Deflection control catheters, support catheters and methods of use

Abstract

A deflection and support catheter provided for improved manipulation of elongated medical devices used during percutaneous procedures in difficult to reach situations. In particular, the deflection and support catheters can facilitate placement of guidewires, guide catheters, and intervention devices such as angioplasty balloons and stent delivery devices.

1 . A catheter comprising a proximal segment and a rapid exchange segment connected at or near the distal end of the proximal segment, the rapid exchange segment comprising a tubular element with a lumen having a slit structure and sufficient rigidity to track over a cylindrical object within the lumen by pushing from the proximal end of the proximal segment.  
   
   
       2 . The catheter of  claim 1  wherein the proximal segment comprises a rod.  
   
   
       3 . The catheter of  claim 2  wherein the rod is solid.  
   
   
       4 . The catheter of  claim 1  wherein the slit comprises overlapping lips.  
   
   
       5 . The catheter of  claim 1  wherein the slit has a spiral configuration.  
   
   
       6 . The catheter of  claim 1  wherein the rapid exchange segment further comprises an overtube that slides over the tubular element with the slit structure.  
   
   
       7 . The catheter of  claim 1  wherein the tubular element comprises a radiopaque marker band.  
   
   
       8 . The catheter of  claim 1  wherein the tubular element comprises a radiopaque-loaded polymer.  
   
   
       9 . A medical delivery tool for elongated medical devices, the tool comprising a flexible rod and a tubular element operably connected to the rod wherein the tubular element has a distal opening, a proximal opening and an open lumen connecting the distal opening and the proximal opening such that the tubular element forms a rapid exchange element to fit over an elongated medical device, wherein the tubular element has a side port.  
   
   
       10 . The medical delivery tool of  claim 9  wherein the side port has an elongated shape with a length along the longitudinal direction of the catheter that is at least about 2 times the average diameter of the guide lumen.  
   
   
       11 . The medical delivery tool of  claim 9  wherein the tubular element has a durometer value of at least about 60 D at the side guide port.  
   
   
       12 . The medical delivery tool of  claim 9  wherein the tubular element has a slit.  
   
   
       13 . The medical delivery tool of  claim 9  wherein the tubular element is curved.  
   
   
       14 . A method for the delivery of an elongated medical device into a vessel within a vascular network, the method comprising loading a rapid exchange segment of a delivery tool onto the elongated medical device and using the delivery tool to provide support for the placement of the elongated medical device into the vessel wherein the rapid exchange segment comprises a slit that provides for the loading of the rapid exchange segment.  
   
   
       15 . The method of  claim 14 , wherein the elongated medical device comprise a balloon or a stent delivery structure.  
   
   
       16 . A method for the delivery of a guidewire into a vessel within a vascular network, the method comprising extending a curve tip of the guidewire through a side port of a deflection catheter into the vessel wherein the side port is positioned at the opening into the vessel.  
   
   
       17 . The method of  claim 16  wherein the vessel is a coronary artery.  
   
   
       18 . A catheter comprising a proximal section, and a rapid exchange segment operably connected to the proximal section, the rapid exchange segment comprising a tubular element having a guide lumen, a tip, a distal guide port and a side guide port, the tubular element having a curve in the tip.  
   
   
       19 . A guidewire delivery system comprising a guidewire having a curved tip and a deflection catheter comprising a proximal section and a rapid exchange segment operably connected to the proximal section, the rapid exchange segment comprising a tubular element comprising a guide lumen, a distal guide port at the distal end of the guide lumen and a proximal guide port.  
   
   
       20 . The guidewire delivery system of  claim 19  wherein the rapid exchange segment comprises a side guide port.  
   
   
       21 . The guidewire delivery system of  claim 19  wherein the rapid exchange segment has a bent tip.  
   
   
       22 . The guidewire delivery system of  claim 19  wherein the rapid exchange segment is curved.  
   
   
       23 . The guidewire delivery system of  claim 19  wherein the rapid exchange segment has a plurality of curves.  
   
   
       24 . The guidewire delivery system of  claim 19  wherein the tubular element comprises a proximal tubular segment, a distal tubular segment and a non-tubular connection element connecting the proximal tubular segment and the distal tubular segment, wherein the side port is formed by the opening at the non-tubular connection element.