The various embodiments disclosed herein relate to balloon catheters for use as medical devices in various procedures, including, but not limited to, endovascular aortic repair, occlusion, and vessel sizing. More specifically, the various embodiments relate to such balloon catheters having variable shaft stiffnesses.
The use of balloon catheters during various procedures, including endovascular aortic repair (“EVAR”) procedures, is well known. In a typical EVAR procedure, one or more covered stents are placed in the aorta or a vessel in the neighboring vasculature, to treat an aneurysm. The covered stent(s) allows the blood to flow through the stent(s) and thus relieves the aneurysm of the blood pressure (thus preventing the aneurysm from rupture). In certain procedures, a non-covered stent or flow diverter is used. The stents are delivered on a catheter inserted through an entry site (typically the femoral artery in the groin area) via an introducer sheath and over a guidewire. Once the stents are deployed, a balloon catheter is inserted over a guidewire through the entry site. The balloon catheter is advanced to the area in the vessel where a stent graft has been deployed and then inflated in order to improve the apposition of the stent graft within the vessel and to mold the stent after placement. The covered stent typically has a fabric within its structure and the molding (or modeling) also helps smooth out any wrinkles. The balloon may also be inflated within the various vessels in order to occlude blood flow as may be required during EVAR or other medical procedures. Other medical procedures may utilize the balloon catheter to size or remodel vessels or other anatomical structures.
A known, single stiffness balloon catheter 10 is shown in
There is a need in the art for improved balloon catheters for use in various medical procedures, including EVAR procedures.
Discussed herein are various balloon catheters having shaft segments and/or zones of varying stiffness and related methods for performing procedures with such catheters.
In Example 1, a balloon catheter comprises a catheter shaft and an expandable balloon operably coupled to the catheter shaft. The shaft comprises a proximal segment of the catheter shaft having a first predetermined stiffness, a distal segment of the catheter shaft having a second predetermined stiffness, and a transition zone disposed between the proximal segment and the distal segment, wherein the transition zone comprises a stiffness that varies gradually along a length of the zone.
Example 2 relates to the balloon catheter according to Example 1, wherein the second predetermined stiffness is lower than the first predetermined stiffness.
Example 3 relates to the balloon catheter according to Example 1, wherein the first and second predetermined stiffnesses are higher than any portion of the stiffness of the transition zone.
Example 4 relates to the balloon catheter according to Example 1, wherein the transition zone comprises proximal, middle and distal portions, wherein the proximal and distal portions are stiffer than the middle portion.
Example 5 relates to the balloon catheter according to Example 1, wherein the transition zone comprises a proximal portion and a distal portion, wherein the proximal portion is stiffer than the distal portion.
Example 6 relates to the balloon catheter according to Example 1, further comprising a second transition zone disposed distally of the distal segment, wherein the second transition zone comprises a proximal portion and a distal portion, wherein the proximal portion is more flexible than the distal portion.
Example 7 relates to the balloon catheter according to Example 6, further comprising a second distal segment distal to the second transition zone, wherein the second distal segment has a predetermined stiffness.
Example 8 relates to the balloon catheter according to Example 1, wherein the gradual variation in the stiffness is caused by a gradual variation in a composition of the transition zone.
Example 9 relates to the balloon catheter according to Example 8, wherein the gradual variation in the composition comprises a gradual variation in amounts of at least two different components.
Example 10 relates to the balloon catheter according to Example 1, wherein a proximal portion of the transition zone comprises a stiffness substantially similar to the first predetermined stiffness and a distal portion of the transition zone comprises a stiffness substantially similar to the second predetermined stiffness.
In Example 11, a method for performing a medical procedure comprises inserting a balloon catheter over a guidewire into a blood vessel through an entry site, positioning the balloon within an anatomical structure, inflating the balloon, deflating the balloon, and retracting the balloon catheter from the blood vessel. The balloon catheter comprises a catheter shaft and an expandable balloon operably coupled to the catheter shaft. The catheter shaft comprises a proximal segment of the catheter shaft having a predetermined stiffness, a distal segment of the catheter shaft having a predetermined stiffness that is lower than the proximal segment, and a transition zone disposed between the proximal segment and the distal segment, wherein the transition zone comprises a stiffness that varies gradually along a length of the zone.
Example 12 relates to the method according to Example 11, wherein the medical procedure is an endovascular aortic repair procedure, wherein the blood vessel is an aorta or neighboring vessel, wherein the inflating the balloon further comprises expanding a stent or improving apposition of the stent.
