Guide extension catheter

Abstract

Guide extension catheters and related methods are disclosed. A guide extension catheter can comprise an elongate tube member, a push member, and a concave track. The elongate tube member can define a lumen and three distinct portions of different diameter. A distal portion can define a first diameter, a proximal portion can define a second diameter which is larger than the first diameter but smaller than a lumen of a guide catheter with which the guide extension catheter is used, and a tapered portion, positioned between the distal portion and the proximal portion, can have a variable diameter. The push member can be eccentrically coupled relative to the tube member and extends proximally therefrom for slidably positioning the tube member within and partially beyond a distal end of the guide catheter. The concave track forms a transition between the tube member and the push member, and defines a partially cylindrical opening leading into the tube member.

1 - 20 . (canceled) 
     
     
         21 . A catheter comprising:
 an elongate tube member extending from a proximal end to a distal end and defining a lumen;   a push member mechanically coupled to the proximal end of the elongate tube member; and   a manipulation member slidable along the push member and disposed around an outer perimeter of the push member,   wherein the manipulation member is controllably engageable with the push member, and   wherein, when the manipulation member is engaged with the push member, the manipulation member is configured to transmit an axial force to the elongate tube member, and when the manipulation member is not engaged with the push member, the manipulation member is movable in at least one direction along a length of the push member while transmitting substantially no axial force to the push member.   
     
     
         22 . The catheter of  claim 21 , wherein the push member is eccentrically coupled to the proximal end of the elongate tube member. 
     
     
         23 . The catheter of  claim 21 , wherein the elongate tube member includes a distal portion having a first diameter, a proximal portion having a second diameter that is larger than the first diameter, and a tapered portion positioned between the distal portion and the proximal portion. 
     
     
         24 . The catheter of  claim 21 , wherein the push member comprises a handle member at or near a proximal end of the push member, and wherein the handle member is configured to prevent the manipulation member from being slid off the proximal end of the push member. 
     
     
         25 . The catheter of  claim 21 , wherein the manipulation member surrounds the outer perimeter of the push member so that the manipulation member is not radially removable from the push member. 
     
     
         26 . The catheter of  claim 21 , wherein the manipulation member comprises at least one engagement feature on an inner surface of the manipulation member, and wherein the at least one engagement feature is configured to increase engagement of the inner surface of the manipulation member with the push member. 
     
     
         27 . The catheter of  claim 21 , wherein the manipulation member comprises a tab configured to be engageable with the push member when a compressive force is applied to the tab. 
     
     
         28 . The catheter of  claim 21 , wherein the manipulation member is configured to default not to being engaged with the push member, and to engage the push member in response to a radially inward force being applied to the manipulation member. 
     
     
         29 . A catheter system comprising:
 a guide catheter extending from a guide catheter proximal end to a guide catheter distal end and defining a guide catheter lumen; and   a guide extension catheter comprising:
 an elongate tube member extending from a proximal end to a distal end and defining a guide extension catheter lumen; 
 a push member mechanically coupled to the proximal end of the elongate tube member; and 
 a manipulation member slidable along the push member and disposed around an outer perimeter of the push member, 
 wherein the manipulation member is controllably engageable with the push member, 
 wherein, when the manipulation member is engaged with the push member, the manipulation member is configured to transmit an axial force to the elongate tube member, and when the manipulation member is not engaged with the push member, the manipulation member is movable in at least one direction along a length of the push member while transmitting substantially no axial force to the push member. 
   
     
     
         30 . The catheter of  claim 29 , wherein the push member is eccentrically coupled to the proximal end of the elongate tube member. 
     
     
         31 . The catheter of  claim 29 , wherein the elongate tube member includes a distal portion having a first diameter, a proximal portion having a second diameter that is larger than the first diameter and smaller than a diameter of the guide catheter lumen, and a tapered portion positioned between the distal portion and the proximal portion. 
     
     
         32 . The catheter system of  claim 29 , wherein the elongate tube member of the guide extension catheter defines a maximum outer diameter that is less than a diameter of the guide catheter lumen. 
     
     
         33 . The catheter system of  claim 29 , wherein the guide extension catheter defines a length that is greater than a length of the guide catheter. 
     
     
         34 . The catheter system of  claim 29 , wherein the push member comprises a handle member at or near the a proximal end of the push member, and wherein the handle member is configured to prevent the manipulation member from being slid off the proximal end of the push member. 
     
     
         35 . The catheter system of  claim 29 , wherein the manipulation member surrounds the outer perimeter of the push member so that manipulation member is not radially removable from the push member. 
     
     
         36 . The catheter system of  claim 29 , wherein the manipulation member comprises at least one engagement feature on an inner surface of the manipulation member, and wherein the at least one engagement feature is configured to increase engagement of the inner surface of the manipulation member with the push member. 
     
     
         37 . A method comprising:
 introducing a guide catheter in vasculature of a patient, wherein the guide catheter extends from a guide catheter proximal end to a guide catheter distal end and defines a guide catheter lumen;   introducing a guide extension catheter in the guide catheter lumen at the guide catheter proximal end, wherein the guide extension catheter comprises an elongate tube member extending from a proximal end to a distal end and defining a guide extension catheter lumen, a push member mechanically coupled to the proximal end of the elongate tube member, and a manipulation member slidably disposed about an outer perimeter of the push member, wherein the manipulation member is controllably engageable with the push member, wherein, when the manipulation member is in an engaged state with the push member, the manipulation member transmits an axial force to the push member to enable the push member to transmit the axial force to the elongate tube member, and wherein, when the manipulation member is in a disengaged state with the push member, the manipulation member is movable axially in at least one direction along a length of the push member while transmitting substantially no axial force to the push member;   while the manipulation member is in the engaged state with the push member, applying a distal axial force to the manipulation member to advance the guide extension catheter distally within the guide catheter lumen;   disengaging the manipulation member from the push member;   repositioning the manipulation member along the length of the push member;   engaging the manipulation member with the push member; and   while the manipulation member is in the engaged state with the push member, applying a distal axial force to the manipulation member to further advance the guide extension catheter distally through the guide catheter lumen.   
     
     
         38 . The method of  claim 37 , wherein the push member is eccentrically coupled to the proximal end of the elongate tube member. 
     
     
         39 . The method of  claim 37 , wherein introducing the guide extension catheter in the guide catheter lumen includes introducing an elongate tube member including a distal portion having a first diameter, a proximal portion having a second diameter that is larger than the first diameter and smaller than a diameter of the guide catheter lumen, and a tapered portion positioned between the distal portion and the proximal portion. 
     
     
         40 . The method of  claim 37 , further comprising advancing a balloon catheter, a stent, or a stent catheter through the guide catheter and the guide extension catheter and into a coronary artery of the patient.