudinal section of the dilatatj.on zone of the catheter of FIG. l.
:Cn the catheter represented in FIG. l, the dilatatiorl ~one l oE the catheter comprises three diJ.atat.ion elements 3a-c, in bundled side-by-side arrancJement around a support tube 2. The d.ilatation elements 3a-c are each closed at one encl 3d and open at t.he other end 3e. The ends 3d are fixed, for example welded, to the out~ide of the support tube 2. The open encls 3e are each inserted into an opening 27 of the support tube 2 and fixed therein ànd to the inside of the support tube 2 (FIG. 4), for example bonded with a cyanoacrylate adhesive. Fxamples of the support tube 2 are shown in F'IGS. 2a and 2b and described further belcw. The interiors of the dilatation elements 3a-c communicate by way of passayes 9a-c (FIG. 2a) or by way 3n of a co~non anr1ular passage 31 (FIG. 2b) with a pressure-suction pump, known per se and not shown in the ficJures. Bet.ween the ends 3d and 3e of the cli]atation eiements 3a-c, the support tube 2 may be sincJle-lumened, or of the same configuration as outside -this zone.
-4~ 85 The dilatation elemellts 3a c in expanded condition exhibit crvss-sec~ionally a yenerally circular wall, but may alternatively be elliptical instead, depending on the specific application. The inflation of the dilatation elements 3a-c may be effected in known manner with a liquid medium or gas. For this purpose, the interiors of the dilatation elements 3a-c are preferably interconnected, so that they may be respectively expanded simultaneously. When using the support tube of FIG. 2a, the passa~es 9a-c are joined on the pump side for this purpose. Conceivabl~, however, the dilatation e]ements 3a-c may instead be separately supplied and independently inflated.
The support tube 2 has a passage 8 or 20 leading to the outside at the tip 29, through which a guide wire 32 may be thrust, or contrast media as well as medication delivered. On the support tube 2, marking elements 4 of a suitable metal may be provided for locating the dilatation zone by X-rays.
~0 The support tube 2 is connected to a fitting 31 pro~ided with a connection 6 for the pressure-suction plm~p, and a gauge ~nd injection connection 7.
The use of a support tube 2a as in FIG~ ~a has been ~ouncl especially suitable. It has a cylindrical wall 11 subdivided internally by partit:ions 10a-c into a triangular inner passage a an~ three outer passages 9a-c. The outer passages 9a-c lead to the pressu,e-suction pump and to the dilatation elements 3a-c, whlle the inner passage 8 opens to the outside at the tip 29. However, the configuration o~ the support tube may instead be as shown in FIG. 2b. This double-lumened tube 2b has an outer annular passage 31 communicating with the dilatation elements 3a-c. A
coaxial inner wall 22 forms an inner passage 20 through -5- ~5~

~hich a ~t~-d~ wire 3~ ~ay be thrust. In this elnbodi.ment the sp~ces in passage 31 between the .respec.iv~ ends 3e of the dilatation elements are fil,led with pieces of a suitabl--~ sealing material such as an epoxy polymer Ino~- shown in the igures). The tubes 2a and 2b are flexible and may be made of a suitable pl.astic, for example by e~trusion.
The cat:heter according to the invention is brought in~o the region of the place to be clilated with the aid 1l~ of the guide wire 3~ in a mannex known.per se, with the dilat..ltion elements 3a-c folded as schematically represented in FIG. 3a. The dilatation elements 3a-c are then expanded to the requ:ired size by increased pressl1re. In this condition, the walls la-c o the d.i]ata~ion elements 3a-c, taken together, are generall~
circular in cro.s;-section and press externally against the wall 33 of the constrict.ion (FIG. 3b). Upon in''lation of the di].atation elements 3a-c, central passages 25 and peripheral passages 26 are formed, extending through the dilatation zone 1 in the lengthwise direction of the catheter, so that body fluid can pass through zone 1 with only slight resistance.
Since t,he flow oE the bocly fluicl is not interruptea~ ~. period of thexa.peutic intervent.ion of ade~,~uate length, during which the dilatation of the constl~i.ct.i-)n need not be interrupted, is available.
Compared to the use of known catheters, the overall durat:ion of t.he treatment can thereby be reducecl substanti.ally.
The catlleter according to the invention may be u.sed to en:l.arc3e constrictions in ,all sorts of vessels carryinc3 body fluids. Examples of other fields of application are the treatment of. constrictions in the esophagus or in the bile duct. Simult:aneously with the -6- ~3~ 5 dilati~n of the constriction, chemical substances may be introdu~e(l into thè body through the central passage, or, for example, the blood pcessure may be measured.
The catheter of the invention is particlllarly suitable for use in valvuloplasty procedures, in which the leaElets of stenotic heart valve~, in particular the aor-tic and mitral valves, are forced apart to re-open the valve and restore it to full Eunction, without havirg to perform open heart surgery. The advhntages of the use o the catheter of the present invention (as compared to a dilatation catheter having onlv a single expandable dilatation element) are the increased surface pressure that can be applied to force 1~ open the valve and, when three dilatation elements are ernployed as shown in the igu~es herein/ the capability to concenlrate that. pressure at 120 intervals ~as viewed in FIG. 3b), which is ideally suited for openiny the calcified seams of stenotic tri-leaflet valves.
In a preferred valvuloplasty procedure for opening a stenotic aortic valve, for example, a catheter of the invention (with the dilatation elements folded and non-expanded) carrying an appropriate guide wire 32 may be inserted through a suitable guiding catheter into the Eemoral arteryO The catheter and guide wire are advanced together to the end of the gl~iding catheter, after which the guicle wire is advanc~d by itsclf to th~
stcnotic valve and through the remaining opening thereo. The catheter of the invention is then advanced along the guide wire until the dilatation zone is positionecl in the valve opening, and the dilatation eleltlents are then expanded to open the valve. After deElating the dilatation elements the catheter of the invention, guide wire and guiding catheter are withdrawn from the patient 1 5 body.