Example 13 relates to the method according to Example 11, wherein the medical procedure is vessel occlusion.
Example 14 relates to the method according to Example 11, wherein the medical procedure is sizing of the blood vessel or another anatomical structure.
Example 15 relates to the method according to Example 11, wherein the medical procedure is vessel or structural remodeling.
In Example 16, a method for performing a medical procedure comprises inserting a balloon catheter over a guidewire into a blood vessel through an entry site, positioning the balloon within an anatomical structure, inflating the balloon, deflating the balloon, and retracting the balloon catheter from the blood vessel. The balloon catheter comprises a catheter shaft and an expandable balloon operably coupled to the catheter shaft. The catheter shaft comprises a proximal segment of the catheter shaft having a predetermined stiffness, a distal segment of the catheter shaft having a predetermined stiffness that is lower than the proximal length, and a middle segment disposed between the proximal segment and the distal segment.
Example 17 relates to the method according to Example 16, wherein the medical procedure is an endovascular aortic repair procedure, wherein the blood vessel is an aorta or neighboring vessel, wherein the inflating the balloon further comprises expanding a stent or improving apposition of the stent.
Example 18 relates to the method according to Example 16, wherein the medical procedure is vessel occlusion.
Example 19 relates to the method according to Example 16, wherein the medical procedure is sizing of the blood vessel or another anatomical structure.
Example 20 relates to the method according to Example 16, wherein the medical procedure is vessel or structural remodeling.
Example 21 relates to the method according to Example 16, wherein the middle segment has a stiffness that is lower than the proximal segment and higher than the distal segment.
Example 22 relates to the method according to Example 16, wherein the middle segment has a stiffness that is substantially the same as the proximal segment.
Example 23 relates to the method according to Example 16, wherein the middle segment has a stiffness that is substantially the same as the distal segment.
In Example 24, a method for performing a medical procedure comprises inserting a balloon catheter over a guidewire into a blood vessel through an entry site, positioning the balloon within an anatomical structure, inflating the balloon, deflating the balloon, and retracting the balloon catheter from the blood vessel. The balloon catheter comprises a catheter shaft and an expandable balloon operably coupled to the catheter shaft. The catheter shaft comprises a transition zone comprising a stiffness that varies gradually along a length of the zone, wherein a proximal portion of the transition zone is stiffer than a distal portion of the transition zone.
Example 25 relates to the method according to Example 24, wherein the medical procedure is an endovascular aortic repair procedure, wherein the blood vessel is an aorta or neighboring vessel, wherein the inflating the balloon further comprises expanding a stent or improving apposition of the stent.
Example 26 relates to the method according to Example 24, wherein the medical procedure is vessel occlusion.
Example 27 relates to the method according to Example 24, wherein the medical procedure is sizing of the blood vessel or another anatomical structure.
Example 28 relates to the method according to Example 24, wherein the medical procedure is vessel or structural remodeling.
Example 29 relates to the method according to Example 24, wherein the first predetermined stiffness is a higher stiffness, wherein the catheter shaft further comprises a higher stiffness segment distal to the transition zone.
Example 30 relates to the method according to Example 24, wherein the catheter shaft further comprises a proximal segment of the catheter shaft having a first predetermined stiffness, wherein the proximal segment is disposed proximally of the transition zone.
Example 31 relates to the method according to Example 24, wherein the catheter shaft further comprises a distal segment of the catheter shaft having a second predetermined stiffness, wherein the distal segment is disposed distally of the transition zone.
In Example 32, a method for performing a medical procedure comprises inserting a balloon catheter over a guidewire through an entry site, positioning the balloon within an anatomical structure, inflating, deflating the balloon, and retracting the balloon catheter from the blood vessel. The balloon catheter comprises a catheter shaft and an expandable balloon operably coupled to the catheter shaft. The catheter shaft comprises first higher stiffness length at a proximal portion of the catheter shaft, a first medium stiffness length distal to the first higher stiffness length, a higher flexibility length distal to the first medium stiffness length, and a second medium stiffness length distal to the higher flexibility length.
Example 33 relates to the method according to Example 32, wherein the medical procedure is an endovascular aortic repair procedure, wherein the blood vessel is an aorta or neighboring vessel, wherein the inflating the balloon further comprises expanding a stent or improving apposition of the stent.
Example 34 relates to the method according to Example 32, wherein the medical procedure is vessel occlusion.
Example 35 relates to the method according to Example 32, wherein the medical procedure is sizing of the blood vessel or another anatomical structure.
Example 36 relates to the method according to Example 32, wherein the medical procedure is vessel or structural remodeling.
