Devices and methods for treating a stricture along the biliary and/or pancreatic tract

Abstract

Medical devices and systems for treating a stricture, for example along the biliary and/or pancreatic tract, are disclosed. An example system may include a guidewire having a distal end and defining a lumen. A stiffening rod may be slidably disposed within the lumen. The stiffening rod may have a distal end and a distal end region disposed adjacent to the distal end. The stiffening rod may be configured to shift between a first position where the distal end of the stiffening rod is disposed proximally of the distal end of the guidewire and a second position where the distal end of the stiffening rod is disposed distally of the distal end of the guidewire.

What is claimed is: 
     
         1 . A system for treating a stricture, the system comprising:
 a guidewire having a distal end and defining a lumen;   a stiffening rod slidably disposed within the lumen, the stiffening rod having a distal end and a distal end region disposed adjacent to the distal end; and   wherein the stiffening rod is configured to shift between a first position where the distal end of the stiffening rod is disposed proximally of the distal end of the guidewire and a second position where the distal end of the stiffening rod is disposed distally of the distal end of the guidewire.   
     
     
         2 . The system of  claim 1 , wherein the guidewire comprises a tip region. 
     
     
         3 . The system of  claim 2 , wherein the tip region includes a coil. 
     
     
         4 . The system of  claim 3 , wherein the coil defines a passageway configured to accept the stiffening rod. 
     
     
         5 . The system of  claim 4 , wherein the passageway includes a tapered region. 
     
     
         6 . The system of  claim 5 , wherein the tapered region defines a stop that limits distal translation of the stiffening rod through the passageway. 
     
     
         7 . The system of  claim 5 , wherein the stiffening rod includes a shoulder region configured to engage the tapered region of the passageway. 
     
     
         8 . The system of  claim 1 , wherein when the stiffening rod is at the first position, a proximal end of the distal end region is disposed adjacent to the distal end of the guidewire. 
     
     
         9 . A method for crossing a stricture along the biliary and/or pancreatic tract, the method comprising:
 advancing a guidewire system toward a stricture along the biliary and/or pancreatic tract, the guidewire system comprising:
 a guidewire having a distal end and defining a lumen, and 
 a stiffening rod slidably disposed within the lumen, the stiffening rod having a distal end and a distal end region disposed adjacent to the distal end; 
   shifting the stiffening rod from a first position where the distal end of the stiffening rod is disposed proximally of the distal end of the guidewire to a second position where the distal end of the stiffening rod is disposed distally of the distal end of the guidewire; and   advancing the guidewire system beyond the stricture.   
     
     
         10 . The method of  claim 9 , wherein the guidewire defines a passageway configured to accept the stiffening rod. 
     
     
         11 . The method of  claim 10 , wherein the passageway defines a stop that limits distal translation of the stiffening rod through the passageway. 
     
     
         12 . The method of  claim 11 , wherein advancing the guidewire system beyond the stricture includes advancing at least a portion of the stiffening rod beyond the stricture. 
     
     
         13 . The method of  claim 12 , further comprising advancing a medical device toward the stricture in a retrograde direction. 
     
     
         14 . The method of  claim 13 , further comprising engaging the portion of the stiffening rod beyond the stricture with the medical device. 
     
     
         15 . The method of  claim 14 , further comprising retracting the medical device, wherein retracting the medical device includes advancing the stiffening rod in an antegrade direction. 
     
     
         16 . The method of  claim 15 , wherein advancing the stiffening rod in an antegrade direction advances the guidewire beyond the stricture. 
     
     
         17 . A system for treating a stricture, the system comprising:
 a guidewire having an open distal end and defining a lumen;   a stiffening rod slidably disposed within the lumen, the stiffening rod having a distal end and a distal end region disposed adjacent to the distal end; and   wherein the stiffening rod is configured to shift between a first position where the distal end of the stiffening rod is disposed adjacent to the distal end of the guidewire and a second position where the distal end of the stiffening rod extends through the open distal end and is disposed distally of the distal end of the guidewire.   
     
     
         18 . The system of  claim 17 , wherein the stiffening rod is configured to shift to a third position where the distal end of the stiffening rod is disposed distally of the distal end of the guidewire and where a proximal end of the distal end region is disposed adjacent to the distal end of the guidewire. 
     
     
         19 . The system of  claim 17 , wherein the lumen includes a tapered region that defines a stop that limits distal translation of the stiffening rod. 
     
     
         20 . The system of  claim 19 , wherein the stiffening rod includes a shoulder region configured to engaged the tapered region.