Claims (7)

1. A catheter for opening constricted regions in the cardiovascular system of a patient comprising an elongated support tube having distal and proximal ends, a radially expandable dilatation means carried by said support tube adjacent the distal end thereof, and means for expanding and contracting said dilatation means, with said dilatation means comprising a plurality of dilatation elements arranged side-by-side around the support tune, and the walls of said plurality of dilatation elements, taken together, exhibiting a generally circular transverse cross-section when said dilatation means is expanded.
2. A catheter of claim 1 wherein said dilatation means consists essentially of three dilatation elements of substantially identical configuration.
3. A catheter of claim 1 wherein each of said dilatation elements is of elongated tubular configuration and extends in the lengthwise direction of the support tube, and said dilatation elements are each attached at their respective ends to the support tube.
4. A catheter of claim 3 wherein the support tube is single-lumened between said ends of said dilatation elements.
5. A catheter of claim 3 wherein each of said dilatation elements is closed at one end and connected at the other end to a passage formed within the support tube extending to the proximal end of the support tube.
6. A catheter of claim 5 wherein the interiors of all of said dilatation elements are in fluid communication with one another so that said elements are capable of being simultaneously expanded and contracted.
7. A catheter of claim 5 wherein separate passages are formed within the support tube for connection to each of said dilatation elements.
CA000505120A 1985-11-29 1986-03-26 Catheter for opening constricted regions in the cardiovascular system Expired - Lifetime CA1305385C (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CH5108/85 1985-11-29
CH5108/85A CH668192A5 (en) 1985-11-29 1985-11-29 CATHETER FOR TREATING NARROW BODIES, FOR EXAMPLE IN A BLOOD VESSEL.

Publications (1)

Publication Number Publication Date
CA1305385C true CA1305385C (en) 1992-07-21

Family

ID=4288059

Family Applications (1)

Application Number Title Priority Date Filing Date
CA000505120A Expired - Lifetime CA1305385C (en) 1985-11-29 1986-03-26 Catheter for opening constricted regions in the cardiovascular system

Country Status (10)

Country Link
US (1) US4787388A (en)
EP (1) EP0231725B1 (en)
JP (1) JPS62133970A (en)
AT (1) ATE68710T1 (en)
CA (1) CA1305385C (en)
CH (1) CH668192A5 (en)
DE (2) DE3682189D1 (en)
DK (1) DK172616B1 (en)
ES (1) ES8706453A1 (en)
IE (1) IE57524B1 (en)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3320943A1 (en) 2016-11-11 2018-05-16 Osypka Stiftung Peter Balloon dilation assembly
EP3569280A1 (en) 2018-05-14 2019-11-20 Peter Osypka Stiftung Balloon dilation assembly with av node /his bundle sensing-stimulation system

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EP0231725A1 (en) 1987-08-12
CH668192A5 (en) 1988-12-15
JPH0313907B2 (en) 1991-02-25
DK172616B1 (en) 1999-03-01
IE861117L (en) 1987-05-29
IE57524B1 (en) 1992-11-04
EP0231725B1 (en) 1991-10-23
DE3682189D1 (en) 1991-11-28
ES8706453A1 (en) 1987-07-01
DE8614552U1 (en) 1986-07-10
ATE68710T1 (en) 1991-11-15
DK151186A (en) 1987-05-30
DK151186D0 (en) 1986-04-03
US4787388A (en) 1988-11-29
ES553692A0 (en) 1987-07-01
JPS62133970A (en) 1987-06-17

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