Example 37 relates to the method according to Example 32, wherein the catheter shaft further comprises a second higher stiffness length distal to the second medium stiffness length.
While multiple embodiments are disclosed, still other embodiments of the present invention will become apparent to those skilled in the art from the following detailed description, which shows and describes illustrative embodiments of the invention. As will be realized, the invention is capable of modifications in various obvious aspects, all without departing from the spirit and scope of the present invention. Accordingly, the drawings and detailed description are to be regarded as illustrative in nature and not restrictive.
The various embodiments disclosed herein relate to balloon catheters for use in various medical procedures, including EVAR procedures.
With the advent of increasingly more flexible stent grafts, more stent grafts are being implanted into tortuous and highly angulated blood vessels, including, for example, the aorta or neighboring vessels. This creates a need for balloon catheters that have more distal flexibility and trackability. That is, it creates a need for balloon catheters that are more flexible, at least on the distal end, in order to access the deployed stents and more trackable to navigate more tortuous vasculature. It is still advantageous to have a less flexible proximal section in order to maintain good catheter pushability.
The implementations disclosed and contemplated herein relate to variable stiffness balloon catheters, including variable stiffness multi-lumen and coaxial catheters, for use in various medical procedures, including EVAR procedures. In certain balloon catheter embodiments, the shaft has a stiffer proximal end and a relatively more flexible distal end. This gives the catheter embodiments the characteristics of having similar pushability features in the proximal portion as known balloon catheters while having a distal end that is more flexible and trackable to conform and track through more tortuous or angulated vessels and anatomical structures.
It is understood that the term “stiffness” as used herein means bending stiffness of a catheter shaft, which is the resistance of a beam-like member (such as a catheter shaft) to lateral deformation or deflection given the application of a lateral force. In certain implementations as described herein, a material with a higher durometer is described as a material that has a higher stiffness than a material with a lower durometer. In this context, it is understood that a catheter shaft made of a higher durometer material has a higher stiffness than catheter shaft of the same geometry and cross-sectional area made of a lower durometer material.
One embodiment, as shown in
In one embodiment, the transition zone 36 of
It is understood that the variation in stiffness can be comprised of any known variation. For example, in certain implementations, the transition zone can have a proximal portion that has a first predetermined stiffness, and then there is a transition moving distally to a higher stiffness, followed by a further transition moving further distally to a lower stiffness. In a different alternative embodiment, the transition zone can have a proximal portion that has a first predetermined stiffness, and then there is a transition moving distally to a lower stiffness, followed by a further transition moving further distally to a higher stiffness. In yet another alternative, the transition zone can have a variation in stiffness that changes linearly along at least a part of the transition zone.
In accordance with certain implementations, the variation in the stiffness of the transition zone is accomplished by predetermined variation in the amounts of at least two different materials that make up the transition zone. Alternatively, the variation can be accomplished using predetermined variation in the amounts of three or more different materials.
For example, in one embodiment, a variable stiffness catheter with a transition zone is produced during the shaft extrusion process. That is, a two-way valve mechanism on the extruders allows the extruded material to switch between a high stiffness material (such as a 72 durometer (“D”) or 63D PEBA-based compound) and a low stiffness material (such as a 35D or 40D PEBA-based compound or polyurethane). In one specific example, the extruded material transitions from a 72D PEBA-based compound to a 63D PEBA-based compound. In another specific example, the extruded material transitions from a 72D PEBA-based compound to a 55D PEBA-based compound. It is understood that alternative implementations have transitions from any known higher stiffness material to any known lower stiffness material. The switch from the high stiffness material to the low stiffness material creates the transition zone (such as the transition zone 36 discussed above and depicted in
Alternately, the two-way valve on the extruder may also be set up in a manner that allows both high & low stiffness materials to be extruded simultaneously in varying amounts. For example, the extrusion may have 90% of the high stiffness material & 10% of the low stiffness material being extruded and then transition to have 10% of the high stiffness material & 90% of the low stiffness material being extruded. Alternatively, the transition zone (whether extruded or produced by any other known process) can be made up of any combination of two materials: one of high stiffness and one of low stiffness. For example, the amount of the two materials can vary from 99% of the high stiffness material (and 1% of the low stiffness material) to 1% of the high stiffness material (and 99% of the low stiffness material). Further, any amount in between can also be used. For example, some portion of the transition zone can have 80% high stiffness material and 20% low stiffness material. Alternatively, some portion of the transition zone can have 80% low stiffness material and 20% high stiffness material. In a further implementation, some portion of the transition zone can have 70% high stiffness material and 30% low stiffness material. Alternatively, some portion of the transition zone can have 70% low stiffness material and 30% high stiffness material. It is understood that any other combination is also possible. It is further understood that the transition zone in other alternative embodiments can be made up of three or more different materials of different stiffnesses that can vary in any known amounts.
