Forwardly directed fluid jet crossing catheter

Abstract

The present invention provides a forwardly directed fluid jet crossing catheter having a distally directed cylindrical flow fluid jet stream to cross a chronic total occlusion. The distal end of the device includes a formable catheter tip region having flexible internal components. Low and high pressure cavities are formed substantially by joined proximal and distal catheter tubes having an adhesive plug seal in common therebetween which partially defines one end of each of the low pressure and high pressure cavities. A guidewire tube and a high pressure tube are aligned along and within the low pressure and high pressure cavities and through the adhesive plug seal. The high pressure tube openly terminates in the high pressure cavity, whereby pressurized fluid transfers from the high pressure cavity in the guidewire tube entry hole to subsequently pass along the guidewire lumen and co-located guidewire to exit as a cylindrical fluid jet stream.

What is claimed is: 
     
         1 . A medical device, comprising:
 an elongate tubular member having a high pressure cavity and a low pressure cavity;   an adhesive plug seal separating the high pressure cavity from the low pressure cavity;   a high pressure tube extending within the elongate tubular member and between the high pressure cavity and the low pressure cavity, wherein the high pressure tube extends through the plug seal, and wherein the high pressure tube includes a distal portion located in the high pressure cavity;   a guidewire tube extending within the elongate tubular member and between the high pressure cavity and the low pressure cavity, wherein the guidewire tube extends through the plug seal;   wherein the guidewire tube includes a fluid entry hole located distal to the plug seal; and   wherein the distal portion of the high pressure tube is located adjacent the fluid entry hole.   
     
     
         2 . The medical device of  claim 1 , wherein the guidewire tube includes a distal end and the high pressure tube includes a distal end, and wherein the distal end of the guidewire tube is positioned distal to the distal end of the high pressure tube. 
     
     
         3 . The medical device of  claim 2 , wherein the elongate tubular member includes a distal end, and wherein the distal end of the elongate tubular member is located distal to the distal end of the high pressure tube, and wherein the distal end of the elongate tubular member is located proximal to the distal end of the guidewire tube. 
     
     
         4 . The medical device of  claim 3 , further comprising a tip member having a proximal portion and a distal end, wherein the distal end of the tip member is substantially aligned with the distal end of the guidewire tube, and wherein the proximal portion of the tip member is coupled to the distal end of the elongate tubular member. 
     
     
         5 . The medical device of  claim 4 , wherein the tip member includes a taper. 
     
     
         6 . The medical device of  claim 4 , wherein the distal end of the guidewire tube extends into a distal portion of the tip member. 
     
     
         7 . The medical device of  claim 1 , wherein the guidewire tube includes a lumen extending therein and a tubular wall, wherein the fluid entry hole extends through the tubular wall of the guidewire tube such that the lumen of the guidewire tube and the high pressure cavity are in fluid communication via the fluid entry hole. 
     
     
         8 . The medical device of  claim 7 , wherein the high pressure tube includes a lumen extending therein, and wherein the distal portion of the high pressure tube and the fluid entry hole are aligned such that a fluid jet stream flows along a shortest path between the lumen of the high pressure tube and the lumen of the guidewire tube. 
     
     
         9 . The medical device of  claim 1 , wherein the fluid entry hole includes a proximal end and distal end, and wherein a distal end of the high pressure tube is longitudinally aligned proximal the proximal end of the fluid entry hole. 
     
     
         10 . The medical device of  claim 1 , wherein the fluid entry hole includes a proximal end and distal end, and wherein a distal end of the high pressure tube is longitudinally aligned between the proximal and distal ends of the fluid entry hole. 
     
     
         11 . The medical device of  claim 1 , further comprising a manifold coupled to a distal portion of the elongate tubular member, wherein the manifold includes a sealing member. 
     
     
         12 . The medical device of  claim 1 , wherein the fluid entry hole has a first length extending along the longitudinal axis of the guidewire tube and a second length extending substantially perpendicular to the length, wherein the first length is at least twice the second length. 
     
     
         13 . A medical assembly, comprising:
 an elongate tubular member having a high pressure cavity and a low pressure cavity;   an adhesive plug seal separating the high pressure cavity from the low pressure cavity;   a high pressure tube extending within the elongate tubular member and between the high pressure cavity and the low pressure cavity, wherein the high pressure tube extends through the plug seal, and wherein the high pressure tube includes a distal portion located in the low pressure cavity;   a guidewire tube extending within the elongate tubular member and between the high pressure cavity and the low pressure cavity, wherein the guidewire tube extends through the plug seal;   a guidewire configured to extend within the guidewire tube;   wherein the guidewire tube includes a fluid entry hole located distal to the plug seal; and   wherein the distal portion of the high pressure tube is located adjacent the fluid entry hole.   
     
     
         14 . The medical device of  claim 13 , wherein the guidewire tube includes a distal end and the high pressure tube includes a distal end, and wherein the distal end of the guidewire tube is positioned distal to the distal end of the high pressure tube. 
     
     
         15 . The medical device of  claim 13 , wherein the fluid entry hole includes a proximal end and a distal end, and wherein a distal end of the high pressure tube is longitudinally aligned proximal the proximal end of the fluid entry hole. 
     
     
         16 . The medical device of  claim 13 , wherein the guidewire tube includes a lumen extending therein and a tubular wall, wherein the fluid entry hole extends through the tubular wall of the guidewire tube such that the lumen of the guidewire tube and the high pressure cavity are in fluid communication via the fluid entry hole. 
     
     
         17 . The medical device of  claim 16 , wherein the guidewire is designed to advance or retract within the lumen of the guidewire tube such that advancing or retracting the guidewire controls the shape of a fluid jet stream extending from the lumen of the guidewire lumen. 
     
     
         18 . The medical device of  claim 13 , further comprising a manifold coupled to a distal portion of the elongate tubular member, wherein the manifold includes a sealing member. 
     
     
         19 . The medical device of  claim 18 , wherein the sealing member is designed to seal against the guidewire. 
     
     
         20 . A method of using a medical device, the method comprising:
 advancing a guidewire through a body lumen to a target region;   advancing the medical device over the guidewire, wherein the medical device includes:
 an elongate tubular member having a high pressure cavity and a low pressure cavity; 
 an adhesive plug seal separating the high pressure cavity from the low pressure cavity; 
 a high pressure tube extending within the elongate tubular member and between the high pressure cavity and the low pressure cavity, wherein the high pressure tube extends through the plug seal, and wherein the high pressure tube includes a distal portion located in the high pressure cavity; 
 a guidewire tube extending within the elongate tubular member and between the high pressure cavity and the low pressure cavity, wherein the guidewire tube extends through the plug seal; 
 wherein the guidewire tube includes a fluid entry hole located distal to the plug seal; and 
 wherein the distal portion of the high pressure tube is located adjacent the fluid entry hole.