The various embodiments herein can be constructed using an extrusion process such as that described above. Alternatively, any other known process for constructing catheters of variable stiffness as described herein can be used to create the implementations described herein. Further, any known materials or components of varying stiffnesses can be used to create the catheter shafts as described herein.
In a further embodiment,
As shown in
Alternative catheter embodiments, and any of the implementations disclosed or contemplated herein, can have any number of zones, lengths, or segments. That is, the number of zones, lengths, or segments can vary from 2 to as many such zones, lengths, or segments as desired or necessary for any such catheter. Further, additional alternative implementations can have zones, lengths, or segments of any length as desired or necessary for any such catheter. It is further understood that any of the zones, lengths, or segments can extend to any portion of any catheter embodiment herein.
According to various additional variable stiffness balloon catheter embodiments, any catheter implementation disclosed (including any embodiment as shown in
According to another exemplary implementation, the various catheter implementations can be compatible with guidewires having a diameter ranging from about 0.014 inches to about 0.038 inches. Alternatively, the various implementations are compatible with a guidewire having a diameter ranging from about 0.035 inches to about 0.038 inches. Further known diameters are also compatible, according to further alternative embodiments.
Any catheter embodiment disclosed or contemplated herein can be compatible with introducer sheaths sized 6 Fr or larger. Alternatively, the embodiments herein can be compatible with any sheath sized 8 Fr or larger. In yet another alternative, the embodiments herein can be compatible with any sheath sized 10 Fr or larger.
In accordance with a further implementation, the various balloon catheter embodiments disclosed and contemplated herein can have a distal tip (such as any exemplary distal tip 39, 49, 69, 79, 99, 109 as discussed herein) made with material softer than that of the distal shaft. For example, in one specific embodiment, the tip can be made of a lower durometer material such as 25 or 35 durometer PEBAX material. Alternatively, the tip can be made of polyurethane. In yet another alternative, the tip can be made of any other known material softer than that of the distal shaft.
Certain embodiments of the catheter disclosed and contemplated herein can have an effective length of between about 40 cm and 150 cm. Alternatively, any of the catheter embodiments can have an effective length ranging from about 55 cm to about 110 cm. In a further alternative, any catheter embodiment can have any known length for a balloon catheter.
The balloon catheter, in certain implementations, can have a flow limiting switch (or controller) on the inlet to the balloon inflation port to control inflation or deflation of the balloon.
According to a further embodiment, any balloon disclosed or contemplated herein can be capable of occluding vessels having diameters ranging from about 2 mm to about 60 mm. Alternatively, the occluding vessels can have diameters ranging from about 25 mm to about 45 mm.
As mentioned above, in certain embodiments, the balloon catheter embodiments disclosed or contemplated herein can be also be used for other procedures beyond EVAR procedures. For example, in some implementations, the various catheter embodiments herein can be used for procedures relating to the sizing of vessels or other anatomical structures. Such a procedure can involve inflating the balloon with a radiopaque solution (or other known detectable solution) under fluoroscopy (or other type of detection system) with a system or technology that allows for measurements to be taken. According to another example, in other embodiments, the various catheter embodiments herein—including those with a substantially non-compliant balloon—can be used for angioplasty or stent-deployment procedures. Alternatively, the various catheter embodiments can be used for any known procedure that utilizes a balloon catheter.
In addition, the shaft of any device embodiment disclosed or contemplated herein (such as shaft 32 of
In another implementation, any shaft of any catheter embodiment disclosed herein (including the shafts 32, 42, 62, 72, 92, 102 disclosed and discussed herein) can be a coaxial shaft, rather than a multi-lumen shaft. One example of such a coaxial shaft 180 is depicted in cross-section in
Although the present invention has been described with reference to preferred embodiments, persons skilled in the art will recognize that changes may be made in form and detail without departing from the spirit and scope of the invention.
This application claims the benefit under 35 U.S.C. §119(e) to U.S. Provisional Application 62/068,911, filed Oct. 27, 2014 and entitled “Variable Stiffness Balloon Catheter and Related Methods,” which is hereby incorporated herein by reference in its entirety.
Number | Date | Country | |
---|---|---|---|
62068911 | Oct 2014 | US |